Anne Cooper on nursing informatics

Digital nurse leader Anne Cooper is joining the Highland Marketing advisory board; a group of NHS IT and industry experts that provides a sounding board for discussion of healthcare IT.

She talks to Lyn Whitfield about her career, her ongoing passion for technology to support nurses and patients, and why ambulances need to be part of the NHS and digital picture.

At the start of May, Anne Cooper told her many Twitter followers that she felt “sad” because she had decided to let her nursing registration lapse. Their response: “It’s the end of an era, but you’ll always be a nurse”. And: “Your legacy will never lapse.”

It seems appropriate that this conversation took place on Twitter, because a big part of Cooper’s legacy lies in the development of technology and the concept of digital nursing. Asked how she first became involved in IT, she says: “People will have heard this story before, but I was part of the team that was asked to set up the West Yorkshire NHS Direct site.

“None of us expected to have IT people knocking on our door and asking us questions, but when they did, I realised it might be quite important for them to be able to get good answers. I became lead for IT, realised I enjoyed it, and eventually went on to become national system development lead for NHS Direct.”

Finding a digital tribe

From NHS Direct, Cooper went to NHS Connecting for Health, the agency responsible for the National Programme for IT. There, she worked on the NHS Summary Care Record, a list of key demographic and medical details about a patient that can be accessed, with patient consent, from anywhere in the country.

Over the years, the fortunes of the SCR have fluctuated, as governments have put more or less emphasis on expanding its content. But it was developed during the Covid-19 pandemic to give health professionals more information about the patients they were treating and, later, to show their vaccination status.

“I look back on that work with some pride,” Cooper says. “We turned it around and we made it usable. Which is very important. Technology won’t get adopted unless there is a good interface.”

From NHS CfH, Cooper moved on to more senior roles at the Department of Health Informatics Directorate, NHS England and NHS Digital. At the same time, she developed a distinctive role as a digital nurse, blogging, Tweeting, and working with @WeNurses, which was set up to “share information, ideas, knowledge and support in order to improve patient care.”

“I started blogging because I thought that people working in a senior position in NHS IT needed to be more visible,” Cooper says. “I started tweeting for the same reason. I could see how useful it could be. @WeNurses was great. I really found my tribe there. It was a leader in the digital space.”

Nursing takes its place in digital health  

Both healthcare technology and digital nursing have come on at pace since then. For example, Cooper notes that when she moved into NHS IT, there were no chief nursing information officers. Now, NHS England has a national CNIO (Dr Natasha Phillips) and there are CNIOs at regional and trust level.

Although, in some ways, it is the community sector that has led the way. Cooper points out that it was the Queen’s Nursing Institute, the charity that is dedicated to improving nurses care for people in their own homes and communities, that produced a landmark report on Digital Nursing in 2012, followed by a further report in 2018.

“There is a lot of technology in use in the community,” she points out. “Long before nurses in acute care were using technology, there were nurses doing telecare, remote care; and they have facilitated a lot of the conversation about the role of technology in nursing.”

A passion to bring ambulances into the debate:

Cooper retired as deputy clinical director and chief nurse at NHS Digital four years ago and started to develop a new phase of her career by taking on a number of non-executive roles. At the moment, she is chair of Ethical Healthcare Consulting, a community interest company, and a non-executive director of the Yorkshire Ambulance Service NHS Trust.

Ambulance services have been in the news for all the wrong reasons, recently, as the huge pressure on the health and care system has shown up as queues outside A&E. But Cooper thinks they should be part of the positive conversation about how healthcare can use new skills and new technology to find better answers to the challenges it is facing.

“Our paramedics are very skilled,” she says. “Nurses really want to watch out, because they’re developing fast. Back in the day, ambulance crews just used to pitch up and take people to hospital, but now they treat people, and they co-ordinate care for them.

“At the same time, Yorkshire Ambulance Service is very digitally enabled. We have our own electronic patient record. We can transfer information to hospitals. We can send information to GPs. We use technology for dispatching and for communicating with our teams.

“And we also have a lot of data. I hear people talking about how great it would be to be able to predict who will turn up at A&E and when; but we can tell you that. We’re the opposite of non-mature, if that is a thing. What we need to be is part of the conversation. I really hope that the arrival of integrated care systems will change that, as they start to develop their thinking on place.”

The future is technology empowering patients  

After more than 20 years in and around the NHS IT scene, Cooper remains very hopeful for the future use of technology in health and care. Asked what makes her optimistic, she focuses in on the potential benefits for patients.

For example, she points to the impact that technology has had people like herself, who live with type one diabetes. She points out that when she was younger, measuring her blood sugar levels involved a clunky pin prick and strip test kit. Now, she can wear a monitor that sends readings to an app.

“I can also get access to my medical record,” she adds. “I once wrote on my blog about how much time it used to take me on a Sunday to get a repeat prescription: filling in the form and walking down to the surgery to post it through the door.

“Now, that does not happen. I ordered a prescription from my car the other day. All of this helps patients to do more for themselves. Of course, we have to do it carefully, and we have to make sure we don’t leave people behind, but it’s transformational.”

Similarly, Cooper is a fan of the roll-out of virtual wards, which took off during the Covid-19 pandemic, and are now being promoted by NHS England at pace. Although she’s not a fan of the term. “I don’t like the term virtual wards, because we’re not setting up wards: we’re caring for people at home,” she says.

“We also need to get the infrastructure and the staffing right. We can’t do this as a bolt-on to existing services. We can’t say to a community nurse: here’s your normal workload and here’s another 20 people on a virtual ward. But there are lots of people we can care for at home, and if we get this right, it will make a big difference to them.”

Lots done, lots still to do

Cooper says, sadly, that she won’t be at the coalface of these developments. Which is why she is giving up her nursing registration. However, she is certainly not giving up her interest in healthcare technology or its impact on nurses and patients.

She is enjoying the challenge of working at Ethical and is about to join the Highland Marketing advisory board, which provides a forum for NHS IT and health tech leaders to discuss the big policy, technical, and practical issues around advancing digital.

“For me, this is all about continuing the conversation,” she says. “When I look back, I can see that so much has been achieved in digital; but when I look ahead, I can see there is still so much to do.”