March 2025

REBUILDING TRUST IN THE CQC

Sir Julian Hartley on how he will restore credibility in the health and social care regulator “SOCIAL CARE CHALLENGES ARE A TIME BOMB”

Exclusive interview with Helen Morgan, the Lib Dems’ health lead TACKLING THE TRIPLE THREAT

TO WOMEN’S HEALTH

Overcoming barriers and unlocking innovation in female healthcare

WELCOME

MARCH 2025

“The depth and scale of the challenges we are facing are perhaps even greater and more significant than I had initially anticipated…”

In the wake of an independent review that found the Care Quality Commission suffering from significant internal problems and a lack of faith from the public, Sir Julian Hartley knows that he has a mountain to climb as the head of England’s health and social care regulator.

In an exclusive interview with Healthcare Today, he talks about about his plan to restore credibility in the organisation, learning from mistakes, and how to improve patient safety.

Also in this issue, Liberal Democrat MP Helen Morgan reveals why she is passionate about improving access to primary care, fixing social care and investing in prevention; Kirsten Shastri explains how to overcome barriers and unlock innovation in female healthcare; and much more...

Tell us your news: Contact: Adrian Murdoch, Editorial Lead adrian.murdoch@healthcaretoday.com +44 (0)7983 407607

Glen Ferris, Editor-in-Chief glen.ferris@healthcaretoday.com +44 (0)7780 298825

To download a copy of our media pack, click here.

20-23

25-29

30-33

NHS TRUSTS PAY OUT MORE THAN £1 BILLION FOLLOWING SURGERY ERROR

NHS TRUSTS have had to pay out more than £1 bilion to patients who have lodged claims following a surgery error since 2019.

From 2019 to 2024, 11,405 claims regarding surgical errors were lodged against NHS Trusts, 8,400 of which were settled according to figures obtained by Medical Negligence Assist.

Over the past five years, the trusts have paid out a total of £1 billion reaching a peak in 2021/22 when it stood at £263.5 million.

Common errors can include foreign objects left in the body, such as surgical instruments and cleaning materials, as well as wrong site surgery, where patients can be put at a greater risk of infection and additional scarring.

Every year, 12,000 medicolegal claims are brought against the NHS in England at a cost of £8 billion –6.7% of the NHS England budget.

In 1,000 of these claims, the primary speciality is general surgery.

University Hospitals Birmingham had the highest compensation costs at over £44 million, with Barts Health NHS Trust following with costs of over £34 million.

The most common causes for surgical error claims were failures/ delays for treatment, which was lodged 1,999 times, and the most common surgery error injury was unnecessary pain, seeing 1,990 claims submitted.

DOCTORS IN LONDON OVERWHELMED BY INCOMING PATIENTS

More than 32,000 shifts, which should have been filled by doctors in hospitals across London, were not staffed over a six-month period last year, impacting patient safety.

Results from Freedom of Information (FOI) requests submitted by the British Medical Association (BMA) showed that across 23 London Trusts, at least 32,576 shifts were offered to doctors but were not filled.

The BMA is warning that the large number of unfilled shifts across London trusts is unsustainable and is having a detrimental impact on patient care and on the remaining doctors who are working in increasingly understaffed and challenging shifts.

“I sent these Freedom of Information requests so that we would have the data to back up what doctors in London already know: we are untenably short-staffed. Every single one of those 32,000 unfilled shifts meant overworked doctors were left trying to do the work of multiple medics. Patients in London deserve doctors who can give them the time and energy they need,” said Shivam Sharma, London resident doctor and cochair of the BMA North Thames regional resident doctors’ committee, who sent the Freedom of Information requests to all Trusts in London.

“I recently did a night shift where there were two spots on the rota they didn’t manage to fill, so only one registrar and one senior house officer, seeing new patients coming in through A&E overnight,” said one resident doctor working at a North London Trust. We ended up having patients waiting all night to be seen because both doctors were so overwhelmed by new incoming patients.”

The BMA argues that the pay rates that London hospitals offer doctors to do extra shifts are capped lower than other parts of the country. This means shifts are going unfilled as pay rates are not competitive enough and often worse than those offered outside of the capital.

Doctors can join the Scrap the Cap campaign by signing up to the pledge and commit to stopping all extra-contractual work if BMA London calls for it to support negotiations with London NHS trusts.

STARMER ANNOUNCES PLANS TO ABOLISH NHS ENGLAND

Prime minister Keir Starmer has announced plans to abolish NHS England and bring the health service back under the direct control of government and back into the Department of Health and Social Care (DHSC) over the next two years.

“I can’t in all honesty explain to British people why we should spend their money on two layers of bureaucracy,” he said in a speech in Hull. “That money could and should be spent on nurses, doctors, operations and GP appointments.”

Starmer’s move is a desire to move the management of the NHS away from NHS England – what he dubbed an “arms-length body” – back into “democratic control”.

More pithily, health secretary Wes Streeting told the House of Commons that the government was now “abolishing the biggest quango in the world”.

As chief executive of NHS England, James Mackey will lead the transformation team alongside Penny Dash as the incoming chair.

The move is the final nail in the coffin for NHS reforms under the Conservative-Liberal Democrat coalition which followed the 2010 general election. In 2013, then Conservative health minister Andrew Lansley established NHS England to give the health service greater independence and autonomy. It was a deliberate attempt to allow it to operate at arm’s length from the government.

“It has been increasingly clear that NHS England no longer has a grip on the health service, its staffing or the future of the NHS,” said Phil Banfield, chair of BMA council while Ajay

Verma, consultant gastroenterologist at Kettering General Hospital NHS Foundation Trust, described it as “a failing organisation that has undermined doctors and patient safety”.

Matthew Taylor, chief executive of the NHS Confederation, and Daniel Elkeles, incoming chief executive of NHS Providers, which represent NHS leaders around the country, however, described the abolishment of NHS England as “the end of an era for the NHS” and that it marked “the biggest reshaping of its national architecture in a decade” while Thomas Reynolds, director of policy and communications at not-for-profit medical defence organisation the Medical Defence Union (MDU) said that it had the potential to be “a landmark moment in the NHS’s story”.

As news of the move broke more widely, it was cautiously welcomed.

Ryan Shorthouse, founder and chair of the think tank Bright Blue, called the government’s plans “sensible” and highlighted NHS England’s “too many layers of governance”.

“To be fair, I can see the logic,” agreed Hina Choksy Evans, co-founder of healthcare consultancy Colligo Labs. “NHS England and the Department of Health and Social Care have been tripping over each other for years, duplicating roles, forming separate strategies, and spending money on two different sets of comms teams

who, ironically, might have struggled to communicate,” she said. “This is not just a restructuring on a spreadsheet. Thousands of NHS England staff are losing their jobs.”

The immediate attention of the government plans will be on the human cost of the changes. NHS England currently employs around 15,300 people, while the DHSC employs 3,300. Streeting said that work has already begun “to strip out the duplication between the two organisations” and his aim is to cut headcount across both in half.

Nuffield Trust chief executive Thea Stein said that “the news will be devastating for staff at all levels of NHS England, and we must remain mindful of the human cost of this decision”.

“This is not just a restructuring on a spreadsheet. Thousands of NHS England staff are losing their jobs. Many of them have worked tirelessly to keep the system running through endless pressures, only to now be told their roles are redundant. If the goal is to improve efficiency, will we also lose the expertise that makes those efficiencies possible?” asked Colligo Labs’ Evans.

No wonder then that the BMA’s Banfield calls the reform “a high stakes move” from government. “Without NHS England acting as a buffer between himself and delivery of healthcare to patients, the buck will now well and truly stop with the health secretary,” he said.

The prime minister has said that the reforms will mean shorter waiting times, less bureaucracy and more money for nurses.

The devil as is so often said, will be in the details.

BUPA AD TO GO IN HERE

CALLS FOR COMPENSATION AFTER EXAM ERROR

ADATA PROCESSING issue at the Royal Colleges of Physicians means that 222 doctors were erroneously told they had passed an exam. The BMA is calling for compensation.

The error made by the Federation of the Royal Colleges of Physicians of the UK, in which 222 doctors were told they had passed an exam they had in fact failed, and a further 61 were told they had failed when they had passed, has been described by the British Medical Association (BMA) as a “catastrophic error”.

The Royal Colleges of Physicians admitted the mistake in a statement saying that an internal audit process revealed that 1,451 took the exam –called the MRCP(UK) Part 2 Written Examination – in September 2023 but almost 300 got the wrong results.

“On behalf of the Federation of the Royal Colleges of Physicians of the UK, we deeply and unreservedly apologise for this situation. We appreciate how distressing the candidates affected will find this, and for some, it will create an additional burden to the hard and vital work they do,” wrote Mike Jones, executive

medical director of the Royal Colleges of Physicians.

Out of 1,451 candidates in the MRCP(UK) Part 2 Written Examination on the 6 September 2023 (Diet 2023/3), 283 were given the wrong result – 61 candidates who were told they had failed have passed and 222 candidates who were told they had passed have failed. The organisation said that the errors were “due to a data processing issue” which was isolated and has now been fixed.

“Our own audit processes identified the issue which we can confirm is isolated to this specific exam and there is no fault on the part of any candidate. UK resident doctors who are likely to have taken this examination are at an early level of practice and are under the supervision of consultant physicians and therefore no new risk to patient safety,” added Jones.

The Royal Colleges of Physicians said that examination fees will be refunded, a resit will be free of fees and other help will provided according to individual circumstances. The exam is one of three parts and must be taken by doctors who want to progress in their training in a medical specialism such as cardiology, respiratory or

intensive care medicine. The BMA highlighted the fact that the mistake by the Colleges’ exam body, and the time it has taken to discover it, means there will be doctors, who having been told they had passed, have progressed in their careers but now face uncertainties about their future because of this error.

There are also potential lost earnings for doctors not able to progress because of this mistake, it continued. Even worse, some may have abandoned their medical career altogether, wrongly believing they were not good enough to get any further as a doctor.

“Failing an exam is devastating and has consequences for doctors as they work their way up the ladder of expertise; being told you have failed when in fact you have passed, is even worse… The moral, legal and governance aspects of this truly terrible mistake are far-reaching and must not be under-estimated by the public, government, and the NHS,” said BMA chair of council Philip Banfield. “The Federation must commit to significant support and compensation for all the doctors whose lives and careers will be in turmoil today because of this mistake.”

Before performing a colonoscopy on my patient, an 81-year-old woman suffering with abdominal pain, I’d talked her through the risks.

I removed a polyp and biopsied three further polyps using hot diathermy forceps. A few hours after returning home, my patient was rushed to the emergency department in severe pain. An emergency laparotomy revealed and repaired a perforation to the right colon. A few weeks later, she brought a case of clinical negligence against me.

Medical Protection instructed a consultant gastroenterologist to give an expert opinion. He felt that a hot biopsy technique was inappropriate, that alternatives had not been considered and discussed, and that consequently consent had been limited.

Taking into account the apparent vulnerabilities in the case, Medical Protection settled the matter on my behalf and with my consent, with a payment of over £125,000.

Never before have I valued my Medical Protection membership so deeply. Of course, my indemnity was a lifesaver in terms of the claim costs. But my support team’s swiftness to respond, their legal expertise, and their empathetic guidance as I reflected on my practice were all beyond value.

medicalprotection.org/case8

Always there for you

THE LATEST report from the Health Services Safety Investigations Body (HSSIB) has found not only that integrated care boards (ICBs) do not have visibility of some patient safety risks, but also that there is variation in how risks are escalated to a regional and national level, and how responses to escalations are fed back.

The investigation from the executive non-departmental public body sponsored by the Department of Health and Social Care considers how safety management is co-ordinated and integrated across the health and care system.

In order to understand the organisational patient safety accountabilities and responsibilities, HSSIB spoke to staff working in multiple ICBs plus a number of national organisations across the health and care system. This included speaking to national healthcare organisations, and regional teams in NHS England about how patient safety risks are escalated to them and how they are managed.

ICB s BLIND TO SOME PATIENT SAFETY RISKS

A key message coming from the investigation is there are currently no overarching principles that all health and care providers and ICB’s can use which enable a consistent and collaborative approach to safety management. This has created a difference in understanding between organisations, including accountability for patient safety within organisations.

“It is crucial that lines of responsibility and accountability are defined including at a national level, and those we spoke to welcomed any further work on establishing approaches that would help them to manage recurring or emerging risks more proactively,” said Sian Blanchard, head of patient safety insights at HSSIB.

The report’s main recommendation is that health and care organisations can improve patient safety by working together to identify the challenges with the practical use of the Learn from Patient Safety Events service to enable the identification of risks that span multiple providers. They can also improve patient safety by having clear lines of safety accountability and assurance of risk management

processes. Currently, patient safety risks are not managed in line with established UK government risk management principles. HSSIB suggests that integrated care boards seek assurance of how health and care providers will work together when commissioning services so that patient safety can be managed across health and care providers. This is to help support the visibility and management of patient safety risks across an integrated care system.

“Any opportunity to improve safety management should be examined because as we see through our investigations, safety incidents and patient harm happen as patients transition between health and care providers,” said Blanchard.

Finally, HSSIB suggests that integrated care boards develop their patient safety capability and expertise to ensure they can effectively analyse safety data and intelligence about patient safety risks. This would help to identify and understand patient safety risks that exist across multiple providers in order to proactively investigate and manage these risks.

LITTLE EVIDENCE TO SUPPORT USE OF PHYSICIAN ASSOCIATES

THERE is little evidence to support the safety and efficacy of physician associates (PAs) and anaesthetists associates (AAs) in the UK, which adds to the questions being asked about their role within the NHS.

A study in the BMJ by researchers from the Nuffield Department of Primary Care Health Sciences, University of Oxford, and the London School of Hygiene and Tropical Medicine was written to inform the ongoing government-commissioned Leng Review which is examining the effectiveness and safety of these roles.

“At present, we simply do not have the data to support claims that these roles improve efficiency or maintain patient safety,” said Trisha Greenhalgh, lead author of the study and professor of primary care health sciences in the Nuffield Department of Primary Care Health Sciences, Oxford.

The study’s key finding is that research on PAs and AAs is limited. Only one small study assessed the competence of PAs through direct observation and no studies directly assessed the safety of AAs. Few of the studies screened for this research it

found were of sufficient quality and relevance to current NHS policy and many studies were small or lacked rigorous methods, making it difficult to assess the safety, effectiveness, or impact of PA and AA roles. Significantly, it found no research that examined safety incidents or prescribing safety and there is no robust evidence assessing PA and AA in managing high-risk or complex patients.

There was some preliminary evidence that PAs could support hospital ward teams and emergency departments when undertaking carefully circumscribed roles and closely supervised. Evidence, however, suggests PAs struggled in primary care, where the role is more autonomous and clinically complex. There is no direct evidence supporting the value of AAs in anaesthetics.

The limited evidence for the use of PAs in a clinical setting was jumped on by the British Medical Association which has long opposed the use of PAs and is currently taking the General Medical Council to court over what it calls a dangerous blurring of lines for patients between experienced doctors, and assistant roles.

“This research suggests that NHS leaders’ reliance on the absence of evidence of safety incidents in a small number of research studies is an error of logic that is likely to cost lives,” growled Phil Banfield, chair of BMA council.

The reason that the debate has become so fractious is because deaths have already occurred. As Healthcare Today reported, Karen Henderson, assistant coroner for Surrey, has raised concerns after an elderly lady was seen by an unsupervised PA in A&E in February last year and sent home without a medical review. She subsequently died.

“The mismatch between policymakers’ enthusiasm for expanding these roles and the lack of rigorous research evidence should be a red flag,” said Martin McKee, coauthor of the study and professor of European public health at the London School of Hygiene and Tropical Medicine. “Workforce shortages are a real challenge, but they cannot be addressed by replacing doctors with people whose training maps poorly to the duties expected of them.”

Responses to the Leng Review close at the end of the month.

NHS ROLLS OUT CERA SOFTWARE

A predictive AI tool, developed by health tech provider Cera, which can prevent as many as 2,000 falls and hospital admissions each day, is being rolled out across the NHS.

The software is in use across more than two-thirds of NHS integrated care systems across the country and helps to provide care at home by flagging as many as 5,000 high-risk alerts a day, reducing hospitalisations by up to 70%.

Cera’s AI software will also be used to detect the symptoms of winter illnesses like COVID-19, flu, respiratory syncytial virus (RSV), and norovirus, allowing NHS and care teams to intervene before hospital care is needed.

The technology works by allowing carers, family members and healthcare staff to record patient updates on an app which then monitors and reacts to a range of

vital health signs in real time, such as blood pressure, heart rate and temperature.

“This AI tool is a perfect example of how the NHS can use the latest tech to keep more patients safe at home and out of hospital, two cornerstones of the upcoming 10-year Health Plan that will see shifts from analogue to digital, and from hospital to community care,” said Vin Diwakar, national director of transformation at NHS England.

Falls are the largest cause of emergency hospital admissions for older people with estimates that around 30% of people aged 65 and above – 2.5 million people – and around half of those aged 80 and above will experience a fall at least once a year. These falls and fractures account for more than four million bed days a year at a cost that the NHS estimates to be around £2 billion.

Since a successful trial in July 2023, the use of Cera has led to a reduction of A&E attendances and freed up hospital beds, which the NHS says is saving the NHS more than £1 million a day.

“This is smart, preventative healthcare in action, and exactly the kind of transformation we’re championing in our 10 Year Health Plan – shifting from treating sickness to preventing it, from hospital to community care, and from analogue to digital solutions,” said minister of state for care Stephen Kinnock.

MHRA PUBLISHES NEW GUIDANCE FOR MEDICAL DEVICE MANUFACTURERS

THE Medicines and Healthcare products Regulatory Agency (MHRA) has published a suite of guidance to help medical device manufacturers understand and prepare for new postmarket surveillance (PMS) regulation for medical devices in the UK which will come into force in mid-June.

Key requirements are enhanced data collection, shorter timelines for reporting serious incidents and summary reporting to enable the MHRA and manufacturers to identify safety issues earlier, as well as clearer obligations for risk mitigation and

communication to protect patients and users.

“The new post-market surveillance regulations will provide us with more safety information on medical devices in use in Britain, allowing us to act swiftly when needed to reduce potential harm,” said Laura Squire, medtech regulatory reform lead and chief officer at the MHRA.

These new regulations are part of wider regulatory reform and will introduce clearer and more riskproportionate requirements that improve the safety of medical devices across the country.

In 2021, the MHRA consulted on the future regulation of medical devices.

Responses to the consultation were strongly supportive of introducing clearer and more robust requirements to improve patient and public safety and called for closer alignment with international approaches.

The new regulations will apply to medical devices, including in vitro diagnostic (IVD) devices and active implantable medical devices.

The regulation comes into effect on 16 June.

RESEARCH FINDS POOR NHS ADMINISTRATION HARMS PATIENTS

LETTERS arriving after appointments, not being kept updated about waiting times for treatment and chasing test results are not only frustrating, but they also risk some patients not receiving the care or diagnosis they need on time.

New research from The King’s Fund, National Voices and Healthwatch England shows that poor administration within the NHS is widespread and is worse for some people including those with long-term health conditions and people who are struggling financially.

“Poor admin drives up perceptions of an NHS that wastes money and staff time and puts people off seeking care. Admin matters and it’s time that the staff that deliver it, are recognised for the value they bring,” says Julia Cream, policy fellow at The King’s Fund and co-author of the report.

New public polling conducted by Ipsos for the report reveals the scale of poor NHS admin. While just over (52%) of the public felt that the NHS is good at communicating with patients about issues like appointments and test results, a quarter (25%) said it was poor, and those who had actually interacted with health services in the last year reported widespread issues. Of those who had used the NHS in the past 12 months, almost three-quarters (64%) said that they had experienced at least one issue with NHS admin or poor communication.

“The government is trying to bring down waiting lists and improve access but these efforts will fail if the NHS

cannot communicate effectively with people about when their appointment is or who they need to contact,” added Cream.

The study found that 75% of patients with one or more long-term health conditions had experienced an issue with NHS admin in the last year, compared to 57% of those with no long-term health conditions.

“The results of ineffective and inefficient admin are not felt equally across our society and affect those already experiencing health inequalities more acutely. For people with multiple long-term conditions, the burden of managing admin is multiplied for each interaction with the system,” said Jacob Lant, chief executive of National Voices.

As well as making some patients less likely to seek care in the future, the research shows that poor admin drives a perception of NHS waste. Of those who have experienced at least

one problem over the past year with NHS Admin, 61% said that it made them think money was being wasted, 56% said their time was being wasted and 55% felt that NHS staff time was being wasted.

Patients and carers told researchers how poor admin has led to stress, anxiety and deteriorating mental health. Many patients described being unable to cancel or reschedule appointments.

One person described how they were automatically discharged from a service when they did not attend an appointment they had been unable to cancel. Another patient received a text confirming their appointment for 99 January. Researchers also heard from a patient who is deaf and described how they are still called on the telephone despite asking for all communication to be via text or email.

The King’s Fund, National Voices and Healthwatch England say they want the government and the NHS to focus on improving patient communication and admin, with the health service required to regularly report on patient experience of admin processes. They are also calling for admin to be prioritised in the upcoming government 10 Year Health Plan expected later this year.

The three organisations recommend that NHS leaders and policymakers ensure there is adequate training and development for NHS admin staff and that patients are part of the design, delivery and testing of new admin approaches.

SAFETY AND QUALITY IMPROVE IN THE PRIVATE SECTOR

THE proportion of independent healthcare providers rated “good” or “outstanding” has hit 92% according to the Care Quality Commission.

The proportion of independent healthcare providers rated “good” or “outstanding” has hit the highest ever level as the sector continues to treat record levels of both NHS and private patients.

An analysis of official safety and quality data from across the sector has found that overall 92% of independent sector hospitals are rated overall good or outstanding by healthcare regulator the Care Quality Commission (CQC). This is a notable jump from 2018 when only 70% of independent healthcare providers achieved that rating.

“It’s hugely welcome to see that the overall standards of quality and safety

in the sector continue to improve, from what was an already very high level,” said Dawn Hodgkins, director of regulation at The Independent Healthcare Providers Network (IHPN), which represents independent providers which deliver both NHS and privately funded care.

“Whether it’s shorter waiting times, patients’ own experiences of their care, or the view of independent audits or regulators, independent providers are demonstrating that they are prioritising delivering safe, accessible, high-quality care for patients, with a real culture of learning and improvement within their organisations,” she continued.

Particularly high levels of care were found in diagnostic imaging services by independent providers (85%), independent community healthcare providers (92%) and independent doctors (94%).

The report also notes the work the

sector doing to help support and empower its staff to drive through improvements in patient safety and develop a culture of openness and learning. This includes a 50% yearon-year increase in the number of Freedom to Speak Up Guardians in the sector and the establishment of new patient safety specialists who are required in all organisations that deliver NHS-funded care. The sector’s focus on safety and quality is significant following the new agreement that Keir Starmer struck with the independent sector in midJanuary as part of plans to end the hospital waiting list backlog.

As Healthcare Today reported at the time, the new deal will set out how independent sector capacity can be used to tackle some of the longest waits in specialist areas of treatment, such as gynaecology, where according to government figures there is a backlog of 260,000 women waiting more than 18 weeks for treatment.

POOR EMPLOYMENT CHANCES FORCING GPs OUT OF THE NHS

In a survey of more than 1,400 family doctors, one in five GPs in England told the British Medical Association (BMA) that they plan to change their career because they can’t find any or enough work as doctors.

A further 47% said they were expecting to make changes. The most popular change considered is to take clinical jobs outside of the NHS (43%), but respondents also considered taking up GP opportunities abroad (40%) and, for some, leaving healthcare altogether (38%)

The BMA survey confirms the finding of a general practice workforce report from Cogora that Healthcare Today reported on in January which highlighted both staff shortages in the NHS and a shortage of jobs.

“At a time of immense pressure on the NHS, and patients waiting too long to be seen, it’s ridiculous that so many GPs can’t find work,” said Mark Steggles, chair of the BMA’s sessional GP committee.

“These findings confirm our worst fears. Not only is the issue spreading through the profession, but it’s also leaving many wondering why they should bother staying in the NHS at all, further depriving patients of the vital care they need,” he continued.

The BMA’s first survey on GP under- and unemployment last year, found that locums were struggling to find roles. The latest figures show that other GPs, mainly salaried, are also now struggling to find a job.

Rising running costs and underfunding in general practice have made it harder for practices to hire the staff they need. As a short-term solution, the government expanded the Additional Roles Reimbursement Scheme (ARRS) – a ring-fenced fund for hiring non-GP staff – to include GPs.

It is not, however, seen as a real solution because it offers only fixed-term roles to 1,000 newly qualified GPs. Because there are so few available positions, they are often miles away from where GPs live.

HOW TO FIX NHS DATA INFRASTRUCTURE

TO UNLOCK the true potential of NHS data to improve population health, transform patient care and stimulate economic growth, England’s health data infrastructure should be designed to meet the needs of academic and industry researchers.

Developed by the Association of the British Pharmaceutical Industry (ABPI), the Association of British HealthTech Industries (ABHI), and the BioIndustry Association (BIA), the new cross-industry report highlights the role that NHS data and the underpinning infrastructure play in supporting vital research – alongside the factors holding back its full potential for the life sciences sector.

“To achieve the government’s ambition for growth and for the UK to become a world leader in AI, it is essential that we design a health data infrastructure that will enable small and large companies across the life science sector to flourish,” said Janet Valentine, ABPI executive director of innovation and research policy.

The report recommends that the regional Secure Data Environment (SDE) network must prioritise high-value datasets and services for discovery science, AI development, precision medicine and local health improvement research.

It must differentiate between the types of research best supported by the regional SDEs, and those best held through existing central resources, such as the Clinical Practice research Datalink (CPRD). And at the same time provide a unified, integrated service, with a single point of entry, to streamline user experience and reduce duplication of effort.

Governance, contracts, and pricing for data access should be standardised and an external advisory group should be set up to ensure industry and other key users are at the heart of strategic decision-making about the regional SDE network.

HOSPICES RECEIVE INITIAL £25 MILLION FUNDING

THE government has confirmed the release of an initial £25 million for upgrades and refurbishments for hospices across England.

As Healthcare Today reported in late December, the government announced £100 million of capital funding, spread over two years, to help hospices provide the best end-oflife care to patients and their families in a supportive and dignified physical environment.

Hospices for children and young people will also receive a continuation of £26 million in revenue funding for 2025/26 through what until recently was known as the Children’s Hospice Grant.

Minister for care Stephen Kinnock has called it “the largest investment

in a generation” saying that it will transform hospice facilities across England. The cash will be distributed immediately for the 2024/25 financial year, with a further £75 million to follow from April. More than 170 hospices across the country will receive funding, including those run by Marie Curie and Sue Ryder, as well as independent hospices like Zoe’s Place in Liverpool.

The immediate cash injection, allocated through Hospice UK from the department, will enable hospices to purchase essential new medical equipment, undertake building refurbishments, improve technology, upgrade facilities for patients and families and implement energy efficiency measures.

The larger £75 million investment will support more substantial capital projects, including major building

works and facility modernisation, throughout the next financial year. The funding was welcomed by the industry.

“The greater stability provided by the government’s funding injection this year and next gives us a golden opportunity to now reform the palliative and end of life care system, so it’s fit for the future,” said Toby Porter, chief executive of Hospice UK.

Paul Bytheway, chief executive of Birmingham Hospice said that the money was “a boost after a very challenging year”; Elinor Eustace, chief executive of St Giles Hospice in Lichfield, Staffordshire, said that the funds would enable her “to make meaningful improvements to our Inpatient Unit”; and Lisa Hunt, chief executive of Garden House Hospice Care in Letchworth, said that the money would make “a real difference”.

AI PREDICTS HOSPITAL STAY LENGTHS FOR PEOPLE WITH LEARNING DISABILITIES

COMPUTER scientists at Loughborough University have used GP and hospital data from more than 9,600 patients with learning disabilities and multiple health conditions to develop the AI model.

An artificial intelligence model, developed by computer scientists at Loughborough University as part of the DECODE project, aims to tackle healthcare challenges faced by people with learning disabilities and multiple health conditions.

This group has a life expectancy of 20 years lower than the UK average, often due to poorer physical and mental health and a higher likelihood of having multiple chronic illnesses. These factors increase the risk of preventable complications, reduced quality of life, and prolonged hospital stays.

“This research demonstrates how AI could help tackle these vast inequalities by spotting patterns and predicting resource needs, which could all improve patient outcomes,” said Jon Sparkes, chief executive of learning disability charity Mencap.

The Loughborough University researchers used GP and hospital data from over 9,600 patients with learning disabilities and multiple health conditions to develop an AI model capable of predicting hospital stay lengths within the first 24 hours of admission.

The model was 76% effective in distinguishing between patients likely to have prolonged hospital stays and those who would be discharged sooner. It was also used to analyse

the hospital data to identify key reasons for hospitalisations and health patterns among people with learning disabilities and multiple health conditions.

It found that cancer is the leading cause of hospital admissions for men and women with learning disabilities and multiple health conditions and on average people with learning disabilities and multiple health conditions stay in hospital for three days. Stays that exceed 129 days are often linked to mental illness.

“With early and accurate predictions, hospitals can plan better and provide more personalised care, ensuring fair treatment for all patients,” said Cosma. The insights from this study will be used to support the NHS in developing risk prediction algorithms to assist clinicians in decision-making.

“While hospital care is an important part of healthcare provision, we are exploring ways to minimise the need for hospitalisation by

exploring where health interventions could be delivered earlier and people with learning disabilities could be engaged in their care better,” said Satheesh Gangadharan, consultant psychiatrist with the Leicestershire Partnership NHS Trust and the DECODE co-principal investigator.

The data used to train the AI model came from GPs and hospitals in Wales. As part of their next steps, the researchers are applying the model to datasets from hospitals in England to assess whether similar patterns emerge across different populations.

“We’re also seeking additional funding for a clinical trial to test how this personalised prediction tool can reduce emergency admissions and improve quality of life for patients with learning disabilities and multiple long-term conditions,” said Thomas Jun, an expert in sociotechnical system design at Loughborough University and DECODE co-principal investigator.

HOW TO REBUILD TRUST IN THE CQC

SIR JULIAN HARTLEY

started as chief executive of the Care Quality Commission in December 2024. The former chief executive of NHS Providers and a career that includes a ten-year stint as chief executive of Leeds Teaching Hospitals NHS Trust, he has come into an organisation in much need of leadership.

Last year’s independent review into England’s health and social care regulator found an organisation with significant internal problems and one that had lost the faith of the general public. It is something he is trying to fix.

Here he talks to Healthcare Today about his plan to restore credibility in the organisation, learning from mistakes, and how to improve patient safety.

You were appointed in October and you started only in December. What’s been the largest surprise so far?

The depth and scale of the challenges we are facing are perhaps even greater and more significant than I had initially anticipated.

Before I began my role, I conducted some preliminary work by asking staff to identify their top three priorities. What has struck me most forcefully is the significant toll these changes have taken on our colleagues.

Sir Julian Hartley, the new chief executive of the Care Quality Commission explains the steps he is taking to restore credibility in England’s health and social care regulator.

Written by Adrian Murdoch.

Despite these challenges, there is a silver lining. The CQC is fortunate to have a committed and passionate group of colleagues who are determined to overcome these obstacles and strive to be the best regulator possible.

How do you go about restoring credibility to the organisation?

The first step in addressing the challenges we face is to acknowledge the truth of what our staff and the organisation have endured. I have dedicated significant time to engaging with staff internally, as well as with the sectors we regulate externally, to gather their perspectives and insights on our work. This process has been a form of catharsis.

Following this, we have established a clear set of immediate priorities – four critical areas that demand urgent attention.

First, we must significantly increase the number of assessments we conduct. Second, we need to address the backlog of assessments that

are currently stuck in the regulatory platform. Third, we must tackle the backlog of notifications and information of concern. Our standard is to act on these within ten days, but we currently have a backlog of approximately 5,000 cases, some of which date back months. Fourth, we need to improve our processes for registering new providers. At present, around 35% of applicants wait more than ten weeks for a response, which is unacceptable.

While these four areas are essential, they are not sufficient on their own. We must also focus on mediumterm improvements to ensure lasting change. To this end, we have identified five key areas for development. We need to enhance our use of data and insight to improve effectiveness; we must repair the regulatory platform, which has been a source of significant problems; we need to refine the single assessment framework, which has faced criticism for being overly complex; and we are aiming to rebuild our clinical and sector expertise.

REBUILD CQC

Finally, and perhaps most critically, we must address our organisational culture. Every member of staff should feel a sense of pride and purpose in being part of CQC, and they should feel supported and engaged by leadership.

Externally, we must also reset our relationships with those we regulate. We need to establish clear expectations about what providers can expect during inspections, foster more positive and collaborative relationships, and ensure that our assessments not only deliver judgments but also drive meaningful improvement.

You’ve talked in the past about learning lessons from mistakes. How can you do it in a way that’s meaningful?

Over the past few weeks, we have embarked on an extensive and collaborative process to co-design a new approach for the CQC. This initiative involves all 3,000 members of our staff, as well as our stakeholders and partners across the sectors we regulate.

To ensure inclusivity, we have held a series of all-staff meetings where I have personally addressed the

team, outlining our vision and inviting feedback.

Additionally, we have introduced an online resource which allows every member of staff to share their views and feedback anonymously. Last week, we took this engagement a step further by hosting a number of major events across England.

These large-scale, in-person gatherings brought together over 1,500 staff members and more than 500 providers, stakeholders, and partners. It provided a platform for frontline staff, middle managers, and leadership to come together, share insights, and contribute to the ongoing dialogue.

this feedback into a set of values that will guide our work.

How can you make sure that your inspections and your ratings actually improve the quality of care?

The first and foremost principle we are focusing on is transparency. Building trust with the sectors we regulate requires us to be upfront about what we are assessing and why.

We need to instil confidence in those we regulate by ensuring that the individuals conducting inspections have the necessary understanding and experience in the specific services they are assessing. The tone and approach we take as a regulator are also critical. How we

The depth and scale of the challenges we are facing are even greater and more significant than I had initially anticipated

The leadership team used these events to discuss the challenges we face and the lessons we are learning, while also listening to the concerns and ideas of those in the room.

The most important lesson from our recent past is that the organisation did not listen well enough to its people.

This is why our current efforts to engage staff, rebuild trust, and create a culture of openness and collaboration are so critical. By the end of May, we aim to refine all of

present ourselves during inspections and the way we engage with those we regulate must reflect respect and a commitment to positive collaboration.

We want to create an environment where those we regulate feel supported and valued, rather than apprehensive.

One way we plan to achieve this is by involving more of the people we regulate in our work. I believe it is important for senior leaders in the NHS, social care, and other sectors

to participate in inspections and reviews.

This peer-to-peer approach can help shift the dynamic from An Inspector Calls scenario to a more collaborative and constructive experience.

Finally, it is crucial that we demonstrate tangible improvements in our performance and operational delivery. But we must never lose sight of our ultimate goal which is to protect the people who use these services.

Many of the issues that face the sector come down to a simple lack of funding. How can the CQC address that in a useful manner?

As a regulator, we must ensure that our approach takes into account the immense financial and resource pressures that providers are under.

Penny Dash’s report on the operational effectiveness of the CQC also highlighted this point, emphasising the need for a regulatory approach that balances quality with efficiency and resource

use. By doing so, we can better support providers in delivering excellent care while navigating the financial challenges they face.

Given the need to collaborate with various regulators and government agencies, how can you ensure that oversight of the healthcare system remains coherent?

Providers often express frustration when they receive conflicting directions from different regulators. Since taking on this role, I have been encouraged by the

genuine willingness and desire for collaboration among all the regulators I have engaged with.

With the development of the 10-Year Health Plan for the NHS, we have a unique moment to define our complementary but coordinated roles.

This will enable us to tackle the major challenges we face collectively, while also seizing the opportunities to drive meaningful improvement across the health and care system.

HELEN MORGAN: CHALLENGES IN SOCIAL CARE

The Liberal Democrat spokesperson for Health and Social Care talks about the disconnect between how healthcare and social services are funded.

Written by Adrian Murdoch.

HELEN MORGAN, Liberal Democrat MP for North Shropshire,

and the party’s spokesperson for health and social care, talked to Healthcare Today about why the current disconnect between health and social services needs urgent reform and her vision about how it could be fixed.

There has recently been a huge amount of talk and rumour about the healthcare sector. At its heart seems to be an attempt by the government to create a leaner NHS. Do you think this is the right approach?

Most people who have visited a healthcare setting, particularly a hospital, in recent years would likely agree that there is some level of waste within the NHS and that resources could be used more effectively.

There is broad recognition that a shift in how money is spent within the NHS is needed, with a greater focus on frontline and community-based services. As such, I have some sympathy with efforts to reduce duplication and inefficiency.

The recent announcement about reducing headcount at NHS England, if it genuinely targets unnecessary duplication, seems reasonable in principle. However, without specific details, it is difficult to offer a definitive verdict.

One of the biggest stories that we’ve seen this year has been the acknowledgement that there’s going to be greater use of the private sector to reduce NHS waiting times. Is this a threat, an inevitability or is it something to be welcomed?

What ultimately matters are the outcomes for patients. If the use of private providers leads to faster treatment, maintains or improves

The concept of private provision is already wellestablished within the NHS, particularly in areas like general practice and dentistry

the quality of care, and does not significantly increase costs for the NHS, then I don’t have an ideological objection to their involvement.

After all, the concept of private provision is already wellestablished within the NHS, particularly in areas like general practice and dentistry.

That said, the key focus must remain on the patient experience.

If patients encounter difficulties accessing care or receive a poorer experience because private providers prioritise profits over patient care, that would be deeply problematic.

The true measure of success will be in the results – how these changes impact patients and the overall efficiency of the health service.

You campaigned for re-election on ambulance waiting times. This year was the worst on record for emergency services. What is the answer?

It used to be unheard of for an ambulance not to arrive within a reasonable time, yet this is now a reality in some areas. The problem appears to be more acute in certain hospital trusts and ambulance services than in others. For example, ambulance services in Westminster have faced significant challenges,

largely driven by specific issues at individual hospitals within their area, where ambulances are forced to wait for hours to hand over patients.

This winter, a perfect storm of factors exacerbated the situation, including an early flu season, ongoing COVID-19 pressures, and outbreaks of norovirus. While these challenges were widespread, some areas have managed to perform better than others.

This disparity suggests that we should look to high-performing areas to understand what they are doing differently and seek to replicate their successes in areas that are struggling.

Take Shrewsbury and Telford, for example, which consistently ranked among the worst performers last winter.

This year, they have only had one critical incident so far and data indicates that the situation is improving due to operational changes they have implemented.

That said, there are limits to what individual trusts can achieve without addressing broader systemic issues.

Improving access to primary care, fixing social care, and investing in prevention are all critical to creating a sustainable solution.

Is the answer just more money? Would money fix this?

We are currently spending in the wrong areas, and this misallocation is driving inefficiencies. For instance, treating someone in a hospital is significantly more expensive than treating them at home. At home, patients can maintain their independence and benefit from the comfort of familiar surroundings. This approach is not only more cost-effective but also leads to better outcomes for patients.

Lord Darzi’s report underscores this point very clearly. For decades, there has been widespread agreement that we should

invest more in prevention and community-based care. Yet, in practice, the system has continued to prioritise hospital-based treatment, which is far more expensive.

While additional funding is undoubtedly needed in some areas, the real issue is how we use the resources we already have. By investing in prevention and community-based support, we can reduce the strain on hospitals, improve patient outcomes,

and create a more sustainable healthcare system.

You mentioned the disconnect between health and social services. How do the Liberal Democrats plan to integrate health and social care services to improve patient outcomes?

A local health system can run a deficit, whereas a council is required to balance its budget. This creates a fundamental tension when trying to move patients into

social care rather than keeping them in hospital, even when doing so would be more cost-effective. From the council’s perspective, taking on additional social care responsibilities is financially burdensome, so there is little incentive to do so.

The system, however, has been designed in such a way that councils seek to limit demand for social care, while the NHS can operate at a deficit without triggering a major local crisis. This

Ensuring proper support is available is not just a healthcare issue –

it is a social and economic

imperative

structural imbalance is a significant issue. Ultimately, patients and their families do not care which budget funds their care; they just want services to be delivered efficiently and effectively.

And how would you fix that?

This issue is precisely why we are pushing for cross-party talks with the government and other parties on social care. The current approach – funding social care through council tax – is clearly

neither fair nor effective. Areas with a low council tax base often have higher social care needs – whether due to an ageing population or a greater number of people requiring intensive support – but they generate less revenue from local taxation. This creates significant regional disparities. The current system is simply not working, and it must be reformed.

As Healthcare Today has reported, cancer death rates are nearly 60% higher for people living in the

most deprived areas of the UK. The Liberal Democrats have often advocated for more localised decision-making. How would this work in practice?

Health disparities should be a concern for everyone. The data is clear: cancer rates, maternal mortality and overall life expectancy are all significantly worse in deprived areas. Addressing these inequalities must be a priority for central government, but the causes are complex. Take obesity, for example.

A recent debate in Parliament highlighted that obesity rates are far higher in deprived areas. Multiple factors contribute to this, from the prevalence of fast-food outlets to the nature of people’s jobs, which may make it harder to maintain regular, healthy eating habits. While central government can implement broad policies, it is local authorities that are best placed to address the specific challenges within their communities.

As a final question. If you could give Wes Streeting three pieces of advice right now, what would they be?

Social care reform requires urgent, collaborative action. The challenges in social care are a ticking time bomb.

Another key priority should be strengthening primary care. Far too many people end up in A&E when they might have been treated more effectively elsewhere.

Finally, mental health must not be overlooked. A significant number of people are unable to work due to poor mental health, and accessing treatment is often frustratingly difficult.

Ensuring proper support is available is not just a healthcare issue – it is a social and economic imperative.

Trusted by Clinicians, Chosen by Patients

Located in the Harley Street Health District, Pharmacierge supports over 4,500 GPs and Consultants with seamless, secure e-Prescribing apps tailored for private practitioners.

With our state-of-the-art robotically enabled dispensary and nationwide delivery, we ensure your patients receive their medications promptly, while you prescribe with confidence - anytime, anywhere.

mPrescribe®

Revolutionises private prescribing by allowing you to prescribe flexibly without a laptop, for delivery to your patients nationwide.

Medication range

Due to the range of specialists we support, we stock and source medication not typically found outside of a hospital setting, including refrigerated, controlled, injectable and biologic medication.

Courier delivery

We include same weekday delivery to London postcodes, or next weekday nationally as standard. International deliveries are also available.

"Your mobile app changed my life!"

— Dr Dominic Paviour, Consultant Neurologist "Intuitive and secure." — Dr Tim Wigmore, Consultant Intensivist & Anaesthetist

Join thousands of clinicians today. Download the app and register online www.pharmacierge.com/register

HOW TO TACKLE THE TRIPLE THREAT TO WOMEN’S HEALTH

Kirsten Shastri explains how to overcome the barriers and unlock innovation in female healthcare.

WOMEN’S health has historically been underresearched, and the gender health gap now poses a very real threat. After years of underinvestment, women are less likely to have access to pharmacological or technological solutions to sexspecific problems and are more likely to be misdiagnosed, misdosed and mistreated.

There are a growing number of female-led startups fighting back, seeking to redress this imbalance and tackle unmet female health needs through innovation. From a menstrual cup that monitors blood to an AI system that detects breast cancers, the female healthcare (FemHealth) sector has the potential to become a $100 billion industry by 2030.

There is clear demand, so why do FemHealth founders face so many barriers when it comes to scaling their businesses?

The answer can be boiled down to what we have termed the triple threat: the investment barrier, digital censorship and the insurance barrier, all of which are inherently interlinked.

The triple threat: overcoming structural barriers

A consequence of women’s health being under-researched is that there is a chronic lack of data on women’s health issues. As a result, FemHealth firms often need more time to conduct studies and impact assessments. Naturally, this slows product development. However, often this does not meet with venture capital firms’ models, which deem such investments too long-term, compounded by a concern that they are “too risky” with concern around the financial and reputational implications of a product malfunction.

A recent survey conducted by

More than three-quarters of FemHealth founders reported issues when seeking insurance, citing a host of concerns

insurance provider Tokio Marine Kiln found that 84% of FemHealth founders have struggled to secure funding from investors.

FemHealth businesses which navigate these initial hurdles, secure funding and develop their products, then risk having these

innovations censored on key search platforms.

The keywords used to describe some women’s health products can be flagged as inappropriate or explicit content, leading to advertisements being automatically removed and accounts being suspended.

More than half (59%) of FemHealth founders interviewed had suffered from digital censorship.

Online marketplaces and social media platforms have a responsibility to ensure that their algorithms are fit for purpose. While more experienced FemHealth businesses are often able to overcome these algorithms and tailor content to minimise the risk of it being flagged as “adult”, new market entrants often get caught out. The time taken to resolve the matter through official complaints procedures can result in significant lost revenue, for which there is little appropriate insurance cover. Insurance can help tackle both the investment gap and digital censorship, but as it stands it is another barrier to these founders.

More than three-quarters (76%) of FemHealth founders reported issues when seeking insurance, citing a host of concerns. Over half (56%) said the cost was prohibitive, with policies designed for larger, corporate entities that do not account for the unique risks and needs of the FemHealth industry.

Half (50%) of founders also cited the complexity of the insurance buying process as a barrier, with those who managed to find a potential policy met with unacceptable exclusions. This onerous and discouraging process is thanks, in part to, a lack of understanding of women’s health issues within the insurance market. More than a third (39%) of FemHealth founders said underwriters had no appetite for the risk, with 42% of brokers

not understanding the issues to begin with. Some 76% of FemHealth founders surveyed by Tokio Marine Kiln reported barriers when seeking insurance, citing a host of concerns.

Addressing inequalities through insurance

Historically, FemHealth businesses haven’t had access to bespoke insurance policies, because there is little precedent for underwriters to price the risk. Without the right insurance, however, they cannot run clinical trials. Without proof of concept and a working product, they struggle to secure investment. Those who do might allocate some funding to marketing, only to have their efforts squashed by digital censorship. Without being able to showcase demand, securing investment is harder. No money equals no clinical trials. The challenges FemHealth firms face in getting their products to market are clear: without insurance, they will fail at the first hurdle.

Given the vital need to redress the balance and tackle the structural barriers that have held progress in women’s health back for generations, the need for action is clear. The cycle is hard to break, but the insurance industry has the ability to do so. While insurance is currently proving difficult for the industry to navigate, offering bespoke policies, combined with a commitment to better understanding the importance of this growing industry, can provide a way forward. As FemHealth firms face a host of threats, from cyberattacks to lawsuits and regulatory actions, tailored insurance coverage and specialist expertise can help these businesses achieve their full potential. The FemHealth sector needs a true partner in insurance and the industry must step up to prevent another generation of women from receiving insufficient healthcare.

Kirsten Shastri is head of life sciences at Tokio Marine Kiln.

BREAKING BARRIERS FOR NEURODIVERGENT SURGEONS

AS A NEURODIVERGENT consultant surgeon, I often feel thankful that I was not diagnosed with autism until I was 48. By that time, I had established myself in both my professional and personal life, and my diagnosis could not possibly thwart me on either front.

This is a different story for many neurodivergent trainees, and surgeons diagnosed early in their careers. Often, they are told that it is not possible to have a successful surgical career, and are shamed into giving up their dreams altogether. Those who persist are rarely offered any specific support.

Reactions to neurodiversity among surgeons span from denial or passive resistance to accommodating changes right up to outright refusal.

Requested changes are generally quite small, but may spell the difference between a surgeon being able to work comfortably and not. It is not possible, for example, to have my own office in my current workspace; the alternative is a noisy open-plan office with shared desks that I am unable to use. Providing me with a Trust laptop allowed me to do all my administrative tasks in a place I feel comfortable, or from home.

I am the deputy leader of Autistic Doctors International (ADI). It is telling that four of the 17 doctors on its leadership team are anonymous, and 29% of all autistic doctors conceal their diagnosis because of fear of workplace discrimination. ADI is a voluntary group, and we do our best within this limitation to provide support and mentorship to everyone who needs it.

James Henderson, and neurodiversity

Confederation of British says that 29% of autistic conceal their diagnosis fear of discrimination.

In doing so, it is highlighted just how little support there is for neurodivergent surgeons.

When I speak to managers, it is clear that they do not want, do not know, or do not understand how to make practical changes that could support me and others. It is 2025: how can we still be losing talented surgeons

a surgeon neurodiversity lead at the British Surgery, autistic doctors diagnosis because of discrimination.

from the profession through stigma and ignorance?

As far as I know, I am the only openly autistic consultant surgeon in the UK, and this speaks volumes about the stigma attached to neurodivergence in the surgical community. Nobody knows how many surgeons are autistic because they are too

afraid to declare or even to seek a diagnosis. What needs to change?

For a start, the NHS must stop paying lip service to neurodiversity and start effecting tangible change.

We need dedicated teams to help guide hospitals in how to make reasonable adjustments. The guidelines from the National Autism Implementation Team (NAIT), a Scotland-based practitionerresearcher partnership, have yet to be implemented widely. Autism is still viewed through a deficit-based lens, forgetting – or ignoring – our strengths, which include attention to detail, reliability, persistence and integrity. A struggle to communicate or understand social nuances does not mean that we lack empathy, yet this is widely believed to be a fact.  I will not give up. I’m the neurodiversity lead for the

Confederation of British Surgery (CBS), I’m deputy leader of ADI, and I’m starting a project with the Royal College of Surgeons of England. I will hopefully be able to influence change at a higher level now.

I’m passionate about shaping the way forward for neurodivergent surgeons. We must ensure these issues are addressed with the urgency they deserve, and the barriers being faced by so many daily are torn down.

If you’re a neurodivergent surgeon struggling with support or adjustments, I encourage you to seek support. There are groups like ADI that are here to help. And if you’re facing challenges at work, I’d recommend connecting with CBS, which offers support and signposts for neurodivergent surgeons.

‘THE NHS NEEDS GREATER RADICALISM’

Sandeep Chauhan, chief executive and co-founder of Definition Health, writes that delivering on NHS England’s 2025/26 priorities will require a system-wide shift.

NHS ENGLAND’s 2025/26 Priorities and Operational Planning Guidance sets a clear direction for the coming year, focusing on tackling elective care backlogs, improving urgent and emergency care, and enhancing access to primary and mental health services.

While the reduced number of national priorities offers sharper focus, achieving these goals amid tight financial constraints will demand radical transformation.

One of the biggest challenges remains elective care. An ambitious new target for 65% of patients to receive treatment within 18 weeks by March 2026 will require local NHS leaders to make tough, and potentially very unpopular, decisions about resource allocation.

From my experience as a surgeon in the NHS, the key question is not just about efficiency but about how we can deliver more care without compromising patient safety.

From digital adoption to digital integration

The guidance sets clear expectations for driving the transition from analogue to digital, urging systems and providers to leverage digital tools to support reform and ensure the NHS is fit for the future. While broader adoption of the NHS App, Federated Data Platform, electronic patient record (EPR) systems and electronic prescriptions will be welcome, their implementation alone is not enough. To truly transform surgical care in the UK, a system-wide shift is required, one that rethinks how digital tools are integrated into healthcare delivery. This goes beyond digitising existing processes; it involves the creation of digitally enabled care pathways.

This shift requires a fundamental reevaluation of how care is designed, delivered and supported through digital innovation. It means moving beyond

simply digitising paper-based workflows to strategically embedding digital tools throughout the patient journey. This includes leveraging capabilities such as predictive analytics, remote monitoring, virtual consultations and AI-driven decision support.

Rather than using technology to replicate outdated processes, we must harness it to develop more agile, responsive and patient-centred models of care.

The ability to schedule and track appointments digitally through the NHS App is a start, but we must go further. Data-driven technology can predict demand, triage patients more effectively, and identify those most at risk. Virtual care models can streamline both pre-operative and post-operative pathways, which reduces unnecessary hospital visits and enables patients to recover safely at home with continuous digital support.

The shift to a more proactive, datadriven and digital-first approach will empower care teams to anticipate patient needs, optimise resource allocation and improve patient experiences.

Embedding digital tools into everyday clinical workflows is crucial, ensuring they are intuitive, interoperable, and designed with frontline staff in mind. This will reduce delays and enable clinicians to deliver high-quality, patient-centred care more effectively.

Turn vision to reality

For me, the case for a system-wide shift is undeniable. But I also appreciate the process will be challenging. The guidance lays out bold targets, but these cannot be achieved through incremental changes alone. Recognising the transformative potential of digital health is just the first step. Turning this vision into tangible patient care improvements requires overcoming technical, cultural, organisational, and financial barriers.

Progress across regions continues to intensify the digital divide. Recent reports indicate parts of the NHS are making glacially slow progress in digital transformation which leads to inconsistent adoption of tech and disparities in care.

Outdated and disconnected IT hinders interoperability, impedes data sharing, and delays clinical decisionmaking. Even some modern systems can exacerbate this issue, as their proprietary nature makes it difficult to integrate more effective, specialised digital solutions. Trusts are often encouraged to rely on their EPR, despite the availability of better tools designed to address specific challenges more effectively.

Regulatory complexity and a riskaverse culture also slow down adoption, as rigid procurement processes, inflexible policies and time-consuming bureaucracy discourage trusts from exploring new solutions. This conservative approach limits agility and delays the benefits of digital transformation.

Workforce engagement and digital literacy gaps are also significant challenges. I’ve seen firsthand how limited frontline staff involvement and inadequate training impede effective adoption. Compounding these issues are concerns around data governance and trust, with inconsistent practices and fears about data security undermining confidence.

At times, the sheer scale of these challenges feels overwhelming, as if the system is being asked to climb a mountain with no clear path to the summit.

Invest in the future

The government’s recent commitment to invest £2 billion in NHS technology and digital is a much-needed step in the right direction, but it is critical to ensure that this funding delivers real transformation. The guidance

states that, to live within budget, providers must reduce their cost base by at least 1% and achieve a 4% overall improvement in productivity, targets that are among the most demanding in recent years. To meet these stretching ambitions will require more than investment alone; it will require a strategic approach to how digital tools are integrated into care pathways.

The Treasury’s pledge to modernise IT infrastructure, improve cyber security and enhance patient access through the NHS App is a step forward. Without a clear strategy to scale innovations and embed best-in-class, clinically validated digital solutions across the system, however, the NHS risks failing to unlock the full potential of this funding.

A long-term approach is needed, one that prioritises interoperability, ensures technology works for frontline staff and expands digital adoption beyond the tech outlined in the guidance.

A sustainable future for the NHS

The 2025/26 guidance echoes the government’s strong focus on bringing down long waiting lists. While the reduction in the number of priorities offers clarity, to achieve long-term sustainability requires both recovery and reform.

Of course, digital transformation is not a silver bullet, but it is a necessary enabler of improved efficiency, safety and outcomes.

The emphasis on digital solutions as a mechanism to cut elective waiting lists is welcome. But for the NHS to be truly fit for the future, as ministers have committed, the forthcoming 10-year plan for health will need to show greater radicalism.

What’s needed now is bold action, innovative thinking, and a commitment to embed digital at the heart of service redesign... The future of the NHS depends on it.

FOUR KEY QUESTIONS TO DRIVE MORE ENQUIRIES WITH YOUR HEALTHCARE MARKETING STRATEGY

Long wait times and limited NHS access – especially for elective and non-emergency care – mean more patients are exploring private healthcare options. This growing demand also fuels competition between providers.

The task of cutting through this increased competition to reach and acquire new patients falls to marketers. If you want to maintain a steady flow of new and returning patients as demographics, research habits, and channels change, now’s a good time to take a look at your healthcare marketing strategy and refresh your approach.

Here are four key questions to ask to consider:

1. Do we use the right channel mix to reach the kind of patients we’re looking for?

There’s been a recent generational shift in the type of patients who choose to go private, with more 18-34 year olds funding private care themselves or via insurance. Younger audiences often prefer different research channels than older patients, meaning your marketing mix may need adjusting.

“Marketing across diverse channels helps capture multiple audiences,” explains Faye Thomassen, Head of Marketing for Mediahawk. “But

If you want to maintain a steady flow of new and returning patients as demographics, research habits, and channels change, now’s a good time to take a look at your healthcare marketing strategy and refresh your approach.

you shouldn’t waste budget on underperforming channels that aren’t delivering high-intent leads.”

With better tracking and attribution, you can identify and prioritise highperforming channels, and prioritise your spend accordingly.

2. Are we engaging potential patients throughout their research journey?

Patients compare facilities, services, fees, and reviews before deciding. Your strategy should support them at every stage.

“Seeking healthcare can be a vulnerable time,” says Faye. “Given the costs of private care, people want to be sure they’re choosing the right provider. Many visit multiple times before enquiring.”

Proper attribution helps both measure marketing performance

and personalise patient experiences. Call tracking, where each marketing activity is assigned a unique phone number, helps you understand:

• How a lead found your website.

• What they’ve interacted with.

• Where they are in their journey.

With this data, you can serve relevant content or calls to action, guiding them toward an enquiry. Integrating these tools with your customer relationship management (CRM) system also provides valuable context for support teams handling enquiries.

3. Are we reaching high-intent patients ready to book – and handling enquiries well?

A phone conversation remains the best way for patients to enquire about consultations, allowing them to discuss concerns in real time without entering sensitive health details online.

With conversation analytics, you can ensure these phone calls are effective, efficient, and personalised. You can even get insight into your patient demographics with the right data protection rules in place.

A speech analysis tool uses artificial intelligence to understand the interaction, its outcome, and keywords that were used during the call.

This can help you understand:

• Whether the caller was ready to book an appointment.

• The kinds of questions your callers need answers to before they’re ready to convert.

• Whether your support team has the information and training they need to offer consistently high-quality responses to enquiries.

• If your patient journey guides people to the right resources and department.

• How you can adapt your marketing campaigns and patient journey to attract and retain more patients.

4. Can we clearly demonstrate the impact of our marketing strategy on the volume of booked appointments?

By tracking potential patients from the moment they engage to the moment they convert, you can draw clear lines between your efforts and the outcome.

It’s one of the ultimate challenges of marketing attribution – but it’s within your grasp.

You can achieve this level of attribution by combining dynamic call tracking with a sales reporting tool that links every touchpoint to a booked appointment.

It gives you a clear, step-by-step view of the journey your patients took, starting from the marketing activity that caught their attention in the first place.

This is highly valuable for two key reasons:

1. You can do more of what works, and avoid using budget on activities that don’t deliver a good return on investment. When you know which channels to prioritise, the right keywords to use, and the most valuable resources to offer your prospective patients, you can drive more enquiries for your clinic.

2. You can show other stakeholders in the organisation how your strategy is performing, and directly connect marketing activities to revenue. This leads to better engagement and buy-in from your colleagues – and can assist with budget discussions, too.

Summary

According to analysis by healthcare marketers Medico Digital, the average cost-per-click for paid media is £1.23, while the cost-per-acquisition is £30.66, with costs creeping significantly higher for specialties that offer a lot of elective procedures. Private healthcare is a highly competitive, complex industry to market in, so it’s wise to take every advantage that data, analysis, and marketing tools can offer to ensure you’re gaining real value from your investment.

For more information about Mediahawk, click here.

PATIENT SAFETY STRENGTHENED THROUGH CONSENT PROCEDURES

Understanding the consent issue and its impact on patient

outcomes

Consent in healthcare is the process by which a patient willingly agrees to a medical intervention after receiving all necessary information about the benefits, risks, and alternatives.

This process is not merely a legal formality; it is a trust-building exercise that helps ensure that patients fully understand their treatment plans. When consent is not adequately obtained or documented, it can lead to misunderstandings, feelings of vulnerability, and even trauma for patients if unforeseen complications arise.

Furthermore, incomplete consent documentation can leave healthcare providers and institutions vulnerable to legal challenges. In cases of adverse outcomes, courts will closely scrutinise consent processes to determine if patients were genuinely informed. A lack of documented consent can expose hospitals to costly litigation, damaging both reputation and patient trust.

The role of healthcare management in promoting patient safety

For healthcare management, improving consent procedures is an essential element of patient safety and risk management.

By prioritising thorough consent processes, management helps reduce patient safety incidents, manages patient safety concerns more effectively, and fosters a culture of transparent communication.

A proactive approach to consent improves healthcare outcomes by setting clear expectations, reducing the risk of disputes, and minimising

TMLEP’s

Lead Healthcare

Investigator Nina Vagad issues a call to action for healthcare leaders.

misunderstandings between patients and clinicians.

Implementing robust consent processes not only enhances patient trust but also reduces the potential for litigation - a crucial step for healthcare facilities facing increasing scrutiny in patient safety.

Medical leaders play a vital role in establishing consent as a priority and in ensuring that clinicians are equipped with the necessary resources to communicate effectively with patients.

How TMLEP’s risk management consultancy supports improved consent processes

TMLEP offers extensive services that can assist healthcare providers in establishing or strengthening consent procedures through specialised risk management consultancy. By engaging TMLEP, hospitals can develop comprehensive policies tailored to their unique operational and patient care environments. Here’s how TMLEP’s consultancy services help:

Expert-led assessment and recommendations: TMLEP’s team, comprising more than 2,600 healthcare professionals, provides expertise across medical disciplines. The consultancy begins with an in-depth assessment of current consent practices and identifies specific areas for improvement. TMLEP’s experts

recommend evidence-based, legally sound practices that ensure patients receive clear, understandable information, helping to reduce both confusion and consent-related risks.

Implementation of clear consent protocols: With TMLEP’s guidance, healthcare organisations can implement clear and consistent consent protocols. These protocols ensure that all interactions related to consent are documented and that patients fully understand the risks and benefits of their treatment plans. This not only builds trust but also safeguards against claims of insufficient consent.

Ongoing support and training: TMLEP’s consultancy services extend beyond initial recommendations by offering ongoing support, including staff training to maintain high standards of patient communication and consent management. Training programs developed by TMLEP ensure that healthcare staff are upto-date on best practices, are able to explain procedures comprehensively, and consistently apply consent protocols.

Specialised incident response services: Should a patient safety incident occur, TMLEP’s independent investigation services provide healthcare organisations with timely, unbiased insights to address the issue effectively. An investigation can include site visits, clinician interviews, and access to relevant patient records, ensuring a thorough understanding of what occurred and identifying areas for improvement. This service not only resolves specific incidents but also equips healthcare facilities to prevent similar events in the future.

Discover more about TMLEP here.

LIFTING THE LID ON MEN’S HEALTH

IT’S WELL KNOWN that men face specific health challenges such as higher rates of suicide, lower life expectancy and increased prevalence of certain health conditions, while also being less likely to seek medical help for both physical and mental health concerns.

The ripple effect of lack of communication breaks down relationships, reduces workplace productivity, and increases the burden on healthcare systems as men seek support when things become more serious.

Our latest Bupa Wellbeing Index [1] examines this important issue and encourages conversations between generations about health and wellbeing.

Mental health

Half of men in the UK have suffered with poor mental health at some point during their lives. Yet only 40% of those surveyed say they’d talk to a medical professional, 30% to their partner and 24% to a friend. And 30% of men still don’t know where to turn for help, which suggests an urgent need for better awareness of mental health treatment options.

Relationships are inextricably linked with mental health - when one suffers, the other often suffers too. Yet, more than a third of men say that they have hidden their mental health issue from their partner.

Two thirds of people say that there’s still stigma attached to men’s mental health issues, although they feel that this has improved over the past five years.

Silence, societal expectations and harmful stereotypes that discourage men from seeking support have held back conversations about men’s wellbeing for too long, writes Dr Robin Clark, Medical Director for Bupa Global, India and UK Insurance.

Half of men with mental health issues say that observing male public figures talking openly about their issues would encourage them to talk about their own struggles.

Employers are also seen as key, all age groups want them to offer more support for men struggling with their mental health (49% of men aged 25-34, 49% of those aged 35-44, 40% of those aged 16-24 and 41% of 45-55).

Conversations across generations

Almost a quarter of those aged 55 and older lack confidence in their knowledge about men’s health, compared to one in six 25-34-yearolds.

This reflects a greater hesitancy among the older generations to

discuss health topics due to lower confidence or awareness.

Talking about health concerns is key to acting on them and for many men, their family is their main source of support. However, a quarter of men would rather deal with health issues on their own, showing that they feel the need to keep health issues private owing to stigma around the subject.

The figures show that younger generations are slowly becoming more comfortable discussing men’s health issues but there are still hurdles to overcome. Parents or carers of ageing parents should be open about their own mental health as this can lead to conversations about their mental health.

On a societal level, part of the solution may be to make it easier to learn about men’s health issues, with different approaches for different generations.

This will create a larger, public conversation so that it’s no longer a taboo topic.

Sexual function

The perception of stigma is especially problematic when it comes to men’s decisions about seeking advice and talking to people about sexual function. One in three men report problems with their sexual function, whether that’s loss of libido (32%), erectile dysfunction (31%) or premature ejaculation (33%). And they said the most common factors behind these were poor mental health (39%) and stresses at work (41%).

However, 62% if men say stigma and harmful stereotypes affect their decisions to seek help, 34% say a fear of being judged and 34% say feeling embarrassed. This is most commonly felt by those aged 25-34, and 35-44.

Men often face these issues alone, creating a vicious circle that worsens their mental health and negatively affects their relationships. In fact one in five men say they would rather end their relationship than talk about their sexual function issues with their partner.

Over a third of men and women feel there’s a need for greater awareness regarding men’s sexual function.

Achieving this will take concerted action from the government in

it’s plans for a new men’s health strategy, and through public figures leading the way in speaking out about their personal sexual function issues. In fact, 38% of men say this would help to make them comfortable in speaking about their own problems.

Conclusion

Many men are suffering in silence while dealing with their own mental or physical health struggles.

The research shows that often they aren’t seeking help because they’re embarrassed or fear showing signs of weakness. And we know that waiting for problems to go away by themselves can often do more harm than good.

The Government’s upcoming Men’s Health Strategy represents a pivotal moment to drive real change. Employers, policymakers and healthcare providers all have a critical role in tackling these challenges.

We need to foster an environment where men feel empowered to speak openly, seek help and prioritise their health without embarrassment and fear of judgement. We know how powerful a conversation can be, especially when it comes to our mental health.

[1] The research was carried out by Censuswide between 30 October 2024 and 04 November 2024 across a nationally representative sample of 8,000 UK adults (aged 16 and over).

CREDIT CARDS AND PRIVATE TREATMENT

Bailey v (1) Bijlani (2) MBNA Ltd [31.01.2025]

In what has turned out to be a notable judgment relating to negligently performed private dental treatment, the judge found both the dentist performing the treatment and the credit card provider used to pay for the treatment to be jointly and severally liable for damages.

It is a judgment that will be of particular interest to claimants and compensators alike where private treatment was paid for by credit card and there are concerns about appropriate levels of indemnity for the negligent practitioner.

Background to the case

In May 2018, the claimant underwent private dental treatment under the care of a dentist (the first defendant) the sole director of the dental practice. The treatment had been paid for on an MBNA Ltd (MBNA) credit card.

Regrettably, the claimant suffered extreme pain following the treatment, requiring subsequent revision surgery to remove a damaged tooth and the implant that the dentist had inserted. The claimant suffered bone loss in her jaw and ischaemic colitis associated with the medication she was prescribed for pain.

The claim

The claimant brought a claim against the dentist for failure to conduct a comprehensive assessment before the implant

Kennedys Law’s

Laura Collins, Christian Lowden and Nico Fabri explain who is liable for damages arising from clinical negligence when patients use a credit card to pay for private medical treatment.

procedure, to obtain informed consent, and to recognise the risks associated with treatment.

Relying on Section 75 of the Consumer Credit Act 1974, the claimant also brought a claim against MBNA, as the second defendant.

Section 75 of the Act provides that: “If the debtor under a debtorcreditor-supplier agreement falling within section 12(b) or (c) has, in relation to a transaction financed by the agreement, any claim against the supplier in respect of a misrepresentation or breach of contract, he shall have a like claim against the creditor, who, with the supplier, shall accordingly be jointly and severally liable to the debtor.”

To put it in simple terms, under these circumstances, the claimant was considered the debtor; the dentist the supplier; and MBNA the creditor.

The decision

It was found that the claimant had contracted with the dental practice for the provision of dental services which were provided by the dentist. A duty of care was owed to the

claimant in the provision of those services.

Furthermore, a contractual relationship was established with MBNA resulting in potential liability for any breach of contract, pursuant to the implied contractual term under section 49 of the Consumer Rights Act 2015 and section 75(1) of the Consumer Credit Act 1974.

The judge ruled that the dentist had been negligent in the performance of the treatment and MBNA was jointly and severally liable under the provisions of the Consumer Credit Act 1974. The claimant was awarded damages recoverable from both defendants.

Notably, the judge held that MBNA was entitled to an indemnity and/ or contribution from the dentist in respect of damages and costs on a 100% basis, stating specifically that “though jointly and severally liable, there was no suggestion that the Second Defendant was liable other than through the mechanism of the Consumer Credit Act 1974”.

Why this matters

While establishing a claim against a negligent practitioner is not unusual, it is noteworthy that the claimant successfully relied upon section 75 of the Consumer Credit Act 1974 in a clinical negligence claim.

As a mere provider of credit, MBNA had no control over the performance of the treatment but, as is regularly observed under section 75, the credit card provider will often be jointly responsible with the retailer or supplier where things go wrong.

THE ROLE OF BILLING COMPANIES IN REVENUE CYCLE MANAGEMENT

Efficient revenue cycle management is the backbone of a financially healthy healthcare practice. Partnering with a medical billing company like Medserv can be a game-changer, offering expertise, efficiency, and financial stability while allowing healthcare professionals to focus on delivering exceptional patient care.

The importance of revenue cycle management

Revenue cycle management encompasses every step in the financial process of a healthcare practice, from patient registration to final payment collection. It includes insurance verification, claim submission, payment processing, claim rejections, and compliance with ever-changing regulations. A well-optimised process ensures steady cash flow, minimises claim denials, and reduces administrative burdens on medical professionals. However, managing these financial operations in-house can be time-consuming and prone to errors. Staff may struggle with coding complexities, insurance regulations, and rejected claims, leading to revenue loss and inefficiencies. This is where a specialised billing company can provide invaluable support.

How a billing company will help Reducing errors and maximising revenue: Medical billing errors can lead to claim rejections, delays, and revenue leakage. Billing companies employ trained professionals well-versed in coding standards, insurance policies, and compliance regulations, significantly reducing errors and ensuring claims are processed correctly the first time.

In an era where administrative burdens and regulatory complexities continue to grow, medical consultants must ensure that their billing and collections processes are optimised to sustain their practice’s success, says Medserv’s Derek Kelly.

Compliance and regulatory expertise: Healthcare regulations and insurance policies are constantly evolving. Billing companies stay updated with industry changes, ensuring that claims are submitted in compliance with the latest guidelines. This mitigates the risk of audits, penalties, and claim rejections.

Streamlining operations for efficiency: A billing company leverages technology and automation to streamline billing workflows, from electronic claims submissions to automated followups. This not only speeds up reimbursement times but also reduces the administrative burden on healthcare staff.

Real-time claims tracking and reporting: Medserv provides a live reporting system that gives realtime information on the status of claims. This system is accessible 365 days a year, ensuring complete transparency and allowing healthcare professionals to track their claims effortlessly. With instant access to claim statuses, practices can reduce delays, address issues proactively, and maintain financial control.

Proactive denial and rejection management: Denied or rejected claims can be costly if not addressed promptly. Billing companies provide proactive claim monitoring and appeal services, ensuring that revenue is recovered efficiently. Their expertise in identifying patterns of denials helps in reducing future occurrences.

Monthly and year-end financial reporting: Medserv offers comprehensive financial reporting, including monthly and year-end tax reports. These detailed reports provide healthcare professionals with a clear overview of revenue trends, tax obligations, and overall financial health. By leveraging this data, practices can make informed financial decisions, ensuring longterm stability and growth.

Enhanced cash flow and financial predictability: With an optimised process, practices experience faster reimbursements and improved cash flow. Billing companies provide detailed financial reporting, offering valuable insights into revenue trends, payer performance, and operational efficiency. This datadriven approach enables medical consultants to make informed financial decisions.

Why partner with Medserv?

Our expertise in medical billing, coupled with technology, ensures that your practice operates efficiently while maximising revenue potential.

With Medserv handling your billing operations, you can concentrate on what truly matters... Providing exceptional care to your patients.

Discover more about Medserv here.

Published by Healthcare Today Media Ltd. Healthcare Today is editorially independent. Material is governed by copyright.

No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form without permission, unless for the purposes of reference and comment.

© Healthcare Today Media Ltd 2025 Registered office: Connect 38, 1 Dover Place, Ashford, Kent, TN23 1FB

Tell us your news: Contact: Adrian Murdoch, Editorial Lead adrian.murdoch@healthcaretoday.com +44 (0)7983 407607

Advertise with us: Advertise with us: Contact: Andrew Schofield andrew@spotonmedia.co.uk +44 0161 408 3912

To download a copy of our media pack, click here.