Supporting the NHS - Q1 2022

Q1 2022 | A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its content

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Supporting the NHS

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“NHS pressures and understaffing have led to an increased strain on the healthcare service, there is now a high demand for support, investments and a clear workforce plan.”

Danny Mortimer Deputy Chief Executive of NHS Employers, NHS Confederation

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“The opportunities of AI for the workforce are vast and the next five years will be pivotal in cementing the place for automation in healthcare.”

Jenny Thomas Programme Director, DigitalHealth.London

We’re committed to making breakthroughs – the kind that change patients’ lives. Dedicated to our mission of discovery and leading the way in pharmaceutical innovations to help the NHS manage serious disease.

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IN THIS ISSUE

Early detection and prevention are key to improving outcomes for people and ICSs have an opportunity to address people’s needs early on.

Dr Rosie Benneyworth Chief Inspector of Primary Medical Services and Integrated Care, Care Quality Commission

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Can high street health provide solutions to NHS challenges?

Throughout the pandemic, the health and care workforce have gone above and beyond, saving lives and caring for the most vulnerable in the hardest of circumstances.

Government healthcare policies need to invest in innovation, from drug-delivery devices to repurposing generic drugs, providing the NHS access to cost effective, lifesaving medicines for the future.

Mark Samuels Chief Executive, British Generic Manufacturers Association

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Digital healthcare has been a lifeline for many over the past two years as the pandemic has provided a catalyst for change within the NHS when it comes to the integration of digital healthcare.

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n important, but often overlooked, aspect of the health service, are providers of health on the high street. Pharmacists, dentists and other services faced the same challenges as primary and secondary care in protecting patients and staff from COVID-19, but often found themselves to be the most accessible local health providers.

of existing roles. Training and career development supports staff and relieves pressures on other services. High street health could provide routine vaccinations, minor injury assessments and referral into secondary care for concerning symptoms. Expanded roles can aid in diagnostics, management of long-term conditions and independent living. Furthermore, accessible services on the high street can contribute to reducing health inequality across the life Making better use of the tools we have course, improving the experience of navigating the health The Government could acknowledge and service for both patients and staff. increase the contribution of high street To support this shift toward high street health roles through policy, including health, the elective backlog recovery and elective recovery planning and the Health other government plans must integrate High street health could and Care Bill, reorganising the health these services more effectively into the wider service structure. health service. We need to provide career provide routine vaccinations, Elective care recovery means more long training for staff and embed record minor injury assessments training, recruiting new staff and investing sharing and digital tools to allow patients and referral into secondary in new resources and solutions which and professionals, regardless of location, care for concerning symptoms. to communicate effectively and ensure take time to implement. However, high street health has shown us the potential the best possible care. associated with making better use of the tools we have.

Pharmacists, dentists, opticians and other professionals have Calling policy-makers to take action a skill set that could be mobilised to promote prevention The pandemic has demonstrated the pace and scale of and personalised, place-based care. Local health care change that is possible within the health service. Through professionals see more patients in total than other primary the work of the All-Party Parliamentary Health Group, and secondary care services. the challenges have been revealed, but so have possible solutions. Policy-makers have a chance to do more than Expanding roles within high street health recover the NHS, we can work together to make lasting This vision of care can be achieved through the expansion reforms for the benefit of staff and patients.

Barry Cassels Head of Product for the NHS App,

WRITTEN BY Dr Lisa Cameron MP Chair, All-Party Parliamentary Group on Health (APHG)

NHS Digital

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How technology is playing a pivotal role in patient care Greater integration of NHS IT systems is crucial if the health service in the UK is to deliver more joined up care for patients.

W INTERVIEW WITH David Hancock Healthcare Executive Advisor, InterSystems

WRITTEN BY Mark Nicholls

Paid for by InterSystems

ith many hospitals, clinics and healthcare units having different systems, integration and interoperability are paramount with the introduction of the new NHS structure of integrated care systems (ICS), where the health and care sectors will work in closer partnership to deliver a holistic healthcare approach to patients.

A core element of this is the utilisation of the electronic patient record (EPR) and building a shared care record, making the medical notes of individuals available at whatever point they access the NHS. Major NHS transformation Healthcare IT expert, David Hancock, explains the current NHS transformation is happening because “the way it has been organised in the past is not able to solve the problems of today.”

“Now,” he continues, “we need to be focussing on prevention, and on how people can remain healthy, in order to do that, care needs to be rooted far more in the community. We need to be able to treat the care system far more holistically, integrating primary care, community, acute and social care.”

The Health and Social Care Bill going through Parliament will create 42 ICS across England – made up of GPs, community trusts, acute trusts, mental health trusts, local councils for social care and the charity and the voluntary sector - to improve population health and reduce health inequalities.

This, combined with the shared care record, he adds, will deliver a clearer, longitudinal patient centric view across health and care systems, with better treatment and greater continuity of care.

Shared care records Hancock, who is Healthcare Executive Advisor with InterSystems, explains how the software company is supporting the NHS to deliver that.

One example, in the large rural county of Lincolnshire, with health challenges in managing the disparate – and often elderly – population, the shared care record has transformed how the population is being treated. That has led to innovations such as the use of neighbourhood teams - groupings GPs, community and social care - to look after specific patients, such as the frail elderly.

Digital transformation is making this joining up of care more possible with the shared care record accessible for healthcare professionals via an internet browser, with no need for specialist software or hardware.

Pockets of computerisation A broader challenge, however, is that NHS units are still reliant on paper, while others have pockets of

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computerisation. Integration technology specialists, InterSystems has the capability to extract data from those systems and make it relevant to users, as well as work with customers to digitise their operations.

“Different organisations have different needs because nobody is starting from the same place,” says Hancock. “But all see the benefit of having something more integrated where systems talk to each other and give an overview of patients.”

With hospitals under pressures from the pandemic and staff shortages, InterSystems has helped many – such as North Tees and Hartlepool Hospital - to “progressively migrate” to an integrated EPR, rather than undergo an immediate switch. “To progressively migrate is something which is increasingly being appreciated across the NHS,” he says.

Digital transformation is making this joining up of care more possible with the shared care record accessible for healthcare professionals via an internet browser.

Accessible care plans The shared care record enables healthcare professionals to work more efficiently and means that patients do not have to keep repeating themselves and be assured the person treating them has their latest medical information. The facility also allows for care plans for patients – such as for strokes - to be shared across multi-disciplinary teams.

A next step from the vertical integration of GPs, community and mental health care services is the horizontal integration of acute hospitals to enable them to work together as a provider of collaboratives and create economies of scale, or specialise in certain areas, such as hyper acute centres for stroke and collaboration around reducing the waiting list for operations.

Find out more at intersystems.co.uk

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An NHS workforce plan that is fit for the future is needed to give staff hope NHS pressures and understaffing have led to an increased strain on the healthcare service, there is now a high demand for support, investments and a clear workforce plan.

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anny Mortimer, Chief Executive of NHS Employers (part of the NHS Confederation) explains that while the NHS is still experiencing major staff shortages, health service leaders and their teams will be working hard to tackle the enormous backlog of non-COVID care over the weeks, months and years to come.

WRITTEN BY Danny Mortimer Chief Executive, NHS Employers (part of the NHS Confederation)

Mounting NHS pressures It’s no secret that the health service is understaffed, it went into the pandemic with 90,000 staff vacancies and, in the intervening two years, has unfortunately lost a further 20,000 on the last count.

Yet despite these numbers and the pressure and exhaustion staff have faced over an extraordinarily difficult 24 months, the NHS has continued to do its best to deliver for patients. Last year, 302,000 people were admitted to hospital with COVID, six million people sought treatment for other emergency health problems and NHS staff answered 10 million 999 calls – the highest on record. Primary care has also witnessed a 20% jump in footfall, treating nearly 30 million patients in December 2021 alone and let’s not forget the 138 million COVID vaccinations NHS staff have given.

Supporting the NHS workforce While NHS leaders, like the Government, are prioritising addressing the delays in care, they also know that supporting our workforce and fostering positive employment practices and a culture that values staff must be at the heart of what we do.

Leaders are also aware of the necessity to be prompt in ensuring they invest in and carefully manage vital international recruitment to fill vacancies in nursing and medicine. This includes continued efforts to improve productivity, use of technology and different ways of working to speed up access to treatment in every part of the NHS. They also know that as the nation’s largest employer, the NHS has a vital part to play in supporting the health and wealth of their local communities, helping with the Government’s focus on skills and broadening access to education including apprenticeships and creating opportunities.

There is still more for the Government to do. The target that matters most is the one that confirms a workforce plan for the NHS. The Chancellor and Prime Minister must also urgently and clearly describe how their investments to date will help tackle vacancies and shore up an NHS workforce that is fit for the future.

Weary healthcare staff need to be given hope that help is coming.

Ensuring ICSs and local authorities work together to meet the needs of people The Health and Care Bill gives the Care Quality Commission (CQC) new powers to assess local authorities on the delivery of their social care duties and to have oversight of integrated care systems (ICSs).

T WRITTEN BY Dr Rosie Benneyworth Chief Inspector of Primary Medical Services and Integrated Care, Care Quality Commission

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Assessing effective leadership in systems he new powers will be used to ensure that all As well as looking at integrated pathways of care for people system partners, including ICS leaders and local using health and social care services, we will also assess government, work together to improve outcomes how effectively leaders in systems work together to plan and for people. develop services in partnership with local people and deal Ensuring quality and safety and reducing inequalities with quality and safety issues. will be central to ICSs and our role will be to ensure they It is vital that our role adds value and does not duplicate deliver excellent, joined-up care that meets the needs the important work done by our system partners. We of the populations they serve. recognise the complexity of this work, Early detection and prevention are the importance of getting it right and key to improving outcomes for people we are committed to co-producing and ICSs have an opportunity to our approach with key partners, wider address people’s needs early on. This stakeholders and people who use will require ICSs to really understand Early detection and prevention health and social care services. the populations they serve and to think are key to improving outcomes Supporting improvement and sharing innovatively to tackle problems. good practice for people and ICSs have A new single assessment framework Finally, we want to be clear that while an opportunity to address At the core of our approach will be our we will be holding the organisations new single assessment framework, we regulate to account where there are people’s needs early on. against which we will assess providers, failings, we also want to continue to ICSs and local authorities. This work across the health and social care framework will set out what we expect good care to look like sector to enable improvement and share good practice. in terms of what a person should experience when accessing We will ensure that this forms a key part of our approach as care and navigating the health and social care sector. we develop it in partnership over the coming months. This We want our assessments to provide independent will include working with people using services, their carers assurance to people about how well health and social care and families, voluntary sector organisations, health and partners within an ICS area are working. We also want to social care providers and other key stakeholders. identify good practice, innovation and share learning.

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Helping the NHS to unlock the full potential of transformative technology that the pandemic has accelerated digital transformation in healthcare by between four and six years. The challenge now is to help the NHS avoid going back on this progress and make it stick in a way that’s sustainable and clinically right.”

Paid for by BT

Improving patient experience A key vision for future NHS partnerships is to develop the kind of architecture that enables systems to integrate and interoperate in a more flexible way, improving the experience for patients who could be seen at home or monitored remotely using health tech.

For clinicians, better access to a combination of live clinical data and smart platforms could enable them to act on a wider range of health information in a more timely – even, pre-emptive way – to reduce exacerbations. “Certainly, there are elements of this technology already in use across the UK but it’s not systemised,” says Sultan. “Levelling up is needed within the NHS to make sure that a base level of infrastructure, digitisation and clinical translation is there across the country.”

Digital transformation has long had the potential to improve health services and outcomes for patients using the NHS and it’s time to make it a reality across the UK.

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INTERVIEW WITH Professor Sultan Mahmud Director of Healthcare, BT’s Enterprise unit @ProfSulMahmud

WRITTEN BY Ailsa Colquhoun

s the NHS battles with waiting lists, winter pressures and workforce challenges arising from the pandemic, there is a growing view that digital innovation is crucial to support a service that is severely stretched.

As a trusted partner of the NHS, telecoms and technology provider, BT has its sights on a programme of digital health transformation – one that realises the full potential of data that could alleviate current pressures and offer better anticipatory care; addressing patient needs before they become more severe. The company is working with the NHS to develop fully integrated healthcare experiences with digital touchpoints wherever clinically appropriate, to ease operational pressures and help offer people smarter ways to access care.

Delivering an efficient service Throughout the pandemic the company has been by the NHS’ side, moving at rapid pace to

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provide connectivity at 180 COVID vaccination centres and the Nightingale hospitals. The company was also central to the LifeLines programme - virtually connecting families isolated from loved ones in intensive care due to changes in visiting policy throughout COVID-19.

Levelling up is needed within the NHS to make sure that a base level of infrastructure, digitisation and clinical translation is there across the country.

For the Director of Healthcare at BT, Professor Sultan Mahmud, it feels almost like a duty for the company to play its part in transforming the digital capability of the NHS. He says: “The pandemic is an inflection point for the NHS because it has made us all realise how quickly we can move if we really want to. It is estimated

Winning hearts and minds Buy-in from the NHS frontline from doctors, nurses, managers and patients - is key to this vision, which is where the company holds unique strength, believes Sultan. An important step in this process was the creation of BT’s clinical advisory board. “We recognise the challenge of clinical translation of technology into real-world settings and we’re now organised in a way that ensures we understand before being understood,” he explains. Comprising clinicians with decades of experience in front line care, clinical IT implementation and NHS executive backgrounds, the board is tasked to ensure that all new connected healthcare solutions are fully trialled, tested and embedded with direct feedback from NHS partners. There are also new partnerships with the King’s Fund, Health Tech Alliance and digital hyperscalers to foster collaboration and insight within the company.

Sultan explains: “We’ve been with the NHS since 1948, through thick and thin, and are very proud of the fact that we’re here to serve our country.

Across our company, each one of us recognises that our friends, family and loved ones are relying on a future ready NHS. We have the power to convene with world-class digital partners and the experience of largescale transformation across other industries. Now, we are committed to bringing that expertise to bear for the NHS. For us, the NHS is not just a customer, it’s a partnership.”

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Supporting patients and the NHS through early detection The benefits of diagnostics are well understood. It is now time for the appropriate investment to realise their capabilities for the NHS and the patients they serve.

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etting a fast, accurate diagnosis is a fundamental element of modern healthcare. It guides clinical decisions on appropriate treatments or interventions and determines ongoing healthcare needs.

Through the COVID-19 pandemic, awareness of the role diagnostic solutions play in disease detection and management grew profoundly.

What might the future look like if this model is expanded to help address more health conditions?

time-consuming tasks. Rapid test platforms also have the capability to reduce testing turnaround times.

Yet despite the well-recognised importance of diagnostics, and the fact that 95% of all clinical pathways rely on patient access to pathology services, including cancer diagnosis, funding for pathology only accounts for 2% of the NHS budget.

Investment is key to driving improvements Appropriate investment and a shift towards early diagnosis, rather than simply just treatment, would therefore Vision for diagnostic technologies lead to significant improvements, not At ABHI, it is our vision to make high only in patient outcomes, but in the quality diagnostic workload of those technologies working within the accessible to all who NHS. need them, so that Diagnostic tools diseases and health and tests are Not only can diagnostics conditions can be fundamental to bring significant benefits modern healthcare. detected and treated earlier.

They need to be to patient care, but they Earlier diagnosis is funded properly and can also cut waiting critical to improving fully integrated into times and alleviate NHS the survival rates clinical strategies to of those who have a enable our healthcare workforce burdens. serious condition. workers to utilise For example, 92% of them effectively. patients with bowel cancer diagnosed At ABHI, we are currently working at stage 1 survive their disease for at with the health technology industry, least five years, compared to 10% of government, the NHS and national patients diagnosed at stage 4.1 Early partners to make this vision a reality. disease detection opens the door to References planning the care and support for 1. www.ons.gov.uk/peoplepopulationandcommunity/ healthandsocialcare/conditionsanddiseases/datasets/ those in need. cancersurvivalratescancersurvivalin

How artificial intelligence will help tackle workforce challenges Digital tools and artificial intelligence (AI) are key in combatting workforce challenges in the healthcare system.

WRITTEN BY Jenny Thomas Programme Director, DigitalHealth.London

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Supporting the NHS workforce Not only can diagnostics bring significant benefits to patient care, but they can also cut waiting times and alleviate NHS workforce burdens.

In clinical oncology, for example, AI-powered medical imaging has the potential to revolutionise clinicians’ workflow and automate 06

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WRITTEN BY Nishan Sunthares Managing Director, Diagnostics, ABHI

To find out the other four key opportunities in digital health identified in the report, visit DigitalHealth.

London

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n October, we started a five-week conversation with NHS and social care staff, industry, patients and academics to hear about their learnings from the last five years and the opportunities for the next five years in digital health.

AI tools to support healthcare needs The final report, Driving digital: Insights and foresights from the health and care ecosystem identified five key opportunities. One of these was combatting workforce challenges exacerbated by COVID-19, through equipping staff with new models of working, digital knowledge and AI tools.

This aligns with a recent trend of new training opportunities for healthcare professionals on using digital tools. Health Education England, for example, will launch a self-assessment tool in Spring 2022 for all NHS staff to assess their own digital skills and be directed to relevant e-learning.

AI was highlighted as a key supporter of the workforce and many believe that AI and robotic process automation (RPA) will soon be used to replace repetitive tasks, support clinical decisions and triage patients through chatbots, thereby freeing up staff time for other vital tasks.

Digital health companies lead the way The DigitalHealth.London Accelerator is a 12-month programme for digital health companies that have products or services with high potential to meet NHS and social care challenges. Companies making up cohort six of the programme, illustrate the permeation of AI into the healthcare industry.

Ufonia for example, has built an AI-enabled autonomous clinical assistant which can telephone patients and conduct a routine clinical conversation, such as a follow-up after cataract surgery. Initial studies have indicated that it can reduce routine clinician activity by over two-thirds.

Healthtech 1, another cohort six company, automates administrative tasks in the NHS so staff can instead focus on care. They are starting by automating the nation’s 190,000 monthly patient registrations.

From automating healthcare to supporting with decision making – the opportunities of AI for the workforce are vast and the next five years will be pivotal in cementing the place for automation in healthcare.

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Supporting the advancement of health and social care innovation The future is bright for those working within life sciences innovation in Wales. Start-ups through to global organisations are using Wales as their base to improve health and economic outcomes.

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t is an exciting time to be in life sciences, where innovators can help transform economies, health and social care systems and overall quality of life.

Governments, health and social systems and private companies are thinking big, whether advancing emerging fields like precision medicine to improve patient outcomes or transforming systems to meet our evolving needs.

Leaders across the UK are now planning to implement this vision in the long term. This includes Wales, where our bold approach to innovation is rapidly unlocking its applications.

Innovating in health and social care can be difficult; fragmented services, complex processes and limited resources are challenging.

In Wales, our political, health and social care systems can help overcome such hurdles. We are small and agile enough for easy navigation, but impactful enough with our economic ecosystem. Our joined-up services also provide system-wide access from primary care, hospitals and out in the community. The businessfriendly environment, highly skilled workforce and renowned life sciences academic landscape also provides opportunities for funding, research and partnerships.

Leading the way We have long welcomed global organisations to base themselves here and undertake pioneering work in our health and social care systems, which our organisation, Life Sciences Hub Wales, has supported on.

Pfizer is undertaking pioneering value-based health care (VBHC) work

in Wales, focussing on creating and delivering sustainable care solutions with the greatest value to those receiving them. They are working closely with partners like Swansea University to develop and deploy solutions. Emma Clifton-Brown, Head of Health and Value at Pfizer, says: “Pfizer is proud to work in Wales for our ambitious strategy to embed valuebased health care worldwide. Wales’ supportive policy agenda, innovation appetite and available funding make it an ideal location for us to co-create transformative solutions.”

WRITTEN BY Cari-Anne Quinn Chief Executive Officer, Life Sciences Hub Wales

Investing in Wales Wales is also supporting the global COVID-19 response. Multinational life sciences organisation, Cytiva, is investing £36 million in a new strategic Cardiff site, producing critical components to make biopharmaceuticals such as vaccines.

Another global organisation working in Wales is Zimmer Biomet, whose Bridgend site supplies orthopaedic products worldwide.

Ruth Griffiths, Associate Director at Zimmer Biomet, says: “We are proud to be in Wales with its history of engineering excellence and have drawn on its skilled and experienced workforce to establish one of our most important global manufacturing centres. Our partnership with the Welsh Government has allowed access to funding opportunities that have strengthened our base; supporting the expansion and offering significant employment opportunities to locals.”

Grounding your innovation in robust data helps progress projects.

Wales is home to the SAIL databank, which provides secure access to anonymised and extensive health and population datasets, and has attracted partnerships with leading national and international life sciences and healthcare organisations.

Supporting innovation Life Sciences Hub Wales supports local, national and global innovators wanting to benefit from our life sciences landscape. We work closely with health and social care colleagues to better understand the challenges they face, then support the industry to address them.

Our understanding of both life sciences and healthcare helps to accelerate patient access to innovation. With the support of the Welsh Government, we are working with national and international partners like the Academic Health Science Networks and NHS Accelerated Access Collaborative to achieve this.

We support a whole-system approach to innovation in Wales and can help put organisations in touch with the right people across multiple sectors.

Find out more at lshubwales.com/nhs

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Why drugs from the Improving the life chances past can provide of babies born preterm future innovation There are many factors to consider when trying to make sure a baby born earlier than 34 weeks has the best possible outcome. A new perinatal approach is helping ensure the best care is provided for all.

WRITTEN BY Mark Samuels Chief Executive, British Generic Manufacturers Association (BGMA)

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eneric and biosimilar medicines sell at around 80-90% less than pharmaceutical patentprotected drugs. Generics reduce the NHS’s drugs bill from approximately £36 billion to £21 billion a year - we couldn’t afford a national health service without them. Significantly, the £15 billion annual saving covers the salary cost of over one in four NHS staff.

The impact of generic innovation Generic manufacturers punch above their weight in manufacturing and engineering innovation. The generic industry’s innovation often includes novel drug-delivery devices to make treatments far more effective. For example, Ethypharm created the world’s first ‘take home’ opioid overdose kit and supplied it to Scotland’s drug deaths taskforce.

According to the taskforce, the generic company’s innovation helped save approximately 1,400 lives in Scotland alone last year.

Additionally, drug repurposing research which was made possible by government investment found that a generic medicine, dexamethasone, was the first effective treatment for COVID-19 patients. COVID-19 has shown us that while vaccines has helped us out of the grips of the pandemic, it is generics that have got us through it. All patients in intensive care units in hospitals will have been treated using generics.

Innovation does not have to be expensive Dexamethasone has since helped

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Government healthcare policies need to invest in innovation, from drug-delivery devices to repurposing generic drugs, providing the NHS access to cost effective lifesaving medicines for the future. save the lives of approximately 22,000 people in the UK and an estimated one million worldwide. Crucially, it was already widely available for the NHS and was not hugely costly to supply because it was off patent.

Drug repurposing is exciting because it brings new and affordable treatments for previously unmet patient needs and affordability is crucial for an NHS with finite resources. Elsewhere, the BGMA has supported pioneering work in repurposing the hormone replacement therapy medicine, anastrozole, to reduce the risk of breast cancer in postmenopausal women. It could make a difference to the lives of over 4,000 women at high risk of this disease.

Government support is crucial Using a low cost generic medicine to address these areas is highly cost effective for the NHS, compared to the expense of a patent protected product. Unfortunately, the Government’s recent Life Sciences Vision, which placed innovation at its heart, lacked specifics regarding the sector accounting for generic medicines which are four out of five NHS drugs.

Generic and biosimilar medicine manufacturers are awash with novel and innovative activity from agile manufacturing processes to the treatments themselves. Future healthcare policies regarding innovation need to recognise the contribution of generics to this sector – one of the nation’s most critical industries.

WRITTEN BY Natasha Swinscoe, Patient Safety National Lead, AHSN Network and CEO, West of England AHSN

ational child mortality data show that 69% of infants who died under a year old were born preterm. With so many risks from very early birth, how can healthcare professionals make the right intervention at the right time? One solution being trialled in the South West of England is PERIPrem, a care bundle of eleven interventions, each of which has the power to transform a baby’s life.

New mum Lauren says, “I truly believe that this care package saved my twin boys lives.” Like others in the South West, she was given a bespoke PERIPrem passport setting out the care she and her newborn babies would receive. These interventions range from delayed cord clamping to offering mothers magnesium sulphate, which reduces the risk of the baby developing cerebral palsy later in life.

Creating a safety net The care bundle helped Lauren to focus on having a more positive experience at a frightening time. ‘I have two beautiful little boys, who are just starting to smile, and that is down to PERIPrem,’ she says.

Maternity and neonatal professionals are working to cut instances of mortality and serious brain injury in half by 2025, in line with the NHS Long-Term Plan. The care bundle also contributes to the aims of the national NHS maternity and neonatal safety improvement programme.

A collaborative approach PERIPrem was developed by the West of England and South West Academic Health Science Networks. In partnership with the South West Neonatal Network, every maternity and neonatal unit in the region, along with parent groups, has helped design and test the care bundle.

Dr Sarah Bates and Professor Karen Luyt are the programme’s joint clinical leads. Sarah says, ‘PERIPrem has created a brilliant community, where clinicians have joined together to ensure that every preterm baby born in our region has access to the most effective care, at the right time and in the right place.’

The AHSN Network works with NHS England and Improvement, industry and healthcare partners to spread innovation. For more information on PERIPrem, visitweahsn.net/ periprem

Proving impact Initial outcome data is encouraging and shows that rates for both severe brain injury and mortality have fallen in the region.

‘My early analysis indicates a reduction in mortality of 22% so far, which if scaled up nationally would mean 220 fewer extremely preterm babies dying per year,’ says Karen.

This shared purpose created through the PERIPrem care bundle is set to give many more vulnerable babies the best chance at a healthy life.

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Working together, we can help patients and protect our NHS inhalers has gone from being one of the highest to one of the lowest. The change will improve asthma outcomes and is also significantly reducing carbon footprint.

Partnerships like this demonstrate how together we can identify new approaches to important challenges.

It’s vital these learnings are shared across the NHS so they can be scaled up to improve health at the population level and free up much-needed resources elsewhere.

Paid for by AstraZeneca

It’s vital these learnings are shared across the NHS so they can be scaled up to improve health at the population level and free up much-needed resources elsewhere.

Transforming population health and reducing inequalities are critical for the long term survival of the NHS. Recent experiences have shown how collaborations can catalyse innovation and fundamentally change outcomes.

WRITTEN BY Tom Keith-Roach President, AstraZeneca UK

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he NHS has been a fundamental pillar of UK society since its inception and the dedication of NHS staff is a source of national pride. Nevertheless, health outcomes in the UK have lagged behind other Western nations in many areas and the situation has been exacerbated by the pandemic.

The service is facing the largest backlog in its history and an oncoming landslide of chronic disease in the wake of delayed diagnoses and reduced access. For example, the pandemic has seen the highest cardiovascular mortality in a decade and it is estimated that 23,000 diagnoses of heart failure were missed.1 Partnering for early intervention AstraZeneca has taken steps in partnership to begin addressing this impact. Project OPERA is a diagnostic and prevention partnership programme between the NHS

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in Glasgow and AstraZeneca to accelerate heart failure diagnosis and adherence to effective and timely patient management. The initiative uses handheld devices in addition to smart patient management, and has already reduced waiting lists for echocardiograms (which is required for a diagnosis of heart failure) from 12 months to 12 weeks. We hope to see further transferable learnings from the use of artificial intelligence and machine learning in the programme.

We’re working together on OPERA as part of AstraZeneca’s Medical Missions, which include eradicating unplanned hospital admissions for heart failure. We’re particularly targeting our Medical Mission work to areas of high need, tackling health inequalities that undermine the essence of the NHS. We launched the SENTINEL project in Hull where people with asthma were some of the highest users of rescue inhalers in the country. Practice there has now changed and use of rescue

Societal health change starts now Before the pandemic the NHS’s own Long Term Plan recognised the urgency of dealing with the growing burden of chronic diseases. This is even more critical at a time where unplanned admissions from such diseases take resource that could otherwise be used to clear the COVID backlog. Caring for patients with chronic diseases poses a significant finance and resource burden to the NHS, accounting for 70% of NHS acute and primary care expenditure and 70% of bed days in England.2 Slowing or stopping disease progression through earlier patient diagnosis and proactive risk management would help to address this challenge by reducing the risk of hospitalisation and death.

We believe that we can support our NHS not only to recover from the pandemic but to “build back better”, partnering as the NHS and others did in the pandemic with a bold approach to innovative new ways of working.

We want to work together, as we have done in OPERA and SENTINEL, to accelerate the early detection of chronic disease and ensure swift implementation of evidence-based care. Doing so will deliver for all patients and ensure a sustainable service worthy of national pride well into the future.

References 1. https://www.ippr.org/files/2021-03/state-of-health-and-care-mar21.pdf 2. NHS. House of Care – a framework for long term condition care.

Available at: https://www.england.nhs.uk/ourwork/clinical-policy/ltc/houseof-care/. Accessed March 2022.

GB-34835 | Date of preparation: March 2022

Find out more at astrazeneca.co.uk

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How electronic repeat prescriptions are helping to cut GP footfall Electronic repeat prescriptions have reduced footfall in GP surgeries with increased take-up since the COVID-19 pandemic began.

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lectronic Repeat Dispensing means that patients who regularly get the same medicine don’t need to visit their GP every time they need a repeat prescription. Instead, the prescription is sent straight to their pharmacist.

WRITTEN BY Michael Brodie Chief Executive. NHS Business Services Authority

Launch of electronic Repeat Dispensing (eRD) GPs can issue up to 12 months’ worth of regular prescriptions, which can be stored securely on the NHS database, so they are ready at the pharmacy each time a patient needs them.

Electronic repeat prescriptions are managed by the NHS Business Services Authority (NHSBSA) and it was rolled out nationally in April 2019. Within three months, nearly 700,000 patients were using the repeat dispensing process and today, over 1.2 million patients benefit from it.

Saving GPs and pharmacists’ time Electronic repeat prescribing has helped people to avoid unnecessary face-to-face contact during the COVID-19 pandemic. It has also helped manage increased pressure on the health service.

It is estimated that it has saved up to 100,000 hours of GP practice time which can be reinvested in patient care.

To save time for GP practices, eRD provides NHS numbers

for patients who may be suitable for electronic repeat prescriptions, highlights which patients no longer receive medicines through it and provides reports showing GPs where their practices are with it.

Real time exemption checking Electronic repeat prescriptions work hand in hand with another system developed by NHSBSA with NHS Digital, Real Time Exemption Checking (RTEC), to save pharmacists’ time.

RTEC allows pharmacy teams to digitally check if their patients are eligible for free NHS prescriptions due to an exemption (such as medical, maternity, age or low income).

It saves pharmacies time because a patient who is found to be exempt from paying for prescriptions via RTEC, does not need to complete an exemption declaration electronically.

Michael Brodie, Chief Executive of NHSBSA says: “We are driven by wanting to support our frontline NHS colleagues.

To this end, electronic repeat dispensing is proving to be really effective. We have made it much easier for patients to receive the healthcare they need and have saved a significant amount of clinicians’ time. It is estimated that up to 80% of all repeat prescriptions could eventually be replaced with electronic repeat dispensing.”

Why supporting clinically led collaborations in the NHS is crucial With a key aim to improve patient care, a new collaborative clinical approach is enabling the NHS to make cost effective decisions whilst still providing patients with the best quality service.

WRITTEN BY Jodi Chapman Director of Customer Engagement, NHS Supply Chain

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HS Supply Chain supports the NHS by managing the sourcing, delivery and supply of healthcare products, services and food at the best value for NHS trusts and healthcare organisations across England and Wales. The aim of the NHS Supply Chain is to leverage the buying power of the NHS to negotiate the best deals from suppliers and deliver savings of £2.4 billion back into NHS frontline services by the end of the financial year 2022/23.

It is focused on increasing collaborative working with the NHS, aligning with the greater integration of health and social care in line with the Health and Care Bill expected to take effect on 1st of July. In addition, it is helping to rethink how procurement maximises its support of frontline patient care.

Successful collaboration reaps rewards The organisation has already

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successfully demonstrated this collaborative approach in a recent clinician-led procurement project with expert buyers working closely with procurement teams from five London NHS trusts, known collectively as the South London Cardiac Operational Delivery Network. Cardiologists have transformed how high-end medical devices are chosen for percutaneous coronary intervention (PCI), procured at the best cost for the NHS. Using robust value analysis and medical leadership brought together in a clinical council, which places clinicians at the heart of the procurement activity, the project achieved the lowest device prices seen in the NHS and £1.3 million annual savings – without limiting choice or compromising product quality.

Importance of clinically led collaboration NHS Supply Chain’s Director of Customer Engagement Jodi Chapman says: “This is just one innovative project we have been working on to

understand the best clinical choice of product for safe patient care and delivers significant value to the NHS. It is an excellent example of clinical input being placed at the heart of the buying process to deliver products that are fit for purpose, value for money and represent the needs of health and care professionals.

“We have learnt a lot during the COVID-19 pandemic about collaborative working with the NHS. We look forward to building on that, adding value by supporting integrated care systems to access system level opportunities and finding flexible procurement solutions that work for their broader localities and populations. This will help to streamline patient pathways and improve outcomes for their patients.”

NHS Supply Chain is also working on a clinically led collaborative wound care products pilot project with some trusts in the north of England, supporting the local NHS to develop a consistent approach to wound care.

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The use of automation can address the NHS administration crisis Automation holds the key to rapidly solving the NHS’ administrative resourcing problem and ultimately improving patient care.

WRITTEN BY Max Jones Health Managing Partner, Agilisys

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hile the impact of COVID-19 has undoubtedly exacerbated the problem, the growth in administrative resourcing in the NHS is a problem that existed well before the pandemic. In fact, since 2014, the NHS has piled on a further 25,000 clerical and administrative roles – a number that highlights how the system has failed to adopt a transformative approach to work.

I believe this is a direct consequence of the failure of the now dismantled National Programme for Information Technology to transform the local NHS Trust IT landscape and a legislative system in the H&SC Act 2013 that valued competition over collaboration.

Potential automation benefits Whatever the reason, this administrative growth symbolises the enormous potential benefits of automation to the NHS. In fact, from our experience of delivering the latest digital solutions to the NHS and wider public sector, we estimate that over £200 million can be saved each year across NHS trusts, pharmacies, dental and optometry.

The recently published Health

Education England (HEE) AI Roadmap Dashboard details the impact of automation and service efficiency technologies on the NHS. While automation is most often applied to non-clinical areas, the benefits are felt across multiple clinical areas. This seems common sense in that if you remove administrative pressures from staff, they can spend their time better supporting patients.

Developing coherent approaches to automation There’s a clear opportunity for the NHS to develop a coherent approach to transforming processes using the very best that change management and technology has to offer. Automation makes sense as it delivers rapid benefits, so now is the time for the NHS to embrace an automation and transformation revolution. For me, creating a federated automation hub approach is the best option.

Such an approach would help the NHS build centres of excellence for automation that are anchored around the local opportunities for automation, linked to a clear National Automation Strategy and supported by expert automation partners.

Private partnerships with the NHS are needed Crucially, however, to deliver the pace and build skills across the whole of the NHS, a partnership with the private sector will be necessary.

Agilisys developed an automation partnership with NHSBSA to develop skills, recruit and train people, implement management processes and co-develop successful automations, covering critical areas such as the NHS Electronic Staff Record and NHS pensions.

We are proud to have supported NHSBSA in developing its centre of excellence. We’ve demonstrated how automation can be effective and drive efficiencies across multiple processes at scale and remain a sustainable asset for the NHS. Success for centres of excellence Centres of excellence succeed because they focus on two imperatives for automation success. A report by McKinsey stresses the first, which is the need for automation to be made a strategic priority. When it is, organisations enjoy vast increases in success. We need national digital leaders to establish a National Automation Strategy.

Secondly, successful organisations gather individuals’ expertise and embed it in the design of automation solutions. Success is more likely when automation is scaled up using “human in the loop” solutions. This is not about a loss of control or taking humans out of the process entirely. It’s about automating the robotic and repetitive tasks to free up valuable time for our brilliant NHS staff.

The NHS is at a turning point in its adoption of digital and at a critical moment when it comes to staffing.

Add in the enormous explosion in administration and we have a situation that we simply cannot ignore.

We want to enable our fabulous NHS staff to spend their time caring.

The NHS has a terrific opportunity with automation – and we’re ready to support the NHS as a constructively disruptive partner.

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Find out more at agilisys.co.uk

References https://public.tableau.com/app/profile/unity.insights/viz/HEEAIRoadmapDashboard/Home https://www.mckinsey.com/business-functions/operations/our-insights/the-imperatives-for-automation-success https://www.agilisys.co.uk/insights/automating-the-pensions-error-handling-process-for-nhsbsa-using-blueprism-cloud/

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half of people in England now able to access digital healthcare services through NHS login. Through the services integrated with NHS login people can book GP appointments, order lateral flow tests, register their organ donation preferences and much more. This helps free up valuable time for GP practice staff and provides a simple and efficient way for people to take control of their healthcare and access services easily and securely.

How efficient digital methods are supporting healthcare needs More than half of the adults in England now have access to digital healthcare, according to NHS Digital.

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igital healthcare has been a lifeline for many over the past two years as the pandemic has provided a catalyst for change within the NHS when it comes to the integration of digital healthcare.

The NHS login service, which is managed by NHS Digital, provides people with a quick and secure single point of access to a variety of digital healthcare websites and apps using just one email address and password.

It now has more than 28 million registered users, up from 2.2 million in September 2020.

A total of 52 apps and e-health services are available through NHS login, including e-Referral services,

COVID-19 support and advice, maternity and child health services, online pharmacies, and services to monitor and improve health and wellbeing.

An efficient way to access healthcare needs A peak in the number of people setting up an NHS login took place in May 2021, which coincided with the launch of the NHS COVID Pass. On 17 May alone, when the NHS COVID Pass launched, around 245,000 people created an NHS login account.

There has been a massive uptake in people managing their healthcare needs digitally throughout the COVID-19 pandemic, with around

WRITTEN BY Barry Cassels Head of Product for the NHS App, NHS Digital

The NHS App offers benefits for all Alongside NHS login, users are benefiting from easier access to NHS services through the NHS App. During the past four months, almost 3.2 million repeat prescriptions were ordered and over 268,000 GP appointments were booked via the NHS App, saving valuable time for patients and clinicians.

The increase in app downloads could also have a life-saving impact as 1.5 million people have now used the app to manage their organ donation decision, with 265,000 of these registering their organ donation for the first time via the app. Over 150,000 of those new registrations took place in just four months last year.

NHS login follows the UK Government’s data storage standards to keep information private and secure. For more information, visit the NHS login privacy policy.

Massive savings from the NHS transitioning to digital medical records The transition from paper to digital medical records has streamlined a decades-old process and made massive financial and operational savings for a hospital trust.

T INTERVIEW WITH Neil Darvill Director of Informatics, North Bristol NHS Trust

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he massive shift from a decades-old system requires huge numbers of paper records to be transformed into digital content that is secure, easy to use, reliable and accessible to all authorised users across the entire healthcare system.

The transition to a digital, paperless world is no longer an option and many trusts are already seeing major benefits in terms of more efficient processes and significant cost savings.

Paper records When North Bristol NHS Trust (NBT) opened a new hospital in 2014, it was designed to take advantage of the latest improvements in IT, including the use of an electronic patient record (EPR). While providing the opportunity for digital transformation, its medical records were still held in one central store leased for about £200,000 a year.

Digital solution NBT Director of Informatics, Neil Darvill, acknowledges that the way the trust stored and accessed medical records was unsustainable. “So, we set corporate and clinical objectives to find a digital solution and ensure our staff were case note-free at the point of care,” he says.

To digitise its paper medical records and provide instant access to these documents for staff, NBT turned to CCube Solutions’ electronic document and records management

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(EDRM) software. CCube Managing Director, Vijay Magon, says: “EDRM in the NHS is all about transformation and presenting unstructured information contained on paper and electronic files to clinicians in a much more efficient and effective way.”

Digital transformation “We have gone from an archaic costly way of working, represented by a massive warehouse full of documents, to a timely system where multiple staff can access patient records simultaneously online,” says Darvill. Significantly, the trust is saving £1.1 million a year, information is available to clinicians when they need it, records are securely stored and the era of paper records is in the past.

CCube Solutions specialises in providing EDRM solutions, based on their software suite which holds and manages some 450 million documents containing over 52 billion pages for 33 million patients across 30 NHS organisations around the UK. Health and Social Care Secretary, Sajid Javid, speaking recently at the Health Service Journal’s Digital Transformation Summit, emphasises that electronic patient records are the essential prerequisite for a modern, digital NHS, he says: “We must make sure that we have the structures in place that support the level of ambition that we all have for digital transformation.”

INTERVIEW WITH Vijay Magon Managing Director, CCube Solutions WRITTEN BY Mark Nicholls

Find out more at ccubesolutions.com

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