How combining data, curiosity and operational expertise is improving immunisation uptake

By Iona Rees and Harry Canty-Davis

By Iona Rees, Head of Improving Immunisation Uptake, and Harry Canty-Davis, Service Development Manager, Public Health Services, NHS South, Central and West Commissioning Support Unit (CSU).

Vaccination is one of the most effective public health interventions, but uptake is decreasing. It will require dedicated uptake improvement programmes to reverse this trend. Analysis and reporting of data is crucial in identifying vaccine eligibility and take-up, areas of highest need and potential barriers. However, in our experience of working with public health and NHS teams, operational insights – particularly around primary care – are essential to interpret that data accurately so that vaccination campaigns are appropriately targeted and resources are well spent.

Vaccinations reduce serious illness and hospitalisation, benefiting both individuals and health and care providers. The World Health Organization reports that childhood vaccines prevent between 3.5 and 5 million deaths every year across the globe and COVID-19 vaccines are estimated to have saved more than a hundred thousand lives in England alone. However, vaccination uptake was already in decline before the COVID-19 pandemic, and in the three years from 2020 to 2023, 67 million children globally were reported to have missed out on one or more vaccinations. NHS data for the UK showed that coverage for all 14 standard childhood vaccinations decreased in 2023/24, with uptake lower among children living in the areas of greatest deprivation.

To realise the benefits of better health and reduced burden on NHS services through improved immunisation uptake, it is necessary to understand what barriers exist and why, before deciding how best to direct staff and financial resources.

Key principles for vaccination programmes

Through NHS South, Central and West CSU’s work in delivering the National Immunisation Management Service, Child Health Information Services (CHIS) and wider operational and analytical support for public health, we’ve identified three core principles that can be applied across any geography to increase vaccination uptake while making best use of limited resources:

1. Making data meaningful

Regional screening and immunisation teams often tell us they are “drowning in data”. The challenge lies in making that data useful – getting, cleansing and interpreting the right data to enable robust, informed decisions. This requires regional teams, commissioners, GP practices and CHIS providers to collaboratively extract and process live data from operational systems to give a timely, accurate picture of vaccination status, rather than relying on information that may be several weeks out of date.

But we also need to ensure we are making recommendations and decisions on data that is accurate and complete. Building in mechanisms to fill gaps in data or improve how information is coded, such as insight reporting, can significantly improve an organisation’s ability to target the right cohorts in the right way. To improve quality of primary care ethnicity data in London, for example, we used a text message campaign to enable registered patients to select their ethnicity which was automatically coded into the practice record.

2. Understanding the issues

Being curious about what the data appears to show, and applying operational insights to inform interpretation, can make a significant difference to the direction – and ultimate success – of a vaccination programme. For example, when the East of England region was experiencing poor COVID-19 vaccine uptake among white working-class young males, it was easy to link this to typically low engagement with health services.

A contact centre campaign to call those who hadn’t responded to invitations revealed that the real issues were the high number of people on zero-hour contracts, who couldn’t afford to take time off work for appointments, and lack of access to transport to get to vaccination centres. By deploying vaccination buses to places of high employment, such as large warehouses and farms, take-up improved, benefiting individuals, health services and large regional employers who were able to avoid operational disruption.

Similarly, when COVID-19 uptake levels within the Chinese population in the North West were reported to be low, initial assumptions were that this was culturally motivated. By viewing the data through a primary care operations lens, however, we were able to discern that the issue was only among 20- to 30-year-olds, who had registered with practices near to universities, but had since moved areas or countries. It was a simple record-keeping issue rather than a more complex cultural issue, avoiding the need for a costly community engagement campaign.

3. Enabling multidisciplinary discussion

Real-time data and dashboards are useful tools but bringing together people to discuss and interrogate what the data means is incredibly valuable. Allowing time to talk though the ‘why’ helps to ensure that when organisations take action, it is productive and cost-effective. Useful questions to cover include: what are the key issues coming through? What are the continuing trends? Where is the evidence for this? What methodology is being used and is it sound? What could this mean operationally?

In the North West, the NHS England regional team uses monthly reports on the measles, mumps and rubella (MMR) vaccination campaign to bring together public health, screening and immunisation colleagues to share and work through the analysis, making time for important dialogue and collaboration on potential issues and interventions. This approach has proved so positive that it has now been commissioned for the entire 0-5s childhood immunisation programme across Greater Manchester.

Using limited resources effectively

Vaccine promotion must be targeted in the most effective way possible to benefit our patients and communities. This is as much about the activity organisations stop doing as it is the plans they pursue. In applying the above principles, we are seeing organisations develop cost and resource-efficient strategies based on a sound understanding of both the data and how it applies operationally.

Using this approach, Blackburn with Darwen ICS discovered that clinic locations and language were the main barriers to flu vaccine uptake among 2- to 3-year-olds in deprived and multi-ethnic areas. Adopting a collaborative approach with regional, ICB and GP practice colleagues, including arranging weekend clinics and sending out information in multiple languages, has helped to increase flu vaccine uptake by 10 per cent in 12 practices.

Bringing curiosity and operational expertise to data analysis has also avoided additional investment in a resource-intensive ‘call and recall’ campaign to improve MMR vaccination rates in young adults and teenagers. Although the data initially suggested the campaign was working, further analysis showed this was due to vaccination records being retrospectively updated within GP practices rather than vaccine uptake increasing.

The Darzi investigation urges the NHS to focus on furthering the shift from ‘treatment to prevention’. Ensuring our core public health interventions are optimised is a solid first step, and these principles apply not just to vaccines but also to screening and health checks programmes. More than 12 months on from the launch of the first NHS vaccination strategy, there is still much learning and best practice to emerge. But in our drive to progress, we must take time to challenge assumptions and fully understand what the data is telling us so that interventions are resource-efficient and deliver results.

New framework agreement to support mental health services goes live

By Integrated Care Journal

Corporate services provider NHS Shared Business Services (NHS SBS) has launched a new £70m framework agreement designed to speed up the time it takes for patients to access mental health services.

The unique Mental Health, Learning Disability and Autism: Assessment and Diagnosis, NHS Talking Therapies and Crisis Services framework agreement provides NHS organisations with easy access to suppliers, including voluntary, community and social enterprises, that offer a wide range of services and can help reduce waiting times.

The mental health charity, Mind, has found that the cost of poor mental health is around £300bn a year in England alone. For children and young people, mental health services now account for over £1bn of NHS spending annually in England.

The new framework agreement is one of the first to be awarded under the new Provider Selection Regime, providing NHS trusts with the assurance that contracts awarded are fully compliant with the new legislation.

It is split into three Lots:

Lot 1 – Assessment and diagnosis

This includes a range of services and clinical assessments used in the diagnosis of common mental health conditions, severe mental illness, and neurological conditions. The lot will also include provision for ongoing assessments.

Lot 2 – NHS talking therapies

This lot covers NHS talking therapies for anxiety and depression. It provides treatment and psychotherapy for people with common mental health problems, including mixed depression and anxiety, panic disorder, agoraphobia and post-traumatic stress disorder (PTSD).

Lot 3 – Crisis services

This focuses on relapse prevention, helping relevant authorities respond to patients at times when their mental health and/or social situation has deteriorated to the point they are at considerable risk and require additional support to remain in their current accommodation and/or prevent further harm.

Laura Goodwin, Category Manager for NHS SBS, explained: “Following extensive research and market engagement, NHS SBS understood the need and urgency for this one-of-a-kind Mental Health, Learning Disability and Autism: Assessment and Diagnosis, NHS Talking Therapies and Crisis Services Framework Agreement.

“Mental health problems are rising, and as a result, people are waiting longer than they should to access the care they need – a problem that has been highlighted in the Long Term Plan, the NHS 2024/25 priorities and Lord Darzi’s review of the NHS.

“Trusted, competent third-party suppliers are an efficient and effective way of tackling waiting lists. With our NHS customers contacting us regularly looking for help, we are confident that this new framework agreement will enable trusts to get the additional support they – and their patients – so desperately need.”

For more information, contact the NHS SBS team at: sbs.hello@nhs.net.

Evaluation of NHS Artificial Intelligence Lab identifies lessons to shape AI’s future in health and care

By Integrated Care Journal

Review finds that the NHS AI Lab has been integral in advancing and scaling AI development in healthcare, with early evidence demonstrating returns on investment for taxpayers. However, researchers flag challenges in scaling and adoption of AI, and the need for stronger alignment with NHS system needs.

Researchers from The University of Edinburgh have released a report highlighting the ‘transformative’ impact of the NHS Artificial Intelligence (AI) Lab, a pioneering DHSC and NHS England initiative aimed at effectively integrating AI into the health and care sector.

The independent evaluation was conducted by a senior team of interdisciplinary researchers from The University of Edinburgh spanning public health, social science, informatics and business disciplines. With health economics support from NHS Arden and GEM Commissioning Support Unit, the report offers assessment of the NHS AI Lab’s achievements and challenges as well as identifying learning for future opportunities driven by AI.

The independent review was conducted between March and December 2024 using a range of evaluation techniques including document reviews, interviews, observations, analytics and outputs measurement. Key findings include:

Significant progress and learning: The NHS AI Lab has helped to advance AI development and scaling in healthcare, generating valuable insights and lessons that can help to shape future AI strategies for the NHS.
Return on investment: Early evidence indicates promising financial and patient care benefits, with health economics approaches demonstrating AI-driven technologies yielding substantial cost savings and improved health outcomes for some technologies supported by the NHS AI Lab. There is also early evidence of returns on investment for taxpayers.
Challenges in scaling and adoption: The report identifies barriers to widespread AI implementation and adoption, including procurement processes, integration with existing infrastructures and processes and the need for stronger alignment with NHS system needs.
Long-term impact: While some benefits are already evident, the full value of the NHS AI Lab’s work is expected to unfold over longer timeframes, requiring continued monitoring of emerging benefits and adoption processes.

Launched in 2019, with an initial investment of £143.5 million, the NHS AI Lab was established to accelerate the safe and effective adoption of AI in healthcare. Over the past five years, it has played a critical role in supporting and coordinating the development, testing and deployment of AI in health and care, as well as shaping regulatory frameworks. The evaluation explores the AI Lab’s contributions to AI policy, infrastructure and real-world applications, ensuring that the NHS remains at the forefront of AI-driven healthcare advancements.

One AI project cited implemented a diagnostic tool in a non-elective care setting across a range of regional networks within the NHS. The technology provided a set of decision support tools that aided frontline clinicians to make time critical treatment decisions, this resulted in efficiencies in longer term care and patient outcomes leading to a cost saving estimate of over £44 million across a cohort of 150,000 patients.

The evaluation report emphasises the need for sustained national support, strategic leadership and evidence-based decision-making to ensure AI’s full potential is realised in healthcare. It also highlights the importance of fostering positive collaboration between AI developers, policymakers and frontline healthcare providers.

Professor Kathrin Cresswell, lead researcher on the evaluation from The University of Edinburgh, commented: “The NHS AI Lab has been instrumental in positioning the UK at the forefront of delivering system-based change to promote AI-driven healthcare. This evaluation provides real-world empirical evidence and learning that can help to shape future efforts in the UK and internationally.”

Dom Cushnan, Director of AI, Imaging and Deployment, NHS England, commented: “The findings from this report will inform the ongoing development of AI strategies and approaches that can help the NHS to make the strategic shift from analogue to digital in health and care. Helping to shape a future where AI will enhance patient care, operational efficiency and overall healthcare outcomes.”

Rose Taylor, Executive Director Health and Care Transformation at NHS Arden & GEM, commented: “This evaluation demonstrates the important role that AI can play in the transformation of NHS services. The health economics approach taken in the review has enabled systems to demonstrate that AI technologies can deliver benefits for patients while simultaneously providing productivity and efficiency gains.”

Promising new treatment strategy for acute heart failure launches to patients

By Integrated Care Journal

A new strategy for treating acute heart failure has been shown to improve patients’ quality of life, as well as potentially easing pressure on NHS services by reducing patient admissions.

A new approach to monitoring and treating acute heart failure, which could significantly improve patients’ quality of life, has been launched at St George’s Hospital in London and Morriston Hospital in Swansea, Wales.

Heart failure is a long-term condition where the heart is unable to pump blood around the body properly. It tends to get gradually worse over time, but its symptoms can often be controlled with appropriate management.

The change to the heart failure pathway – an innovative approach to treatment plans coupled with frequent patient monitoring and testing – enables clinicians to increase doses of medication early, more quickly, and with frequent safety monitoring. This works to reduce patients’ symptoms and help prevent hospital readmissions, which can ease demand on Emergency Departments and acute care services.

The new treatment strategy, which has been endorsed by the European Society of Cardiology (ESC), was adopted from the landmark international STRONG-HF trial. This multinational, 1,500 patient clinical trial showed a reduction in a composite measure of mortality rates and hospital readmissions for patients undergoing the new approach to treatment in the six months following discharge from hospital.

St George’s and Morriston are working in partnership with Roche Diagnostics UK & Ireland to implement the new and improved approach to treatment. The new treatment strategy will potentially benefit up to 100 patients in the first year of activity at St George’s and 10 per cent of all heart failure patients in the Swansea and Neath Port Talbot areas.

Paul Curtis, the first St George’s patient to be treated according to the new strategy, said: “After my heart attack, and the acute heart failure diagnosis that followed, I knew that it would be a long time before I felt ‘normal’ again. But just weeks after starting my treatment, I began to notice a steady improvement to my energy levels and ability to do physical jobs around the house. Recently, I’ve even been able to go on holiday. I hope that many more people with heart failure are able to be treated on this new pathway so they can recover more quickly too”.

Matthew Sunter, Lead Heart Failure Nurse at St George’s, said: “Heart failure kills as many people as cancer, yet cancer treatments such as chemotherapy start faster. Now, armed with our new knowledge, we’re able to replicate this with heart failure patients, starting them on higher doses of medicines and increasing them much more quickly – in around three weeks, as opposed to several months.

“I’ve been in this role 10 years, and when I started I never imagined we could treat patients in this manner. We’ve come a really long way, and I’m so proud of the work we’ve been doing at St George’s.”

A Roche blood biomarker test, which checks for signals given off by a heart if it is under stress or dysfunctioning, is a key component of the new, innovative treatment strategy.

Katherine Booth, Clinical Market Manager – Cardiac for Roche Diagnostics UK&I, said: “We know this small but significant change to the management of acute heart failure could improve the lives of many patients. We’re delighted to be working with St George’s and Morriston on introducing this improvement, and we hope to partner with more NHS organisations to ensure even more patients can benefit from it.”

Nick Hartshorne-Evans BEM, Founder and CEO of heart failure charity, Pumping Marvellous, said: “Reducing the significant symptomatic burden and improving health outcomes for individuals diagnosed with heart failure is crucial. The STRONG-HF treatment strategy represents an important system improvement.

“It has the capacity to onboard patients swiftly and ensure they are placed on GDMT (Guideline Directed Medical Therapy) more quickly. It will ensure that patients receive timely treatment, if required, following discharge, improving their health outcomes. I hope this approach is further adopted across the NHS, enabling patients to live better with heart failure.”

News, Population Health April 24, 2025

Bridging the Gap: Connecting people with the stairlift grants they need

By Integrated Care Journal

Thousands may be missing out on stairlift grants worth up to £36,000. A new guide explains the eligibility criteria for accessing a grant, and how to apply.

Installing a stairlift into a property can provide residents with improved mobility, allowing people to continue to enjoy their independence as their mobility decreases.

The price to purchase and fit this equipment can put some people off investing in these mobility solutions though. According to a Which? survey of stairlift owners, the average sum that a respondent paid for a new stairlift as of December 2022 was £3,867.

Curved stairlifts provider Access BDD has created a guide, advising how to bring down the cost of these home modifications, by explaining who is eligible for any of these stairlift grants.

Disabled Facilities Grants

A Disabled Facilities Grant (DFG) is a source of financial aid that is available to disabled people across England, Wales and Northern Ireland when they need to make home adaptations so that a property can become more accessible.

Current uptake

The House of Commons Library’s Disabled Facilities Grants (DFGs) For Home Adaptations document has shed some light into how many people have been helped by this form of financial aid.

Although it has been voluntary since 2010 for local authorities to submit annual returns to the Department for Levelling Up, Housing and Communities about their DFG activity, a parliamentary question posed to the Minister, Luke Hall, in February 2020 found that the estimated number of DFGs delivered increased from 40,645 in 2014/15 to 53,500 in 2018/19.

What financial aid is there?

Here’s how much applicants can apply for when it comes to receiving a DFG:

In England, a grant of up to £30,000
In Wales, a grant of up to £36,000
In Northern Ireland, a grant of up to £25,000

Applicants may receive more than these amounts from some councils, though how much you get will usually be determined by your household income and having household savings that are above £6,000.

Take note too of the following caveats when it comes to applying for a DFG:

Disabled children under the age of 18 are eligible for a DFG without their parents’ income being factored into the decision.
A landlord will not have their income or savings considered if they apply for a DFG to make adaptations to a property they own. If the current tenant moves out within five years of this financial aid being received though, a council may request that another disabled person moves into the property.

Who is elible?

Anyone looking to join the thousands of people who have successfully applied for a DFG will be eligible for this financial aid if someone in their household has a disability.

This individual must also intend to live in the property throughout the grant period, which is usually set at five years but may be adjusted for circumstances such as someone being terminally ill.

The council which provides the DFG must be satisfied that any work carried out is necessary and appropriate for the needs of the disabled individual too, as well as being able to be done on the property depending on its age and condition.

Once a DFG has been approved, all work should be completed within a year. However, do not start this work before the council states the application is approved – a grant can be turned down by the council in this type of scenario.

How to apply

Applicants can apply for a DFG through their local council by clicking here. A decision must be provided by councils within six months of the application being submitted.

Scotland: Scheme of Assistance

Scotland is not included in the section on DFGs. This is because local authorities across this country are responsible for providing its citizens with stairlift grants through what is referred to as the Scheme of Assistance.

According to the Scottish Government’s Housing Statistics 2022 and 2023 publication, a total of 6,353 Scheme of Assistance grants were paid to householders during the 2022/23 period. This is up by four per cent when compared to how many of these grants were delivered in 2021/22.

Financial help in the form of grants or loans can be provided through the Scheme of Assistance, so that private housing can be adapted because one of its occupants is disabled.

Grants must be at a minimum level of 80 per cent of the eligible cost, though recipients might get 100 per cent if you receive one of these benefits:

Income-based Jobseeker’s Allowance
Income-related Employment and Support Allowance
Income Support
The guarantee credit part of Pension Credit
Universal Credit

It is to the discretion of a local authority to pay a grant that is more than 80 per cent of the eligible cost to a person who is not legally entitled to 100 per cent though. Circumstances which lead to this decision will be set out by the local authority in its Scheme of Assistance statement.

Eligibility in Scotland

Local authorities throughout Scotland must provide help in the following situations:

A property needs to be adapted so that it becomes suitable for a disabled person to occupy it. When these home adaptations will assist an individual to gain access to standard amenities, this financial aid must come in the form of a grant.
To reinstate a property that has been adapted previously.
When an owner of a property has been served a work order or statutory order.

It is also within the law that any help provided through the Scheme of Assistance must not discriminate against an individual in any of these ways:

A cognitive impairment
A physical impairment
Gender reassignment
Pregnancy or maternity
Their age
Their race
Their religion or belief
Their sex
Their sexual orientation

Anyone can apply for financial help through the Scheme of Assistance by filling in an application form. These will be available for download from local authority websites or in physical format at local housing officers, with local Citizens Advice Bureau advisers available to answer any questions while applying through this link.

RABI Independent Living Grants and SSAFA Help With Mobility

Specific stairlift grants may also be available to applicants depending on the type of industry they have worked in.

The Royal Agricultural Benevolent Institution (RABI) Independent Living Grants for farming families and the Soldiers’, Sailors’, and Airmen’s Families Association (SSAFA) Help With Mobility for those who have served in the Armed Forces are just two examples to take note of.

RABI states on its website that it awards an estimated £3 million of direct financial support annually, while SSAFA’s Annual Report and Accounts for 2023 detailed that it provided support to over 53,000 individuals through its services in 2023 alone.

Both RABI and SSAFA can assist individuals across the UK with adapting their properties to make a home more accessible. This is how you can be eligible for a stairlift grant through either of these charities:

RABI Independent Living Grants are available to support low-income farming families in the UK, as well as possibly those in the farming industry when there is a financial crisis.
SSAFA Help With Mobility services are available to any individual who has received a minimum of one day’s pay from the British Army, Royal Air Force, Royal Navy or Royal Marines, which includes the Reserves. Immediate family of a person who has served for these Armed Forces are also eligible to receive these services.

How to apply

To find out more about the financial assistance available through RABI Independent Living Grants, contact the charity’s support team on 0800 188 4444 to start an application.

To begin applying for SSAFA Help With Mobility, get in touch with one of the charity’s advisors via their Forcesline service.

Whether it is through a government source or a charity, there is plenty of help available when looking to achieve enhanced mobility around a property.

All news

Skills for Health announces Our Health Heroes finalists

By Integrated Care Journal

The finalists for the 2025 Our Health Heroes Awards have been shortlisted.

Our Health Heroes champions the incredible people at the heart of our NHS and is delivered by Skills for Health in partnership with NHS Employers, NHS Shared Business Services, SFJ Awards, NHS Race and Health Observatory and Integrated Care Journal.

After an extensive selection process, 23 finalists have been chosen across nine categories, each recognising the outstanding health heroes of the UK.

The selected finalists will be invited to attend the ceremony held in Central London on 22 May where the gold, silver and bronze award winners will be announced.

The finalists are as follows:

Individual categories

Apprentice of the Year, sponsored by SFJ Awards:

Nasser Mohammed, Service Desk Supervisor/Developer, Leeds and York Partnership NHS Foundation Trust
Tim Muttock, Business Administration Apprentice, Bridgewater Community Healthcare NHS Foundation Trust
Olivia Parsons, Clinic Manager, Beacon House

Healthcare Volunteer of the Year:

Andy Emery, Transport Volunteer, Royal Voluntary Service
David White, Patient Befriender Volunteer, Cardiff and Vale Health Board
Chris Wilson, Volunteer Community First Responder, Yorkshire Ambulance Service NHS Trust

Outstanding Life Contribution, sponsored by NHS Employers:

Caroline Dowsett, Clinical Nurse Specialist, East London Foundation Trust
Vedantee Shiebert, CAMHS Lead Nurse, Central and North West NHS Foundation Trust
Pauline Taylor, Children’s Complex Care Quality Assurance Nurse, Hampshire and Isle of Wight Healthcare NHS Foundation Trust

Operational Support worker of the Year:

Hayley Pedwell, Information Assistant, Macmillan Cancer Care
Brian Taylor, Ambulance Welfare Officer, North East Ambulance Service Unified Solutions
Lois Ward, Communications and Engagement Officer, Chesterfield Royal Hospital

Clinical Support Worker of the Year:

Lynette Cook, Ward Coordinator, Northern Care Alliance NHS Foundation Trust
Sam Desborough, Assistant Practitioner Occupational Therapist, Southwark Council
Sarah Haynes, Healthcare Assistant, Modality Partnership

Team categories

Best Healthcare Workforce Collaboration:

Personalised Independence Programme, Age UK HBW
The What Matters Team, Royal Berkshire NHS Foundation Trust

Dedication to Lifelong Learnt Culture:

Coventry and Warwickshire Training Hub
Patford House Partnership

Equity, Diversity and Inclusion Champion, sponsored by NHS Race and Health Observatory:

Wakefield Hospice
West Midlands Ambulance Service

Digital Innovation, sponsored by NHS Shared Business Services:

Paediatric Virtual Ward Team, Dudley Group of Hospitals NHS Foundation Trust
Recruitment RPA Project Team, Kent Community Health NHS Foundation Trust

Follow #OurHealthHeroes on X (formerly Twitter) and LinkedIn for all the latest updates. To find out more visit: www.skillsforhealth.org.uk/awards

King’s College London becomes first to benefit from two whole-body PET-CT imaging systems

By Integrated Care Journal

As part of the National PET Imaging Platform, King’s College London will support transformational research to improve the calibre of care across the UK, including providing new insights and enhancing the development of drugs and diagnostics for conditions including cancer, cardiovascular and neurological diseases.

King’s College London (Kings) has become the first site in the UK to benefit from two Biograph Vision Quadra systems from Siemens Healthineers, marking a new era of PET-CT. This crucial, non-invasive imaging technique can detect diseases’ early onset, accelerating quality of care for patients while also enabling King’s to conduct innovative radiopharmaceutical, basic science and clinical research.

As part of the UK’s first-of-its-kind National PET Imaging Platform (NPIP), a collaborative initiative bringing together transformational research for clinical discovery, King’s will use the whole-body PET-CT systems for research to improve the calibre of healthcare across the UK.

With PET-CT demand rising nearly 10 per cent annually, this technological upgrade will help King’s meet this demand and significantly expand clinical and research capabilities, positioning King’s at the forefront of global PET-CT research. With higher sensitivity than existing technology, the hospital’s whole-body PET-CT scanners will provide unprecedented insights into anatomy, improving the detection, diagnosis and treatment of complex, multi-organ diseases.

Beyond supporting NPIP, the systems will bolster complex radiopharmaceutical production and tracer development research at King’s (one research tracer production can be used for twice as many scans). Patients will benefit from improved image quality and speed of examination, while a reduction in dose will enhance paediatric diagnostics and treatment.

The UK’s adoption of whole-body PET-CT signifies a major leap forward in medical imaging, promising significant improvements in patient care and research capabilities. Funding for the first installed scanner was secured from the Medical Research Council (MRC), with the system jointly managed by King’s and Imperial College London, scientific co-applicants alongside the King’s team. The second system is financed through a strategic investment by King’s.

Image caption: (L) Peter Kyle – Secretary of State for Science, Innovation and Technology; (R) Professor Sebastien Ourselin, FREng, FMedSci, Assistant Principal (Innovation) at King’s College London visit St.Thomas’ Hospital to launch the NPIP-funded whole-body PET-CT scanner from Siemens Healthineers.

The two whole-body PET-CT systems at King’s are two of four across the UK supporting NPIP, all of which are supplied by Siemens Healthineers. By facilitating access to whole-body PET-CT imaging for clinicians, academics and industry, NPIP is set to accelerate discoveries, leading to more advances for UK researchers and better outcomes for patients. This not only enhances the UK’s clinical infrastructure but also reinforces its position as a global leader in medical technology and research.

Equipped with technical precision that redefines molecular imaging and optimises operational performance, the Biograph Vision Quadra systems from Siemens Healthineers enable near real-time imaging of a patient’s entire body. With an in-depth look at how the body interacts with administered substances, tumours can be characterised allowing for more personalised and precise treatment.

“Whole-body PET-CT has been an area of exciting development and exploration for several years now,” commented Professor Alexander Hammers, Head of the PET Imaging Centre, School of Biomedical Engineering & Imaging Sciences at King’s College London.

“We were very proud to obtain research funding for one whole-body PET-CT system; having a second one on the same site available for clinical use signifies a fundamental milestone in the advancement of nuclear medicine. I am looking forward to enhancing our research activities and our clinical services with two of these innovative scanners.”

“The addition of two new cutting-edge whole-body PET-CT scanners in our PET Centre makes us proud and excited,” added Professor Sebastien Ourselin, FREng, FMedSci, Assistant Principal (Innovation) at King’s College London.

“They will create an incredibly unique setting for the benefit of our patients, and for scaling up research and collaboration endeavours in partnership with Siemens Healthineers.”

Ghada Trotabas, Managing Director of Siemens Healthineers Great Britain and Ireland, stated: “We are honoured to collaborate with King’s College London in their ongoing pursuit to advancing molecular imaging. The installation of two Siemens Healthineers Biograph Vision Quadra systems marks the beginning of a new era in PET-CT imaging, paving the way for groundbreaking advancements in both clinical research and patient care.”

Lead image caption: (From left to right) Giulia Ginami – Strategic Partnerships Manager, Daniel Darian – Collaboration Manager Molecular Imaging, Graham Plant – Head of Diagnostic Imaging at Siemens Healthineers Great Britain & Ireland, Professor Alexander Hammers – Head of the PET Imaging Centre at the School of Biomedical Engineering & Imaging Sciences at King’s College London, Ghada Trotabas – Managing Director of Siemens Healthineers Great Britain & Ireland with one of the two new Biograph Vision Quadra systems at St. Thomas’ Hospital.

This content was kindly supported by Siemens Healthineers.

Reducing misdiagnosis and helping patients back to work

By Mark Thomas

New imaging technology promises to bring affordable, more detailed 3D imaging to care settings around the world, providing faster and more accurate diagnosis and helping patients get the right care.

Scaphoid fractures are notoriously difficult to diagnose, typically presenting among young men following a fall onto an outstretched hand, car accident or contact sport incident. One of eight small bones that make up the ‘carpal bones’ of the wrist, the scaphoid connects two rows of bones: one closer to the forearm and the other closer to the hand. These fractures can present with wrist or thumb pain but not necessarily any visible deformity or significant loss of motion, leading many incidences to be misdiagnosed as wrist sprains.

The scaphoid bone has an avascular blood supply that means, depending on the location and size of the break, there is a real risk of bone death where blood supply is cut off. This leads to a loss of wrist function and dexterity, which can have significant financial implications for those who rely on their flexibility of wrist movement that the scaphoid supports.

This is why MRI and CT images have become the ‘gold standard’ for diagnosis. However, limited resources and long imaging waiting lists mean clinicians across the UK instead rely on X-rays in the first instance. If a scaphoid fracture is suspected, clinicians will typically request four X-ray views, versus two for other wrist injuries, but even that is not a guarantee that the fracture will show as the scaphoid bone can be easily hidden by other carpal bones in a 2D image.

*Traditional 2D film X-ray radiograph showing broken carpal bone (scaphoid fracture)*

It is easy to understand how scaphoid fractures can be easily missed then, particularly in overstretched A&E departments where there may not be sufficient scanner time or radiology cover to diagnose ‘minor injuries’ quickly. Clinical teams usually adopt a conservative approach therefore: Initially treating the injury as if the bone is fractured, with splinting recommended to protect it from further damage, and a follow-up appointment with the fracture clinic in 7-10 days’ time. By this point, if the patient is still experiencing pain, new X-rays will likely reveal initial bone healing more clearly than the original scaphoid break.

It is a sensible approach but one that ultimately causes several problems:

Firstly, where clinicians are concerned about the possibility of a scaphoid fracture but unable to confirm it during the initial visit, splinting the wrist while awaiting further imaging or specialist review means patients can find themselves unable to work unnecessarily, with significant financial implications due to lost earnings.

Scaphoid fractures are usually slow to heal because tiny blood vessels supplying nutrients to the site are often damaged at the time of injury. This means that even though the results of both surgical and non-surgical interventions are very good following diagnosis, both approaches require considerable time in plaster, with knock-on impacts for patients and their dependents, including inability to drive, work and earn normally. Should surgery ultimately be required, it is easy to see how treatment delays of just a couple of weeks can have a real impact on patients’ lives.

Finally, requiring all patients to attend follow-up appointments in fracture clinic has significant resource implications for a healthcare system already under pressure, not least in terms of clinician time and additional imaging requirements.

Improving diagnosis through next-gen imaging

Accepting all of the above, how then can we improve diagnosis for these patients? How can we prevent patients with sprained wrists taking unnecessary time off work, while supporting those with scaphoid fractures to access faster treatment and limit injury-related loss of earnings?

One potential solution lies in a new imaging technology – already proven in the veterinary industry – which promises to bring affordable, more-detailed 3D imaging to the point of care in hospitals and clinics around the world.

This next-generation technology builds on the foundations of digital tomosynthesis (DT) imaging, which is widely used for breast imaging across the NHS. With traditional DT, a conventional X-ray tube moves through a range of angles to derive 3D data – providing better diagnostic information than 2D X-ray but, restricted by its limited depth resolution capabilities, creating difficulties localising some structures and elements.

Adaptix’s unique 3D X-ray technology ‘sweeps’ in two dimensions, enhancing the Z resolution relative to conventional DT. Images are quickly reconstructed – in under 20 seconds – providing slice-by-slice images that can be analysed extremely quickly. This allows for slice thickness adjustments over regions of interest – a particularly important feature when looking for ‘tricky’ fractures, such as those to the scaphoid bone.

The result? A high-resolution 3D image that provides far greater definition and clarity than 2D X-ray techniques, at a cost and radiation dose similar to traditional X-ray. What is more, the compact design of the technology and low-radiation dose, mean it can be brought directly to the point of patient care – reducing time spent moving between hospital departments and allowing clinicians to obtain imaging ‘in clinic’ if needed.

About the author

Mark Thomas, BSc (Hons), PgC, HCPC Reg., Product Manager, Adaptix

Mark spent the first 10 years of his career working as a Radiographer in human healthcare both in the UK and Australia. Later, he focused on CT, managing the Neuro CT Service in Oxford in his final position. In 2008, Mark joined Toshiba/Canon Medical as a CT Specialist, and spent the next 15 years initially providing training, before managing the UK Clinical CT Team. With a strong team Mark drove the adoption of new technologies pushing clinical boundaries, maintaining high clinical integrity and importantly customer satisfaction. Mark’s background gives him real clarity on the future and opportunity for inclusion of Digital Tomosynthesis Imaging in a modern, forward thinking Imaging Service.

Data solutions to solve the South West’s patient discharge crisis

By Professor Christos Vasilakis and Dr Zehra Onen Dumlu

Professor Christos Vasilakis, Founding Director of the Centre for Healthcare Innovation and Improvement – CHI²) and Dr. Zehra Onen Dumlu from the University of Bath discuss the IPACS project – a collaborative, data-driven approach to improving patient flow.

Delayed discharges, often known as ‘bed blocking’, is a serious operational challenge for NHS managers across the country. According to NHS England data, in February 2024 there were between 13,200 and 14,200 patients remaining in hospital each day who did not meet the criteria to stay. This accounts for more than one in eight general and acute beds in England.

While patients are deemed medically fit for discharge, they remain in hospital due to complexities in arranging necessary social care or community nursing support for a safe transition. The knock-on effects are significant, placing immense strain on acute bed capacity and negatively impacting patient flow and their experience.

The IPACS project: A collaborative, data-driven approach

To address the issue, the Improving Patient Flow between Acute, Community, and Social Care (IPACS) project was launched in 2020. This significant three-year initiative received funding from Health Data Research UK (HDRUK), an independent charity focused on using health data research to address major healthcare challenges.

IPACS brought together a diverse team, combining academic expertise with frontline NHS operational knowledge. Collaborators included the University of Bath, the University of Exeter Medical School, and significantly, the Bristol, North Somerset, and South Gloucestershire (BNSSG) Integrated Care Board (ICB).

The goal of the project was to develop an open-source computer simulation model capable of analysing the complex dynamics of patient flow. This tool would offer a potential blueprint for healthcare organisations nationwide grappling with delayed discharge pressures.

Central to the project was the application of Operational Research (OR) techniques – using advanced analytical models to dissect and solve complex systemic problems. Several team members brought extensive OR experience, with affiliations to The Operational Research Society, demonstrating the project’s robust methodological foundation aimed at enhancing healthcare efficiency.

A multidisciplinary, team-driving innovation

The success of IPACS hinged on its multidisciplinary collaboration. BNSSG ICB’s Head of Modelling and Analytics, Dr Richard Wood, and University of Bath Research Fellow Dr Paul Forte provided essential insights into real-world healthcare operations and ensured the project outputs were relevant and accessible to NHS decision-makers.

Academic leadership came from Professor Christos Vasilakis (founding director of the Centre for Healthcare Innovation and Improvement – CHI²) and Dr Zehra Onen Dumlu at the University of Bath, working alongside Professor Martin Pitt and Dr Alison Harper from the University of Exeter Medical School. This combined team undertook the intricate task of designing, developing, and validating the simulation framework.

Focusing on the critical ‘Discharge to Assess’ service

A key focus for the IPACS project was the transition of patients from acute settings into community care, specifically via the ‘Discharge to Assess’ (D2A) service. Optimising this service is key to improving hospital throughput. The project modelled the three core D2A pathways:

Pathway 1 (P1): Enabling patients to return home with domiciliary support.
Pathway 2 (P2): Providing bed-based rehabilitation for those needing more intensive recovery support post-discharge.
Pathway 3 (P3): Catering for complex care assessments, frequently leading to long-term care placements.

The IPACS model aimed to help optimise capacity planning and resource allocation across these vital pathways.

The BNSSG region: A relevant testing ground

The Bristol, North Somerset, and South Gloucestershire (BNSSG) region, serving approximately one million people, served as a practical case study. Its demographic mix and blend of urban and rural environments reflect challenges common across the NHS. The region’s D2A pathways were experiencing significant pressure, with high occupancy and discharge delays, providing a rich, real-world dataset and demonstrating the urgent need for the solutions IPACS explored.

Operational Research and simulation modelling in practice

Professor Vasilakis and Dr Wood pinpointed the core management challenge: the complex interdependencies between acute, community, and social care services. Bottlenecks in community and social care inevitably impact upstream services, contributing to emergency department pressures and ambulance handover delays.

The IPACS team used real-time data on patient occupancy and discharge delays to build their model. This allowed them to establish baseline performance and, critically, to run “what if” scenarios, varying parameters like length of stay and arrival rates to understand potential impacts of service changes.

Computer simulation modelling, a cornerstone of OR, was central to this. The model allowed the team to:

Simulate patient journeys through the D2A pathways in detail.
Test potential interventions virtually to assess their likely impact on flow and delays.
Analyse how best to allocate resources to mitigate discharge delays.
Account for time-varying demand patterns.

Built using the open-source ‘R’ programming language, the model prioritised accessibility and transparency.

Demonstrating real-world impact and future potential

The IPACS model provided valuable quantitative insights. Outputs clearly demonstrated the potential benefits of achieving target pathway splits and reducing lengths of stay within the D2A service. Significantly, estimates generated by the model were used to support a £13 million business case for enhancing the local D2A system – highlighting the project’s tangible value in informing strategic investment decisions.

The team acknowledged the model does have some limitations. It doesn’t yet capture every element of discharge, such as specific social care inputs, palliative care routes, or detailed post-D2A placement dynamics. Data completeness also needs some ongoing attention. Future work could involve expanding the model’s scope to incorporate social care elements more deeply, analyse the impact of acute capacity constraints, optimise home-based care models, and potentially develop faster analytical tools.

The ongoing challenge and strategic steps forward

Tackling delayed discharge requires effective strategies, and the IPACS project highlights the value of OR. Using OR methods such as simulation modelling allows NHS managers to better understand complex discharge pathways, evaluate potential solutions before implementation, and make more informed, evidence-based decisions about resource allocation to improve patient flow and reduce delays.

*Dr Zehra Onen Dumlu, Assistant Professor, University of Bath*

*Professor Christos Vasilakis, Founding Director, Centre for Healthcare Innovation and Improvement – CHI²*

Accelerating NHS net zero goals through medicine carbon footprinting

By Samantha Semmeling

With medicines accounting for a quarter of the NHS carbon footprint, Nazneen Rahman, Founder of YewMaker and co-creator of MCF Classifier, explains how AI-driven medicine carbon emissions data can support practical, scalable strategies that align clinical excellence and environmental stewardship.

The climate crisis is resulting in acute and chronic health challenges, which are putting pressure on global health systems. In turn, the healthcare sector is estimated to account for 5 per cent of global greenhouse gas emissions. This places a unique responsibility on the sector to both manage these impacts and reduce its contribution to climate change.

More than 20 countries have committed to delivering net zero health systems. In the UK, the Health and Care Act 2022 embedded the commitment for the NHS to become net zero by 2045 into legislation, making it the first health system worldwide to do so.

Progress on sustainable medicines

Medicines make a sizeable contribution to the NHS’ carbon footprint (an estimated 25 per cent), so a comprehensive strategy to reduce medicines-related emissions is necessary for the NHS to reach its net zero goals.

The NHS is already making headway. Green plan guidance now recommends that systems and trusts use lower carbon inhalers and anaesthetics, which has already seen successful uptake.

However, of the 25 per cent attributed to medicines, inhalers and anaesthetics only account for 5 per cent. The remaining 20 per cent comes from the manufacture and supply of the billions of medicines prescribed across the NHS every year.

Progress on reducing these emissions has been hindered by a lack of accessible product-level emissions data. Manufacturer data is rarely made available and is not standardised, making it difficult to use as a baseline for carbon reduction strategies.

MCF Classifier – Medicine emissions data at scale

YewMaker creates science-based solutions to help make healthcare more sustainable. Chief Executive Officer, Nazneen Rahman and Chief Technology Officer, Haroon Taylor saw an opportunity to harness industry standards in green chemistry, using AI and data science to develop a standardised methodology for calculating the carbon footprint of individual medicines. The resulting technology suite, MCF Classifier (MCF = Medicine Carbon Footprint), provides data and tools that enable the manufacture, supply, emissions, procurement, and prescription of medicines to be carbon-informed.

“We developed MCF Classifier to make medicine emissions visible, consistent, and usable,” says Nazneen. “Without that foundation, it’s difficult for anyone – whether in procurement, policy or practice – to take meaningful action.”

The methodology behind MCF Classifier has been peer-reviewed and published, bringing transparency and credibility to an area where data has been limited and inconsistent. Research using MCF Classifier has shown wide variation in medicine carbon footprints across all therapeutic areas, highlighting significant opportunities for carbon-informed decisions in procurement, supply chain planning, and prescribing.

YewMaker is now building MCF Classifier tools and products to drive awareness and action. MCF Formulary, supported by NHS funding, provides standardised per-dose carbon ratings for thousands of medicines through a free, user-friendly web portal. It allows healthcare practitioners to explore the relative carbon impact of medicines and integrate sustainability into medicine optimisation strategies.

For manufacturers and suppliers, YewMaker uses MCF Classifier to deliver a range of data products and services, including product carbon footprint reports, large-scale emissions analyses, portfolio-wide carbon assessments, and therapy emission comparisons. These support organisations to understand and mitigate the carbon impact of their medicines and to meet reporting requirements.

Advancing NHS net zero goals

The NHS has committed to reach net zero by 2045 for emissions influenced through the procurement of goods and services, including medicines. To help suppliers align with this goal, the NHS has developed a roadmap outlining key milestones. By 2027, all suppliers are required to publish a Carbon Reduction Plan, and by 2028, they must provide carbon footprint data for individual products.

Reducing supply chain carbon emissions will be essential. However, delivering on these targets will require practical and proportionate approaches. Nazneen highlights the importance of ensuring that new expectations, such as product-level carbon reporting, are introduced in ways that support, rather than disrupt, medicines supply. Tools like MCF Classifier can help by providing suppliers with accessible, consistent data that supports engagement without creating unnecessary complexity or burden.

Nazneen emphasises that carbon data should not be seen as a compliance exercise, but as a resource to support informed, balanced decisions. As understanding of product-level emissions improves, suppliers will be better placed to identify areas for reduction while maintaining stability and quality across the supply chain.

Improving the sustainability of the medicines supply chain will require coordinated efforts among multiple stakeholders. Collaboration at the organisational, sectoral, national and global levels will be essential in creating a supply chain that is not only resilient and cost-effective but also environmentally responsible.

By embedding carbon considerations into decision-making, the NHS can continue to lead in aligning clinical excellence with environmental sustainability and take meaningful steps towards delivering a net zero health system.

Further information

Dr Nazneen Rahman is CEO and Founder at YewMaker, a purpose-driven business building science-based sustainable healthcare solutions, and the Executive Director of the Sustainable Medicines Partnership action collaborative.

If you are interested in this topic or PPP’s pharmacy and medicines work more broadly, please contact Samantha Semmeling, Policy and Programmes Manager, Public Policy Projects (samantha.semmeling@publicpolicyprojects.com).