Unlocking the potential of NHS data: A vision for a unified health data platform

By Ruth Holland and Mark Kewley

By Ruth Holland, Director of Data & Analytics, London Secure Data Environment, OneLondon Health Data Portfolio, and Mark Kewley, Programme Director, London Secure Data Environment, OneLondon Health Data Portfolio.

The landscape of healthcare is increasingly being shaped by the effective use of data, yet the journey towards realising the full potential of NHS data is fraught with challenges. At the core of this transformation is the OneLondon programme, an ambitious initiative that seeks to overcome the fragmentation of health data across the capital and, ultimately, improve patient care, operational efficiency, and research outcomes.

The origins of OneLondon: Addressing fragmentation

The OneLondon programme was born out of a need to address a longstanding issue within the NHS: the fragmentation of health data. Historically, patient information has been scattered across various care settings, making it difficult for both healthcare providers and patients to access a complete picture of an individual’s health. This fragmentation not only hampers the delivery of efficient care but also limits the ability to derive meaningful insights from the data.

In response, London’s healthcare leaders embarked on a journey to create the London Care Record, a unified platform that allows for the sharing of relevant patient data across care settings. Initially focused on providing a ‘view-only’ access to patient information, the programme has now evolved into a more sophisticated data platform capable of generating actionable insights for both direct care and research purposes.

Building a comprehensive data platform to support integrated care

Our efforts have now moved beyond simply making data accessible. The goal, which is supported by funding from the NHS England Data for R&D Programme and London’s integrated care systems (ICSs), is to create a London-wide data platform that can provide insights that inform care decisions at both the individual and population levels. The transition from a ‘view-only’ system to a dynamic data platform represents a significant milestone. It allows us to harness data from across London’s health system to support integrated care, drive proactive care strategies and facilitate advanced research.

In North West London ICS, for example, we’ve seen the success of integrating data across different care settings. Clinicians now have access to a comprehensive view of their patients, enabling them to deliver more informed care. The next step is to expand across London and incorporate data from all other care settings for the population of 10.6 million people.

Leveraging advanced technologies

Central to this transformation is the integration of cutting-edge technologies like Federated Learning Interoperability Platform (FLIP) and AI tools. These tools enable us to bring together different types of data, such as electronic patient records and radiology images, into a single, interoperable platform. By doing so, we can develop predictive models that not only support clinical decision-making but also enhance the accuracy and efficacy of research.

The use of natural language processing (NLP) to convert unstructured data into structured formats is a significant advancement. With approximately 80-90 per cent of healthcare data stored in unstructured formats, such as clinical notes and images, NLP allows us to unlock a wealth of information that was previously inaccessible. This capability is crucial as it significantly increases the insights we can derive from our data, paving the way for more personalised and effective healthcare solutions.

Ruth Holland will be the Chair of a Spotlight session with Dr Jessica Morley at Digital Health Rewired 2025, taking place 18-19 March in Birmingham.

Overcoming challenges through collaboration

The scale and ambition of the OneLondon programme are unprecedented, and so are the challenges. Integrating data across multiple care settings, ensuring stakeholder alignment and navigating complex information governance (IG) issues are just a few of the hurdles we face. However, these challenges also highlight the importance of collaboration.

We’ve worked extensively with the public to understand their expectations around data use, and this feedback has been invaluable in shaping our approach to IG. The public’s support for data integration across care settings has provided a strong mandate for us to push forward with this initiative. Additionally, our collaboration with data controllers, particularly GPs, has been critical in ensuring that the platform brings tangible benefits back to the practitioners who contribute to it.

A vision for the future

The vision for OneLondon is clear: a comprehensive, interoperable data platform that not only supports the immediate needs of patient care but also drives long-term improvements in population health and research. While we recognise that we are still at the early stages of this journey, the progress we’ve made thus far is encouraging. The successful integration of data in North West London serves as a model for the rest of the city, and with continued investment and collaboration, we are confident that we can achieve our goals.

The OneLondon programme represents a bold and necessary step towards a future where data is used to its fullest potential to improve health outcomes. By overcoming the challenges of data fragmentation, leveraging advanced technologies, and fostering collaboration across the healthcare ecosystem, we are laying the foundation for a more integrated, efficient, and patient-centred NHS.

Ruth Holland will be the Chair of a Spotlight session with Dr Jessica Morley at Digital Health Rewired 2025, taking place 18-19 March in Birmingham.

*Ruth Holland, Director of Data & Analytics, London Secure Data Environment, OneLondon Health Data Portfolio*

Report details perilous state of UK adult social care

By Gabriel Blaazer

Latest Sector Pulse Check report calls for a multi-year funding settlement when the government’s Spending Review concludes in summer 2025, alongside a fully funded roadmap towards parity between care workers and NHS counterparts.

An annual review of adult social care services in the UK has warned that thousands of vulnerable adults are at risk of eviction due to mounting and far-reaching cost pressures.

The Sector Pulse Check 2024, produced by Care England and the learning disability charity Hft, is the culmination of a survey of more than 200 independent and charitable providers of adult social care. It says that social providers are operating in “survival mode… sprinting to stay afloat”, arguing that spiralling cost and workforce pressures have put “the entire sector…in a state of acute precarity”.

Financial pressures mounting

The report finds that the financial pressures on social care providers are far-reaching and having a tangible effect on the sector’s ability to provide quality services. In their responses to the survey, 90.9 per cent of providers said that workforce related costs were among the top financial pressures, with 38.8 per cent citing the cost of utilities, and 29.1 per cent unpaid or delayed bills by local authorities. Of these workforce related costs, increases to the national living wage were identified by 95.8 of providers as one of the biggest challenges. Critically, 85 per cent of providers did not experience increases in fees paid by local authorities to cover the national living wage rise

To cope with financial pressures, three in ten providers closed parts of their organisation or handed back care contracts to local authorities in 2024, often evicting some residents in the process. One third of all providers have curbed inward investment in the last year to offset rising costs, rising to two fifths of providers of care for older people, a move likely to impact care capacity and quality over the long-term.

Although the share of providers in deficit fell for the third consecutive year (down to 29 per cent from 40 per cent the year before), 60 per cent of those in deficit reported an increase in the size of deficit from the year before. It is estimated that seven in ten providers currently operating with a decreasing surplus will be in deficit within three years. This is expected to increase if the government does not add exemptions for social care from the rise in Employer National Insurance Contributions (NICS) announced in the 2024 Autumn Budget. Social care providers have been pushing the government for exemption, but the government has yet to announce any policy to mitigate the increased costs for the sector.

“Severe” workforce shortages

The report identifies workforce concerns as an ongoing and “severe problem” for the social care sector, pointing to its 8.3 per cent vacancy rate. The whole UK economy’s vacancy rate is 2.6 per cent, indicating the unique difficulties facing social care. 33 per cent of providers reported a fall in job applications in 2024, compared to 2023. This is partly attributed in the report to changes to legal migration rules introduced in March 2024, which include a ban on foreign care workers bringing dependants on their visa, along with an increase to the minimum baseline salary to be sponsored as a Skilled Worker (rising from £26,200 to £38,700).

While 40 per cent of providers (particularly smaller organisations) reported relying on international recruitment to fill posts, providers reported a decline in international applications following the new immigration restrictions, and expect to see yet further impact with time. Hft and Care England argue that the government should lift the ban on dependents for international social care staff to help protect the sector’s supply of workers.

Due to staff shortages, 29 per cent of providers reported refusing new admissions, while 40 per cent have increased their use of agency workers to fill gaps. Agency workers are typically more expensive and considered “less prepared to deliver quality care compared with their full-time equivalents”.

The sector’s future

The Sector Pulse Check report concludes that “there can be no expansion in the capacity of the social care sector without both more funding and more workers”. Lord Darzi’s recent revelation that the equivalent of 13 per cent of NHS beds are occupied by people waiting for social care support or care emphasises that the NHS cannot thrive without a functioning social care sector. The sector’s high turnover rate of nearly 26 per cent demonstrate social care’s challenge in attracting and retaining skilled workers.

While the government has recently announced the launch of an independent commission to reform adult social care, led by crossbench peer Baroness Louise Casey, some in the sector have voiced concerns over the commission’s three-year scope. Martin Green, Chief Executive of Care England, commented that “waiting until 2025 is not an option,” and voiced concerns that this will be “yet another report that gathers dust while the sector crumbles”. Regarding immediate action, the report highlights Skills for Care’s Workforce Strategy for 2024, which offers a series of policy recommendations to “attract, retain, train and transform the social care workforce”.

The report makes two major policy recommendations:

Commit to a credible, multi-year funding settlement for the adult social care sector when the Spending Review concludes in Summer 2025. Funding increases must cover future increases in the national living wage, and any changes to Employers National Insurance, and inflation, to avoid real-term pay cuts and the large-scale market exit of care providers.
Create a fully funded roadmap toward parity between care workers and workers in the NHS. Pay and conditions are central to this, yet the significance of status and respect must not be ignored. This should include adopting the recommendations of the Skills for Care Workforce Strategy to address the high vacancy and turnover rate in the sector.

Alongside these, it calls on the government to either exempt care providers from the increase in Employer NICS contributions, or to fully fund the rise itself. It also urges the government to ensure that the NHS and local authorities are sufficiently funded to reimburse care providers through the Local Government and NHS funding settlement.

The full Sector Pulse Check 2024 report can be accessed here.

Nominations open for Our Health Heroes Awards 2025, delivered by Skills for Health

By Integrated Care Journal

Nominations are now open for the Our Health Heroes Awards 2025, celebrating the wider healthcare workforce – from porters and cleaners to receptionists, gardeners and security guards – that supports NHS doctors and nurses on the frontline.

Supported by NHS England, NHS Employers, NHS Shared Business Services, NHS Race & Health Observatory and Integrated Care Journal, Our Health Heroes celebrates the wider healthcare workforce that supports NHS doctors and nurses on the frontline.

From porters and cleaners to receptionists, gardeners and security guards, these often unsung heroes make up roughly 40 per cent of the NHS’s million strong workforce.

Our Health Heroes Awards is a national celebration of their achievements and an opportunity to give thanks for the important role that they play in keeping the health service functioning.

Our Health Heroes Awards 2025 categories:

Individual awards

Clinical Support Worker of the Year
Operational Support Worker of the Year
Outstanding Lifetime Contribution to Healthcare
Apprentice of the Year
Healthcare Volunteer of the Year

Team awards

Best Healthcare Workforce Collaboration
Dedication to a Lifelong Learning Culture
Equity, Diversity, and Inclusion Champion
Digital Innovation

Nominations close at midday on Tuesday 4 March. An expert panel of judges will then decide the finalists in each category.

John Rogers, Chief Executive of Skills for Health, comments: “Our Health Heroes is an opportunity to recognise and celebrate the remarkable dedication of the wider NHS workforce.

“The awards shine a much-deserved spotlight on the unsung heroes – cleaners, porters, security staff, receptionists, medical secretaries and many more – who don’t often get the recognition that they deserve.

“The commitment, compassion and hard work displayed day in day out by the wider healthcare workforce is a credit to, and the backbone of, our NHS.”

Erika Bannerman, Managing Director of NHS Shared Business Services, comments: “The Our Health Heroes Awards are an expression of appreciation for those who make such a significant impact on patient care and the wider community.

“It is vital to acknowledge the contributions of individuals and teams who go above and support the delivery of outstanding care, and we are proud to be able to support the awards again this year.”

The winners of the awards will be announced at a glittering ceremony held at the Queen Elizabeth II Centre in London on 22 May 2025.

To make a nomination visit: www.skillsforhealth.org.uk/awards

Harnessing data-led approaches to patient safety: a case study

By Jonathan Webb, Head of Safety and Learning at NHS Wales

Jonathan Webb, Head of Safety and Learning at NHS Wales, relates two data-led approaches aimed at reducing avoidable harm and litigation costs across Wales, demonstrating the success of unified and standardised approaches to patient safety.

NHS Wales faced growing challenges in improving patient safety and reducing harm across its healthcare system. Rising litigation costs, inconsistent training, and fragmented data across health boards limited the ability to identify trends and implement evidence-based improvements. Specific issues, such as preventable harm in maternity services and the lack of a unified approach to handling incidents, complaints, and claims, highlighted the need for systemic solutions.

These challenges created opportunities to:

Implement a unified training programme to improve outcomes in maternity services (PROMPT Wales).
Develop centralised data systems to connect incidents, complaints, and claims and workforce data, enabling shared learning and improvements (Once for Wales Concerns Management System).

The solutions

PROMPT Wales

This initiative introduced a structured, multi-professional training programme for maternity teams across NHS Wales. Designed to improve safety, teamwork, and communication, PROMPT Wales delivered:

Standardised, scenario-based training for all staff.
Data-informed guidance to address identified risks, such as postpartum haemorrhage.
Comprehensive engagement, with 93 per cent of maternity staff trained within a year.

Once for Wales Concerns Management System (OfWCMS):

Led by the Welsh Risk Pool, part of NHS Wales Shared Services Partnership, this platform centralised incident, complaint, and claim management across all health boards. By unifying disparate systems:

Data could be analysed holistically, identifying trends across complaints, incidents, and claims.
Integration ensured consistent national approaches to handling patient concerns and improving quality of care.

Collaboration between healthcare teams, Welsh Government, and RLDatix ensured that initiatives were implemented with consistency and aligned with national safety goals.

Scalability

The scalability of these initiatives lies in their structured and integrative approaches.

PROMPT Wales: Its team-based training model and use of data can be adapted to other clinical specialities or regions. The methodology ensures alignment with local needs while maintaining national standards.
Once for Wales: The centralised framework can be replicated in other healthcare systems to unify and optimise incident management, feedback collection, and data analysis.

Enablers:

National buy-in and strong governance frameworks.
Robust technology platforms for data collection and integration.
Proven impact, such as measurable safety improvements and cultural change.

Constraints:

Initial investment in technology and training.
Variation in local infrastructure and staff capacity.
Need for sustained leadership and stakeholder engagement.

Evidence of success

PROMPT Wales, along with the sheer hard work of staff within services, delivered significant clinical improvements:

33.8 per cent reduction in severe postpartum haemorrhage (≥2500mL).
43.5 per cent reduction in term APGAR scores <7 at 5 minutes.
Enhanced safety culture, as evidenced by improved staff safety attitude scores.

Once for Wales outcomes included:

Uniform data collection across all health boards and trusts.
Real-time insights into patient and staff feedback, enabling proactive safety measures.
Improved learning from incidents and claims, contributing to better service quality and reduced harm.

Quantitative data from PROMPT Wales shows statistically significant improvements in clinical outcomes (P-value <0.0001). Feedback from OfWCMS users highlights enhanced decision-making due to integrated data systems.

Lasting benefits

Patients receive safer care and improved health outcomes across maternity and broader services.

Staff benefit from greater confidence, reduced stress, and better training support.

Systems benefit from enhanced efficiency, reduced costs, and a model for future healthcare improvements.

Digital Implementation, Featured, News January 13, 2025

Building confidence in AI telephony tools for primary care

By Max Gattlin

Max Gattlin discusses whether AI telephony tools are ready to deliver transformation in primary care and help end the ‘8am rush’, accelerating patients’ time-to-care.

The latest figures show that general practice delivered a record 38.6m appointments in October 2024 (or more than 40m when counting COVID-19 jabs). That’s the highest ever one-month total on record. Amid this surging demand this, primary care is struggling with overwhelming demand and clinician shortages, and GP leaders have warned that the pressure facing services is not sustainable.

The solution cannot lie solely in hiring more staff at practices – there’s a bigger picture at play. It’s about making better use of the tools and technology already available to ease the load on existing teams. This is an area where AI can help, but in order to maximise benefits and ensure use and adoption at scale, ensuring that clinicians and patients trust in the tools is critical.

Why is AI in digital telephony so important?

Use of the ‘digital front door’ is ever-increasing, but despite advancements, over two thirds (68 per cent) of patients continue to contact their GP practice via telephone as the first port of call. The shift from analogue to digital is something we all know is coming in the 10 Year Health Plan, and as the most used element of the digital front door, it is clear that primary care has a fantastic opportunity to embrace the use of AI in telephony. It’s also something that the Social Market Foundation has touched on recently in its report, In the blink of an AI, which has recommended further integration AI and automation into user-facing workstreams.

What benefits could it bring?

The integration of AI in digital telephony for primary care can offer transformative benefits, addressing some of the pressing challenges facing the sector. Integrating technologies such as cloud telephony, unified communications, and AI-enabled healthcare tools, means practices can alleviate the pressure on GPs and other clinicians. By integrating AI-powered features such as voice agents, call routing, speech-to-text, and automated signposting, practices can alleviate the inbound pressure on call handlers while simultaneously improving access. This will also enable practices to accelerate a patient’s time-to-care by offering an assessment of need at the first point of contact, in line with NHS national priorities.

By removing the notorious 8am rush, AI-powered systems can enable more efficient call handling, prioritising urgent cases and directing patients to other appropriate services, such as pharmacy and community, without delay. This enhanced accessibility not only improves patient satisfaction but also fosters better health outcomes by ensuring timely care. Additionally, these streamlined processes reduce administrative burdens and repetitive tasks for staff, creating a more manageable workload and mitigating burnout. Together, these advancements pave the way for a more sustainable, patient-centred approach to primary care.

How do we get patients and clinicians onboard?

The challenge is how do we ensure that patients and clinicians are harmonised with the progress to build their trust?

To build trust among patients is not a simple process, particularly when considering digital poverty, which creates many disparities and makes it harder for people to access the very tools that are designed to help them. Patients value human interaction, especially when discussing health concerns, so AI tools must simplify communication and prioritise empathy in design. Data monitoring is key here, and should be used to help evidence that effective digital tools will also improve access for all, including those less digitally-abled who require human contact.

Patients should not feel intimidated by the use of AI, and it needs to be introduced in a straightforward way, focusing on the benefits in relatable terms. However, transparency of data usage is vital, otherwise we risk the further creation of a two-tier system for those that trust the data and those that do not, also increasing the burden for GP teams and undermining broader population health management strategies.

Patient empowerment means putting AI in their hands and allowing them to self-serve for non-urgent needs, allowing clinicians to focus on more complex patient needs and preventative care. If we can remove the demand before it flows into the practice then it eases the burden immediately.

For clinicians and practice staff, it needs to be clear that AI is an opportunity to reduce the pressure, not a threat to jobs. Clinicians are more likely to trust tools that they understand how to use, so time dedicated to training can demystify the AI’s capabilities and limitations. The tech may be transformative but it needs the support around it and training for staff to make best use of systems already in place, as well as to integrate additional tools such, as Surgery Assist.

Take for example Tudor Lodge, a practice in South-West London that is an early adopter of AI tools. The implemented Surgery Assist, a digital assistant, as part of a wider Access Optimisation Service and the practice has experienced 54 per cent fewer calls in the 8am rush as a direct result. Applied nationally, it is estimated that this service could result in 9.1 million fewer calls received per month by GP surgeries.

Will AI live up to the hype?

One of the questions asked to the discussion panel at X-on Health’s recent AI in primary care event was ‘will it live up to the hype?’ AI is by no means a magic bullet, and it could be said that it is currently not up to the hype, but applied correctly AI has the potential to move primary care forward beyond all expectations.

As referenced by an integrated care board member at the recent X-on AI in primary care event, AI is a tool, not a solution and must be viewed as such. To my mind it’s the correct approach and AI is just one of the tools available to reduce the burden. There is a crisis at the door of primary care and the technology is needed now to help practices survive. Technology cannot simply be layered over inefficient processes; instead, the two need to be addressed hand-in-hand to build trust and preserve the NHS as we enter the AI era.

What are the next steps?

While some GP partners have pushed on, giving lots of their time to self-appraising AI products in the pursuit of improved efficiencies to support their staff, there have been calls for the formation of an AI advisory board or list of approved AI suppliers to expedite procurement and adoption. To further build trust, the technology testing needs approval at a national level and the creation of a framework of consistency is something that is essential. The In the blink of an AI report supports the creation of a strong Digital Centre of Government in the Department for Science Innovation and Technology (DSIT) and recommends that it becomes a one-stop-shop for all public sector AI and automation needs, highlighting tools that are already working and have been successfully implemented.

One thing is clear – if the NHS doesn’t work out how to become agile enough to embrace the technology and build trust quickly then organisations like Google will do, as is clear from the Public First report, AI and the public sector, that was recently commissioned by Google Cloud.

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Landmark ruling sets critical precedent for adult social care funding and local authorities

By Integrated Care Journal

The landmark judgement on social care finance was handed down on 17th December in Julie Richardson Ltd & Banbury Heights Ltd v Oxfordshire County Council, increasing pressure on local councils to meet adult social care funding obligations.

In late December, Her Honour Judge Walden-Smith handed down a landmark ruling with potentially far-reaching implications for local authorities and their obligations to fund adult social care for eligible residents.

The case, Julie Richardson Limited & Banbury Heights Limited v Oxfordshire County Council, was brought by two family-owned care homes – The Julie Richardson and Banbury Heights Nursing Homes.

Represented by Paul Ridout, Healthcare Regulatory Partner at HCR Law, the claim was filed against Oxfordshire County Council (Oxfordshire CC) on 13 August 2021. The dispute centred on unpaid care costs exceeding £195,000 for two adult social care residents. Both individuals had been assessed by Oxfordshire CC as meeting the care eligibility criteria under the Care Act 2014 and were placed in the respective care homes.

While the care homes provided essential services, the financial resources of the residents fell below the statutory threshold, triggering an obligation for Oxfordshire CC to begin funding their care.

However, as essential care and accommodation continued to be delivered, the bills were being left unpaid. This placed the care homes in the difficult position of delivering unfunded care or discharging residents with nowhere else to go, an outcome no care home would ever willingly choose.

A spokesperson from the nursing homes said, “We are pleased that the court has, so far, ruled in our favour regarding the injustice we faced at the hands of Oxfordshire County Council. We refused to evict vulnerable elderly residents from our nursing homes simply because they had exhausted their funds. The council suggested we should have done so but failed to provide any indication of where these individuals could go to receive the care they needed. When faced with a crisis in the lives of these residents, the council shirked its legal obligation to fund their care, instead expecting a small, family-owned nursing home to bear the financial burden of hundreds of thousands of pounds for their upkeep and care.”

During the legal proceedings, Oxfordshire CC sought to strike out the claim. In response, the claimants filed an application to amend the particulars of their claim, alleging unjust enrichment on the part of the council.

On 17 December, the court ruled in favour of the care homes, granting permission to amend the claim and rejecting Oxfordshire CC’s application to strike it out. The judgment marks the first positive ruling under key provisions of the Care Act 2014 (Sections 8, 13, and 18) and underscores the statutory duty of local authorities to provide care funding for eligible individuals.

Paul Ridout commented: “This is a landmark ruling and the first positive judgment under the Care Act. It serves as a powerful reminder to local authorities across the country of their legal obligations.”

The court reaffirmed that once a resident’s care needs are established, local authorities must ensure those needs are met at a reasonable cost. This ruling sets a significant precedent, highlighting that councils cannot neglect their legal obligations. Paul Ridout added, “I am certain care homes nationwide will take note of this decision and review any outstanding payments owed by local authorities for the essential care they have provided.”

This ruling adds to the strong headwinds surrounding adult social care funding and the financial pressures on local authorities. Care England has recently reported a £2.2bn shortfall in residential care provision, while the 2024 State of Local Government Finance in England report revealed that 16 per cent of councils are planning to cut adult social care services. This judgement could lead to significant national policy implications for the government, who ultimately may need to support local authorities in meeting their obligations, reinforced by the ruling.

The nursing home spokesperson concluded, “This case involved two individuals whom the Council knew required a high level of care and for whom they were responsible under the Care Act. Instead of meeting these obligations and paying the fees for this care the Council decided to use their power within the market to force the costs onto a small care provider. I would be amazed if this was the only council doing this, and we were the only provider that had been forced to bear these costs.”

The judgment reinforces the rights of eligible individuals to access essential care, empowers adult social care providers across England to pursue outstanding payments from local authorities, and serves as a critical reminder to councils of their statutory responsibilities.

The case is now on course to proceed to a full trial in the High Court.

New research calls for action to address risk culture in healthcare management

By Integrated Care Journal

Global survey of healthcare risk and financial professionals highlights the need for integrated approaches to risk management to tackle emerging challenges.

The healthcare sector faces unprecedented risks, from skills shortages and cybersecurity threats to economic pressures and the unintended consequences of AI technologies. A new report by the Association of Chartered Certified Accountants (ACCA) underscores the growing recognition of the importance of a collaborative risk culture to navigate these complexities effectively.

The study of nearly 100 healthcare professionals from across the world identified the integration of clinical, operational, and financial management as a critical step towards achieving enterprise risk management. This alignment fosters better decision-making and enables healthcare organisations to deliver quality patient care – the common purpose shared across the sector.

The report, Risk cultures in Healthcare: The Role of Accountancy, outlines key enablers of a strong risk culture, including effective communication, cooperative education, and a transparent environment. It also emphasises cross-functional knowledge-sharing and ethical decision-making as essential practices for managing interconnected risks, from rising cybercrime and fraud to fast-changing workforce challenges.

Rachael Johnson, Head of Risk Management and Corporate Governance for ACCA, said: “By collaborating and learning from each other, different departments in healthcare can meet shared objectives – of quality care, financial sustainability, and regulatory compliance – more effectively. They also crucially become better prepared for emerging threats and trends.”

The study also reveals regional nuances in risk priorities:

Africa: Balancing the promise of telemedicine with infrastructure challenges and corruption risks.
Canada: Addressing cybersecurity concerns while adapting to regulatory changes.
UK: Striving for talent retention amid rising living costs and advancing technology adoption.
Caribbean: Managing climate-induced risks alongside workforce shortages.
Ireland: Integrating clinical and enterprise risk management to overcome fragmented systems.

The report highlights that while the specifics of risk differ by region, the universal need for collaboration and a shared understanding of risk remains critical.

Mark Millar, past ACCA President and Non-executive Director at East Suffolk & North East Essex NHS Foundation Trust, warned against viewing risk management solely as a financial function, saying: “Understand that risk in healthcare is far more than a financial issue. It is about life and death. Old cultural attitudes viewed people who raised the profile of risk as admitting to failure and they were therefore subject to criticism or censure. A more helpful culture is one that encourages the sharing of information willingly to address challenges and make improvements,” he said.

As healthcare becomes increasingly complex, the role of accountancy professionals is pivotal. From promoting cross-departmental communication to embedding risk cultures, they provide the financial insights and strategic frameworks necessary to achieve resilient and patient-centric systems.

This report is a call to action for the sector to break down silos and embrace a cohesive approach to risk management, aligning financial, clinical, and operational goals for the betterment of healthcare systems globally. Read it here.

New prostate cancer test “cuts biopsies by 50%” in US real-world use

By Integrated Care Journal

Test has demonstrated 94 per cent accuracy in identifying prostate cancer, compared to 55 per cent from traditional PSA tests, along with significant reduction in false positives.

Kearney Urology Center, a specialist clinic in Nebraska, USA, has reported a 50 per cent reduction in biopsies since adopting a new blood test for prostate cancer. The reduction is credited to the adoption of the EpiSwitch^® PSE, which has helped reduce the high number of false positives associated with the standard prostate-specific antigen (PSA) test.

EpiSwitch is the culmination of a ten-year British collaboration between Imperial College, Imperial NHS Trust, University of East Anglia and Oxford Biodynamics, itself a spin off from Oxford University.

There is currently no NHS prostate cancer screening programme in the UK. The UK National Screening committee advises against a national screening programme for prostate cancer due to the low sensitivity of the PSA test; approximately 15 per cent of men who do have prostate cancer do not have a raised PSA level.

Guidance for primary care is provided through the Prostate Cancer Risk Management Programme, and men over 50 (or over 45 for men at higher risk) are eligible to ask for a PSA test from their GP, however GPs are not recommended to proactively engage men in PSA testing, in part due to the test’s low sensitivity and tendency to produce false positive results. As many as three quarters of men with a high PSA do not have cancer. This means a significant number of men undergo the pain and potential side effects of unnecessary biopsies.

EpiSwitch PSE increases the accuracy of the PSA test from 55 per cent to 94 per cent and cuts false positives from 75 per cent to just 7 per cent.

Dr Alexandre Akoulitchev, CSO at Oxford BioDynamics, sad: “Having first demonstrated high accuracy of detection of prostate cancer in the NHS PROSTAGRAM trial in the UK, the EpiSwitch PSE test is today undergoing fast adoption in the US, where it is reimbursed by Medicare and other insurers. PSE leads to a significant reduction of biopsies and overtreatments in the real-world practice of US clinics. There is much value in this test, as recognised by clinical and private health-care institutions in both the US and UK today. Extending access to the general public in the UK would be subject to the NHS and National Screening Committee.”

Dr. Garrett Pohlman, Urologist at Kearney Urology Center, said: “I cannot imagine running my practice without EpiSwitch PSE; it’s a game changer. EpiSwitch increases the accuracy of the PSA test from 55 per cent to 94 per cent and cuts false positives from 3 in 4 to less than 1 in 10. Since adopting this test, I have cut the number of biopsies in half, allowing men who have tested negative for prostate cancer to avoid the pain and potential side effects of an unnecessary intervention.”

EpiSwitch is available privately from Goodbody Clinic and The London Clinic, the private hospital which diagnosed King Charles’ cancer when he was admitted for treatment to his prostate. In the US, the test is reimbursed under its own reimbursement code by several US insurers including Humana, UnitedHealthcare, Medicare and Optum Health. EpiSwitch PSE is not currently available on the NHS.

According to a Prostate Cancer Research report: “This (EpiSwitch) test combines the PSA test with a DNA test, resulting in substantially improved accuracy. Additionally, the test is minimally invasive and has the potential to reduce or eliminate the downsides of the PSA test, such as the high rate of false positives. The timing is ideal to explore innovative screening strategies and consider their benefits to patients, their loved ones and society as a whole.”

Mathias Winkler, Consultant Urologist and Surgeon at Charing Cross Hospital and Imperial College London, added: “The PSA test turns up very few cases of cancer and huge numbers of men are subjected to MRI scans and biopsies, as well as the worry that goes with that, and then it turns out they don’t have cancer.

“PSE is a diagnostic prostate cancer test with unprecedented accuracy. Nine of 10 cancers are found compared to 3 of 10 with PSA alone. Likewise, false-positive results are reduced avoiding unnecessary anxiety and expense.”

Breakthrough infection test to tackle antimicrobial resistance on target for 2025 NHS availability after positive trial results

By Integrated Care Journal

Trial of RNA-based host response analytics technology shows up to 95 per cent accuracy in ruling out lower respiratory tract infection.

UK medtech company, Presymptom Health, has announced positive results from a clinical trial aiming to tackle antimicrobial resistance. The trial, called PRECISiON, was designed to assess the performance of Presymptom Health’s technology in the management of infection and sepsis in patients presenting to emergency departments with respiratory infection.

Accurate infection diagnosis, by identifying patients who don’t require antibiotics, is crucial to saving lives and to tackling antimicrobial resistance, which has been labelled a global emergency by UK government health officials. Failure to address the problem of antibiotic resistance could result in an estimated 10 million deaths per year globally by 2050 and could cost the global economy £66 trillion.

As part of the PRECISiON clinical trial, which was conducted between May 2021 and April 2024 at Portsmouth Hospitals University NHS Trust and eight other NHS sites, Presymptom Health assessed the performance of its InfectiClear^® diagnostic product. Early results show the InfectiClear® diagnostic product may have >95 per cent accuracy at ruling out lower respiratory tract infection, a significant improvement over standard of care.

The core of the InfectiClear® technology lies in RNA-based host response analytics, which examines the body’s response to an infection rather than attempting to detect the pathogen directly – a method that sets it apart from marketed tests available in the UK today. This approach provides an early, highly sensitive signal for infection or sepsis and avoids the delays and inaccuracies often seen with traditional tests, which can lead to unnecessary or incorrect treatments. These tests are platform agnostic, and will over time be offered on multiple different NHS PCR platforms, which were widely deployed during the COVID pandemic and are now often under-utilised.

“Antimicrobial resistance is a global crisis. If it’s not addressed, it will kill more people than cancer does today by 2050.”

Dr Iain Miller, CEO, Presymptom Health

Once ongoing validation work is complete and the product made available in the NHS, starting in 2025, this will enable clinicians to rule out infections earlier, and avoid unnecessary prescription of antibiotics in patients presenting with non-infectious inflammatory symptoms, such as fever and elevated heart rate or breathing. Such symptoms are not necessarily signs of active infection, and existing blood tests are not specific enough to diagnose infection or sepsis.

Further analysis of the trial results is ongoing, and full results will be announced later in 2025.

Dr Iain Miller, CEO of Presymptom Health, said: “Identifying the presence, or lack of, infection at the earliest possible opportunity is crucial to tackling the crisis. Current methods to detect infection are slow and inaccurate, leading to antibiotics being prescribed when they really don’t need to be. In fact, 20-70 per cent of the UK’s annual 35 million antibiotic prescriptions are unnecessary or inappropriate, depending on the clinical setting.

“This clinical trial, when combined with data from other NHS trials, was crucial to further evidencing the efficacy of the technology. It has also enabled us to collect vital data around infection from the 484 patients that took part. We are now looking to raise further funding to help us get this lifesaving technology into the NHS as a UKCA-accredited product in 2025 and to deliver further clinical trials across the NHS and overseas.”

Host response analytics: a new way to detect infection

Presymptom Health was established to exploit IP developed by scientists working at the UK Defence Science & Technologies Laboratory (Dstl), initially researching how to tackle biological threat infection, such as anthrax, plague and ebola. Ploughshare – the company that converts technology research created by government organisations into civilian applications – identified the innovation as having potential societal impact and spun it out from the UK Ministry of Defence in 2019.

Dr Paul Schmidt, Consultant at Portsmouth Hospitals University Trust and lead researcher for the study, said: “This study offered a fantastic opportunity to see how this leading-edge technology for recognising infection and sepsis, developed by UK Dstl scientists combining machine learning and molecular technologies, could benefit NHS patients. I am excited to continue to work with Presymptom Health to unlock the huge potential of this technology”

Dr Schmidt led the collaborative development of the study design, working with Presymptom Health on behalf of Portsmouth Hospitals NHS Trust, the NHS Sponsor of the study.

Presymptom Health is developing a unique portfolio of blood tests powered by machine learning that accurately detect infection and sepsis up to three days before current standard of care. The technology has been trained on a dataset of blood samples collected over 15 years, encompassing thousands of cases, including patients who went on to develop infections and sepsis.

Earlier this year Presymptom Health was selected as one of only eight companies to be part of the Innovative Devices Access Pathway (IDAP) – a government initiative to bring new medical technologies to the National Health Service (NHS) to help with unmet medical needs.

Presymptom Health to launch a further clinical trial

Presymptom Health plans to run a follow-on 350-patient trial in 2025 to assess the accuracy and utility of InfectiClear® in patients with symptoms of respiratory and other infections. It is hoped that the results from this trial, named Precision 2, would help drive adoption at scale across the NHS. The trial is being designed with inputs under the IDAP program from the NHS, the Medicines and Healthcare products Regulatory Agency, and NICE.

New AI initiative to reduce demand on urgent and emergency care in North East London

By Integrated Care Journal

Thousands of patients across North East London are set to benefit from new initiative, using artificial intelligence (AI) and personalised clinical coaching, easing pressure on NHS services.

NHS North East London Integrated Care System, in collaboration with Health Navigator and UCLPartners, this week (Thursday 12 December) launched a new, three-year programme, providing preventative care for patients with long-term conditions. This comes as urgent and emergency care services in North East London are facing unprecedented pressure and all-time high demand.

Through advanced AI screening technology and targeted, phone-based clinical coaching, patients at high risk of needing unplanned emergency care will be identified and offered personalised support from healthcare professionals trained in delivering preventative care and self-management techniques.

The initiative is designed to identify and better support people with long-term conditions, like asthma, by taking a proactive and preventative approach to healthcare delivery.

Forecasting models estimate that the programme will save 26,673 unplanned bed days in North East London hospitals across the three years of the programme, with an anticipated reduction of 13,000 A&E attendances annually.

Dr Paul Gilluley, Chief Medical Officer at NHS North East London, said: “More than 15 million people in England live with one or more long-term conditions, accounting for 50 per cent of all GP appointments, 64 per cent of outpatient visits, and over 70 per cent of inpatient bed days. This new approach represents a landmark step in harnessing technology for preventative care to better support these patients before they reach crisis points.”

Supported by the largest randomised controlled trial to date on AI-assisted preventative care, the initiative has shown significant impact when piloted in Staffordshire. Notable results include a 46 per cent reduction in deaths among men over 75, a 34 per cent reduction in emergency attendances and 25 per cent reduction in bed days, and a 26 per cent reduction in GP referrals to secondary care, further supporting sustainable healthcare delivery.

Tim, who benefited from clinical coaching when it was piloted in Staffordshire, said of the programme: “If you are brave enough to take control with the help of the coach, you truly can make a difference to the immediate crises as they turn up. In my case I went from being an asthmatic, to someone who happens to have asthma. I went from six admissions to hospital to none within a couple of months.”

Waltham Forest will be the first area to receive this new initiative through Barts Health NHS Trust and Barking, Havering and Redbridge University Hospitals NHS Trust, with plans to expand across North East London in the coming weeks. The AI technology and clinical coaching will then be implemented throughout the rest of North East London in the coming months.

Shane DeGaris, Group Chief Executive at Barts Health NHS Trust, added: “As winter approaches, the pressure on A&E services is rising. By predicting demand and providing earlier interventions, we can improve patient outcomes and reduce the burden on the NHS.”

Dr Chris Laing, Chief Executive Officer of UCLPartners, said: “This project provides a template for how the NHS can use modern technology to deliver predictive, proactive and preventive care that is customised for local communities and prioritises those most in need of our help. Our collaboration with Health Navigator and NHS North East London will not only enhance the lives of at-risk patients but will also relieve critical pressure on our healthcare system too, aligning with the government’s prevention priority.”

Dr Simon Swift, Chief Executive of Health Navigator said: “Our AI-driven technology, combined with personalised clinical coaching, has consistently demonstrated its ability to improve patient lives and shift care, allowing hospitals to be more productive. This collaboration represents a major step forward in proactive, preventative healthcare. We’re confident that this program will enhance the quality of life for patients and contribute to a more efficient and sustainable healthcare system.”