How digital innovators are transforming the NHS

Public | April 2018 | The promise of Healthtech: How digital innovators are transforming the NHS 

Innovations such as cloud computing,  VR, 3D printing, genomics and artificial intelligence all provide opportunities for the NHS to sustainably relieve the
demographic and financial pressures it faces. Public, an organisation that helps startups to support the public sector, cautions that “without major reform, the NHS may see a £30 billion funding gap open up over the next three years alone.”

There are three factors driving this change, they are  the growing, ageing populations who are net consumers of public services, especially health care.  The rise in long-term, chronic conditions evident across all age groups.  The compounding effect of higher demand for health services and higher expectations for those health services as, in many cases, more expensive treatments become standard.  The report includes a feature on ‘Healthtech 27’ which are the most promising startups in healthcare.
Nicola Blackwood, the author of this report and former Health Innovation Minister,
argues that the NHS is still ‘risk averse’.  As part of this research, Public surveyed a number of health startups- they also spoke to NHS professionals, interviewing key decision-makers across the health and care landscape-to explore some of the barriers to innovation.

These interviews revealed:

  • Lack of clarity about evidence 
  • Regulation of digital health products is fast evolving
  • Slow procurement
  • Partial interoperability 
  • Unclear data security standards 
  • Limited change management and digital skills

 

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Image source: public.io

Alongside this, Healthtech also predicts 9 areas of opportunity for the future

  1. Procurement and productivity 
  2. Recruitment and training 
  3. Prevention
  4. Winter pressures and supported self-care
  5. AI in Pathology and Radiology
  6. Patient safety
  7. Mental health
  8. Social care
  9. Research 

Further details are available from Public’s website 

Public’s blog features a post on this report 

The full report is available here

 

 

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NHS England scheme discovers four new innovations that will benefit patients

NHS England | April 2018 | Heart patients among those to benefit as NHS England backs innovation

A scheme run by NHS England to identify and fast track specific innovations into the NHS  is now in its second year.  It delivers improvements in patient care by cutting bureaucracy for clinicians and other innovators and encouraging uptake through the NHS. NHS England has just announced four innovations that have the potential to benefit patients.  Among the innovations is image analysis software that creates a 3D model of the heart and could prevent up to 35,000 patients a year undergoing invasive tests.  Other innovations identified include a suture which is designed to reduce infections, a new device that will reduce the number of infections from catheters and a ‘bowel scope’ to improve colorectal examinations.

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  • HeartFlow – Advanced image analysis software that creates a 3D model of the coronary arteries and analyses the impact that blockages have on blood flow to rapidly diagnose patients with suspected coronary artery disease. The use of the device can avoid the need for invasive investigations such as coronary angiography, usually carried out under local anaesthetic, where a catheter is passed through the blood vessels to the heart to release a dye before X-rays are taken. NICE estimate up to 35,000 people per year could be eligible.
  • Plus Sutures – A new type of surgical suture – stitching – that reduces the rate of surgery-linked infection (surgical site infection) such as MRSA, through the use of antimicrobial suture packs. There were 823 cases of MRSA reported in the NHS in 2016/17.
  • Endocuff Vision – A new type of ‘bowel scope’ that improves colorectal examination for patients undergoing bowel cancer tests. Bowel cancer is the fourth most common cancer in England with 34,000 people diagnosed each year. For every 1,000 people screened for cancer, it is estimated that six cases could be avoided thanks to early detection through the use of this device.
  • SecurAcath – A device to secure catheters that reduces the infection risk for patients with a peripherally inserted central catheter. The use of this equipment helps to reduce the time taken to care and treat dressing changes. This type of catheter is normally used in people needing intravenous access for several weeks or months in both inpatient and outpatient settings. NICE estimate up to 120,000 people per year could be eligible.

Professor Tony Young, National Clinical Lead for Innovation at NHS England, said: “For new innovations to flourish and spread at scale access to funding is critical, by buying these four innovations centrally NHS England has removed the barriers to the spread of these innovations so patients can benefit faster.

The NHS’ 15 Academic Health Science Networks across England – will take direct responsibility for accelerating uptake locally.

All information from NHS England, the news release can be read on this webpage

Successfully Scaling Innovation in the NHS

In Against the Odds: Successfully scaling innovation in the NHS, the Innovation Unit and The Health Foundation identity 10  different UK innovations.  The authors look at various case studies to explore how these insights build on, and challenge, existing wisdom in the NHS.

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Image source: http://www.innovationunit.org

The key findings of the report include:

  • The ‘adopters’ of innovation need greater recognition and support. The current system primarily rewards innovators, but those taking up innovations often need time, space and resources to implement and adapt an innovation in their own setting.
  • It needs to be easier for innovators to set up dedicated organisations or groups to drive innovation at scale. Scaling innovation can be a full-time job, and difficult to do alongside front-line service delivery. Dedicated organisations are often needed to consciously and strategically drive scaling efforts, including when innovators ‘spin out’ from the NHS.
  • System leaders need to take more holistic and sophisticated approaches to scaling. Targets and tariffs are not a magic bullet for scaling; while they can help, they don’t create the intrinsic and sustained commitment required to replicate new ideas at scale. Different approaches are needed, including articulating national and local health care priorities in ways that create strategic opportunities for innovators, and using commissioning frameworks to enable, rather than hinder, the sustainable spread of innovations.

 

The full report can be found here

Adoption and spread of innovation in the NHS

This report, commissioned by the Academic Health Science Network, looks at opportunities to accelerate the adoption of service innovation in the NHS, drawing on findings from eight case studies of successful spread of innovation in the NHS | Kings Fund

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From new communication technologies for patients with long-term conditions, to new care pathways in liver disease diagnosis, to new checklists for busy A&E departments, the report details the highs and lows of an innovator’s journey through the NHS.

While thousands of patients are now receiving new innovative treatments for arthritis, diabetes, cardiovascular disease and chronic liver disease, thanks to successful innovations, the report outlines the significant barriers that stand in innovators’ paths.

The case studies reveal common themes:

  • Providers need to be able to select and tailor innovations that deliver the greatest value given local challenges and work in the local context.
  • Fragmentation of NHS services remains a barrier to adoption and spread of innovation, making it harder to develop shared approaches and transmit learning across sites.
  • New innovations may appear simple to introduce but can have a domino effect – triggering a series of changes to diagnosis and treatment, revealing new patient needs and resulting in big changes to staff and patient roles. That’s why staff need time and resources to implement them.
  • As long as the NHS sets aside less than 0.1% of available resources for the adoption and spread of innovation, a small fraction of the funds available for innovation itself, the NHS’s operating units will struggle to adopt large numbers of innovations and rapidly improve productivity.

Full report: Adoption and spread of innovation in the NHS

 

Growing innovative models of health, care and support for adults

This briefing explains that innovative, often small-scale models of health, social care and support for adults could be scaled up to benefit as many people as possible | Social Care Institute for Excellence

Based on research conducted during the spring of 2017, this briefing from the Social Care Institute for Excellence offers the following key messages:

  • Innovation is needed more than ever as challenges grow. Innovation does not only mean technological breakthroughs or large restructures. New and better ways of delivering relationship-based care are needed, and already exist, but are inconsistently implemented or poorly scaled.

 

  • For innovation to flourish,  better ways to help people bring good ideas from the margins into core business need to be found . The keys to success are:
    • a shared ambition to embed person- and community-centred ways of working across the system, using the best available tools and evidence
    • co-production: planning with the people who have the greatest stake in our services from the beginning
    • a new model of leadership which is collaborative and convening
    • investment and commissioning approaches which transfer resources from low quality, low outcomes into approaches which work effectively
    • effective outcomes monitoring and use of data to drive change
    • a willingness to learn from experience.

The report also has a series of recommendations for Local and National Government.

Full report: Growing innovative models of health, care and support for adults

 

The effect of good people management

This report illustrates the effect of good people management with an analysis of the NHS | What Works Centre for Wellbeing

This report found Trusts that made the most extensive use of good people management practices were over three times more likely to have the lowest levels of staff sickness absence and at least four times more likely to have the most satisfied patients.

They were also more than twice as likely to have staff with the highest levels of job satisfaction compared to NHS Trusts that made least use of these practices, and over three times more likely to have staff with the highest levels of engagement.

Full report: Good work, wellbeing and changes in performance outcomes: Illustrating the effects of good people management practices with an analysis of the National Health Service.

Making a reality of the Accelerated Access Review: Improving patient access to breakthrough technologies and treatments

Department of Health

The government has announced a new fast-track route into the NHS for “breakthrough” medicines and technologies. This will speed up the time it takes for patients to benefit from ground-breaking products for conditions such as cancer, dementia and diabetes.

From April 2018, the new ‘accelerated access pathway’ will mean products with the greatest potential to change lives could be available up to 4 years earlier. It will be done by reducing the time it takes to negotiate evaluation and financial approvals before the NHS can purchase the products.

Under the scheme, a number of products each year will receive ‘breakthrough’ designation. This will unlock a package of support allowing firms to accelerate clinical development and gain a fast-track route through the NHS’s approval processes.