Helen Vernon, chief executive of NHS Resolution, on learning and prevention as much as on litigation and claims
A UNIVERSAL PROPOSITION
Doctify co-founder Stephanie Eltz on giving doctors a space to shine ENTERING THE 1.5 CARE ZONE
HeliosX chief Stuart Peak on the future of care between general practice and hospital intervention
“Within our remit, we’re doing everything possible to reduce the need for litigation,” says Helen Vernon, chief executive of NHS Resolution.
“Keeping cases out of court brings multiple benefits, including financial ones. For every case that doesn’t go to litigation, we save around £100,000 in legal costs.”
In an in-depth interview and ahead of NHS Resolution’s 30th anniversary later this year, Vernon talks about how the ‘arm’s-length body of the Department of Health and Social Care’ has changed and the organisation’s role in the wider patient safety agenda.
Also in this issue, Stephanie Eltz, the co-founder of Doctify, discusses the value of patient feedback and why she wants to give doctors a space to shine; HeliosX chief executive Stuart Peak explains the “1.5 care zone” that sits between general practice and hospital intervention; and much more...
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INDIAN healthcare group Narayana Health has acquired Practice Plus Group, Britain’s fifth-largest private hospital group and fourth-largest NHS healthcare service provider, for £188.8 million in its first move into the British market.
The Reading-based group, which was founded in 1997, has seven hospitals, three surgical centres, two urgent treatment centres, three musculoskeletal/diagnostic centres and one ophthalmology centre with 330-bed capacity. It has around 1,300 doctors and clinical staff.
Practice Plus Group has been expanding rapidly. Growing at 12% a year, it posted revenues of £229 million last year and has an expected turnover this year of £250 million. Profits have shown similar growth. Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization) have jumped from £13 million in 2023 to £16 million last year. It is expected to rise to £20 million this year.
“The acquisition of Practice Plus Group hospitals and surgical centres is an incredibly exciting step for Narayana Health,” said Devi Prasad Shetty, founder and chairman of Narayana Health.
A company presentation seen by Healthcare Today makes clear that the two significant rationales behind the deal were a market shift towards day care procedures and the increasing use of private pay.
Practice Plus Group was acquired from private asset growth investor Bridgepoint, which had itself acquired the group in 2010 as part of the Care UK healthcare division.
The acquisition price was made up of 60,001 equity shares in Practice Plus Group Hospitals with a face value of £0.02 each. The price per share was £3,146.29.
Narayana Health was founded 25 years ago in Bengaluru by cardiac surgeon Devi Prasad Shetty. It now has a network of 21 hospitals across the country with almost 4,000 doctors.
The new business will be led in the UK by Practice Group’s current deputy chief executive Ross Dowsett. Jim Easton will remain as executive chair of the remaining businesses in Practice Plus Group and take a non-executive leadership role under Narayana Health in its new UK business.
The acquisition includes Practice Plus Group’s secondary care business only, which will separate from its integrated urgent care business, including NHS 111 contact centres and out-of-hours GP services, and from its Health in Justice division, which provides healthcare throughout the justice pathway.
The transaction is expected to close this week.
AS HIGH-STREET boutiques increasingly offer medical procedures, there is growing recognition that medicine should belong to the professionals. Both the Society of Radiographers and the Harley Street Skin Clinic have called for an end to the “wild west”.
Most seriously, healthy foetuses are being misdiagnosed as dead or malformed, and pregnant women are facing lifeendangering situations because high-street baby-scan clinics are offering ultrasound scans conducted by non-specialists. While anyone calling themselves a radiographer, a dietician, an art therapist or an occupational therapist must be qualified and registered with a regulatory body, anyone with an ultrasound machine can call themselves a sonographer.
This has resulted in a proliferation of highstreet clinics offering pregnancy scans with no guarantee that the scan will be conducted by a trained sonographer who knows how to read and interpret it.
“Patients often don’t know who’s conducting their scan. Many are appalled when they
that someone with no qualifications, who has been struck off a professional register, can still perform their ultrasound said Gill Harrison, the professional for ultrasound at The Society of Radiographers (SoR).
are also dangers to both mother foetus from the high-frequency sounds emitted by an ultrasound machine. scan for too long on a very early pregnancy, or use the wrong settings, initiate thermal effects that can generate heat in foetal tissues,” said Elaine Brooks, former hospital sonographer and Midlands regional officer for the SoR. “And important that machines are regularly serviced – which in the past I’ve found some private clinics don’t do.”
SoR has called for sonographers to become a protected title, which would that only those who are properly qualified and registered with the appropriate regulatory body would be allowed to call themselves a sonographer. Existing protected titles include dietician, podiatrist, art therapist, hearing-aid dispenser, and radiographer. The society that if sonographers were a protected title, it would mean that only
someone who has completed approved postgraduate qualifications in sonography, or a practitioner who has taken an accredited undergraduate degree course in sonography, would be allowed to call themselves a sonographer. This would help expectant parents to understand who was carrying out their scan and what qualifications they had.
“When people go for a scan or any kind of diagnostic test, they assume that the person they’re going to see is qualified to do it,” said SoR president Katie Thompson. “They don’t realise that anybody can buy a machine and call themselves a sonographer.
This is not, however, an isolated treatment. Last year, the British College of Aesthetic Medicine reported that there were 3,547 cases of complications from non-medical injectors, with 60% being traced back to beauticians. On top of that, there were at least 41 cases of botulism alone.
Experts at boutique private cosmetic clinic Harley Street Skin Clinic have demanded urgent government action to put an end to the dangers of what it calls the “wild west” of cosmetic injectables.
It has urged members of the public to sign its petition
“Injectables like Botox and dermal fillers are prescription-only drugs for good reason,” the petition says.
“They can cause blindness, necrosis, sepsis, and systemic illness. When injected by a trained doctor, these risks are managed. When injected by someone with no medical training, they are catastrophic. A doctor studies anatomy for years. A beautician can take a weekend course and start injecting the public. This absurdity must end,” it continues.
The clinic points out that more than twothirds (68%) of cosmetic injections are not administered by doctors.
“We have seen a concerning rise in patients experiencing complications from unregulated and unsafe cosmetic treatments,” said Aamer Khan, lead practitioner and founder of the Harley Street Skin Clinic. “It is vital that people seek medical professionals with the right qualifications. Your safety should always come first.”
CHILDREN are facing unacceptably long waits for NHS community services that deliver care closer to home, including for paediatric services that help children with developmental problems or disabilities.
Almost a quarter of children spend more than a year on the waiting list, and one in 15 wait over two years, according to a new briefing on growing waits for community care by the Nuffield Trust.
The analysis found that the size of the community care waiting list for children has increased by 58% since data began in 2022, compared with a 23% increase for adults. More than half of children and young people on the waiting list are waiting for community paediatric services (55%) – that includes support for developmental problems and diagnosing and managing conditions like autism and ADHD – and 21% are waiting for speech and language therapy services.
“Children across the country are waiting far too long for the community care they desperately need,” said Nuffield Trust fellow and author of the briefing, Jessica Morris. “For the families affected, it can feel like life is on hold while they’re stuck waiting for support. To take just one example, many children on the list are in urgent need of life-changing speech and language therapy because of difficulties with communicating or swallowing.”
Government targets have focused on reducing long waits for hospital treatment, but the overall community care list – which stands at almost 1.2 million – has received much less attention, argues the Nuffield Trust. As part of the 10 Year Health Plan, the government has ambitions to shift more care from hospitals into communities, but the briefing shows how existing community services are already struggling to keep up with demand.
In a health system where targets tend to increase visibility of key
issues, there are limited national targets for services, with most focusing on hospitals. To begin to tackle the issues around neglected community services, the authors say that introducing a waiting time target should be considered, to draw attention to how they are coping. As the government says community services and neighbourhood health are a priority, this needs to come with a shift in resources, along with realistic workforce and service plans to drive faster access for patients and reduce variation across local areas.
“This report should be a wake-up call for the government,” said Luisa Pettigrew, senior policy fellow at The Health Foundation.
“Waiting lists for community services are a major problem, with too many people, including children, waiting far too long for vital care. If the government is serious about moving care from hospitals to the community and from sickness to prevention, then addressing long waits in community care is crucial,” she continued.
THE problems of racism within the NHS continue, with recent reports claiming that both nurses and patients are struggling.
Analysis of calls to the Royal College of Nursing (RCN) shows a surge in complaints about racism at work. The data reveals an increase of 55% in three years, with the RCN advice line receiving three calls a day from global majority nursing staff from across the country.
The number of calls is expected to exceed 1,000 this year. This follows consistent increases over the past three years, with nearly 700 cases in 2022, nearly 800 cases in 2023 and more than 900 last year. The real figures are likely much higher, with most racial abuse and discrimination going unreported.
“These racist incidents are absolutely disgusting, and it is a mark of shame that they are rising like this across health and care services,” said RCN general secretary and chief executive Nicola Ranger.
“Every single global majority nursing professional deserves to go to work
without fear of being abused, and employers have a legal duty to ensure workplaces are safe. These findings must refocus minds in the fight against racism,” she continued.
The RCN recently joined other health unions in signing a joint statement demanding an end to anti-migrant rhetoric and calling for safer communities for all. At the same time, a new report from charity Age UK draws on interviews with older black Caribbean people to understand more about what it’s like to age in our country while black.
It finds that in later life, they often continue to face significant barriers in many aspects of their lives, including accessing vital public services like the NHS and benefits, because of disadvantages that have accumulated over a lifetime and the way this intersects with institutionalised racism and ageism they encounter today.
The charity says that although the needs and experiences of older people from racially minoritised communities are under-researched, with official data often scanty or
completely absent, all the evidence that does exist tends to point in the same direction: these are people who are often faring less well than the rest of our older population, and they are over-represented among the groups who experience problems that undermine a person’s capacity to live well as they age.
Rates of poor health among black Caribbean men and women in England and Wales are equivalent to white British people ten years older and over half of people from minoritised ethnic backgrounds aged above 50 in England (53%) are experiencing one or more issues, such as loneliness, poor health, an unmet need for care and poverty compared to two fifths (42%) of white people of the same age.
“Our report shows that racism and discrimination have lifelong impacts – on health, income, housing, and wellbeing – and these inequalities don’t disappear in later life. In fact, if anything, they intensify, especially when they combine with ageism to hold people back,” said Caroline Abrahams, charity director at Age UK.
MORE than six million tests and operations for NHS patients were delivered by independent healthcare providers over the past year, cutting waiting lists by 206,000.
Independent healthcare providers delivered an average of 19,000 surgical procedures and 100,000 outpatient appointments every week this financial year. In doing so, they helped to treat more than 1.1 million people.
“I’ll do everything I can to get NHS patients treated faster, free at the point of use,” said health and social care secretary Wes Streeting.
Using spare capacity in the private sector is central to the government’s goal that 92% of patients in England should wait no longer than 18 weeks from referral to treatment.
At the start of the year, prime minister Keir Starmer struck a new agreement
with the independent sector as part of plans to end the hospital waiting list backlog.
The deal set out how independent sector capacity can be used to tackle some of the longest waits in specialist areas of treatment, such as gynaecology, where, according to government figures, there is a backlog of 260,000 women waiting more than 18 weeks for treatment.
“These latest figures demonstrate just how important the independent sector is in providing much-needed NHS treatment – delivering around 10% of all NHS elective activity, and a record amount of appointments,” said David Hare, chief executive of the Independent Healthcare Providers Network.
While NHS use of the private sector is booming, invoice volumes for insured healthcare fell for the second consecutive quarter in the third quarter of this year, according to Healthcode, the UK’s official clearing
organisation for medical invoices. It processed and validated 2.9 million invoices on behalf of private healthcare providers in which is a rise of 2% year-on-year but a quarterly fall of 1.6% on the previous quarter, itself a fall of 0.7% on the first three months of the year.
Similarly, insured healthcare activity generated £1.3 billion for the sector, which was 4.9% higher year-on-year but down slightly on the second quarter.
The fall was put into context by Healthcode’s managing director, Peter Connor, who said that it was “unrealistic” to expect another year of double-digit growth in insured healthcare.
He went on to say that this year “marked a return to a more sustainable level”, pointing to invoice volumes 3% higher than at this point last year, whereas the equivalent annual growth in 2024 was 12%.
CARE home operator HC-One has been fined £1.8 million at Inverness Sheriff Court after the death of a 96-year-old resident of Cradlehall Care Home in the city.
The resident was on a specialist diet of soft, moist and bite-sized food, and her care plan stated that she should be closely supervised when eating and drinking. On the afternoon of 11 June 2022, the unit in which she was accommodated was staffed by two agency carers who had responsibility for 12 residents.
At about 1745, the woman was served a meal of macaroni and chips while sitting up in bed. Her carer left to get a drink to accompany her meal, but was then forced to deal with immediate issues with two other residents, which required her to call for assistance from another unit.
As a result of this disruption, the resident was left on her own for up to 20 minutes. The carer raised the alarm, and other staff came to assist. A paramedic arrived shortly afterwards and pronounced her dead.
“The death of this vulnerable woman could have been prevented if a safe system of work were in place to ensure that on any occasion she ate a meal, she was subject to an appropriate level of supervision,” said Debbie Carroll, who leads on health and safety investigations for the The Crown Office and Procurator Fiscal Service (COPFS), Scotland’s public prosecution service and death investigation authority.
“HC-One’s failure left all residents at risk. This prosecution should reiterate the need for all care homes to protect their residents and remind them they will be held accountable if they fail to do so,” she added.
TECHNOLOGY secretary Liz Kendal has announced plans to look at how companies and innovators can test new AI products in real-world conditions, with some rules and regulations temporarily relaxed under strict supervision.
Known as sandboxes, individual regulations are temporarily switched off or tweaked for a limited period of time in safe, controlled testing environments. They would initially be set up for key sectors of the economy, like healthcare, professional services, transport, and the use of robotics in advanced manufacturing, to accelerate the responsible development and deployment of AI products.
It will be overseen by tech and regulatory experts and backed up by a strict licensing scheme with strong safeguards, meaning any breaches of individual agreements or the emergence of unacceptable risks, would stop testing in its tracks and open users who have breached their terms up to potential fines.
“We want to remove the needless red tape that slows progress so we can drive growth and modernise the public services people rely on every day,” said Kendall.
“This isn’t about cutting corners –it’s about fast-tracking responsible innovations that will improve lives and deliver real benefits,” she continued.
The emphasis on AI and technology is central to the government’s 10 Year Health Plan and the benefits are already being seen.
First, a pilot of Microsoft 365 Copilot across 90 NHS organisations found that AI-powered administrative support could save NHS staff on average 43 minutes per staff member per day. Results from the trial show that a full roll-out could save up to 400,000 hours of staff time per month.
“Innovations like this will help drive NHS productivity so patients can get the treatment they need sooner and there is better value for taxpayers,” said health innovation minister Zubir Ahmed.
Elsewhere, the Medicines and Healthcare products Regulatory Agency (MHRA) is leading three new government-backed projects using AI-driven approaches. In the first, scientists from the MHRA, working with PhaSER Biomedical and the University of Dundee, will use AI to look for patterns in anonymised NHS data showing how different medicines behave when used together, focusing on cardiovascular medicines. The second is a pilot of the use of AI-assisted tools to support experts in scientific advice, clinical trial assessments and licensing decisions. The third will trial the use of synthetic patient data to support clinical trials in cancer, inflammatory bowel disease and rare paediatric seizure conditions.
DOCTORS, physician associates (PAs) and anaesthesia associates (AAs) must speak up if they spot patient safety concerns, and healthcare leaders must act when issues are raised with them, the General Medical Council (GMC) has said as it launches a review of key guidance.
It is seeking views on two pieces of its guidance, Raising and acting on concerns about patient safety and Leadership and management
Both pieces of guidance play roles in setting positive workplace culture standards that prioritise patient safety. They make clear the regulator’s
expectations on when and how concerns should be raised, as well as how those in management positions should respond.
The regulator is ensuring the guidance reflects developments across the UK’s healthcare systems, and wider social changes, while remaining clear, relevant and helpful. It will be the first significant update since they were published in 2012.
Earlier this year, results from the GMC’s annual national training survey revealed that more than one in five trainee doctors were hesitant about escalating concerns about patient care, and GMC Chief Executive Charlie Massey warned, in
a speech in September, that maternity services were at risk from harmful cultures that put “cover-up over candour” and “obfuscation over honesty”.
“Whenever we update guidance, it is important we hear views from a range of respondents. Their voices and real-life experiences will be instrumental in ensuring our guidance is clear, relevant, and helpful, and reflects the needs of everyone it affects,” said GMC’s director of education and standards, Pushpinder Mangat.
The GMC’s consultation runs until 22 January. Updated versions of the guidance are expected next year.
LONDON-based diagnostic imaging services provider medneo UK has acquired Fairford Medical’s fleet of MRI and CT scanners in a move that strengthens its ability to support the NHS in addressing rish demand for diagnostic imaging services.
Financial terms have not been disclosed.
The transaction is medneo’s first acquisition since being acquired by CVC DIF, the infrastructure arm of global private markets manager CVC, in August last year.
Founded in 2018, it was acquired from medneo Group, a diagnostic-imaging operator with operations in the UK, Germany and Switzerland.
The move also represents the first stage in a programme of expansion for medneo.
medneo UK’s chief executive Ella Tracey said that the acquisition was a “significant step forward” and that this was “the first of many steps in medneo’s UK growth story”.
NEARLY three in five doctors reported they had delivered care in a temporary care environment between June and August 2025, including in corridors, gyms, offices, and even cupboards. And of those who reported providing care in a temporary environment over the summer months, 45% said they had done so daily or almost daily.
The findings from a Royal College of Physicians (RCP) snapshot member survey of 553 physicians across the UK confirm that corridor care is now a year-round issue.
“Delivering care in corridors and other temporary spaces has sadly become an everyday reality for many doctors, placing immense physical and emotional strain on staff,” said Hilary Williams, RCP clinical vice president.
“Patients deserve better. They should receive care in safe, private, and properly equipped environments.”
“Lasting change requires urgent systemic action. Strengthening social care, improving patient flow, and expanding alternatives to hospital admission within the community, such as hospital-athome programmes, are essential,” he added.
Digging into the findings, nearly all (94%) of the respondents who reported providing care in temporary environments over the summer said that patient privacy and dignity had been compromised – 84% reported that patient confidentiality was compromised, and 81% said that clinical practice was physically difficult.
The impact on doctors delivering care in these spaces is also significant. Almost three-quarters (72%) of those who reported providing care in a temporary care environment over the summer said they felt forced to provide care in these environments, while 66% said they felt this was the new norm. Concerningly, 8% said the experience had made them consider leaving their roles altogether.
“As this survey shows, not only is corridor care unsafe and undignified for patients, it is also pushing doctors out of the door when we need them most. It is hard to feel professional pride in what you do when you’re reduced to treating patients in cupboards and waiting rooms,” said BMA consultants committee co-chair Helen Neary, commenting on the results.
As Healthcare Today has repeatedly reported, this is an issue that is not getting any better.
Back in January, the Royal College of Emergency Medicine (RCEM) hit out at guidance from NHS England, which details how patients can be safely treated in corridors. Adrian Boyle, president of the independent professional association, called it the
“normalisation of the unacceptable and dangerous”.
In mid-September last year, NHS England published a guidance paper on how to treat patients in what it euphemistically calls “temporary escalation spaces”.
The cost to NHS Trusts of negligence claims from corridor care is eyewatering.
In August, we reported that over the past five years, Trusts have paid out a total of £501.3 million following negligence in an A&E setting, with the highest amount being paid in 2021/22, at £118.5 million. A drastic rise in patient waiting times has also piled pressure on A&E services, with thousands of patients having to wait up to three days, often spending much of that time in hospital corridors.
Analysis by the Royal College of Emergency Medicine (RCEM) also shows that there were more than 16,600 deaths associated with long A&E waits before admission in England last year. That’s an increase of 20% (2,725) compared to 2023.
The figures are a concern. In September, the Health Services Safety Investigations Body (HSSIB) – which carries out independent patient safety investigations in England’s NHS and independent health care settings – said that it would investigate “temporary care environments”.
This is the first time official investigators will examine the impact of corridor care. HSSIB will provide a report directly to Westminster at the end of the year.
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A 15-MINUTE blood test, which can fast-track the diagnosis of children with potentially life-threatening conditions, is being trialled by the NHS at three hospitals in England this winter.
The test can distinguish between bacterial and viral infections much more quickly than traditional tests, which means that serious diseases like sepsis or meningitis can be picked up sooner.
NHS England has funded a trial of the technology at emergency departments in Alder Hey Children’s NHS Foundation Trust, St Mary’s Hospital in London and Great North Children’s Hospital in Newcastle.
Doctors taking part say they have already seen the benefits of the test, including in a child with meningococcal meningitis who could be treated much more quickly as a result and a child with sepsis who could start antibiotics straight away.
“Quick diagnosis is crucial in ensuring patients get the most effective treatment, particularly for children who may have a potentially life-threatening illness,” said Simon Kenny, national clinical director for children and young people at NHS England.
The study looking at the MeMed BV test is being led by the University of Liverpool and Health Innovation North West Coast, with funding provided through NHS England’s Small Business Research Initiative (SBRI) Healthcare.
“Our study is investigating whether this definitive test for a bacterial or viral infection will be useful in helping doctors make faster decisions and reducing the use of unnecessary antibiotics,” said Enitan Carrol, professor of paediatric infection at the University of Liverpool, who is leading the project.
Currently, the most likely type of infection can only be confirmed by a blood test, which then needs to be analysed by a lab and which can take a few hours.
In the meantime, children may be given antibiotics or other treatment until a full diagnosis can be made, which takes time and resources, or they may initially be diagnosed with a minor illness.
NHS-licensed embedded healthcare platform Evaro has partnered with period and cycle tracker Clue to provide access to NHS-funded contraception directly through Clue’s app.
Users can transition directly from tracking their cycle in Clue to ordering contraception through Evaro’s embedded pharmacy infrastructure – accessing free NHS-funded contraception with free delivery. The collaboration offers an alternative to existing digital NHS services, which are limited to specific postcodes and is the first major cycle tracker to integrate prescription healthcare in the UK.
“Nearly half of UK women can’t access basic contraception and I believe this is a systemic failure that technology can solve,” said Thuria Wenbar, chief executive and co-founder of Evaro. “This partnership with Clue
represents what I call the banking moment for healthcare. Just as we’d never queue at a bank to transfer £20 today, women shouldn’t wait two months for contraception.”
The partnership highlights the emphasis that the government is placing on women’s health, which is central to the NHS modernisation agenda. Last week, it renewed the Women’s Health Strategy to tackle inequalities and improve access to healthcare for women across England.
“Too many women are still subject to a system that doesn’t listen to their experiences or understand their needs,” said health and social care strategy Wes Streeting.
The renewed strategy will set out how the government will take the next steps to improve women’s healthcare as part of the 10 Year Health Plan and, it says, create a system that listens to
women’s experiences and tackles the inequalities they face.
As part of the renewal, which will be published next year, the government will look to identify specific barriers in access to healthcare and set out concrete actions to remove them.
“Whether it’s being passed from one specialist to another for conditions like endometriosis or polycystic ovary syndrome (PCOS), the lack of proper pain relief during procedures, or unacceptable gynaecology waiting lists – it’s clear the system is failing women, and it shouldn’t be happening,” said Streeting.
He pointed to steps that the government had already taken to improve women’s healthcare since taking office. Gynaecology waiting lists had begun to fall, he said, and he pointed to the introduction of Jess’s Rule, which was introduced in September.
THE Medicines and Healthcare products Regulatory Agency (MHRA) has published recommendations to reform rare disease therapies to make it quicker and easier to get these therapies tested, manufactured and approved in the UK.
Central to this will be tackling the barriers that currently prevent rare disease therapies from reaching patients, like small patient numbers and difficult evidence generation, while maintaining safety.
Fewer than 5% of rare diseases currently have an approved treatment. The average diagnostic journey takes 5.6 years, and 30% of affected children die before the age of five.
At the same time, the cost of delayed diagnosis and limited treatment options is estimated at £340 million a year, with a further £4.7 billion in health-related disability costs and a £14.9 billion annual loss to the economy.
“There is still more work to be done, but I hope this paper reassures all those affected by rare disease that we are listening and are prepared to take bold action to speed the path from discovery to delivery, while maintaining strict standards of safety,” said Julian Beach, MHRA executive director of healthcare quality and access.
It is more challenging to develop a therapy for a rare disease than for a more common disease. With small, scattered patient groups and limited scientific understanding of the condition, recruiting participants and conducting clinical trials can be difficult and expensive. This also reduces the financial incentive for companies to invest.
But gene-based therapies such as CRISPR or mRNA can be tailored to target specific patient subgroups. In the case of CRISPR, a treatment may even be designed for a single individual based on their unique genetic profile, despite many others sharing the same condition.
Currently, each new rare therapy requires a separate route through regulatory approval, including an approval to get the clinical trial set up and then an approval to be marketed in the UK.
While the framework won’t be published in full until next year, the paper considers whether an early, single approval could be issued for both a clinical trial application and marketing authorisation based on compelling but limited evidence.
This approval would be granted with a strict safety monitoring plan with real-world evidence review at a set frequency.
“Advancing regulatory approaches for rare diseases is essential to ensure that patients with the greatest unmet need can access innovative treatments without unnecessary delay,” said Jacqeline Barry, chief clinical officer of innovation and technology organisation Cell and Gene Therapy Catapult.
ASTUDY by neurosurgeons from Queen Square Imaging Centre in London has developed a non-invasive imaging technique for essential tremor that enhances the precision and outcomes of MR-guided focused ultrasound (MRgFUS).
Essential tremor causes uncontrollable shaking, typically in the hands, and severely impacts an individual’s work, independence and mental wellbeing. While medication is often the first line of treatment, it fails to help many patients long-term, leading to the need for more advanced interventions.
A new technique using FAT1 imaging – an MRI approach that fuses multiple scan types – offers a new option to invasive surgeries or limited treatment options.
The study marks the first clinical use of FAT1 imaging to guide focused ultrasound treatment for essential tremor. Traditionally, clinicians have relied on generalised brain maps to estimate the location of the target area
deep within the brain – the Ventral Intermediate Nucleus (Vim) – which is extremely small and hard to visualise on standard MRI scans.
FAT1 imaging overcomes this by giving surgeons a clear, direct view of the individual patient’s Vim, enabling treatment to be far more precise.
“FAT1 imaging is a game changer,” said consultant neurosurgeon Harith Akram, who both developed the technique and led the research. “By improving the visibility of the brain structures we need to target, we can deliver this non-invasive treatment with greater accuracy, faster results and fewer side effects, making a meaningful difference to patients’ lives,” he continued.
The study showed strong results for patients. Of the 14 patients with essential tremor treated using MRgFUS guided by FAT1 imaging, tremor improved by an average of 60% at 12-month follow-up.
Procedures were faster, required less energy, and achieved accurate targeting on the first attempt in every case. And side effects were milder and shorter-lasting, with better avoidance of nearby brain regions.
Unlike traditional treatments such as Deep Brain Stimulation (DBS) or Radiofrequency Ablation (RFA), MRgFUS is completely non-invasive and incisionless.
It works by focusing sound waves to heat and destroy the tremor-causing area of the brain, all carried out under real-time MRI guidance.
With no surgery, no implants and a quicker recovery, MRgFUS is increasingly being seen as the treatment of choice for eligible patients who do not respond to medication.
THE NHS Health Research Authority, which protects and promotes the interests of patients and the public in health and social care research, has established an advisory group to help develop a set of principles for simplified arrangements for consent in low-intervention clinical trials.
The group has been set up as part of the authority’s work on amended clinical trials regulations, which come into force at the end of April next year.
Updated regulations will offer sponsors of clinical trials on existing
medicines that meet certain criteria the option to use simplified arrangements for seeking and evidencing informed consent.
It will provide guidance for those looking to use simplified arrangements and will assist research ethics committee members to evaluate the ethical considerations of using simplified arrangements.
The advisory group, which met for the first time in October, is made up of 12 members and includes HRA staff, research ethics committee members, legal experts, researchers
and sponsors, and members of the public. Collectively, the group has expertise in informed consent, ethics, and UK legislation, as well as experience in managing and taking part in clinical trials.
The advisory group will meet four times up until early next year to discuss and develop the principles, with input from the review network throughout the process.
The final set of principles is expected to be developed by spring next year, ahead of the amended regulations coming into effect.
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OFFICERS from the Medicines and Healthcare products Regulatory Agency (MHRA) say that they have dismantled a major illicit manufacturing facility, making and distributing unlicensed weight-loss jabs, during a raid on a warehouse in Northampton.
In early October, the MHRA, in partnership with the Advertising Standards Authority (ASA) and General Pharmaceutical Council (GPhC), jointly released an updated enforcement notice to reiterate the rules around the advertising of prescription-only medicines used for weight management.
This follows a joint enforcement notice, which was issued towards the end of April, making clear that adverts for named prescription-only medicines for weight management are prohibited, and in August, with a letter from Roz Gittins, the chief pharmacy officer at the GPhC, to pharmacists, which raised concerns about a number of patient safety risks.
During the search of the first illicit production facility for weight-loss medicine discovered in the UK, officers seized tens of thousands of empty weightloss pens ready to be filled, raw chemical ingredients, and more than 2,000 unlicensed retatrutide and tirzepatide pens awaiting dispatch to customers.
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“Taking out the first illicit weight-loss medicine manufacturing facility found in the UK is a landmark result for the MHRA and a major blow to the illegal trade,” said Andy Morling, head of the MHRA’s Criminal Enforcement Unit. “These products are untested, unauthorised, and potentially deadly. By taking this organised criminal network out of operation and stopping tens of thousands of potentially fatal products from entering circulation, we’ve prevented a serious risk to public health,” he continued.
Along with large amounts of sophisticated packaging and manufacturing equipment, officers recovered approximately £20,000 in cash suspected to be linked to medicines trafficking. The site, on an industrial estate on the outskirts of Northampton, is believed to have been used for the large-scale manufacture, packaging, and distribution of unlicensed weight-loss products to customers.
The Criminal Enforcement Unit is the MHRA’s in-house law enforcement function, leading the agency’s response to medicines crime.
ABREATH test for pancreatic cancer – a world first – will be trialled nationally on more than 6,000 patients with an unknown diagnosis. The charity Pancreatic Cancer UK, which is investing more than £1.1 million to fund the new trial, has called it “the most significant step toward a lifesaving breakthrough in 50 years”.
This follows a two-year clinical study, in which scientists analysed more than 700 breath samples from people with and without pancreatic cancer, as well as from those with other conditions affecting the pancreas.
George Hanna, head of the department of surgery and cancer at Imperial College London and who is leading the project, believes the initial findings are “a very promising step forward for patients affected by pancreatic cancer” and is confident the test can detect pancreatic cancer with a high degree of accuracy – even when the disease is at an early stage.
Patients will be recruited from the NHS Urgent Suspected Cancer
Pathway – under which patients should receive an appointment within two weeks of a GP referral. Around 40 trial sites are being set up at hospitals across England, Scotland and Wales, and hospital teams interested in participating are encouraged to contact the trial manager.
No screening or early detection tests for pancreatic cancer, which affects around 10,800 people in the UK a year, currently exist.
The test detects volatile organic compounds (VOCs) present in the breath. Thousands of these compounds travel around the bloodstream, are filtered out when the blood reaches the lungs, and are then breathed out. Patients with cancer produce different types of compounds, and these changes are detectable in the breath even at the early stages of disease. Isolating unique combinations of VOCs should enable doctors to quickly identify people likely to have pancreatic cancer and then triage them for urgent investigation.
GPs who suspect pancreatic cancer can request imaging tests or refer
patients to the hospital for further investigations. However, the disease’s vague symptoms are common to many much less serious conditions, meaning health professionals currently face a challenge in deciding who should be referred for further investigation and who can be monitored or reassured.
The breath test, which is designed to be accurate, non-invasive, and usable in a GP surgery or pharmacy, could have a significant impact while remaining cost-effective for the NHS by streamlining referral pathways.
Breath samples can be taken in as little as 30 seconds, and scientists believe it could be possible to provide GPs with the test results within just three days. This would enable patients most at risk to be referred quickly for scans to diagnose or rule out pancreatic cancer.
“If our findings from the initial phase of the breath test study can be validated in a population of patients with an unknown diagnosis, it has huge potential to influence clinical practice and pancreatic cancer referral pathways,” said Hanna.
NHS trusts across England have paid out more than £2.2 billion in compensation for birth injury claims over the past five years, highlighting the ongoing crisis in maternity care services nationwide.
The scandal of maternity care has been covered in depth by Healthcare Today, but new figures from Medical Negligence Assist show that between 2020 and 2025, a total of 6,413 birth injury claims were brought against NHS trusts, with 2,955 cases settled. The highest number of claims was reported in 2022/23, with 1,289 cases lodged.
Over the five-year period, compensation payments reached £2.2 billion, with the largest annual figure recorded in 2023/24, when payouts totalled £534 million. The Royal Free London NHS Foundation Trust recorded the highest compensation total of all NHS trusts, paying out £104.9 million.
Common injuries include bone fractures (particularly of the collarbone), brachial plexus injuries affecting nerves in the neck and shoulder, and brain injuries linked to oxygen deprivation, such as cerebral palsy and hypoxic-ischemic encephalopathy (HIE).
“The scale of these payouts highlights the continuing challenges within maternity care and the devastating impact that avoidable errors can have on families,” said Tomlin & Partners’ Mathilda Blundell.
“From a clinical negligence perspective, the focus must be on learning from these incidents and
improving safety standards to prevent further harm.”
“Every year, the NHS pays out millions in compensation for entirely preventable injuries suffered by mothers and babies due to negligent care. These failings often have lifelong consequences, not only for the child but for the whole family,” said Gareth Lloyd, medical negligence solicitor at JF Law. “It’s vital that lessons are learned from these tragedies, and that affected families understand their right to seek compensation for the harm caused by substandard maternity care.”
THE Royal College of Radiologists (RCR) has raised concerns that a fifth (19%) of all UK cancer doctors are forecast to retire within the next five years. But this rises to over a quarter (27%) for cancer doctors who specialise in treating breast tumours, which puts patient care at risk for one of the most common cancers.
These figures come from the college’s clinical oncology workforce census, generally regarded as the most authoritative picture of the UK cancer workforce.
A chronic shortage of cancer doctors,
combined with rising demand for care, has created a cycle of overstretch and burnout that drives more doctors to leave the NHS, the census says. Cancer doctors are now leaving the workforce at an average age of 54, down from 59 just a year ago. Seven in ten cancer centre leaders are concerned that workforce shortages are affecting patient safety.
“Our data shows that more breast cancer doctors are set to retire than any other cancer site speciality – a trend that could lead to further delays and poorer outcomes for
patients if not addressed,” said RCR president Stephen Harden.
The impact of NHS workforce levels on cancer patients was debated by MPs at the end of October.
Opening the debate, Liberal Democrat MP for Wokingham Clive Jones said: “Without investment, waiting times will lengthen, treatment delays will worsen and costs will rise. I hope it is clear to all of us that workforce shortfalls are a massive barrier to early diagnosis and effective, timely treatment across all cancers.”
HELEN VERNON has been chief executive of NHS Resolution since 2014. Ahead of the organisation’s 30th anniversary later this year, she talks with Healthcare Today about how the ‘arm’s-length body of the Department of Health and Social Care’ has changed, what her measures of success are and the cost of clinical negligence claims.
Since you became chief executive in 2014, how has NHS Resolution changed and evolved?
Around 30 years ago, we were originally established to manage claims for the NHS in a consistent way. At the time, new types of legal actions were emerging which didn’t necessarily centre on one particular organisation, and there was growing concern about precedent being set in the courts without a coordinated approach.
We were also created to risk-pool liabilities –to protect individual NHS organisations from large financial shocks that could otherwise destabilise them, both financially and operationally. The idea was that by pooling risk, organisations could continue improving safety and performance without the fear of catastrophic claims undermining their stability. This also allowed us to deliver economies of scale – in other words, better quality service and better value for the NHS overall.
Over time, we developed a deep specialism in this area. When I became chief executive, the NHS Litigation Authority (as we were then known) had two decades of experience in handling clinical negligence claims. Each time we went through an Arms-Length Body review, we tended to take on new functions and extend our remit. At that stage, we were seen as quite
The chief executive of NHS Resolution explains the organisation focuses as much on learning prevention as on litigation and claims.
Written by Adrian Murdoch.
specialist – even niche – and in some ways more aligned with the justice system than with the health service itself.
By then, we had accumulated not only 20 years of expertise, but also 20 years of data – an extraordinary resource that held huge potential, though we were still only at the beginning of understanding how best to use it. That dataset is unique internationally: we are the only health indemnifier to cover an entire national jurisdiction. In most other countries, multiple insurers operate across different states or cover only certain risks.
When I took up the role, it was the right moment for a strategic shift – a chance to set a new direction. Alongside that came the decision to change our name from the NHS Litigation Authority to NHS Resolution. The name change was both symbolic and practical: it better represented what we did and where we were heading.
Our strategic direction since then has been about moving further upstream – becoming less of a niche, back-office function and more embedded in the mainstream health system. That has meant being more outward-facing, working in partnership with organisations such as the Royal Colleges, and using our rich data – now spanning three decades – to derive insights that help improve patient safety.
We’ve also fundamentally changed are handled. While we can’t framework we operate within, our approach to resolution. a concerted effort to encourage market to adopt alternative cases – keeping them out of on more than just financial about resolving healthcare are fair, proportionate, and improve care.
How has the culture at NHS changed since you started?
The workforce has changed only in the types of people but also in how we go about work. One of the biggest shifts we’ve made has been to bring clinicians in-house, largely on secondment. They join us for a period of time, contribute their expertise, and then return to the NHS – ideally taking with them new insights into the world of claims and litigation, along with valuable leadership
changed how claims can’t alter the legal within, we can change resolution. We’ve made encourage the wider alternative ways of resolving of court and focusing compensation. It’s healthcare claims in ways that and that ultimately help
NHS Resolution started?
changed enormously – not we employ, about our shifts
development and experience of working with a unique dataset to generate safety insights.
This approach has strengthened our clinical credibility and deepened the expertise behind our products and education services. Just as importantly, it’s helped us to build stronger connections across the NHS, creating a far more integrated and collaborative network over time.
NHS Resolution has increasingly focused on learning and prevention as much as litigation and claims. How have you maintained that balance, particularly amid financial pressures and workforce strain across the NHS?
In our world, the two are inseparable. Every incident or claim we deal with represents someone who has had a poor experience within the NHS. Whether or not they’ve been negligently harmed is, of course, what we investigate – but by the time a patient approaches a lawyer and brings a compensation claim, it’s clear that their experience has already gone well beyond a complaint or a concern raised at the bedside. Where claims are settled, they often involve significant costs, because these are people who have been seriously harmed and frequently have lifelong needs. As you’ll have seen, most of our expenditure relates to the most severe and complex cases.
The two issues – safety and cost – are therefore closely linked. The more we can do to prevent such incidents from occurring in the first place, the more we can reduce both the financial pressures on the NHS and the emotional burden on staff, who should be focusing their energy on patient care rather than on investigating or supporting compensation claims. Ideally, it should create a virtuous circle: by improving safety, we prevent harm, reduce costs, and relieve pressure across the system. As the National
Audit Office recently recognised, that’s one of the most important challenges ahead.
How do you measure success now – both in terms of claims outcomes and the impact on patient safety and system learning?
That’s a really important question, and of course, it’s one that’s much bigger than us – we don’t operate in isolation. Any contribution we make to improving safety has an impact well beyond the claims that come across our desks, because those cases are just the tip of the iceberg. The real effect should be felt in better care and safer outcomes, which in turn means fewer incidents overall.
You can see that reflected in some of the broader measures published by NHS England, such as incident data, which are highly relevant
here. We’ve also done work with the Getting It Right First Time (GIRFT) programme, which produces dashboards for the NHS that include claims data provided by us. I co-authored the guidance on litigation with Tim Briggs, and those dashboards show claims data alongside a range of other NHS metrics. That allows trusts to see not only how they compare on, say, orthopaedic claims, but also how that aligns with activity levels and other indicators. For me, that’s one of the most interesting and useful ways of assessing progress. It’s not perfect, but it probably attracts more engagement and interest from the NHS frontline than almost anything else.
As we saw again recently, the cost of clinical negligence remains a major issue. What practical levers exist to bring these costs under control?
What changes would you most like to see in law or policy?
We completely agree with everything the National Audit Office (NAO) said on the subject. It’s a rigorous and excellent analysis, with exactly the right conclusions. The issue, as you’ll have seen from the report, is incredibly complex and multifaceted. There’s no single solution – no silver bullet – but the starting point has to be preventing incidents from happening in the first place. We absolutely share the NAO’s view on that. The cases we see are, as I’ve said, just the tip of the iceberg, and that doesn’t begin to reflect the lifelong consequences for the patients and families involved.
Maternity is a major area of focus for us because it represents such a significant proportion of total costs, even though it involves a relatively
small number of very severe cases. That’s why maternity is one of our strategic priorities and why we established the Maternity Incentive Scheme. It’s also why we changed the way cerebral palsy cases are handled, introducing the Early Notification Scheme. We’ve put a huge amount of energy into that work.
When it comes to broader policy solutions, those are not for us to determine – that’s a matter for the Department of Health and Social Care. They’re currently receiving expert advice on the subject from David Lock KC, but we contribute by sharing our insights and expertise to help inform that process. We also work closely with other jurisdictions that have faced similar challenges, and we exchange knowledge about what has and hasn’t worked elsewhere.
It’s a complex picture – partly about safety, partly about the legal system. Within our remit, we’re doing everything possible to reduce the need for litigation. Keeping cases out of court brings multiple benefits, including financial ones. For every case that doesn’t go to litigation, we save around £100,000 in legal costs. That in itself helps to move the dial on those frictional costs that don’t go to patients as damages.
There is growing concern around expert fees in claims. How much of an issue is this?
One of the things we do regularly is go out to tender for a specialist legal panel. We’re in the middle of a procurement process at the moment and will be issuing the invitation to tender in due course. This approach allows us to harness the collective buying power of the NHS to secure the highest quality legal services at the best possible value.
At the same time, we’re investing in our own teams to bring more work in-house and in technology. We expect the legal firms we contract with to be doing the same – investing in their people and in technology to improve efficiency. That benefits not just them, but the NHS as a whole.
Modern law firms also do far more than provide legal advice. We expect them to support NHS trusts on safety improvement, to work with local claims and inquest teams, and to contribute to wider learning – so their role extends well beyond simply offering legal opinion.
Critics say the NHS still takes too long to admit fault or settle claims. How can you accelerate resolution and transparency?
The most important thing for NHS providers is to ensure that healthcare staff involved in a patient’s care – or the organisation responsible for their management – deal with any issue as close as possible to the incident
itself. We know this matters because our research with former claimants has shown that, had something been done much earlier in the process, many would probably never have made a claim at all. For most people, their objective isn’t simply to secure financial compensation. Often, what they really want is an acknowledgement that something has gone wrong, an apology, and an explanation. Sometimes, they also want to engage directly with the clinician who was involved in their care.
Being open and transparent is central to that process. It’s a fundamentally human instinct to want an honest conversation – one that helps to preserve the bond of trust between patient and clinician wherever possible. Some of the most difficult and protracted claims we handle are those where that openness and dialogue didn’t happen early on.
How does NHS Resolution ensure that learning from incidents feeds back quickly to clinicians and boards, rather than getting lost in the process?
One of the challenges we face is the time lag between an incident and when we actually hear about a claim. It can often take quite some time before a case reaches us.
Understandably, if someone has been injured as a result of NHS care, bringing a compensation claim is not their immediate priority. It may be months or even years before they decide to seek legal advice, and then further time before the case is developed enough to be formally notified to NHS Resolution.
On average, it takes around three years before we first hear about a case. To help address that, particularly for the high-value maternity cases, we’ve introduced the Early Notification Scheme. This asks trusts to tell us about those very
serious incidents right from the start. We then seek the family’s permission to investigate whether there might be grounds for compensation. Doing this at an early stage not only means that families get answers more quickly, but it also allows us to draw learning from those cases much sooner.
Using our in-house clinicians, we can feed that learning back to the relevant organisation promptly –sometimes within months rather than years – and do so consistently across the country.
The Early Notification Scheme in maternity care was designed to encourage openness and early learning. What has it taught you about how to embed those principles across other areas of healthcare?
It certainly has potential. We’re currently evaluating the Early
Notification Scheme to understand its full impact – not only for patients, but also for the healthcare staff involved and from a financial perspective as well. We’re working with the THIS Institute to assess these benefits, and we hope to publish the findings within the next year. That evaluation will help us decide whether to extend the approach more widely.
It is, however, quite a labourintensive process. The scheme deals with a relatively small number of cases, but they involve the most serious incidents – those causing significant and often lifelong harm.
Given that we handle around 15,000 clinical claims each year, expanding the scheme would be a major undertaking. That’s not to say we won’t do it, but it’s important that we first fully understand and evaluate the results of what we’ve already put in place.
What role does NHS Resolution play today in the wider patient safety and improvement agenda alongside other organisations?
Partnership working is absolutely vital. As I mentioned earlier, most of what we achieve on the learning side is done in collaboration – we don’t operate in isolation. We never issue a recommendation without working closely across the system, engaging with the Royal Colleges, with partners such as the Health Services Safety Investigations Body and the Royal Colleges. We’re very conscious that anything we do must add value rather than place additional strain on the NHS.
At the moment, we’re supporting colleagues through the transformation processes underway across the service, while also contributing constructively to the changes that need to happen. The
new National Quality Board (NQB) is expected to play a key role in bringing the system together and ensuring each organisation plays its part.
We already do much of that convening through our own networks, but the NQB will increasingly become the central fulcrum for that collaboration as its role becomes more established.
Would there be merit in expanding the Clinical Negligence Scheme for Trusts (CNST) into Wales, Scotland and Northern Ireland, or does devolution make that impossible?
At the moment, the devolved nations have their own systems, so that would ultimately be a question for them. When the government decided to establish the scheme for general practice, for example, it followed a careful review, and we were then
asked to act as the delivery partner in developing and running it in England.
It wouldn’t be something for us to determine ourselves. That said, we work very closely with colleagues in the devolved administrations to ensure that we learn from their approaches – and that they, in turn, can learn from ours.
Under Labour’s proposed NHS shake-up, NHS Resolution is expected to remain a distinct entity, though with changes to its accountability and operational context. What do the changes actually mean?
We’re constantly evolving – I can’t think of a single year when we haven’t changed in some way, whether by expanding services, launching new schemes, or responding to new challenges.
The main uncertainty is that we’ll be operating in a different context, given the system changes now underway. But I like to think we’ve built a reputation for responding quickly when needed. For example, during the pandemic, we were able to establish new indemnity schemes almost overnight to support the new models of care being created at the time.
Looking ahead, as healthcare delivery continues to change – as set out in the 10 Year Health Plan –we’ll need to think carefully about how our indemnity schemes adapt and evolve. They can’t be static; we need to anticipate what’s coming. The same applies to the shift from analogue to digital.
There’s a great deal on the horizon. We see ourselves as an organisation that’s agile and well placed to adapt, but we also know we must keep thinking ahead. Like any organisation, we can’t predict the future – but we can make sure we’re ready to respond to whatever emerges.
THE rapid national investigation into NHS maternity and neonatal services announced in the Summer was welcome news; however, there have been concerns about how the government will urgently improve care and safety in this area of care. This isn’t an issue just impacting maternity and neonatal services, many have been worried about how the poor standards seen across the wider health service will be tackled too.
One essential part of improving care and safety in healthcare is by improving whistleblowing procedures and encouraging duty of candour. A health service that learns openly is inherently a safer one. The NHS can meaningfully promote a culture where healthcare professionals at all levels can openly and honestly speak out about concerns in patient care – it is only by doing this that lessons can be learned and standards improved.
However, that culture is lacking. The statutory duty of candour is applied inconsistently, and fewer than half of medical staff say they fully understand what it requires. Staff who raise concerns are often met with hostility rather than support. This discourages honesty and prevents the NHS from learning when things go wrong.
NHS England’s Patient Safety Incident Response Framework (PSIRF) encourages organisations to treat harm as an invitation to improve, with proportionate responses, meaningful involvement of those affected and clear oversight.
The Learn from Patient Safety Events system now serves as the national reporting and analytics hub for safety incidents, helping trusts identify recurring risks and shape improvement.
These policy tools provide a solid foundation, but frameworks alone cannot build trust. That requires openness, protection for those who speak up and a shift in mindset, so negligence is seen as a trigger for learning rather than concealment.
The statutory duty of candour is intended to make transparency the default. Yet application across trusts remains inconsistent. A national review found fewer than half of
Ellen McGreevy, senior Kemp, calls for the duty enforced and whistleblowers the health
respondents believe staff fully understand the duty, and many fear it is becoming a tick-box exercise rather than a genuine commitment to openness.
The Mid Staffordshire Public Inquiry, led by Robert Francis, stressed the need for statutory openness and warned against contractual clauses that discourage disclosures. When trusts fail to uphold candour, public confidence
solicitor at Bolt Burdon duty of candour to be whistleblowers supported across health service.
suffers and the opportunity to learn from mistakes is lost.
Speaking up is essential for patient safety. However, evidence shows that whistleblowers are often labelled as troublemakers, and organisations sometimes miss the chance to act on concerns.
The review at University Hospitals Sussex revealed a culture of fear, with staff reporting bullying,
suppression of concerns and punitive treatment for those who raised issues. The NHS Ombudsman has also warned that a cover-up culture persists, with altered care plans, missing records and retaliation against those who speak up.
When harm occurs, the instinct in some parts of the NHS can be to deny, deflect or manage reputations. This deepens the distress for patients and families and obstructs organisational learning.
Early admission, honest explanation, focused learning and timely redress reduce harm to families and lower litigation costs. Major reviews such as the Ockenden Review have shown
the devastating consequences of minimising or ignoring failures.
A true culture of learning requires honesty when things go wrong, strong protection for those who raise concerns and an attitude that treats negligence as a springboard for improvement rather than something to hide.
My firm, Bolt Burdon Kemp, recently launched its 2025/26 Manifesto for Injured People, focused on seven priorities that we believe are vital to improving the lives of those living with serious injury. Each priority sets out clear and practical policies to deliver real change, and we have launched this to ensure that injured people’s needs remain firmly on the political agenda at Number 10, in parliament and across government.
As part of our manifesto, we are calling for the NHS to enforce candour through clear policies, transparent metrics and consistent use of statutory powers; to protect whistleblowers with stronger board oversight, adequate support and independent checks; and to treat negligence as a trigger for learning through early resolution, open communication and sharing of lessons.
The NHS already has frameworks and data systems in place. While the rapid national investigation into NHS maternity and neonatal services is very much needed, what is now required is visible and consistent action, with candour enforced, whistleblowers supported, and learnings shared openly across the health service.
INEQUALITY is the quiet driver of too many poor outcomes in cardiology in England. We see it in patients who get diagnosed early, who get referred promptly, and who end up in hospital after a preventable event. As a country, we’ve made huge strides in cardiovascular care and developed innovative wearable technologies that accurately pick up on cardiac irregularities, yet the benefits remain unevenly distributed. If we’re serious about improving heart health, we need to ensure that modern methods for detecting rhythm disorders, which can lead to greater patient engagement, fewer repeat appointments and reduced waiting lists, are available to every community, not just those near well-resourced services. With more consistently accurate and timely diagnostics across England, gaps in cardiovascular outcomes can close.
Around 390 people die each day in England from heart and circulatory diseases; more than 2 million live with arrhythmias, and 1.5 million live with atrial fibrillation (AF). The pressures are rising as people live longer after surviving previously fatal illnesses, while obesity, high cholesterol, physical inactivity and alcohol consumption continue to take their toll. Add to that the uncertain longer-term effects of widespread vaping and post-viral syndromes since the pandemic, and demand on cardiology is not easing.
Crucially, this burden is not shared equally. Deaths caused by cardiovascular disease (CVD) account for one-fifth of the life expectancy gap between the most and least deprived communities in England. There are clear and consistent gaps between the most deprived and least deprived groups across cardiovascular pathways, including: prevalence of risk factors (such as high cholesterol, physical inactivity, hypertension), hospital admissions, management of healthcare, and health outcomes, especially premature mortality.
Patients in communities with less flexible work, poorer transport and fewer local services find it harder to access timely assessment. A recent study showed that those living in the most deprived areas of England are less likely to receive treatment after an aortic stenosis diagnosis, which, if left untreated, can lead to heart failure.
It’s clear that cardiovascular outcomes still map closely to socioeconomic status, geography and access to care. With these barriers, access to earlier diagnostics is still missing the mark for many and outdated equipment only reinforces the postcode lottery of care.
For decades, standard ambulatory electrocardiogram (ECG) options have been adopted across England. They are relatively cumbersome devices restricted to short monitoring
Professor Jay Wright cardiologist at Liverpool Hospital and advisor why modern heart rhythm be more accessible.
windows that were never designed for sporadic symptoms. The consequences of the continued use of these outdated models are compromised care from missed events, repeat appointments and growing waiting lists.
The knock-on effects are behavioural and systemic. Without timely, accurate answers, patients disengage and conditions escalate. Early diagnosis, by contrast,
prompts behaviour change, improves adherence and reduces re-presentations. The impact is sharpest in deprived areas, where legacy diagnostics slow care and restrict access.
Today, there are prolonged ECG patch technologies which can drastically improve patient outcomes and, therefore, regional inequalities. These small, unobtrusive patches record continuously for up to two
weeks and have a higher diagnostic yield than a portable, batterypowered 24-hour Holter. Adopted more widely, these devices have the potential to address regional inequalities. They fit around life, so people can work, exercise and shower as normal, which improves adherence. Patches can be posted to patients with clear instructions, applied at home and returned for analysis. That single operational shift removes multiple hospital trips and opens the door to people who cannot spare the time or cost of repeated visits.
Alongside better detection, these innovative patches also use leading AI technology to ease the administrative burden and free up time for clinicians, leading to quicker pathways between diagnosis and treatment. AI-supported analysis distils long-form ECG data into
structured, relevant reports for clinicians. Physiologists spend less time on manual annotation, and consultants are able to assess patients more accurately with higher-quality information to hand. This aligns closely with the 10 Year Health Plan; improving earlier diagnosis, making care more efficient and empowering patients through technology.
These devices could ultimately help to tackle long waiting lists and lead to better diagnoses. However, due to unclear frameworks and a lack of standardised guidance, prolonged ECG monitoring devices are not rolled out widely across England.
To convert proven technology into national progress, we need clear commissioning guidance for prolonged ambulatory ECG monitoring so Integrated Care Boards can plan with confidence. There needs to be evidence-based recommendations on monitoring duration and device selection for specific patient groups. There also needs to be aligned reimbursement and procurement so modern patchbased services are correctly coded and fairly tariffed. Adopting a system to repeat proven technologies from one Trust to many without starting from scratch each time would help to delay additional administration and create some national consistency.
Cardiac inequalities in England are real and measurable across prevention, access, treatment and outcomes, and they have widened in recent years, especially along lines of deprivation. In a strained national health system, technologies and innovations with proven clinical benefit must reach patients faster. With digitally-supported patient pathways, there are fewer unnecessary hospital visits, better use of specialist time and more patients diagnosed before harm occurs. The result: accessibility and equity in England improving in tandem.
WHEN orthopaedic surgeon Stephanie Eltz and Suman Saha founded Doctify in 2015, they wanted to tackle a familiar frustration: how little reliable information patients had when choosing a doctor. The idea was simple: a platform where people could read verified, meaningful reviews of clinicians, and where healthcare professionals could use that feedback to improve care. Doctify now operates in multiple countries and is part of a wider push to bring transparency and trust to healthcare through technology. Here, she talks to Healthcare Today about why she created the site and the value of feedback.
What was the gap that you and Suman saw in healthcare that convinced you that Doctify was needed?
The idea for Doctify came from a very personal experience. I had a mole that I feared might be cancerous. At the time, I was working as an orthopaedic registrar and found it surprisingly difficult to find a doctor who could see me on my one day off.
It struck me as absurd that, in a world where you can find a reliable restaurant or a taxi driver in seconds on your phone, accessing trustworthy information about healthcare professionals was so difficult. At the same time, I was surrounded by extraordinary doctors – dedicated people who work tirelessly to make the NHS function every day. I wanted
The co-founder of Doctify talks about the value of patient feedback and why she wants both to empower patients and to give doctors a space to shine.
Written by Adrian Murdoch.
to create something that helped patients find and connect with them, but also something that celebrated and supported doctors themselves.
Doctify was built on that dual purpose: to empower patients and to give doctors a space to shine. That’s how it began, nearly ten years ago.
About three years ago, we launched something new – a network that allows doctors to connect and communicate with one another. The idea was to create a global network of healthcare professionals, a bit like LinkedIn, but designed specifically for doctors.
That concept became even more meaningful to me after a deeply personal experience. My daughter was born prematurely and cared for in the neonatal intensive care unit at Chelsea and Westminster Hospital. During that time, doctors from different parts of Europe collaborated on her care – a specialist in Iceland examined her scans, communicating with colleagues in the Netherlands. They were among the leading experts in the world at interpreting scans of premature babies.
Although my daughter sadly died,
that experience showed me the power of professional connection –an unofficial, international network of doctors who support each other in the most complex cases. It reinforced my belief that we should help build those connections more deliberately, bringing together people who may never have met but who are united by the same mission to solve the same problems.
Was it hard to persuade doctors to open themselves up to patient feedback?
Doctors are already exposed to reviews. There aren’t many other professions where an individual professional has their own public Google panel, open to comments from anyone who wishes to post one.
The problem is that if you don’t actively invite feedback from every patient, and instead just wait for reviews to appear, you’re only going to hear from the extremes. You’ll get the glowing reviews from grateful patients and the very negative ones from those who are angry or dissatisfied.
Doctify gives doctors the tools to change that. By encouraging every patient to provide feedback, doctors
his reviews, you can immediately see his areas of expertise: he has 32 reviews for shoulder replacement, 71 for shoulder pain, rotator cuff injury and shoulder instability. It’s clear that this is a genuine shoulder specialist. If you have a shoulder problem, you know you’re in the hands of a true expert.
What’s also fascinating is that he has been endorsed by 34 other doctors for shoulder replacement surgery. For patients, this provides a powerful form of social proof –both the endorsements from fellow clinicians and the volume of positive feedback from patients with similar issues. That is far more meaningful than a simple overall rating.
How do you avoid bias or inequality in feedback – for example, reviews that might unfairly penalise clinicians serving more complex or disadvantaged patient groups?
What we tend to find is that negative reviews rarely relate to medical outcomes. They’re almost always about communication or the patient’s overall experience.
Complaints are seldom about the fact that patients have to wait, because healthcare is inherently complex and often involves difficult circumstances. Rather, it’s about how they are made to wait.
If staff fail to keep patients informed, or if they appear indifferent or unempathetic, then the waiting experience can feel disrespectful, and that’s what tends to upset people. In the same way, reviews of doctors are not really about the clinical outcome; they’re about whether the doctor demonstrates expertise in their field, communicates clearly and makes the patient feel cared for.
How does Doctify balance the interests of patients and healthcare providers – two groups that don’t
always see feedback in the same light? Can you be fair to clinicians and stay honest to patients?
Our approach is straightforward. In the rare cases where a review isn’t published, it’s because it breaches clear and standard terms and conditions – the same as you’d find on any healthcare review platform. That typically means the review is racist, defamatory or otherwise inappropriate.
When that happens, the decision isn’t made by us internally. It goes to an independent Clinical Governance Committee, which has no financial interest in Doctify. They review the case and make the final decision. Once they’ve reached a conclusion, one of our operations team members contacts the reviewer to explain that the committee decided not to publish the review and why. We’re also introducing a transparency report to show exactly how many reviews were not published and for what reasons. The first of these reports will be released shortly, and we’ll publish one every twelve months thereafter. The number of reviews withheld is extremely small.
The committee itself is chaired by a group of consultants and includes a lawyer. They debate every case carefully and independently. We actually welcome negative reviews – they’re part of what makes the platform authentic. Interestingly, patients tend to trust doctors more when they see a few lower-rated reviews, especially if the doctor has taken the time to respond. It feels more real and helps build confidence.
Healthcare information is obviously sensitive. What’s your approach to privacy and data ethics?
We make a conscious effort to limit the amount of data we collect and to remove any sensitive information as soon as it’s no longer required. For example, once identifying details
are no longer needed, we delete them, leaving only anonymised data such as first and last initials. Our approach is guided by the principle of data minimisation – holding only what is strictly necessary.
We also invest heavily in security, ensuring that our systems are as robust and secure as reasonably possible. But just as important as the technology itself is our commitment to keeping the amount of sensitive data we handle to an absolute minimum.
Since last year, you have been in several countries around the world. How does Doctify fit into healthcare systems where transparency and digital maturity vary so widely?
Different markets place emphasis on different aspects of what we do. For example, in Germany, doctors aren’t necessarily looking for more patients – they want fewer, but more of a particular kind. If a surgeon specialises in shoulder replacements, for instance, being able to demonstrate that expertise online helps attract patients who are specifically seeking that kind of care.
Trust, transparency and online reputation are universal concepts, but the weight they carry varies by market. The network aspect of Doctify – connecting doctors and clinics – is particularly relevant in places like the UK, the Middle East and Australia, and even Austria to some extent. Germany, on the other hand, is more challenging when it comes to building a social, networked community among doctors.
Looking ahead, we’re planning to expand further in the Middle East and continue to globalise the platform. The goal isn’t necessarily to have a major physical presence in every region, but to make it simple for doctors anywhere in the world to join the platform and connect with patients.
Trust, transparency and online reputation are universal concepts, but the weight they carry varies by market.
AS THE government works on creating an NHS that is “fit for the future”, it is putting digital technologies at the forefront of what Keir Starmer describes as radical change.
Among the initiatives outlined in the recently published 10 Year Health Plan is the establishment of a new Health Data Research Service. Its responsibilities will include making data more available for the development of treatments and products that can support “health promotion and early detection”.
As the NHS deploys next-generation clinical decision support (CDS) systems, the current conversation tends to focus on the inclusion of AI tools. However, it’s the availability of data and analytics capabilities that will be the real game changer.
As the Health Plan states, data is central to transforming healthcare for patients. While deidentified
patient data will be vital to the improvement of care, we should also be talking about the data we can extract from the digital technologies used by healthcare professionals.
The interactions between medical professionals and their CDS tools are one of the most overlooked sources of real-world data available to healthcare organisations today. So, it’s worth taking a closer look at how decision support systems used at the point of care can play a broader role in supporting the new NHS strategy.
CDS tools have been around in the NHS for a long time, supporting clinicians with the right information at the time of decision-making. But it’s clear that faster access to reliable and trusted information and analytics data will enhance their capabilities.
Improving point of care access to the latest evidence and the insights derived from the vast swathes of CDS usage data will not just impact care quality. It could help
Garry Edwards, vice president Wolters Kluwer Health, explains clinical decision support radical
to identify emerging patient needs, population health trends, and medical knowledge gaps. The tools can help to spot knowledge gaps, create more efficient systems of work and give time back to frontline staff to focus on patientfacing care.
Analysis of CDS usage data can help to identify educational needs, for example, by pinpointing frequently searched topics where clinicians still have many questions on diagnosis and treatment. Or a surge in searches for a specific condition, highlighting a potential public health concern that clinicians and population health managers need to be aware of and prepared for.
support systems can deliver change.
Identifying knowledge and education opportunities in real time through CDS analytics dashboards provides critical insights that can inform training planning and also ensure resources are strategically allocated. It can also highlight patterns of care to support benchmarking and ensure treatment standards are consistent across the country.
By extrapolating CDS search data, the NHS can access a context-rich source of information that can guide wider public health initiatives. For instance, this would enhance the ability of public health teams to spot trends in patient needs and make meaningful comparisons between populations. One of the biggest potential public health
benefits is the ability to aggregate CDS data at a regional and national level to enable early warning systems.
Usage data would help to highlight seasonal surges in communicable diseases, such as flu, and outbreaks of other infectious diseases that pose a significant risk to public health.
In the last few years, we’ve seen several serious disease outbreaks, which have included measles, mpox and E. coli, in the UK. Search data from CDS tools can highlight a spike in patients presenting relevant symptoms. This is crucial information that can provide a real-time feed for surveillance tools, such as the UK Health Security Agency’s (UKHSA) Real-time Syndromic Surveillance Team (ReSST).
Usage data from CDS tools is already being used to track disease paths outside of the UK. This information has been used to monitor outbreaks of coronaviruses, such as Covid and MERS, and more recently to track the
spread of waterborne diseases in Spain and Brazil
Outbreaks of waterborne disease are also an issue in the UK and, as climate change continues to drive unexpected weather patterns, medical professionals need to remain vigilant for new or rarely seen diseases.
Data taken from CDS tools will be vital in preparing the NHS for such eventualities. Improving access to CDS data insights could have a significant impact on population health and help to reduce the numerous challenges faced by the NHS by driving workflow efficiencies and making best use of limited NHS resources.
The ability to identify the needs of patients and medical professionals, to inform public health initiatives and enhance early warning systems will all help to create a robust health system that is fit for the future and capable of delivering Keir Starmer’s radical change.
STUART PEAK is the chief executive of digital health platform HeliosX, a digital bridge between users and prescription treatments, which cuts out the traditional hurdles of in-person appointments and pharmacy lines.
With more than three million customers a year and providing treatments for more than 30 chronic health conditions via a network of 500 UK-equivalent licensed doctors and pharmacists, he talks to Healthcare Today about how his technology is making healthcare more accessible to all.
HeliosX describes itself as a “disruptor”. Which parts of healthcare are you most intent on disrupting – pricing, access, pharmacy, care pathways?
We often debate internally what we mean when we talk about “healthcare”, because it is such a broad term. Fundamentally, we focus on modernising healthcare and making it easier for people to manage chronic conditions from home. We are not dealing with high-acuity conditions; instead, we are looking at the growing area where healthcare is becoming more consumer-led.
The pressures on the NHS mean people are actively seeking convenient ways to supplement their care or access different
The chief executive of HeliosX talks about the future of care that sits between general practice and hospital intervention.
Written by Adrian Murdoch.
pathways, and that creates a real opportunity. Many long-term or lifestyle-related issues sit at that intersection of consumer health and clinical need – such as weight management, skincare, sexual health and a wide range of common pharmacy-treatable conditions. Technology allows us not only to improve accessibility, but also to make care more affordable.
Crucially, technology also helps to improve consistency and quality. By taking consultant-led models and combining them with digital tools, a consultant can safely support many more patients than would ever be possible in a purely traditional setting.
Does telemedicine shift patient behaviour? Does better access drive earlier intervention?
People want access to trusted, highquality clinical care in a way that fits with their lives – and they want support when they need it.
What they do not want is constant reminders or pressure to track every
metric or follow rigid instructions every day.
However, when something is wrong – if they have questions, side effects or feel they are not seeing the results they hoped for – they expect nearinstant access to assistance and a real conversation with a clinician. That expectation has shaped how we have developed our model: we focus closely on customer behaviour and treat our services as consumer products, then build the appropriate healthcare wrap around them.
Will telemedicine lead to more personalised health journeys – or could algorithmic standardisation make care feel more generic?
I often talk about care being personal, rather than personalised. If you want the most personalised experience, go to the NHS. It may be inconvenient and difficult to scale, but it remains a very personal service. You see a GP who knows your history and who has a proper conversation with you – notwithstanding the current pressures on access. Where companies like ours can make
a real difference is by engaging people on a personal level, but in ways that better suit their lives. We can offer more time, more convenience and more relevant touchpoints. And because we collect numerous data points along the way, we can surface support exactly when it is likely to matter most.
I’m not convinced that hyperpersonalised pathways will resonate with consumers. What we can do is provide care that feels human and personal, delivered through more modern channels that reflect how people live today.
You’ve spoken about the “1.5 care zone” – care that sits between general practice and hospital intervention. How big is that unmet need in the UK?
If you can accurately predict the size of this market with a precise number, you’re already ahead of everyone else. What I can say with confidence is that the
opportunity is enormous. It’s no surprise that within the NHS, the shift towards digital health is only becoming more urgent and more visible.
Focusing solely on whether care takes place in hospitals or community settings
Our clinicians understand that accountability remains with them, not with an algorithm.
slightly misses the point. The real question is how care can be delivered in personal settings – enabled by digital tools and technology – because that is what best fits the way people live now.
Whether someone is treated in a hospital or a pharmacy makes relatively little difference to the individual. What matters is being able to access help in the right moment and in the right way. The real challenge lies in all those interactions that fall in between – the day-to-day management of health that doesn’t fit neatly into traditional models.
This is where digital platforms powered by AI can provide a new and valuable layer of infrastructure. They can generate insights, support early intervention and ultimately reduce pressure across the system.
What does success look like for the “1.5 care zone”? Fewer GP visits? Reduced hospital activity? Better personal health literacy?
I’d say the answer is probably all of the above, in different ways. From our perspective, the core impact we’re aiming for is improved access for patients with conditions typically managed in primary care, rather than in hospital.
If people get care earlier and don’t have to wait to see their GP, then you start to see the knock-on benefits further along the pathway – fewer outpatient referrals, and ultimately, less demand on secondary care.
At a macro level, that comes back to patients receiving the right care at the right time. If you achieve that, you should see better outcomes and, in theory, greater financial sustainability.
I am curious about accountability. If an AI-driven assessment leads to a patient being mis-triaged, who is accountable: the provider, the developer or the clinician?
We’ve spent a lot of time developing the right internal governance around AI –ensuring we’re very clear about which decisions are being made and where accountability sits. Everything operates within a robust audit framework, with ongoing measurement of accuracy and internal testing to continually validate performance.
For us, AI should never replace clinical judgement. Our clinicians understand that accountability remains with them, not with an algorithm.
The technology is not making medical decisions – it is supporting efficiency, summarising information and helping clinicians scale their work safely.
We also ensure clinicians can always access the full details behind any AI-generated insight so they can interrogate it as needed. I think we’ve achieved the right balance: improving efficiency and capacity at a time when the system is under real pressure, while keeping clear checks and safeguards so the clinician remains firmly in control – they’re making the decision, not just ticking a box.
The future that HeliosX envisions relies heavily on personal data. How do you convince patients to trust you with sensitive health information beyond the transaction?
For us, earning trust isn’t only about the quality of care we provide – it’s also about how we handle data. We are very clear with customers about what data we collect and why. Where possible, they can opt out, though there are situations where we do need certain information to deliver safe and effective care, such as accessing NHS records to ensure prescribing is appropriate and joined up.
We also work hard to explain the value of data in improving their personal health journey, what the value exchange looks like.
If someone is happy for us to use their information, we can support them in more proactive and personalised ways. If not, we will always offer alternatives, but there may be limitations on the level of support we can provide. Ultimately, our responsibility is to be transparent, give people meaningful choices, and ensure they know their rights when it comes to their own data.
The UK market is crowded and margins are tight; where does the growth come from?
In the UK, people have largely used private digital health solutions for specific issues, where the NHS doesn’t fully meet their needs, they want something more convenient, or they’re falling through the gaps. Historically, individuals have come to us to solve a single problem.
What we’re now seeing is a shift: patients are starting to use us alongside – not instead of – their GP, across multiple needs. That opens up an opportunity for us to deepen our role in supporting people with more aspects of their care, particularly chronic conditions that can be managed safely and effectively from home.
To be clear, we’re not looking to move into highly acute or complex interventions. But we do see real value in bringing together various lower-acuity services under one provider, easing pressure on the system while offering patients a more seamless experience.
As that expands, we expect to grow in two directions: continuing our private self-pay offering, and –increasingly – partnering with the NHS as it looks to digital solutions to deliver care in the community.
International expansion is another exciting avenue. The UK is now a relatively mature digital health market. There’s a huge opportunity to take lessons learned here and help build stronger, more scalable systems from the start, rather than retrofitting later.
This isn’t about rushing into 50 countries for the sake of it. It’s about choosing markets where our model can genuinely improve outcomes for patients and deliver real value for health systems, and then proving we can make that work.
ARTIFICIAL intelligence is no longer only a back-end tool for scheduling, billing, or scanning X-rays. Agentic AI is poised to change the world of healthcare more rapidly and positively than any technology before. In fact, 68% of healthcare businesses are already using agentic AI in some form. The advantage agentic systems have over all other versions of AI is that rather than waiting for human instructions, they can take initiative, reason through complex tasks, and act on their own within defined limits.
Agentic AI systems are designed to behave like a capable medical assistant. They can monitor patients, anticipate needs, coordinate care, and even draft clinical notes. The goal isn’t to replace doctors or nurses, but to free them from the constant administrative load and help them focus on maximising patient care.
The current climate is one of rising costs, workforce shortages, and ageing populations. This puts hospitals and clinics under extraordinary pressure to deliver more care with fewer people. Agentic
Chetan Dube, AI pioneer and founder and chief executive of Quant, explains how to future-proof patient care with agentic AI.
AI offers a solution by enhancing human decision-making and making healthcare systems more adaptive, efficient, and resilient. There are four areas in which agentic AI provides immediate help to future-proof patient care.
Traditional patient monitoring systems collect data points like heart rate, oxygen levels and glucose readings, but rely on humans to interpret the results. Agentic AI can continuously review vital signs, lab results, or wearable device data, and then act on what it finds. If a patient’s blood oxygen drops, for instance, the AI can alert a nurse, cross-check recent medications, and even schedule an immediate assessment.
That kind of real-time monitoring can catch problems before they
become emergencies. For patients with chronic conditions, early intervention prevents complications, shortens hospital stays and lowers costs. This is a win-win for both patients and providers.
Fragmentation in healthcare has always been an issue for both providers and patients. One patient seeking a treatment or cure could have to visit multiple specialists, then undergo lab tests, and even more follow-up visits. Each of these stops on the journey would be managed by different teams using different systems. Agentic AI can coordinate across those silos, automatically updating records, scheduling appointments, and ensuring that everyone involved has the right information at the right time.
Agentic removes the chance of a provider or patient missing a call, text, fax, email, or chat message and makes the process simple. This
results in fewer delays, fewer errors and less friction for both patients and staff.
A staggering example of how agentic AI can create more precise and effective personalised care is taking place at Memorial Sloan Kettering Cancer Center in Manhattan. Its researchers have collected and preserved detailed patient records going back over 100 years. That data, originally gathered for clinical purposes, has become a cornerstone of the centre’s modern research strategy. Every cancer case offers new insights not only into the individual patient but into the disease itself, how it mutates, spreads and responds to treatment.
The scale of this information is staggering. Every human genome contains roughly three billion base pairs, equivalent to about 30 gigabytes of raw data. To analyse just four genomes for a single research project requires about a petabyte of storage. Identifying a single mutation or understanding a particular protein behaviour demands massive computational power.
“Without the power of computing and AI, it’s just too much for individual researchers to do,” said Tsvi Gal, chief technology officer and head of enterprise technology services there.
Knowing that even the best researched care plans often need to adapt in real time, having this type of data at the ready is revolutionary. Agentic AI can analyse the current patient, and then compare their data to all of the data from the past century, and recommend personalised treatment options that can be modified based on how similar patients responded to the same therapy.
This kind of adaptive intelligence helps physicians make more informed decisions, especially in complex cases. Over time, it can turn every hospital into a “learning system,” where each new patient encounter improves care for the next.
In 2024, physicians in the US worked on average 57.8 hours a week. Of those hours, only 27.2 were direct patient care. They averaged 13 hours
on order entry, documentation, test results and referrals, and another 7.3 hours on admin tasks like prior authorisation, insurance forms and meetings. Agentic AI can potentially remove 20 hours of work from a doctor’s plate.
By cutting administrative work, hospitals can address one of the main drivers of clinician burnout while improving billing accuracy and cash flow. It’s one of the few technologies that simultaneously helps both caregivers and revenue.
Healthcare organisations that integrate agentic AI early will gain efficiency and adaptability. As valuebased care expands and margins tighten, the ability to predict, personalise, and automate care will become a core differentiator.
Hospitals that use agentic systems to coordinate care more effectively, reduce waste, and deliver better outcomes will naturally attract patients, staff, and partners. Agentic AI is the next step toward a healthcare system that is not only smarter, but also more human and gives clinicians the ability to focus the overwhelming percentage of their time on direct patient care.
THE mental health crisis in the UK is deepening. According to government data released this year, the number of people struggling with their mental health is up 20%. The Adult Psychiatric Morbidity Survey (APMS), which monitors mental illness and treatment across the population in England every seven years, has found that more than one in five adults (22.6%) are being clinically assessed as having a common mental health condition, compared to 18.9% in 2014.
For anyone working at the heart of the NHS, sadly, this will come as no surprise. The question is, how do we find novel ways to support existing efforts in mental health services that also meet the criteria of delivering cost efficiencies, protecting staff capacity and time and driving positive patient outcomes? Could greater utilisation of accredited and regulated allied health care professionals like acupuncturists be part of the solution? At the British Acupuncture Council, we certainly think so – and we have the evidence to support it.
While acupuncture has the highest quality supporting evidence of any complementary therapy and is recommended by NICE as a treatment for primary chronic pain and headaches, it isn’t commonly available as part of current NHS services.
Some GP practices, however, do offer integrated healthcare that includes acupuncture. In fact, back in 2022, the British Acupuncture Council (BAcC) was approached by a primary care network (PCN) in Inner Gloucester to partner on a groundbreaking acupuncture service, delivered as a multi-bed setting in an area of high deprivation.
This innovative and inclusive initiative had a vision to make acupuncture more accessible to NHS patients and
more cost-efficient via a referral network of GP surgeries. Since the initial set-up, traditional acupuncture and ear acupuncture have been provided by BAcC members as part of an enhanced access programme which delivers two six-week programmes for eligible patients outside of standard working hours – sessions take place in the evenings and Saturdays. The two programmes encompass auricular acupuncture clinics: a group setting for ear acupuncture to support people with depression and anxiety, which allows for conversation and mutual support. And full body acupuncture clinic: one-to-one sessions to support chronic pain.
Alex Jacobs, chief executive Acupuncture Council, explains can be incorporated into health pathways.
The acupuncturists work as part of an interdisciplinary team alongside GPs, nurses, counsellors, and social prescribers, who are all able to refer patients to the project.
Fellow BAcC member, acupuncturist Fleur Clackson, co-developer and co-deliverer of the Inner Gloucester scheme, has commented that this project is a true representation of harmonious integration with the NHS.
executive of the British explains how acupuncture into primary care mental pathways.
Results of the project are being released this November, coinciding with Acupuncture Awareness Week, which demonstrate the effectiveness of acupuncture in helping people to manage anxiety, making a positive impact on their mental health and overall quality of life.
Average GAD-7 scores (the NHS Generalised Anxiety Disorder metric) significantly improve for patients in the programme – with an average GAD score of 15.53 at course entry
(indicating severe anxiety), reducing to 8.09 (indicating mild anxiety) on completion of the course.
Anecdotally, some people have reported how they’ve been able to return to work, having previously been unable to leave the house or are now less or no longer reliant on medication or harmful substances.
The release of the outcomes from our collaboration with Inner Gloucester PCN comes as a new survey of our members suggests that there has been a significant rise in people seeking treatment with acupuncture for mental health issues, with over two-thirds (68%) of acupuncturists asked admitting that
the prevalence of patients seeking support for mental health concerns had increased over the past year.
Furthermore, a staggering 93% said they had supported a patient for mental health issues in the past six months. The biggest uplift (82%) was seen in women aged over 40, followed by young adults (67%) and men aged over 40 (50%).
The most prominent condition amongst these patients was generalised anxiety disorder, followed by depression. Over half of those acupuncturists asked (55%) said they had seen clients presenting with social anxiety, a third (30.6%) reported that clients were experiencing addiction issues, and 49% said they had seen clients with ADHD or attention deficit disorders. Encouragingly, 99.5% of the acupuncturists reported that patients had generally experienced positive results.
Despite the rise in demand for acupuncture, only 15% of professional acupuncturists surveyed said that their patients had been recommended the treatment by their GP. Asked why they thought some GPs and NHS consultants are not widely recommending acupuncture, the highest-ranking reason is a perceived lack of understanding of the benefits of this complementary therapy (58%). Additional factors given included GPs not realising that acupuncture could be available to patients on the NHS and the fact that they felt GPs are sceptical of acupuncture’s evidence base.
To help bridge this gap, a new digital resource has been developed. This new guide aims to provide the definitive evidence GPs and allied healthcare professionals need to refer patients confidently. This is about driving up standards in care for patients, with a call to doctors to broaden their understanding of acupuncture.
RECENT reporting has renewed focus on the differing standards that exist within obstetric ultrasound services across the UK.
The sector now includes a broad spectrum of providers, from fully regulated clinical environments to commercial operators offering scans for non-clinical or ‘entertainment’ purposes. As this diversity has grown, so too have questions regarding governance, transparency, and public understanding of what these services actually provide.
Obstetric ultrasound is traditionally a clinical tool designed to identify
foetal development issues, confirm gestation, and escalate medical concerns when necessary. In contrast, the rise of non-clinical or commercially driven scanning services has introduced a new category of scans where the primary purpose may be reassurance, imagery, or experience rather than diagnosis.
George Maughan, THEMIS Clinical Defence’s head of client relations, raises questions regarding governance, transparency, and public understanding around ‘high-street’ ultrasound services.
This differentiation is not always clearly communicated to expectant parents, leading to potential misunderstandings about the purpose and limitations of each type of scan.
A central issue highlighted in recent discussions is practitioner qualification. While many
sonographers operating in clinical contexts follow established professional guidelines, training requirements and oversight vary considerably among commercial providers.
This variability can affect the consistency of referrals when unexpected findings occur, raising questions about where responsibility lies and how effectively risks are managed.
Across the healthcare and insurance sectors, stakeholders point to the importance of clear role definition. Understanding who is conducting the scan, the environment in which it is delivered, and what
obligations apply if something abnormal is detected is increasingly seen as essential for maintaining transparency and trust. These considerations extend beyond clinical accuracy to how risks are interpreted, documented, and communicated.
At the same time, it is recognised that demand for accessible and affordable scanning options continues to grow. Many families value the additional reassurance or bonding experience that non-clinical scans can provide.
The challenge, therefore, lies in ensuring that such services are accurately represented, that their
scope is clearly understood, and that any limitations are disclosed in a way that supports safe and informed decision-making.
As the landscape continues to evolve, the conversation is shifting toward alignment — not the elimination of commercial scanning, but improved clarity about what each service offers, who is qualified to deliver it, and how any concerns identified during a scan should be handled.
Stakeholders across the sector acknowledge that a consistent approach would support both patient confidence and operator accountability.
IN HEALTHCARE, revenue isn’t just comforting; it’s crucial. As 2026 approaches, practices across the country are asking the same question: how can we plan next year’s revenue with confidence when so much depends on claims still in limbo?
For many providers, 2025 has been marked by mounting administrative burdens, delayed reimbursements, and ever-changing payer requirements. These pressures make it difficult to forecast revenue accurately, a challenge that directly impacts staffing, budgeting, and long-term growth planning. But with the right systems and support, financial success and predictability are entirely achievable.
When claims pile up, it doesn’t just slow cash flow; it clouds visibility. Practice leaders may see the daily deposits, but without clarity on what’s still pending or rejected, they’re missing the bigger picture. That uncertainty can stall investments in new equipment, limit hiring, and create anxiety around expansion plans.
With 2026 on the horizon, Medserv’s Derek Kelly has some words of advice to ensure private practices can plan next year’s revenue with confidence.
Revenue unpredictability also strains team morale. Billing staff feel the pressure of constant followups, clinicians are frustrated by administrative inefficiencies, and leadership ends up spending more time reacting than on strategy. The good news is that unpredictability isn’t inevitable. It’s a sign of process gaps, and those gaps can be closed.
Even well-managed practices encounter revenue forecasting issues. The most common culprits include:
• Claim backlogs and delayed payments: When old claims remain unresolved, projections become guesswork.
• Staffing shortages and turnover: A lack of trained billing personnel often leads
to inconsistent follow-up and higher bad debt rates.
• Coding and documentation errors: Small mistakes can trigger rejections, stall payments, or lead to underpayments.
• Inefficient reporting tools: Without real-time insights, practices can’t spot patterns or make proactive corrections.
• Shifting rules: Each new update adds complexity, requiring vigilant compliance management.
Left unaddressed, these factors compound over time. What starts as a small backlog can grow into a significant revenue problem by year-end.
The first step toward a more predictable 2026 is visibility. Practices need a clear, real-time understanding of what’s in process, what’s at risk, and what’s already collected.
Modern revenue cycle management is as much about data as it is about pounds. Medserv helps practices
translate billing information into actionable insight; empowering leaders to make confident, datadriven decisions.
Here’s what that looks like in action:
• End-to-End Claim Oversight: Every claim tracked from submission to settlement, with transparent reporting on status and value.
• Rejection Prevention and Resolution: Identifying and correcting issues before they affect payment, not months later.
• Real-Time Analytics: Dashboards that reveal cash flow trends, payer performance, and forecast accuracy.
• Process Automation: Reducing manual touchpoints to speed up cycles and lower human error rates.
• Strategic Consulting: Medserv experts collaborate with you to benchmark performance and identify improvement opportunities.
Predictability is the natural outcome of visibility. When you can see the whole revenue picture (not just the parts), you can plan with precision.
Imagine entering 2026 knowing your billing operations are running smoothly, your cash flow is steady, and your projections are reliable. That’s not optimism; it’s possible when you are supported by the right systems and partners.
Medserv’s mission is to make that a reality for every client. Our tailored billing and practice management solutions are built to ensure revenue stability and transparency.
How Medserv helps transform uncertainty into control:
• Accelerated Cash Flow: Faster claim turnaround times and proactive rejection management.
• Staffing Flexibility: Scalable billing support that adapts to your needs.
• Compliance Assurance: Stay ahead of evolving requirements and changes.
• Forecasting Support: Clear reporting and analytics that enable accurate budgeting and financial planning.
• Operational Relief: Free up clinical and administrative teams to focus on what matters most... Patient care.
Financial predictability isn’t only about technology; it’s about adopting a mindset of continuous improvement. Practices that treat revenue cycle management as a strategic function (not just backoffice work) consistently outperform their peers.
By taking a proactive stance now, you position your organisation for a year defined by stability, clarity, and confidence.
Partnering with Medserv today means entering 2026 with a clear picture of your revenue and the peace of mind that comes with knowing your financial operations are in expert hands.
Let’s make 2026 your most predictable and successful revenue year yet!
Discover more about Medserv here.
ELECTRONIC prescribing is no longer a future ambition, it’s here and it’s changing the way clinicians work. CLEO EPS is an accredited, instant electronic prescribing solution designed to make prescribing faster, safer, and more sustainable. By eliminating paper prescriptions, CLEO EPS delivers significant efficiency gains while supporting the NHS drive for digitisation.
Now fully live and available across secondary care outpatient services, community pharmacy, and independent healthcare providers, CLEO EPS is helping clinicians focus on what matters most: patients, not paperwork.
In today’s fast-paced clinical environments, time and resources are precious. CLEO EPS simplifies prescribing with secure, seamless transfer of patient data.
Prescriptions can be entered and sent electronically to the patient’s nominated community pharmacy - quickly, safely, and without the risk of lost or illegible paperwork.
Built using cutting-edge FHIR messaging standards and integrated with the NHS Spine, CLEO EPS enables instant prescribing with
minimal training. Clinicians can get started after watching a five-minute instruction video.
CLEO EPS is already making a measurable difference.
Following a successful First of Type deployment where CLEO Systems worked collaboratively with Midlands Partnership Foundation Trust and NHS Digital to achieve full NHS accreditation.
Today, the solution is supporting clinicians and patients across nearly 30 NHS Trusts, modernising prescribing processes and aligning with NHS England’s digital agenda.
One standout example is Hampshire and Isle of Wight Healthcare NHS Foundation Trust (HIOWH), which deployed CLEO EPS across approximately 60 community teams, including Urgent Treatment Centres, Older People’s Mental Health, CAMHS, Perinatal Services, Specialist Palliative Care, Frailty, and Eating Disorders.
The results speak for themselves:
• 88% of prescribers in scope are actively using CLEO EPS
• Nearly 20,000 prescriptions processed electronically
• Significant time savings— clinicians report up to seven minutes saved per patient
Feedback has been overwhelmingly positive:
“A million times quicker and easier than paper prescriptions. No lost prescriptions, no lost paper trail.”
“It’s a game changer! It has freed up my time and that’s priceless.”
• Improved clinical safety: Eliminates lost or stolen FP10s and issues with illegible handwriting.
• Flexible prescribing: Supports emergency prescribing, including evenings and weekends.
• Enhanced efficiency: Prescriptions sent at the touch of a button, reducing admin and patient wait times.
• Patient convenience: No need to travel to hospital - medication can be collected from the patient’s chosen pharmacy.
• Cost savings: Cuts stationery, postage, storage, and mileage costs associated with paper prescriptions.
• FHIR messaging compliant: Ensures interoperability, prescription traceability, and robust governance.
• Advanced safety features: Search functionality reduces identification errors; full reporting and audit capabilities support compliance.
• Sustainability: Reduces paper waste and clinician travel, supporting a greener NHS.
By streamlining workflows and reducing administrative burdens, CLEO EPS enables clinicians to
dedicate more time to direct patient care. This means more personalised appointments, improved patient satisfaction, and better outcomes.
Clinicians describe CLEO EPS as “revolutionary,” reducing prescription turnaround from hours to minutes. Patients appreciate the convenience and cost savings, while pharmacies report smooth integration and positive feedback.
CLEO EPS is more than a prescribing tool - it’s a scalable, innovative
solution designed to meet evolving healthcare demands. It benefits clinical teams, improves patient pathways, and supports environmental sustainability.
As David Brown, Managing Director at CLEO Systems, explains:
“CLEO EPS is delivering measurable benefits for clinicians, patients, and the NHS. It supports the national drive for digitisation and electronic prescribing, improving efficiency and enhancing the patient pathway.”
CLEO EPS is not just transforming prescribing - it’s simplifying connected care.
AFTER a decade of devastating maternity scandals, a new national investigation has been launched to uncover why harm continues to occur in maternity and newborn care. But for these inquiries to truly make a difference, they must move beyond blame, and turn insight into action.
The UK’s maternity services are once again under the microscope. In June 2025, the government announced a nationwide investigation into maternity and neonatal care, following a series of high-profile scandals that exposed deep-rooted failings across NHS trusts. This comes after a decade of tragic revelations:
• Morecambe Bay (2015) found “serious failures of clinical care” leading to avoidable deaths of mothers and babies.
• Shrewsbury and Telford (2022) revealed that at least 201 babies and nine mothers might have survived with better care.
Following a decade of devastating maternity scandals, TMLEP’s lead healthcare investigator Nina Vegad suggests that the newly launched national investigation must turn insight into action.
• East Kent (2022) identified 45 preventable baby deaths and described a “culture of denial, collusion and cover-up.”
Each of these inquiries called for learning and change. Yet many of the same themes, poor communication, failure to escalate, lack of accountability, continue to reappear.
Healthcare investigations too often focus on who is to blame rather than why things went wrong. When that happens, the opportunity for
systemic learning is lost. Effective investigations must uncover the full context of harm: how staffing pressures, communication breakdowns, leadership failures and cultural issues intersect to create risk. Human factors analysis, understanding the real-world conditions under which clinicians operate, is vital.
An investigation is not a legal exercise. It is a learning process that should bring clarity, compassion, and constructive accountability. Families need honesty. Professionals need psychological safety to speak openly and improve. Only when both are present can true learning take place.
Culture is the invisible thread that binds every clinical action and decision. When staff are fearful of being blamed, they stop reporting concerns. When leaders fail to listen, silence becomes the norm.
Each of the major maternity investigations revealed environments where staff were afraid to speak up
and lessons were not shared. This is not simply a failure of individuals, it is a failure of systems and culture.
Building psychological safety within healthcare organisations must therefore be a priority. Leaders set the tone: when they model openness, empathy and accountability, teams follow. Policies cannot change culture, but leadership can.
The new maternity services investigation presents a vital opportunity: to move from isolated reviews to coordinated, system-wide learning.
Each trust’s experiences, its data, its themes, its human stories, should feed into a national learning framework capable of identifying trends and predicting risk. That requires independent analysis, consistency in methodology, and a commitment to transparency.
This is where organisations such as TMLEP can play a transformative
role, connecting the dots between individual cases to identify patterns of risk before they escalate into tragedy. Data-driven insights, when paired with a human understanding of care, can shift investigations from reactive to preventive.
Many reports conclude with long lists of recommendations that quietly fade from view. To achieve meaningful change, investigations must produce measurable, trackable outcomes that drive ongoing improvement. Effective learning systems should include:
• Real-time feedback loops, ensuring findings lead quickly to action.
• Integrated governance, linking investigation outputs to organisational oversight.
• Patient and staff involvement, ensuring learning reflects lived experience.
• Public transparency, so progress is visible and accountability maintained.
Learning that isn’t shared, measured or embedded will not last. Investigations must therefore evolve into continuous improvement systems, living processes that inform daily practice, not static documents gathering dust.
Improving maternity safety cannot rest on one inquiry or one organisation. It demands collaboration between families, clinicians, investigators, and policymakers. Families deserve compassion and clarity. Clinicians deserve environments where they can learn without fear. The public deserves a healthcare system that is open about its failings and relentless in its pursuit of improvement. Investigations are not endpoints, they are catalysts. If this new national effort can move the conversation from shame to system learning, the outcome will not just be safer maternity care, but a stronger, more trustworthy NHS.
For more information on TMLEP’s services, click here.
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