Simon Hammond, director of claims management, on overseeing a reduction in litigation rates
IMAGING IMPROVES CLINICAL OUTCOMES
How outdated IT systems hinder even the best AI tools and tech initiatives
BREAKING BARRIERS FOR FEMTECH FOUNDERS
Delving into the structural hurdles faced by female innovators
“The ultimate goal is singular, evidencebased guidance that clinicians can implement confidently...”
Simon Hammond has been director of claims management at NHS Resolution since January 2019. During that time, he has overseen a dramatic reduction in litigation case rates to 2024’s record low of 19%.
It is, he says in an exclusive interview with Healthcare Today, due to fostering a culture of collaboration with Trusts, claimant solicitors and the broader healthcare ecosystem.
Also this month, we speak to Amy Davis, consultant radiologist and CCO of Hexarad, about the growing demand for radiology services and how to use AI more efficiently; Paula Bellostas Muguerza, Kearney’s global healthcare and life sciences lead, about the structural hurdles that face femtech innovators; and much more.
We hope you enjoy!
Tell us your news: Contact: Adrian Murdoch, Editorial Lead adrian.murdoch@healthcaretoday.com +44 (0)7983 407607
Contact: Glen Ferris, Editor In Chief glen.ferris@healthcaretoday.com +44 (0)7780 298825
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IMPERIAL COLLEGE LONDON is working with Cambridge-based biopharmaceutical company Apollo Therapeutics to develop a prospective monoclonal antibody treatment for pulmonary arterial hypertension.
Pulmonary arterial hypertension is a condition that affects the blood vessels in the lungs. Increased blood pressure makes the heart work harder than normal, causing damage and symptoms such as shortness of breath, chest pain, and light-headedness. The illness affects approximately 8,000 people in the UK. The potential treatment is based on a protein that was identified in original research by the university and is currently undergoing a proof of concept trial at Hammersmith Hospital, part of Imperial College Healthcare NHS Trust.
The partnership between Imperial and Apollo Therapeutics helped translate the basic science into proof-of-concept trials in ten years.
“Our APL-9796 program is a perfect example of the model we are deploying at Apollo Therapeutics, where we work with academics at the world’s top universities, such as Imperial College London in order to translate their breakthroughs in basic science into new therapies for major diseases,” said Richard Mason, chief executive officer of Apollo Therapeutics.
The prospective treatment (APL-9796) is based on a protein target identified by Imperial researchers in a paper in 2015. Apollo worked with Imperial to translate the target into one of its flagship drug candidates, providing expertise in antibody production and supporting collaborative research with Imperial using animal models. The treatment was the first candidate from Apollo to enter Phase 1 trials and is among the first to enter trials with patients.
The proof of concept trial is expected to return results quickly due to innovative remote monitoring technology pioneered in PAH patients by Alex Rothman at the University of Sheffield that will make it possible to see patient outcomes in real time. An Orphan Drug Designation from the US Federal Drug Administration will further accelerate progression through trials, and the teams hope to enter later phase trials quickly if results are positive.
CARE leaders, unions and one of the devolved parliaments line up to criticise the government’s new plans to ban recruitment from abroad.
The government’s new plans to ban recruitment from abroad have been criticised by leaders in the care industry with Martin Green, chief executive of Care England, complaining that social care has been, yet again, “sacrificed to score political points”.
As part of Keir Starmer’s plans to cut levels of immigration into the UK, the British prime minister made what has been interpreted as an attempt to calm his critics on the right of British politics with the deliberately provocative description of Britain as an “island of strangers” without immigration controls.
The prime minister launched its immigration white paper on Monday 12 May, setting out proposals for future laws that it claimed would make the system “controlled, selective and fair”.
The paper calls for overseas recruitment care visas.
“In line with our wider to skills thresholds, close social care visas applications from
It is also closing a for social care providers to recruit from abroad, the previous government introduced after Brexit. This, it said it was of what it called “concerns exploitation and abuse sector”.
For a transition period while the workforce being developed visa extensions and switching would be those already here, government emphasised would be “kept under
The paper was slammed immediately by care unions and, at the by one of the country’s parliaments.
for an end to recruitment for social
wider reforms thresholds, we will visas to new abroad,” it said.
dedicated visa providers that want abroad, which government had Brexit.
was doing, because “concerns of abuse in the period until 2028, workforce strategy is and rolled out, and in-country be permitted for here, though the emphasised that this under review”.
slammed almost care leaders, the time of writing, country’s devolved
Jane Townson, chief executive of the Homecare Association, described international recruitment as “a lifeline” for the homecare sector.
“Care providers are already struggling to recruit within the UK. We are deeply concerned the government has not properly considered what will happen to the millions of people who depend on care at home to live safely and independently,” she continued.
Describing it as “a crushing blow to an already fragile sector”, Care England’s Green pointed out that the sector has been “propping itself up” with dwindling resources, rising costs and mounting vacancies.
“International recruitment wasn’t a silver bullet, but it was a lifeline. Taking it away now, with no warning, no funding, and no alternative, is not just short-sighted – it’s cruel,” he said.
Their views were echoed by Christina McAnea, general secretary of the trade union UNISON.
“The NHS and the care sector would have collapsed long ago without the thousands of workers who’ve come to the UK from overseas,” she said.
“The social care sector has been in crisis for years. With so many thousands of workers short, it’s unable to provide care packages for all those needing support. That has a huge impact on the NHS too,” she said.
They were joined by Scotland’s equalities minister Kaukab Stewart who said that the plans on migration stand in stark contrast to Scotland’s values and do not reflect its distinct population needs.
“The Scottish government is proud to welcome and support people from around the world to live, work and build their lives in Scotland. Not only does migration enrich our communities and culture, it is vital for economic growth, public services like the NHS and addressing our population challenges,” he said.
Widespread cynicism about the government’s motives for
publication of the report is backed up by the government itself which highlighted what it called significant levels of unmet care needs in the care sector in a report it published only two weeks ago, at the start of May.
The report estimates that the level of unmet care needs in the country affects two million people aged 65 and above, and potentially 1.5 million people of working age. It cites the 2021 Census, which suggests that there are approximately 4.7 million unpaid carers in England which make up 9% of the population.
“Research by the Centre for Care and Carers UK valued contributions made by unpaid carers in the UK at £184.3 billion a year in 2021-22, an increase of £64.9 billion, or 54%, since 2011, and noted this was ‘equivalent to a second NHS’,” it said. “The sector cannot take any more. We need proper funding, a real workforce plan, and immediate recognition that without care, the NHS, our communities, and countless families will fall apart,” concluded Care England’s Green.
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FATIGUE amongst NHS healthcare staff poses a significant yet underrecognised risk to patient safety, warns the English safety watchdog.
The Health Services Safety Investigations Body (HSSIB) has examined the impact of staff fatigue in healthcare on patient safety. It found, despite some data from surveys and staff anecdotes on exhaustion and fatigue, there is still little evidence available to help understand the size and scale of the problem, the scale of its impact on patient safety and those staff who are at most at risk from fatigue.
The healthcare sector lacks robust systems to monitor and manage this issue, even as demands on the NHS workforce become more challenging and intense.
The report highlights that fatigue in healthcare is often misunderstood, and viewed primarily as a well-being concern rather than a critical patient or staff safety risk.
“Fatigue is more than just being tired – it can significantly impair decisionmaking, motor skills, and alertness,” said Saskia Fursland, senior safety investigator at HSSIB.
“We must move away from viewing fatigue as an individual issue and putting the onus on personal responsibility and instead treat it as a system-level risk that deserves urgent attention.”
The report highlights four areas of concern.
First, fatigue is linked to preventable patient harm and staff safety incidents, including fatal road accidents postshift. Staff who spoke to HSSIB spoke of colleagues they had known who had lost their lives in road accidents where fatigue was thought to be a contributory factor.
Organisational and personal factors are also mentioned. Issues like shift length, lack of breaks, caring responsibilities and socioeconomic pressures all contribute to fatigue.
None of this is helped by a culture of celebrating fatigue in the NHS. A pride – the report uses the word “heroism” – in long working hours and discouragement of open conversations about fatigue.
Finally, fatigue risks are not consistently captured in data or addressed in governance or safety learning systems. There is also limited consideration of the risk of staff fatigue in national initiatives addressing workforce challenges and care delays.
The report concludes with two recommendations – that data capture mechanisms on fatigue be improved and that a consensus definition of fatigue for healthcare be established.
“The report underscores the need for strong, unified action to protect both patients and healthcare professionals from the risks associated with fatigue,” said Fursland.
It is a sign of how serious an issue this is, that the report was welcomed by insurers almost immediately.
“We are pleased that the HSSIB’s report recognises the importance and impact of staff fatigue on patient safety,” said Michael Devlin, head of professional standards and liaison at not-for-profit medical defence organisation Medical Defence Union (MDU).
“It is troubling that there has been so little evidence gathered to identify the scale and scope of the problem, despite the introduction in the NHS of new investigation methods, such as the systems approaches in the Patient Safety Incident Response Framework.”
The findings of the HSSIB report echo those from an MDU report in March which highlighted that nearly 90% of respondents said that they feel sleep-deprived at work and another, earlier this month from the Medical Protection Society (MPS). It reported that three in five (60%) doctors said they have continued to work when not feeling mentally well enough because they feel guilty adding to colleagues’ workloads, and half (50%) cited staff shortages.
Rob Hendry, chief member officer at MPS said that the HSSIB report summed up the “day-to-day reality for most NHS workers”.
It also welcomed the call for a review better to understand the risks and inform a strategy to tackle the issue.
“In the meantime, NHS employers must consider how they can encourage and better facilitate staff to take breaks, hydrate, and rest before shifts so they can continue to care for patients safely,” he said.
NEW FIGURES from the Association of Ambulance Chief Executives (AACE) show that UK ambulance services have the highest rate of reported incidents of violence, aggression and abuse directed at their people ever recorded – with 22,536 incidents across the 14 UK ambulance services in the 2024-25 financial year, an increase of almost 15% on the previous year.
The data from AACE shows that the summer months were when the most incidents of violence and aggression were reported, with summer 2024 recording the highest number of incidents on record, with 6,093 reported.
Alcohol is the most prominent factor in assaults against ambulance staff, followed by drugs and people in mental health crises. Race and sexuality have also increased as exacerbating factors in these assaults.
The figures mirror those reported by Healthcare Today recently from the 2024 NHS Staff Survey which found that one in seven NHS staff had experienced physical violence from patients, their relatives or other members of the public in 2024.
The chair of AACE Jason Killens has written to the ministers responsible for ambulance services in England, Scotland, Wales and Northern Ireland seeking to explore what further national policy interventions could be developed to help combat the growing number of violent assaults against UK ambulance people.
“These figures are truly shocking and reflect a pattern of increased violence, aggression and abuse directed at hard-working ambulance people who are there to help people in their times of greatest need,” he said.
“Frontline staff as well as call handlers are affected by this horrendous abuse and this unacceptable behaviour has a
major long-term impact on the health and wellbeing of ambulance people who are simply trying to do their jobs and help save lives,” he continued.
The Royal College of Emergency Medicine backed up the calls for government intervention.
“No one, especially those whose primary role is to help and care for people, should live in fear of violence of aggression at work, but sadly this is a daily occurrence for many frontline staff working in emergency care,” said Ian Higginson, president-elect of the Royal College of Emergency Medicine.
“Any assault on a healthcare professional is one too many, and we must collectively act on this behaviour within our health system, ensuring that staff are protected, all incidents are reported, every victim is properly supported, and those responsible are held to account in a meaningful way,” he continued.
ANEW INVESTIGATION into operations carried out by a Manchester surgeon found to have harmed patients has been announced.
NHS England has said it will look back into two hospital reviews that examined the care provided by John Bradley Williamson, who worked at Salford Royal Hospital and Royal Manchester Children’s Hospital from 1991 to 2015.
The latest review comes after patients raised concerns that the previous reviews were too limited.
“While the announcement of another review is welcome, it will not on its own address the wider concerns that many patients, including our clients, continue to have. Previous reviews were too limited in scope and didn’t consider the individual views of patients and their treatment,” said Catherine Slattery, medical negligence lawyer at Irwin Mitchell, which is representing patients.
“Any new review must be as thorough and transparent as possible in order to satisfy our clients’ concerns going forward and will be a key component in ensuring public confidence in the system is maintained,” she continued.
Northern Care Alliance NHS Foundation Trust, which now runs Salford Royal, launched a review examining Williamson’s work while he was employed by the former Salford Royal NHS Foundation Trust which used to run the hospital.
The investigation which examined the cases of more than 130 patients operated on by Williamson between 2009 and 2014 found that seven people suffered “severe harm” while 13 suffered “moderate harm”.
The report found issues including substandard surgery, patients suffering long-term pain and mobility issues, while those operated on suffered higher than expected blood loss as well as a lack of informed consent from patients.
Last March 2024, Manchester University NHS Foundation Trust, published its report into Mr Williamson’s practice relating to 56 patients operated on at the children’s hospital.
In parallel, in May last year, Spire extended its recall of patients treated by Williamson at Spire Manchester Hospital. It had already carried out a comprehensive recall of patients who underwent specific spinal procedures by Williamson between 2008 and 2013.
“We are committed to reviewing the care of all patients where concerns are raised,” said Cathy Cale, Spire Healthcare’s group medical director at the time.
“As we near the completion of the review of Mr Williamson’s patients who underwent certain procedures in the last five years that he performed surgery at Spire Manchester, we have concluded we should try to review all his patients that received these procedures.
A CROYDON woman fractured her spine using a bed-turning aid that the NHS had installed after the council withdrew funding for the woman’s night-time care.
The NHS instead installed a turning system. But she only used the system for two nights before injuring her lower back, leaving her in considerable pain. A scan later diagnosed her with a fractured spine.
“While the council and NHS were deciding who should be responsible for this woman’s care package, she was left without adequate care and support and was hospitalised on multiple occasions,” said local government and social care ombudsman Amerdeep Somal.
The woman, who uses a wheelchair and is dependent on care staff to meet her needs originally received payments for care staff to help her overnight until January 2022.
The council decided, after reassessment following the scan,
that any overnight care should be paid by the NHS. But she would only receive this funding if she was in a nursing home.
In September 2023, she told the council she had serious problems with deep pressure sores that were putting her health at risk because she was not being turned overnight.
She was admitted to hospital in November 2023 and in January 2024 a professionals meeting was held which concluded the woman needed turning every three to four hours overnight. And although the council increased the funding the woman received for day-time care, it reiterated the NHS should fund overnight care.
The woman was again admitted to hospital in April 2024 and complained to the ombudsman.
The council told the ombudsman it had started funding night-time care in August 2024 and intended to claim the money back from the NHS.
“If there is any question, once an assessment has been completed, of who is responsible for funding a care package, the person in need of support should never feel the impact of this on their health and welfare. The council should have considered putting in an interim plan while discussions were ongoing with the NHS,” said Somal.
THE PRESSURE of staff shortages, the guilt of putting pressure on colleagues, and because it is just what is expected of them means that almost threequarters of doctors have said that they have continued to work despite not feeling mentally well enough to do so.
The Medical Protection Society (MPS) surveyed more than 1,000 doctors in the UK on presenteeism in the medical workforce and the factors driving it.
60% said they have continued to work when not feeling mentally well enough because they feel guilty adding to colleagues’ workloads, and half (50%) cited staff shortages.
Almost half (47%) said it is what is expected of them, and two in five (42%) said it is because their patients rely on them. Perturbingly, more than a quarter (27%) said that taking time off for mental wellbeing issues is not “acceptable” where they work.
Anonymous comments left by the doctors surveyed, also indicate that some struggle into work due to the “shame” of having to state mental wellbeing as a reason for their absence, and because they are fearful it will jeopardise career progression.
Doctors who participated said working despite not feeling mentally well enough had led to a lack of empathy with patients (63%), a loss
of concentration (63%) or practising defensive medicine (42%). Almost half (46%) suspected it may have contributed to a lower standard of care, and 12% said it may have resulted in an incorrect diagnosis.
“It’s worrying that a culture of silence and stigma remains for medics experiencing mental health challenges,” said Roman Raczka, president of the British Psychological Society. “For the sake of staff wellbeing and patient care, long-term investment in dedicated mental health support for staff is urgently needed,” he added.
1,075 MPS members participated in the survey which took place in January 2025.
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Healthwatch has found almost one in four (23%) adults have noticed inaccuracies or missing details in their medical records.
Harley-quarter-ad-60x100.indd 1 13/10/2016 11:08
Incorrect information can cause both inconveniences and represent a clinical risk to individuals. For example, the most common issue is inaccurate personal details, such as name or date of birth.
There are more serious dangers. Other errors include inaccurate records of medications, diagnoses or treatments. Over one in seven (16%) of those who reported an inaccurate record said that this related to inaccurate information about what medication they had taken.
A Health Services Safety Investigations Body (HSSIB) report in February last year reiterated that the misidentification of patients remains a persistent safety risk across the NHS and it is one that is underrecognised and under-researched.
“Despite national improvement efforts, misidentification remains a persistent safety risk,” said Nick Woodier, senior safety investigator at HSSIB at the time.
Healthwatch said that it is unclear how many of these individuals since been able to correct their records, though patient feedback indicates that correcting records be a long and difficult process.
When it comes to missing information, 29% of those who noticed inaccuracies in their said that one or more diagnosed health conditions are not on medical record. The same proportion (29%) said important information from their medical history such as periods of serious ill or time spent in hospital.
Information added to the NHS from other sources, such as letters and test results, currently varies, and people may have to each service to request a their full records. This represents an issue, demonstrating the clear communication to help understand how their records
Healthwatch said the most consequence is the inconvenience of filling in the missing information for medical professionals during appointments. Over one in (26%) of those who have noticed inaccuracies say they must their patient history.
unclear individuals have their feedback records can process. who have their records diagnosed on their proportion information is missing, ill health NHS App as hospital currently have to go a copy of represents the need for help people records work. common inconvenience information during four noticed must repeat
Sometimes, inaccurate patient records may lead to poor or incorrect treatment and care.
More than one in eight (13%) of those who have noticed inaccuracies in their records said they had not received an important test or treatment that they would have if the information had been correct. A similar number of people (12%) said they had been refused treatment because of inaccurate or missing information. Concerningly, 10% said they have been given incorrect or inappropriate medication, and 9% said they have received potentially unsafe care or treatment.
The issue of incorrect or inappropriate medication is a significant one. Medication error claims have cost the NHS £54 million in compensation payouts alone in the last five years, as well as a further £35.6 million in legal costs, according to data obtained by Medical Negligence Assist (MNA).
“Though they may be rare, medication errors can have devastating and life-altering consequences for both the patient and their families,” said Sophie Cope, clinical negligence solicitor at JF Law.
“It is really important that mistakes are acknowledged and challenged quickly and effectively to prevent them from happening in the future, and it is key that those affected know that support is available to them,” she added.
Between April 2019 and March 2024, NHS Resolution – the legal arm of the health service – received a total of 1,129 claims and incidents relating to errors in the medication process. Of those, 765 claims have been settled with damages amounting to £54 million. East Kent Hospitals University NHS Trust alone has paid out £4.7 million settling ten claims between 2019-2024, the highest amount out of any identifiable Trust in England.
Healthwatch has made three recommendations to improve the issue.
First, better record keeping could be achieved by promoting relevant guidance and regulations by professional regulators, as well as better interoperability to ensure records are shared effectively.
“The government’s ambition to have a single patient record should help address this,” it said.
People’s right to amend their records needs to be clearer, along with the legal reasons why services may still have to retain a record of contested information. “It is also important to make more people aware that they can complain to the NHS or the Information Commissioner’s Office,” Healthwatch said.
Finally, there needs to be clearer guidance for patients about how to change incorrect records.
In response to the research, Kamila Hawthorne, chair of the Royal College of GPs, said that “inadvertent and unfortunate” mistakes were inevitable given the pressures that GPs are under.
“There may be many reasons for administrative errors occurring but inadequate IT infrastructure, intense workload and workforce pressures in general practice, high levels of unnecessary bureaucracy, and poor communication between different parts of the health service could all contribute to mistakes being made,” she said.
BMG Research conducted a nationally representative survey for Healthwatch of 1,800 adults between 24 and 27 March this year.
TACKLING health inequalities is essential to drive improvements in cardiovascular disease.
A report from the British Heart Foundation points to a range of factors which exacerbate the disease including higher rates of obesity and smoking, and less effective detection and management of conditions such as high blood pressure and high cholesterol. Patients from deprived areas also have less planned treatment than those in affluent areas, and also struggle to access cardiac rehabilitation.
The report mirrors the nearly 90% of doctors who responded to a Royal College of Physicians survey in late April who said that they were concerned about the impact of health inequalities on their patients. Healthcare Today also reported at the end of February on huge disparities in cancer care across the country. People living in more deprived areas are more likely to
be diagnosed late and offered less effective treatments.
“Cardiovascular disease is one of the biggest drivers of health inequalities across all our four nations, a price that people pay in both length of life, as well as quality of life,” said Charmaine Griffiths, chief executive of the British Heart Foundation.
“We must do better – we cannot accept a world in which someone’s chances of living in good health, or staying well enough to enjoy our later years, are set by factors such as where we are from, our sex, or our ethnicity.”
The report highlights the links between deprivation and risk of cardiovascular disease. It finds that in every UK nation, more deprived people are at greater risk of dying prematurely from heart disease.
Patients from deprived areas also have less planned treatment
than those in affluent areas, and also struggle to access cardiac rehabilitation.
Women also face significant barriers when it comes to receiving timely and effective care. This ranges from misdiagnosis caused by clinical bias to inadequate treatment and management of cardiovascular disease in women.
Women have also historically been poorly represented in cardiovascular research, meaning knowledge gaps drive inequalities women experience.
“The misperception that cardiovascular disease is a man’s disease has also resulted in unconscious bias during clinical decision-making and care, leaving women inadequately treated for cardiovascular conditions,” notes Julie Marsh, partner within the medical negligence team at Boyes Turner.
PATIENTS who are suicidal or who have self-harmed spent on average nearly 11 hours in A&E last year.
A report from the Royal College of Emergency Medicine finds that despite the standard of care patients received improving, the average time a person in a mental health crisis spent in A&E last year was an hour more than in 2023.
The three-year programme focuses on the level of care these patients are receiving in the A&E from the moment they arrive through the doors of the department and how their experience and quality of care can be improved.
“People in mental health crisis are among the most vulnerable patients our members and their colleagues care for. And the sad reality is that they don’t receive the support they need in our emergency departments,” said RCEM president-elect Ian Higginson. Across the UK, 146 emergency
departments collated and analysed data, capturing the experiences of almost 20,000 patients who needed urgent care due to self-harm.
Of these patients, 81.8% had a mental health triage when they arrived in the emergency departments to gauge their risk of self-harm and/or leaving the department before an assessment or treatment was complete. The outcome of this was then used to determine where the patient should be placed in the emergency departments and the level of observation they needed to keep them safe. That’s an increase of 7% compared to 2023. Meanwhile, an average of 42.8% of patients considered to be medium or high-risk received an appropriate level of observation during their stay in emergency departments – a significant improvement compared to year one’s mean of 29.1%.
Despite an 8% rise in documented cases of patients receiving compassionate care, 62% lacked evidence of getting this vital
level of support while in A&E. Recommendations from the report are that parallel assessment should be encouraged and incorporated into practice, evidence of compassionate and practical care should be captured better, and capacity assessments should be the responsibility of all involved in care and not the sole responsibility of the triage nurse.
Patients leaving before seeing an A&E clinician or adult psychiatric liaison services review should have a followup plan arranged and documented. At a Trust level, the report recommends that safeguarding and drug / alcohol concerns should be considered and addressed in all cases.
“Emergency departments are not the ideal environment for people in mental health crisis – they are busy, noisy, bright and crowded. And while clinicians will always do what they can to give people the best care possible, the causes and solutions to the problems within our department, lie outside it,” said Higginson.
WELSH health secretary Jeremy Miles has accepted the 29 recommendations made by the ministerial advisory group on NHS Performance and Productivity, which was set up in October.
The review, led by David Sloman, focused on planned care, diagnostics, cancer performance and urgent and emergency care and considered ways to improve productivity and performance, including digital and data and improving regional working.
“The message in the report is very clear: we have a significant challenge in performance and in productivity. The service is not performing at the levels that we or the public need and expect it to,” said Miles.
He talked about a “step change” in the approach needed to improve the services the public receives.
There are three immediate recommendations in the report – those to be worked on over the next three months. The first is that all health boards should develop a plan to reduce referrals to outpatients in highvolume specialities with a particular focus on unwarranted variation and ensure the adoption of new models and best practice in outpatient management.
In terms of cancer care, the report suggests that no additional cancer performance plans should be produced for the next two years, rather there should be an immediate focus on implementing a narrow
but nationally mandated set of deliverables drawn from existing policy proposals.
Finally, the Welsh government should consolidate all accountability and escalation meetings with health boards and trusts into individual monthly performance and productivity meetings, with a focus on delivery against key areas of both performance and productivity.
The government’s response to all the recommendations is positive and it broadly accepts all points raised. It called outpatient transformation an “integral aspect” of its planned care programme and is included as a “core element of the optimising planned care approach”. It said that it accepted “the principle” of the recommendation on cancer performance plans and said that the interventions described are underway by the NHS Executive. And it said that it recognised the need “to streamline and simplify existing accountability and delivery arrangements”.
A RECORD number of private diagnostic scans and tests were delivered last year as patients seek speed of service and convenience.
More than 1.1 million private tests and scans were delivered in 2024 – double-digit growth on last year according to the Independent Healthcare Providers Network (IHPN).
The key draw is fast diagnosis. IHPN’s latest report shows that the ability to offer scans and tests within 48 hours is hugely important for patients. At the same time, the ability to choose the time and location of their test or
scan, with many being able to find appointments near their workplace rather than home, is particularly attractive to people.
“Going private for vital scans and tests is becoming increasingly normalised, with speedy access to appointments and the ability to receive results often within 48 hours a key attraction for patients looking for much-needed peace of mind and value for money,” said David Hare, chief executive of the IHPN.
The results of the report bolster those published earlier this month which suggested that independent healthcare providers are anticipating
strong growth in their private pay markets in the coming year.
Almost three-quarters of providers (74%) said that they are “positive” or “very positive” about the private medical insurance (PMI) market, while almost two-thirds (62%) say that they feel “positive” or “very positive” about the self-pay market.
The optimism has been driven by the record numbers of people using private healthcare with the numbers of people currently covered by PMI, mostly via their employers, at levels not seen since before the 2008 financial crash.
GIVEN the rapid rise in robotassisted surgery, NICE has approved 11 robotic surgery systems as it evaluates their cost-effectiveness over the next three years.
The National Institute for Health and Care Excellence (NICE) has approved 11 robotic surgery systems which could transform care for thousands of NHS patients undergoing soft tissue and orthopaedic procedures.
The 11 systems can be used while further evidence is collected over the next three years demonstrating their cost-effectiveness for robot-assisted surgery, as part of the organisation’s Early Value Assessment process.
Five systems for soft tissue procedures – such as hernia repair, removal of tumours, and gallbladder removal – and six for orthopaedic surgery – such as full and partial knee replacement procedures and hip replacements – have received conditional approval. The use of robotic systems for prostatectomy, a surgical procedure to remove
the prostate gland, either fully or partially, is outside the scope of these two pieces of guidance and already established practice in the NHS.
“The data gathered over the next three years will allow us to evaluate exactly how these technologies can improve patient care and help ensure NHS resources are directed toward interventions that deliver meaningful clinical benefits and long-term value to our health service,” said Anastasia Chalkidou, programme director of NICE’s healthtech programme.
The recommendations will allow a coordinated approach to the expansion of surgical technologies so that the NHS can maximise the benefits for patients. At the same time, evidence will be collected to help NICE validate these benefits to prove the technologies’ value and inform future implementation decisions.
Some robotic systems allow surgeons to perform procedures
using mechanical arms controlled from a nearby console. Others are handheld. The surgical instruments attached to these arms can move with greater dexterity than the human hand, offering greater precision. They improve recovery times, reduce complications, and potentially increase access to these procedures.
The robot systems each cost between £500,000 and £1.5 million and are typically only found in specialist centres which perform hundreds of procedures every year.
In 2011/12, only 20% of robotic procedures were for conditions other than urological cancer. By 2023/24, this had grown to 49%, with significant expansion in colorectal surgery, which now accounts for 25% of all robotic procedures.
Orthopaedic robot-assisted surgery has seen the fastest rise, growing from approximately 300 procedures in 2018/19 to more than 4,000 last year.
SINCE 2019, NHS Trusts across the country have had to pay out almost £1 billion to patients who have lodged claims following a misdiagnosis.
Compensation is covered by insurance policies, meaning frontline care is unaffected by negligence claims.
Between 2019 and 2024, 8,067 claims regarding misdiagnoses were lodged against NHS Trusts, with 5,677 of these claims being settled, according to new figures from Medical Negligence Assist.
The highest number of claims came in 2019/20 when 1,824 claims were made against the trusts. The trusts have seen a rise in the number of claims over the past year, hitting 1,539 last year.
“Misdiagnosis is an all-embracing
clinical negligence case type and covers a wide range of clinical situations from the simple diagnosis of a fracture to potentially fatal cancer diagnoses,” said Gareth Lloyd, medical negligence solicitor for JF Law. According to NHS Resolution, diagnostic errors contribute approximately 20% of all clinical negligence claims.
The reasons for misdiagnosis naturally vary from case to case, but NHS Resolution highlights two consistent failings across England: diagnostic error (particularly early incorrect diagnoses of soft-tissue injuries) and issues with requests for imaging, including failure to complete further imaging.
A couple of years ago, the British Medical Journal (BMJ) conducted a study that found approximately 1 in 18 patients in primary and secondary care are affected by misdiagnosis. It
also found that misdiagnosed cancers, strokes, and heart attacks were among the most serious cases, often leading to life-altering consequences or death.
Over the past five years, the trusts have paid out a total of £970.7 million with the highest amount being paid in 2022/23, at £240.9 million.
Based on figures gathered from NHS Resolution, Mid and South Essex NHS Foundation Trust had the highest compensation costs at over £32 million, while University Hospitals Sussex and Northern Care Alliance NHS Trusts also had costs of over £28 million.
The most common outcome for misdiagnosis claims was unnecessary pain, which was lodged 1,005 times, with the trusts paying £45.8 million in compensation, followed by fatalities, which saw 470 claims submitted.
AVIVA’S in-house capital unit Aviva Capital Partners and mixed-use developer Socius are planning a £1 billion development to create the world’s leading centre for cancer research and treatment in London.
A planning application has been submitted to the London borough of Sutton for the development which will be delivered on a 12-acre site at the London Cancer Hub, adjacent to The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust’s Sutton site. Aviva Capital Partners and Socius intend to build a research and laboratory space in order to bring leading life sciences companies together with academic researchers and clinicians to drive innovation in cancer research.
“The London Cancer Hub has great potential to enhance our scientific partnerships with companies in the pharmaceutical and broader life-
sciences industries, in areas from the discovery and development of new cancer drugs to the creation of new treatment and diagnostic technologies,” said Kristian Helin, chief executive of The Institute of Cancer Research.
The firms say that the development will support 3,000 new jobs, the majority of which will be in R&D and small-scale manufacturing related to life sciences.
The London borough of Sutton says that by the time the development is complete, it expects the London Cancer Hub to support 13,000 jobs in total and contribute £1.2 billion a year to the UK economy.
The new buildings will range from large-scale facilities for global pharmaceutical and life sciences companies to smaller, flexible lab and incubator spaces for start-ups, with the capacity to accommodate wet labs, good manufacturing practice
facilities, specialist equipment as well as modern office and collaborative workspaces.
Aviva Capital Partners and Socius say that the buildings will exceed mandatory sustainability and energy efficiency standards with the aim of achieving net-zero carbon in operation.
The development will also deliver new amenities to support workers including restaurants and cafes, a creche and affordable homes for approximately 220 key workers.
It will also, they say, include classroom and educational spaces to inspire the next generation to pursue a career in science and technology.
The planning application has been submitted following extensive consultation with the local community. It is expected to be determined in 2025.
The director of claims management at NHS Resolution talks about how he has managed a reduction in reduction in litigation rates over the past five years.
Written by Adrian Murdoch.
SIMON HAMMOND has been director of claims management at NHS Resolution since January 2019. Since then, he has overseen a dramatic reduction in litigation case rates to last year’s record low of 19%. Here, he talks to Healthcare Today about his approach and how he has fostered a culture of collaboration with Trusts, claimant solicitors and the broader healthcare ecosystem.
How do you work with NHS Trusts to analyse and learn from claims? How does it work on the ground?
There are multiple ways in which we work with Trusts on a day-to-day basis. In relation to analysing and learning from claims, we have a dedicated Safety and Learning Directorate, which operates regionally to review each Trust’s claims portfolio. This involves examining the claims encountered by the Trust at a local level, supporting them in analysing these claims and collaborating with them to develop learning and quality improvement plans based on the findings.
Increasingly, we use the SEIPS (Systems Engineering Initiative for Patient Safety) framework, which aligns with patient safety science. This methodology helps identify underlying factors contributing to harm, thereby supporting targeted safety improvement initiatives.
Where does the responsibility lie in tracking what’s been done?
The way we engage with Trusts varies. It’s important to recognise that our role is primarily informative – we are not a regulatory body overseeing healthcare. Instead, we leverage tools such as our interactions with the legal team, governance frameworks and scorecards to provide insights. We do not have the full picture, as we only handle claims, whereas Trusts themselves manage a broader spectrum of incidents, complaints and concerns.
Another critical factor is the time lag inherent in claims. There is often a significant delay – sometimes years –between an incident occurring and a claim being brought to our attention. By the time we analyse a claim, frontline Trusts may have already identified the issue and taken corrective action. This delay must be factored into our approach. Nevertheless, we have seen effective collaboration
across the system. For instance, we work with the GIRFT (Getting It Right First Time) team to produce annual litigation packs, enabling Trusts to benchmark their data against the national picture. Together with GIRFT, we co-designed the Five Point Plan, which assists Trusts in reviewing their performance. Through these initiatives, we can influence improvement efforts and provide additional insights from our perspective – complementing the local data Trusts already hold – to inform their improvement strategies.
One distinct initiative is the Maternity Incentive Scheme, which operates differently from standard claims analysis. Here, we bring together system partners through a collaborative group to establish safety plan actions. Trusts must self-certify annually, confirming they have implemented the required ten safety actions to comply with the scheme.
How do you balance claims and confidentiality?
It’s important to recognise that as we act on behalf of NHS Trusts, the claims data we hold ultimately belongs to them. This means discussions with Trust legal teams about claims are open exchanges, as these matters directly involve their clinicians and services. We handle all data within strict legal frameworks, but our approach differs depending on the context. At a Trust level, conversations about specific claims remain transparent because Trusts have full access to their own claims information for learning and improvement purposes.
When sharing insights across the wider NHS system, we carefully anonymise and aggregate data to produce thematic analyses. This approach allows us to identify valuable patterns and trends while maintaining patient confidentiality and protecting identifiable details about individual cases.
You have emphasised a collaborative approach to negotiation. Is this approach working?
We have seen a notable reduction in litigation rates over the past five years culminating in last year’s record low of just 19% of cases requiring litigation. It is worth remembering that a proportion of cases will always need to proceed through the courts, either because they require judicial approval or because they fall under specific legal mandates. Nevertheless, these results represent considerable progress.
Claimant solicitors play their part by ensuring proper representation for their clients and safeguarding access to justice, while we act on behalf of the NHS with an awareness of the human impact on both sides – the patient who has experienced harm and the clinicians or healthcare workers facing claims. Our approach has been to minimise unnecessary stress and complexity in what is inherently a difficult process for everyone concerned. The benefits of this collaborative model are clear. Beyond the financial advantages, reducing reliance on formal litigation creates a more efficient system for all parties, proving that fair resolutions can be achieved without defaulting to adversarial proceedings.
In many ways, you’re a legal canary down the mine. Are you seeing any particular flashpoints at the moment with an upswing in claims?
Not at the moment. There is a relatively stable pattern in claims
across specialities. Maternity claims understandably remain a key focus area, given the tragic consequences for families and the significant financial implications –particularly where lifelong care is required for children affected by birth complications. It would be inaccurate, however, to characterise maternity as a flashpoint.
The data does not show exponential growth in maternity claims compared to other specialities.
You have a number of programmes like NHS Resolution’s Early Notification and Learning from Deaths scheme. Are they working? Are you bringing down costs?
We fully recognise that every claimant approaching us is someone who has suffered harm. While
Our approach has minimise unnecessary complexity in what a difficult process concerned.
organisations, and specialist groups like our Maternity Voices Partnership. This forum intentionally brings together charities, patient representatives and sector bodies, creating a platform for diverse perspectives. While consensus isn’t always unanimous, these discussions ensure all voices are heard. Within our Safety and Learning Directorate, we’re particularly mindful of our position in the wider healthcare landscape. While we possess comprehensive claims data, we acknowledge it represents only part of the picture. Other organisations hold complementary insights into specific specialities or health inequalities. The ultimate goal is singular, evidence-based guidance that clinicians can implement confidently, secure in the knowledge it represents unified sector wisdom. Through this consolidated approach, we aim to support measurable improvements in clinical practice and, ultimately, reduce patient harm - an objective shared across the entire NHS
has been to unnecessary stress and what is inherently process for everyone
not all cases meet the threshold for negligence, we treat each one with equal seriousness. For claims we determine to be nonmeritorious, we work closely with the claimant’s solicitors to provide clear explanations of our decisionmaking process. This approach of transparency and dialogue has been instrumental in reducing litigation rates to sustainable levels. Importantly, it also helps contain costs – non-litigated matters invariably incur lower expenses than those proceeding through formal court processes.
How do you collaborate with other bodies like NHS England, the Care Quality Commission and the GMC?
Our approach is fundamentally collaborative. This extends to our work with Royal Colleges, patient
Based on your work, what is the one piece of advice would you give to NHS Trusts to reduce avoidable harm and litigation risks?
My key recommendation to Trusts would be to adopt a truly holistic approach to governance. Some Trusts exemplify this particularly well by comprehensively analysing all available data – not just formal complaints, but all patient concerns raised post-treatment, incident reports, claims data and other governance information.
The power lies in bringing these disparate elements together into a unified analytical framework. A claim might not meet the legal threshold for compensation, but it often still contains valuable insights. Patient and family concerns frequently highlight areas where clinical practice could be refined, even when no negligence has occurred.
DUE TO the number of precautions that need to be taken to protect patient health and to reduce potential risks, the healthcare sector has typically been slow to adopt new technologies and solutions, particularly compared to other industries. However, during the pandemic, the industry actively embraced innovation and saw wearable devices, digital health tools and telemedicine deliver important care, helping to alleviate the pressure on the NHS at a crucial time.
More recently, the NHS has deployed virtual wards, also known as “the hospital at home”, to monitor and care for patients remotely. An alternative to hospital care, virtual wards hold the promise of being able to improve recovery and reduce the length of a patient’s stay in hospitals. However, to get the most out of the scheme, and to ensure healthcare professionals can provide effective and convenient care, the industry should continue to look to medtech solutions that can empower patient self-management.
The
Staff are under increasing pressure to keep reducing costs, maximise their resources and increase efficiency while still meeting patient expectations. The healthcare industry experienced a surge in demand during the pandemic and remains under pressure to deliver timely and effective care. This has resulted in the NHS facing a backlog of millions of patients, with high occupancy rates and an increase in ambulance waiting times. In 2024, the NHS delivered a record 370 million GP appointments, up 4.5% compared with 2023.
A significant proportion of this demand can be attributed to the treatment of chronic conditions. In 2018, chronic and long-term conditions accounted for 50% of GP
appointments and 70% of hospital beds, and these rates could be higher now. Meanwhile, in England alone, more than 15 million people have a long-term health condition that requires ongoing treatment. This shows no signs of slowing down, with an estimated 35% of the adult population above 50 years of age projected to have at least one chronic condition by 2035.
With pressure building on the NHS to deliver timely care to patients, the rollout of virtual wards is enabling healthcare professionals to manage rising rates of chronic conditions. Currently, patients who need more urgent care are less likely to receive the treatment they need due to a lack of capacity in hospitals. By utilising virtual wards, patients who previously would have been in the hospital can now be treated at home. With the NHS’ plans of reaching net zero by 2045, virtual wards will also play a significant role in reducing home visits by nurses and the carbon emissions associated with frequent travel.
Virtual wards enable patients to be supported at home via smart connected devices that keep healthcare professionals informed about those in their care. By staying at home, patients can access consultations on their computer or phone and be treated that
Bernard Ross, chief founder of Sky Medical explains how virtual the demand for healthcare the years
way alongside necessary – but less frequent in-person visits. This improves healthcare accessibility, particularly for patients who are unable to attend in-person appointments at the hospital due to certain medical conditions or transport issues.
As the virtual wards programme expands, innovations can be adopted to improve the standard of care in the home setting. In particular, leveraging selfapplication devices can inspire patients to manage and take charge of their own care. When used correctly, patients can improve healing and recovery rates. As their condition improves, the reliance on regular checkups can become less frequent. This gives community nurses and carers more time to deliver care to more patients.
health reviews can often be more effective when delivered in person. Therefore, human intervention should continue, albeit less frequently, to ensure efficient healthcare delivery. In some cases, remote solutions may not be suitable for the patients, especially for those who may be mentally compromised, not computer literate or lack a close network of support.
Healthcare systems are constantly evolving and so is adopting new models of care and technologies to help make the lives of patients easier and the jobs of medical professionals more efficient.
Virtual wards are among the latest innovations changing the face of healthcare and hold significant promise in meeting the demand for healthcare services in the years ahead. The first generation of virtual wards saw NHS England meet its target of 10,000 beds by the end of 2023, showcasing their position as a permanent addition to the UK healthcare landscape.
chief executive and Medical Technology, virtual wards can meet healthcare services in years ahead.
In addition to self-application devices, wearables can further enhance virtual wards by remote monitoring. This allows patients to stay at home, spending more time with family and other local networks, which contributes to improved wellbeing and recovery.
Remote solutions, however, should not be a substitute for in-person healthcare delivery. For example,
This innovative approach allows clinical teams efficiently to monitor patients through automated text check-ins and diverse communication tools such as automated text check-ins, and phone and video calls. By using hospital-at-home technology, combining hospital-grade continuous monitoring devices and a command centre hub for data and resources, even more patients can be treated safely at home.
Relieving this pressure and tackling waiting lists is no simple task. Deploying virtual wards to do some of the heavy lifting is a huge step in the right direction for the industry. With continued advancements in medtech and data analytics, virtual wards will play a crucial role in shaping the future of healthcare.
AMY DAVIS is a consultant radiologist and the chief commercial officer of London-based Hexarad, a radiologist-led company providing teleradiology services and also developing AI workflow management tools to make radiology departments more efficient. Here, she talks to Healthcare Today about growing demand for radiology services, how to use AI more efficiently and bottlenecks within the NHS.
Why has the demand for private radiology services evolved so rapidly in recent years? Is it something as basic as NHS capacity challenges, or are you bringing something else to the table that wasn’t there before?
It is a bit of both. Teleradiology is a service the NHS has long relied upon, primarily due to a global workforce crisis in radiology.
There are too many scans and not enough radiologists. Meanwhile, imaging technology has advanced rapidly. I recall my days as a junior doctor when we still used digital film. Back then, you had to go to the radiology department in person to view a scan, and a single computed tomography (CT) scan could take up to 40 minutes. Now, a full-body CT scan takes just five minutes.
The consultant radiologist and chief commercial officer of Hexarad talks about how outdated IT systems and overwhelmed teams actively hinder even the best AI tools or tech initiatives.
Written by Adrian Murdoch.Written by Adrian Murdoch.
The mathematical algorithms and imaging technology have improved so dramatically that it would now be unethical not to use imaging for diagnosis and follow-up, given how much clarity it provides.
The reason teleradiology is expanding in the private sector is that healthcare systems are struggling to keep up with demand. Diagnostic scan requests have increased by at least 10% a year for more than a decade.
Yet, the path to becoming a radiologist is long: in the UK, it requires five years of dedicated radiology training after several years as a junior doctor.
One major challenge in the UK is the commitment required from consultant radiologists to train the next generation. Training capacity hasn’t expanded as needed, partly
because there aren’t enough senior radiologists to supervise trainees. This creates a vicious cycle: without enough trainers, we can’t produce enough radiologists, perpetuating the shortage.
What role does technology, such as AI and advanced imaging software, play in enhancing the efficiency and accuracy of outsourced radiology services?
We use AI for the unsexy work – the logistical heavy lifting. When people discuss AI in radiology, they usually focus on AI interpreting scans. That was the big trend a few years ago, but the market has since seen significant consolidation. While some have thrived, others have failed to deliver.
As a teleradiology provider, our primary focus has been on optimising the logistics of radiology.
Radiologists specialise in different scan types and work at varying speeds.
Managing this is a complex challenge – especially when thousands of scans arrive daily, each needing to be routed to the right specialist at the right time. Most systems rely on manual allocation, which is inherently inefficient.
To solve this, we’ve developed our own AI-driven workflow management tool. Our platform assesses incoming scans, profiles radiologists’ expertise, checks their availability and dynamically assigns cases.
Solving this requires clinical insight. Most NHS departments lack the tools to optimise workflow without burdening radiologists with administrative tasks.
Our second platform – OptiRad – is a radiology workflow and business intelligence tool designed for the NHS. It lets hospitals apply our logistics technology internally, enabling admin staff to allocate scans more effectively.
This isn’t about profit-seeking. The NHS isn’t a cash cow for us – we’re tackling problems we’ve faced firsthand. Teleradiology alleviates staffing shortages, but we also want to improve NHS efficiency so fewer scans need outsourcing.
In one pilot with a hospital, our tools helped them cut annual outsourcing costs by £150,000.
There has been much in the papers about cuts to AI tech in radiology. How much does that impact the sector really?
While many companies focus on AI that interprets scans, we’ve taken a different approach. To my knowledge, no AI tool currently has regulatory clearance as a diagnostic tool – they’re all classed as decision support. That means radiologists still
bear full responsibility for signing off reports, so the question becomes: What are you really paying for? Does the AI make reporting significantly faster or more accurate?
Some tools do add value, particularly in NHS Radiology workflows (which differ from teleradiology). But broadly, they’re far from the panacea predicted five years ago. The real disruption lies in optimising how radiologists work.
Streamlining logistics – matching scans to specialists, reducing administrative friction – can dramatically boost productivity. Ironically, while this is where the greatest gains can be made, the UK risks being left behind.
Most cutting-edge radiology
There’s no shortage within the NHS –direction they want
tech is now developed abroad, and many companies have no interest in entering the UK market. At global conferences, we’ve seen groundbreaking tools that could transform radiology, but when we’ve asked to pilot them, the response is
How do private radiology providers like Hexarad collaborate with the NHS to address diagnostic backlogs and improve patient outcomes?
of a lasting partnership and we’re now their sole teleradiology provider.
Our in-house software team lets us adapt quickly. Our integration team, for example, ended up solving an unrelated crisis for one of our customers who were struggling to integrate an AI tool. Though it wasn’t our problem, we stepped in and our head of clinical systems cracked it in a few hours.
How do you see the relationship in the years ahead. Would we have the same conversation if I came back in five years?
There’s no shortage of vision within the NHS – staff know the direction they want to take. But with recent uncertainty around NHS England’s restructuring and the sheer volume of concurrent technology upgrades, radiology teams are stuck in a cycle of firefighting.
Yet the commitment runs deep. As a former NHS clinician, I’ve seen firsthand how passionately staff believe in the service. The current shake-up could be transformative: reducing bureaucracy might finally empower teams to drive change. That’s why we founded Hexarad –we hit walls trying to solve problems from the inside. Paradoxically, as an external partner, we gained traction faster.
shortage of vision staff know the want to take.
often: “The UK isn’t on our roadmap.” That’s a worrying sign. If the UK doesn’t adapt, it may find itself sidelined in the next wave of medical innovation – not because the technology isn’t there, but because the system can’t keep up.
We pride ourselves on being an agile, problem-solving partner to the NHS. Take one of our customers: when we first met them, they were struggling with an unsupported, obsolete radiology information system (RIS) – the core platform for booking scans and managing reports. The original vendor had gone bust, leaving them stranded. While waiting for a new system, they faced a mounting backlog.
We built a custom gateway, bypassing their defunct RIS with a semi-manual workaround, and cleared their backlog. That collaboration became the foundation
But one critical bottleneck remains: the NHS’s crumbling digital infrastructure. Outdated IT systems – and overwhelmed teams – actively hinder progress. One integration took us over a year because a key IT lead, drowning in daily crises, couldn’t spare 30 minutes. Without foundational IT support, even the best AI tools or tech initiatives fail at the starting gate.
If I could make one plea to policymakers? Invest in digital backbone first. Innovation can’t thrive where basic connectivity falters. The NHS has the talent and the will – it just needs the tools.
THE ABILITY to connect systems and share data across the healthcare ecosystem isn’t just a technical requirement, it’s the foundation for delivering truly patient-centred care. This insight captures why interoperability has become the cornerstone of modern healthcare transformation yet remains one of its greatest challenges. As healthcare rapidly digitises, strategic implementation of artificial intelligence offers unprecedented opportunities to overcome barriers, revolutionising how we deliver care.
Interoperability is the ability of different systems, applications, and devices to access, exchange, and collaboratively utilise information. The lack of standardisation across healthcare systems creates significant barriers, with disparate platforms often using varying formats and protocols that complicate seamless information exchange. This fragmentation results in data silos where valuable patient information remains trapped within isolated systems.
Beyond technical challenges, interoperability faces additional obstacles. Data security concerns naturally arise when sharing sensitive patient information, regulatory compliance adds complexity, and perhaps most significantly, cultural resistance emerges from practitioners accustomed to traditional workflows. As Paul Kovalenko, chief technical officer of software development company Langate, notes: “This lack of interoperability creates significant challenges for healthcare providers, patients, and the industry at large. The inability to effectively share and exchange data can lead to delayed care, redundant testing and even medical errors.”
Alex Fairweather writes about how to facilitate interoperability and improve patient outcomes through the strategic use of AI in healthcare.
Yet the promise of true interoperability is compelling: improved patient care through complete information access, reduced medical errors, greater operational efficiency, and enhanced regulatory compliance. The question becomes not whether to pursue interoperability, but how to overcome these entrenched challenges.
Artificial intelligence offers powerful capabilities to bridge interoperability gaps that traditional approaches cannot. AI can normalise inconsistent data formats, extract meaning from unstructured information, recognise patterns from large data pools, and create connections between previously siloed systems.
Real-world implementations demonstrate AI’s transformative potential. University of Michigan Health-West pioneered AI-powered documentation using Nuance Dragon Ambient eXperience (DAX), an example of ambient intelligence and scribe technology, which automatically captures and contextualises patient encounters. This approach removes the computer as a barrier between providers and patients, enabling better engagement and relieving administrative burden. Such systems have been shown to reduce documentation. Similarly, the Mayo Clinic implemented an in-basket augmented reply technology where generative AI drafts responses to patient portal messages. In initial studies, nursing users spent approximately 30 seconds less per message when using AI-generated drafts.
Importantly, these messages were rated as more empathetic and effective at addressing patient needs, showing how AI can enhance – not replace – human capabilities.
This reflects a crucial principle in healthcare AI adoption: technology should augment human expertise. As Ken Odak Odumbe, founder and director of SPID Consulting, a firm that specialises in management consulting for development and humanitarian organisations in Africa, Europe and Latin America, writes, AI should “complement, not replace, human expertise”.
The most successful implementations view AI as an intelligent assistant that amplifies clinical judgment and streamlines workflows, allowing healthcare professionals to focus on patient relationships. Ultimately clinicians,
and all humans for that matter, possess an innate ability for creative and intuitive application of information in individual contexts, the way in which AI works cannot fully replicate this, meaning the role of AI to support and make clinicians more effective is crucial.
Successfully integrating AI to enhance interoperability requires a thoughtful, strategic approach. Organisations should begin with small-scale pilot projects that integrate AI into existing frameworks, allowing teams to identify challenges and refine approaches before broader implementation.
Leadership plays a critical role in creating a supportive environment
for innovation. Research identifies several leadership theories that facilitate innovation in healthcare, including creating a psychological climate for innovation, supporting team reflectivity, and fostering an organisational culture that embraces change. Leaders must walk the walk, encouraging experimentation while ensuring proper governance.
Stakeholder engagement from the beginning is essential. This includes involving both clinical staff and patients in the planning process. The generational divide between tech-savvy junior staff and experienced clinicians can become an asset rather than a barrier when leaders facilitate collaborative dialogue.
Additionally, strategic partnerships with technology providers can accelerate innovation. Collaboration with specialists in AI solutions provides access to cutting-edge applications and expertise that would be challenging to develop internally.
The journey toward healthcare interoperability enhanced by AI isn’t without challenges, but the potential rewards – improved patient outcomes, enhanced efficiency, and more personalised care – make it essential.
-As healthcare evolves, those who strategically implement AI to address interoperability will not just adapt to the future; they’ll help create it.
Ask yourself: how could your organisation leverage AI to break down data silos and create more seamless patient journeys? The technologies exist today to transform this vision into reality, enabling us to enhance both the experience and outcomes for our patients.
Paula Bellostas Muguerza, Kearney’s global healthcare and life sciences lead talks about the structural hurdles that face femtech innovators.
Written by Adrian Murdoch.
PAULA BELLOSTAS
MUGUERZA is Kearney’s global healthcare and life sciences lead, and leader of the firm’s [w]Health initiative – a platform that aims to move the dial on women’s health. Here she talks to Healthcare Today about the glaring gap in mid-stage/ late-stage funding for femtech, the barriers that femtech entrepreneurs face and why investors neglect the sector.
You’ve highlighted the “missing middle” in femtech funding. Why do you think growth-stage funding is so scarce despite strong early-stage interest?
I would argue that there are roughly four key considerations at play here.
Firstly, once we move beyond venture capital, the burden of proof regarding revenue potential becomes significantly heavier – and it is here that we encounter some of the most substantial structural challenges. Take endometriosis, for example. It is widely recognised as an area with immense potential, not only in terms of alleviating disease burden and improving lives but also in generating substantial revenue, given the vast, untapped market.
However, we quickly run into a fundamental problem: a glaring research gap. Endometriosis remains poorly understood, largely due to chronic underinvestment.
Currently, diagnosis is heavily reliant on invasive, costly surgical procedures and the process is notoriously slow. Compounding this issue is the inherent gender bias within healthcare systems, where women with endometriosis are often passed from one clinician to another, leading to diagnostic delays that can stretch to seven or even ten years.
From an investor’s perspective, the potential is evident – but so too are the barriers. The market size is not
remains poorly understood, largely due to chronic underinvestment.
yet fully established, the diagnostic pathway remains fraught with inefficiency, and systemic biases persist.
As a result, even if a promising treatment were developed, the lengthy and convoluted diagnostic process would hinder its commercial viability. The market potential may exist, but the path to realising it is prohibitively complex.
This same pattern repeats across other conditions, such as polycystic ovary syndrome (PCOS) and numerous others.
The systemic failures are so pervasive that, as an investor, it becomes difficult to justify deploying growth capital unless these structural
issues are streamlined and resolved. Without tangible progress, the risks simply outweigh the opportunities.
Why do you think the perception persists that femtech is more about impact than commercial viability?
This is undoubtedly one of the key issues. If we, as investors, lack a fundamental understanding of female biology, we are essentially operating in the dark.
The question then becomes: why take the risk? Why invest in a field riddled with unknowns when there are safer, more established alternatives – erectile dysfunction, diabetes, or obesity, the latter of which is currently the subject of intense commercial interest?
The same uncertainty plagues research into menopause. We know that declining progesterone and oestrogen levels affect bone density, the immune system and cardiovascular health – but we don’t fully understand why. Without substantial investment in basic research to unravel female biology, making informed investment decisions will remain incredibly difficult.
This circles back to a deeper, systemic issue: why is such research so chronically underfunded when women make up 51% of the population?
Are we, consciously or not, undervaluing women’s health compared to men’s?
Until recently, this might have been a uncomfortable but abstract question. Yet given recent events – and the broader cultural reckoning they’ve sparked – I suspect we now have our answer.
From your conversations with investors, why do they hesitate to fund femtech companies at the growth stage?
The core issue is this: the system is fractured at every level, making the path to unlocking commercial potential in women’s health anything but straightforward. We lack the necessary diagnostic tools. Biomarkers – which may differ significantly between men and women – remain poorly defined. And persistent biases linger,
both in healthcare delivery and investment committees, where underrepresentation skews decision-making.
The challenges compound at each stage. Too few women in STEM mean that when clinical trials are designed or biomarker protocols drafted, the female perspective is often an afterthought. Compounding this is the historical exclusion of women from clinical trials, a practice that only ended in 1993.
We are now playing catch-up with a decades-long data gap –a fundamental handicap. Then there’s the healthcare system itself: access is uneven, and treatment is too often marred by ingrained prejudice.
Meanwhile, the investment community still dismisses women’s health as “niche”, reductively framing it as limited to reproductive biology.
There is no quick fix. No magic wand to wave before investors that will suddenly rectify decades of neglect. Progress demands coordinated action across research, investment, medical education, technology, care pathways and policy advocacy.
Beyond the Flo app, are there other femtech companies or initiatives that you see as potential success stories or models for scaling?
Maven Clinic is a really great example and highlights an important principle. When evaluating women’s health innovations, we must look beyond isolated therapies, diagnostics or point solutions. The critical question is: how will these integrate with existing systems?
Another we should all be watching closely is UK-based Aneira Health, which is now expanding into the US market. Its approach represents a fundamental redesign of healthcare delivery, placing women at the absolute centre of the care model. This paradigm shift could finally break the vicious
cycle of misdiagnosis and delayed treatment that plagues women’s healthcare – with all the welldocumented consequences that entails. By addressing multiple potential concerns simultaneously within a coordinated framework, we can prevent the diagnostic odysseys that currently characterise so many women’s healthcare journeys.
Is the lack of investment interest consistent around the globe?
I would say, it is consistently rubbish, though there are glimmers of progress. I had genuine hope when high-income nations in the Global
North began making strides. Some of the most inspiring work is emerging from the Global South. In Kenya, we’re seeing pharmaceutical coalitions revolutionise womencentred care through integrated cervical, breast and lipid screening programmes.
My personal favourite example is Pakistan’s Sehat Kahani which addresses a uniquely local challenge through brilliant social innovation. Pakistan faces the phenomenon of “Doctor Brides”, female clinicians who graduate but leave practice after marriage. The founder created a solution that enables these “Doctor
Brides” to deliver both remote and in-person consultations flexibly.
Having already treated approximately 500,000 women, this model represents exactly the kind of context-specific innovation that gives me hope.
Partnerships is the buzzword something trumpeted by organisations like Microsoft, Salesforce, and UCB. Will they achieve anything?
There’s too much noise about initiatives before they’ve demonstrated real impact. I’d prefer
we invert this approach: stay quiet until we have tangible proof points.
This philosophy extends to our work at [w]Health. Partnerships are absolutely critical. No single entity can solve these challenges alone. That’s precisely why we launched the initiative: to foster collaboration at scale. But what ultimately matters isn’t the fanfare of announcements, but demonstrable change where it matters most – in the lives of women navigating these broken systems every day.
If I come and talk to you in five years’ time, are we going to have the same conversation again?
I sincerely hope not though the fight does often feel exhausting.
My hope rests on three fundamental changes. First, we must revolutionise our approach through data and science. This isn’t merely about diversity. It’s about rigorous research. When 80% of autoimmune disease patients are women, clinical trials must reflect that reality. Otherwise, we’re developing therapies that may fail in actual clinical practice. Let’s stop framing this as political correctness and recognise it as scientific necessity.
Second, we need systemic reforms to diagnostic pathways. No more of this endless referral cycle where women ricochet between specialists without answers. Through the pilot programmes we’re currently implementing, we’re demonstrating how revised guidelines can break this vicious circle.
Finally, we require dedicated funding streams – capital allocation that mirrors the focused investment we’ve seen in areas like antimicrobial resistance (AMR).
When these three elements converge, I believe we could see transformative change within just five years.
WORD on the street is artificial intelligence, it’s all about AI in its many guises… conversational, agentic, models, ambient, you name it... Yet one of the areas where there is largescale growth and innovation is rarely mentioned so I’m going to address that stat. Let’s talk robotics.
Some incredibly exciting developments in the healthcare industry are truly transforming patient care around the world right now. Robotics is becoming a game-changer, and it’s fascinating to see how these technologies are making a real difference in health outcomes. Let’s dive into some specific examples and explore the value robotics brings to healthcare.
Robotics is gaining traction globally, with hospitals and clinics investing in advanced robotic systems to enhance the quality of care. The market for surgical robots alone is expected to soar, reaching over £10.6 billion by 2026. This growth is a testament to the huge potential of robotics in healthcare, covering the full lifecycle of care.
Surgical robots, like the da Vinci Surgical System, are revolutionising the way surgeries are performed. This system comprises four robotic arms/robots that assist surgeons in conducting minimally invasive procedures with unparalleled precision and control. Imagine a robot helping a surgeon make tiny, precise movements that reduce recovery times and minimise complications. The da Vinci system has already been used in more than 8.5 million procedures worldwide, showcasing its impact. Interestingly, this advancement is not a new one, robotics used to support noninvasive procedures have been in action for many years already.
Robotic exoskeletons and rehabilitation robots are helping patients regain mobility and strength after injuries or surgeries. These devices provide personalised therapy, enabling patients to perform movements with robotic support, leading to faster and more effective recovery.
Rehabilitation is one of the most demanding care pathways, each patient has different needs and levels of strength where the exoskeletons excel in support, but each patient wants independence back and a good standard of living, and it is amazing to see how these solutions are aiding in the healing process. Fun fact – exoskeletons
Hema Purohit, non-executive Birmingham Women and fellow of the British writes about the growing in healthcare.
are also used widely in defence to support soldiers to carry large, heavy loads over distance to preserve the individual’s strength and energy levels.
Robotic systems are enhancing diagnostic accuracy and imaging capabilities. For example, robotic catheter navigation systems are used in cardiac procedures
non-executive director of & Children’s Hospital British Computer Society, growing adoption of robotics healthcare.
to navigate through complex vascular pathways with precision. This technology improves the success rates of procedures and reduces the risk of complications, making a significant difference in patient outcomes. Blood tests are now widely available with the use of a robot phlebotomist that has unerring accuracy levels – the development of this technology utilising enhanced imaging, improved consistency and reliability.
Service robots are being deployed in hospitals to assist with tasks like medication dispensing, patient monitoring, and even providing companionship to elderly patients.
These robots help reduce the workload on healthcare staff and improve the overall patient experience. Conversational AI along with enhanced robotics create harmony and improve wellbeing, all in all a positive impact on patient care.
The adoption of robotics in healthcare varies across regions, influenced by factors like healthcare infrastructure,
policies, and funding. High-income countries are leading the way, but there’s a growing effort to expand the use of robotics in low- and middle-income countries to bridge the healthcare gap.
The integration of robotics in healthcare is yielding significant benefits. Robotic systems enable surgeons to perform complex procedures with greater accuracy, reducing the risk of human error.
These are minimally invasive procedures. Smaller incisions lead to less pain, reduced scarring, and faster recovery times for patients.
As a result, there is improved patient safety. Robots can perform repetitive and high-precision tasks consistently, reducing the likelihood of complications.
They are also efficient. The automation of routine tasks allows healthcare professionals to focus more on patient care, improving overall efficiency.
The growing adoption of robotics in healthcare is a testament to the transformative power of technology. As these innovations continue to evolve, they hold the promise of further enhancing patient outcomes and revolutionising the healthcare landscape globally. Embracing robotics in healthcare not only improves the quality of care but also paves the way for a more efficient and patient-centric healthcare system.
In the near future, there may be an increased use of robots in adult care homes, assisted living facilities, and various stages of the health lifecycle.
Progression will continue, but let’s embrace more testing, governance and diverse design and education to maximise this tech enabler for healthcare.
IN ZGONEC-ROZEJ V PEREIRA [2025] EWCA Civ 171, the Court of Appeal reaffirmed a fundamental principle of clinical negligence law: that the doctrine of material contribution is of limited applicability, arising only where the court is unable to determine causation on a but-for basis.
Although the case arose from a psychiatric context involving suicide, the court’s reasoning has general application across all areas of clinical negligence.
The judgment also highlights the difficulties that courts face when the claimant settles out of court with some, but not all defendants before trial, leaving one party to defend their actions in isolation.
Finally, the case includes some interesting comments on contributory negligence, a defence that does not often arise in clinical negligence cases.
Mr John Richard William Day Jones was a renowned human rights barrister, previously head of Doughty Street Chambers. He unfortunately suffered from mental health issues in 2016, receiving voluntary inpatient psychiatric treatment at the Nightingale Hospital London under the care of consultant psychiatrists Dr Bakshi and Dr Pereira. Tragically, he died after stepping in front of a train at West Hampstead station.
The claim, brought by Ms Misa Zgonec-Rozej (his partner and executor of his estate), alleged negligence in risk assessment, discharge planning, and follow-up
Neil Rowe, senior in-house counsel at THEMIS Clinical Defence, considers the latest Court of Appeal ruling on causation.
care causing his suicide. She sought damages of £5 million.
Three defendants were initially named, the hospital, Dr Bakshi and Dr Pereira. The claimant settled with the hospital and Dr Bakshi just before trial, without admission of liability and for undisclosed sums, leaving Dr Pereira as the only defendant to face the claim at trial. The High Court noted that if the claim against Dr Pereira was successful it was valued at £1.75 million less the settlements reached with the hospital and Dr Bakshi.
The court found in Dr Pereira’s favour, concluding that while there had been breaches of duty, including a failure in the holiday handover to Dr Bakshi leading to delay, the claimant had not proven causation under the but-for test. In other words, even if the treatment had not been negligent, Mr Jones would still have taken his life.
The claimant appealed, inviting the Court of Appeal to apply the material contribution test on the basis that the complicated overlapping factors that led to the suicide in this (and similar cases) were the paradigm
for the application of that test. The claimant also appealed the findings on contributory negligence.
Clear rejection of the material contribution test: The court at first instance found that despite the complex web of factors which may lead to or prevent suicide, on the evidence available it was possible to determine causation on the balance of probabilities. Accordingly, the doctrine of material contribution had no role to play.
In the Court of Appeal, the claimant’s argument was entirely rejected. It was reaffirmed that the but-for principle is the primary mechanism for determining factual causation in the law of tort. Material contribution is a recognised exception to this –Bailey v MOD [2009] 1 WLR 1052 and Williams v Bermuda Hospitals Board [2016] AC 888 – but its scope is limited.
Accordingly, the claimant was required to prove that but for the negligence, the death would not have occurred. The court found the evidence too speculative to support that conclusion and upheld the trial judge’s decision. It was not necessary to enter an analysis of whether Mr Jones’s death by suicide constituted a divisible injury, or a single, indivisible outcome, where amongst cumulative causes the breach of duty more than negligibly contributed to the outcome.
Procedural difficulties from partial settlements: Because the claimant had settled with the hospital and Dr Bakshi before trial, they did not attend court to give evidence, and
there was no evidence before the court as to the merits or demerits of Dr Bakshi’s treatment of Mr Jones. It followed that a finding that Dr Pereira’s inadequate handover to Dr Bakshi caused or materially contributed to the death could not properly be made. Such a finding would necessarily rely on the Court making findings of fact as to what Dr Bakshi would have done but-for the defendant’s breach – a question which had not been tried.
At the appeal, the Court of Appeal confirmed in such circumstances a trial judge would be entitled to decline to find causation on the basis that to do so would be to speculate on issues which had not been tried.
Contributory negligence:
Contributory negligence is not often pleaded in defence to a claim of clinical negligence given that the vast majority of claimants are following treatment plans when an adverse incident occurs. However, psychiatric cases will often involve patients who have sufficient autonomy to make decisions not to follow recommended treatment and, for example, abscond and self–harm or commit suicide.
In this case, the High Court did not rule on contributory negligence as the claim had failed on causation, but the Judge made some observations. Having reviewed the evidence, including Mr Jones interacting calmly with staff earlier that day, as captured on CCTV, and making a telephone call shortly before taking his own life, it was
found that while Mr Jomes was clearly very unwell, his illness had not overruled his autonomy and a reduction of damages of 25% would have been appropriate.
Unfortunately, whilst evidence was given on the key issue of the deceased’s state of mind at the point of death, including in this case the absence of a suicide note, the Court of Appeal did not determine this point, again because the claim had failed on causation.
This judgment is not groundbreaking but has wide-reaching application across the healthcare and legal landscape:
Causation thresholds reinforced: Claimants in medical negligence cases must meet the traditional butfor standard. Courts will not lower that bar by applying the material contribution test unless it is not possible to reach a conclusion on the but for test. Claimant solicitors should be wary of indiscriminately pleading material contribution where it is inappropriate.
Broad relevance beyond psychiatry: Though the case involved suicide, its principles apply across all branches of medicine, including general practice, surgery, oncology, emergency medicine, and maternity care.
Contributory negligence affirmed: On the appropriate facts, contributory negligence remains
an available defence in clinical negligence cases.
Caution against isolated trials: Defendants, insurers, and claimant lawyers alike should be alert to the strategic and evidential risks of settling with some parties while continuing against others. Doing so may hamper the court’s ability to fairly assess causation, or reduce the prospects of success against the remaining defendant.
Zgonec-Rozej v Pereira [2025] EWCA Civ 171 is a significant reaffirmation of a key legal boundary: if the court can determine causation of injury and death on the but-for basis there is no need to consider the material contribution test. Defendant practitioners will be relieved that the Court of Appeal was not tempted to take the opportunity to allow creep of the material contribution test, given the potential ramifications.
The case also provides a useful example of when contributory negligence may arise in clinical negligence and the evidence required to prove it and underlines the strategic and evidential complexities that arise when claims are resolved against some defendants but not others and the matter proceeds to trial. For practitioners, providers, insurers, and lawyers, the judgment serves as a welcome reassertion of the relevant test of causation and a cautionary note on navigating complex medical litigation.
THE RECENT announcement of a £102 million investment to upgrade more than 1,000 GP surgeries across the UK marks a pivotal moment in the evolution of primary care. The move, championed by Health Secretary Wes Streeting, follows growing concern that many GP practices are “unfit for purpose”, with outdated facilities compromising patient care and safety. As a clinical investigator at TMLEP, I have seen first-hand how poor infrastructure can lead to clinical failings, miscommunication, and ultimately, harm. While discussions around patient safety often focus on diagnostics, communication and care pathways, we must not overlook the silent contributor to many adverse events: the physical environment in which care is delivered.
In our investigations, we frequently encounter incidents where the limitations of a practice’s infrastructure have contributed to substandard care. Small consultation rooms limit privacy and restrict proper examination. Poor ventilation and inadequate infection control measures elevate the risk of crosscontamination. Accessibility issues prevent timely care for patients with disabilities. And overcrowded waiting areas delay triage and increase the chance of missed red flags.
From a medico-legal perspective, infrastructure can be a hidden
TMLEP’s lead healthcare investigator Nina Vegad explains how poor infrastructure can lead to clinical failings, miscommunication, and ultimately, harm.
liability. Clinical negligence claims may arise not only from individual decisions but from systemic failings, such as a lack of facilities to carry out routine tests or safely store medications. A robust infrastructure is foundational to a defensible standard of care. When it is lacking, clinicians are often forced to work around risks rather than resolve them.
It is also important to consider the toll on healthcare professionals. Investigations increasingly reveal how outdated environments exacerbate staff stress and burnout. GPs and practice nurses are navigating high caseloads in
cramped, under-resourced spaces, conditions that affect decisionmaking, morale, and retention. Good governance demands that the wellbeing of healthcare staff be treated as a cornerstone of patient safety.
The new government funding, if appropriately distributed and monitored, could be transformative. Larger, modernised surgeries will not only accommodate growing patient lists but could also enable multidisciplinary working and integrated care, both crucial in a system under increasing strain. However, we must ensure that safety is not only about aesthetics or capacity but about embedding clinical risk awareness into design.
At TMLEP, we advocate for healthcare investigations that do not only look back at what went wrong but also forward, highlighting where risks remain unaddressed. As GP surgeries plan refurbishments or rebuilds, incorporating lessons from clinical investigations can ensure that physical spaces are not just bigger, but safer and more functional.
This investment is an opportunity to reimagine primary care for the better. But unless infrastructure improvements are informed by realworld failings, we risk building new walls around the same old problems.
For more information on TMLEP’s risk management and incident response services, click here.
A Bupa survey recently found that more than half of employees (57%) admit to having struggled with some form of addiction, including alcohol (15%), gambling (14%), and recreational drugs (7%). And just over a third (34%) report having used or witnessed substance use or addictive behaviours during work hours.
For those who have battled addiction, stress is reported to be a major driver, as almost half of employees surveyed (48%) say they’ve turned to addictive behaviours as a way to cope with professional stress, while 46% cite work-related pressure as a contributing factor. For two in five (40%), it’s the workplace culture itself that plays a role in fuelling these behaviours.
There is very little research on addiction among doctors, however back in 1998, a British Medical Association Working Group suggested that as many as one in 15 doctors in the UK may suffer from some form of dependence on alcohol and/or other drugs. This equates to approximately 13,000 doctors and is growing each year.
Bupa’s survey comes as Dr Alan Stout, Northern Ireland chair of the British Medical Association, spoke about how medical staff in Northern Ireland are suffering from a mental health crisis as a result of poor conditions and abuse from patients.
Dr Stout talked about how doctors are at higher risk of occupational
Work is a huge part of our lives, so it’s vital that we’re happy and healthy when we’re there. But what should we do when work is the cause of stress and mental ill health for a colleague or employee asks Dr. Robin Clark, Medical Director for Bupa Global, India and UK Insurance?
stress, addictions, infections, and exposure to violence. He also said that they’re very poor at self-help and accessing help, so problems can escalate quite quickly.
This is backed up by mental health charity Mind which found that less than half of people who struggle with mental health issues speak to their managers about it.
As colleagues and managers, it’s important that we are aware of the signs of poor mental health and addiction so we can support those who are struggling. We can use them as a way of noticing when to check in and start a conversation about how they’re coping right now.
Some early signs might be:
• Poor concentration
• Being easily distracted
• Worrying more
• Finding it hard to make decisions
• Low mood
• Feeling overwhelmed by things
• Tiredness and lack of energy
• Talking less, or a flat, slow way of speaking
• Avoiding social activities
• Talking more or talking very fast, jumping between topics and ideas
• Finding it difficult to control their emotions
• Drinking more
• Irritability and short temper
• Aggression
If someone is misusing drugs or alcohol, you may notice symptoms of this such as:
• Frequent absence from work
• Decline in performance or productivity
• Accidents or near misses
• Changes in behaviour
Employees with behavioural addictions may also have similar symptoms as those with substance addictions. They may also be restless when they’re unable to engage in the activity they’re addicted to.
At Bupa, we have resources that can help you approach the conversation. Our workplace mental health hub provides further guidance on talking about mental health problems and dealing with disclosure. Something as simple as ‘How are you?’ is a good place to begin. Let them know that the discussion is confidential, but some information sharing may be necessary.
Choose honest questions rather than avoiding the issue completely or referring to it indirectly. For example:
• “You seem a bit down lately and I’d like to take some time to check in with you.”
• “I’ve noticed that you’ve had more days off than usual recently – I just wanted to check in with you and ask whether there was anything I could do to help?”
• When discussing addiction, provide specific examples of behaviour at work that has caused concern such as unkempt dress, punctuality, or a change in attitude.
The way you listen and respond could affect how much your colleague tells you and how comfortable they feel about further disclosure...
• Ask simple, open and nonjudgmental questions – let them explain in their own words. Give
them time and be prepared for some silences.
• Don’t interrupt or impose your opinions or ideas.
• Show empathy and understanding. Don’t make assumptions about what they’re experiencing or try to guess how it will affect their work.
• Make sure they don’t feel pressured or judged if you’re discussing addiction. Avoid outwardly using the terms ‘addiction’ or ‘addict’. Instead, try saying ‘excessive use’ or ‘frequent use’ when talking about substance misuse.
As a manager, it’s important to understand any policies your organisation has relating to mental health and wellbeing, and also to understand any legal obligations on you or your organisation. Check how aware the person is of support options offered by your organisation.
Doctors in Distress provides a range of support for any healthcare worker who feels like they need it.
The Sick Doctors Trust offers support via a 24-hour helpline and it also takes calls from colleagues and members of the doctors’ families.
The mental health charity Mind offers free resources to support staff mental health. You can also find organisations offering support for addiction in our Workplace Health and Wellbeing Academy resource: Supporting employees with addiction.
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Running a successful medical practice today means balancing quality care with operational efficiency. But too often, billing and revenue management get in the way, draining time, resources, and peace of mind. That’s where Medserv comes in, says Derek Kelly
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