Slide deck for ILN symposium

Welcome

#ILNsymposium

Tom LindleyFounder, Inspiring Leaders Network

#ILNsymposium

Chris BainCEO, Rotherham Doncaster & South Humber NHS Foundation Trust

#ILNsymposium

Morning Session 1

The Importance of Integration for Innovation

#ILNsymposium

Carol WilbyHead of Commercial & International Innovation, NHS England

#ILNsymposium

www.england.nhs.uk

Innovation in healthcare

Carol Wilby

10 March 2015

www.england.nhs.uk

• The 5 Year Forward View identified a number of priorities to accelerate useful health innovation including new treatments and diagnostics and new ways of delivering care specifically through “combinatorial (integrated) innovation”.

A manifesto for the NHS

www.england.nhs.uk

• Sustainability & viability in delivering care that is “best in class”

• Developing the NHS as an innovation incubator - doing more of the same is not an option!

Why should we innovate?

www.england.nhs.uk

The power of innovation

www.england.nhs.uk

What’s stopping us?

www.england.nhs.uk

• Data & information• Innovation Scorecard• NHS Exchange• Innovation Connect

• Financial Incentives• Innovation tariff • CQUIN

• Leadership• Leadership & accountability framework

Key programmes

www.england.nhs.uk

Reward & Recognition

• Challenge Prize Programme• NHS Innovator Accelerator

System Architecture

• AHSNs• NICE Implementation Collaborative• Office for Innovation

Tools & Capability

• Innovation Compass• AHSNs• National Clinical Director for Innovation

Key Programmes

www.england.nhs.uk

Tools & Capability

Reward and Recognition

Access to data

• Uptake & Utility

• Profile & Priority

• International Blueprint

• Improved relationships

System Architecture

Financial levers

Culture

How are we doing?

www.england.nhs.uk

High volume of redundancies

1. Policy Framework for innovation is well regarded

2. Give it time, be patient – no overnight solutions

3. The more data you have the better

4. Need the right policy, regulatory and financial environment

5. Must collaborate

6. Need support at grass roots level

7. Finance is the elephant in the room

8. Need patient demand for innovation, top down won’t work

LearntLessons learnt

www.england.nhs.uk

A new industry council puts industry at the heart of policy development

More routine and systematic dialogue with AHSNs, and reduce the number of cotact points

A ne signposting and support service for industry

What might the future hold? look like?

www.england.nhs.uk

• Deliver partnerships with patients, social care, local authorities, citizens and technology industries to:• Use technology to increase social inclusion• Develop processes that are clinically supported and have

patient consent• Deliver personalised care/fully interoperable care record• Assist with the delivery of the digital health agenda• Delivery of high impact innovations

Further work to be done

www.england.nhs.uk

• Partner with the EU to deliver more “bang for the buck” that:• Utilises incentive based innovation funding that galvanises the use of ground-

breaking innovations in the NHS• Creates incentivised technology adoption in the NHS• Transforms the lives of individuals and families and enable people to stay healthy

and prevent hospital admissions

Increasing the size of the funding pot

www.england.nhs.uk

• Making Innovation everyone’s business, will significantly change the culture, the NHS’s greatest asset is its staff, but we do not harness their skills, ideas or knowledge as effectively as we could

“you need every brain in the game to win”(Jack Welch , Business Executive and former CEO at GE)

The NHS has 1.3 million brains

Whose business is it?

www.england.nhs.uk

Finally..

Andrew RileyMD, Yorkshire & Humber Academic Health Science Network

#ILNsymposium

Adopting Excellence, Creating Opportunity

www.yhahsn.org.uk @AHSN_YandH

AHSNs InnovationAndrew Riley MBA

Managing Director Yorkshire & Humber AHSN


Outline

• Brief introduction to AHSNs• Spotting innovation• Due Diligence• Building Partnerships• Improvement and Change• Evaluation and Evidence• Summary


National AHSN Picture

North West Coast North East and North Cumbria

Greater Manchester

Kent Surrey and Sussex

Yorkshire and Humber

East Midlands

Eastern

UCL Partners

Imperial College Health PartnersOxford

Wessex

South LondonSouth West Peninsula

West of England

West Midlands


The Yorkshire and Humber AHSN

• Population covered 5.8m

• Annual Budget £5.2m

• 47 NHS Members

• Regional NHS budget £12bn

• >180 Health related SME

• >20 health related MNO

• 2/8 English Core cities

• Regional economy £80bn


15/16 Strategic Objectives & Programmes

Population HealthEmpowering Citizens to manage their own health

Healthy Active Ageing

Improving HealthcareAcross Systems

In Organisations

Economic Growth

Accelerating Industry/NHS Partnerships

Accelerating Spread and adoption

Maximising International Growth


Spotting Innovation

• Innovation Scouts• Partnership with HEI and Business• Open Innovation• Investment and sponsorship, Dragons Den• International liaison and Partnerships


Due Diligence

• Search for Evidence, JED (Just Enough to Decide)• Due Diligence;

• On the company• the concept• the market• benefits

• Market Analysis; New, “me too”, cost• Health Economics


Building Partnerships

• AHSN + HEI • Translating research output into service impact

• AHSN + Business• Developing ideas• Proof of concept• Funding• Navigating the system• Connecting to the NHS

• AHSN + NHS• Innovation Scouts• Communities of best practice• Open Innovation Workshops, Show casing, workshops, conferences

• AHSN + Patients• Patient pull, early engagement and co-creation

• Right Organisations

• Right people

• Clearly defined need

• Safe Environment

• Time and Space

• Leadership

• Results


Improvement and Change

• Proven Techniques for improvement and change• Stick to the process• Education and Training• Cross cutting/system• Develop organisations to become change ready/ eager• Build team confidence, coach and support in choppy waters• Rapid feedback• “Dare to try” culture


Evaluation and evidence

• Credible reviewers/auditors; HEI academic rigour• KPI/ Outcome measures• Return on Investment• Patient Outcome Measures• Scalability• Spread and Adoption


Summary

• AHSN’s role in innovation• Making innovation real

Morning Session 2

Structuring successful Integration: What does good look like?

#ILNsymposium

Professor David WelbournMD, EutropiaVisiting Professor, CASS Business School

#ILNsymposium

Eutropia Limited © 2015 Company registration no. 7551009. Registered address 132 The Street, Rushmere St Andrew, Ipswich, IP5 1DH

Structuring Integrated Care

David Welbourn

Eutropia Limited © 2015 10 Mar 2015 37

“We must find and create tensions—force people

into different space for thinking...This is not just

a performance issue but a survival issue,

because managing paradox helps foster

creativity and high performance.”

Paul Polman,

Unilever CEO


A resourced plan to achieve defined goals Illustrated

experience of the journey

Tasks Behaviours Imagination & feelings

The way things are done

Framing the goal


A strong narrative provides:

Total clarity of a compelling purpose

A powerful picture describing outcomes

An enticing invitation to join the journey

A basis for distributed power & influence

Reason to be fully engaged

Inspiration for social movement to flourish

Offer of shared ownership and ambition

Flexibility to be resilient and sustainable


Gen Stanley McchristalFormer commander,International Security

Assistance Force,Afghanistan

“We had to change our structure to become a network…. Instead of decisions being made by people who were

more senior – the assumption that

senior means wiser – we found that the

wisest decisions were usually made by those

closest to the problem”


Redefining purpose

The NHS system was designed to make sick people well

30% of the population have health conditions from which

they can not be cured

70% of the NHS budget is spent treating failure to manage

their known conditions


Enabling communities to flourish and everyone to live fulfilled lives to the

greatest extent possible with their conditions.


Alan Lafley

CEO of Proctor & Gamble

“The firms with the

greatest capacity to

win, will be those

whose strategic

choices extend out to

networked

stakeholders,

suppliers and even

competitors in the

right circumstances”


Different problems: differing solutions

Help 30% of population live more effectively with their conditions

A coherent approach to urgent care

Encourage people to take more

responsibility for healthier lifestyles

Deliver “routine” acute care via best protocols

Concentrate complex and specialist care around very best

expertise


The business model

Governance

Model

The set of structures, processes and relationships within which decisions are made, resources deployed and accountability is managed to

achieve agreed purpose.


The business model

Governance

Model

Contracting

Model

Addresses how co-ordination is achieved for the service user. Defines how commissioner exerts their influence, and the manner in which the relationships

within the supply chain are managed.


The business model

Governance

Model

Contracting

Model

What is valued in the process? What will be paid for? How is each member of the supply chain paid?

How will payment be channelled?How will delivery be measured?

Reimbursement

Model


The business model

Governance

Model

Contracting

Model

Describes how the services are constructed and experienced by the service user. For best value and resilience, ownership should rest within the

provider supply chain, NOT with the commissioner

Service

Model

Reimbursement

Model


The business model

Governance

Model

Contracting

Model

Service

Model

Reimbursement

Model


Systems no stronger than weakest link

Acute & Specialist

health

Primary & community

health

Mentalhealth

Welfare & Housing

Social care

Value of voluntary

care

£300bn

Healthcare

Social

Volunteers

9m People


Integration - contracting model

Commissioner AllianceIndependent

Integrator

AccountableCare

IntegratedOrganisation

Network of peers act collaboratively to

deliver common goals

Traditional modelCommissioner letsand manages all discrete contracts

Specialist independent integrator manages

supply chain subcontracts

Single organisation has capacity and

capability to deliver full solution

Special purposevehicle

Partners invest equity to share ownership in a single organisation

as a joint venture

Single provider takes lead to be accountable for all the supply chain

partnerships


Aligning the model

Help 30% of population live more effectively with their conditions

A coherent approach to urgent care

Encourage people to take more responsibility for healthier lifestyles

Deliver “routine” acute care via best protocols

Concentrate complex and specialist care around very best expertise

Integration,Partnerships

Peer networks,Partnerships

Public Health & education

Hub & spokenetworks

Integration,Partnerships


Quality – A system responseThe vast majority of failures occur at boundaries!

Reduce number of boundaries

Reduce risk of failure at

boundaries

Reduce impact of failure at

boundaries

Stronger standardsBetter informationMutual respect & understandingBetter communication

Redesign care to eliminate waste stepsReduce fragmentation

Focus on outcomesGreater oversight/ assuranceShared risk and rewardCommon leadership


Quality – a person response

Reduce frequency of

exacerbations

Reduce severity of exacerbations

Rapid and appropriate intervention

Better use of personal recordEarly detectionRegular monitoring and diagnosisMore appropriate intervention

Increased self awareness Changes in lifestyleBetter monitoring and diagnosisMore accessible care support

Joined-up planningRapid access to right careWider range of interventionsMore use of intermediate care

Focus on outcomes that matter!


“If you are not

confused about

current events, you

are not paying

attention”

Bob Johansen

Former President.

Institute for the Future


Further detailsDavid Welbourn 07889 [email protected]

• DisclaimerIn keeping with our values of integrity and excellence, Eutropia Limited has taken reasonable professional care in the preparation of this report. Although Eutropia Limited has made reasonable efforts to obtain information from a broad spectrum of sources, we cannot guarantee absolute accuracy or completeness of information/data submitted, nor do we accept responsibility for recommendations that may have been omitted due to particular or exceptional conditions and circumstances.

• Confidentiality This report has been prepared for the client within the terms of our contract, and contains information which is proprietary to Eutropia and confidential to our relationship. This may not be disclosed to third parties without prior agreement.

Except where permitted under the provisions of confidentiality above, this document may not be reproduced, retained or stored beyond the period of validity, or transmitted in whole, or in part, without prior, written permission from Eutropia Limited.


Additional materials


Mark Moore – strategic triangle

Authorisingenvironment

Legitimacy – is there political

& regulatorycover?

The practical reality – is it possible?

Operationalcapability

Public valueproposition

What matters – is the uniting

purpose valuable?

After Mark Moore, Creating public value – strategic management in government, published by Harvard University Press, 1997


Draw on widely diverse

perspectives

Adopt open enquiring mindset

Go out of your way to make connections

Tasks& ideas

Relationships & behaviours

Be Clear

Be Curious

Be Courageous

Invest in promoting

values

Establish compelling

vision

Embrace uncertainty

Distribute leadership &

decisions

System leadership characteristics

© 2012 Prof David Welbourn, Prof Dean Fathers


VUCAChaos &Paradox

If it were only complexity….

Uncertainty

Volatility Complexity

Ambiguity

Paradox:not susceptible

to logical analysis

high frequency,multi-dimensional

turbulence at scale

past experience is no longera reliable predictor

cause & effect relationships

are indiscernibleeven experts fail to make sense

of conflicting signals


Systems leadership

Shared Vision and Values

Burning platform vs burning ambition

Powerful narrative to energise/ motivate

An authorising environment

Ceding power for greater good

Magnanimity, humility, servant leadership

Cooking the conflict – managing the paradox

Information rich, deep engagement


Governance

Structures Processes

Agreed outcomesachieved

Accountability

Decisions ActionsResources

deployed

Wh

at..

. “

Stu

ff”

Eth

os.

..

“Sty

le”

Governance: Stuff ’n ’Style

Relationships

Peter CrowExecutive Director, Quarry Group

#ILNsymposium

What does good look like?Peter Crow | Quarry Group | New Zealand

Important considerations

• Islands of excellence

• Social, political and economic demands

• Acceptable rate of change

Purpose

StrategyExecution

Towards a working model

Underlying mechanisms

Conclusions

“Together” trumps “apart”

A commitment to a higher purpose

Active engagement of the board

[email protected] | +64 21 611 635 | @petercrow1

CoffeeBack at 12.00

#ILNsymposium

Case Study

Sheffield Hallam University Health & Wellbeing Programme

#ILNsymposium

Hanna LeahyBusiness Development Manager, SHU Wellness

#ILNsymposium



Workforce Health and Wellbeing Project

Hanna Leahy, MSc

Project Partners

www.yhahsn.org.uk@AHSN_YandH

Project Background

• Chronic disease and health inequalities are rising in an ageing population.

• Absenteeism and a decline in productivity associated with chronic disease costs the UK an

estimated £100 billion every year (Nice, 2009).


ProductivityAbsenteeism• Short-term• Long-term

Presenteeism• Inconsistent quality (service/product)• High staff turn-over• Poor customer satisfaction• Temporary staff• Low levels of efficiency


The NHS

• UK's largest employer

• Health and health behaviour of employees is poorer than national averages... reflected by absenteeism rates

• Improving staff wellbeing is crucial for delivering improvements in patient care


Workforce Wellbeing Programmes

• Absenteeism and a decline in productivity associated with chronic disease costs the UK an estimated £100 billion every year ...

with a large proportion of this attributable to

physical inactivity in the workforce (NICE, 2009).

• Lifestyle changes that result from an effective workforce health programme can equate to at least a 400% return on investment for employers (Pricewaterhouse Coopers, 2008).


Workforce Wellbeing Programmes

Workplace Wellbeing

Programme

Behaviour Change

Improved Health and Wellbeing

Improved Productivity

• "Good health is good business" (Dame Carol Black, 2008)


SHU Wellness - The Model


SHU Wellness•Multicomponent programme:

– 1-to-1, hour long annual health and fitness assessment. – Includes measurement of blood pressure, cholesterol, blood

glucose, lung function, aerobic capacity, body composition.

•Motivational Interviewing (MI)

– Directive client centred collaborative approach to facilitate lifestyle related behaviour change goals.


SHUWellness STH Pilot• Representative cohort (N=50)

• Can be delivered and achieve same health impact in the NHS... in 6 months

• Significant improvements in total cholesterol, waist circumference, aerobic capacity

• 96% staff rating the experience as excellent or very good and 71% increased physical activity levels.

• ROI between 302% and 571% (YHEC, 2013)

www.yhahsn.org.uk@AHSN_YandH www.yhahsn.org.uk@AHSN_YandH

Regional PilotN= 277 (out of 300 at baseline) completed the programme


Results: Cardiovascular Risk

– Cardiovascular disease risk significantly improved, with observed improvements in the following:

• Blood pressure (systolic and diastolic)*

• Resting heart rate*

• Total cholesterol*

• BMI and body fat (%)*

• Aerobic capacity

• * denotes statistical significance


Results: Cardiovascular Risk


Results: Self-Report–Improvements in staff quality of life:

• Physical function*

• Vitality*

• Role Emotional*

• Mental Health*

–Improved Diet: Increased fruit and vegetable consumption*

–Increased physical activity* *statistically significant


What next? Regional roll-outProduct 1. Organisations who want external wellness service to staff

SHU/AHSN Spin-out company

2. Organisations who deliver SHUWellness to their staff

TTP Model

3. Organisations who deliver SHUWellness to their staff and their clients

TTP Model

4. Roll-out across other AHSN's

TTT Model

Fees Delivery of service Staff software licence Staff software , Client , Community Licence

TTT licence (franchise)

Examples SME's, Schools NHS, Councils Sheffield Utd community foundation

Other Universities

Product/

Services

Annual individual health check and lifestyle review

Online follow-ups

Online workshops

Individual and company wellness reports

Complimentary services

As product 1, plus

Yearly refresher course

Quality assurance/sharing practice workshop (SHUWellness network)

As product 2 The whole SHUWellness offer


Regional Roll-out

• Train the practitioner– 5 day training course for suitably

qualified staff

• SHU delivery via a spin-out company– affordable labour via SHU graduates

"The tutors had an obvious passion for the subject and a great

communication style."

"A great training course! The facilitators were patient,

knowledgeable and approachable which made it an enjoyable

programme."

"I liked how the trainers adapted the programme flexibly to suit us to

meet our needs."


The 'Offer'

• Y&H AHSN fund organisations to receive FREE:

– Wellness taster sessions for up to 3-5 organisation 'opinion leaders'

– Delivery training via the 'train the practitioner' course


Additional Services

Wellness Software Active Challenge


What are the costs?

Cost

Start-up kit Approx. £5000

Cost per head Approx. £15

Delivery staff Approx. £25k p/a

Cost per head, delivered by SHU

Approx. £70


Uptake

• NHS – Engagement events – Tasters– Train the practitioners– Challenges

• Non-NHS


Summary

• The justification for workforce health and wellbeing programmes appears unambiguous... on an individual, employer, business and national basis.

• Yorkshire and Humber AHSN and SHU provide an example of an evidence-based, scalable and sustainable programme.

• Implementation is challenging without a profound culture change.


"In the early 90’s I used to smoke at my desk; now can you imagine anyone smoking

at their desk now? It’s just so completely out there. It would be nice to look back to

this time in 20 years and say can you imagine someone sitting for 6.4 hours a

day?

Can you imagine that?”


Any questions?

Hanna Leahy - [email protected] - Hanna Leahy

mailto:[email protected]


Results: Staff Feedback"The programme was excellent- the assessment

appointments and report were very thorough and gave me a great understanding of how lifestyle and

diet affect my wellbeing.

The information I was given empowered me to take charge of my own health.

The guidance provided me with the insights on what I could do to improve my health and how

different things affect me - not just nutrition and exercise, but general lifestyle, work and home life balance and stress management. I was given the

knowledge to help address the issues that are affecting me and how to tackle them. I would highly

recommend this programme!"

"I am really pleased that I took part in the programme as it gave me the motivation

to finally do something positive.

It also highlighted a health problem that I wasn't aware of which could have

potentially led to more serious health problems."

"This programme really did motivate me to stop smoking. Overall I found the programme really rewarding and the assessors were great too."

"I found the whole project very interesting. It enabled me to improve my exercise plan,

making it more achievable and realistic."

"It would be great if this programme could be extended. I would certainly welcome

repeating the assessment in a year or so to enable progression. Maybe this could be something that could be partly funded in the same way as the iChoose scheme?"

Afternoon Session 1

Provider Organisation and Public Sector Integration

#ILNsymposium

Sir Andrew CashCEO, Sheffield Teaching Hospitals NHS Foundation Trust

#ILNsymposium

Integration - the key to true ‘patient centred care’Sir Andrew CashChief Executive, Sheffield Teaching Hospitals NHS Foundation Trust

• Sheffield Teaching Hospitals NHS Foundation Trust is one of the UK’s busiest and most successful NHS Foundation Trusts (Est 2004)

• Above all, patients lie at the heart of everything we do

• 16,000 staff, 1960 beds, 2 campus sites, 5 hospitals and multiple community locations

• With a turnover approaching £1 billion

• Adult Community Services joined April 2011

About Sheffield Teaching Hospitals

Local and system wide Integration is proving critical to the delivery of these objectives

Integration is the key to true ‘patient centred care’.

National Level:

• NHS Five Year Forward

• Dalton Report

• Financial Climate

• Patient expectations

Trust Level:

• Adult Community Services joined 2011

• Opportunity to re-think how we delivered care across the pathway and across the local health system

• 3 years later we have combined acute medicine and community services into a Combined Directorate.

• New culture, approach and significant patient and organisational benefits.

• Discharge to Assess, virtual wards, joint social care and community care teams


City Level:

• Right First Time Partnership formed in 2011

• Acute care, primary care, commissioners, Local Authority working together with a common set of goals

• Significant benefits achieved

• Phase 2 – Better Care Fund, Acute Provider Board, GP Provider Board, Health and Wellbeing Board

• Prime Minister’s Challenge bid


Regional Level:

• Working Together Partnership – 7 acute Trusts across South Yorkshire and North Derbyshire

• Clinical and non clinical benefits realised since inception in 2012

• Vanguard bid - Exploring a Federated approach which will enable providers to explore the different options identified through the Dalton Review

• Aim is to support the sustainability of local, clinical and non clinical services and determine how best the different organisational models can facilitate wide scale change


Working Together

Professor Dean FathersChair, Nottinghamshire Healthcare NHS Foundation Trust

#ILNsymposium

115

“Provider Organisation &Public Sector Integration”

Inspiring Leaders Network (ILN)Annual Symposium

Presented by:

Dean FathersChair, Nottinghamshire Healthcare &Professor in Practice of Healthcare Management, Cass Business School

116© 2012 Prof Welbourn and Prof Fathers Cass Business School

Draw on widely diverse

perspectives

Adopt open enquiring mindset

Go out of your way to

make connections

Tasks& ideas

Relationships & behaviours

Be Clear

Be Curious

Be Courageous

Invest in promoting

values

Establish compelling

vision

Embrace uncertainty

Distribute leadership &

decisions

Desired leadership characteristics

117

Contact Details

Thank you for listening, if there are any questions I’d be delighted to answer them but if you wish to contact me later please do so. My contact details are:

• E-mail: [email protected]

• Mobile: +44(0)7970 183780

• Skype: DeanFathers1

• Twitter: @DeanFathers1

Julian HartleyCEO, Leeds Teaching Hospitals NHS Foundation Trust

#ILNsymposium

LunchBack at 14.15

#ILNsymposium

Afternoon Session 2

Integration with Industry: Delivering successful partnerships

#ILNsymposium

Richard StubbsCommercial Director, Yorkshire & Humber Academic Health Science Network

#ILNsymposium



Industry Integration – Powering UK plc

Richard StubbsCommercial Director, Yorkshire and Humber AHSN


Life Science UK – A Snapshot

Pharma MedTech & BioTech

UK Jobs 70,000 96,000

UK companies 477 4,400

Annual Turnover £30bn £20bn

The UK has a uniquely powerful combination of: • World-leading universities• Established industrial R&D, manufacturing and supply chain • Translational research infrastructure and clinical network • Globally renowned research charities • An NHS with 60+ million patients and access to unrivalled health data• A firm commitment to partner with industry and establish access points

for industry to the UK life science base


Our Challenge

The NHS is facing its biggest ever challenge:

• £20 billion productivity shortfall• a global economic crisis• a growing and ageing population• increasing costs of new drugs and

technologies • growing public expectations


Expectations

Technology and medicine are changing fast, as are people’s expectations:

• Technology – smart phones and wearable devices; “internet of things” and remote monitoring; outbreak of online transactions; smart medical tech; the Cloud and pervasive big data

• Medicine & Discovery – genomics; proteomics; personalised and stratified medicines; regenerative medicine; the end of blockbusters and the rise of niche-busters; the return to translational medicine; the challenges to “big pharma”

• Services – rise of social media; 24/7 access taken for granted; highly personalised and customised services; brands as purveyors of meaning and value

www.yhahsn.org.uk @AHSN_YandH129

Reduce variation in the NHS, and drive greater compliance with NICE guidance

Create a more systematic delivery mechanism for innovation

“If we always do what we always did, we will always get what we always got”

And that means increasing financial pressure on an already hard pressed service


What are Academic Health Science Networks?

• In May 2013, England became the first country in the world to create a nationwide system

of Academic Health Science Networks (AHSNs)

• Each of the 15 AHSNs has a five-year licence to deliver against four broad objectives:

• Focus on the needs of patients and local populations

• Build a culture of partnership and collaboration

• Speed up adoption of innovation into practice

• Create economic prosperity


2015/16 Strategic Objectives & Programmes

Population Health

Empowering Citizens to manage their own health

Healthy Active Ageing

Improving Healthcare

Across Systems

In Organisations

Economic Growth

Accelerating Industry/NHS Partnerships

Accelerating Spread and adoption

Maximising International Growth

Across Systems

In Organisations


Economic Growth

The healthcare sector contributes to economic growth in a number of ways: • By making people better and keeping people well

• Through working in partnership with academia and industry to grow research in healthcare

• Through accelerating the adoption and diffusion of innovation and best practice

• Through promoting services, innovations and expertise overseas


Economic Growth

Examples of the AHSN contribution to economic growth:

• Improving the health, and thereby productivity, of the population

• Improving productivity of healthcare providers

• AHSNs as market makers

• Making UK healthcare an attractive place to invest and do research

• Promoting UK healthcare expertise


Health and Wellbeing Programme

• Sheffield Teaching Hospitals, Bradford Teaching Hospital, Airedale Hospital – staff employed > 26,000.

• Exercise & fitness a competitive advantage.

• Evidence;• ROI for every £1 expect between £3-8• STH potential savings up to £2m pa not including productivity gains• Nationally £350m savings pa• Improved Staff satisfaction• Improved patient satisfaction

• Phase 1: > 750 staff recruited onto program• ↓ BP, ↓ Cholesterol, ↓ Waist circumference, ↓ BMI• ↑Aerobic Fitness, ↑ Staff satisfaction, 7:1 ROI to date

Rapid spread and adoption

Commercialisation through Franchising

model

Significant return on investment


Supporting Y&H SMEsRD Biomed: New innovative diagnostic device

adopted by AHSN

AHSN support enabled:

• Validated cost consequence models

• Focussed business cases

• Networks of key clinicians, GPs and support

agencies

Outcomes:

• Engaged with CCGs to start crucial audit studies

• Engaged with key hospital clinics

• Major collaborative study in London, Leeds and

Newcastle.

• Networked across North of England AHSNs

• Future International work


Open Innovation Programme

• Digital Health for Healthy Ageing

• 24 UK/China SMEs/Academics in Open Innovation programme

• Potential £2m in China funding for UK participants

• AHSN 7.5% equity stake in UK/China partnerships

• Funding provided by Guangzhou Development District

• 2015 – China part 2, Canada, India, Mexico


International Activity

• Close partnership working with other Government agencies including Healthcare UK, UKTI & Office of Life

Sciences

• Seeking projects bringing increased export opportunities and creating inward investment

• Quebec/Ontario

• Mexico

• Arab Health 2015

• UbiFrance Trade Development

• Africa Healthcare Summit 2015


The Ask From Industry

• Relationships based on trust not transaction

• Quicker adoption of new ideas

• Failing faster

• Better understanding of each others business

• Less criticism and more collaboration

• Co-development of patient-centred solutions

• Fewer access points

• Consistency of decision making

• Commitment to “do once”



Richard StubbsCommercial [email protected]@Richarddstubbs

Kevin Kiely CEO, Medilink

#ILNsymposium

1. Medilink integration

2. Technology integration

3. Cross sector integration

4. Cross national boundary integration

5. Brokerage & Translation

Clinical

Business

Academia

Où est le marché pour

cette nouvelle technologie ?

¿Cuál es la necesidad? Y ¿cuál es el modelo de negocio?

How can we solve this

clinical need?

Medilink Integration

Technology Integration

Cross Sector Integration

Cross National Boundary Integration

Brokerage & Translation

NOCRI

NICE

NHS England

DoH

NIHR

CLAHRC

HTC

DEC

AHSN

CCG

SMEs

LEPsLocal

Enterprise Partnership

s

BGHBusiness Growth

Hub

UKTI

Innovate UK

Universities

KTN

Embassies & Consulates

Innovation Patient Benefit

BBSRC

EPSRC MRC

WHO

FCO

Healthcare UK

Further Educatio

n

Northern Healthcare Alliance

Catapults

Creative Sheffiel

d

Case Study

3M & Nottingham University – Lymphoedema Project

#ILNsymposium

Professor Christine Moffatt CBEProfessor of Clinical Nursing Research, Faculty of Medicine & Health Sciences, University of Nottingham

#ILNsymposium

Carol AriesHead of Strategic Partnerships, 3M

IngeniousSolutions

Transforming Health

3M Confidential – Internal Use Only

Yorkshire and Humber AHSN Inspiring Leaders Conference – 10th March 2015

Chronic Oedema Programme

Carol AriesHead of Strategic Partnerships3M Health Care Limited

Professor Christine Moffatt, CBEProfessor of Clinical Nursing Research / Nurse Consultant University of Nottingham / Royal Derby Foundation NHS Trust

3M Confidential.156 April 15, 2023. All Rights Reserved.© 3M

Chronic Oedema Programme

Background Chronic Oedema and scale of problem Knowledge Transfer Partnership Programme Progress so far Alignment to integrated care Key learns

© 3M 2015. All Rights Reserved.


Background



Chronic Oedema Management

Coban 2 and Coban 2 Lite:― Saves valuable clinic time

― Supported with clinical evidence and cost effective

Key challenge - No clear national standard or care pathway

3M Critical & Chronic Care Solutions

Knowledge Transfer Partnership in Chronic Oedema – Supporting Service Transformation


Knowledge Base Partner

Professor Christine Moffatt C.B.E.― Awarded a CBE in the 2006 New Year's Honours List

― Life Fellow of the Royal College of Nursing

― 2008 Nursing Times Diamond 20 Award (20 most influential nurses in the last 60 years)

― Experience in transferring care to community nurses

The KTP Associate - Rebecca Gaskin

- Skilled, motivated, enthusiastic, eager learner!

- Project manager


Chronic Oedema: An international problem…an international approach


KTP project to develop a chronic oedema community

pathway

International epidemiology Study LIMPRINT funded by research grant from 3M and

using electronic platform

10 countries participating

European Grant to define size and impact of CO and disease

mechanisms (LIMPRINT)

Development of Coban system from venous disease to chronic oedema

Evaluation of system in RCT and observational studies (UK and

Canada)Qualitative assessment of patient

impact and professional challenges

Cost effectiveness study

Understanding Coban Within specialist services


Only 60% of sufferers being treated. Care provision limited by:― Nos. of trained specialists― Resources in specialist clinics― Leading to ad hoc management in the community

Background on chronic oedema

“…identification at general practice level… more specialist nurses….and

also the communication factor…(professionals) not being able to talk

to each other because of different trusts, or whatever it may be, it

seems totally farcical…”

.

Patient Feedback


Prevalence and impact of Chronic Oedema x 3 higher than previously

estimated using the same methodology 10 years ago

Mean age of sample – 72.6 years

Leg ulceration in 50% of community patients

With 31% having an ulcer for more than 5 years

9% had previously quit work due to condition


3.99/1000Overall Prevalence

10.31 /1000 65 - 74

28.57/100080+

Study in Derby, 2012


Chronic oedema is a life long condition Related to long-term conditions including: obesity ,aging ,immobility and cancer

Prevalence and impact of chronic oedema

NHS Five Year Forward View 2/3 of us are overweight or obese Long-term health conditions = 70% NHS budget Sickness absence costs estimated £22 billion a year 2/3 patients admitted to hospital are over 65 1/6 people over 85 live in care homes


Prevalence and impact of chronic oedema – hidden costs: Limited data – data acquisition is a key output of this project

Cellulitis is a common problem associated with chronic oedema London study: 53% chronic oedema patients suffered an acute infection since swelling commenced Average frequency of infection per chronic oedema patient = 7.4 9% of which required hospital admission Average length of hospital stay for cellulitus = 11 days HES 2011 / 2012 more than 25,000 acute admissions 65+ age range for Cellulitis (circa 24,000

in 19-64 age range)

Better management and earlier intervention can prevent incident progression reducing acute admissions and antibiotic prescriptions



Knowledge Transfer Partnerships

Collaboration between Universities and industry for a specific project with positive financial outcomes for the company

Co –funded by Dept of Business, Innovation and Skills (50%) via Technology Strategy Board

Scheme running since 1976 with 800 ongoing in the UK across wide range industries

Graduate Associate appointed full time to project for 2 years Academic lead commits 10% time to project


KTP Stakeholders:

KTP

University

Industry

Graduate

Specialist Community

Social Care

Patient


Project aims

Deliver a “consensus care pathway”

“ An agreed, multi-disciplinary practice based on guidelines and evidence... for a specific patient group”

Implement a shared care model with appropriate trainingCollect data for CCG considerationPublications in leading journalsProvide business opportunity for Coban II


Project steps…2 year plan and programme deliverables

• Plan• Consensus

meeting (Oct.)• Review pathway

Develop care pathway

• Embed in systems• Education• Data collection

Implement in community care • Publications

• Tool kit• HE case• Implementation ££

Build business case for CCG adoption

2014 2015 2016


Stakeholder group

Pathway draft and consensus

Data collection Training and education

packages Pathway pilot Data analysis and

dissemination

Progress so far…


Expected programme benefits

Better control of chronic oedema Improved experience of care and quality of life for patient e.g. Mobility Reduced incidence of secondary complications e.g. leg ulcers Reduced acute admissions with severe oedema Better understanding and control of/reduced use of antibiotic prescriptions Improved practitioner confidence and skills in delivering care.

Big data – better understanding of condition and causes UK reputation enhanced as we are leading the way globally on understanding and

treating this condition Cost saving to the NHS



Alignment to integration agenda Project engaging all key stakeholders from primary, secondary and social care and

across all hierarchies and clinical expertise Anticipated care pathway will be patient centred drawing on appropriate clinical

and social care experts to manage cause and symptoms – move to a fully effective networked care management system.

Engaging full suite of relevant suppliers to ensure treatment solutions and care pathway are fully aligned.



International interest in chronic oedema managementJapan

Japanese 5th ILFJ conference in Sapporo, September 21st 2015.

Integration with Dr. Kobayashi at Hokkaido University

France

Invitation to present project details and support similar prevalence n Montpellier France, October 2015

Integration with Prof. Isabelle Quere at University of Montpellier, France



Key learns/observations

KTP pathway project approach is ideal for med tech products and care pathway design

Critical to make sure have strong stakeholder group – take time to research, engage and decide team

Ensure front line staff appropriately represented Regular project reviews – iterative process – amend project plan accordingly if its

not working. Manage widespread interest – say focused on the project and deliverables whilst

supporting wider interest e.g. this conference. Draw on expertise of all partners to help deliver the project e.g. commercial

facilitators.© 3M 2015. All Rights Reserved.


Thank you3M.co.uk

Chris BainCEO, Rotherham Doncaster & South Humber NHS Foundation Trust

#ILNsymposium

Tom LindleyFounder, Inspiring Leaders Network

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