Improving health outcomes, driving economic growth

Rishi Das-Gupta [pictured below], Chief Executive of the Health Innovation Network (HIN), shares how the Network chooses new projects to ensure south London benefits from innovation.

For any readers unfamiliar with the work of the HIN, can you tell us about your role and work in south east London?

As the innovation arm of the NHS for south London we have four clear priorities:

• Ensuring south London benefits from national innovation priorities which address health inequalities.
• Delivering health and care change programmes with a focus on long-term conditions and mental health to improve health outcomes.
• Supporting innovators and the workforce in the health and care system to achieve faster adoption of innovations and drive economic growth – with a focus on digitally-enabled business models.
• Evaluating the effectiveness of innovations in a real-world setting and generate evidence to identify which innovations should be adopted in health and care.

We choose new projects by considering what will have the biggest impact on health outcomes for south Londoners and what will drive economic growth for south London and beyond.

The most recent south east London examples include our Dermatology Improvement Collaborative where a joint consultant rota was generated so consultants across the three south east London Trusts could review referrals before they are actioned. We are also demonstrating how remote consultations for those using mental health services make care more accessible but are not the right solution for all patients. Our interim evaluation of remote monitoring in care homes showing over 160,000 vitals and 61,000 NEWS2 or risk assessments have been calculated since January 2020.

How has the COVID-19 pandemic impacted the spread of innovation in our region?

There is no doubt that the pandemic increased the appetite for innovation, purely because we had an unprecedented situation that needed solutions quickly and where permission was granted to try and pilot those quickly.

It’s in this environment where innovations (and innovative people) thrive. A good example was the rollout of virtual wards across multiple organisations which required collaboration on agreement on technical specifications but ultimately resulted in the increased care and safety of patients both in and out of traditional hospital settings by using tech and remote monitoring of oxygen saturation levels. In terms of outcomes the team could demonstrate lives saved, reduced bed days and early admissions which improved mortality and morbidity rates and ultimately this also led to the project winning the HSJ Patient Safety Award which we were very proud of.

What has the HIN learned from the pandemic?

Clearly there is a will and creativity in south London for innovation from NHS, private sector and academic partners.

We saw NHS providers looking to scale up pilots and expand them quickly. This is an area we’ve helped a lot with both before and during the pandemic. I think it’s important to provide support to clinical and operational teams doing this to prevent the experience being frustrating and to make sure the right evaluation is designed at the outset to make sure that it continues to improve.

The private sector was also keen to support during the pandemic and a number of the alumni from our DigitalHealth.London Accelerator allowed NHS organisations to use their innovations for free. In the whole people adapted to working and delivering care remotely where possible. The recipients of our 2021 Innovation Grants highlighted this with winning projects including artificial intelligence rehab for musculoskeletal disorders, a self-care app for patients with inflammatory bowel illness and digital urine screening for chronic kidney disease.

However, the pandemic also really highlighted there is a need for in person, face to face interactions as well. Where relationships are established, moving to digital workarounds was easier than trying to start a project from scratch with new members online. It provided a positive learning curve that just because something is possible, doesn’t mean it is the best solution.

Academic colleagues have been vital during the pandemic in supporting us to review innovations across the AHSN Network, and to help design and run evaluation for innovations or new care models. In my opinion, this has been most successful where we have been flexible about timescales and able to match academic research themes to more pragmatic short-term goals. This is an area I’m keen to look at how we can do more of in the future as we’ve seen colleagues elsewhere in London playing very prominent roles, particularly in understanding the impact on health outcomes and health inequalities.

Digital technologies play an increasingly big part in healthcare – what could be next in this sphere?

With increasing waiting lists for treatment and diagnosis due to the pandemic, there is a real need to deploy technology where it helps improve health outcomes either by increasing capacity or helping us to target care to those who need it most (reducing health inequalities).

In terms of increasing capacity, we’ve already seen a growth in remote consultations, but there is probably more to do in remote diagnostics and monitoring (and in virtual wards). We are working increasingly closely with the AI centre on this.

However, as with all digital tech we are increasingly concerned about the impact on health inequalities and making sure any solutions do not accidentally exacerbate existing problems, by assuming everyone is tech literate for example. We recently held a roundtable with subject matter experts over a wide range of perspectives to explore how we can mitigate the risk of exacerbating inequalities when implementing digital health innovations by challenging the way innovations are selected and adopted. The details of our conversation are being translated into a series of recommendations on how to reduce inequalities for patients, both for the NHS as a customer when selecting and adopting the innovations, as well as for innovators when providing and developing them, which we will be publishing soon.

Finally, looking ahead to 2022 – what are the HIN’s biggest priorities?

Although we are nearly two years in, the impact of the pandemic will continue to be felt for a number of years. We aim to help our system by:

1. Supporting health and care change programmes with a focus on long-term conditions and local priorities.
2. Evaluating the impact of innovations in the real-world, plus develop the evidence base to choose interventions for spread and adoption.
3. Achieving faster adoption of innovations and driving economic growth by supporting innovators and the health and care workforce – with a focus on digitally-enabled solutions.
4. Helping members and other organisations to articulate their needs to be addressed by innovations, to select the best interventions / technologies to meet partners’ needs and design programmes to deliver improvement.
5. Collaborating on major local programmes, connecting people, creating partnerships, and increasing the capabilities of provider and commissioner organisations through a range of people development programmes.

Find out more on the Health Innovation Network website, and watch the third part of our Annual Conference 2021 chaired by Rishi Das-Gupta on improving urban population health.