Academic Health Science Networks: Impact report 2016 Improving health and promoting economic growth Overview Contents

Across England, there are 15 Academic Health Science Networks (AHSNs). We were established by NHS England in 2013 to spread Foreword 4 innovation at pace and scale in order to improve health and generate economic growth. As the only bodies that connect NHS and academic organisations, local What AHSNs do 4-5 authorities, the third sector and industry, we are catalysts that create the right conditions to facilitate change across whole health and social care economies, with a clear focus on improving outcomes for patients. Introduction from the Chair of The AHSN Network 5 This means we are uniquely placed to identify and spread health innovation quickly and at serious levels, by driving the adoption and Our collective impact 6-10 spread of innovative ideas and technologies across large populations.

Addressing the NHS’s three biggest challenges: This is the story of what we are doing The health and wellbeing gap 11-14 “ and how we are doing it. We hope • you will find it useful, and use it often. • The care and quality gap 15-18 ” • The finance and efficiency gap 19-20

The AHSN Network - collective impacts Driving economic growth 21-25 in numbers Contact details and regional footprint 26-27 • £20 million support for • Supporting 7 test bed sites, businesses through the SBRI which link industry into the Healthcare programme NHS and improve outcomes Acknowledgements 28 for citizens • Enabling 33,000 patients to self-manage with Flo Simple • Supported over 500 new Telehealth products or services to • 3 million patients benefiting be co-developed and / from innovations via the NHS or supported into the NHS Innovation Accelerator • At least 365 strokes, one • More than 800 jobs created every day, prevented by our or safeguarded work, saving lives, reducing disability and saving almost • Running 15 Patient Safety £8.5m to the NHS and social Collaboratives, which are care preventing avoidable harm

2 | Impact Report 2016 | 3 Introduction from the Chair Foreword of The AHSN Network

Delivering the Five Year Forward View requires As our Academic Health Science Networks, or national programmes, such as SBRI Healthcare radical care redesign within and across local AHSNs across England enter the fourth year of and the NHS Innovation Accelerator. systems. It involves changing the gearing operation, we are delighted to work together This report details our progress in these and between formal care and mobilising the to present our second national impact report. other areas, where we are working closely potential of patients and their communities to together to explore opportunities around stay healthy and well. It means realising the This report demonstrates the depth and specific health challenges (such as the use potential of technology and data to change breadth of our work – not just within our own of digital tools to enhance patient activation care delivery models. It is also about engaging areas, but also our collaborations to address and atrial fibrillation). and organising the NHS workforce very issues of national importance. differently, in new roles as part of new teams. I am often asked, ‘what role do AHSNs play Across England, AHSNs are helping to implement in the health system?’ Our remit is clear: we the NHS Five Year Forward View. This impact This report illuminates how AHSNs are right connect NHS and academic organisations, local report provides examples of where we have made in the thick of supporting these changes to authorities, the third sector and industry. We progress under each of the Forward View themes, create a more sustainable NHS. They are do this to help create the right conditions to and where we are delivering on economic growth. providing a safe and expert place in their achieve change across whole health and social geographies to unlock innovation. Our message for this report? On our own, care economies, with a clear and consistent we are strong: delivering new innovations into Uniquely, AHSNs connect industry partners, focus on citizens, service users and patients. the NHS, improving patient experience and universities, local communities and the Alongside transforming services through enabling economic growth for our regions. NHS to speed up the initial take up and innovation, we play an important role in Together, we are making a huge collective subsequent spread of innovations. In doing generating economic growth. As examples: impact for the wider health system, united by this, their mission is not just to benefit the we enable companies to grow and create the common goal of making care better for NHS but directly and demonstrably to support jobs by supporting the NHS and industry to citizens, service users and patients. economic growth and create jobs. engage productively; and by meeting the AHSNs will remain an important part of the health needs of our populations, we help health and care landscape. The opportunity people keep well and in work. and challenge for each individual network, as Each AHSN works within its own area to well as for all networks working as a collective, develop projects that meet the diversity of their is to build on the progress they have made to local populations and healthcare challenges. Dr Liz Mear, Chair of The date, by creating the greatest possible value Crucially, AHSNs also work together on key AHSN Network and Chief for the patients, communities, NHS partners areas which include promoting economic Executive of the Innovation and the taxpayer. Ian Dodge, National Director growth; diffusing innovation; Agency (Academic Health for Commissioning Strategy, optimisation; improving quality and patient Science Network for the NHS England safety; putting research into practice; and North West Coast)

What AHSNs do What AHSNs do

AHSNs are flexible regional organisations. • Diffusing innovation: creating the right • Improving quality and reducing variation: Our licence from NHS England sets our four We have a small staff base but use our environment, and supporting collaboration by spreading best practice, we increase broad objectives: extended networks across regions to achieve across boundaries, to adopt and spread productivity and reduce variation, which great impacts for our partners. Our impact • Focus on the needs of patients and innovation at pace and scale. should improve patient outcomes. rests in our ability to bring people, resources local populations. and organisations together quickly, delivering • Improving patient safety: using our • Putting research into practice: our strong • Build a culture of partnership and benefits that could not be achieved without knowledge, expertise and networks to links with academia mean we are uniquely collaboration. these connections. bring together patients, healthcare staff placed to support the translation of Speed up adoption of innovation into Each AHSN works within its own geographical and partners to determine priorities and research into clinical practice. • develop and implement solutions. practice to improve clinical outcomes area to develop projects and programmes Collaborating on national programmes: which reflect the diversity of our local populations • and patient experience. • Optimising use: ensuring that our unified programmes focus on delivery and healthcare challenges. However, we all share • Create wealth through co-development, the following priorities: medication is used to its maximum benefit of the SBRI Healthcare initiative supporting – improving safety and making efficient small-to-medium enterprises, the NHS testing, evaluation and early adoption. • Promoting economic growth: fostering use of NHS resources. Innovation Accelerator, Patient Safety opportunities for industry to work effectively Collaboratives and medicines optimisation. with the NHS.

4 | Impact Report 2016 | 5 Our collective impact Our collective impact

The system needs to network its best practice collaboratively across • AliveCor - a highly effective mobile heart This system has now been widely adopted all health economies: AHSNs are a means to that end. monitor that detects heart arrhythmias, across the UK, reaching over 70 health and including instantly highlighting AF in social care organisations with 33,000 patients electrocardiograms. Being adopted by registered for a wide range of conditions, using the Innovation Agency, Oxford, Imperial clinically-approved pathways: an increase “It is no secret that the NHS I am encouraged by the from 11,000 registered patients in 2015. It is College Health Partners, UCLPartners and is under extreme pressure even in use in the USA as part of a healthcare individual and collective work of North East and North Cumbria AHSNs. to deliver sustainable the AHSNs since their inception, programme for military veterans, and is being taken on as a national AHSN theme. transformation over the and their achievements to • Increasing anticoagulation rates in – following success in Camden in Another example is Digital Health.London, a next few years. Demand is date which this report clearly 2014, London AHSNs are working together increasing, and funding is virtual digital institute to help provide a single illustrates. I look forward to their with GP practices across London. Based way into London’s NHS for small-to-medium on early results, 70-90 lives will be saved tight. Against this backdrop, continuing development and sized digital enterprises and to increase uptake I remain strongly committed and almost £700,000 in added value will of digital innovation in healthcare across the contribution to the priorities be delivered to the NHS (net health cost) to the AHSNs, and to ensuring capital. This work is a collaboration between identified in the Forward View each year. the Health Innovation Network, Imperial College they help drive the uptake of Health Partners, UCLPartners, MedCity and the The AF landscape tool - providing data innovation which is so critical and successive NHS Business • NHS England Digital team. Plans over future years.” to influence decision-makers and to our future. Theirs is a unique monitor the progress of improvement. offering, initiated by the NHS Led by Greater Manchester AHSN and National sharing on in the knowledge that this is supported by powerful infographics, mental health provided by East Midlands AHSN. would be a new way to bring We ran our first intra-AHSN learning event the benefits of innovation to • Healthy Futures – a commissioning focused on mental health in March 2016. strategy leading to an additional 1,940 Examples of AHSN mental health projects patients and to population Sir , patients receiving anticoagulation in include: health more generally. Chairman, NHS just seven months. Led by Yorkshire England & Humber AHSN. • Bradford checklist toolkit – expanding the use of checklists to improve the quality of physical health checks for people with The Five Year Forward View, published in 2015 increases the risk of having a stroke - a major serious and enduring mental illness: identifiedthree gaps that must be closed cause of death and disability - and this can be Telehealth and digital in order to deliver health and care provision reduced by using anticoagulation medication. technology Yorkshire & Humber AHSN. in England; health and wellbeing; care and If AF patients who needed it took the correct iTHRIVE - a comprehensive new approach New technologies can help the NHS in many • quality; and finance and efficiency. medication, almost 12,000 strokes could be to child and adolescent mental health avoided each year. ways, such as self-management, remote AHSNs developed a range of projects that seek monitoring and access to interventions, services, rolling out to 11 NHS Innovation to better tackle these gaps. While these projects Across the AHSN Network diagnosis and therapies or GPs. People who feel empowered Accelerator sites: UCLPartners. have started in individual regions, we have actively management of AF is a major focus and through and confident to take an active role in their DeAR GP and House of Memories - two shared outcomes and methodologies among our Improvement Directors Forum formed the healthcare will have improved outcomes. • the AHSN Network to expand impact and help approaches to improve training, screening AHSN Network AF Community to spread and One hugely successful example is Flo Simple and empathy in dementia care, particularly achieve spread. This includes work around stroke adopt the work nationally. The AF Community Telehealth. This system is helping to support in care homes: Health Innovation Network prevention and the use of digital technology. aspires to prevent an additional 4,500 strokes people and increase patient activation. and the Innovation Agency. In this section, we show how AHSNs have in people over the next five years. The Flo system uses text messages to support enabled the work’s impact to extend well people to manage their own health and • RAID - an effective whole system approach beyond a single region. Examples of work advancing in this area include: wellbeing. Flo can help people in many different to prevention of mental health crisis: West • Don’t Wait To Anticoagulate - quality ways: to manage diabetes; to live with chronic Midlands AHSN. improvement programme, which supports obstructive pulmonary disease; and even to Targeting illnesses - • MINDSet - a quality improvement toolkit primary care to reduce the burden of AF- breastfeed. for mental health: West of England AHSN. atrial fibrillation related stroke. This programme is increasing rates of anticoagulation, and optimises Three AHSNs (East Midlands, North East and Atrial fibrillation, or AF causes irregular or North Cumbria and West Midlands) have helped therapy for AF patients unstable on current abnormally fast heart rate and it affects around to secure funding for trials, evaluation and medication. Led by West of England AHSN. one million people in the UK. AF markedly further investment. 6 | Impact Report 2016 | 7 Our collective impact Our collective impact

NHS Innovation Accelerated Access 5. Lancashire and Cumbria Innovation “There is a real need across Alliance - supporting the frail elderly Accelerator Review and people with long term conditions the NHS to speed up the to remain well: Innovation Agency. The role of the AHSNs in driving innovation is Collectively, AHSNs are supporting the featured in the 2016/17 NHS England Business process of innovation, from government’s Accelerated Access Review 6. Perfect Patient Pathway - improved Plan: “During 2016/17 we will support our initial invention right through which aims to speed up access to transformative care for people suffering from long term Academic Health Science Networks to help to mass uptake of the most health technology that can change the lives of conditions: Yorkshire & Humber AHSN. drive the uptake of innovation in the NHS at NHS patients, service users and citizens. AHSNs local and regional level” (p48). successful across the health have been identified as one of the factors which 7. Technology Integrated Health and care system. Together will drive and enable the review. We have helped Management for Dementia - using In 2015/16 UCLPartners, East Midlands, the review take place, participated in a sub technology to improve the quality of life Yorkshire & Humber, the Innovation Agency with their mentors, who group working directly with the Office of Life for people with dementia: Kent Surrey and Imperial College Health Partners AHSNs are some of the most high- Sciences and we have supported a wide range Sussex AHSN. The 5G centre in Guildford, were partners in delivering the NHS Innovation profile leaders in England, of events to gain comments on the review from which is part of the test bed consortium Accelerator (NIA) programme. To date, some of a range of partners. led by Surrey and Borders Partnership NHS the NIA’s key achievements include: the NIA fellows will provide Foundation Trust, was highlighted at the G7 • Three million patients are benefiting models and lessons for us Test beds Summit in Japan in April by the Information from new innovations, including: apps, all in how to do that.” and Communication Technology Ministers, safety devices, online networks, and a host AHSNs are supporting the test beds announced indicating the worldwide interest in its of other new technologies and services. Professor Sir Bruce Keogh, Medical by Simon Stevens at the World Economic development. Director, NHS England Forum in Davos in January 2016. Test beds are • Supporting 17 fellows to scale their taking place across the UK to test the impact tried and tested innovations through the of “combinatorial innovation”. In these seven Place-based planning programme, which involves mentorship localities, frontline health and care workers AHSNs are supporting change across the health from seasoned healthcare innovators. “The support I am receiving are pioneering and evaluating the use of novel and care landscape, driving innovation at a combinations of different technologies and range of levels – local, regional and national. • Generating almost £8 million in from the Academic innovations in service delivery. This might be investment (primarily through the private All parts of the country are currently engaged Health Science Networks a new model for people with dementia that in creating collaborative Sustainability and sector and charities). combines wearable devices linked into mobile is invaluable. I have been Transformation Plans. AHSNs are playing Signing contracts with 66 NHS technology, implemented alongside tech- an active role in supporting development of • enabled housing with new roles helping support organisations, representing 14% of the only UK employee these plans and will be central to successful them stay well at home. Successful innovations the NHS. implementation. of AliveCor Ltd and for will then be available for other parts of the The role of AHSNs has been noted by the NIA sole representatives it country to adopt and adapt to the particular As neither commissioners nor providers, programme: “The country’s 15 AHSNs have is extremely difficult to needs of their local populations. AHSNs have a unique role in systems as an honest broker. AHSNs are experts in assisted in getting the innovations adopted access NHS organisations. All of the test beds involve AHSNs. These are; into clinical practice.” In 2016/17 all AHSNs implementation and have the knowledge, relationships and resources to operate credibly will continue to support the NIA. I’m not aware of any other 1. The Long Term Conditions Early organisations that work Intervention Programme: Greater at a micro-level with regional partners to Manchester AHSN. understand issues at a granular level, and together nationally and use importantly to help solve them. 2. RAIDPlus integrated mental health urgent their individual local networks care test bed: West Midlands AHSN. to help industry innovators Vanguards 3. Diabetes Digital Coach: West of England open doors in this way.” AHSN. NHS England has identified 50 vanguard sites 4. Care City: a London-based project to for the new care models programme. AHSNs Francis White, NIA Fellow and EU are collaborating with their local vanguards and enable implementation and evaluation General Manager, AliveCor Ltd the patients they serve in a wide range of ways of nine innovations that will improve to help support improvement and integration of care delivered to people with long-term services, and advance the introduction of new conditions, improve the experience of models of care. people with dementia, and improve resilience of carers.

8 | Impact Report 2016 | 9 Our collective impact The health and wellbeing gap

Patient safety and genomics for the future. AHSNs have also Since our inception, AHSNs implement the new pathway to suit their locally proved to be effective in communicating have worked towards delivering commissioned services and to integrate it into medicines optimisation genomics to the public. For instance, West future diabetes services. The South East Coast Midlands AHSN has spread the message improved clinical outcomes Ambulance Service NHS Foundation Trust is AHSNs lead a network of 15 Patient Safety across the region and supported collaboration and patient experience by now using new blood glucose meters, supplied Collaboratives to tackle the leading causes of across 18 acute trusts involved via three collaborating with multiple teams by Nova Biomedical, to ensure accurate blood avoidable harm to patients. These collaboratives Genomics Medicine Ambassadors, as well and organisations. We focus our glucose readings, which are fed back to GPs are tasked with empowering local patients and as through co-ordinated public involvement and are improving communication. healthcare staff to work together to identify and communications. The Health Innovation efforts on significant health, care safety priorities and develop solutions. Network has brought Macmillan Cancer Support and wellbeing challenges in our The project was shared with the Health Innovation Network, and following work with the These priorities are then implemented and and Genetic Alliance UK into a partnership with regions, and can show successes acute trusts and university partners to shape the London Ambulance Service NHS Trust a new tested within local healthcare organisations, in every area of England. hypoglycaemic pathway that meets the National before being shared nationally with the other way patients and their families are supported and guided through the project. Imperial Health The health and wellbeing gap described by Institute for Health and Care Excellence diabetes collaboratives. South West AHSN developed the Quality Standard 15 is now being implemented. LIFE quality improvement project documentation College Partners, the Innovation Agency and NHS England highlights diabetes and mental and sharing platform, which is now in active West Midlands AHSNs ran regional consultation health as areas of concern. Below is a selection use at six other AHSNs and their Patient Safety workshops on behalf of NHS England to advise of case studies which demonstrate how we are The Diabetes Improvement Collaboratives. For a full update on activity on the next stages of the project. beginning to accelerate the closure of these Collaborative nationally visit www.ahsnnetwork.com and gaps, and tackle other important challenges. download the progress report. The Health Innovation Network has undertaken “The UK is already a leader in work in South London which is improving Using the collaboratives, AHSNs are working Diabetes outcomes for people with Type 1 diabetes. with NHS England and the Association of the genomic technologies and the In the UK, it is expected that by 2030 4.6 million The national insulin pump audit showed British Pharmaceutical Industry to promote world renowned structure of people will develop Type 2 diabetes, driven that only 6% of people with Type 1 were best practice that ensures patients get the by increasing obesity. NHS England’s Annual using National Institute for Health and Care best outcomes from medicines. Many AHSNs the NHS allows us to deliver Report 2014/15 estimates that £1 in every £10 Excellence recommended pump therapy, even across the country are carrying out ‘transfers these advances at scale and of NHS funding is spent on diabetes. though evidence indicated that 15-20% of of care’ projects within the medicines pace for patient benefit. I’m patients could benefit. In South London uptake optimisation programme. (See p15-16). Hypoglycaemia care pathway for of insulin pumps was between 3% and 15%. delighted that AHSNs have people living with diabetes stepped up to the challenge The Collaborative consists of ten secondary 100,000 Genomes A hypoglycaemia pathway developed by South care diabetes teams and more than 60 This ground breaking NHS England led project and are providing a growing East Coast Ambulance Service NHS Foundation healthcare professionals, pump will sequence 100,000 genomes from around level of support to the project. Trust in collaboration with Merck Sharp & Dohme manufacturers and people with 70,000 people and will be used to help deliver Limited, is being implemented across the Type 1 diabetes, focusing personalised medicine and potentially deliver I am sure they will make a entire Kent, Surrey and Sussex region with the on improving access to more effective treatments for cancer and highly valuable contribution assistance of Kent Surrey Sussex AHSN and technologies and patient rare diseases. To support this project, 13 to ensuring we achieve our the South East Clinical Network. Patients were education. Results: missing out on education and intervention to NHS Genomic Medicine Centres have been 350 more patients goals.” prevent further 999 call-outs, following episodes • established with a clear remit to: gained access to of severe hypoglycaemia. Impacts from two pilot Consent and recruit eligible patients. Professor Sue Hill, Chief Scientific • Clinical Commissioning Groups (CCGs) showed: pump therapy. Officer for England • Collect and process samples for extraction. • 15 fewer ambulance trips to hospital per • Insulin pump uptake • Collate data, validate and communicate month in North West Surrey and Surrey increased by whole genome sequencing results. Downs CCGs. 30.8% thanks to the Collaborative. AHSNs are actively supporting delivery of this • Estimated savings in reduced admissions, project, including starting to build its legacy, emergency medicine costs and call-outs of • Pump usage across helping to form international collaborations £317,925 for the two CCGs in nine months. South London in April and having significant impact on its pace 2016 was 11.9% (UK and achievements. AHSN support has been • Savings could exceed £650,000 through average 6%). most valuable in building CEO awareness swift follow-ups and improved self-care. and engagement across the system and • Sustainable plans are in place helping to drive inward investment Kent Surrey Sussex AHSN is working with clinical to reach at least 15% of Type 1 and strategic insight in mainstreaming leads and commissioning managers in CCGs to patients by 2018.

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Martyn Hicks Photography, courtesy of Yorkshire & Humber AHSN The health and wellbeing gap The health and wellbeing gap

Mental Health Individual placement and Early intervention in psychosis “Congratulations on this support - helping people into pathway People with severe mental ill health have a great work. Type 1 is a reduced life expectancy of 15-20 years, with an employment Imperial College Health Partners worked with really important area and estimated annual cost to the economy of £105 Individual placement and support is an local teams and service users to co-design I am hugely grateful for the billion. evidence-based approach to supporting people and deliver a pathway for early intervention with severe and enduring mental illness to get in psychosis, adopted by all North West focus you are bringing to People recovering from mental employment or to stay in education or training. London mental health providers. The AHSN’s involvement was instrumental in supporting the diabetes space.” illness – using robust evidence to It is consistently proving the most effective approach to helping people who want to work. local teams to adhere with National Institute for Professor Jonathan Valabhji, National support change A RAND Europe economic analysis indicated Health and Care Excellence guidance on waiting Clinical Director for Obesity and an overall £1.59 benefit to the UK Exchequer times for mental health patients, and to collect The Oxford AHSN Anxiety and Depression and share clinical data that enabled service Diabetes, NHS England Clinical Network increased recovery rates for every £1 spent on individual placement and support. user outcomes to be measured against targets by 10%. These improvements came from for delivering evidence-based care. Imperial comprehensive data collection, accessing high- The East Midlands AHSN works with four College Health Partners also supported the NHS Diabetes Prevention quality research; identifying patient outcome mental health providers to ensure a consistent co-design process for a new portal, Patients themes; and putting the right training in place. Programme approach. A study by NIHR Collaboration for Know Best, enabling service users to access An independent return on investment Leadership in Applied Health Research and their clinical records and share their information The NHS Diabetes Prevention Programme was assessment by the Office of Health Economics Care East Midlands to implement individual at the point of care. Results: announced in 2015 and the first wave covers placement and support in Nottingham showed and Rand Europe concluded that: “The project Provider oversight of patient care records 26 million people in 11 of the 15 AHSN regions. has led to an estimated net saving of that 59% of service users were able to attain • Local health services will work with their chosen paid work or work-related opportunities. and waiting time data across institutional £750,000 of NHS money, mainly through boundaries. provider/s to deliver a service for their area. reductions in physical healthcare needs, The project is reducing variation, assisting Two AHSNs, Health Innovation Network and with navigating complex commissioning and has helped an estimated 384 additional Reduced referral time to assessment – East Midlands played an integral part in their arrangements, and engaging the national • people return to work. The Oxford AHSN has average patient seen within 2.2 weeks, local tendering processes supporting providers Centre for Mental Health. Greater Manchester therefore added significant value in this area, down from an average of 7.7. with their bids for the framework. by improving patient lives, cutting NHS costs, is now looking to develop a similar project. and contributing to the wider economy.” • Creation of a patient-based portal, enabling service users to access their “Thank you for your support. An additional 3,199 patients have been helped medical records and manage their care. to recovery, with recovery rates consistently I can confidently say that we in the high end of the 50% range • Increased access to services for patients. would have not secured this (the national average is approximately 45%). Oxford AHSN is running The pathway has been adapted and adopted without the skill, expertise a series of ‘how we did it’ by Wessex AHSN (TRIumPH - Treatment and and perseverance from East workshops for NHS Recovery In PsycHosis), with interest from England nationally. Yorkshire & Humber, West of England, South Midlands AHSN. We are very West and North East and North Cumbria AHSNs. fortunate to have this level of expertise to help us in the East Midlands.”

Melanie J Davies CBE, MB ChB MD FRCP FRCGP, Professor of Diabetes Medicine and NIHR Senior Investigator

12 | Impact Report 2016 | 13 The health and wellbeing gap The care and quality gap

Faecal Microbiota Transplantation Workplace wellness The NHS is recognising the • In the last 12 months, the GMCRN has - effective treatment of recurrent importance of reducing variation, completed more than 250 feasibility Yorkshire & Humber AHSN has worked in searches for industry and academia Clostridium Difficile partnership with Sheffield Hallam University delivering value, supporting studies in primary care. and the National Centre for Sport and Exercise new care models/vanguards and Wessex AHSN supported the creation of a Medicine to roll out a highly effective workplace Faecal Microbiota Transplantation bank in the use of digital technology • After rolling out in Lancashire, FARSITE is wellness programme to the NHS, public and Portsmouth through their Innovation and Wealth in healthcare. The following also being extended across the Innovation private sectors. The ‘Working for a healthier Creation Accelerator Fund. Transplantation is the Agency’s entire geography over the next tomorrow’ report stated that poor staff health examples reference these areas. National Institute for Health and Care Excellence two years. and wellbeing is estimated to cost the UK recommended provision of screened faecal economy £100 billion a year. Public sector matter via a nasal tube into the small intestine, organisations have historically lost over eight Harnessing digital Transfers of care using e-referrals restoring the balance of bacteria in patients. days of working time per employee due to and medicines adherence – This is tackling Clostridium Difficile infections, technology sickness absence each year. which are a major cause of mortality. Each improving patient safety and costs £5,000-10,000, with an average The programme provides staff health and wellbeing FARSITE – rapid searching web outcomes length of stay of 27 days and 22% chance of benefits, reducing sickness absence and application We know that things can go wrong when relapse. Around 2,500 people die from infections improving attendance. Results from the pilot: each year. Greater Manchester AHSN and the Greater patients need to move between settings, • For every £1 spent on the programme, the Manchester Clinical Research Network (GMCRN) sometimes leading to readmissions, poorer Wessex AHSN helped overcome the many NHS as an employer saved £3 in costs. are accelerating health innovation through outcomes and poor patient experience. Good logistical issues involved in the process, which helping researchers and clinicians improve the referral of care regarding medicines from was previously a major barrier to diffusion and • 45% were identified as having one or more way data is handled and studies are planned hospital to community pharmacy is helping spread. The first 23 patients have now received risk factors of cardiovascular disease and conducted. FARSITE was developed by to change this. a transplant and the service will reach 30 (CVD), of which 42.9% improved their NorthWest EHealth, a partnership between patients within a year, with an expected cure health by reducing at least one risk factor. Based on evaluation from Wessex AHSN the University of Manchester, Salford Royal in the Isle of Wight, an electronic referral rate of 94%. It can be expected to have saved NHS Foundation Trust and Salford Clinical A health economics evaluation showed template using PharmOutcomes is resulting nine lives in a year. The bank serves the region, • Commissioning Group. The tool confidentially that reductions in CVD risk factors are in readmissions being halved, and on average including places as far afield as Jersey. It is a finds and contacts groups of patients in centre of excellence, and work has started with linked to improved productivity and four beds saved per medicines review. a population. It can be used to gauge the AHSNs collaborated to agree a common the South West AHSN and Exeter Hospital to outcomes, with a potential return on feasibility of and to recruit for clinical trials, increase access for more patients. investment of 302% - 571%. data set for referrals and data collection to medicines reviews, and also used for risk support evaluation of these new pathways, Two local authority, seven NHS and three private stratification.Results: which have now been endorsed by the Royal sector organisations deliver the programme • Operational across the four northern Pharmaceutical Society and are available for which is now being rolled out regionally. AHSNs, covering over 1.3 million patients. all AHSNs to use. • Greater Manchester outperforms all other regions of the country for recruitment to life sciences trials as a consequence of FARSITE, for example, more than 4,500 people from 33 GP surgeries with were recruited to a care evaluation programme within 16 weeks with FARSITE. • Hitachi is building FARSITE into their large- scale diabetes prevention programme, as it can rapidly establish which patients should be targeted for preventative therapy. • Greater Manchester is currently reviewing whether FARSITE could be used to screen high-risk patients and help GPs target therapeutic interventions for stroke prevention.

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Nottingham University Hospitals NHS Trust, courtesy of East Midlands AHSN The care and quality gap The care and quality gap

In the North East and North Cumbria AHSN, Neurorehabilitation - e-referral Increasing patient access to hospital pharmacy staff are using the system pathway improving patient care innovative treatments and “We are proud to be working successfully to refer patients to their community with the team at UCLPartners pharmacist and the project is improving and reducing variation clinical trials communication and assisting patients with to further enhance our UCLPartners has partnered with Quintiles, the their medicines. Results: Imperial College Health Partners has co- world’s biggest clinical research organisation, to ability to recruit patients designed and implemented a new system to Six acute trusts are now making referrals increase access to clinical trials and innovative and investigators, who are • help overcome the fragmented rehabilitation to a potential 700 community pharmacies treatments for over 4.2 million people in care pathway for acquired brain injury patients. critical to an efficient and for follow up support with their medication north central and east London and Essex. The previous pathway was difficult to navigate, after discharge from hospital. UCLPartners is now the highest performing effective drug development as it relied on a complex system of referrals Quintiles Prime Site in the world, with 619 process. We have gone from • More than 750 patients have now between multiple providers, delaying timely patients recruited to trials in 2015/16. received follow-up support. rehabilitation and overall negatively impacting strength to strength since • Community pharmacists reported that on patient experience and outcomes. Through UCLPartners and the Clinical Research this relationship began, and nearly 90% of patients had a better Network North Thames, hospital trusts in Imperial College Health Partners worked with we are proud of what we have understanding of their medicines and north central and east London harmonised commissioners, providers, academia and NHS would be therefore more likely to adhere the approvals process and reduced the achieved together, for the England London to co-design the new system. to their prescribed medicine regimes. average time taken to approve trials from 104 benefit of London as a whole.” Results: to 17 days. The success of this work led to • The project team has won two prestigious Lindy Jones, Chair of the Quintiles More accurate patient assessments UCLPartners becoming a Quintiles Prime Site, HSJ Awards in 2015, in the categories • Europe, Middle East and Africa Board for ‘Enhancing Care by Sharing Data and through standardised provision of meaning they get first notification of all trials Information’ and ‘Most effective adoption information on referral. taking place in Europe. and diffusion of best practice’. Dementia memory clinics - • Time between patient referral and Prime Site has now been extended to Essex, This work has been taken on and adapted by the admission to services reduced by almost increasing patient access to innovative treatment thousands of patients are getting South West AHSN, where existing services are half - 17.37 days to 9.78 days. and supporting research capabilities. Results: better care being used in community pharmacy to support An additional one million people have patients with their medicines following discharge Reduced costs on average by £1,700 per • All memory clinics in Oxford have been brought • access to clinical trials since its expansion from hospital. Improving these transfers of patient and saved 482 acute bed days. up to the standard of the best in the region to Essex. care is helping patients better understand their through a comprehensive national accreditation medicines, improve patient outcomes, increase • Staff satisfaction drastically improved, programme. Memory clinics provide valuable having previously been weighted towards • For every 100 patients recruited, trusts support to people with dementia and their adherence, and reduce readmissions and receive an average of £1 million. medicines waste. They are working with Yeovil 1-3 out of 5, staff now report exclusively 3-5. carers. Having identified unwarranted Hospital and Somerset Local Pharmaceutical For every 100 patients recruited, trusts variations, Oxford AHSN appointed a specialist As a result of the programme’s success, • nurse to work with six different memory clinic Committee on the implementation, funding them • also save approximately £6 million in costs the eight referring Clinical Commissioning teams. The aim was to bring them up to the to help develop a package that can be shared of treatment if those patients were not on Groups have agreed to fund the initiative standard of the best through the Royal College across the South West and supporting The Royal trials and were accessing normal care. Cornwall Hospital to move to electronic referrals going forward, guaranteeing sustained of Psychiatrists (RCP) Memory Services National instead of faxing. improvement. • UCLPartners is now replicating the model Accreditation Programme (MSNAP), which for other companies. provides a structured means of working and embeds consistent high standards. Results: “Without your input, this • By January 2016, all six memory clinics service most definitely the Oxford AHSN worked with had been accredited by the RCP MSNAP, three of wouldn’t have been as them receiving an excellent rating. dynamic as it now is, and • Improvements have been embedded into goes far beyond what I had dementia services, with benefits felt by anticipated at the start of 8,500 patients and their carers, with lots of positive feedback. this journey so thank you.” • Policies and procedures within memory Matt Harvey, Chief Officer, Somerset clinics have been improved. Local Pharmaceutical Committee • Multi-disciplinary and inter-agency working has improved.

16 | Impact Report 2016 | 17 The care and quality gap The finance and efficiency gap

Eastern AHSN is developing a quality AHSNs are assisting with closing • A Falls Summit held with three other improvement infrastructure to support the finance and efficiency gap AHSNs had over 200 delegates. “When we were first continued service improvement and innovation. considering taking our The programme is based on the substantial in many ways. Whether by • Kent Surrey Sussex AHSN’s Patient Safety memory service through experience of AQuA in delivering a similar delivering direct savings through Collaborative is adopting the HUSH programme in the North West funded by the the MSNAP review process, our programmes, supporting approach in their implementation work. Innovation Agency and Greater Manchester test bed sites, making better AHSNs throughout the lifespan of the networks. the prospect was somewhat use of technology, leveraging Using this experience existing programmes “Huddles are the best thing daunting and overwhelming. have been tailored to meet Eastern AHSN's non-NHS funding or supporting We were extremely grateful needs based on virtual design testing with scientific research and innovation, we’ve ever done.” system leaders in the region. that the Oxford AHSN was AHSNs are at the forefront of Amy Hargreaves, Senior Sister, J46, able to provide a very Five NHS trusts from across the East of delivering new ways of working Lincoln Wing, Leeds Teaching Hospitals experienced clinician to England have participated in the programme, and collaborations with diverse NHS Trust with more planning to do so. East Midlands partners, with patients at the act as an overall lead." AHSN also approached AQuA to work with them heart of our work. to deliver a similar programme. Eastern and PolyPhotonix – light therapy mask Frances Finucane, Team Manager, East Midlands AHSNs have agreed a reciprocal improving patient experience and North Buckinghamshire Memory Clinic approach, to allow trusts in either region to Patient safety - reducing falls, saving costs access the most convenient dates. So far in improving safety, saving money the East Midlands, the AHSN has enabled Current treatments for diabetic retinopathy seven organisations to participate, with Falls are estimated to cost the NHS more than Developing a strong Board are expensive and invasive, but sleep masks a total of 72 senior staff attending two- £2.3 billion per year. Inpatient falls can lead to enhance patient experience as there is no to improve safety culture – day board development sessions. The West hip fractures and other injuries, while even falls need for expensive injections and the condition Midlands AHSNs is also investigating the without harm can lead to loss of confidence and AQuA Programme can be treated and monitored at home. It is use of AQuA. increased length of stay for patients. Yorkshire estimated that savings of over £1 billion per NHS Boards hold the ultimate responsibility & Humber AHSN’s Improvement Academy is year could be made if this new non-invasive for the quality and safety of care their actively working with more than 66 frontline technology were rolled out across the UK. organisation provides. teams across 23 organisations to roll out The Noctura 400 mask is currently being sold the Huddle Up for Safety Healthcare (HUSH) The Advancing Quality Alliance (AQuA) privately, and is in the process of National programme. Results: programme brings together Boards to explore Institute for Health and Care Excellence how their organisation currently measures and • The average step change reduction in approval for use in the NHS. monitors safety, using a proactive systems falls is 50%. approach. Their Board development North East and North Cumbria AHSN supported local company PolyPhotonix, as it was new to programme is consistently extremely • One ward moved from an average of one highly rated by delegates who fall per week to repeatedly achieving 30 working with the NHS. The AHSN assisted them with clinical trials and opening up routes to include executive and non- days between falls, and in some cases market. PolyPhotonix successfully bid for executive directors coming up to 60 days. together to learn how they SBRI funding. can more effectively provide • A preliminary health economics evaluation the top leadership for showed a return on investment of 388% - safety in their organisation. savings of £185,000. • £500,000 funding received from the Health Foundation’s Scaling Up initiative. • To date, 1,354 patients who would have fallen haven’t and £967,000 has been saved from direct care costs. • The programme is being extended to include pressure ulcers, care of deteriorating patients and reducing delayed discharges.

18 | Impact Report 2016 | 19 Nottingham University Hospitals NHS Trust, courtesy of East Midlands AHSN The finance and efficiency gap Driving economic growth

Following successful trials, the sleep mask West Midlands AHSN supported the wider AHSNs bring together industry The Innovation Pathway is now commercially available with sales for adoption of STarT Back, a stratified care tool partners with the health and 2015/16 estimated to be in excess of £3 million. for low back pain. Patients are screened for risk – supporting businesses PolyPhotonix’s workforce is expected to triple and placed into three risk groups, with matched social care sectors, speeding up over the next two years to 60 employees: jobs pathways to target the right treatment to the development of innovations and every step of the way directly created as a result of SBRI funding. The right patient. STarT Back has now been adopted their uptake into practice. We AHSNs have developed the national Innovation company has secured approximately £2 million into several high quality clinical care pathways. help life sciences and healthcare Pathway framework. This pathway clarifies our of additional investment, and North East and Results: offer to all potential industry and enterprise North Cumbria AHSN has worked closely with technology companies navigate partners. It articulates the offering from Kent Surrey Sussex and South West AHSNs • Improved clinical outcomes and reduces the complex NHS marketplace, AHSNs and showcases our services to industry to extend the project’s reach through trials. back pain disability. driving economic growth by and to NHS innovators. Benefits include: In addition the Innovation Agency has provided • Reduced sickness absence, physiotherapy creating an environment more procurement support to get the product into wait times, GP consultations, referrals to conducive to effective working • A consistent approach across AHSNs. the NHS. secondary care and referrals for imaging. between industry and the health • A single contact point: helping companies • Cost-effective,saving £34 per patient and and social care sectors. navigate the complex health system. £675 in societal costs. “There is no contest that • Advice and access to expertise on issues • AHSN support has meant that an additional such as evidence base, evaluation and I would choose the mask 18 community physiotherapy services “AHSNs connect academics, market access. over the laser treatment. nationally have adopted the STarT Back NHS, researchers and approach. • Signposting to local partners and regional It is easy to use, and removes industry to accelerate the and national funding sources (such as the any traumatic experience • The Innovation Agency is rolling out the adoption and diffusion of SBRI Healthcare programme) and support tool across their geography. More than 80 that occurred when having innovation helping to catalyse within the system for companies awarded GP practices in Liverpool have adopted funding. my eyes lasered. I still wear the tool so far. economic growth at the same the mask at night and would • At least eight CCGs across the UK are time as driving improvements encourage anyone with adopting the approach. in the quality and efficiency of diabetes and suffering • The STarT Back tool has been translated care. They are working with from retinopathy to do into 12 languages. partners locally and nationally the same.” • The programme team is working with to develop innovation eco- services overseas, including Australia Anonymous, patient and the USA. systems right across the NHS, so that innovation is • STarT Back has been included in the Allied Health Professional Musculoskeletal championed by all - from STarT Back – keeping patients toolkit, Map of Medicine and the Royal patients to CEOs. Nationally, well and at work College of General Practitioners’ e-learning they are core to the delivery module. Back pain is the most common reason why of the Small Business middle-aged people visit their GP and indirect Research Initiative, National economic costs to the UK are over £10 billion a year (Pain Journal). It is the second most “The STarT Back tool Innovation Accelerator common reason for sickness absence, and for represents a high-value programme and test beds - persistent disability and work loss in people tool - this is what we need under 65. Some patients are over-treated, three fundamental national while others fail to get the right care. more of in the NHS.” delivery platforms for Sir Muir Gray, Director of the National innovation.” Knowledge Service and Chief Knowledge Officer, NHS England George Freeman, MP, Minister for Life Sciences

20 | Impact Report 2016 | 21 Driving economic growth Driving economic growth

Greater Manchester AHSN helped the surgeon Leanvation – speeding up the inventor win his first deal with an NHS trust. adoption of innovative surgical Following this, the National Institute for Health THE and Care Excellence developed a Medtech gloves INNOVATION Innovation Briefing to encourage its wider PATHWAY use. Central Manchester University Hospitals The Innovation Agency championed and assisted Leanvation, a manufacturer of Success NHS Foundation Trust has procured a further BESPOKE SERVICES COVERING THE ENTIRE contract and as of March 2016, more than 1,570 innovative latex-free surgical gloves, to break INNOVATION LIFE CYCLE FROM CONCEPTION patient examinations had been completed in through barriers and join the NHS Supply OF AN IDEA THROUGH TO ITS EVENTUAL Adoption the first adopting hospital trust. Clinical results: Chain (NSC). The AHSN helped the company REALISATION OF COMMERCIAL SUCCESS. overcome rigorous processes and secure • A greatly improved and far less three framework award contracts with Shared distressing process for women with Business Services, Health Trust Europe and Finance cervical cancer. NSC. Brokering 40% reduction in the number of follow-up Markets • Leanvation surgical gloves are now available appointments in Sheffield. to all NHS trusts throughout the country. • Reduction in ‘over-treatment’ of patients as The company recently received £500,000 a result of improved diagnostic capability. venture capital investment. Three jobs have been safeguarded and an additional six posts Intellectual Commercialisation • 11% drop in the number of biopsies have been created in this St Helens-based Property undertaken over the last two years. start-up. Reduction in patient waiting times and Clinical Trials Evaluation • immediate results for patients. “This is the breakthrough Health Economics we have been waiting for. “The benefit to patients is that Ideas It is only as a result of the they will get an immediate intervention of the AHSN’s and objective result. It will Culture commercial team that we AHSNs help companies and innovators reduce the need for biopsies, were able to break through navigate a fragmented landscape. sparing patients a painful barriers to joining NHS process often associated frameworks, such as a with bleeding afterwards.” requirement for a £1 million Each AHSN will provide support along the Helping Zilico with adoption of John Tidy, Professor of Gynaecological turnover.” Innovation Pathway for innovations of high their ZedScan technology to help Oncology, Sheffield Teaching Hospitals potential in relation to local health needs and detect cervical cancer NHS Foundation Trust and Clinical Dr Jonathan Day, Managing Director, supporting economic growth. This might be in Founder, Zilico Ltd Leanvation terms of: The ZedScan system uses measurement of • Stimulating inward investment. electrical resistance to help detect cervical cancer cells. It can identify patients who require • Supporting the export of UK products. treatment at first visit, reducing the number of cervical biopsies performed and pin-pointing • Keeping people well and in work. the optimum site for biopsy. • Increasing productivity. Some examples of our impacts on behalf of companies follow in this section. This is just a small selection and further details can be found at www.ahsnnetwork.com and individual AHSN websites.

22 | Impact Report 2016 | 23 Driving economic growth Driving economic growth

SBRI Healthcare • The breathalyser is simple to use, and “The biggest impact of “The SBRI Healthcare produces a result in just 30 seconds. SBRI Healthcare is both a funding initiative run SBRI funding has been in competition process enabled by the AHSNs and the source of some of the • If the test was used in a national screening clearest examples of the benefit to companies accelerating the commercial us to make a real difference programme, it could be used in around from interaction with the AHSNs. On behalf of side of the business and in the care of long-term 1.3 million tests each year. NHS England, the AHSNs host this £20 million programme to develop innovative products considerably increasing respiratory disease. It that address unmet health needs while creating the pace of activity with has been more than just “Owlstone’s technology UK-based industry and jobs. the NHS.” funding; without it, the novel has the potential to deliver SBRI run competitions inviting companies products we are developing a quick and easy-to-use to come forward with their ideas and new Richard Kirk, Chief Executive, technologies. It offers a fast track to funding PolyPhotonix would never have been breath test, and SBRI for developing products matched to needs the developed.” Healthcare funding is NHS has specified. Critically, AHSNs provide allowing us to turn that support to companies by mobilising the Aseptika - home test for Kevin Auton, Managing Director, expertise available in their localities, before, Aseptika potential into a reality.” during and after the SBRI process. AHSNs are predicting lung infection flare-ups Billy Boyle, Co-Founder, Owlstone uniquely placed to assist with NHS evidence Aseptika developed the Activ8rlives self-care requirements, market insights and adoption system and home-use sputum test to give and procurement challenges. This approach Owlstone’s lung cancer patients with chronic obstructive pulmonary breathalyser – helping develop is really delivering impact. disease (COPD) early warning of chest infections. a promising, early stage, Last year’s highlights include: This means that they can be treated effectively at home and reduce unplanned hospital technology • Six new clinically-led competitions to admissions. Estimated savings to the NHS attract businesses’ interest. could exceed £50 million each year (SBRI Owlstone developed a handheld breathalyser Healthcare website). It has also secured a US which can detect early stage lung cancer. The • 44 Phase 1 and 2 contracts awarded, patent. Results: low-cost, non-invasive test has the potential to with a total value of £17.5 million. be used in national screening programmes and • Reliably predicts exacerbations 7-21 days primary care settings. It could diagnose cancer • 258 applications from industry assessed. before the patient would typically seek early, transforming survival rates and potentially help. saving the NHS £245 million within three years, Impact since NHS England funding saving 10,000 lives. began in 2012/13: • Patients find the self-monitoring tools and Activ8rlives website easy to use (more than Thanks to using SBRI funding, using microchip • Approximately 250 jobs created or 80,000 people have signed up), showing technology originally developed to ‘sniff safeguarded. very high adherence rates. out’ explosives, Owlstone reprogrammed the software to detect chemical biomarkers • Annual savings forecast for 2013-15 • Aseptika was involved in the Eastern AHSN found in the breath of people who have lung £723 million. COPD test bed bid, and has been selected cancer. They collaborated with researchers as an innovation partner for the Sheffield and designers from across Europe to design • £56.7 million total funds awarded (Phases 1 and 2). test bed site, where it will be integrating user-friendly breathalyser hardware. Eastern the self-monitoring package into new AHSN was able to connect the company to NHS • 181 contracts awarded (Phases 1, 2 respiratory disease care pathways. organisations who wanted to trial and test their and 3) and 20 products already on diagnostic. Results so far: the market. Advice from Eastern AHSN led to Aseptika gaining SBRI funding to develop its self-care • Laboratory testing showed that the system for people with COPD. Aseptika now chemical sensor can detect all 12 funds five full-time staff and two researchers, biomarkers, potentially detecting lung with testing underway in Eastern and Wessex cancer at an early stage. AHSNs.

24 | Impact Report 2016 | 25 Contact details and regional footprint

North East Note: East Lancashire and North Hospitals NHS Trust sits with Greater Cumbria Manchester AHSN

@EM_AHSN @Ldn_ICHP @UCLPartners www.emahsn.org.uk www.imperialcollegehealthpartners.com www.uclpartners.com Yorkshire & Humber

Innovation Agency East Midlands @TheEAHSN @KSS_AHSN @WessexAHSN www.eahsn.org www.kssahsn.net www.wessexahsn.org.uk

Greater Eastern Manchester

@GM_AHSN @AHSN_NENC @wmahsn www.gmahsn.org www.ahsn-nenc.org.uk www.wmahsn.org West Midlands

Oxford @HINSouthLondon @OxfordAHSN @WEAHSN UCL www.hin-southlondon.org www.oxfordahsn.org www.weahsn.net Partners

West of England Health Innovation Network @innovationnwc @sw_ahsn @AHSN_YandH www.innovationagencynwc.nhs.uk www.swahsn.com www.yhahsn.org.uk

Kent Surrey Sussex www.ahsnnetwork.com

Wessex Imperial College South West Health Partners

26 | Impact Report 2016 | 27 Author: Lucy Hose – East Midlands AHSN Editorial group: Cathy Young – South West AHSN Séamus O’Neill – North East and North Cumbria AHSN Tara Donnelly – Health Innovation Network Design: The Dairy – www.thedairy.biz

With many thanks for contributions from the communications teams in every AHSN.

The header icons on pages 11 to 25 are created by Freepik at: www.flaticon.com © The AHSN Network