EAHSN Impact 2021.Indd

2020/21

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Making an impact

ooking back on an extraordinary year, we are pleased with how much practical support Eastern AHSN was L able to offer to our regional health and care system in the East of England, despite the pressures of the two waves of Covid-19 and the months spent under lockdown. We have also deepened our collaborations with our partners in the health and life sciences industries, leveraging their direct support to the NHS and supporting the introduction of their innovative products and solutions. At the start of the pandemic, we mobilised our staff to support the rollout of telephone, online and digital consultation in primary care within just a few weeks. This included distributing £3 million worth of hardware, including 4,500 laptops, and working with Astra Zeneca, which kindly volunteered its field teams to help us quickly train NHS staff to conduct safe virtual consultations. Some of our staff with clinical qualifications returned to frontline duties for a while, and we supported an extensive rollout of remote technology to more than 200 care homes in the region to enable them to monitor residents’ vital signs. This helped managers to know when it was safe to care for residents in the home setting and when GP or emergency medical resources were needed. In the autumn, we also supported the wide roll-out of home oximeters to people across the East of England, contributing to a virtual ward arrangement where people with Covid-19 could self-monitor to check whether they needed an emergency hospital admission, facilitating safe discharge earlier. We also supported the “Technology-driven recruitment of volunteers to assist in the vaccine roll-out across the East of England. service change will be Much has been written about how, in the face of the essential in helping the pandemic, the NHS was able to achieve levels of beneficial service and technology transformation in a period of just a few NHS to address the long weeks that would normally have taken many years. Innovative wait lists” technologies were adopted at pace because of the need to manage infection risk, but in many cases these technologies have saved valuable clinician and patient time and the need for administrative support that could be better directed elsewhere. Many of these innovations are here to stay, and their success has driven the reflection that technology-driven service change will be essential in helping the NHS to address the long wait lists and potential unmet need that has built up in non-Covid illness over the past year. We are also mindful though of the consequences of digital exclusion and will be looking at how we can direct our work to assist excluded communities in a more targeted way. With change in mind, we held our first online event in partnership with NHS England and NHS Improvement to showcase innovative ways of looking after patients in our region during the pandemic, with notable examples being the virtual orthopaedic rehab clinics run in Cambridgeshire and Peterborough and the teledermatology service in Suffolk. We have also supported, with Yale University, an evaluation of the innovative Covid Protect service, which was devised to proactively offer support to people in Norfolk and Waveney who were shielding and had been identified as vulnerable. This engaged more than 50% (22,894) of the target group and triggered over 12,000 calls to action for support. Finally, we are delighted with the successes achieved by our partners in our longer-term collaborations. We are supporting GPs in Great Yarmouth to pilot EarlyCDT Lung, a simple blood test to detect autoantibodies associated with lung cancer that can be done in primary care in high-risk populations. It has identified 277 people for triage into CT scanning, and Suffolk and North East Essex ICS has agreed to support the adoption of four innovations in cardiac and primary care. Both these achievements were facilitated by our new innovation managers hosted by the ICS, and we hope to further these arrangements next year. Our Health Data Research Hub Gut Reaction has passed its second milestone and secured substantial We are in awe of the commercial support, and we secured two new collaborations “ with the pharmaceutical industry that will support investigations expertise, energy and into persistent depression and the education of specialist nurses in lysosomal disease. dedication of our Piers continued to chair the AHSN Network throughout the community in responding year (you can read about our collective achievements on the to the pandemic AHSN Network website) and we are grateful to the senior ” management team at Eastern AHSN for stepping up to enable him to respond to a request to lead a diagnostics innovations team at NHS Test and Trace over the summer and autumn. He was part of the team that secured funding for the development of new lab-based and mobile testing technologies and supported the expansion of the UK’s world-leading genomic testing capability. We are in awe of the expertise, energy and dedication of our community in responding to the pandemic and our thanks go to the whole team at Eastern AHSN and all our partners for their collaborative efforts and successes over the past year that you can read about in this review.

Piers Ricketts Elisabeth Buggins Chief Executive Chair Foreword

Making an impact

Piers Ricketts Elisabeth Buggins Chief Executive Chair National adoption and spread: an update on our national programmes

Putting cardiovascular disease at the heart of health services CENTRE FOR AGEING BETTER AGEING FOR © CENTRE

Dr Mike Knapton, Clinical Advisor at Eastern AHSN, highlights our work to improve heart health in our region. Mike is a Non-Executive Director of Cambridge University Hospitals NHS Foundation Trust and was a local GP. He was also Associate Medical Director at the British Heart Foundation from 2006 to 2018

eart and circulatory diseases, also known as cardiovascular disease (CVD), cause Our national a quarter of all deaths in the UK1 and are the most significant cause of premature adoption mortality in deprived areas. The NHS Long Term Plan highlighted CVD as the and spread H single biggest area where the NHS can save lives over the next 10 years2. programmes A regional approach The AHSN Network deliver Addressing the CVD challenge locally requires a review of patient pathways across the region the adoption and spread of and identifying opportunities for reducing health inequalities as well as improving the integration programmes, selected by our of services, particularly for people with multiple long-term conditions. commissioners, which have This year, we have facilitated regional workshops and held focus groups with key stakeholders been shown to be effective at who share our ambition for preventing CVD. This included clinicians, commissioners, providers improving patient outcomes in and the Genomics Laboratory Hub (GLH), which helped us map stakeholders and identify best piloted areas of the country. practice and existing care pathways. Due to the success of this collaboration, we were able to In this impact review we lead the development of a shared CVD prevention action plan for the region and gain support to provide updates on three implement it from Public Health England and NHS England and NHS Improvement. of our programmes from Working with Cambridge University Hospitals NHS Foundation Trust, we also delivered a series 2020/21 which we have been of online seminars to increase the understanding and discussion of CVD-related issues. More implementing across the East than 300 healthcare professionals have attended these so far from across the East of England of England: our cardiovascular and we are continuing the series into 2021. disease (CVD) programme, Building on this community engagement, we have implemented the adoption and spread of Focus ADHD and improving the three nationally proven CVD programmes across the region as follows: diagnosis and treatment of eating disorders in young people. ● Diagnosis of familial hypercholesterolemia (FH) ● Optimising lipid management medications in people with high cholesterol ● Improving the diagnosis of atrial fibrillation (AF), which builds on our ambition to reduce avoidable strokes, which we have been working on since 2018

Increasing the detection of familial hypercholesterolemia Familial hypercholesterolemia (FH) is an inherited condition due to a faulty gene, which interferes with how the liver removes low-density lipoprotein (LDL) cholesterol (which contributes to fatty buildups in arteries) from the body. FH affects around 1 in 2503 of the UK population. People with FH are born with high LDL cholesterol. Cholesterol levels tend to rise with age, but people with FH have LDL levels that start high and increase over time, which means that, if untreated, they will develop heart disease at an early age. There are approximately 50,000 children with FH in the UK. Currently only about 1% of these have been identified and are under paediatric care4. This year, we started a new national programme to partner with clinical commissioning groups in our region to pilot and evaluate a child-parent screening service for FH. As part of this “Eastern AHSN is one of our pilot, children will be tested for the condition in routine key regional partners in the immunisation visits to their GP. If they are found to carry an FH gene, they can benefit from preventative lifestyle advice, as collective efforts to prevent well as treatment to reduce LDL levels to help avoid future cardiovascular disease in the disease. Additionally, both parents and siblings are then tested to determine if they also have the condition so that they can get East of England” treatment. Research shows that child-parent screening for FH – Sara Godward, Consultant in Public Health and identifies approximately one new case per 70 children5 CVD Prevention Lead, Public Health England (East of England) screened and we hope to have data on the impact of our pilot by October 2021.

David Wald, Professor of Cardiology at Barts Heart Centre: “Identification leads naturally to cascade testing to other family members besides the parent and has the potential to prevent about 3,500 heart attacks under the age of 50 each year in England.”

Early detection, through new models of care, will lead to early treatment that can give people with FH the same life expectancy as the general population6. Without this treatment, studies estimate that 50% of men with FH will have a cardiac event by the age of 50 and 30% of women by age 606. We led a bid for funding from NHS England and the AHSN Network that enabled us to develop support resources and secure 40 GP practices to pilot the programme from April 2021. It involves practices across our region, including in Norfolk and Waveney, Suffolk and North East Essex and Hertfordshire and West Essex Integrated Care Systems (ICSs). Eastern AHSN has also agreed to build on this work by facilitating a regional FH Alliance with the Genomic Laboratory Hub.

Optimising lipid management to prevent cardiovascular events Lipids are blood fats, called cholesterol and triglyceride. Patients with high cholesterol are at increased risk of cardiovascular events such as heart attacks, stroke and vascular dementia. This year, we started the regional rollout of the National Institute for Health and Care Excellence Click here (NICE) approved clinical pathway for managing lipids to reduce the risk of hospital admissions and re-admissions due to heart disease. to learn more To achieve this, we are working with NHS providers and primary care to optimise treatment about the drugs options for people with high cholesterol and reduce health inequalities by ensuring a consistent, approach to lipid management. We supported Cambridge University Hospitals on the lipid NHS Foundation Trust to establish a lipid clinic, with funding secured via the NHS management Accelerated Access Collaborative for two full-time specialist nurses, who will work across secondary pathway care specialities, and two GP surgeries to identify and 1 British Heart Foundation. (2021). UK test people at risk of cardiovascular events. Factsheet. Available: https://www.bhf.org. uk/-/media/files/research/heart-statistics/bhf- In October, we ran a regional event to educate more cvd-statistics---uk-factsheet.pdf. Last than 30 colleagues in primary and secondary care about accessed 28/04/21. available lipid management drugs and their eligibility criteria. We continue to 2 NHS England. (2019). The NHS Long Term Plan. Available: https://www.longtermplan. work with primary care networks serving our most deprived populations to identify nhs.uk/wp-content/uploads/2019/08/nhs- high-risk patients. long-term-plan-version-1.2.pdf. Last accessed 28/04/21. Dr Paul Flynn, Consultant Physician in Acute and Metabolic Medicine and Clinical 3 British Heart Foundation. (2021). Familial Lead for the Lipid Clinic at Cambridge University Hospitals NHS Foundation Trust, hypercholesterolaemia (FH). Available: said: “I am hugely grateful to the Eastern AHSN team for their support in improving https://www.bhf.org.uk/informationsupport/ conditions/familial-hypercholesterolaemia. cardiovascular risk management across the region. They have brought together Last accessed 28/04/21.

the whole clinical community to deliver a programme that will make a huge 4 Ramaswami, U. et al. (2019). Current difference for patients with high cholesterol levels and save lives.” management of children and young people with heterozygous familial hypercholesterolaemia - HEART UK Reducing avoidable strokes through better statement of care. Atherosclerosis. 290 (1-8) detection of 5 Wald, DS, Bestwick, J. P., Morris, J. K. et al atrial fibrillation (2016). Child-parent familial Atrial fibrillation (AF) is the most common type of irregular heart rhythm and hypercholesterolemia screening in primary care. The New England Journal of Medicine. increases the risk of stroke, leaving survivors with disabling consequences. 375, pp1628-1637 Around 200,000 people in the UK develop AF each year7. Detecting AF early 6 Public Health England. (2018). Improving and making sure people are given optimal treatment – usually blood-thinning the diagnosis and treatment of familial hypercholesterolaemia. Available: https:// medication to prevent clots (anticoagulants) –reduces the risk of stroke by publichealthmatters.blog.gov.uk/2018/08/14/ two-thirds. improving-the-diagnosis-and-treatment-of- familial-hypercholesterolaemia/. Last We started the rollout of a national AF programme in 2018 and have continued accessed 28/04/21.

to support its sustainability across acute providers and primary care. In 2019/20 a 7 Martinez C, Katholing A, Wallenhorst C, et further 14,280 people in our region were newly diagnosed with AF, although this al. (2015) Increasing incidence of non- valvular atrial fibrillation in the UK from 2001 data hasn’t been collected in 20/21. The AHSN Network has produced an AF to 2013. Heart 2015;101:1748-1754 Toolkit to provide methodologies, resources and support for commissioners and References clinicians working to reduce AF-related strokes.

Share this article ● Get involved Find out more about how you can get involved in our cardiovascular disease (CVD) prevention programme by visiting the Eastern AHSN website. National adoption and spread: an update on our national programmes

Putting cardiovascular disease at the heart of health services CENTRE FOR AGEING BETTER AGEING FOR © CENTRE

FREEDom from eating disorders Dr Jaco Serfontein, Consultant Psychiatrist in Eating Disorders at Cambridgeshire and Peterborough NHS Foundation Trust, explains how Eastern AHSN is ensuring young people get the treatment they need within a critical time window

ating disorders are serious mental illnesses that involve extreme concern about eating, weight or shape, plus disordered eating. The importance It is estimated that around 1.25 million people in the UK have an of early eating disorder1. Most eating disorders develop during intervention adolescence. They are estimated to affect one in seven women Eover their lifetime and they have the highest mortality rates of any mental Simon Brown health disorder2. is the patient Research tells us that we should try and reach someone with an eating and public disorder with support within the first three years of their illness as this window involvement for early effective intervention is when changes to their body, brain and representative behaviour are more easily reversed. After three years, eating disorder for the FREED symptoms tend to become hard-wired in the brain which means it gets harder programme: to make changes and there may be long-lasting consequences3,4. “Eating disorders are so There are three main reasons for this: devastating because as you get For anorexia nervosa in particular, illness duration is deeper into the illness it gets 1 a key predictor of treatment outcomes. Outcomes harder and harder to leave are best with duration of illness less than 3 years. it behind and engage in your Growing evidence suggests that eating disorders treatment. That’s why it’s so 2 are associated with significant structural and important for young people to functional brain changes. Eating disorder get tailored treatment as early behaviours are initially rewarding, then habitual and as possible. then neurocognitively engrained. “The tragedy of this illness Because eating disorders typically develop in is not just the loss of life, but FREED – Inspiring change through early adolescence and young adulthood, when the brain also the loss of potential. My intervention for eating disorders 3 is still developing, these brain changes have daughter, Emma, was a force of potential to disrupt brain maturation. nature; gifted academically and a There are two key things that stop early intervention for eating disorders: talented runner being trained to difficulties spotting the illness early and difficulties getting help. That is why the become an Olympic-level athlete. AHSN Network is working with local NHS systems across the country to Despite this, right up until address both sets of difficulties by embedding theFirst episode Rapid Early she passed away, her life was intervention for Eating Disorders (FREED) service model and care package. dominated by an illness she was The FREED programme aims for 16 to 25-year-olds with suspected anorexia afraid of recovering from. nervosa, bulimia nervosa or binge eating disorder who have had the condition “FREED is the best chance for less than three years to be triaged within 48 hours of the referral and begin we have of enabling people treatment within four weeks. This approach has been found to improve the to recover or manage their quality of life and reduce the severity and longer-term impact of eating condition and live a happy and disorders on patients and families5. healthy life. It gives me hope that

1 Beat Eating Disorders. (2021). How Many FREED is designed to meet the specific needs of young we can provide young people People Have an Eating Disorder in the UK?. people in the early stages of an eating disorder and with effective help quickly to Available: https://www.beateatingdisorders. org.uk/how-many-people-eating-disorder- complements rather than replaces existing services and reduce the impact of eating uk. Last accessed 28/04/21. treatments. It emphasises early, proactive engagement with disorders and save lives.” 2 Priory. (2020). Eating Disorder Statistics. both the individual and their families while paying particular Available: https://www.priorygroup.com/ eating-disorders/eating-disorder-statistics. attention to the effects of eating disorders on the brain, the Last accessed 28/04/21. impact of social media use, and transitions into adulthood (out of school, to university, into work). 3 Brown A, McClelland J, Boysen E, Across the East of England, Eastern AHSN has taken a coordinated system-level approach to the Mountford V, Glennon D, Schmidt U (2016). The FREED Project (first episode and rapid adoption and spread of FREED. I am the clinical advisor for the programme, and we began by early intervention in eating disorders): service model, feasibility and acceptability. assembling an implementation group to bring together NHS bodies, commissioners, integrated care Early Intervention in Psychiatry, 12, system leads, clinicians and patients to shape our strategy. We are ahead of schedule to embed a 250-257. FREED champion to lead the adoption of the programme in each of the five eating disorder services that 4 McClelland J, Hodsoll J, Brown A, Lang K, Boysen E, Flynn M, Mountford VA, Glennon cover our region throughout summer 2021. We have also established a community of practice to provide D, Schmidt U (2018). A pilot evaluation of a peer support and enable collaboration between FREED champions and service managers. The group novel First Episode and Rapid Early Intervention service for Eating Disorders has already found ways to work more effectively together by developing shared innovative solutions (FREED). European Eating Disorders Review, 26, 129-140. and materials to support the roll out. Ensuring we reduce health inequalities as we embed the programme was identified early on as 5 NHS England (2015). Access and Waiting Time Standard for Children and Young important and to ensure this, we have completed equality impact assessments for each site. Additionally, People with an Eating Disorder Commissioning Guide. London: NHS the Eastern AHSN team has been working with their neighbouring AHSNs to ensure that FREED England. 15. Available: https://www. services in our region are connected with those in surrounding regions. england.nhs.uk/wp-content/ uploads/2015/07/cyp-eating-disorders- Over the next year, we will continue to be working to ensure all young people in the region are able to access-waiting-time-standard-comm-guid. pdf Last accessed 28/04/21. rapidly access support and treatment for eating disorders. Eastern AHSN continues to provide programme support to the FREED programme and we are working with commissioners and NHS References England and NHS Improvement to ensure the long-term sustainability of the service.

Share this article ● If you’d like to know more... Find out more about the FREED programme on our website National adoption and spread: an update on our national programmes

The ADHD puzzle - helping children get a validated diagnosis faster

Six benefits of the QbTest Dr Venkat Reddy, Neurodevelopmental Paediatrician at Cambridgeshire Patients whose and Peterborough NHS Foundation clinicians have access Trust, explains Eastern AHSN’s to the QbTest report are programme to improve ADHD 44% more likely to receive a diagnostic decision within assessment for children and 6 months and the likelihood young people in our region of correctly excluding ADHD in the1 first 6 months ttention Deficit Hyperactivity Disorder (ADHD) is diagnosed is doubled3 through analysis of behaviour. It is more likely to affect boys than girls, with an estimated prevalence in the UK of 3.6% and 0.9%, respectively1. Although no two people with ADHD are the same, they show a persistent pattern of inattention and Ahyperactivity and impulsivity that interferes with day-to-day functioning and/or development. However, not everyone with ADHD gets a diagnosis of the condition, Optimise treatment which affects their chance of receiving treatment and support. Without treatment, decisions objectively ADHD can significantly impact personal development, academic outcomes, mental 2 health, and relationships. There are no laboratory tests, such as blood or urine, that diagnose ADHD. The diagnosis of children is often subjective and reliant on observation and anecdotal input from parents and teachers in addition to clinical interviews and rating scales. Notably, according to some studies, doctors are able to identify ADHD more easily in males2, which might in part explain the greater prevalence of male diagnosis. This may be because females tend to have different predominant Release between symptoms of ADHD (internalising rather than externalising) and do not always display in 20% and 33% the behaviours typically associated with it such as hyperactivity. The NHS spends an clinical workforce estimated £23 million a year on diagnosing ADHD and, on average, it takes time4 3 18 months for a diagnosis in the UK. Reducing the diagnosis time could not only reduce this cost to the NHS but also ease the personal emotional costs on young people and their families. Eastern AHSN is working to deliver a new national adoption and spread programme that aims to transform the diagnosis of ADHD regardless of gender. Enhance The Focus ADHD intervention uses an evidence-based digital assessment tool

communication called QbTest, created by health technology company Qbtech Ltd (which also and clarify objective developed QbCheck for use in non-clinical settings). QbTest uses a headband, measures diagnosis motion-tracking camera and stand to observe and measure three of the critical is based on with symptoms of ADHD: attention, impulsivity and motor activity all at the same time. Data patients and 4 is compiled instantly into a report comparing an individual’s results against a their families normative dataset based on age and gender, which is designed to be added into the assessment process by a clinician, along with a clinical interview and rating scales. A 2017 evaluation found that 94% of clinicians reported a greater understanding of patients’ symptoms having used the test, and 85% of patients surveyed suggested that the test helped them to Better identify girls understand their symptoms better. The QbTest provides clinical with ADHD who teams with objective data to inform their decision about ruling in don’t exhibit or or ruling out ADHD. Click on the buttons, left, to find out how. mask5 symptoms

Save the NHS £343 per diagnosed ADHD patient on6 average

I have been using the QbTest with patients for a few years now and, with this data, I am often able to rule in or out ADHD at the first appointment with a child. As I was experienced with the test and challenges of diagnosing the condition, I was invited by Eastern AHSN to be a clinical advisor for the programme. We kicked off the programme in April 2020 by bringing together 20 key stakeholders to share the objectives of our national programme and how the QbTest works and listen to their feedback and local insights. Working closely with five sustainability and transformation partnerships (STPs) in the region, the AHSN team identified a service within each locality to be in the first wave of adopters, which would be empowered to support later adopters in East Midlands – Improving the diagnosis of the region. Given Attention Deficit Hyperactivity Disorder 1 Holden, S., Jenkins-Jones, S., Poole, C. et (ADHD) in children al. (2013). The prevalence and incidence, the pressures the resource use and financial costs of treating people with attention deficit/hyperactivity healthcare system faced as a result of the coronavirus pandemic, disorder (ADHD) in the United Kingdom the Eastern AHSN team has been fantastic in keeping us on track, (1998 to 2010). Available: https://www.ncbi. nlm.nih.gov/pmc/articles/ and we are still on target for seven services across the region to PMC3856565/#:~:text=Attention%20 deficit%2Fhyperactivity%20disorder%20 offer these tests to children from June 2021. (ADHD)%20is%20common%20and%20 In order to support the rollout in Hertfordshire, we worked more,%2DIV%20criteria%20%5B1%5D. Last accessed 04/05/21. with the STP to redesign the pathway for ADHD to include the

2 Quinn, P. O. and Mahdoo, M. (2014). A QbTest and are working with Herts Valley Clinical Review of Attention-Deficit/Hyperactivity Commissioning Group (CCG) to co-fund a pilot to test this new Disorder in Women and Girls: Uncovering This Hidden Diagnosis. Available: https:// pathway. Hertfordshire was chosen for this pilot because the www.ncbi.nlm.nih.gov/pmc/articles/ PMC4195638/#. Last accessed 28/04/21. QbTest was already more embedded where I work in Cambridgeshire and Peterborough, and it was, therefore, 3 Hollis C. et al. (2018). The impact of a computerised test of attention and activity a great opportunity to address potential health inequality in (QbTest) on diagnostic decision-making in children and young people with suspected the region. attention deficit hyperactivity disorder: To support the long-term improvement in services, we have single-blind randomised controlled trial. Journal of Child Psychology and Psychiatry, also helped establish a regional community of practice for Available: https://acamh.onlinelibrary.wiley. com/doi/full/10.1111/jcpp.12921 Last accessed clinicians and service managers that provides peer-to-peer 28/04/21. support and practical advice to help implement change. 4 NIHR CLAHRC East Midlands and the East Despite the added pressures of the pandemic, Eastern AHSN Midlands Academic Health Science Network (EMAHSN). (2018). ADHD care in the East has already made a real impact on the lives of patients and their Midlands. Available: https://emahsn.org.uk/ families by bringing the neurodevelopmental community in the our-work/innovations/focus-adhd. Last accessed 28/04/21. region together to overcome the challenges of diagnosis. I look forward to working with them to expand the rollout of the testing References so that all patients in the region are able to access it.

Living with ADHD

Dr Annie difficult, as children struggling with Phrases such as “they are doing well Clements, (Hons) concentration, organisation and academically” or “it won’t lead to more Founder of Autism social situations don’t get the support support” are common, but it is missed and ADHD, gives and understanding they need, which that this ‘label’ is actually part of our her insight into has both a personal emotional and identity. It relates to far more than our living with ADHD: system cost. ability to achieve in school, and many “All too often, undiagnosed young are left confused and isolated, “I was only people are written off as being badly struggling to understand this sense of diagnosed with behaved and there are still many people ‘failing in life’. It is so valuable to have ADHD when I got who think ADHD doesn’t exist, or that a recognised diagnostic test that a test after my son was diagnosed. In ADHD won’t even be considered if a enables children to get the right many ways, both mine and my son’s child has experienced trauma. Also, as diagnosis faster so that they can get diagnosis came as a relief. It answered with other neurodivergent profiles, it can the care and understanding they need so many questions and relieved be referred to as getting a ‘label’, and – I wish I had been able to benefit from confusion over why there were so many why would you want to ‘label’ a child? it as a child.” things that it appeared I ‘couldn’t do’, in spite of my level of academic ability, which definitely impacted on my self- In many ways, both mine and my confidence and sense of self that I “ had lived with into my 40s. Growing son’s diagnosis came as a relief as it up without a diagnosis can be very answered so many questions”

● Interested in piloting the test? Share this article Learn more about the Focus ADHD programme on the Eastern AHSN website and get in touch with Andy Foster, Senior Advisor at Eastern AHSN at [email protected] if you are interested in piloting the test. National adoption and spread: an update on our national programmes National adoption and spread: an update on our national programmes

The ADHD puzzle - helping children get a validated diagnosis faster

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Save the NHS Save£343 the per NHS diagnosed£343 per ADHDdiagnosed patient ADHDon6 average patient on6 average

I have been using the QbTest with patients for a few years now and, withI have this been data, using I am oftenthe QbTest able to with rule patients in or out for ADHD a few atyears the firstnow appointment with a child. As I was experiencedand, with with the this test data, and I challengesam often able of diagnosingto rule in or theout condADHDition, at theI was first invited appointment by Eastern with AHSN a child. to beAs aI was clinicalexperienced advisor with for thethe testprogramme. and challenges of diagnosing the condition, I was invited by Eastern AHSN to be a clinicalWe kicked advisor off for the the programme programme. in April 2020 by bringing togetherWe kicked 20 key off stakeholdersthe programme to sharein April the 2020 objectives by bringing of our nationaltogether programme 20 key stakeholders and how theto share QbTest the works objectives and listen of our to their feedbacknational programme and local insights. and how Working the QbTest closely works with and five listen to their sustainabilityfeedback and and local transformation insights. Working partnerships closely with (STPs) five in the region, thesustainability AHSN team and identified transformation a service partnerships within each (STPs) locality in the to region,be in the firstAHSN wave team of identified adopters, a whichservice would within be eachempowered locality to to besupport in the first wave of adopters, which would be empoweredlater adopters to support in East Midlands – Improving the diagnosis of thelater region. adopters Given in EastAttention Midlands Deficit – Improving Hyperactivity the diagnosis Disorder of 1 Holden, S., Jenkins-Jones, S., Poole, C. et Attention Deficit(ADHD) inHyperactivity children Disorder al. (2013). The prevalence and incidence, the pressuresregion. Given the 1 Holden, S., Jenkins-Jones, S., Poole, C. et (ADHD) in children resource use and financial costs of treating al. (2013). The prevalence and incidence, healthcarethe pressures system the faced as a result of the coronavirus pandemic, resourcepeople with use attention and financial deficit/hyperactivity costs of treating peopledisorder with (ADHD) attention in the deficit/hyperactivity United Kingdom thehealthcare Eastern system AHSN teamfaced has as a been result fantastic of the coronavirus in keeping uspandemic on track,, (1998 to 2010). Available: https://www.ncbi. disorder (ADHD) in the United Kingdom the Eastern AHSN team has been fantastic in keeping us on track, (1998nlm.nih.gov/pmc/articles/ to 2010). Available: https://www.ncbi. and we are still on target for seven services across the region to PMC3856565/#:~:text=Attention%20 nlm.nih.gov/pmc/articles/ offerand we these are stilltests on to target children for sevenfrom June services 2021. across the region to PMC3856565/#:~:text=Attention%20deficit%2Fhyperactivity%20disorder%20 deficit%2Fhyperactivity%20disorder%20(ADHD)%20is%20common%20and%20 offerIn order these to tests support to children the rollout from inJune Hertfordshire, 2021. we worked more,%2DIV%20criteria%20%5B1%5D. Last (ADHD)%20is%20common%20and%20 In order to support the rollout in Hertfordshire, we worked accessedmore,%2DIV%20criteria%20%5B1%5D 04/05/21. . Last with the STP to redesign the pathway for ADHD to include the accessed 04/05/21. with the STP to redesign the pathway for ADHD to include the 2 Quinn, P. O. and Mahdoo, M. (2014). A QbTest and are working with Herts Valley Clinical 2Review Quinn, ofP. Attention-Deficit/HyperactivityO. and Mahdoo, M. (2014). A CommissioningQbTest and are workingGroup (CCG) with Hertsto co-fund Valley a Clinicalpilot to test this new Disorder in Women and Girls: Uncovering Review of Attention-Deficit/Hyperactivity Commissioning Group (CCG) to co-fund a pilot to test this new DisorderThis Hidden in Women Diagnosis. and Available:Girls: Uncovering https:// pathway. Hertfordshire was chosen for this pilot because the www.ncbi.nlm.nih.gov/pmc/articles/ This Hidden Diagnosis. Available: https:// pathway.QbTest was Hertfordshire already more was embedded chosen for where this pilot I work because in the www.ncbi.nlm.nih.gov/pmc/articles/PMC4195638/#. Last accessed 28/04/21. PMC4195638/#. Last accessed 28/04/21. CambridgeshireQbTest was already and more Peterborough, embedded and where it was, I work therefore, in 3 Hollis C. et al. (2018). The impact of a Cambridgeshire and Peterborough, and it was, therefore, 3computerised Hollis C. et al. test (2018). of attention The impact and of activity a a great opportunity to address potential health inequality in (QbTest) on diagnostic decision-making in computerised test of attention and activity the region.a great opportunity to address potential health inequality in (QbTest)children onand diagnostic young people decision-making with suspected in childrenattention and deficit young hyperactivity people with disorder: suspected the region.To support the long-term improvement in services, we have single-blind randomised controlled trial. attention deficit hyperactivity disorder: To support the long-term improvement in services, we have single-blindJournal of Child randomised Psychology controlled and Psychiatry, trial. also helped establish a regional community of practice for Available: https://acamh.onlinelibrary.wiley. Journal of Child Psychology and Psychiatry, cliniciansalso helped and establish service amanagers regional communitythat provides of peer-to-peerpractice for Available:com/doi/full/10.1111/jcpp.12921 https://acamh.onlinelibrary.wiley. Last accessed 28/04/21.com/doi/full/10.1111/jcpp.12921 Last accessed supportclinicians and and practical service advicemanagers to help that implementprovides peer-to-peer change. 28/04/21. 4 NIHR CLAHRC East Midlands and the East supportDespite and the practical added pressuresadvice to helpof the implement pandemic, change. Eastern AHSN Midlands Academic Health Science Network 4 NIHR CLAHRC East Midlands and the East hasDespite already the made added a real pressures impact ofon the the pandemic, lives of patients Eastern and AHSN their Midlands(EMAHSN). Academic (2018). ADHD Health care Science in the Network East (EMAHSN).Midlands. Available: (2018). ADHD https://emahsn.org.uk/ care in the East familieshas already by bringing made a thereal neurodevelopmental impact on the lives of community patients and in the ir our-work/innovations/focus-adhd. Last Midlands. Available: https://emahsn.org.uk/ families by bringing the neurodevelopmental community in the accessedour-work/innovations/focus-adhd. 28/04/21. Last region together to overcome the challenges of diagnosis. I look accessed 28/04/21. forwardregion together to working to overcome with them theto expand challenges the rollout of diagnosis. of the testi I lookng References forward to working with them to expand the rollout of the testing References so that all patients in the region are able to access it. so that all patients in the region are able to access it.

Living with ADHD Living with ADHD Dr Annie difficult, as children struggling with Phrases such as “they are doing well Clements,Dr Annie (Hons) concentration,difficult, as children organisation struggling and with academically”Phrases such as or “they“it won’t are lead doing to wellmore FounderClements, of (Hons) Autism socialconcentration, situations organisation don’t get the and support support”academically” are common, or “it won’t but lead it is missedto more andFounder ADHD, of Autismgives andsocial understanding situations don’t they get need, the support which thatsupport” this ‘label’ are common, is actually but part it is of missed our herand insightADHD, into gives hasand bothunderstanding a personal they emotional need, whichand identity.that this It‘label’ relates is actuallyto far more part than of our our livingher insight with ADHD:into systemhas both cost. a personal emotional and abilityidentity. to It achieve relates into school,far more and than many our living with ADHD: system“All too cost. often, undiagnosed young areability left to confused achieve inand school, isolated, and many “I was only people“All too are often, written undiagnosed off as being young badly strugglingare left confused to understand and isolated, this sense of diagnosed“I was only with behavedpeople are and written there off are asstill being many badly people ‘failingstruggling in life’. to understand It is so valuable this senseto have of ADHDdiagnosed when with I got whobehaved think and ADHD there doesn’t are still exist, or many peoplethat a recognised‘failing in life’. diagnosticIt is so valuable test that to have a test after my son wasADHD diagnosed. when I Ingot ADHDwho think won’t ADHD even doesn’t be considered exist, or ifthat a enablesa recognised children diagnostic to get the test right that manya test ways,after my both son mine was and diagnosed. my son’s In childADHD has won’t experienced even be considered trauma. Also, if a as diagnosisenables children faster so to thatget thethey right can get diagnosismany ways, came both as mine a relief. and Itmy answered son’s withchild other has experienced neurodivergent trauma. profiles, Also, itas can the carediagnosis and faster understanding so that they theycan getneed sodiagnosis many questions came as aand relief. relieved It answered bewith referred other neurodivergent to as getting a profiles,‘label’, and it can –the care I wish I andhad understandingbeen able to benefit they need from confusionso many questions over why and there relieved were so many whybe referred would youto as want getting to ‘label’ a ‘label’, a child? and it– asI wish a child.” I had been able to benefit from thingsconfusion that over it appeared why there I ‘couldn’t were so do’, many in why would you want to ‘label’ a child? it as a child.” spitethings of that my itlevel appeared of academic I ‘couldn’t ability, do’, in whichspite of definitely my level impactedof academic on ability,my self- “In many ways, both mine and my confidencewhich definitely and impactedsense of selfon thatmy self-I son’s“In many diagnosis ways, came both as mine a relief and asmy it had livedconfidence with and into sense my 40s. of self Growing that I son’s diagnosis came as a relief as it up withouthad lived with a diagnosis into my 40s. can Growingbe very answered so many questions” up without a diagnosis can be very answered so many questions”

● Interested in piloting the test? Share this article Learn● Interested more about in pilotingthe Focus the ADHD test? programme on the Eastern AHSN website Share this article Learnand get more in touch about with the Andy Focus Foster, ADHD Senior programme Advisor on at the Eastern Eastern AHSN AHSN at website [email protected] get in touch with Andy if you Foster, are interested Senior Advisor in piloting at Eastern the test. AHSN at [email protected] if you are interested in piloting the test. National adoption and spread: an update on our national programmes

The ADHD puzzle - helping children get a validated diagnosis faster

Save the NHS £343 per diagnosed ADHD patient on6 average

Living with ADHD

Championing patient safety during a pandemic

Caroline Angel, Director of Patient Safety at Eastern AHSN, highlights the key activities from Eastern AHSN’s Patient Safety Collaborative in 2020/21

atient Safety Collaboratives (PSCs) play an essential role in implementing safer care initiatives across the system, working in acute, non-acute and Click here to community settings to quickly share and spread evidence-based practices, Read more products and tools. The PSCs are a joint initiative, funded and coordinated nationally by NHS Improvement and delivered locally by the AHSN Network. about our work PClinical staff across the healthcare system showed an amazing willingness to go above rolling out and beyond their usual roles in response to the pandemic, including members of our own team, who voluntarily took frontline and logistical roles within the region. Ensuring that the telehealth workforce had the right skills and tools to deal with COVID-19 patients was vital. COVID-19 forced healthcare providers to rapidly review almost every activity and piece of in our region equipment within a clinical setting, right down to the layout of wards as increased infection control and social distancing became an immediate priority. This meant that many traditional ways of working were no longer possible, particularly as GPs were restricted from visiting care home residents because of the risk of infection and cross-contamination between patients and sites. Eastern AHSN built on our existing safety improvement programmes to address these challenges through staff training and the rapid acceleration of our drive to make better use of telehealth. Since 2019, we have been working with providers across the East of England to embed tools to better identify and respond to the deterioration of a patient’s condition (including NEWS2, Soft Signs and SBARD) into local acute and community care settings. We worked with clinical commissioning groups (CCGs) in our region to combine the use of these tools with telehealth, to enable care home staff to calculate patients’ scores and escalate them to a clinician using a structured communication tool. We have also included GPs in our training, enabling digital ward rounds and allowing them to deliver care remotely. Did you know? We were able to use webinars to train more than We helped NHS North East 100 members of care home staff and GPs to use Essex Clinical Commissioning the system, which has already been adopted across ambulance and secondary care, and we will Group with its COVID Oximetry be evaluating the impact of this work over the at Home programme, which This animation will inform you about summer. It’s been incredibly heartening to see such COVID-19, how to measure your oxygen saw 1,500 oximeters levels (using a pulse oximeter), what progress in breaking down silos across care settings distributed across its the danger signs to look out for are during such a challenging time, which is testament to and when to seek urgent help. local services. the amazing and committed staff we have across health What is NEWS2 and social care. and SBARD? Oximetry at Home As our understanding of the virus evolved, so did our support for those providing care to COVID-19 NEWS2 – National Early patients. It was identified that many vulnerable COVID-19 patients presented at hospital with very low, Warning Score 2: a standardised and sometimes fatal, oxygen saturation, but no accompanying severe symptoms of breathlessness1. tool used to identify and To address this, the Patient Safety Collaboratives, NHS England and NHS Improvement developed escalate a deteriorating patient, the COVID Oximetry at Home pathway to enable the remote monitoring of individuals with confirmed by measuring a set of key or suspected COVID-19 using a pulse oximeter to measure oxygen saturation in the blood. physiological parameters. As the programme rolled out rapidly in primary care, PSCs were asked to support acute hospitals to implement virtual wards. This, again, used a pulse oximeter to safely monitor patients recovering from SBARD – Situation, Background, COVID-19 at home or in care homes, allowing earlier discharge of patients. Assessment, Recommendation As Dr David Gannon, Lead Acute Physician at Colchester General Hospital, reflects: “The and Decision: a framework to programme allowed many people to recover in the comfort of their own home with confidence guide structured communication and it allowed for timely identification of people who required of a patient’s condition when further assessment and admission because of a fall in their handing over from one staff blood-oxygen level. member to another. “One of the first patients to benefit was a lady who More than had spent eight days in hospital. She started crying when I told her she could go home with virtual ward 4,566 patients were support and oxygen weaning. She had missed her monitored through the family very badly and couldn’t believe they could be COVID Oximetry at reunited so quickly.” We supported primary and secondary care colleagues to Home pathway from rapidly implement the service, being a critical friend to systems 1 Nov 2020 to and sharing good practice and learning from across the country. We hosted a series of webinars and training sessions to support 28 Feb 2021 the rapid uptake of the Oximetry at Home and virtual ward models. By the end of March 2021, the programme was successfully rolled out across all our CCGs and all but one acute trust in the Eastern region.

Dr Melanie Iles, Medical Director, System Improvement and Professional Leadership (East of England) at NHS England and NHS Improvement: “Working collaboratively with Eastern AHSN, we were able to quickly implement COVID oximetry and COVID virtual hospitals. The supportive approach of the PSC really benefitted the whole East of England health system.” Ensuring safe tracheostomy care Eastern AHSN’s PSC worked with the National Tracheostomy Safety Improving Project (NTSP) to embed elements of a toolkit to support healthcare maternity care staff assigned to care for patients with tracheostomies. A tracheostomy is an opening created at the front of the neck so a Part of the Maternity and tube can be inserted into the windpipe (trachea) to help you breathe. Neonatal Safety Improvement The COVID-19 pandemic saw a sharp rise in patients requiring Programme, the Preventing relatively prolonged ventilatory support, many of whom have required Cerebral Palsy in Pre-term temporary tracheostomies and were often not cared for in permanent, Labour (PReCePT) programme established intensive care unit settings. aims to ensure mothers going The toolkit gives information, practical resources and links to useful into labour before 30 weeks are online training videos and websites to ensure staff have the right offered a dose of magnesium skills and knowledge to appropriately care for these patients. Working sulphate, which costs just £1 and individually with the acute hospitals in the region, we supported the reduces the risk of cerebral palsy. tracheostomy care leads and critical care training lead nurses Despite the pandemic, we to rapidly review the toolkit against current policies, with all worked with all 11 maternity units 1 Richardson S, Hirsch J S, Narasimhan M, et al. (2021). Remote management of COVID-19 sites within our network in the East of England confirming across the region to successfully using home pulse oximetry and virtual ward support. BMJ. 372:n677 adoption of the three safety interventions. This was a priority maintain the excellent 86% rate during the first wave of COVID-19 because of the anticipated achieved last year. References high volumes of patients requiring a tracheostomy.

If you are interested in patient safety in our region and would like to get in touch, contact Caroline at [email protected]

Championing patient safety during a pandemic

Caroline Angel, Director of Patient Safety at Eastern AHSN, highlights the key activities from Eastern AHSN’s Patient Safety Collaborative in 2020/21

If you are interested in patient safety in our region and would like to get in touch, contact Caroline at [email protected]

Championing patient safety during a pandemic

Caroline Angel, Director of Patient Safety at Eastern AHSN, highlights the key activities from Eastern AHSN’s Patient Safety Collaborative in 2020/21

If you are interested in patient safety in our region and would like to get in touch, contact Caroline at [email protected]

● Learning from experience Care during a crisis: Learning from the military-style NHS response to COVID-19 Share this article – Tania Holland, Quality Improvement Project Manager Four things I learned working on the intensive care ward during COVID-19 – Tara Marshall, Clinical Lead for Deterioration The innovation experience: scaling up From seed to growth: securing investment and scaling up What do you need to secure investment and grow your business? We asked two innovators we have worked with in 2020/21 to tell us their stories.

e know how important it is for innovators to access capital to develop your ideas and scale your business, but with so any options out there, where do you start and who should you trust? W Eastern AHSN helps our partners to focus their efforts on funding sources which are right for them and help them write winning applications. We can facilitate partnerships with commercial organisations or investors and connect innovators with appropriate entrepreneurship schemes. We spoke to two innovators we have supported to secure significant investment in 20/21 about their experiences and tips for others looking at funding options.

The Little Journey is a preparation and support tool to help Dr Chris reduce anxiety in children getting ready for healthcare Evans is procedures and surgery, including a smartphone app that Creator of uses VR to familiarise them with the hospital. It has been the Little adopted across more than 60 hospitals to date. Journey app We’ve been working with Eastern AHSN for a few years now and they’ve really helped us understand where we can grow and how to get there. We have had great traction in acute care settings, but when my team attended the scale-up academy run in partnership between Eastern AHSN and Cartezia (and sponsored by the AHSN) it really helped us realise the potential for our innovation and how we could refine our value proposition to help us expand into primary care services and life sciences. As a result, we’ve been able to engage a contract research organisation and pharmaceutical partners to use Little Journey to support children who are taking part in a clinical trial across 11 countries and in different care settings. This funding has allowed us to redevelop the app to be much more flexible so providers can We’ve been working with tailor it to the needs of their patients. We are learning from “ each organisation we work with and applying that learning Eastern AHSN for a few years constantly to benefit everyone. We were delighted to be accepted onto the NHS Innovation now and they’ve really helped Accelerator (NIA) in March 2021 with support from Eastern AHSN. us understand where we can grow The NIA is delivered in partnership with NHS England and the and how to get there. AHSNs and supports uptake and spread of proven, impactful ” innovations across England’s NHS, benefitting patients, populations and NHS staff. Being accepted onto the programme comes with funding and mentoring and has helped build our profile. I am also part of a peer network of NIA Fellows keen to learn from each other. A large part of the evidence base came from the evaluation Eastern AHSN conducted in 2019 and the ongoing support the team have given us has been really helpful in developing and proving the sustainability of the business, which was important in our application. Accessing funding can be hard and it won’t come overnight. As a clinician it was somewhat of a new world to me but over a sustained period of support from Click here to Eastern AHSN we’ve been introduced to investors and NHS stakeholders, aided with successful applications to read more about accelerator programmes and been supported in so Little Journey’s many ways that I didn’t fully realise the value of at the time, but can now see were fundamental in our growth impact as we started out.

MediShout is the only app in healthcare for staff to report any Ash operational issue, while using artificial Kalraiya intelligence (AI) to predict future is CEO of problems; so clinicians can focus on MediShout delivering patient care Grant funding has been a lifeline in our growth in recent years, but the key is understanding what funders are looking for. Eastern AHSN funded a health economic impact assessment which showed the potential of our innovation on healthcare services. This was a big part of our successful application to the NHS Innovation Accelerator in 2020, and we were then thrilled to receive a £1 million investment from a seed venture capital company for which Eastern AHSN had provided an endorsement for us. My advice to other innovators is to remember that funding is Growing your business only part of the equation for scaling your business. Eastern “ AHSN also brokered a pilot with Cambridge University requires funding, profile, Hospitals NHS Foundation Trust and Mid and South Essex customers and evidence NHS Foundation Trust and helped us secure a £75,000 grant from Innovate UK to run it. These relationships are core to of effectiveness, and delivering impact for patients and working within Eastern Eastern AHSN has AHSN’s strong and trusted network has helped us find new opportunities. been amazing in helping Eastern AHSN will be funding a pilot at Royal Papworth us develop all four. Hospital using MediShout with QR codes to enable ” staff to report hand sanitiser gel dispensers that are running out, to ensure they can be topped up. This has enabled us to invest in our technology while offering the trust a chance to Click here to utilise our innovation in an NHS trust for free. Early feedback has read more about been great. MediShout in our Growing your business requires Learn more about how MediShout connects funding, profile, customers and impact story healthcare teams and systems to enable evidence of effectiveness, and them to report any issues and improve operational efficiency Eastern AHSN has been amazing in helping us develop all four.

Share this article ● Get involved Do you have a great idea that could make a positive health impact? Click here for more information The innovation experience: scaling up From seed to growth: securing investment and scaling up What do you need to secure investment and grow your business? We asked two innovators we have worked with in 2020/21 to tell us their stories.

Share this article ● Get involved Do you have a great idea that could make a positive health impact? Click here for more information The innovation experience: scaling up The innovation experience: scaling up From seed to growth: securing investment and scaling up What do you need to secure investment and grow Whatyour business? do you need We toasked secure two investment innovators and we havegrow yourworked business? with in 2020/21We asked to two tell innovatorsus their stories. we have worked with in 2020/21 to tell us their stories. e know how important it is for innovators to access capital to develop your ideas and scale your ebusiness, know how but important with so any it is options for innovators out there, to accesswhere docapital you tostart develop and who your should ideas you and trust? scale your W business,Eastern but AHSN with helps so any our options partners out tothere, focus where their doefforts you starton fundin and whog sources should which you trust? are right for themW and help themEastern write AHSN winning helps applications. our partners We to can focus facilitate their efforts partnerships on fundin withg sourcescommercial which organisations are right foror investorsthem and and help connect them write innovators winning with applications. appropriate We entrepreneurship can facilitate partnerships schemes. with commercial organisations or Weinvestors spoke and to two connect innovators innovators we have with supported appropriate to entrepreneurshipsecure significant schemes. investment in 20/21 about their experiences andWe tips spoke for others to two looking innovators at funding we have options. supported to secure significant investment in 20/21 about their experiences and tips for others looking at funding options.

The Little Journey is a preparation and support tool to help Dr Chris Thereduce Little anxiety Journey in childrenis a preparation getting readyand support for healthcare tool to help DrEvans Chris is reduceprocedures anxiety and in surgery, children including getting ready a smartphone for healthcare app that EvansCreator is of proceduresuses VR to familiariseand surgery, them including with the a hospital.smartphone It has app been that Creatorthe Little of usesadopted VR toacross familiarise more themthan 60with hospitals the hospital. to date. It has been theJourney Little app adoptedWe’ve beenacross working more than with 60 Eastern hospitals AHSN to date.for a few years Journey app nowWe’ve and been they’ve working really withhelped Eastern us understand AHSN for wherea few years we can grow and how to get there. We have had great tractionnow and in acutethey’ve care really settings, helped but us when understand my team where attended we can growthe scale-up and how academy to get there. run in We partnership have had betweengreat traction in acute care settings, but when my team attended theEastern scale-up AHSN academy and Cartezia run in (andpartnership sponsored between by the AHSN) it really helped us realise the potential for our Easterninnovation AHSN and and how Cartezia we could (and refine sponsored our value by theproposition AHSN) itto really help ushelped expand us realiseinto primary the potential care services for our innovationand life sciences. and how we could refine our value proposition to help us expand into primary care services andAs life a result, sciences. we’ve been able to engage a contract research organisation and pharmaceutical partners to useAs Little a result, Journey we’ve to been support able children to engage who a are contract taking research part in a organisationclinical trial across and pharmaceutical 11 countries and partners in to use Little Journey to support children who aredifferent care taking part in settings. a clinical This trial funding across 11has countries allowed andus to in different careredevelop the app tosettings. be This much funding more hasflexible allowed so providersus to can We’ve been working with redevelop thetailor it to the needs app to of be their much patients. more flexibleWe are learningso providers from can “We’ve been working with tailoreach organisation it to the needs we of work their withpatients. and applyingWe are learning that learning from Eastern“ AHSN for a few years each organisationconstantly to benefit we workeveryone. with and applying that learning Easternnow and AHSN they’ve for really a few helped years constantlyWe were to delighted benefit toeveryone. be accepted onto the NHS Innovation now and they’ve really helped AcceleratorWe were delighted (NIA) in March to be 2021accepted with supportonto the from NHS Eastern Innovation AHSN. us understand where we can grow AcceleratorThe NIA is delivered (NIA) in March in partnership 2021 with with support NHS fromEngland Eastern and AHSN.the us understandand how whereto get there.we can grow TheAHSNs NIA and is delivered supports in uptake partnership and spread with NHS of proven, England impactful and the and how to get there.” AHSNsinnovations and supportsacross England’s uptake and NHS, spread benefitting of proven, patients, impactful ” innovationspopulations acrossand NHS England’s staff. Being NHS, acceptedbenefitting onto patients, the programme comes with funding and mentoring and has populationshelped build and our NHSprofil staff.e. I am Being also partaccepted of a peer onto network the programme of NIA comesFellows with keen funding to learn and from mentoring each other. and has helped build our profile. 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Meeting the cancer challenge

Katrina Wilson, Principal Advisor for Cancer at Eastern AHSN, provides an overview of how we are working across the region to improve cancer services

upporting cancer innovation has been a long-term priority for Eastern AHSN, underpinned by the NHS Long Term Plan ambitions that more people each year will survive five years or more following their diagnosis and 75% of cancers will be diagnosed at an early stage. The COVID-19 pandemic forced healthcare services to adapt how they delivered services as NHS providers acted quickly to minimise the impact on cancer treatment. However, as the pandemic took hold routine Sscreening, investigative tests and some treatments were disrupted. At the same time, fear of catching COVID-19, wanting to support the NHS by reducing burden, and a hesitancy or inability to use online “Tackling the cancer consultations caused fewer people to seek support from their GPs. challenge requires us As a result, Macmillan estimates that there are around 50,000 missing cancer diagnoses1 from 2020 across to use the best tools the UK. Fewer people also started treatment after a cancer diagnosis than in 2019. In England alone, we can to empower between March and August 2020, around 30,000 fewer people started their first cancer treatment compared clinicians and support with the year before. earlier diagnoses” Supporting a regional approach We have been working closely with our local integrated care systems (ICSs) and sustainability and transformation partnerships (STPs), the NHS England and Improvement cancer innovation team and the East of England Cancer Alliance to explore how we can make the best use of innovative cancer solutions to drive advances in treatment and improve patient outcomes. The agreed approach was to prioritise innovations that could speed up patient journeys, simplify access to results, and wherever possible deliver services without the need to attend hospital. We have successfully launched two cancer projects to evaluate innovations we think can help meet these challenges.

Embedding cancer innovation across Norfolk and Waveney Following interest arising from our cancer innovation exchange event in 2019, we agreed to fund a role embedded within the Norfolk and Waveney Sustainability and Transformation Partnership (STP) to support the rollout of two cancer innovations in their local system:

Skin Analytics Skin Analytics has developed a machine learning algorithm, DERM, to help identify skin cancer, supporting primary care clinicians to decide if patients need referral or further monitoring. Using a smartphone with dermatoscopic attachment, patients’ lesions are assessed by DERM in seconds to support their referral decision, ensuring the patient is placed on the right pathway, or safely reassured if no referral is needed. We have commissioned an evaluation to compare cancer detection rates with and without the tool and the evaluation will be completed in summer 2021. Find out more about Skin Analytics.

EarlyCDT Lung test This innovation from Oncimmune is a blood test to support the early detection of lung cancer. Eastern AHSN has brokered a pilot with Norfolk and Waveney STP using the test to screen patients at high risk of developing lung cancer across Great Yarmouth Primary Care Network (PCN), which began in January 2021. In the first four months of the pilot, 988 smokers were booked in for their blood test, which identified 277 with possible lung cancer for referral to hospital tests. To ensure the local healthcare system can process the additional referrals into secondary care, Eastern AHSN is part-funding a staffed modular CT scanner at the James Paget University Hospitals NHS Foundation Trust with the East of England Cancer Alliance to ensure that patients testing positive with the EarlyCDT Lung test are able to be promptly triaged into a CT scan to identify or rule out a cancer diagnosis. Find out more about Oncimmume.

Robert Mayes, Senior Project Manager for Norfolk STP, reflects on the impact delivered across Norfolk: “We’re so grateful for the vital support we’ve had from Eastern AHSN. Beyond the funding for my role and the delivery of these projects, the team has added so much value through helpful insight and constructive challenge arising from years of innovation expertise. I’m so proud of what we have managed to deliver despite the coronavirus pandemic and we have Eastern AHSN, my colleagues across Norfolk and Waveney and the commitment of clinicians locally to thank for that.”

Cancer innovations under the spotlight In October, we partnered with Macmillan Cancer Support to help them identify possible solutions and partnerships for their innovation team. We were able to showcase a number of exciting innovations that have been recommended through our Innovation Review Panel. Some of the innovations showcased included:

Airglove is a warm-air system that gently heats up a patient’s lower arm to widen blood vessels (a process known as Airglove has helped out vasodilating) and make cannulation easier “ for healthcare professionals. With extended with some really difficult courses of treatment such as chemotherapy, repeated cannulation is cases where we would often required and can be difficult. An economic assessment of Airglove found sometimes have to move that it saved an estimated £64 per patient per year through reduced wastage2 and to central lines” nursing time3 and, most importantly, it – Nurse at Addenbrooke’s Hospital, Cambridge improves the experience of vulnerable patients. Eastern AHSN supported the piloting of Airglove across 11 oncology departments in the region, all of whom adopted the innovation based on data from the pilots. Cambridge University Hospitals NHS Foundation Trust purchased eight Airglove units for use by services beyond oncology to increase its adoption across the trust. As a result of the Macmillan Cancer Support event, we are currently in discussion with another local NHS trust to pilot an adaptation of the innovation to improve circulation in lower limbs. Find out more about Airglove.

C the Signs is an integrated clinical decision support tool that uses artificial intelligence mapped with the latest clinical evidence to support GPs to identify patients at risk of cancer at the earliest stage of the disease. Eastern AHSN is funding a post for a head of innovation, Caroline Angus, within the Suffolk and North East Essex ICS to embed innovation and transformation. Caroline has been working closely with ICS colleagues to find an appropriate clinical decision support tool and has brokered a pilot of C the Signs across 38 GP practices commissioned by Ipswich and East Suffolk CCG. We are providing programme management support and will be funding an independent evaluation of the service. Caroline Angus, Head of Innovation at Suffolk and North East Essex ICS, said: “Tackling the cancer challenge requires us to use the best tools we can to empower clinicians and support earlier diagnoses. We hope C the Signs 1 Macmillan Cancer Support (2020). The can help GPs in our region identify possible cases of cancer more easily and give patients the best forgotten ‘C’? The impact of Covid-19 on cancer care. .: Macmillan Cancer Support. possible chances of recovery”. Find out more about C the Signs. 3. Available: https://www.macmillan.org. uk/_images/forgotten-c-impact-of-covid-19- on-cancer-care_tcm9-359174.pdf Last NeutroCheck has been designed to enable patients with symptoms to test for neutropenic sepsis, accessed: 28/04/21 a potentially life-threatening complication of chemotherapy, quickly and accurately at home using a 2 Green Cross Medico. (2017). Service Evaluation of the AirGlove Patient Warming finger-prick test. Despite NeutroCheck still being in development, we’ve had a lot of excitement from Device. Available: http://www. clinicians keen to trial it as detecting the early signs of neutropenic sepsis would enable patients to get greencrossmedico.com/wp-content/ uploads/2018/01/Patient-Evaluation-Final- to hospital as quickly as possible and get the treatment they need, as well as avoiding unnecessary Report-030118-1.pdf. Last accessed 28/04/21. hospitalisations for those who test negative. In April 2020, Cambridge-based NeutroCheck received a £125,000 grant to further develop its test 3 Scales, K. (2005). Vascular access: a guide to peripheral venous cannulation. through the Medtech Accelerator, a joint venture between Eastern AHSN, Health Enterprise East and Nursing standard: official newspaper of the Royal College of Nursing, 19(49), pp.48–52. public sector partners. The Macmillan team was so impressed with the innovation it was invited to present at a Macmillan conference in March and conversations are ongoing about how it can support References NeutroCheck in the future. Find out more about NeutroCheck.

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Meeting the cancer challenge

Katrina Wilson, Principal Advisor for Cancer at Eastern AHSN, provides an overview of how we are working across the region to improve cancer services

Share this article ● Like to get involved? Do you have an idea that could improve cancer patient outcomes or support earlier diagnosis? Get involved Priority update: cancer

Meeting the cancer challenge

Katrina Wilson, Principal Advisor for Cancer at Eastern AHSN, provides an overview of how we are working across the region to improve cancer services

Share this article ● Like to get involved? Do you have an idea that could improve cancer patient outcomes or support earlier diagnosis? Get involved Focus on: mental health Same storm, different boats: supporting mental health services through COVID-19

Dr Sarah Robinson, Director of Delivery at Eastern AHSN and clinical psychologist, explores how innovation can help meet the mental health challenge arising from the COVID-19 pandemic

n March 2020, writer Damian Barr reflected on the COVID-19 pandemic by saying “we are not all in the same boat. We are all in the same storm. Some are on super-yachts. Some have just the one oar”1. It is still too early to fully understand the impact of the pandemic on the population’s psychological wellbeing in the longer term. Early analysis suggests a significant increase in Istress, anxiety, depression and eating disorders in the general population2, with the Royal College of Psychiatrists reporting that 43%3 of psychiatrists saw an increase in urgent and emergency cases and referrals for psychosis4 during the first COVID-19 lockdown. At Eastern AHSN, we have looked to help address this challenge through supporting mental health services and helping embed innovation to prepare services for a surge in demand in 2021 and beyond. Supporting the initial COVID-19 I can’t thank Eastern AHSN response “ As the first national lockdown was announced, we helped NHSX launch enough for what they’ve done TechForce19, a call to find and fund innovations that could help vulnerable people isolated by the pandemic. The AHSN Network was for us. As well as the expertise well placed to recommend hundreds of proven innovations that had and input they have given to been through our innovation review panel and, in many cases, had gathered real-world evidence through AHSN-funded pilots. The AHSNs help us develop our product, mentored those innovators, who received funding to maximise the I’ve really valued how impact to the system. At the same time, we worked closely with our regional mental health they’ve helped me connect clinical network, supporting it to evaluate how transformation funding with talented people who was spent in urgent care, partnering to provide additional assurance around how our local systems were planning their commissioning, and are just as excited about our supporting the delivery of quality improvement programmes. The mission as we are” compiled findings were the basis of a best practice report for mental – Becky Cotton, Founder at Lumino health developed in partnership with RAND Europe and NHS England and NHS Improvement. Embedding innovations to better manage service capacity We have seen fantastic transformation occurring with our two nationally commissioned programmes, both of which have the potential to have significant patient impact through earlier diagnosis and treatment (Early Intervention for Eating Disorders and in improving ADHD diagnosis). This year, we have partnered with Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), the University of Cambridge Department of Psychiatry, and the NIHR Applied Research Collaboration East of England to investigate the biological, psychological and social factors underlying persistent depression and how to help people recover. This programme, called i-VALiD (Informing VALues-based practice in persistent Depression), has convened health professionals, science and technology partners, and experts with lived experience to consider how we can work together to improve the depression care pathway and pursue the most promising, cost-effective new treatments to transform lives now and in the future. We are also using this engaged network to accelerate innovation in NHS mental health care. 1 Barr, D. (2021). George Takei just shared this thought of mine…. Available: https:// We are really excited about numerous emerging digital solutions that carefully consider a specific area www.damianbarr.com/latest/damian-barr- george-takei-we-are-not-all-in-the-same- of distress and design a bespoke solution. An example of this is a therapeutic tool called Seren, created boat. Last accessed 04/05/21. by Lumino to support women experiencing the menopause via an app. The evidence-based clinical 2 Jia, R et al. (2020). Mental health in the resources contained are built on a detailed understanding of the psychological impact of the UK during the COVID-19 pandemic: cross-sectional analyses from a community menopause and it has been co-produced with digital experts and women who have and are cohort study. BMJ Open. 10, 1-14. experiencing the menopause. We have been working with Lumino this year to support development 3 Royal College of Psychiatrists. (2020). alongside clinical psychologists and GPs, and are looking to support a feasibility pilot in 2021. Psychiatrists see alarming rise in patients needing urgent and emergency care and “I can’t thank Eastern AHSN enough for what they’ve done for us. As well as the expertise and forecast a ‘tsunami’ of mental illness. input they have given to help us develop our product, I’ve really valued how they’ve helped me Available: https://www.rcpsych.ac.uk/ news-and-features/latest-news/ connect with talented people who are just as excited about our mission as we are,” says Becky Cotton, detail/2020/05/15/psychiatrists-see- alarming-rise-in-patients-needing-urgent- Founder at Lumino. and-emergency-care. Last accessed 4th May 2021. Looking forward 4 Rodgers, R F et al. (2020). The impact of the COVID-19 pandemic on eating disorder As a clinical psychologist myself, I understand the pressures that already existed on mental health risk and symptoms. The International services, many of which have been compounded by the pandemic. However, I also see the huge Journal of Eating Disorders. 53 (7), 1166-1170. potential for healthcare organisations to deliver services differently and embed innovative tools

that empower patients in their own treatment and enable better use of technology and emerging References evidence-based solutions.

Share this article ● Get in touch If you have a mental health innovation that could deliver patient impact, get in touch. Focus on: mental health Same storm, different boats: supporting mental health services through COVID-19

Dr Sarah Robinson, Director of Delivery at Eastern AHSN and clinical psychologist, explores how innovation can help meet the mental health challenge arising from the COVID-19 pandemic

that empower patients in their own treatment and enable better use of technology and emerging References evidence-based solutions.

Share this article ● Get in touch If you have a mental health innovation that could deliver patient impact, get in touch. Innovator profile: Laudit

Celebrating NHS staff achievements with Laudit

Dr Will Davies, Consultant Interventional Cardiologist at Royal Papworth Hospital NHS Foundation Trust, explains how Eastern AHSN has supported the development of the Laudit platform to help staff recognise the excellent work of their colleagues.

hile many NHS staff receive thanks from grateful patients for the care they provide, there was no formal process in our trust for staff to recognise and thank their colleagues. We comprehensively record and report if an adverse event occurs but it’s so easy for great care to go uncredited. The Laudit reporting portal was conceived to enable the recognition and celebration of the everyday extraordinary actions and behaviours of both clinical and non-clinical staff within their day- to-day work. To date, we have received just under 2,800 submissions, which are called laudits. Having created the tool for use within Royal Papworth Hospital, the drive is now to develop a robust digital platform that couldW be adopted across the NHS nationally. Laudit will be built on Amazon Web Services (AWS) with the support of its professional services team. Creating the application on AWS will enable us to develop and innovate more quickly. It also means that the app can scale up and down rapidly in response to demand and as Laudit “Eastern AHSN’s becomes used more widely. Laudit reports are generated and shared with staff and their managers. The data knowledge, from generated will also help to inform appraisals, revalidation and employee recognition practical advice to initiatives. Balancing the development of an innovation with a busy clinical job is difficult and broader strategy, has turning an idea into a viable product requires specialist expertise, which is where Eastern AHSN’s knowledge, from practical advice to broader strategy, has been been invaluable” invaluable. Eastern AHSN has also helped amplify our story, develop our brand and make connections within its network of like-minded experts. I attended one of its clinical entrepreneur events and learned so much about what we needed to do and was reassured to meet other people who were on the same journey. We are already in talks with organisations both within and outside the NHS about trialling the new portal once it has been developed and I’m so excited about how Laudit can help other people in the NHS get the recognition they deserve.

Insight

Stephen Posey, Royal Papworth Hospital, Laudit has Laudit has been recognised as an Chief Executive been an excellent way to capture and outstanding example of caring practice Officer Royal recognise moments where staff have in a Care Quality Commission (CQC) Papworth supported each other or delivered report in 2019 and the domains within Hospital NHS exceptional care to patients. the Laudit reporting system mirror the Foundation Trust: During the COVID-19 pandemic, our CQC framework. This enables our staff have come together and supported board to demonstrate areas of Over the past year, each other through a very difficult time. outstanding performance within the we have seen so I have been so proud to see the volume trust while also allowing us to find best much public and variety of posts our staff submitted practices and individuals who make a appreciation of the role that NHS staff to Laudit in the past year, each one a difference in our organisation. play in delivering excellent care for celebration of the positive impact our I’m thrilled that such a fantastic patients. Here at Royal Papworth staff have had on the people around idea came from one of our own Hospital, Laudit has been a great way them. As the pandemic took hold, we clinicians and that we have been for us to quickly and easily celebrate saw a steep rise in submissions, with supported by Eastern AHSN to develop the “everyday extraordinary” things that over 1,700 between March 2020 and the initiative further. It would be great to our staff do in support of each other March 2021 alone. I have no doubt that see Laudit adopted nationally so we and our patients. these Laudits really boosted morale can identify and celebrate the NHS At Royal Papworth Hospital, we have during what was a very stressful time. heroes everywhere. an excellent culture of reporting adverse events and are grateful to our quality and risk team for instilling this It would be great to see Laudit ethos. However, before Laudit, we did “ not have a robust mechanism in place adopted nationally so we can identify for the day-to-day reporting of positive events. This is something we need to and celebrate the NHS heroes do more of across the NHS, and here at everywhere”

● Would you like to adopt Laudit? Share this article If you want to learn more about adopting Laudit in your trust, contact Joanna Dempsey, Commercial Enterprise Lead at Eastern AHSN: [email protected] Innovator profile: Laudit

Celebrating NHS staff achievements with Laudit

Insight

More common than you think: understanding rare diseases Dr Louise Jopling, Commercial Director at Eastern AHSN, explains how we are working to improve the diagnosis and treatment of rare diseases across our region and beyond

rare disease is defined as a condition that affects fewer than 1 in 2,000 people1. With approximately 7,000 individually identified rare diseases, it has been calculated that 1 in 17 people will be diagnosed with a rare disease at some point in their life. In the UK, this amounts to more than 3.5 million people1. Our work to support the rare disease community is underpinned by the UK Rare Diseases Framework, published January 2021, calling for a focus on making better use of diagnostic technologies and genomics to Ahelp patients receive a final diagnosis faster. The framework also highlighted a need to increase awareness of rare diseases among healthcare professionals, while ensuring that those involved in patient care are provided with the appropriate education and support will also be critical in Click here improving the quality of care received. to catch up on all the sessions from Reducing the diagnostic odyssey for the AHSN Network rare disease patients Bridging the Gap We have worked with Mendelian and East and North Hertfordshire Clinical Commissioning Group event over the past couple of years to broker an initial pilot of MendelScan, a software package for analysing targeted, whole-exome, or whole-genome, sequencing data in family studies of inherited disease. The pilot ran across the Lea Valley GP Federation to understand how it could support GPs to identify patients for appropriate referral, with the aim of accelerating rare disease diagnosis. The recently announced partnership between Modality NHS Partnership and Mendelian will enable further scale of this technology across 45 GP practices. We are brokering a relationship between Mendelian and other AHSNs, and its experience of working with the network was showcased in a workshop at the Bridging the Gap event hosted by Eastern, KSS and Oxford AHSNs. Using patient insight to develop innovations that make a difference Working with Eastern A key priority for us is to support the development of innovations that “ improve the everyday lives of those living with rare diseases. In November, AHSN to launch the patient we partnered with the Cambridge Rare Disease Network (CRDN) to sponsor insight survey helped capture their bi-annual RAREfest event, where we launched a survey to gather the experiences and stories of those living with rare diseases, including families the experience of those living and carers. with rare diseases so we can The insights shared by the survey respondents highlighted a broad range of issues and opportunities for innovation to help address the challenges of start to address the everyday care coordination, education and the potential for better use of technology. issues they face We are using the survey results to create challenge statements that we ” can share with the innovator community, which may have technologies to – Jo Balfour, Managing Director of the Cambridge Rare Disease Network address these challenges. We hope to be able to present some of these innovations in a pitch event with members of the rare disease community at CRDN’s Rare Disease Summit later this year.

Bringing together the rare disease community

Jo Balfour, The funding that Eastern AHSN experiences across different diseases. Managing Director provides is vital for organisations Because of the small number of people of the Cambridge such as ours, but it’s also the team’s affected by some rare diseases, people Rare Disease expertise and support in gathering often feel isolated in their experiences. Network (CRDN) insights that lead to impact that is This survey has shown the potential for so valuable. innovation to support the whole rare Because of the It was fascinating to read the survey disease community and I’m so excited to coronavirus findings, which highlighted a number of work with Eastern AHSN to find pandemic, challenges arising from specific solutions that can have the biggest RAREfest20 was conditions, as well as a lot of common impact and improve lives. hosted online for the first time. While this presented a challenge for us, it offered a wonderful opportunity to have a far more inclusive event, which attracted more than 1,000 attendees from 41 countries. People who may not have been able to attend a physical event could contribute and be heard. Working with Eastern AHSN to launch the patient insight survey helped capture the experiences of those living with rare diseases so we can start to address the everyday issues they face. NETWORK DISEASE RARE © CAMBRIDGE

Supporting rare disease education for the healthcare workforce RAREfest20 With so many individual rare diseases, it is vital to support the continuing education of NHS staff working in had 1,030 this space. One group of rare diseases is known as Lysosomal Storage Disorders (LSD) and comprises attendees from approximately 70 individual diseases that result from inborn errors of lysosomal function. Lysosomes are 41 countries intracellular organelles within all tissues, which contain a wide variety of enzymes that break down complex molecules required for normal cellular digestive processes. Problems with lysosomal function leads to diseases such as Gaucher Disease, Fabry Disease, Mucopolysaccharidoses and many more. In January 2020, we were introduced to Elizabeth Morris, Clinical Nurse Specialist in LSD at Cambridge University Hospitals NHS Foundation Trust. Elizabeth had been working with her peers across the country to create a national LSD nurse steering committee. She had identified the need for a comprehensive nurse More than educational platform over many years, but needed funding and support in engaging stakeholders alongside 45 patient groups their busy clinical duties. were represented at RAREfest20 Elizabeth Morris, Clinical Nurse Specialist at Cambridge University Hospitals NHS Foundation Trust: “As a clinician, it can be difficult finding reliable training to help deliver better care for patients with rare diseases. We want to help educate nurses and other health professionals by providing accessible, digestible and accredited resources so they can understand more about these conditions and their patients’ experiences. Eastern AHSN is helping us turn this vision into reality.”

Many pharmaceutical companies have therapeutics in the LSD domain and were keen to collaborate with the nurse steering committee to develop an educational programme. Working with the Association of the British Pharmaceutical Industry, Eastern AHSN acted as secretariat for the project, drawing on our expertise in brokering collaboration to ensure appropriate and equitable inclusion for each interested company and to outline the proposal and funding requirements. As a result, we have secured educational grant funding from four companies and, following a successful tender, are now working with a medical communications agency to bring the nurse steering committee’s vision to life. We are engaging the Royal College of Nursing to ensure the educational modules are accredited before they are hosted on the British Inherited Metabolic Disease Group website. This resource will support the NHS Long Term Plan’s aims for better workforce education and retention, as well as improving the experiences of patients with rare diseases. We are already looking to the future potential for expanding the platform to additional healthcare professionals, pharmacists, genetic counsellors References and GPs, as well as international colleagues.

● Want to know more? Share this article If you want to learn more about our work with rare diseases, contact Dr Louise Jopling, Commercial Director at Eastern AHSN, at [email protected]. You can learn more about our business priorities on our website. Focus on: rare diseases

Bringing together the rare disease community

A hundred -year life?

Our life span is increasing – but what can we do about our health span? Charlotte James, Director of Communications, Marketing and Engagement, shares an update on our work to support our communities to live and age well

he majority of children born in the UK today can expect to live to more than 100. This increase in life expectancy has been happening for decades, but these extra years of life are not always spent in good health, with many people developing conditions that reduce their independence and quality of life. This discrepancy between our life span and health span has major implications for public health, the economy and our national health service. Living and ageing well is therefore a key priority for us in helping Tto deliver the NHS Long Term Plan. We believe we have a key role to play in helping older people receive the right kind of support to help them live as well as possible while not overwhelming health and social care services.

“We believe we have a key role to play in helping older people receive the right kind of support to help them live as well as possible”

Living well Crucially, the challenges of an ageing population require that we maintain healthy behaviours throughout life. These dynamics and long-term demographic trends point to a growing role for enabling everyday health. As the world population grows and ages, the need for safe and effective self-care will grow with it. That will involve a considerable effort from healthcare professionals and the industry in educating people in self-care for both their mental and physical health.

We are therefore proud to be a partner of the (NIHA) AGEING HEALTHY OF © NORWICH INSTITUTE Norwich Institute of Healthy Ageing (NIHA) - a new research group, launched in November, that To find out more brings together researchers, policy-makers, commercial partners and the local community to about the investigate the social, cultural, economic, geographical and Norwich Institute of environmental determinants of behaviours that impact public health. The new institute believes, as we do, in adding life to years and researchers will collaborate Healthy Ageing (NIHA), on reducing the risk of a range of health issues – from dementia and diabetes to heart disease. click here They will explore how behaviour changes such as improved nutrition, regular exercise, socialisation and sleep hygiene can lead to better physical and mental health.

Living independently We are committed to make better use of technology, such as wearable devices and monitors, to support people with long-term health problems in new ways, helping them to live independently for longer. Charco Neurotech is one company we have been working with this year to develop a wearable device, called Cue, that has the potential to make a real difference to the lives of people with Parkinson’s disease by improving their movement and quality of life. This non-invasive wearable uses pulsed cueing and focused vibrotactile stimulation to reduce symptoms of slowness and stiffness. We have been supportingCharco Neurotech this year to develop its health economic budget impact model, in addition to giving advice on procurement and clinical positioning. When COVID-19 forced hospitals to deliver services differently, we helpedActive+Me , a cardiac rehabilitation pilot being run at Addenbrooke’s Hospital, to quickly adapt to online classes to ensure patients were able to keep up their exercise and manage their recovery, thanks to funding from Innovate UK. Active+Me is a solution, developed by Aseptika, that empowers patients to take charge of their own recovery through safe exercise and education on risk factors and lifestyle changes. In addition, patients are provided with medical monitors to record their progress, such as on activity levels, blood pressure, weight and oxygen “I am really grateful I saturation. The data are uploaded to an app and shared securely with the took part in the pilot; hospital’s cardiac rehabilitation team. One patient using the Active+Me platform is Cambridgeshire-based Steve King. Steve enrolled onto the pilot after a triple I feel much more self- heart bypass. He reflected:“After my surgery I started my cardiac rehabilitation, aware, confident and but what was different this time was I enrolled onto theActive+Me pilot, which piqued my interest because of my research background. I also found out that I in control of what was borderline type 2 diabetic, which was further motivation to make a change to I do now my lifestyle. Now, I measure my weight, blood pressure and blood-oxygen levels ” – all of which I didn’t pay any attention to before – as part of my daily routine. But what interests me most is the trends in my data over time, which I can monitor through the app. I am really grateful I took part in the pilot; I feel much more self-aware, confident and in control of what I do now.” Buddi Connect is one of the innovations we supported following a grant from NHSX as part of its TechForce19 call out for innovations to help those isolated by COVID-19. The app enables people to stay in touch with loved ones as well as raise alerts if they need help. We are providing commercial mentoring for Buddi Connect to shape its approach to market adoption, and supported its successful application to the NIHR Invention for Innovation (I4I) programme. While we were not able to conduct our planned care homes pilot of Washseat during the pandemic, we hope to do this as soon as it is safe to do so. This innovation, which we have supported from prototype, fits over the top of an existing toilet to provide a raised seat and built-in washing facility to enable the user to manage their personal hygiene with dignity. We continue to provide them with mentoring as we look to identify pilots in the region and nationally.

Care at home The NHS Long Term Plan outlines the objective to give people greater control over the care they receive and for more care support at home rather than in hospital. This objective was further prioritised with the added pressure of a global pandemic and restrictions to movement. The rapid digitalisation of life during COVID-19’s acute phase had a huge impact on healthcare delivery, including a major shift to telemedicine across the NHS. While there is more work to do to ensure we don’t exclude people who are not digitally literate, this transformation was vital in enabling continuation of care during the crisis. We supported clinical teams in our region to transition from face-to-face services to online consultations, alongside the virtual monitoring of vital signs to keep patients away from overstretched and potentially infectious hospitals and GP surgeries. Read more about our work enabling telemedicine in the region.

1 Roser, M., Ortiz-Ospina, E. and Ritchie, H.. (2019). Life Expectancy. Available: https:// ourworldindata.org/life-expectancy. Last Living with long-term conditions accessed 28/04/21. In the UK, one in four adults is now estimated to have two or more health conditions. We are working with Suffolk Primary Care to pilot the use of two innovations,Liberate Pro and CareDoctR, to empower Reference clinicians and patients to manage long-term conditions more effectively. Read more here.

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A hundred -year life?

“We believe we have a key role to play in helping older people receive the right kind of support to help them live as well as possible”

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A hundred -year life?

“We believe we have a key role to play in helping older people receive the right kind of support to help them live as well as possible”

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Physically distanced, but just as engaged: Empowering the patient voice © PETER KINDERSLEY

Helen Oliver, Chief Operating Officer and Deputy Chief Executive Officer at Eastern AHSN, explains how we have kept patient involvement at the centre of our programmes in 2020/21

he COVID-19 pandemic forced healthcare services to rapidly innovate and adapt how they delivered care to ensure the safety of both patients and clinicians. The pace of change meant patient and public consultation wasn’t always possible, but as we continue to evaluate the impact of reconfigured services and which changes are worth keeping, it’s vital that we listen to the populations they affect the most. We are passionate about public and patient involvement and want the East of England health and care Tsystem to consistently empower patients and the public to define, determine and deploy innovations that best meet their needs. We work hard to ensure that we have patient and public representation in our programmes and, despite the challenges of engaging locked-down stakeholders, we continue to support healthcare providers to ensure that patient voices shape how services return as the pressures of the pandemic ease. We have delivered this through three workstreams: creating spaces for patients, empowering patient leaders and using insight more effectively. Creating space for patients to influence health services We supported the Cambridge Rare Disease Network (CRDN) with RAREfest20, sponsoring the bi-annual public event and using the occasion to launch a survey to better understand the everyday challenges faced by people living with rare diseases, including families and carers. Because of the pandemic, the event was run online, which presented an opportunity to reach a broader audience. Next, we will be partnering with the CRDN to translate the survey findings into actionable challenges that we will put to the innovation community to make sure we turn insight into health impact. You can read more about this work in more depth in our Focus on: rare diseases article. This wonderful course is For the past four years we have proudly hosted the East of “ England Citizens’ Senate, which provides clinical networks and teaching me so much more other regional healthcare structures with insight, information and than I ever thought views about services and proposed service changes from the perspective of patients and carers. All members either have first- I understood about hand experience of living with long-term conditions or care for humility and curiosity someone who does. Their breadth of experience means we can ” learn from and share emerging approaches to co-production and public and patient involvement with our partners. An example of this is our work with Cambridgeshire and Peterborough NHS Foundation Trust and partners to lead a bid for a new innovation hub to support the adoption and adaptation of innovations across the Cambridgeshire and Peterborough Integrated Care System (ICS), with patient and public involvement representation at its core. We worked with the county’s Healthwatch, the Citizens’ Senate and local providers’ patient groups to use existing forums to gather patient input into the proposed design of the hub. We are currently waiting to hear if the bid has been successful ahead of a launch for the hub in summer 2021.

Empowering patient leaders Listening to patients isn’t enough. For services to be truly patient-focused, feedback needs to translate into influence and change. In partnership with The King’s Fund and the East of England Citizens’ Senate, and with sponsorship from NHS Leadership Academy, we delivered a four-day leadership training course, for free, to patient and public representatives. The programme empowered 21 participants this year to develop the skills, knowledge and behaviours to underpin collaborative and meaningful relationships with NHS decision-makers as they shape the services in our region.

Leading for change programme participant: “This wonderful course is teaching me so much more than I ever thought I understood about humility and curiosity. The stars are aligning on so many levels. I felt it as soon as I stepped into the Zoom room!”

At Eastern AHSN, we strongly believe that people should be valued as experts in their own lives. We previously worked with planners for the Click here Northstowe development to use an innovative, community-based approach to qualitative research – commonly referred to as to learn participatory appraisal – which enables people to develop ideas, more about identify priorities and make decisions about their own future. This year, we worked with Cambridgeshire and Peterborough participatory Clinical Commissioning Group (CCG) to apply a participatory appraisal approach to understanding and addressing poor uptake of smoking appraisal cessation support by some communities living in Wisbech. The project has been paused because of the pandemic, but we are eager to apply the learnings to encourage a healthier population and address health inequalities in the region. Patients have also shaped how we talk about our services in 2020/21, as we continued to work with maternity voice partners, alongside midwives in maternity units across the region, to embed the preventing cerebral palsy in preterm labour (PReCePT) project through the increased antenatal administration of magnesium sulphate (MgSO4) to mothers during preterm labour. By co- producing patient materials with these representatives, we have been able to ensure the language we use and the resources we provide are written by patients, for patients.

Using insight more effectively Gathering insight and involving patients only leads to impact when learnings are put into practice and shape the healthcare system. As we continue to partner with innovators looking to grow their business and make a positive impact on patient care, patients play a vital role in helping choose which innovations we support as part of our Innovation Review Panel. Having patient perspectives at this early stage provides vital insight for innovators. This year, we have been supporting PEP Health, whose Patient Experience Platform uses AI to automate the collation of patient experience data in real time from multiple sources, including social media and online patient forums, to provide a faster and more complete picture of their care experience. We are working with PEP Health to develop their communications and help organisations understand how they can use the platform to inform their quality improvement and patient insight strategies. We continue to also be at the forefront of using patient data responsibly in research as a partner in Gut Reaction, the Health Data Research Hub for Inflammatory Bowel Disease (IBD). The hub is an academic and industry partnership led by Cambridge University Hospitals and funded by the Industrial Strategy Challenge Fund (ISCF) through Health Data Research UK. The team is working with Crohn’s & Colitis UK and the hub’s Patient Advisory Committee to ensure that patient co-design and responsible use of data is at the heart of how we manage data access requests for academic and industry research.

Sarah Sleet, Chief Executive of Crohn’s & Colitis UK: “The Gut Reaction Patient Advisory Committee has played a vital role in changing the culture of health data research by encouraging greater patient involvement in procedures in place to manage data access applications.”

Learn more about Gut Reaction We are also working with the NHS regionally to develop how we at www.gut-reaction.org better involve the public in how we evaluate our programmes. Good patient and public involvement needs to go beyond Click here implementation and inform what success looks like from the public’s point of view. This is particularly true as we look to understand the implications of the pandemic on access to healthcare services. to find out Where many found digitalisation of healthcare refreshing, it also highlighted the inequalities and differences in digital literacy in our region. more about We are delighted to be launching our patient and public involvement (PPI) toolkit in the coming months, aligned with that of the AHSN Network national strategy, signalling our lasting commitment PEP Health to the integral role that PPI must play as we move forward together. As we begin the long recovery from the pandemic, we hope to continue to work closely with our local integrated care systems to ensure that patients and the public are helping to co-create and drive this important agenda forward.

Share this article ● Learn more If you would like to learn more about how we can help you develop your patient involvement strategy, contact [email protected] Focus on: patient and public involvement Focus on: patient and public involvement

Physically distanced, but just as engaged: Empowering the patient voice

Helen Oliver, Chief Operating Officer and Deputy Chief Executive OfficerHelen Oliver, at Eastern Chief Operating AHSN, explains Officer how and we Deputyhave kept Chief patient Executive involvementOfficer at Easternat the centre AHSN, of explains our programmes how we have in 2020/21 kept patient involvement at the centre of our programmes in 2020/21

he COVID-19 pandemic forced healthcare services to rapidly innovate and adapt how they delivered carehe COVID-19 to ensure pandemic the safety forced of both healthcare patients andservices clinicians. to rapidly The paceinnovate of change and adapt meant how patient they delivered and public consultationcare to ensure wasn’t the safety always of possible, both patients but as and we clinicians. continue toThe evaluate pace of the change impact meant of reconfigured patient and publicservices consultationand which changes wasn’t alwaysare worth possible, keeping, but it’s as vitalwe continuethat we listen to evaluate to the populationsthe impact of they reconfigured affect the servicesmost. andWe which are passionate changes are about worth public keeping, and patient it’s vital involvement that we listen and to wantthe populations the East of theyEngland affect health the andmost. care Tsystem to consistentlyWe areempower passionate patients about and public the public and patient to define, involvement determine and and want deploy the East innovations of England that best health andmeet caretheir Tneeds.system Weto consistently work hard to empower ensure that patients we have and patientthe public and to public define, representation determine and in our programmesdeploy innovations and, that best despite themeet their challengesneeds. We workof engaging hard to locked-downensure that we stakeholders, have patient we and continue public representation to support healthcare in our programmes providers to and, ensure despite that patientthe challengesvoices shape of howengaging services locked-down return as the stakeholders, pressures of the we continue pandem toic support ease. healthcare providers to ensure that patient voicesWe have shape delivered how services this through return threeas the workstreams: pressures of the creating pandem spacesic ease. for patients, empowering patient leaders and usingWe haveinsight delivered more effectively. this through three workstreams: creating spaces for patients, empowering patient leaders and using insight more effectively. Creating space for patients to influence health services CreatingWe supported the space Cambridge for Rare patientsDisease Network to (CRDN) influence with RAREfest20 health, sponsoring services the bi-annual public event Weand supportedusing the occasionthe Cambridge to launch Rare a surveyDisease to Network better understand (CRDN) with the RAREfest20 everyday challenges, sponsoring faced the bi-annualby people public living event with rareand usingdiseases, the occasionincluding tofamilies launch and a survey carers. to Because better understand of the pandemic, the everyday the event challenges was run facedonline, by which people presented living with an opportunityrare diseases, to includingreach a broader families audience. and carers. Next, Because we will of be the partnering pandemic, with the the event CRDN was to run translate online, thewhich survey presented findings an into actionableopportunity challenges to reach a thatbroader we will audience. put to the Next, innovation we will becommunity partnering to withmake the sure CRDN we turnto translate insight intothe surveyhealth impact.findings into actionable challenges that we will put to the innovation communityYou canto make read suremore we about turn this insight work into in morehealth depth impact. in our Focus on:You rare can diseases read more article. about this work in more depth in our Focus This wonderful course is on:For rare the diseases past four article. years we have proudly hosted the East of “This wonderful course is EnglandFor the Citizens’ past four Senate, years we which have provides proudly clinical hosted networks the East ofand teaching“ me so much more otherEngland regional Citizens’ healthcare Senate, structureswhich provides with insight, clinical informationnetworks and and teaching me so much more other regional healthcare structures with insight, information and than I ever thought views about services and proposed service changes from the than I ever thought perspectiveviews about ofservices and patients and proposed carers. All service members changes either from have the firs t- I understood about handperspective experience of patients of living and with carers. long-term All members conditions either or carehave for firs t- I understood about hand experience of living with long-term conditions or care for humility and curiosity someone who does. Their breadth of experience means we can humility and curiosity” learn fromsomeone who and does.share Theiremerging breadth approaches of experience to co-production means we can and ” publiclearn from and andpatient share involvement emerging withapproaches our partners. to co-production and An example of this is our work with Cambridgeshire and Peterboroughpublic and patient NHS Foundationinvolvement Trust with andour partners. partners to lead a bidAn for example a new innovation of this is our hub work to support with Cambridgeshire the adoption and and adaptation Peterborough of innovations NHS Foundation across Trustthe Cambridgeshire and partners to andlead a Peterboroughbid for a new innovation Integrated hub Care to System support (ICS), the adoptionwith patient and and adaptation public involvement of innovations representation across the Cambridgeshire at its core. We worked and withPeterborough the county’s Integrated Healthwatch, Care Systemthe Citizens’ (ICS), Senate with patient and local and publicproviders’ involvement patient groups representation to use existing at its core. forums We to worked gather patientwith the input county’s into Healthwatch,the proposed thedesign Citizens’ of the Senate hub. We and are local currently providers’ waiting patient to hear groups if the to bid use has existing been successfulforums to gather ahead ofpatient a launch input for into the the hub proposed in summer design 2021. of the hub. We are currently waiting to hear if the bid has been successful ahead of a launch for the hub in summer 2021. Empowering patient leaders EmpoweringListening to patients isn’t patientenough. For servicesleaders to be truly patient-focused, feedback needs to translateListening intoto patients influence isn’t and enough. change. For In services partnership to be withtruly The patient-focused, King’s Fund and feedback the East needs of England to Citizens’translate Senate,into influence and with and sponsorship change. In frompartnership NHS Leadership with The King’sAcademy, Fund we and delivered the East aof four-day England leadershipCitizens’ Senate, training and course, with sponsorship for free, to patient from NHS and Leadershippublic representatives. Academy, we The delivered programme a four-day empoweredleadership training 21 participants course, for this free, year to to patient develop and the public skills, representatives. knowledge and The behaviours programme to underpin collaborativeempowered 21and participants meaningful this relationships year to develop with NHS the skills, decision-makers knowledge andas they behaviours shape the to servicesunderpin incollaborative our region. and meaningful relationships with NHS decision-makers as they shape the services in our region. Leading for change programme participant: “ThisLeading wonderful for change course programme is teaching participant: me so much more than I ever thought I understood about humility“This wonderful and curiosity. course The is teachingstars are mealigning so much on so more many than levels. I ever I felt thought it as soon I understood as I stepped about into thehumility Zoom and room!” curiosity. The stars are aligning on so many levels. I felt it as soon as I stepped into the Zoom room!” At Eastern AHSN, we strongly believe that people should be valued as expertsAt Eastern in their AHSN, own welives. strongly We previously believe thatworked people with should planners be forvalued the as Click here experts in their own lives. We previously worked with planners for the Click here Northstowe development to use an innovative, community-based to learn approachNorthstowe to developmentqualitative research to use –an commonly innovative, referred community-based to as to learn participatoryapproach to qualitativeappraisal – research which enables – commonly people referred to develop to as ideas , more about identifyparticipatory priorities appraisal and make – which decisions enables about people their to develop own future. ideas, more about identifyThis year, priorities we worked and make with decisions Cambridgeshire about their and ownPeterborough future. participatory ClinicalThis year, Commissioning we worked Groupwith Cambridgeshire (CCG) to apply anda participatory Peterborough appraisal participatory Clinical Commissioning Group (CCG) to apply a participatory appraisal appraisal approach to understanding and addressing poor uptake of smoking appraisal cessationapproach supportto understanding by some communitiesand addressing living poor in Wisbech. uptake of The smoking project has beencessation paused support because by some of the communities pandemic, butliving we in Wisbech. are eager toThe apply project the haslearnings tobeen encourage paused becausea healthier of population the pandemic, and butaddress we are health eager inequalities to apply the in thelearnings region. to Patientsencourage have a healthieralso shaped population how we and talk address about our health services inequalities in 2020/21, in the as region. we continued to work withPatients maternity have voice also partners,shaped how alongside we talk midwives about our in services maternity in units2020/21, across as thewe region,continued to embed to work thewith preventing maternity voice cerebral partners, palsy alongsidein preterm midwiveslabour (PReCePT) in maternity project units through across the increasedregion, to embed antenatalthe preventing administration cerebral palsyof magnesium in preterm sulphate labour (PReCePT) (MgSO4) to project mothers through during the preterm increased labour. By co- producingantenatal administration patient materials of magnesium with these representatives,sulphate (MgSO4) we to have mothers been during able to preterm ensure labour. the By co- languageproducing we patient use andmaterials the resources with these we representatives, provide are written we have by patients, been able for patients.to ensure the language we use and the resources we provide are written by patients, for patients. Using insight more effectively UsingGathering insight insight and involving more patients effectively only leads to impact when learnings are put into practice and shape the healthcare system.Gathering As insight we continue and involving to partner patients with innovators only leads lookingto impact to whengrow theirlearnings business are put and into make practice a positive and shapeimpact the on healthcarepatient care, patientssystem. Asplay we a continuevital role into helpingpartner choosewith innovators which innovations looking to growwe support their business as part of and our make Innovation a positive Review impact Panel on. patientHaving care, patientpatients perspectives play a vital role at this in helping early stage choose provides which vital innovations insight for we innovators. support as part of our Innovation Review Panel. Having patientThis year, perspectives we have atbeen this supportingearly stage PEP provides Health vital, whose insight Patient for innovators. Experience Platform uses AI to automate the collation of patientThis year, experience we have data been in realsupporting time from PEP multiple Health ,sources, whose Patient including Experience social media Platform and onlineuses AI patient to automate forums, the to collationprovide of patienta faster experienceand more complete data in real picture time offrom their multiple care experience. sources, including We are socialworking media with andPEP onlineHealth patient to develop forums, their to provide a fastercommunications and more and complete help organisations picture of their understand care experience. how they We can are use working the platform with PEP to informHealth their to develop quality improvementtheir and patientcommunications insight strategies. and help organisations understand how they can use the platform to inform their quality improvement and patientWe continue insight strategies.to also be at the forefront of using patient data responsibly in research as a partner in Gut Reaction, the Health DataWe Researchcontinue toHub also for be Inflammatory at the forefront Bowel of using Disease patient (IBD). data The responsibly hub is an academic in research and as industry a partner partnership in Gut Reaction led by, theCambridge Health UniversityData Research Hospitals Hub forand Inflammatory funded by the Bowel Industrial Disease Strategy (IBD). Challenge The hub is Fund an academic (ISCF) through and industry Health Datapartnership Research led UK.by TheCambridge team isUniversity working Hospitalswith Crohn’s and & funded Colitis UKby theand Industrial the hub’s Strategy Patient AdvisoryChallenge Committee Fund (ISCF) to through Health Data Research UK. The team ensureis working that with patient Crohn’s co-design & Colitis and UK responsible and the hub’s use Patient of data Advisory is at the Committeeheart of how to we manageensure that data patient access co-design requests and for academicresponsible and use industry of data research. is at the heart of how we manage data access requests for academic and industry research. Sarah Sleet, Chief Executive of Crohn’s & Colitis UK: “TheSarah Gut Sleet, Reaction Chief PatientExecutive Advisory of Crohn’s Committee & Colitis has UK: played a vital role in changing the“The culture Gut Reaction of health Patient data research Advisory byCommittee encouraging has playedgreater apatient vital role involvement in changing in proceduresthe culture of in health place datato manage research data by access encouraging applications.” greater patient involvement in procedures in place to manage data access applications.” Learn more about Gut Reaction We are also working with the NHS regionally to develop how we Learnat morewww.gut-reaction.org about Gut Reaction We are also working with the NHS regionally to develop how we better involve the public in how we evaluate our programmes. at www.gut-reaction.org betterGood involve patient the and public public in how involvement we evaluate needs our to programmes. go beyond Click here Goodimplementation patient and publicand inform involvement what success needs looks to go like beyond from the public’s point of view. This is particularly Click here implementationtrue as we look and to understand inform what the success implications looks likeof the from pandemic the public’s on accesspoint of to view. healthcare This is particularlyservices. to find out trueWhere as wemany look found to understand digitalisation the of implications healthcare ofrefreshing, the pandemic it also on highlighted access to thehealthcare inequalities services. and to find out Wheredifferences many in found digital digitalisation literacy in our of healthcareregion. refreshing, it also highlighted the inequalities and more about differencesWe are delighted in digital to literacy be launching in our region.our patient and public involvement (PPI) toolkit in the coming more about We are delighted to be launching our patient and public involvement (PPI) toolkit in the coming PEP Health months, aligned with that of the AHSN Network national strategy, signalling our lasting commitment PEP Health tomonths, the integral aligned role with that that PPI ofmust the play AHSN as weNetwork move national forward strategy,together. signalling As we begin our lastingthe long commitment recovery fromto thethe integralpandemic, role we that hope PPI mustto continue play as to we work move closely forward with together. our local As integrated we begin care systems the long recovery to ensurefrom that the patientspandemic, and we the hope public to arecontinue helping to towork co-create closely andwith drive our local this importantintegrated agenda care systems forward. to ensure that patients and the public are helping to co-create and drive this important agenda forward.

Share this article ● Learn more Share this article If● you Learn would more like to learn more about how we can help you develop your patient involvementIf you would likestrategy, to learn contact more [email protected] about how we can help you develop your patient involvement strategy, contact [email protected] Focus on: patient and public involvement

Physically distanced, but just as engaged: Empowering the patient voice © PETER KINDERSLEY

Helen Oliver, Chief Operating Officer and Deputy Chief Executive Officer at Eastern AHSN, explains how we have kept patient involvement at the centre of our programmes in 2020/21

Share this article ● Learn more If you would like to learn more about how we can help you develop your patient involvement strategy, contact [email protected] Focus on: digital health

Realising the potential for telemedicine

Mark Avery, Director of Health Informatics at Eastern AHSN, outlines the progress made in the past year of using telemedicine and how we can build on it in the future

welcome outcome of the response to the COVID-19 pandemic was the rapid Enabling online acceleration of the use of digital technology to enable clinicians to deliver care and consultations in monitor patients remotely – often referred to as telemedicine. primary care In 2019, the NHS Long Term Plan1 highlighted digitally enabled primary and outpatient care as one of five major, practical, changes to the NHS service model that would Aunderpin the plan. The ambition was to deliver this within five years but, once it became a necessity amid the pandemic, the challenge was largely realised within just a few short months through an astonishing effort and coordination from the whole healthcare system. Eastern AHSN played a crucial part in this, working as part of the East Accord regional COVID Digital Cell to address the infrastructural challenges that needed to be overcome to enable digital tools to be rolled out at scale. Some of the key elements of our impact in this area are summarised in the panel, left. As the UK vaccination programme is alleviating some of the system pressures, the focus is shifting towards understanding the impact of telemedicine over the past year and the potential for the future. But what are the benefits of telemedicine? Protection of vulnerable patients Being able to monitor and treat a patient without having to see them in person is not just more convenient for many patients who cannot or would rather not travel but it reduces the risk of infections spreading. Vulnerable patients, including those with multiple long-term conditions or compromised immune systems, can be treated safely in their own homes while saving clinicians’ travel time.

Case study: Telemedicine in care homes The coronavirus crisis meant that many traditional ways of working were no longer possible, particularly in care homes. GPs were restricted from visiting care homes because of the risk of infection and cross- contamination between patients and sites. Supported by a grant from Innovate UK, Eastern AHSN built on work already under way by its Patient Safety Collaborative to embed tools, including the Royal College of Physicians’ National Early Warning Score – NEWS2 and SBARD – to help carers identify the signs of deterioration by integrating these tools within the Whzan Blue Box. This all-in-one telehealth box of equipment helps staff conduct clinical assessments and communicate the results to healthcare professionals. This includes the monitoring of vital signs, recording photos, as well as using tools, including NEWS2. This means early signs of decline are flagged before an illness worsens and GPs can effectively conduct virtual rounds to support decision- making to refer patients for further clinical care such as hospitalisation. Eastern AHSN helped engage the CCGs across the region, working with them to identify and distribute the technology to an initial 35 care homes. We continue to support the roll out with more than 200 care homes having adopted the Whzan Blue Box in our region during 2020/21. We are also working with Whzan to develop the technology with input from care homes. “The support we got from Eastern AHSN was vital in embedding the technology in our care homes. Staff were given IT support, including access to secure NHS mail and virtual training on using the tools, and by creating a network of peers across sites, we broke down silos between NHS and care home partners,” said Desiree Jooste, Manager of Fornham House, Bury St Edmunds.

Securely sharing of patient information between clinicians Digital technology not only allows the sharing of information between patients and their GP, it also enables better sharing of data between different care providers. This enables a patient’s care information to be accessed securely by caregivers, from GPs to acute care, ambulance to mental health, ensuring that clinicians have the full information they need when making clinical decisions and saving time. In the East of England, the East Accord is a collaborative comprising technical leads from across the region’s health and care system working to reduce the inefficiencies and improve patient experience through improving the digital maturity of services. Eastern AHSN has representation on its programme board to give oversight and expertise to support better interoperability of services and system design. The AHSN has supported Cambridgeshire and Peterborough integrated care system (ICS) to procure a partner to enable shared care records across all trusts and primary care providers in their local system by the end of 2021. Delivering care more efficiently In emergency situations, every second counts. If specialist clinicians can be connected to care teams instantly, it can improve decision-making and hopefully patient outcomes. Although many clinical conditions require physical examinations or interventions and many patients will still need to be taken to hospital as soon as possible, technology often has the “The support power to enable treatment to start sooner. we got from Eastern AHSN Case study: Using telemedicine to was vital in Click here identify stroke mimics to read more Eastern AHSN has supported the Paramedic embedding about the Stroke Stroke Telemedicine Digital Pioneer Project for the the technology past few years, in which 12 registered paramedics Telemedicine from the East of England Ambulance Service NHS in our care Programme Trust (EEAST) receive additional hyperacute stroke homes education and training on using the ” videoconferencing app on mobile devices, which connected them to stroke consultants based at East Suffolk and North Essex NHS Foundation Trust. This enables paramedics to get clinical advice from a specialist stroke consultant to help identify if they have suffered a stroke and if they require transfer to hospital for further tests and treatment. In 2020, a feasibility study based on the pilot led to Eastern AHSN funding a broader economic evaluation by the University of East Anglia (UEA) using data around stroke pathways in the region. The evaluation estimated this telemedicine service delivered a cost saving compared to usual care of £482k in its first year and this programme was a runner-up in the 2020 NICE Shared Learning Awards. Following the pilot, the East of England Stroke Telemedicine Partnership is launching a service in 2021, initially covering Ipswich Hospital, Queen Elizabeth Hospital King’s Lynn and the Norfolk and Norwich Hospital. As the digital infrastructure in our region continues to develop, so does the potential for telemedicine and telehealth. While there is more work to do to reduce digital exclusion, patients are increasingly able and empowered to manage their own conditions using more advanced and affordable wearable technology and smartphone apps. In addition, the clinical community is making better use of data and technology in how it delivers care. 1 NHS England (2019). The NHS Long Term Plan. London: NHS England. Telemedicine is already having a huge impact on care in the East of England, but there’s so much potential to Reference do more if we keep up the pace.

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Realising the potential for telemedicine

Mark Avery, Director of Health Informatics at Eastern AHSN, outlines the progress made in the past year of using telemedicine and how we can build on it in the future

Share this article ● Get in touch Learn how we can support healthcare providers to embed proven patient safety initiatives and innovations here Focus on: digital health

Realising the potential for telemedicine

Mark Avery, Director of Health Informatics at Eastern AHSN, outlines the progress made in the past year of using telemedicine and how we can build on it in the future

Share this article ● Get in touch Learn how we can support healthcare providers to embed proven patient safety initiatives and innovations here Q&A: understanding our Innovation Review Panel The experts will see you now: casting an expert eye with our Innovation Review Panel

We spoke to Dr Jag Ahluwalia, Chief Clinical Officer at Eastern and chair of our Innovation Review Panel, about how we assess innovator submissions to see how we can best support them on their innovation journey

What is Eastern AHSN’s Innovation Review Panel? At Eastern AHSN, we are continuously identifying innovations that drive positive health impact. Our region is filled with people with brilliant ideas, so prioritising which we can support can be difficult. Our Innovation Review Panel evaluates innovations on a regular basis and provides robust, expert feedback and support to innovators. How does the Innovation Review Panel An innovator’s bring value? perspective: The panel comprises at least 25 senior practitioners spanning a broad range of health and social care disciplines, including: Aviel Blumenfeld, CEO and ● Primary and secondary care clinicians Co-founder of IMedis ● Healthcare scientists ● Innovators, including clinical entrepreneurs At IMedis, our mission is to ● Specialists in procurement, regulation, investment, commercialisation, create a comprehensive quality communications and medicines optimisation management platform for ● Patient and public representatives radiology departments using ● Research and trial funding experts artificial intelligence. We made a submission to Eastern AHSN Each member brings their experience to bear, focusing on how they can in April 2020. contribute to what each innovation needs to move to the next phase of The panel’s feedback and its development. support helped establish a launchpad for us to build What are the benefits to innovators? trusted relationships with NHS The panel offers a wide range of free insights from not only a clinical perspective, trusts interested in our work. but also through the lens of patient representatives, alongside accessibility and We were able to accelerate our inclusion, regulatory, commercial and communications expertise. understanding of the NHS in Innovators are invited to present a short pitch to the panel members and ways that would otherwise have engage in a Q&A afterwards; this provides invaluable real-time feedback and required a significant investment insight to SMEs, raising questions that may arise in the future with other system of time and money. stakeholders. It is also an opportunity to explore who their customers might be in the NHS and where they might focus their engagement strategy, whether providers, commissioners or regional or national bodies. In 2020/21 we received applications from 192 innovators, of which 49 were selected for panel review and were given support ranging from constructive critique of The Innovation Review Panel: project ideas to help establishing pilot Innovations Funnel 2020/21 programmes for more advanced projects. Sixteen have been introduced to key NHS stakeholders and we have helped establish pilot sites for four innovations within the year, two of which have Triage and scoring already gained further traction and spread beyond the pilot sites. 192

Toolkits and How can innovators apply signposting 135 to access the Innovation Review Panel? IRP 49 The first step towards an innovation being considered by the panel is Pilot sites via Eastern AHSN’s company engagement form. Our team conducts established 4 a weekly triage of new innovations to ascertain their market readiness and where we might be able to support an innovation. Spread and 2 adoption Where we think it will be helpful, you may be invited to make a pitch to the panel and will be offered support preparing your pitch.

What makes a great pitch? In our experience, the best pitches: ● Highlight unmet needs: identify a need that is not being met and make a strong case for meeting it. ● Articulate what the innovation does: make it easy to understand how the innovation works and, therefore, how it meets the unmet needs. ● Establish NHS context: consider what benefits the innovation offers and what those benefits help the NHS to achieve in relation to its priorities. ● Know the marketplace: show a robust understanding of the current and potential future situation, in terms of the number of people for whom the innovation can deliver positive health impact and the size of the customer base for the innovation. ● Understand the competition: acknowledge organisations already in the market and identify competitors’ value propositions, where they deliver benefit and any opportunities for improvement. Great pitches use this insight to make it clear how their innovation is outstanding. ● Provide engaging evidence: offer evidence of the impact of the innovation. Evidence is enhanced by the results of pilots, progress towards regulatory approval or outlining how innovations have been adopted. ● Spell out the financial rationale: include a cost-benefit analysis that outlines what the impact of adopting the innovation will be. This might be the total cost savings, the cost relative to established alternatives and/or the cost of time saved as a result of an innovative process. ● Bring the innovation to life: include, where feasible, a video, demonstration or report that helps the innovation spring off the page. The easier it is for panel members to engage with its benefit the easier it is to understand how they can support it. Keeping to the time allocated and not overrunning will also keep the panel engaged.

Share this article ● Get involved If you have a great idea with the potential to have positive health impact, we’d love to hear from you. Get involved Q&A: understanding our Innovation Review Panel The experts will see you now: casting an expert eye with our Innovation Review Panel

Share this article ● Get involved If you have a great idea with the potential to have positive health impact, we’d love to hear from you. Get involved Learning from experience Better together? When to go for a package deal

Joanna Dempsey, Commercial Enterprise Lead at Eastern AHSN, explains how some innovators are better off together and talks about our role in facilitating a Joint Working partnership with AstraZeneca to pilot Liberate Pro and CareDoctR

t Eastern AHSN, we meet so many inspiring innovators whose solutions could make a huge impact on our health services with the right support. Sometimes we are able to spot innovations that perfectly complement each other to make them more effective, more appealing to NHS services and more financially viable. Our focus on helping organisations provide better services for patients means we can Abe an impartial critical friend, brokering deals that can benefit all parties. But what are the benefits for innovators to package their products with those of a partner? A better patient experience When a patient is diagnosed with a long-term condition, it can be daunting to take in all the relevant information, learn to use new tools for managing their condition and keep track of tests or appointments. This can be compounded for patients with multi-morbidities (suffering from more than one condition). If we can integrate digital innovations so that patients just need to familiarise themselves with one tool it can be much easier to adjust and manage their condition. This is particularly important for those who may not be as confident using technology. Simplified commissioning and a smoother roll-out NHS procurement can be complicated to navigate. Not only will a packaged solution that covers more than one need make it more appealing to commissioners and buyers, it makes procurement and contracting less complicated. With digital solutions, an integrated package means IT barriers only need to be overcome once, and staff training requirements are reduced. In the short term, it can be hard to broker an agreement between innovators, but it makes it easier to embed within the healthcare system once this is in place. Sharing risk and costs between partners By partnering with another organisation you can share the cost of future developments for your innovations, more effectively gather feedback from users and customers If you have a great and share marketing and sales expenditure. You may idea and need support want to explore entering a Joint Working Agreement (JWA), which is a specific type of partnership between to understand how you the NHS and the pharmaceutical industry that aims to can make a positive improve the efficiency and delivery of patient care at health impact for a local level. These financial efficiencies can make patients, get in touch your business more profitable and can be passed on to Learn more about Liberate Pro healthcare providers and save the NHS money.

“Eastern AHSN acted as an honest broker for the arrangement and really helped us in building a great partnership built on trust and transparency”

Click here Putting theory into practice: a single solution for managing patients to learn with multi-morbidities with CareDoctR and Liberate Pro more about In 2020, Eastern AHSN was approached by Suffolk Primary Care (Suffolk PC), a partnership CareDoctR of local GP practices from across Suffolk, which wanted to explore how it could better support patients with long-term conditions. In the UK, one in four adults is now estimated to have two or more health conditions1. “In Suffolk, we have been developing a standardised approach for managing patients with multi- morbidities over a period of years. We wanted to see if we could build on these pathways and improve patient outcomes in our region through better use of technology,” said Dr Neil Macey, Co-Chief Medical Officer at Suffolk Primary Care. “We knew Eastern AHSN had expertise in this area and might be able to recommend some solutions. The team recommended two innovations that worked well together, we could easily build into the work we had already begun and fitted our needs perfectly.” Both CareDoctR and Liberate Pro had come through the Eastern AHSN Innovation Review Panel in 2019, providing the potential for both innovations to empower nurses, clinicians and patients to manage long-term conditions more effectively. These innovations were identified as being complementary, so we looked to pilot them together. CareDoctR created the CareMonitR platform, which enables GP practices to automate the identification and monitoring of patients with multiple long-term conditions. Instead of patients attending their surgery several times a year for each of their conditions separately, the system contacts them once a year for a holistic review with a healthcare professional (such as a GP, nurse or healthcare “It enabled us to assistant). Liberate Pro is a digital platform that enables clinicians to record explore ways we important parts of their consultation and share relevant educational content and information about conditions that can be accessed by patients via a could deliver more for secure online portal. The healthcare professional can draw upon pre- loaded content and add notes, attachments and visuals to customise patients than we could information to the patient’s individual case. This enables patients to play achieve separately back, read and digest information and share it with family or carers. ” Having identified the potential to offer the two innovations as part of a package and the opportunity to trial the idea in Suffolk, Eastern AHSN gathered the relevant organisations to facilitate collaboration. We developed simple messaging and an infographic for each innovation to help explain the benefits of each and how they would work together. “It seemed to make sense to everyone that we work together,” said Amita Panwar, Business Director at Liberate Pro. “The innovations lined up so well and it enabled us to explore ways we could deliver more for patients than we could achieve separately, so we were excited to explore the synergy of a packaged solution.” Eastern AHSN has provided funding to support the licensing and evaluation of a pilot across eight practices within Suffolk Primary Care covering around 70,000 patients, which we hope to run from summer 2021. We know that citizens, academia, health services and industry will achieve more working together than they will in isolation. We regularly engage a wide variety of organisations in our work, so when our partners at AstraZeneca told us they were looking at how services might use a single platform for the management of patients with multi-morbidities, we knew they would be interested in this project. As a result of this project, Eastern AHSN has entered a Joint Working Agreement with AstraZeneca, whose real-world evidence team has agreed to support the pilot in a non-promotional capacity. If the pilot shows improved patient outcomes, we will look at further integrating the solutions into a single platform and the long-term sustainability of the project. “We’re really excited to have AstraZeneca on board,” added Dr Ayub Khan, Founder of CareDoctR. “Eastern AHSN acted as an honest broker for the arrangement and really helped us in building a great ReferencesReference partnership built on trust and transparency.”

Share this article ● Like to know more? If you want to find out more about CareMonitR and Liberate Pro or our approach to Joint Working Agreements, contact Joanna Dempsey at [email protected]. Learning from experience

Learning from experience Better together? Better together?When to go for a When to go for a package deal

Joanna Dempsey, Commercial Enterprise Lead at Eastern AHSN, Joannaexplains Dempsey, how some Commercial innovators are Enterprisebetter off togetherLead at Eastern and talks AHSN, about explainsour role inhow facilitating some innovators a Joint Working are betterpartnership off together with AstraZeneca and talks aboutto pilot ourLiberate role inPro facilitating and CareDoctR a Joint Working partnership with AstraZeneca to pilot t EasternLiberate AHSN, we meet Pro so manyand inspiring CareDoctR innovators whose solutions could make a huge impact on our health services with the right support. Sometimes we are able to tspot Eastern innovations AHSN, wethat meet perfectly so many complement inspiring eachinnovators other whoseto make solutions them more could effective, make a hugemore impactappealing on ourto NHS health services services and with more the financially right support. viable. Sometimes we are able to spotOur innovations focus on helping that perfectly organisations complement provide each better other services to make for them patients more means effective, we can Abe an impartial criticalmore friend, appealing brokering to NHS deals services that can and benefit more financially all parties. viable.But what are the benefits for innovators to packageOur their focus products on helping with organisations those of a partner? provide better services for patients means we can Abe an impartial critical friend, brokering deals that can benefit all parties. But what are the benefits for Ainnovators better to package patient their products experience with those of a partner? When a patient is diagnosed with a long-term condition, it can be daunting to take in all the relevant Ainformation, better learn patient to use new tools experience for managing their condition and keep track of tests or appointments. WhenThis can a patient be compounded is diagnosed for withpatients a long-term with multi-morbidities condition, it can (suff beering daunting from moreto take than in all one the condition). relevant If we information,can integrate learn digital to innovationsuse new tools so forthat managing patients justtheir need condition to familiarise and keep themselves track of tests with or one appointments. tool it can be Thismuch can easier be compounded to adjust and formanage patients their with condition. multi-morbidities This is particularly (suffering important from more for than those one who condition). may not If be we canas confident integrate digitalusing technology. innovations so that patients just need to familiarise themselves with one tool it can be much easier to adjust and manage their condition. This is particularly important for those who may not be Simplifiedas confident using technology. commissioning and a smoother roll-out NHS procurement can be complicated to navigate. Not only will a packaged solution that covers more Simplifiedthan one need make it commissioningmore appealing to commissioners and and buyers,a smoother it makes procurement roll-out and NHScontracting procurement less complicated. can be complicated With digital to solutions,navigate. Notan integr only atedwill a packagepackaged means solution IT barriers that covers only more need thanto be one overcome need make once, it andmore staff appealing training to requirements commissioners are andreduced. buyers, In itthe makes short procurement term, it can beand hard to contractingbroker an agreement less complicated. between With innovators, digital solutions, but it makes an integr it easierated to package embed withinmeans the IT barriershealthcare only system need to beonce thisovercome is in place. once, and staff training requirements are reduced. In the short term, it can be hard to broker an agreement between innovators, but it makes it easier to embed within the healthcare system Sharingonce this is in place. risk and costs between partners SharingBy partnering with risk another and organisation costs you canbetween share the partnerscost of future developments for your innovations, more Byeffectively partnering gather with feedbackanother organisation from users youand cancustomers share the If you have a great costand shareof future marketing developments and sales for expenditure. your innovations, You may more idea and need support want to explore entering a Joint Working Agreement effectively gather feedback from users and customers to Ifunderstand you have a how great you and(JWA), share which marketing is a specific and salestype expenditure.of partnership You between may idea and need support wantthe NHS to explore and the entering pharmaceutical a Joint Working industry Agreementthat aims to can make a positive to understand how you (JWA),improve which the efficiencyis a specific and type delivery of partnership of patient between care at health impact for thea local NHS level. and Thesethe pharmaceutical financial efficiencies industry that can aims make to patients,can make get a positivein touch improveyour business the efficiency more profitable and delivery and can of bepatient passed care on at to health impact for Learn more about Liberate Pro ahealthcare local level. providers These financial and save efficiencies the NHS money. can make patients, get in touch your business more profitable and can be passed on to Learn more about Liberate Pro healthcare providers and save the NHS money. “Eastern AHSN acted as an honest“Eastern broker AHSN for the acted arrangement as an honestand really broker helped for the us arrangementin building aand great really partnership helped us built in building on trust a great andpartnership transparency built ”on trust and transparency” Click here Putting theory into practice: a single solution for managing patients Clickto learn here Puttingwith multi-morbidities theory into practice: with CareDoctR more about aand single Liberate solution Pro for managing patients to learn Inwith 2020, Easternmulti-morbidities AHSN was approached by with Suffolk CareDoctR Primary Care (Suffolk PC), a partnership CareDoctR ofand local GP Liberate practices from acrossPro Suffolk, which wanted to explore how it could better support more about patientsIn 2020, with Eastern long-term AHSN conditions. was approached In the UK, by one Suffolk in four Primary adults isCare now (Suffolk estimated PC), to a havepartnership two or CareDoctR moreof healthlocal GP conditions practices1. from across Suffolk, which wanted to explore how it could better support “In Suffolk,patients withwe havelong-term been conditions.developing Ina thestandardised UK, one in approach four adul forts ismanaging now estimated patients to with have multi- two or morbiditiesmore health over conditionsa period of1. years. We wanted to see if we could build on these pathways and improve patient“In Suffolk, outcomes we inhave our regionbeen developing through better a standardised use of technology,” approach said for managing Dr Neil Macey, patients Co-Chief with multi- Medical morbiditiesOfficer at overSuffolk a period Primary of years.Care. We“We wantedknew Eastern to see ifAHSN we could had expertisebuild on inthese this pathwaysarea and andmight improve be able to patientrecommend outcomes some in solutions. our region The through team recommended better use of technology,” two innovations said Drthat Neil worked Macey, well Co-Chief together, Medical we Officercould easily at Suffolkbuild into Primary the work Care. we had“We alreadyknew Eastern begun AHSNand fitted had ourexpertise needs in perfectly.”this area and might be able to recommendBoth CareDoctR some andsolutions. Liberate The Pro team had recommended come through two the innovationsEastern AHSN that Innovation worked well Review together, Panel we in 2019,could providingeasily build the into potential the work for we both had innovations already begun to empower and fitted nurses, our needs clinicians perfectly.” and patients to manage long-termBoth CareDoctR conditions and more Liberate effectively. Pro had These come innovations through the wereEastern identified AHSN Innovation as being complementary,Review Panel in so we 2019,looked providing to pilot them the potential together. for both innovations to empower nurses, clinicians and patients to manage long-termCareDoctR conditions created more the CareMonitR effectively. platform, These innovations which enables were GP identified practices as to automatebeing complementary, the identifica sotion we looked to pilot them together. and monitoring of patients with multiple long-term conditions. Instead of CareDoctR created the CareMonitRpatients platform, attending which their enables surgery GPseveral practices times to a automateyear for each the identificaof their tion andconditions monitoring separately, of patients the system with multiple contacts long-term them once conditions. a year for Instead a holistic of patientsreview with attending a healthcare their surgery professional several (such times as a a year GP, nursefor each or healthcareof their “It enabled us to conditionsassistant). separately, the system contacts them once a year for a holistic reviewLiberate with Pro a healthcare is a digital professionalplatform that (such enables as aclinicians GP, nurse to or record healthcare explore ways we important parts of their consultation and share relevant educational content “It enabled us to assistant). andLiberate information Pro is about a digital conditions platform that that can enables be accessed clinicians by to patients record via a couldexplore deliver ways more we for importantsecure online parts portal. of their The consultation healthcare and professional share relevant can draw educational upon pre- content andloaded information content andabout add conditions notes, attachments that can be and accessed visuals byto customisepatients via a patientscould deliver than wemore could for secureinformation online to portal.the patient’s The healthcare individual professionalcase. This enables can draw patients upon topre- play achieve separately loadedback, read content and digestand add information notes, attachments and share andit with visuals family to or customise carers. patients than we could” informationHaving identified to the patient’s the potential individual to offer case. the This two enables innovations patients as partto playof a achieve separately back,package read and and the digest opportunity information to trial and the share idea itin with Suffolk, family Easter or carers.n AHSN ” gatheredHaving identifiedthe relevant the organisations potential to tooffer facilitate the two collaboration. innovations Weas part of a developed simple messaging andpackage an infographic and the opportunity for each innovati to trialon the to idea help in explain Suffolk, the Easter benefitsn AHSN of each and how they would work together.gathered the relevant organisations to facilitate collaboration. We developed“It seemed simple to make messaging sense to and everyone an infographic that we workfor each together,” innovati saidon toAmita help Panwar, explain Businessthe benefits Director of each andat Liberate how they Pro would. “The workinnovations together. lined up so well and it enabled us to explore ways we could deliver more for“It seemed patients to make than sensewe could to everyone achieve separately,that we work so together,”we were excitedsaid Amita to explore Panwar, the Business synergy Director of a at packagedLiberate solution.” Pro. “The innovations lined up so well and it enabled us to explore ways we could deliver more forEastern patients AHSN has than provided we could funding achieve to separately,support the so licensing we were and excited evaluation to explore of a pilot the synergyacross eight of a packagedpractices within solution.” Suffolk Primary Care covering around 70,000 patients, which we hope to run from summerEastern 2021. AHSN has provided funding to support the licensing and evaluation of a pilot across eight practicesWe know within that Suffolkcitizens, academia,Primary Care health covering services around and 70,000industry patients, will achieve which more we hopeworking to run together from than summerthey will 2021.in isolation. We regularly engage a wide variety of organisations in our work, so when our partnersWe know at AstraZenecathat citizens, toldacademia, us they health were serviceslooking at and how industry services will might achieve use more a single working platform together for the than theymanagement will in isolation. of patients We regularlywith multi-morbidities, engage a wide we variety knew ofthey organisations would be interested in our work, in thisso whenproject. our partnersAs a result at AstraZeneca of this project, told Eastern us they AHSN were lookinghas entered at how a Joint services Working might Agreement use a single with platform AstraZeneca, for the managementwhose real-world of patients evidence with team multi-morbidities, has agreed to we support knew thethey pilot would in a be non-promotional interested in this capacity. project. If the pilot showsAs a resultimproved of this patient project, outcomes, Eastern weAHSN will haslook entered at further a Jointintegrating Working the Agreement solutions into with a AstraZeneca,single platform whoseand the real-world long-term evidencesustainability team of has the agreed project. to support the pilot in a non-promotional capacity. If the pilot shows“We’re improved really excited patient to outcomes, have AstraZeneca we will look on board,”at further added integrating Dr Ayub the Khan, solutions Founder into aof single CareDoctR platform. “Easternand the long-term AHSN acted sustainability as an honest of the broker project. for the arrangement and really helped us in building a great ReferencesReference partnership“We’re really built excited on trust to and have transparency.” AstraZeneca on board,” added Dr Ayub Khan, Founder of CareDoctR. “Eastern AHSN acted as an honest broker for the arrangement and really helped us in building a great ReferencesReference partnership built on trust and transparency.” Share this article ● Like to know more? If you want to find out more about CareMonitR and Liberate Pro or our approach to Joint Share this article Working● Like to Agreements, know more? contact Joanna Dempsey at [email protected]. If you want to find out more about CareMonitR and Liberate Pro or our approach to Joint Working Agreements, contact Joanna Dempsey at [email protected]. Learning from experience

Learning from experience Better together? Better together?When to go for a When to go for a package deal

Joanna Dempsey, Commercial Enterprise Lead at Eastern AHSN, Joannaexplains Dempsey, how some Commercial innovators are Enterprisebetter off togetherLead at Eastern and talks AHSN, about explainsour role inhow facilitating some innovators a Joint Working are betterpartnership off together with AstraZeneca and talks aboutto pilot ourLiberate role inPro facilitating and CareDoctR a Joint Working partnership with AstraZeneca to pilot t EasternLiberate AHSN, we meet Pro so manyand inspiring CareDoctR innovators whose solutions could make a huge impact on our health services with the right support. Sometimes we are able to tspot Eastern innovations AHSN, wethat meet perfectly so many complement inspiring eachinnovators other whoseto make solutions them more could effective, make a hugemore impactappealing on ourto NHS health services services and with more the financially right support. viable. Sometimes we are able to spotOur innovations focus on helping that perfectly organisations complement provide each better other services to make for them patients more means effective, we can Abe an impartial criticalmore friend, appealing brokering to NHS deals services that can and benefit more financially all parties. viable.But what are the benefits for innovators to packageOur their focus products on helping with organisations those of a partner? provide better services for patients means we can Abe an impartial critical friend, brokering deals that can benefit all parties. But what are the benefits for Ainnovators better to package patient their products experience with those of a partner? When a patient is diagnosed with a long-term condition, it can be daunting to take in all the relevant Ainformation, better learn patient to use new tools experience for managing their condition and keep track of tests or appointments. WhenThis can a patient be compounded is diagnosed for withpatients a long-term with multi-morbidities condition, it can (suff beering daunting from moreto take than in all one the condition). relevant If we information,can integrate learn digital to innovationsuse new tools so forthat managing patients justtheir need condition to familiarise and keep themselves track of tests with or one appointments. tool it can be Thismuch can easier be compounded to adjust and formanage patients their with condition. multi-morbidities This is particularly (suffering important from more for than those one who condition). may not If be we canas confident integrate digitalusing technology. innovations so that patients just need to familiarise themselves with one tool it can be much easier to adjust and manage their condition. This is particularly important for those who may not be Simplifiedas confident using technology. commissioning and a smoother roll-out NHS procurement can be complicated to navigate. Not only will a packaged solution that covers more Simplifiedthan one need make it commissioningmore appealing to commissioners and and buyers,a smoother it makes procurement roll-out and NHScontracting procurement less complicated. can be complicated With digital to solutions,navigate. Notan integr only atedwill a packagepackaged means solution IT barriers that covers only more need thanto be one overcome need make once, it andmore staff appealing training to requirements commissioners are andreduced. buyers, In itthe makes short procurement term, it can beand hard to contractingbroker an agreement less complicated. between With innovators, digital solutions, but it makes an integr it easierated to package embed withinmeans the IT barriershealthcare only system need to beonce thisovercome is in place. once, and staff training requirements are reduced. In the short term, it can be hard to broker an agreement between innovators, but it makes it easier to embed within the healthcare system Sharingonce this is in place. risk and costs between partners SharingBy partnering with risk another and organisation costs you canbetween share the partnerscost of future developments for your innovations, more Byeffectively partnering gather with feedbackanother organisation from users youand cancustomers share the If you have a great costand shareof future marketing developments and sales for expenditure. your innovations, You may more idea and need support effectivelywant to explore gather entering feedback a Joint from Working users and Agreement customers to Ifunderstand you have a how great you and(JWA), share which marketing is a specific and salestype expenditure.of partnership You between may idea and need support wantthe NHS to explore and the entering pharmaceutical a Joint Working industry Agreementthat aims to can make a positive to understand how you (JWA),improve which the efficiencyis a specific and type delivery of partnership of patient between care at health impact for thea local NHS level. and Thesethe pharmaceutical financial efficiencies industry that can aims make to patients,can make get a positivein touch improveyour business the efficiency more profitable and delivery and can of bepatient passed care on at to health impact for Learn more about Liberate Pro ahealthcare local level. providers These financial and save efficiencies the NHS money. can make patients, get in touch your business more profitable and can be passed on to Learn more about Liberate Pro healthcare providers and save the NHS money. “Eastern AHSN acted as an honest“Eastern broker AHSN for the acted arrangement as an honestand really broker helped for the us arrangementin building aand great really partnership helped us built in building on trust a great andpartnership transparency built ”on trust and transparency” Click here Putting theory into practice: a single solution for managing patients Clickto learn here Puttingwith multi-morbidities theory into practice: with CareDoctR aand single Liberate solution Pro for managing patients moreto learn about Inwith 2020, Easternmulti-morbidities AHSN was approached by with Suffolk CareDoctR Primary Care (Suffolk PC), a partnership CareDoctR ofand local GP Liberate practices from acrossPro Suffolk, which wanted to explore how it could better support more about patientsIn 2020, with Eastern long-term AHSN conditions. was approached In the UK, by one Suffolk in four Primary adults isCare now (Suffolk estimated PC), to a havepartnership two or CareDoctR moreof healthlocal GP conditions practices1. from across Suffolk, which wanted to explore how it could better support “In Suffolk,patients withwe havelong-term been conditions.developing Ina thestandardised UK, one in approach four adul forts ismanaging now estimated patients to with have multi- two or morbiditiesmore health over conditionsa period of1. years. We wanted to see if we could build on these pathways and improve patient“In Suffolk, outcomes we inhave our regionbeen developing through better a standardised use of technology,” approach said for managing Dr Neil Macey, patients Co-Chief with multi- Medical morbiditiesOfficer at overSuffolk a period Primary of years.Care. We“We wantedknew Eastern to see ifAHSN we could had expertisebuild on inthese this pathwaysarea and andmight improve be able to patientrecommend outcomes some in solutions. our region The through team recommended better use of technology,” two innovations said Drthat Neil worked Macey, well Co-Chief together, Medical we Officercould easily at Suffolkbuild into Primary the work Care. we had“We alreadyknew Eastern begun AHSNand fitted had ourexpertise needs in perfectly.”this area and might be able to recommendBoth CareDoctR some andsolutions. Liberate The Pro team had recommended come through two the innovationsEastern AHSN that Innovation worked well Review together, Panel we in 2019,could providingeasily build the into potential the work for we both had innovations already begun to empower and fitted nurses, our needs clinicians perfectly.” and patients to manage long-termBoth CareDoctR conditions and more Liberate effectively. Pro had These come innovations through the wereEastern identified AHSN Innovation as being complementary,Review Panel in so we 2019,looked providing to pilot them the potential together. for both innovations to empower nurses, clinicians and patients to manage long-termCareDoctR conditions created more the CareMonitR effectively. platform, These innovations which enables were GP identified practices as to automatebeing complementary, the identifica sotion we looked to pilot them together. and monitoring of patients with multiple long-term conditions. Instead of CareDoctR created the CareMonitRpatients platform, attending which their enables surgery GPseveral practices times to a automateyear for each the identificaof their tion andconditions monitoring separately, of patients the system with multiple contacts long-term them once conditions. a year for Instead a holistic of patientsreview with attending a healthcare their surgery professional several (such times as a a year GP, nursefor each or healthcareof their “It enabled us to conditionsassistant). separately, the system contacts them once a year for a holistic reviewLiberate with Pro a healthcare is a digital professionalplatform that (such enables as aclinicians GP, nurse to or record healthcare “exploreIt enabled ways us we to importantassistant). parts of their consultation and share relevant educational content andLiberate information Pro is about a digital conditions platform that that can enables be accessed clinicians by to patients record via a couldexplore deliver ways more we for importantsecure online parts portal. of their The consultation healthcare and professional share relevant can draw educational upon pre- content andloaded information content andabout add conditions notes, attachments that can be and accessed visuals byto customisepatients via a patientscould deliver than wemore could for secureinformation online to portal.the patient’s The healthcare individual professionalcase. This enables can draw patients upon topre- play achieve separately loadedback, read content and digestand add information notes, attachments and share andit with visuals family to or customise carers. patients than we could” informationHaving identified to the patient’s the potential individual to offer case. the This two enables innovations patients as partto playof a achieve separately back,package read and and the digest opportunity information to trial and the share idea itin with Suffolk, family Easter or carers.n AHSN ” gatheredHaving identifiedthe relevant the organisations potential to tooffer facilitate the two collaboration. innovations Weas part of a developed simple messaging andpackage an infographic and the opportunity for each innovati to trialon the to idea help in explain Suffolk, the Easter benefitsn AHSN of each and how they would work together.gathered the relevant organisations to facilitate collaboration. We developed“It seemed simple to make messaging sense to and everyone an infographic that we workfor each together,” innovati saidon toAmita help Panwar, explain Businessthe benefits Director of each andat Liberate how they Pro would. “The workinnovations together. lined up so well and it enabled us to explore ways we could deliver more for“It seemed patients to make than sensewe could to everyone achieve separately,that we work so together,”we were excitedsaid Amita to explore Panwar, the Business synergy Director of a at packagedLiberate solution.” Pro. “The innovations lined up so well and it enabled us to explore ways we could deliver more forEastern patients AHSN has than provided we could funding achieve to separately,support the so licensing we were and excited evaluation to explore of a pilot the synergyacross eight of a packagedpractices within solution.” Suffolk Primary Care covering around 70,000 patients, which we hope to run from summerEastern 2021. AHSN has provided funding to support the licensing and evaluation of a pilot across eight practicesWe know within that Suffolkcitizens, academia,Primary Care health covering services around and 70,000industry patients, will achieve which more we hopeworking to run together from than summerthey will 2021.in isolation. We regularly engage a wide variety of organisations in our work, so when our partnersWe know at AstraZenecathat citizens, toldacademia, us they health were serviceslooking at and how industry services will might achieve use more a single working platform together for the than theymanagement will in isolation. of patients We regularlywith multi-morbidities, engage a wide we variety knew ofthey organisations would be interested in our work, in thisso whenproject. our partnersAs a result at AstraZeneca of this project, told Eastern us they AHSN were lookinghas entered at how a Joint services Working might Agreement use a single with platform AstraZeneca, for the managementwhose real-world of patients evidence with team multi-morbidities, has agreed to we support knew thethey pilot would in a be non-promotional interested in this capacity. project. If the pilot showsAs a resultimproved of this patient project, outcomes, Eastern weAHSN will haslook entered at further a Jointintegrating Working the Agreement solutions into with a AstraZeneca,single platform whoseand the real-world long-term evidencesustainability team of has the agreed project. to support the pilot in a non-promotional capacity. If the pilot shows“We’re improved really excited patient to outcomes, have AstraZeneca we will look on board,”at further added integrating Dr Ayub the Khan, solutions Founder into aof single CareDoctR platform. “Easternand the long-term AHSN acted sustainability as an honest of the broker project. for the arrangement and really helped us in building a great ReferencesReference partnership“We’re really built excited on trust to and have transparency.” AstraZeneca on board,” added Dr Ayub Khan, Founder of CareDoctR. “Eastern AHSN acted as an honest broker for the arrangement and really helped us in building a great ReferencesReference partnership built on trust and transparency.” Share this article ● Like to know more? If you want to find out more about CareMonitR and Liberate Pro or our approach to Joint Share this article Working● Like to Agreements, know more? contact Joanna Dempsey at [email protected]. If you want to find out more about CareMonitR and Liberate Pro or our approach to Joint Working Agreements, contact Joanna Dempsey at [email protected]. Digital inclusion: age doesn’t have to be a barrier

Empowering people to embrace technology Charlotte James, Director of Communications, Engagement and Marketing at Eastern AHSN, explains how we are supporting people overcome the digital barrier to manage their type 1 diabetes from their smartphone.

n today’s society it is easy to think we all live in an entirely digital world, but if you like me have been trying to video call your parents during lockdown, or help them shop for groceries What is type online, you might not be as surprised that in reality there are 12.6 million people in the UK 1 diabetes? who lack basic digital skills and a further 5.3 million people have never been online before.1 When it comes to health, individuals of an older age are one of the main groups less likely to Type 1 diabetes is a life-threatening Iengage in digital technologies.2 As health services continue shifting to a digital first approach, there is chronic condition that requires a danger that the inequalities in health and care already felt by this group become more pronounced.3 ongoing monitoring through life and To avoid this danger, we should always consider ways innovations can reach people who are has a life-long impact on both those digitally excluded. The digital divide has been shown in even sharper focus during the pandemic. It is diagnosed with it and their families. critical that health and care services provide digital inclusion and training programmes, such as the It occurs when the pancreas no NHS Widening Digital Participation programme, and readily consider these individuals for digital-led longer produces insulin, which interventions, even if it may require additional training and support. helps the body to keep blood One individual who we have worked with this year, who once considered himself digitally glucose levels from becoming too challenged, is Roger, aged 69, a retired headteacher from Cambridgeshire, who has lived with type 1 high or too low. This means that diabetes for 40 years. Over the years, he has experienced first-hand a transformation in diabetes care, people must constantly monitor from glass syringes and thick needles sterilised in a saucepan of boiling water to a sophisticated their glucose levels via finger- smartphone app – CamAPS FX – which uses an adaptive algorithm to continually respond to and prick tests or glucose monitoring administer his optimal dose of insulin 24 hours a day. devices and adjust their insulin Eastern AHSN has supported CamDiab, the company commercialising CamAPS FX, by working with doses via injections or insulin pump it to develop its key messages and communications to succinctly tell its story and engage people according to their diet, activity levels living with type 1 diabetes. We also helped it develop an animation to easily explain how the app and lifestyle. works and its positive impact of making living with type 1 diabetes easier.

Eastern AHSN helped CamDiab develop an animation to explain how the app works

“If I can do it anyone can” – Roger’s story At the time I was diagnosed, knowledge and When my two What is the treatment of diabetes was very limited “ CamAPS compared to now. I was given very little children heard I’d be FX app? support, although my mother-in-law lent me her British Diabetic Association handbook and managing my diabetes Developed by researchers at the I can remember sitting in our kitchen with my from a smartphone University of Cambridge, the wife holding open the pages of the book CamAPS FX app helps people while I taught myself how to do the injections. they laughed their more easily manage their diabetes Admittedly, I hadn’t heard of the CamAPS heads off! by mimicking the key functions FX app before, but when my two children heard ” of a working pancreas. The app I’d be managing my diabetes from a communicates autonomously with smartphone they laughed their heads off! Prior to the research, the extent of my the person’s continuous glucose knowledge of using a phone was switching it on, making a call and switching it back monitor and insulin pump and off but, with some support from the very knowledgeable clinical team at uses a complex adaptive algorithm Addenbrooke’s Hospital, I got on really quite well with the smartphone and the to automatically calculate and CamAPS FX app. Its ability to control and treat your diabetes is just tremendous administer the optimal dose of and very liberating. insulin, reducing the burden of Now, when we go out for meals, all I need do is take out my smartphone, enter the living with diabetes and allowing carbohydrate count and away it goes. I can see my levels instantly and can do them to lead more flexible and everything I need to do on the phone. Before I had the app, I needed to carry spontaneous lives.4 around with me needles and insulin and would go to the toilets to do a finger-prick test and injections as needed. 1 – Good Things Foundation. NHS Widening That’s all taken care of now with complete discretion. Digital Participation [online]. Good Things Foundation. [Viewed 11th December 2020]. Another time we benefitted from the app was at the Available from: https://nhs. beginning of the COVID-19 pandemic when I’d taken a real goodthingsfoundation.org/ bad turn. I was thinking the worst, but the app was providing 2 – Davies AR, Sharp CA, Homolova L, Bellis MA., (2019). Population health in a digital age: a continuous reading of my blood glucose levels, which was The use of digital technology to support and a great reassurance. At one point, I fell asleep and my wife monitor health in Wales [online]. Public Health Wales and Bangor University. [Viewed 11th was worried I may be going into a diabetic coma, but she December 2020]. Available from: https://phw. nhs.wales/topics/digital-technology-and- quietly checked my blood glucose levels on my phone health/population-health-in-a-digital-age2/ while I slept and could see all was well. The app provides 3 – Bennet, J. et al., (2018). Contributions of peace of mind, which is a benefit both to mine and my diseases and injuries to widening life expectancy inequalities in England from 2001 wife’s quality of life. to 2016: a population-based analysis of vital The other knock-on-effect is now I feel more comfortable registration data. The Lancet: Public Health [online]. 3(12), E586-E597. [Viewed 11th using a smartphone, so I can use my phone to contact my December 2020]. Available from: https://doi. org/10.1016/S2468-2667(18)30214-7 grandchildren on WhatsApp, which was fantastic during lockdown, and even get the weather forecast. Before I 4 – Lawton, J. et al., (2019). Participants’ experiences of, and views about, daytime use started on the app, I’d never have been able to do anything of a day-and-night hybrid closed-loop system in real life settings: longitudinal qualitative like that. study. Diabetes technology and therapeutics It is amazing how much treatment has changed since I [online]. 21(3), 119-127. [Viewed 11th December 2020]. Available from: https://doi.org/10.1089/ was diagnosed. I really feel like I’ve come from the desert dia.2018.0306 into the digital world. The CamAPS FX app really is References transformational and if I can do it anyone can.

Share this article ● Want to know more? Find out more about our work with CamDiab on our projects page Digital inclusion: age doesn’t have to be a barrier

Eastern AHSN helped CamDiab develop an animation to explain how the app works

Share this article ● Want to know more? Find out more about our work with CamDiab on our projects page Bitesized insight: medicines management

It takes more than a spoonful of sugar: Connecting innovators with local healthcare

Carol Roberts, Chief Executive at PrescQIPP, explains how her organisation worked with Eastern AHSN to run a series of innovator-matching events to support better use of medicines in the East of England

he mission of PrescQIPP is to help NHS organisations improve medicines-related care. We are a community interest company funded by clinical commissioning groups (CCGs), commissioning support units and health boards. We partnered with Eastern AHSN to host two events to showcase innovations with NHS stakeholders and representatives from healthcare partners across the region. TWe have worked alongside Eastern AHSN for years and knew it had an incredible network that could help us in our mission. First, we set a challenge question for the pitches: how do we improve patient outcomes through medicines We have worked optimisation, compliance and adherence? The Eastern “ AHSN team identified suitable innovations that had been alongside Eastern through their innovation review panel and invited them to pitch their solutions to us to explain how they could AHSN for years and support healthcare services to answer the challenge. knew it had an One of the innovations we identified as particularly valuable was MySpira, the world’s first augmented reality incredible network children ’s asthma and inhaler training app. Asthma attacks that could help us are the most common reason for urgent admissions to with our mission hospital in children and young people in England, but 75% ” of asthma admissions are thought to be preventable1. Preventable admissions are generally attributable to incorrect use of inhalers, due often to insufficient time to train young patients in the clinic. MySpira teaches six to 13-year-olds how to correctly use their inhaler. Using a mobile phone, the child completes eight fun modules on the app, helping them better understand their disease and how to manage it. Research has shown that the MySpira app substantially outperforms leaflets or videos when measuring the user’s recall of critical asthma and inhaler information2. The app has been developed by Orbital Media in Stowmarket, Suffolk, in collaboration with the University of Suffolk. Since the matching event, 2,400 licences for the MySpira app have been procured for local childhood asthma services across the Suffolk and North East Essex 1 Asthma UK. (2014). Time to take action on asthma. Available: https://www.asthma.org. Integrated Care System, the Southend CCG, Basildon uk/globalassets/campaigns/compare-your- care-2014.pdf. Last accessed 10/05/21. CCG, Brentwood CCG and Castle Point CCG. Our collaboration with MySpira is just one example of 2 Al-Naimi, S., Brady, P., Andrews, T. (2021). Examining the Efficacy of a Novel Eastern AHSN introducing new and valuable innovator Augmented Reality Mobile Delivery Platform for the Enhancement of Asthma connections to us. Following the success of the two Care Education for Children. International matching events in October 2020, we ran another in Journal of Interactive Mobile Technologies (iJIM). 15 (7). April 2021 to a wider audience to help us identify further promising opportunities for us to support innovations at References a national level. Watch a demo of MySpira

Share this article ● How we can help Find out how we help providers get faster access to the latest innovations and technologies to deliver excellent patient care on our website Bitesized insight: medicines management

It takes more than a spoonful of sugar: Connecting innovators with local healthcare

Share this article ● How we can help Find out how we help providers get faster access to the latest innovations and technologies to deliver excellent patient care on our website Innovator profile: Peezy Midstream Easy Peezy Delivering a reliable urine sampling system Giovanna Forte from Forte Medical tells us about its innovation, Peezy Midstream, and the support received throughout 2020/21

he experts at Eastern AHSN are working with us to navigate supply chain and pricing challenges, overcome common procurement barriers and help us build evidence of savings to healthcare services for our novel midstream urine sampling device, Peezy Midstream. The Forte team developed Peezy Midstream in response to challenges involved with collectingT clean-catch urine samples using traditional hit-and-miss methods, which require the patient to start-stop-start, which can be difficult, especially for pregnant women and the elderly. This practice has led to high levels of specimen contamination, leading to unreliable results and costly repeat patient appointments and tests. Peezy Midstream was designed by an NHS GP; it is a manual device that allows the user to collect a laboratory- ready midstream sample comfortably into a tube that is compatible with automated urinalysis equipment. This removes the need for decanting urine and eliminates any Rubbish in, rubbish out. unnecessary post-collection handling and the resulting risk of “ contamination or false positives. It is especially valuable in If you don’t get the right antenatal services, where urine testing is a regular and specimen, all the clever important part of the maternity patient pathway. We pitched Peezy Midstream to the Eastern AHSN work done in the lab Innovation Review Panel in October 2020, which allowed us to won’t work highlight the impact it has on reducing urine contamination ” – Mark Wilks, Microbiologist, Queen Mary University rates. We received valuable feedback from this expert and of London and Barts Health NHS Trust diverse group of NHS subject matter experts. The panel agreed that Peezy Midstream satisfies an important unmet need to reduce specimen contamination.

We were invited to present at both Eastern AHSN’s clinical innovations forum event and an innovation-matching event with stakeholders from NHS clinical commissioning groups across the region, delivered in partnership with PrescQIPP. We expect our work with Eastern AHSN to accelerate the adoption and spread of Peezy Midstream across England, including the establishment of evaluations in more NHS primary care settings in 2021. We also hope it will be able to help us develop our key messages and communications strategy to strengthen our voice to buyers, commissioners and clinicians. We are already growing quickly in the USA, with a number of agreements and sales How to use Peezy Midstream in place. We still want to ensure we can continue to deliver impact within the NHS and the UK and are confident our partnership with Eastern AHSN will help us do so.

Share this article ● Great ideas wanted Do you have a great idea that could make a positive health impact? Get involved. Innovator profile: Peezy Midstream Easy Peezy Delivering a reliable urine sampling system Giovanna Forte from Forte Medical tells us about its innovation, Peezy Midstream, and the support received throughout 2020/21

Share this article ● Great ideas wanted Do you have a great idea that could make a positive health impact? Get involved. Eastern AHSN: our year in numbers Our impact in numbers

Throughout 2020/21 we have worked with our partners to turn great ideas into positive health impact. At a glance, here are some of our achievements during that time, but you’ll find many more facts and statistics to demonstrate our impact on specific initiatives throughout this review.

Community pharmacists used 27 new GP the Electronic Medication

practices Optimisation Pathway (EMOP) adopted PINCER to to review prescriptions for reduce prescribing errors

in primary care, taking 4,662 people leaving hospital to reduce the the total number to 143 risk of medication errors and in the region readmissions

10 people with highly complex mental health needs were supported through the Serenity Integrated Mentoring (SIM) programme

4,375 pregnant women used Placental Growth Factor We distributed £3 million (PlGF) tests to help rule worth of hardware, including 4,500 out pre-eclampsia laptops, to primary and secondary quickly so they care providers and trained staff to received the most conduct virtual consultations appropriate care

117 people 300+ 306 people with very high cholesterol attendees used HeartFlow were treated with at our cardiovascular to get 3D scans PCSK9 inhibitors disease of their heart and avoid as part of our wider lipid seminar invasive angiograms management series workstream

To support collaborative relationships with the NHS, we empowered 21 patient and public representatives through a leadership training programme, in partnership with the King’s Fund, East of England Citizens’ Senate and the NHS Leadership Academy

EarlyCDT Lung, a simple blood test, More than identified277 smokers 100 staff in have (current and former) with a 200+ care homes used the Whzan Blue Box to monitor heightened risk of lung cancer for residents’ vital signs, enabling GPs to urgent triage to CT scanning complete virtual ward rounds safely during the pandemic

More than 4,566* patients recovering from COVID-19 were monitored at home through the Covid Oximetry at Home pathway

*between 1 Nov 2020 and 28 Feb 2021.

We reviewed 192 We entered into partnership agreements innovations to determine with 10 innovators to support their needs and 49 benefitted from their growth and provide the opportunity to present their ideas an income for us to reinvest to our expert Innovation in our work Review Panel

126 Our innovator innovators support toolkits have benefitted from our been downloaded insight to impact 900+ masterclasses times

124 men with prostate cancer were managed with SpaceOAR during their radiation therapy to target 2,960 their cancer but reduce SecurAcaths damage to healthy were used to reduce tissue around vascular catheter the rectum complications

Share this article Eastern AHSN: our year in numbers Our impact in numbers

Community pharmacists used 27 new GP the Electronic Medication

practices Optimisation Pathway (EMOP) adopted PINCER to to review prescriptions for reduce prescribing errors

in primary care, taking 4,662 people leaving hospital to reduce the the total number to 143 risk of medication errors and in the region readmissions

10 people with highly complex mental health needs were supported through the Serenity Integrated Mentoring (SIM) programme

More than 4,566* patients recovering from COVID-19 were monitored at home through the Covid Oximetry at Home pathway

*between 1 Nov 2020 and 28 Feb 2021.

126 Our innovator innovators support toolkits have benefitted from our been downloaded insight to impact 900+ masterclasses times

Share this article Eastern AHSN: our year in numbers Our impact in numbers

Community pharmacists used 27 new GP the Electronic Medication

practices Optimisation Pathway (EMOP) adopted PINCER to to review prescriptions for reduce prescribing errors

in primary care, taking 4,662 people leaving hospital to reduce the the total number to 143 risk of medication errors and in the region readmissions

10 people with highly complex mental health needs were supported through the Serenity Integrated Mentoring (SIM) programme

More than 4,566* patients recovering from COVID-19 were monitored at home through the Covid Oximetry at Home pathway

*between 1 Nov 2020 and 28 Feb 2021.

126 Our innovator innovators support toolkits have benefitted from our been downloaded insight to impact 900+ masterclasses times

Share this article Awards

And the winner is… ur priority is to deliver patient impact and help healthcare services quickly realise the value of innovations, but it is Oalso important to celebrate when a project is recognised by an award or commendation. Some of our work acknowledged in the past year includes…

Health Data Research UK (HDR UK) – Team of the Year

In June 2020, the team behind the Rare Diseases Sprint Exemplar project was awarded Team of the Year by HDR UK. The judges recognised a collaborative effort that brought together a highly functional interdisciplinary team, including Eastern AHSN staff. Working with the NIHR BioResource, and led by Professor John Bradley at Cambridge University Hospitals, the team focused on integrating research and genomic data across three rare disease groups, supplemented by electronic patient record data from five NHS trusts, and making the combined data available via a secure online research environment. Within just 10 months, the team delivered a proof-of-concept research resource with the potential to transform understanding of rare genetic disorders. The model is now being developed and scaled to deliver Gut Reaction, the Health Data Research Hub for Inflammatory Bowel Disease. Find out more on our website.

The Health Service Journal (HSJ) Awards 2020

Two AHSN network programmes were shortlisted for the Health Service Journal Awards in November 2020. Based on national data, and with input from Eastern AHSN and Yorkshire and Humber AHSN, the first of the programmes, in atrial fibrillation (AF), was shortlisted for Primary Care Innovation of the Year. Atrial fibrillation is the most common cause of an irregular heart rhythm and the cause of 20% of strokes. In 2019/20, 14,280 new cases of AF were diagnosed in the Eastern region, on top of 8,622 the year before. In partnership with West of England AHSN, the PReCePT (Prevention of Cerebral Palsy in PreTerm Labour) programme was shortlisted for the Workforce Initiative of the Year. PReCePT aims to increase awareness and knowledge among maternity and neonatal staff about the use of magnesium sulphate as brain protection during preterm birth. The programmes shortlisted for HSJ awards are underpinned by a collective, system-wide approach and are testament to the energy and collaborative spirit of our stakeholders and network. Find out more here.

Finalists: Excellence in Corporate Communications

Eastern AHSN is a finalist in the Communiqué awards in recognition of our corporate communications, including the development of our purpose and marketing materials. The awards recognise excellence in healthcare communications and winners will be announced in September 2021.

Active+Me – Self Care Forum Coronavirus Innovation Award 2020 (highly commended)

The use of Aseptika’s Active+Me technology to support people with cardiac problems during the first national lockdown led to the initiative being highly commended. Cardiac rehabilitation services at Cambridge University Hospitals NHS Foundation Trust were converted with support from Eastern AHSN from face to face to a technologically enhanced online service, monitoring patients’ physical signs at home via an app that also included a process for encouraging patients to manage their own health. Find out more here

NHS Innovation Accelerator (NIA)

In March 2021, the NIA announced 12 innovators Vinehealth – Dr Rayna Patel, Co-founder & CEO selected to join its award-winning programme, A platform that uses behavioural science and delivered in partnership by the AHSN Network artificial intelligence to improve the quality of and NHS England. These innovations offer solutions life and survival of cancer patients through to some of the most pressing needs in the NHS highly personalised patient support. Vinehealth and will be supported over three years to scale allows patients to understand and optimise across the NHS in England. their care, as well as to communicate with their Eastern AHSN supported three innovations care team. joining this year’s NIA programme; Cyted – Marcel Gehrung, CEO Little Journey – Dr Chris Evans, CEO and Founder Cyted provides services for the earlier detection A health behaviour-modification tool designed to of disease through its proprietary machine reduce children’s anxiety before a healthcare learning and digital pathology infrastructure. procedure. The Little Journey smartphone app It has an initial focus on oesophageal cancer, provides end-to-end support for families through using a device called Cytosponge. Find out more age-tailored immersive and interactive content. on our website.

Cambridge Paediatric HealthTech – Accelerate@ Babraham Start-up Programme

Selection of the winning cohort for the Accelerate@ Babraham Start-Up Competition took place in July 2020. One of the four selected start-ups was Cambridge Paediatric HealthTech, which Eastern AHSN has been delighted to support. The company secured five months’ access to Accelerate@Babraham’s bio-incubator facilities, £10K non-dilutive funding and personal mentoring from renowned experts, and can access the Babraham Research Campus’s extensive networks. Cambridge Paediatric HealthTech CEO Tamsin Holland-Brown was featured in our last impact review.

Share this article Awards

Health Data Research UK (HDR UK) – Team of the Year

The Health Service Journal (HSJ) Awards 2020

Finalists: Excellence in Corporate Communications

Active+Me – Self Care Forum Coronavirus Innovation Award 2020 (highly commended)

NHS Innovation Accelerator (NIA)

Cambridge Paediatric HealthTech – Accelerate@ Babraham Start-up Programme

Share this article Awards

Health Data Research UK (HDR UK) – Team of the Year

The Health Service Journal (HSJ) Awards 2020

Finalists: Excellence in Corporate Communications

Active+Me – Self Care Forum Coronavirus Innovation Award 2020 (highly commended)

NHS Innovation Accelerator (NIA)

Cambridge Paediatric HealthTech – Accelerate@ Babraham Start-up Programme

Share this article Our key national programme priorities for 2021/22 Coming up in 2021/22

t Eastern AHSN, we have a passion for health and technology and a desire to take healthcare forward and solve difficult problems for the benefit of our community. In 2021/22 and beyond, we will continue to support our local healthcare system in the response and recovery from the COVID-19 pandemic. We will continue to support innovators from insight to implementation – helping them design and engineer new Atechnologies and products, navigate complex systems and generate value propositions that make a positive and lasting health impact. We will also be supporting the following national programmes on behalf of the AHSN Network to deliver impact in the areas outlined below.

Reducing suicide Improving Early interventions and self-harm sexual safety for eating disorders

Quicker diagnosis of ADHD Reducing restrictive practices with evidence based testing

Improving Reducing cholesterol diagnosis of Familial with medication Detection of Atrial Hypercholesterolemia to improve lipid Fibrillation (AF) (FH) via expanded management testing

Increasing the Using fractional Increasing the proportion of eligible exhaled nitric oxide uptake of biologics patients receiving (FeNO) testing for in severe asthma the asthma and copd asthma diagnosis discharge care bundles

Improving the early Spread and adoption Increasing the recognition and of the preterm proportion of smoke- management of perinatal optimisation free pregnancies deterioration of care pathway women and babies

Expanding use of tamoxifen for the prevention of breast cancer in women at known risk

• Prevention, identification, • Prevention, identification, escalation and response to escalation and response to physical deterioration physical deterioration in adults and children in adults and children • Medicines safety focused • Increased adoption and on safer administration of spread of evidence based medicines in care homes care bundles

Transformation for service improvement Transformation for patient safety

Share this article ● Find out more If you want to find out more, contact ushere. Our key national programme priorities for 2021/22 Coming up in 2021/22

Reducing suicide Improving Early interventions and self-harm sexual safety for eating disorders

Quicker diagnosis of ADHD Reducing restrictive practices with evidence based testing

Improving Reducing cholesterol diagnosis of Familial with medication Detection of Atrial Hypercholesterolemia to improve lipid Fibrillation (AF) (FH) via expanded management testing

Expanding use of tamoxifen for the prevention of breast cancer in women at known risk

Transformation for service improvement Transformation for patient safety

Share this article ● Find out more If you want to find out more, contact ushere.