The 10-Year Health Plan: What do we need to deliver?

By Piyush Mahapatra

Piyush Mahapatra, a consultant orthopaedic surgeon and chief innovation officer at Open Medical, considers the latest consultation on the future of the NHS, and argues that what is needed is not a new vision, but a plan for delivery – and some radical new thinking on the role of healthcare technology.

There is a new ten-year plan for the NHS. It will “focus efforts on preventing, as well as treating ill-health”; make “out of hospital care a much larger part of what the NHS does”; and “upgrade technology and digitally enabled care”.

Are we talking about the 10-Year Health Plan that will be published next summer? Yes and no. In order, these quotes come from The NHS Plan in 2000, the Five Year Forward View in 2014, and The NHS Long Term Plan in 2019.

But they closely mirror the three shifts that the present government wants to see – from hospital to community, treatment to prevention, and analogue to digital. If these three shifts are not new, then the question is: how do we make them a reality this time?

Technology is going to be an important part of the answer, but for that to happen we need some new thinking. We need to make sure that technology is not seen as a ‘nice to have’ or even as an ‘enabler’ of change, but as an essential, everyday tool.

And we need a shift in mindset as to what that technology looks like, so that we can move away from time and capital-intensive IT programmes, and adopt revenue-funded, zero-footprint platforms that drive efficient, high-quality pathways that work for clinicians and patients alike.

Hospital to community

How does this work in practice? Consider the ‘left shift’ from hospital to community and primary care settings. This can deliver many benefits for patients, including faster access to care and reduced travel times and costs.

However, it will generally be more efficient for clinical expertise to remain in acute settings, serving larger populations. So, the key is to get the mix right, and to move aspects of the pathway, rather than the whole pathway, into the community.

Tele-dermatology is a great example of how this can be done. Diagnostic-quality photographs of skin problems can be taken in skin hubs or community diagnostic centres and sent for expert review, after which the patient can be reassured and discharged, or referred for specialist care.

This has been in the operational planning guidance for several years, but many regions have still not deployed despite NHS England having funded extensive health economic studies evidencing the benefit of turnkey solutions such as eDerma, which already serves significant areas of the country.

For this to work effectively, information needs to flow between primary care, these new care settings, secondary care and the patient.

Treatment to prevention

Similarly, prevention can deliver many benefits for the system and for patients, including the avoidance of more costly treatment. However, it can be difficult to deliver in practice.

Prevention may require the analysis of large data sets, to identify suitable cohorts of patients for intervention, and ring-fenced, dedicated services to make sure they receive that intervention. So, this is another area where technology is essential.

Open Medical’s eTrauma system is used by trauma teams across the NHS to manage their orthopaedic trauma patients and theatre operation as efficiently as possible. Building on that experience, Pathpoint FLS has been developed to replace cumbersome, time-consuming, manual patient identification processes.

It provides a centralised system for patient identification and management. Then, it automatically generates the worklists and patient communications required to make sure patients are assessed and managed. Critically, Pathpoint FLS provides data to monitor outcomes.

All new services represent a cost to the NHS in terms of facilities, staff and resources, so we need to show they are delivering the cost and outcome benefits that were expected.

Analogue to digital

Tele-dermatology and fracture liaison services are good examples of the government’s first two shifts in action. But to deliver them, it is not enough to simply digitise existing records and paper-based workflows.

Since the NHS Plan, the NHS has focused on rolling out national infrastructure, electronic patient records and, more recently, shared care records to try and join-up secondary, primary, and social care. This is capital and time-intensive activity.

It can take years for a trust to procure, implement and optimise an electronic patient record (EPR), and in that time requirements and technology will have moved on. We need to develop a more evolutionary mindset, one that embraces software-as-a-service models that can be deployed in hours and updated rapidly.

We also need to become far more clinically focused. At heart, EPRs and shared care records are repositories of patient records and operational data, in which it can be difficult for clinicians to find the referral, or note, or key piece of information that they need to help the patient in front of them.

What clinicians need are platforms that can integrate with these big record systems, to drive communications along the clinical pathway, and provide the contextual information they need to make a patient decision, when they need to make it.

New thinking on decision-making, funding and technology

Some additional changes will be needed to drive the three shifts. The big question is who is going to plan and implement new models of care and preventative services.

Integrated care systems evolved out of the Five Year Forward View and should be well-placed to take on this role; but as things stand many are focused on finance and performance management.

Whatever new or revamped planning bodies emerge from the 10-Year Health Plan will need budgetary authority to implement change. At the moment, funding is directed to primary or secondary care, and it needs to follow the new pathways. That money also needs to include IT, so information can move around the system.

There also needs to be a shift in thinking away from IT procurement as capital investment, and a move towards revenue-based, software-as-a-service models that can flex in response to demand and further innovation. Also on the IT front, we need a renewed focus on enabling applications and on enforcing standards, particularly for interoperability.

The NHS’ central, digital bodies could have an important role here, not by building new, national applications, but by requiring the big suppliers to open up their systems or creating middleware to make their data accessible to smaller and more innovative companies at a reasonable cost.

From vision to execution

There are many other issues to consider. How do we persuade the NHS to run smaller, more agile technology projects that solve specific problems for clinicians and patients? How do we get more clinical involvement?

How do we make sure that we have a workforce equipped to embrace and manage all this change? How do we engage our patients, and make sure we are not increasing digital and health inequalities? However, what matters is that we ask the questions and find answers.

The government’s three shifts are well understood, so we don’t need the 10 Year Health Plan to create another vision for healthcare. What we need is for it to lay the groundwork for execution.

That means identifying decision makers, funding pathways, recognising that healthcare technology is essential for delivery, and then moving away from large, capital and time intensive IT implementations to revenue-funded, cloud-native, browser-based solutions that can scale and flex at need.

Over the past two decades, companies like Open Medical have developed the clinically focused, patient-centric platforms that we need. Now, it’s time to use them.

AI, simulation and innovation: Navigating the future of healthcare education

By Integrated Care Journal

AI and digital simulation are reshaping healthcare education, offering new opportunities for efficiency, training, and patient care. At the Council of Deans of Health’s Digital Summit 2025, experts explored the promise and challenges of AI integration, from regulatory concerns to the ethical implications of its use in clinical decision-making.

On 28th January 2025, the Council of Deans of Health’s Digital Summit 2025 welcomed 130 attendees from across leadership and academic roles within the healthcare sector, to discuss and debate the current and future direction of digital health.

Following a virtual welcome from the Chair of the Science, Innovation and Technology Committee, Chi Onwurah MP, JISC Director of AI, Michael Webb, discussed the rapidly evolving state of AI adoption within education and healthcare, and the need for regulatory and legislative frameworks to keep pace. Webb argued that we are now into the ‘early reality’ stage of AI adoption, and despite numerous teething problems, AI tools are now so embedded within many digital services that people often do not realise they are using them.

A key aspect of the government’s focus on AI has been efficiency, with the Department for Education a major early investor. The Department is currently exploring the possibility of coding the entire national curriculum, estimating that this could increase the accuracy of automated marking from 30 per cent to 90 per cent, saving teachers a substantial amount of time that could be better used elsewhere.

However, as AI moves into mature operational use, and its input into human lives and decision-making processes increases, it will be increasingly critical to reach a consensus regarding its ethical and responsible use, as well as ensuring that those tasked to use it are able to do so safely and ethically. Webb called on leaders and regulators to set clear boundaries to enable safe exploration of AI, and to create cultures that value curiosity, critical thinking, and progressive human development.

Embedding digital transformation in the future health workforce

This panel examined the need to embed digital literacy into healthcare education to create a healthcare workforce equipped to use technology effectively and meet the future needs of the NHS. Professor Natasha Phillips, Founder of Future Nurse, argued that the pace of technological innovation has outstripped that of pedagogical practice, often placing digitally native students ahead of educators in terms of digital capability. Professor Phillips called for action from regulators to address this disparity, ensuring that the future workforce is prepared to deliver digitally led healthcare.

“We need to weave digital transformation into everything we do and pay attention to people and processes; technological transformation can’t happen without people.”

Professor Natasha Phillips, Founder, Future Nurse

Stating that we stand “on the cusp of the fourth industrial revolution”, Professor Sultan Mahmud, Director of Healthcare at BT Group, made the case for a cultural shift at leadership levels to truly embed digital tools and methods. He observed that a key driver of innovation with NHS trusts is often the personal attitude and culture of those in leadership positions, which can vary substantially from person to another, arguing that “board members not knowing anything about health technology can’t be acceptable”.

(L-R) Professor Natasha Phillips, Founder, Future Nurse; Professor Sultan Mahmud, Director of Healthcare, BT Group; Ed Hughes, Chief Executive, Council of Deans of Health

“The only way is ethics”

Much time was devoted to discussions concerning AI – including the ethical implications of using AI to facilitate and deliver healthcare, alongside its use as an educational tool. Sundeep Watkins, an Education Advisor to the Chartered Society of Physiotherapy, said that AI must be there to supplement and inform, not replace, humans’ clinical and critical judgement. With AI promising to play a critical role in diagnostics, treatment, communication and education, ethical considerations must be at the core of AI’s use and embedded in the way that technology users are taught to ensure that data biases or deficits do not translate to unequal or inequitable care delivery.

“In AI datasets, critical information is often missing – and if you don’t know what’s missing, you don’t know what’s missing.”

David Game, SVP Global Product for Medical Education, Elsevier

Regulatory organisations have started to consider how they might apply the right levels of oversight to this rapidly changing environment, confirmed Jamie Hunt, Head of Education at the Health and Care Professions Council. Paul Stern, a Senior Researcher and Policy Officer at the General Osteopathic Council, reiterated the importance of regulatory oversight of AI to ensure equitable access in education. He added that regulators are now working together with a view to developing a cross-sector regulatory framework for AI’s use in education to reduce regulatory overlap.

AI and associated technologies have the potential to be ubiquitous within simulated medical education and training within the next decade, underscoring the need for effective regulation to render their use safe, effective and equitable. Professor Paula Holt MBE, a Senior Adviser for Nursing at the Nursing and Midwifery Council, explained that for nurses-in-training, 600 of the 2,300 training hours required to register can be completed through simulated training, “allowing students to practice and reflect in a safe, and psychologically safe, environment.” Students like simulated training, added Professor Holt, as they feel it offers an equitable practice environment, and can help them learn to deal with difficult, real-world situations like receiving abuse or racism, or a medical emergency.

Panel covering *The pedagogy of AI: implications for healthcare education*

Professor Sharon Weldon, Professor of Healthcare Simulation and Workforce Development at the University of Greenwich, argued that simulation could be a key tool for attracting a newer generation of healthcare professionals, saying that “fewer and fewer, especially young people, want to go into healthcare. Simulation and AI are their worlds, and we have to embrace it to attract these people.”

“AI is now being incorporated into simulated practice learning – this will change quickly, but the driving fundamentals need to be embedded.”

Professor Sharon Weldon, Professor of Healthcare Simulation and Workforce Development, University of Greenwich

Professor Weldon confirmed that in the US, simulated training has reduced the length of training programmes for private nursing students by up to one-third on some cases – something that could be key for workforce pipeline acceleration globally. Simulated training is now being mandated across all nursing training in India, but Professor Weldon argued the need to work collaboratively with industry partners to ensure that these tools truly add value to a medical education.

The final session saw of the day saw NHS England’s National Chief Nursing Information Officer, Helen Balsdon, join National Chief AHP Information Officer, Prabha Vijayakumar, for an audience Q&A. While both were optimistic that innovation will lead to great strides in predictive analytics, prevention and reducing health inequalities, both cautioned that major progress remains difficult without the fundamental basics of data infrastructure and education in place.

“Good technology is one thing, but too much of implementation focuses on the technology and not on people, and then we wonder why implementation is so poor.”

Helen Balsdon, National Chief Nursing Information Officer, NHS England

“Nurses and midwives collect the most data,” said Balsdon, “but we don’t really harness it. We know we’ve got a shortage of nurses, and we need to work differently to address this – digital can help.”

Critical to this is bringing education and practice close together – in simple terms, to ensure that new entrants into the workforce are equipped with the confidence and minimum foundational understanding needed to use technology effectively.

The overriding note from the Digital Health Summit was optimism that AI and associated technologies offer an unprecedented opportunity to transform healthcare delivery and education for all. However, there was evident caution that the pace of technological change has outstripped the ethical, regulatory and legal frameworks that govern our use of them, and there is a clear need to address this lag. To truly harness the potential AI in healthcare, and digital transformation more broadly, collaboration between educators, regulators, and industry leaders must remain a priority—ensuring that technology enhances, rather than hinders, the delivery of safe, ethical, and equitable care.

The Council of Deans of Health have released a Performance Report following the conclusion of the 2025 Digital Summit, which can be viewed here.

Integrate housing and care budgets to tackle extreme health inequalities, says charity

By Integrated Care Journal

Homeless and inclusion health charity publishes solutions to tackle extreme health inequalities, including calling for safe discharge of people facing homelessness, wrap-around care from GPs for people with complex needs, and earlier help for people facing mental health crises.

The Homeless and Health Inclusion charity Pathway UK has published six expert papers setting out practical action plans to address systematic failures in healthcare experienced by people in health inclusion groups, including those experiencing homelessness.

People in inclusion health groups include people experiencing homelessness, Gypsy, Roma and Traveller people, people engaged in sex work, vulnerable migrants and people in contact with the Criminal Justice System.

With their living conditions described as ‘deprivation on stilts’ by Sir Michael Marmot, their health outcomes are typically worse than people living in deprived communities, driving additional pressure on the NHS. People facing homelessness are admitted six times more often to hospital than people who do have homes.

Written by experts in the field of inclusion health, the six papers highlight existing good practice and set out clear policy solutions based on NICE guidelines to tackle major shortcomings in health, housing and social care services which contribute to the poor health outcomes and early mortality experienced by health inclusion groups.

As the government formulates its new homelessness strategy and NHS 10-Year Plan, the charity’s recommendations align with government’s vision which focuses on three transformative shifts: moving care from hospital to community, embracing digital innovation, and prioritising prevention over treatment.

Alex Bax, CEO of Pathway, said: “We are at a turning point in the long and proud history of our National Health Service. These papers show how choices could be made across the NHS to reverse the inverse care law, tilting time and resource towards those who need it most.”

The six authors, Dr Verity Aaminah, Gill Taylor, Dr Chris Sargeant, Dr Jenny Drife, Samantha Dorney-Smith and Gill Leng, set out comprehensive, evidence-based recommendations to achieve this change, which include:

Introducing local integrated budgets covering both care and homes to enable improved planning and delivery
Establishing a network of specialist hospital teams and a hospital safe discharge programme to prevent discharge from hospital to the street
Reforming funding mechanisms for general practice to allow the complex, holistic work that people facing extreme health inequalities require

Dee O’Connell, Pathway’s Director of Programmes, said: “The pressures currently facing our health, housing and care services are huge. But the good news is that our practical policy solutions will tackle the systematic failures that have persisted for so long and which previous policy interventions have failed to solve. It’s now time to stop researching and time to take action.”

The human element in digital transformation: Insights from a CNIO

By Janet Dodd

Building trust, empowering teams, and balancing innovation with patient care are key to successful digital transformation in healthcare, writes Janet Dodd, Chief Nursing Information Officer at Sheffield Children’s NHS FT, who will speak at Digital Health Rewired 2025

As the NHS continues its digital transformation, it’s clear that the promise of technology to improve patient outcomes and streamline processes hinges on more than just the systems themselves. From my experience leading digital initiatives in paediatric care, I have come to understand that successful implementation lies in relationships—relationships between clinical leaders, frontline healthcare workers, and our children and young people and their families. At the heart of this transformation is the recognition that digital systems must not only enhance healthcare processes but must also support the people who use them.

The critical role of clinical leadership

Effective digital transformation cannot be led solely by IT specialists or senior executives; it requires engagement and ownership at all levels, from the clinical team to design and build, to testing and implementation. This engagement ensures that systems are fit for purpose and improves engagement, manages expectations and enables systems to be used to their optimum.

When leadership is inclusive and collaborative, it makes digital transformation feel less like it is being enforced; it should be a change done with colleagues rather to colleagues. This reduces the risk of resistance to change and suboptimal usage, as digital systems are only as good as the people who use them, and the data entered.

Visibility and support are key to trust

One of the most valuable lessons I’ve learned throughout my career is that visibility is paramount. During the rollout of new digital systems, it is really important that the clinical digital team are present, visible, and approachable. This means showing up during early mornings, late nights, and being available for troubleshooting at the bedside when needed. By committing to support our teams in real-time, we can ensure that our clinical colleagues feel safe and can address issues quickly and effectively, enabling them to continue with clinical care. This not only solves immediate problems but also helps build confidence in the system and allow its full potential to be realised. Our superusers have enabled us to provide support over night shifts and weekends which ensures equitable support across all shifts.

Balancing digital innovation with the human touch

While digital tools have great potential in healthcare, they don’t replace the human element of care. One of the most significant challenges in digital transformation is that the clinical decision-making support built into digital systems will not take away all risk of error. It is vital that we remind ourselves that these tools should enhance, not diminish, our clinical knowledge, judgement and ability to care for patients.

We need to ensure that digital innovation supports our ability to focus on what matters most: the well-being and outcome of our children and young people.

The path to complete digital integration

Full digital integration has been a phased approach within our organisation. The aim is to create a system where digital documentation and systems integrate into daily workflows, improving both clinician efficiency and patient outcomes. While we are not there yet, we have laid great foundations for a future where data is easily visible across teams and systems to improve communication, coordination and care delivery.

I have seen how digital documentation can improve communication, streamline processes and reduce errors, but it requires a consistent commitment to embed and optimise how systems are used, to realise their benefits and potential.

Harnessing the power of emerging technologies

As we look toward the future, emerging technologies such as AI and transcription tools offer tremendous promise. AI has the ability to generate patient information, automate administrative tasks, and even transcribe meeting notes, all of which save time and reduce human error. But with great power comes great responsibility. To unlock the full potential of these tools, we must ensure that they are governed by strong policies, used ethically, and continuously improved to meet the needs of clinicians and patients alike.

This means rigorous training, oversight, and a commitment to iterative learning. It’s not enough to introduce these technologies; we must work alongside them, including well after implementation, to ensure they complement the work of our clinical teams.

Collaboration and overcoming resistance

Collaboration is essential for digital transformation to be successful. Networking across trusts or within individual organisations, the sharing of best practices, lessons learned, and strategies for overcoming challenges, are invaluable. Paediatric care, in particular, benefits greatly from collaboration, as it allows us to ensure consistent standards across the NHS and learn from each other’s successes and lessons learnt.

One of the biggest barriers to digital adoption remains anxiety among clinicians who are accustomed to paper-based systems. This is especially true for experienced professionals who have worked for many years with paper processes. The key to overcoming this resistance is providing training, hands-on support, and clear communication about how digital systems will enhance—not replace—their roles. Building trust at the executive level and conducting thorough safety and risk assessments will also go a long way toward making digital adoption feel safer – less of a threat and more of an opportunity.

Looking to the future

As we move forward, I am optimistic about the future of digital transformation in the NHS. In the next four to five years, I believe we will see AI, integrated systems, and enhanced digital tools redefine workflows and improve patient care delivery. But the key to this transformation is balance—ensuring that technology enhances the work of clinicians without undermining and taking away from the personal touch that defines patient care.

The journey ahead will be iterative, and the challenges will remain. But with strong leadership, collaboration, and a commitment to putting people first, the digital future of healthcare is one we can all embrace.

I look forward to sharing more of these insights and experiences at the upcoming Digital Health Rewired Conference on 18-19 March 2025.

Janet Dodd is Chief Nursing Information Officer at Sheffield Children’s NHS FT

Managing the rising tide of polypharmacy

By Sima Jassal and Meera Parkash

Sima Jassal, Clinical Director at EMIS Health, and Meera Parkash, Senior Clinical Facilitator at Optum, outline the key findings from a new Optum white paper looking at how integrated care systems can strengthen their approach to managing polypharmacy and addressing cases of harmful overprescribing.

The increasing costs, complexities and clinical safety risks associated with polypharmacy make it an important issue for the NHS to address in 2025.

Around 40 per cent of people over 65 are on five or more medications today. Of these, between 10 per cent and 30 per cent experience adverse drug reactions, and nearly half are non-adherent. It is thought that the cost of adverse drug reactions alone could exceed £2.2 billion per year, while £300 million is wasted annually on unused medicines.¹ Thousands of preventable hospital admissions also happen every year due to complications related to medicines.

These numbers are likely to rise further as our population ages over the next few decades – so how do we start to manage this rising tide of polypharmacy and prevent more cases of harmful overprescribing in the years ahead?

Five key challenges

Optum recently facilitated a workshop at the HSJ’s ICS Medicines Forum, bringing together healthcare professionals from across England to explore the challenges and potential solutions.

What became clear is that polypharmacy is a complex, multi-faceted issue – and that there are no quick fixes. However, our discussions did arrive at five strategic challenges that need to be addressed.

These are discussed fully in our new white paper Connecting the dots: Action on polypharmacy and overprescribing – this blog provides a brief overview of each challenge.

1. The technology challenge – delivering a more connected picture for practitioners

First, we heard that one of the biggest challenges that practitioners face is accessing comprehensive, up-to-date patient information. When there is poor join-up between different healthcare record systems, it can be difficult for pharmacists and other primary care and community-based teams to get a full picture of a patient’s medication history, particularly when patients are treated across multiple settings.

Delegates therefore called for a new generation of digital solutions that enable better integration of patient information across different care settings. This would give pharmacists a more joined up and connected picture of the patient’s clinical history, making it easier to assess whether changes to a patient’s medication are necessary. Mobile technologies for community-based teams were also felt to be essential for putting this information into the hands of those working remotely.

2. The data challenge – setting the parameters for success across the system

Linked to this, many respondents also highlighted difficulties getting hold of reliable and meaningful data to shape decision-making. This was sometimes due to incomplete or inaccurate reporting, or technical challenges involved in navigating IT systems to drop down the right data. In some cases, practitioners also resorted to collecting their own data manually via spreadsheets – a ‘make-do-and-mend’ approach because they couldn’t access the right tools to help them.

At the other end of the spectrum, there was also concern about data overload, with too many competing dashboards and datasets. This led to an important discussion about how we develop a meaningful and consistent way of describing what success looks like and how we measure it. As well as improving data systems and tools, the conclusion therefore was that we need more consistent ways of measuring impact, specifically by agreeing common metrics to assess whether interventions are delivering against a given strategy.

3. The people challenge – putting patients at the heart of the process

Deprescribing is a deeply human process involving sensitive, nuanced judgement calls to balance the risks and benefits of changing a person’s medication. Practitioners need to understand the reasons behind a patient’s medication use, their health goals, and their preferences so that they can arrive at a solution that’s best for each individual.

In our discussions, we heard some inspiring examples of good practice – one that sticks out was the role of outreach professionals going into people’s homes to address medication issues in a way that reflected not just clinical considerations but the wider social and environmental factors shaping their health. However, it’s also clear that cultivating these deeper, human interactions to achieve personalised care becomes increasingly difficult when resources are strained.

Respondents described breakdowns in communication between healthcare professionals, particularly at point of transfer, resulting in conflicting advice or missed opportunity to deprescribe. They emphasised too that the process of deprescribing itself can also take time and energy to fulfil – and so, just as there is the New Medicines service to support patients on new medications, some questioned whether a Deprescribing Medicines service may be needed too.

4. The pathways challenge – ensuring continuity of care

A related challenge was the need for better continuity of care, particularly during transitions such as hospital discharge or in cases where patients straddle multiple care pathways. Delegates discussed the importance of having multidisciplinary teams (MDTs) and case management models to ensure better coordination.

Regular structured medication reviews (SMRs) were deemed critical for ensuring that medication is optimised as patients move through the system, while stronger communication between healthcare professionals and close monitoring during transitions were needed to help patients get the joined-up care they need.

To achieve this, delegates felt that funding and contractual models needed to be better aligned with the goal of reducing overprescribing and improving medication safety, so that organisations are incentivised to support patients throughout their care journey.

5. The training challenge – enhancing deprescribing skills

Finally, some professionals felt underprepared to manage polypharmacy and overprescribing challenges effectively. As one delegate put it during the conference: “Pharmacists are taught how to prescribe, but not how to deprescribe.”

Respondents highlighted the need for more robust training that focused not just on the clinical aspects of deprescribing, but on strengthening the interpersonal skills necessary to support shared decision-making with patients. Practitioners, in short, needed the right knowledge and capability to determine when deprescribing is appropriate, understand its impact, and identify and engage patients using population health management principles.

How Optum can help

At Optum, we understand that technology alone won’t solve all the challenges facing pharmacy and medicines management teams today. However, we believe that digital solutions can play a critical role in helping manage workload pressures and overcome some of the barriers preventing action on overprescribing.

Our Population360® product is designed to integrate with GP clinical records, helping pharmacy teams to rapidly stratify the patient population according to risk and identify patients who may benefit from proactive interventions. By streamlining these processes, Population360® allows pharmacy professionals to focus on helping patients get the most appropriate and effective medicines for their needs.

To find out more about how Population360^® can support your organisation, contact us at askoptum@optum.com

You can also download our full white paper, Connecting the dots: action on polypharmacy and overprescribing

This article was prepared by Sima Jassal and Meera Parkash in a personal capacity. The views, thoughts and opinions expressed by the author of this piece belong to the author and do not purport to represent the views, thoughts and opinions of Optum.

1. Source: Evaluation_of_NHS_Medicines_Waste, ©YHEC/School of Pharmacy, University of London

Featured, Health Inequality, News, Thought Leadership February 6, 2025

The fundamental inequalities in women’s health

By Jane Johnston LFEPID

Jane Johnston, Co-CEO of the Association of Professional Healthcare Analysts (AphA), discusses the decision to drop Women’s Health targets from the latest NHS planning guidance, and its impact on persisting inequalities in women’s health.

The latest NHS planning guidance was released last week. But that’s not what I’m going to write about today; I thought I’d bring to your attention to the decision to drop Women’s Health targets from the NHS plan.

It was mooted a week or so ago that this was because there was concern that the NHS gives in too easily to interest group lobbyists. I don’t see that 51 per cent of the population is an ‘interest group’ – they are actually pretty important if we want to reduce inequalities and reduce costs of long-term care through preventative medicine and appropriate treatments and interventions. But the reason, we are assured, is because the target for Women’s Health hubs in every system achieved 93 per cent (39 out of 42) in 2024/25 and therefore need not be repeated in this year’s guidance.

However, a recent poll shows that 18 per cent of women had reduced their working hours or left the workforce because of Women’s Health related issues. Of those, 39 per cent said they would definitely have been able to stay in work or maintain their hours if they had had better access to timely and effective healthcare. Half of the respondents said they had suffered dismissive, discriminatory or harmful treatment at the hands of the NHS.

So perhaps Women’s Health targets need to be reassessed and included in the NHS plan.

Inequalities in research matter

But planning guidance and women’s health hubs aside, there is still an alarming amount of inequality in Women’s Health. This is not just about health hubs and services – it’s much more fundamental than that.

I’m talking about scientific research, drugs, medical devices and lived experience. I would like to present the case for why biology is important because in the treatment of diseases; it’s the biological sex that counts – XX chromosomes, in the case of females.

Let me give one brief example of why the biological sex overrules the gender a person has chosen to identify with. 76 per cent of cell cultures used in lab research are male, i.e. XY chromosomes. In the USA, a five-year cohort study into road traffic accidents involving a high proportion of women found the common factor that many were taking medication for insomnia. It was discovered that the female metabolism metabolises slower than the male metabolism. Yet still, in some cases it took more than two decades for sex-specific doses to be considered. How many more drugs out there are over-medicating women with doses continually optimised for men?

Previous studies on the benefits of aspirin for heart health were optimised for males. Yet, more women die from heart disease in the UK than men. And over a decade, 72 per cent of drugs were introduced to the market without data on pregnant or breastfeeding women, the default advice being to “ask your GP”, who often didn’t know any more than the patient. Women experience five times more side effects from drugs than men – is this because more than 60 per cent of clinical trials are on men? Even in animal testing, using males is the default.

Endometriosis has been cured twice in animals but in human trials it has failed, arguably because scientific discovery which is male based often does not work when translated into human females.

The are of course some amazing examples of funding, and rightly so, for research into horrific diseases such as cancer. Breast cancer research specifically gets 10 times more funding than research for female-specific heart disease. However, twice as many women die from heart disease than do from breast cancer.

Lack of suitable treatments

One thing that is a certainty for all women is menstruation, or problems with menstruation. One in eight women of working age took time off work last year because of symptoms, increasing economic burden through lost productivity.

10 per cent of women suffer adenomyosis where the endometrial cells invade the muscular cells of the uterus. This causes extreme pelvic pain. Often there are no diagnostics and no treatments, so patients are prescribed long-term pain medication or, in some cases, have a hysterectomy. Fibroids are another common occurrence in 70-80 per cent of women, although less than half are debilitated by them and 30 per cent end up having surgery to remove them, or a hysterectomy.

10 per cent of women suffer endometriosis, but again, there is no cure, so they are prescribed long-term painkillers, hormone treatments, surgery to cut away the affected areas, or a hysterectomy. Then there is the lesser discussed pelvic congestion syndrome causing chronic pelvic pain. 49 per cent of gynae appointments are because of pelvic pain and 30 per cent of these are likely pelvic congestion syndrome. As it is difficult to diagnose because of similarity of symptoms to all of the above, the patient is usually given painkillers, hormone treatments or of course, the default hysterectomy. 20 per cent of women in the UK will end up having a hysterectomy at some point.

This is mainly because research does not invest enough in diagnostics, drugs, or devices specifically tailored to Women’s Health. Only 2 per cent of funded research is for pregnancy, childbirth and female reproductive health. Over half of the population suffer conditions specific only to them, yet only 2 per cent of research is dedicated to trying to find cures and treatments for women. The other half have 27 per cent of research dedicated to male-only health and the rest, we know, is optimised for men.

One shocking example of underfunding in research for medical devices for women, is vaginal stents for paediatric surgery, where little girls are operated on because of e.g. tumour removal, trauma or birth defects. There is no such thing as a paediatric vaginal stent. Surgical gloves are stuffed with gauze and inserted to maintain integrity. There have been amazing advancements in medicine and medical devices, yet something as simple as a paediatric vaginal stent is yet to be made readily available.

There is also the very real problem of medical gaslighting. Women tend to go to the doctor a lot more than men, because they are suffering extreme, sometimes chronic, pain, regular excessive and debilitating blood loss with associated fainting nausea and vomiting. But more often than not, they’re made to feel that they’re overreacting, just being oversensitive and there’s nothing really wrong, it’s just part of being a woman.

Among countless documented examples, I have also heard heart-breaking first-hand accounts from female clinicians, who in pregnancy, have voiced their concerns about their unborn child to both male and female doctors, only to be dismissed as overthinking due to their medical background—only to later suffer a stillbirth. They knew their bodies but were persuaded otherwise.

Another first-hand experience was told to me by a colleague, a senior nurse of many years’ experience, who suffered pelvic congestion syndrome. She was prescribed the usual treatments of long-term painkillers and hormones. After being bedbound with pain and finally being offered a hysterectomy, she did her own research and ended up paying privately for scans and ultimately vein embolisation, a minimally invasive day case procedure that according to the private consultant, is frequently overlooked in the NHS. These were women who were trained in medicine. How the rest of the population can possibly feel they can speak up against such gaslighting or have the knowledge or confidence to research their options is worrying.

Inequalities impact the NHS

A consequence of underfunding of research into female-specific diseases in comparison to the burden of diseases, apart from the economic burden, is the cost to the NHS is in terms of long-term medication and preventable surgery. Not to mention mental health services, as some women who have lost a child or who are living with chronic pain, or who find it difficult to come to terms with hysterectomy, will require support through therapies.

And considering the number of hysterectomies being performed, studies show that the long-term consequences indicate potential associations with increased risk of cardiovascular disease, metabolic issues like diabetes and high cholesterol, osteoporosis, depression and even certain cancers and possibly even Alzheimer’s. What is the downstream cost to the NHS for these potentially preventable co-morbidities?

So, if we’re really about reducing inequalities and looking at preventative medicine, better treatments and reducing costs, then maybe we need to start at the bottom, with the building blocks of medicine. By investing more in women’s health, the 39 out of 42 women’s health hubs can provide cutting edge, optimised care, reducing pressures on the system and vastly improving women’s health outcomes and experience.

I would like to thank Brittany Barreto, Ph.D., author of of Unlocking Women’s Health, FemTech & the Quest for Gender Equity for inspiring me and sharing global research stats with me.

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AXREM publishes AI manifesto

By Integrated Care Journal

Association for Healthcare Technology Providers for Imaging, Radiotherapy and Care calls for collaboration on clear and consistent AI innovation to reduce duplication and risk while maximising benefits.

AXREM, the Association for Healthcare Technology Providers for Imaging, Radiotherapy and Care, has called for policymakers, NHS leadership, and AI developers to collaborate on clear, consistent innovation pathways that support the responsible scaling of AI technology in healthcare. In its AI manifesto, AXREM calls on the NHS to avoiding duplication in compliance and validation and to take a balanced approach to risk stemming from the use of AI.

AXREM is the UK Trade association representing the interests of suppliers of diagnostic medical imaging, radiotherapy, healthcare IT and care equipment including patient monitoring in the UK. AXREM members supply the majority of diagnostic medical imaging and radiotherapy equipment installed in UK hospitals. Its member companies and their employees work alongside Radiologists, Radiographers and Practitioners, Oncologists and a wide range of healthcare professionals in delivering healthcare to patients using its technologies.

AXREM’s members have always driven innovation in imaging and oncology. Since 2020, the AI Special Focus Group have been champions of promoting the responsible adoption and upscaling of artificial intelligence and machine learning enabled diagnostics. The group comprises most of the AI providers in the radiology market who innovate by providing research and development to improve accuracy and workflow in the diagnostic portions of care pathways.

The challenges of healthcare delivery are well known, including workforce shortages, increasing demand for services and a real risk of staff burnout. In their 2023 census, the UK Royal College of Radiologists calculated that there are 30 per cent fewer radiologists than needed to meet demand, estimated to rise to 40 per cent by 2028. These are placing immense pressure on healthcare systems. Innovation is needed, not for its own sake, but to help address these challenges and to enable healthcare professionals to focus on higher-value caring tasks instead of wrangling large amounts of information.

The manifesto recognises the UK healthcare system is currently complex, with much duplication of effort. A more consistent approach to innovation for AI is needed if it is to be adopted at scale. The manifesto touches on Innovation: bridging the gap, Ensuring Trust and safety, Regulation and compliance Protecting information, Policy and data access challenges, Practical deployment – balancing risk and more.

Graham King, Solutions Architect at Annalise.ai, Convenor of the AXREM AI Special Focus Group, and one of the authors of the document, said upon its release: “We welcome many positive moves forward on AI in radiology and oncology from the NHS across the UK nations. Our manifesto addresses areas where our members are still experiencing duplicated effort and proposes solutions to help scale the much-needed adoption of AI assistance.”

AXREM Chairman, Huw Shurmer, said: “AI is a powerful tool that will undoubtedly support and address many of the pressures facing the health service. I am pleased to see our members taking on responsibility to set out a clear understanding on how this solution can expand in a safe, regulated and consistent way.”

Sally Edgington, AXREM Chief Executive Officer, said: “I am really pleased the AI SFG have worked collectively, so hard on this manifesto. The group have been very active since we launched it and this manifesto makes clear that we need to work with NHSE, DHSC, MHRA and many other organisations to collaborate and ensure safe adoption, but adoption at scale, as this really can help create efficiencies in the system, at a time when the NHS really needs them.”

You can read the manifesto in full here.

NCA whitepaper outlines ‘critical’ challenges facing adult social care

By Integrated Care Journal

The adult social care system’s funding shortfall could reach £18.4bn within a decade, according to a new whitepaper from the National Care Association and HCR Law.

The adult social care sector in the UK is facing a critical financial crisis, as outlined in a recent whitepaper that examines key challenges through the lenses of funding, workforce, and regulation. The whitepaper, Adult social care: Steering through change, was published by the National Care Association (NCA) in partnership with HCR Law. It paints a stark picture of a sector struggling to stay afloat, with urgent reforms needed to prevent widespread collapse.

The whitepaper explores three critical areas – funding, workforce and regulation – proposing immediate and long-term strategies to address the challenges and to create and thriving, robust sector. Emphasising the intricate web of the adult social care landscape, the report underscores the need for a unified, cross-party approach to implement meaningful changes, and welcomes the recent announcement of the independent commission led by Baroness Louise Casey.

Nadra Ahmed, CBE, Executive Co-Chairman of the NCA, said: “Despite the challenges we face, we have the appetite to ensure that we start to consider and put forward solutions. The paper considers how to overcome the challenges and create a thriving, robust sector which is fit for purpose. It reconfirms the sector’s commitment to playing our part in overcoming the challenges and delivering the rewards.”

Funding crisis threatening sector’s viability

At the heart of the sector’s instability is a glaring funding gap. The Health Foundation estimates an annual shortfall of £8.4 billion, leaving care providers unable to cover basic operational costs, let alone invest in improvements or expansions. This financial strain has already led to bankruptcies and a reduction in available care placements.

Citing the Nuffield Trust, the report argues that the 2024 Budget exacerbated the problem, adding an estimated £2.8 billion in costs to independent care providers. While the planned National Living Wage increase from April 2025 is a positive step for worker compensation, it adds further pressure to an already fragile financial ecosystem. Projections indicate that without significant intervention, the funding gap could grow to £18.4 billion by 2032/33.

Workforce shortages hitting care quality

The sector employs 1.6 million people, representing 5.8 per cent of the UK workforce. The report stresses that years of low pay and worsening working conditions have led to the sector’s high turnover and difficulty recruiting and retaining workers. The Budget, it argues, has worsened these issues, increasing the risk of safeguarding issues that local authorities must manage.

The report stresses that passion alone cannot sustain the workforce; substantial government investment is required to implement the Skills for Care workforce strategy, which aims to elevate social care as a respected and viable career. Alongside this, the report also calls for development of robust career paths, creation of coaching and networking opportunities – and the empowerment of experienced staff while developing the next generation of care workers.

Looking further ahead, the paper supports the notion of a National Care Service. It argues that although the care industry is already interconnected, a fully integrated system incorporating local care services could provide significant, long-term benefits. The proposal aims to create a cohesive and efficient care system which can better serve the UK.

Regulatory inconsistencies erode public trust

Regulation, critical for maintaining care standards, is another area of concern cited in the whitepaper. It criticises the CQC for inconsistent inspection quality and a lack of public confidence in its ability to enforce high standards. Variations in local government oversight further complicate the regulatory landscape, undermining efforts to safeguard service users. The report suggests that comprehensive reform of the CQC, or even the creation of a new regulatory body, may be necessary to restore trust and accountability.

Rebecca Leask, Partner and Head of Healthcare at HCR Law, commented: “In our work, we see the challenges and opportunities faced by all stakeholders in social care and support, from local government and public sector bodies to private and public care providers. We see firsthand their dedication and passion for their work. We take great responsibility knowing the work we do in advising our clients in this sector helps them navigate these challenges and seize opportunities, enabling them to continue delivering for service users and taxpayers alike.”

The whitepaper is available to download from HCR Law.

Patients increasingly want access to personalised medicine, research finds

By Integrated Care Journal

Nearly two-thirds of UK adults believe that access to both standard and personalised medicine is important, as more than a third of UK adults say standard GP-prescribed medicines often fail to meet their health needs.

New research reveals over a third (36 per cent) of UK adults report that standard GP-prescribed medicines often fail to meet their health needs, leaving both patients and their healthcare providers searching for better solutions. The findings, released by Roseway Labs, a private compounding pharmacy specialising in personalised medicines, underscore the opportunity for personalised medicine to fill critical gaps in care.

Healthcare professionals on the front line see daily the challenges of overwhelmed GP services and mounting patient dissatisfaction with standardised treatment options; for patients, more than a quarter (28 per cent) feel resigned that 2025 won’t bring solutions for their health conditions.

The research underscores the potential of personalised medicine to tackle these pressing issues and highlights the growing demand for this choice. 73 per cent of people expressed openness to using a pharmacy that personalises medicines and supplements to better address their health concerns. While compounded medicine is accessible through private care, the findings indicate a growing number of NHS patients want access to greater choice over the medicines they use.

Additionally, 58 per cent believe having the option between standard and personalised medicines is important, rising to 80 per cent among Gen Z and 76 per cent of millennials. The demand for personalised care among younger generations is likely to grow as they age and encounter age-related conditions, highlighting the need for a step change now to ensure future healthcare options meet their evolving expectations.

The government’s cash incentive scheme highlights the urgent need for innovative solutions to alleviate growing GP and hospital waiting times. Compounding pharmacies like Roseway Labs can help ease this pressure by providing personalised treatments that address individual needs and reduce repeat GP visits caused by ineffective standard prescriptions. The average 10-minute face-to-face GP consultation currently costs £56, so it is hoped that providing more effective treatments first time will reduce the need for repeat GP visits, saving costs and alleviating pressure on general practice and wider primary care.

For healthcare professionals unfamiliar with compounding or personalised medicine, safety is paramount. All processes comply with the General Pharmaceutical Council (GPhC) guidelines and the Human Medicines Regulations 2012, ensuring all compounds are made exclusively from valid UK prescriptions as a fully regulated pharmacy.

Skin conditions and allergies are good examples of where compounded medicines can help patients. Simply changing the medication’s form – from pill to liquid – or removing certain ingredients in the pill that are allergenic, can be the difference between a patient finding relief from an allergy or even being able to take their medication as prescribed.

Miriam Martinez Callejas, Superintendent Pharmacist and Founder of Roseway Labs, commented: “With an ageing population and growing demand for tailored care among Gen Z and millennials, personalised medicine provides an essential option for those whose needs aren’t met by standard treatments. Often likened to the Savile Row of medicine, compounded treatments offer custom dosages, formulations, and combination of ingredients, much like a tailored suit fits where off-the-rack clothing cannot. Our goal is to collaborate with GPs and healthcare professionals to make personalised medicine a key part of future healthcare innovations in the UK.”

Compounding pharmacies play a crucial role in addressing medication shortages by formulating alternative solutions when commercially available drugs are unavailable. They can create customised doses, replicate discontinued medications, or offer equivalent treatments, ensuring patients have access to the care they need without interruption.

Elizabeth Philp, CEO and Founder of Roseway Labs, commented: “A one-size-fits-all approach often fails to address the complexities of individual health needs, leaving many patients feeling despondent about their future. While regular prescriptions work well for some, others face challenges such as inadequate symptom relief, adverse effects, or difficulty adhering to treatment plans. Personalised medicine can complement NHS treatments and care, offering tailored solutions that empower patients and help them lead healthier lives.”

AI software tool aims to use high street eye tests to spot dementia risk

By Integrated Care Journal

First-of-its-kind collaboration offers potential for “step change” in the early detection of dementia, using routine eye scans to gain deeper insight into brain health and monitor cognitive decline.

Data scientists and clinical researchers are working with high street opticians for the first time to develop a digital tool that can predict a person’s risk of dementia from a routine eye test.

The NeurEYE research team, led by the University of Edinburgh, with Glasgow Caledonian University, has collected almost a million eye scans from opticians across Scotland, forming the world’s largest data set of its kind.

The scientists will then use artificial intelligence and machine learning to analyse the image data, along with relevant patient data on demographics, treatment history and pre-existing conditions. This data is anonymised and patients can’t be identified, but it allows researchers to find patterns that could indicate a person’s risk of developing dementia, as well as giving a broad picture of brain health.

Permission to use the data comes from the Public Benefit and Privacy Panel for Health and Social Care, a part of NHS Scotland.

The project is the second funded and supported by NEURii, a first-of-its-kind global collaboration between the pharmaceutical company Eisai, Gates Ventures, the University of Edinburgh, the medical research charity LifeArc and the national health data science institute Health Data Research UK. Together, the partners are giving innovative digital projects the chance to become real world solutions that could benefit millions of patients with neurodegenerative conditions like dementia. The first NEURii project, SCAN-DAN, is using brain scans and AI to predict dementia risk.

Retired mechanical engineer, David Steele, 65, whose mum has Alzheimer’s, said predictive software like this could have saved his family ten years of heartache and struggle. He said:“It took ten years for my mum to be diagnosed with Alzheimer’s.

“She was initially diagnosed with dry macular degeneration, but this masked the underlying issue that we now know to be cerebral blindness linked to Alzheimer’s. The connection between brain and eye was the missing link in her case.

“The missing diagnosis meant that my late father, who was also elderly, cared for mum throughout a difficult period without knowing what was wrong.

“If we had known, then we would have had help with the additional and demanding support that became necessary. Preventing the cliff edge, when it becomes too late for the person to understand what is wrong with them, is so important.”

Professor of Clinical Ophthalmology at the University of Edinburgh and NeurEYE co-lead, Baljean Dhillon, said: “The eye can tell us far more than we thought possible. The blood vessels and neural pathways of retina and brain are intimately related. But, unlike the brain, we can see the retina with the simple, inexpensive equipment found in every high street in the UK and beyond.”

Optometrists will be able to use the software subsequently developed as a predictive or diagnostic tool for conditions such as Alzheimer’s, as a triage tool to refer patients to secondary health services if signs of brain disease are spotted, and potentially as a way to monitor cognitive decline.

Identifying people at risk of dementia could also accelerate the development of new treatments by identifying those who are more likely to benefit from trials and enabling better monitoring of treatment responses.

And being aware of a risk of dementia could also help individuals and medical professionals modify the risk through lifestyle changes such as physical activity and diet, according to a Lancet Commission, which added vision loss this year as one of its dementia risk factors.

Optometrist Ian Cameron, who runs Cameron Optometry in Edinburgh, said: “Optometrists as primary carers is not a new thing, and in Scotland we’re becoming an increasingly allied part of the NHS. We see the same people year on year, whether they’re ill or not, we have all the right equipment, so it makes sense for us to be the GP of the eyes and monitor as much health as we can see.

“What is new is that, with AI, we can see even more, and that is extremely powerful.”

Professor of Computational Medicine at the Usher Institute and NeurEYE co-lead Miguel Bernabeu said: “Recent advances in artificial Intelligence promise to revolutionise medical image interpretation and disease prediction. However, in order to develop algorithms that are equitable and unbiased, we need to train them on datasets that are representative of the whole population at risk. This dataset, along with decades-long research at University of Edinburgh into ethical AI, can bring a step change in early detection of dementia for all.”

Dr Dave Powell is Chief Scientific Officer at LifeArc, one of the NEURii collaborators. Speaking on behalf of the partners he said: “Harnessing the potential of digital innovations in this way could ultimately save the NHS more than £37m a year because the hope is that it will speed up the diagnosis and treatment of neurodegenerative conditions like dementia.

“The UK, with its single healthcare provider, is also well placed to become a global leader in the development of new tests that use health data. This is why we are collaborating to advance promising digital health projects that have the potential to improve millions of lives.”

The data will be held safely in the Scottish National Safe Haven which provides a secure platform for the research use of NHS electronic data. This resource is commissioned by Public Health Scotland and hosted by the Edinburgh International Data Facility through EPCC at the University of Edinburgh.