ECRI Institute, one of the leading patient safety and medical technology research organizations, places health technology cybersecurity at the top of its just-released 2019 Top 10 Health Technology Hazards.
How is innovation making a difference in the NHS?
As the NHS celebrates its 70th year, Dr Amanda Begley, National Director of the NHS Innovation Accelerator, discusses how some of the new technologies and innovative solutions being supported to spread, are making a real difference to patients and NHS staff
In the year that our National Health Service celebrates its 70th birthday, what better time to recognise innovation and entrepreneurship in the NHS? The #NHS70Innovations campaign, led by NHS Digital and the AHSN Network, shined a spotlight on some of the latest healthcare solutions and technologies making a positive difference to NHS organisations, staff and patients. To quote Professor Sir Bruce Keogh, NHS England’s former National Medical Director: “Innovation is what links quality expectation with productivity expectation. Never has the importance of innovation for our NHS been as essential as it is now.”
Since its launch in July 2015, the NHS Innovation Accelerator (NIA) has supported the uptake and spread of high impact, evidence-based innovations across England’s NHS. The NIA is an NHS England initiative, delivered in partnership with the country’s 15 Academic Health Science Networks (AHSNs) and hosted at UCLPartners. Created to help delivery of the Five Year Forward View, this national accelerator is providing real-time practical insights on spread to inform national strategy, and in its first year saved England’s health and care system over £12 million.
The NIA’s unique dual focus offers personal development for individuals (or ‘Fellows’) with bespoke support to spread an innovation; recognising that both are critical to scaling innovation in the NHS. To date, the NIA has supported 36 Fellows to spread 37 innovations - including digital, medtech, workforce and models of care - all of which have been through a rigorous assessment process involving patients, clinicians, multiple government health agencies, NHS England, and AHSNs. Fellows come from a variety of backgrounds; some are practicing or former NHS clinicians, some work for SMEs or large corporates, some are academics or from third-sector organisations - one is even a former police officer! The one thing they all have in common is their dedication to spreading innovation for the benefit of patients and NHS staff, and for sharing their real-world insight with colleagues across the system.
An independent evaluation of the NIA, published in March this year, details the impact of the NIA on its first cohort of 17 Fellows. In addition to identifying some of the common factors influencing innovation uptake across the NHS, it crucially evidences the long-term benefits and wider impact of NIA innovations, highlighting the difference being made to people’s lives.
Improved clinical outcomes
One of the key benefits of NIA innovations is improved clinical outcomes. For example, a clinician implementing myCOPD (a patient self-management system for Chronic Obstructive Pulmonary Disease) saw almost instant improvements in symptoms among patients using the platform after only a short period due to improved inhaler technique and medication adherence, alongside a decrease in overall disease burden and anxiety amongst patients. The use of Episcissors-60 (patented fixed-angle episiotomy scissors) avoided incidence and cost of obstetric anal sphincter injuries (OASIS). An economic analysis demonstrated a net saving of over £28,000 per 1,000 births accrued from avoided cases of OASIS - a potential return on investment of over 3,000 per cent for the NHS.
NIA innovations focused on self-management demonstrated improved patient empowerment, enabling people to feel more in control of their own health. This included examples of people with very poor quality of life, whose health improved sufficiently for them to resume leisure activities. Patients reported that the innovations had a positive impact on their mental health, which was of particular benefit for people with complex, long-term conditions. Those using NeuroResponse (an integrated model of care for patients with neurological conditions) reported reduced anxiety and increased confidence to manage their condition, with the model also delivering a reduction in A&E attendances. Clinicians confirmed that patients using OWise (smart phone app for self-management of breast cancer) were more at ease with treatment and better informed during consultations.
Opening up access to new forms of support
Some of the NIA’s digital consumer-facing innovations have helped engage people who might otherwise have shunned healthcare technologies. IT platforms, including Patients Know Best (enabling patients to hold all their medical information in a single record) and HealthUnlocked (a peer-to-peer online social support network linking patients, carers and health advocates with professional organisations), reached a wide number of patients who have benefitted from better communication between healthcare professionals and fellow patients, faster processes and accurate recordings of data. In the case of Patients Know Best, an economic analysis highlighted £26 million cash-releasing savings over five years for NHS trusts with a population of 900,000 patients and average prevalence of long-term conditions.
Earlier diagnosis and access to drug trials
Faster diagnosis and access to new treatments is an obvious benefit to patients, and Sapientia (genome analytics software) has proved especially critical for people experiencing deteriorating health from rare conditions, where they would otherwise commonly wait up to five years for diagnosis.
Improving access is also true of Join Dementia Research (JDR - a digital platform matching volunteers for dementia research with active studies), with one clinician explaining: “A lady in the north east signed up to JDR, was matched to a trial, and three days later was in London getting a very exciting experimental drug. That wouldn’t have happened if it wasn’t for JDR. She lives in a place where there’s no trial activity and she’d never been asked about trials before.”
Health economic impact
These real-world, real-time impacts of NIA innovations are estimated to have generated savings of over £12 million per year to England’s health and social care system - a figure that will inevitably increase as the NIA continues to grow. Significantly, the NIA is, through the partnership between NHS England and Academic Health Science Networks, providing a unified national voice to articulate challenges in innovation scaling. And more importantly, is working in partnership with national bodies to help address these, so that high impact innovations reach the hands of those who need them - patients, populations and NHS staff.
Five innovations supporting safety, quality and efficiency in hospitals
Online and text-based service empowering patients to manage hospital bookings, and enabling hospitals to maximise and manage patient volume. DrDoctor has almost halved ‘did not attend rates’, cut waiting lists by up to 15 per cent and saved an average of £1.8 million per year for year acute trust where implemented.
Pathway reducing post-operative pulmonary complication (PPC) risk by preparing patients for and recovery from major surgery. ERAS+ has more than halved PPC and reduced post-operative hospital length of stay by three days where implemented.
Home monitoring of hypertension in pregnancy (HaMpton), empowers mums-to-be to monitor high blood pressure at home via an app, with data monitored by hospital-based clinicians in real-time. HaMpton has supported a 53 per cent reduction in the number of appointments for hypertension monitoring and the amount of time per appointment.
RespiraSense is a continuous, motion-tolerant respiratory rate monitor, proven to identify deteriorating patients up to 12 hours earlier than the standard of care. RespiraSense improves patient flow by reducing preventable escalations of care, and supporting earlier patient discharge.
Free app combining waiting times at local A&E departments and urgent treatment centres with travel time to show patients the fastest place to access urgent care services for minor injuries. WaitLess has supported an 11 per cent reduction in minor injuries activity in A&E, specifically during the busiest times of day.