Workforce planning programme underway at Countess of Chester Hospital NHS FT

By Integrated Care Journal

A major workforce optimisation programme has started at the Countess of Chester Hospital NHS Foundation Trust in partnership with workforce planning specialists, SARD.

A new workforce optimisation programme has commenced at the Countess of Chester Hospital NHS Foundation Trust. The programme will seek to engage with the Trust workforce to gain a greater understanding of clinical capacity and demand, and empower teams to make more informed decisions about workforce planning. This work will support optimised service delivery, safe and efficient patient care and adequate resourcing to promote staff wellbeing.

Discussing why the project was initiated and the progress so far, Dr Nigel Scawn, Medical Director at Countess of Chester Hospital NHS Foundation Trust, said: “Like many NHS hospitals, we are seeing a rise in demand for our services – coupled with an ageing population who have more complex health needs – so this project is a key part of our workforce strategy which will help to transform services to meet the future change in needs of local patients.

“We’ve completed the discovery and diagnostic phase, which included working with transformation leads, HR teams and our medical workforce to agree plans, review current policies, share SARD methodologies and understand their requirements.

“It’s been a complex, but critical, exercise because every specialty is unique and runs itself slightly differently. Information has been gathered from 303 job plans across the Trust’s 30 specialties and fed into a diagnostic report.”

Over the next twelve weeks, the Trust will focus on the core part of the programme by working closely with clinical consultants to make enhancements to job plans and processes that are aligned with capacity and demand. The process will also involve benchmarking job planning against other NHS Trusts in England.

Dr Scawn added: “At this stage, it’s about piecing all the information together to create a fuller picture of capacity and demand, which we can use to drive informed decisions and decide what resource we need and where. Ultimately, we’re looking to remove some of the peaks and troughs in our capacity and ensure we’re sufficiently resourced and distributed across our clinical areas. This balanced approach will help us make sure we’re using our resources effectively.”

Insights from the programme will support Countess of Chester Hospital NHS Foundation Trust to plan better for future demand. The proactive approach will enable the Trust to devise clear and strategic recruitment plans, especially in areas where demand is anticipated to increase in the short-to-medium term.

In addition, greater oversight and improved job planning capabilities will support the Trust to reach the advanced levels of attainment for medical job planning set by NHS England. The framework ranges from level 0 to level 4 and published data from NHS England indicates that the national average is currently at 0.6. The Countess of Chester Hospital NHS Foundation Trust is expected to be at level 3 on completion of the project.

The Trust also intends to share the outputs and learnings from the work with NHS England to help build a national picture and inform policy and planning.

Phil Bottle, Managing Director at SARD, said: “The Countess of Chester Hospital NHS Foundation Trust’s commitment to redefine its job planning and transform operations is abundantly clear. The Medical Director, Nigel Scawn, and his team are fully embracing new ways of working to resolve long-standing challenges with workforce planning that many NHS trusts are facing. They are demonstrating that best practice goes beyond just deploying job planning systems.

“During the discovery stage, the engagement from the medical workforce has been fantastic and there is a desire to create positive change across the Trust. SARD’s ethical approach to workforce planning is led by service, staff wellbeing and sustainability so we are perfectly aligned with Countess of Chester Hospital NHS Foundation Trust to deliver an effective long-term job planning solution that supports safe and effective patient care. We’re looking forward to helping the trust optimise its workforce planning in the same way we have supported other NHS Trusts including Oxleas NHS Foundation Trust and Cornwall Partnership NHS Foundation Trust.”

The workforce strategy at the Countess of Chester Hospital NHS Foundation Trust is part of an overall improvement programme across the Trust, focusing on improved care for patients and families and a greater emphasis on staff wellbeing. The Trust has three hospitals – The Countess of Chester Hospital, Ellesmere Port Hospital and Tarporley War Memorial Hospital – and provides services to 420,000 people across West Cheshire.

The project is set to be completed by April 2025.

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AXREM hosts event celebrating women in health and care

By Integrated Care Journal

AXREM, the trade association representing the suppliers of diagnostic medical imaging, radiotherapy, healthcare IT and care equipment in the UK held an event to mark International Women’s Day.

AXREM has championed women in health and care during International Women’s Day for several years, but this year elevated its celebration further by hosting an event at The Florence Nightingale Museum at St Thomas’ Hospital, London.

On the eve of International Women’s Day 2025, in an aptly chosen venue, AXREM hosted more than 60 key industry female opinion leaders and key stakeholders.

There was a full programme of speakers including an actor as Florence Nightingale talking about her work, a video address from Baroness Merron, Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health at the Department of Health & Social Care; Preeya Bailie Director of Central Commercial Function, Commercial Directorate at NHS England; Saduf Ali-Drakesmith, Head of Sales at Smart Reporting & Vice Convenor of the Imaging IT SFG; Yasmeen Mahmoud, Business Manager HPM UKI at Philips Healthcare; and Kath Halliday, President of the Royal College of Radiologists.

Florence Nightingale was an English social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during the Crimean War, in which she organised care for wounded soldiers at Constantinople. She significantly reduced death rates by improving hygiene and living standards. Nightingale gave nursing a favourable reputation and became an icon of Victorian culture, especially in the persona of “The Lady with the Lamp” making rounds of wounded soldiers at night.

Sally Edgington, AXREM Chief Executive Officer said in her speech: “we have gathered to celebrate the strength, resilience, and brilliance of women in our industry. I am a female leader and currently lead a fabulous all female team, I am biased… but they really are all inspirational, supportive and hard working women and I feel truly blessed to work alongside each of them.

International Women’s Day is not just a day to acknowledge the progress we’ve made, but a day to remind ourselves of the work that still lies ahead. It’s a day to honour the trailblazers, the changemakers, and the unsung heroes who have shaped history and continue to inspire us all today. There are many of these women within our sector and AXREM membership”.

Sally ended her speech by saying: “When women rise, society rises with them. We all benefit when women are empowered, when they are given the tools, the respect, and the opportunity to lead, create, and flourish.

So, to all the women here tonight, to those who inspire us from afar, and to the generations of women who will come after us:

Keep pushing boundaries.

Keep dreaming big.

Keep shining your light.

The world is better because of all of us”

Reflecting on the event, Sally Edgington said: “It was a fabulous evening where we were able to bring together some thought leaders from our industry, it was also an evening where we could announce an AXREM Women’s network, This will further build on the important work AXREM has done over the last few years to really champion women in our industry and female leaders, so I am excited to launch this initiative and see how we can work with our members and stakeholders to develop this.”

Huw Shurmer, AXREM Chair & Strategic and Government Relationship Manager at Fujifilm Healthcare UK, said: “I was honoured to attend this event represented by so many strong women working in our industry. The speakers provided thought provoking content which gave me a different perspective on how far we have come, and how far there is still to go. I am looking forward to seeing the development of an AXREM Women’s Network to provide an industry forum and platform.”

One in four Brits seeking help from A&E due to GP pressures

By Integrated Care Journal

A new nationally representative survey reveals more than one in four Brits (27 per cent) have visited emergency departments because of delays in accessing GP appointments.

New survey data reveals that more than a quarter (27 per cent) of the public have visited A&E recently because the waiting time to access a GP appointment was too long, despite 2024 seeing a record high (370 million) GP appointments delivered.

Conducted by Savanta and commissioned by digital-first healthcare provider Livi, the findings also revealed that delays are leading to worsening of conditions or prolonged recovery, along with increasing costs to the public system based on the cost of a GP consultation versus an A&E attendance.

Regional data reveals that 45 per cent of Londoners who responded to the survey have visited A&E rather than wait to see their GP, while 41 per cent of under-35s reported visiting A&E as an alternative to waiting for a GP appointment.

GPs and clinicians are also feeling the strain of the challenges facing the healthcare system.

Dr Dan Bunstone, Primary Care Network (PCN) clinical director for Warrington Innovation Network and lead GP said: “As GPs, we see first-hand the strain on the system every day. We’re working in a landscape of chronic underfunding for innovation, severe staff shortages, and an ageing population with increasingly complex health needs. Demand is rising, and the resources to meet it simply aren’t there.”

Last month, the Government outlined its priorities for the NHS in 2025 and 2026 – including an objective to improve access to primary care services, and to invest in data and digital to improve productivity in primary care. On 28 February, the Government and BMA also announced a new contract for general practice

The results of this new survey demonstrate how urgently this action is needed, to tackle patient access, GP workload and workforce shortages to avoid pressures and rising costs reaching into other parts of the public system.

Dr Bunstone explained that GPs are delivering more appointments than ever but need alternative solutions to help them to tackle the pressures of long waiting lists and workforce shortages: “Patients deserve timely care, and GPs are constantly looking for ways that allow us to deliver care more effectively and empower our patients. Against all odds we are still delivering more appointments than ever. By embracing digital tools and integrating digital and physical care settings with services across primary and secondary care, we need continued investment in innovative solutions and system-wide coordination.”

Dr Kalle Conneryd Lundgren, Chief Executive Officer at Livi, who commissioned the research, commented on the findings: “The Government needs to act now. These findings confirm what we have long known: the crisis in A&E, hospital backlogs, and ‘corridor care’ all stem from a fundamental failure to provide timely, accessible care in the community. Patients are being left with nowhere else to turn, forcing them into inappropriate care settings and overwhelming an already stretched system and leading to increased costs.

“This isn’t just about more resources, nor is it about capacity. It’s about smarter solutions to boost efficiency and get more patients seen cost effectively. The Government must act now to invest in digital, empower ICSs to scale primary care, and fund proven solutions. By integrating digital and physical care, we can streamline referrals, optimise patient pathways, lower costs and improve access. Working together, we can build a system that works better for both patients and the workforce.”

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Council of Deans of Health announce 2025 Spring Conference

By Integrated Care Journal

The Council of Deans of Health’s Spring Conference will focus on shaping the future of clinical academia and healthcare education

The Council of Deans of Health – which represents the UK’s university faculties engaged in education and/or research for nursing, midwifery and the allied health professions – has announced the launch of its 2025 Spring Conference, scheduled for April 1, 2025, at the Congress Centre, London. This event will bring together K arin Smyth MP, Minister of State for Health as keynote speaker, and esteemed experts from the ﬁelds of clinical academia and healthcare education to engage in important discussions on the future of these sectors.

This year’s conference will feature an array of distinguished speakers who are shaping the future of clinical academia and healthcare education. One of the key highlights will be Professor Dame Jessica Corner, Executive Chair of Research England at UKRI, who will share crucial insights and recommendations stemming from the clinical academic workforce task and ﬁnish Group. Her presentation will focus on how we can best support clinical academics in the evolving healthcare landscape.

Additionally, Rob Stroud, Director of Assessment Services and Access to Higher Education at the Quality Assurance Agency for Higher Education, will provide an in-depth overview of recent changes to the Nursing and Midwifery Council’s (NMC) education quality assurance process.

Elizabeth Fenton OBE, Director of Nursing and Midwifery at NHS England, will discuss the ﬁndings of the educator survey. This will offer valuable insights into the current state of the healthcare educator workforce, informed by data contributed by the Council’s members.

Additional speakers include:

Professor Anne-Maree Keenan OBE, Pro-Dean for Research and Innovation, University of Leeds; Academic Capacity Development Lead, NIHR Leeds BRC
Beverley Harden MBE, Deputy Chief Allied Health Professions Officer, NHS England
Dr Simon Cassidy, Head of Placement Experience and Improvement, HEIW
Professor Jane Coad, Professor in Children and Family Nursing, The University of Nottingham; Chair, Clinical Academic Roles Implementation Network
Hugh Tregoning, Professional Liaison Consultant, Health and Care Professions Council

Event details:

Date: Tuesday, April 1, 2025
Time: 09:30 – 17:00
Location: Congress Centre, London, WC1B 3LS

The conference will provide ample opportunity for networking and collaborative discussions, ensuring participants can engage with experts and peers in meaningful ways throughout the day.

For more information and to register, visit this link and follow the Council of Deans of Health on social media. We look forward to welcoming you to our 2025 Spring Conference.

New data sheds light on NHS efficiencies challenge

By Integrated Care Journal

Survey of public sector workers in the UK suggests that 93 per cent of NHS organisations are hindered by substantial process inefficiencies, while most are confident that AI and automation will help to ease administrative burdens.

New research has shed light on the potential impact and scale of process inefficiencies across the NHS. The 2025 UK Public Sector Efficiency Survey, conducted by Appian, in partnership with Coforge, polled 1,000 UK public sector workers, including 242 NHS staff. Of those respondents, 95 per cent stated that they face process inefficiencies in delivering services, averaging out at five hours per week in extra work or delays.

Were this data representative of the NHS’s entire 1.5 million-strong workforce, this would equate to 7.5 million hours of extra work per week.

The top reported obstacles were:

Manual and repetitive tasks
Immediate challenges forcing reactive decision-making over proactive solutions
A need to access multiple legacy systems to review or enter the same information
A lack of training and support

NHS workers also reported process change as a common challenge, with 93 per cent stating that their organisation struggles to adapt its processes (specifically while maintaining productivity amid changing service demands and government policies).

These challenges are intensified by mounting pressure to improve productivity. The 2024 Darzi Report revealed that NHS productivity has declined by at least 11.4 per cent since 2019, and there is a significant gap between the NHS and other sectors in digital transformation progress.

Outdated systems obstruct NHS productivity

Legacy technology remains a significant obstacle to NHS efficiency. A 2025 report published by the Department for Science, Innovation and Technology (DSIT) revealed that NHS England experienced 123 critical service outages last year, due to archaic technology.

“With elective care waiting lists at an all-time high, productivity is an urgent priority,” Peter Corpe, Industry Leader, UK Public Sector at Appian. “The research shows that NHS workers are challenged with legacy technology. Asking them to act as the human glue that binds those systems and technologies together only hinders efficiency further.”

AI and automation: the keys to efficiency?

Despite process challenges, the findings suggest that NHS staff are optimistic about the opportunities process automation and AI technologies offer:

Confidence in AI: 64 per cent of NHS workers expressed some or high confidence in AI’s potential to improve organisational efficiency.
Confidence in automation: 69 per cent believe automating repetitive tasks would simplify their jobs and improve outcomes. Among those already using workflow or process automation tools, 95 per cent reported improvements, including enhanced productivity, improved communication, greater consistency and traceability.

The solution to smarter public services

In a recently released AI Opportunities Action Plan, the government committed to building cutting-edge, secure, and sustainable AI infrastructure to support all public sector organisations, including the NHS. “The government is clear on its mission to automate processes in the public sector,” said Corpe. “AI adoption is no longer a question of if but when.” And according to survey respondents, public sector workers are ready for change.

The solution to process inefficiency, Corpe says, is to make technology part of the process. “And no company is better equipped to deploy AI in enterprise processes than Appian. Appian is the leader in process orchestration, automation, and intelligence. By embedding AI in processes with unified, secure enterprise data, Appian is improving service delivery outcomes. And we’ve been at the forefront of better process outcomes in government for over 25 years.”

“Every NHS organisation is built on processes, and when those processes improve, so do the services delivered,” said Corpe. “With millions of hours a week at stake, resolving process inefficiencies and orchestrating pathways such as referrals or discharge management offers the NHS a chance to work more efficiently. This means more time for strategic and value-driven activities that directly improve patient outcomes.”

Coforge, an Appian partner for over 13 years with 350+ Appian practitioners on staff, has seen these outcomes first-hand. “Modern AI and automation technologies are transforming complex government processes into streamlined digital workflows,” said Coforge Chief Customer Success Officer, John Speight. “By partnering with Coforge, organisations are turning this potential into reality – reducing processing times from hours to minutes to achieve significant cost savings, and deliver smarter, faster, community-focused outcomes.”

Download the 2025 UK Public Sector Efficiency Survey for more findings from public servants.

How technology can help reduce, rather than manage, healthcare demand

By Michelle Wheeler

By Michele Wheeler, International Health and Life Sciences Director at Lexica

Healthcare transformation is an ongoing focus in the UK. Economic growth and a healthy workforce are closely linked, with universal healthcare a critical factor.

Yet costs and demand continue to spiral. Living standards and medical innovation have extended lives, but it would be hard to argue that the benefits of better health are equally spread. While progress has been made across many disease areas, it has stalled in others, increasing the burden on the NHS.

The health service is forecast to have a deficit of £4.5 billion for 2024/25, needing to restrict spending by £8 billion to stay within budget and increase productivity by 2 per cent. It also needs to reduce a growing waiting list.

The problem with managing demand

To address this, successive governments have strived to reconfigure how healthcare is delivered over the years, all in an attempt to keep costs and demand contained. However, these endeavours have fallen short of their objectives. The reason? They fail to address the causes of increased demand, instead focusing on how to gatekeep and, ultimately, manage demand instead.

That may now be changing. Introduced in 2022, integrated care systems (ICSs) bring together health sector providers within a geographical area. Their mandate is to plan, shape, and deliver health services to meet their communities’ health needs. This decentralised, place-based model for healthcare is a step towards the holistic partnerships needed to reduce health inequalities.

Alongside other service providers, these partnerships can help design approaches and provisions that support individuals to focus more on early intervention and combat the risk of lost well-being and independence. More self-management, the use of remote technology to deliver care without overburdening the front line, and more reablement therapy are also key tenets.

The autumn statement signals that this place-based systems approach is here to stay, with significant fiscal support accelerating its pace and impact. This includes a £13.6 billion capital increase and a clear signal to invest in both technology and the estate required to increase capacity and performance.

The role of technology in addressing healthcare demand

The autumn statement also anticipates that advancements in MedTech, robotics, artificial intelligence and machine learning, and emerging technologies will be vital in reshaping efficient, affordable, and sustainable frontline clinical services. Critically, these can be achieved without compromising on equitable access and quality.

Of course, technology is already being deployed to improve healthcare delivery. More than half of patients with chronic diseases now accept remote healthcare via telemedicine, releasing millions of in-person appointments and substantial healthcare resource.

AI is shortening screening times for drugs to one day, offsetting shortages of specialists who interpret echocardiograms to diagnose heart disease, and speeding up diagnosis by between five to ten times. It is making hospital management systems smarter, with open, connected digital platforms for real-time visual management of operations, resources, patient flows, bed occupancy, and medical device use. It can help management make informed decisions needed to underpin performance and outcomes.

Hardware is also having a significant impact. In 2024, the UK Research and Innovation Future Flight Challenge funded the first national drone network in Scotland to transport essential medicines, blood, and other medical supplies, connecting hospitals, GPs, laboratories, and remote communities. Guy’s and St Thomas’ NHS Foundation Trust is currently trialling drone transport for blood samples to the labs, cutting transport time to two minutes and speeding up clinical decision-making.

Elsewhere, virtual reality glasses can provide clinical experts with the same view as being in the ambulance, support remote access to global surgical expertise for surgeon training, and, with robotics, allow remote surgery itself.

Even without the use of VR, the use of robotics is growing. The NHS conducted 56,600 robot-assisted surgical procedures in 2023, up 29 per cent on 2022.

Using technology and policy to tackle demand

All of these innovations offer better and safer access, less wasted time, and lower costs. However, to use them effectively, we need to understand the challenges in healthcare from multiple perspectives – patients, professionals, and management – and co-design care models that work. For patients, this means less time away from home and work to attend appointments, offering greater empowerment and less disruption to day-to-day life.

The focus on place, technology, and prevention should aid in this transformation. While efficiency, cost-effectiveness, and performance remain core principles in delivering services, the emphasis is now on “system” performance. That includes the optimal use of collective resources and leveraging technology to offset staff shortages, reduce dependency on high-cost facilities, and improve access to increasingly costly medical expertise and equipment.

A new watchword for healthcare demand

Costs are not going to stop rising, and without targeted, strategic intervention, neither will demand. The proper deployment of technology can dramatically increase the management and delivery of care, but at some point, the focus needs to shift to tackling why there is demand in the first place.

Rather than chasing solutions to alleviate the burden on the NHS, we should change the question to ‘How do we reduce our reliance on the need for social care services?’ Reducing demand, balanced with proactive prevention measures, is the new focus.

*Michelle Wheeler, International Health and Life Sciences Director, Lexica*

AI matches radiologists in detecting prostate cancer in NHS-backed multi-centre study

By Integrated Care Journal

A trial of Pi AI software, already in use in the NHS, has shown high accuracy in analysing MRI scans to distinguish clinically significant prostate cancer.

Hampshire Hospitals NHS Foundation Trust and Lucida Medical have announced the results of a five-year collaboration. Results from the PAIR-1 (Prostate AI Research – 1) study shows that the Pi AI software, now in use in NHS and European hospitals, performs as well as expert radiologists at detecting prostate cancer from magnetic resonance imagining (MRI) scans. Prostate cancer is the most common men’s cancer, leading to around 12,000 deaths in the UK every year.

PAIR-1 is a collaborative research study between eight NHS Trusts and Lucida Medical, approved by the NHS Health Research Authority and funded by the company. The study partners gathered historical data from over 2,000 patients and used this to develop, train and validate Pi, a software platform that uses artificial intelligence (AI) algorithms to analyse magnetic resonance imaging (MRI) scans to help distinguish clinically significant prostate cancer.

Dr Antony Rix, CEO and Co-Founder at Lucida Medical, highlights that “every year, over 50,000 men in the UK and 1.5 million men worldwide are diagnosed with prostate cancer. The disease may start slowly, but can be deadly if it’s not caught early, killing 12,000 men in the UK and 400,000 men around the world each year.”

An MRI scan is a key step to diagnose prostate cancer. The MRI is used to help identify patients at low risk who can avoid a painful, invasive biopsy, and to locate possible lesions so that higher-risk patients can have a targeted biopsy to maximise the chance of finding cancers that need treatment. Mark Hinton, CTO at Lucida Medical, explained: “Pi is medical device software that is CE approved for use in clinics. We developed Pi to automate key steps like outlining lesions and calculating risk scores, to assist radiologists to make these challenging decisions.”

Dr Francesco Giganti, Associate Professor of Radiology at University College London, presents the results of the PAIR-1 study today at the European Congress of Radiology (ECR) in Vienna. He noted that “this research found that Pi is non-inferior to multidisciplinary team-supported radiologists across a validation set of sequential cases from 6 NHS hospitals with a wide range of MRI scanner types. This is the first time that a commercial AI for prostate MRI has been tested on diverse, real-world data.”

Dr Aarti Shah, Consultant Radiologist at Hampshire Hospitals NHS Foundation Trust, was Chief Investigator on the study. She highlighted that “analysing MRI scans is a time-consuming task for expert radiologists, and there are too few of us in the UK and many other countries. Pi offers exciting potential as an aid to help reporting radiologists in triaging workloads as well as producing visual reports to aid contouring of lesions for biopsy.”

“We founded Lucida Medical with a shared vision to use AI to transform the diagnosis of cancer. Five years on, it is wonderful to see this working in practice and recognised by a major journal and conference,” added Prof Evis Sala, Co-Founder of Lucida Medical, Professor of Radiology at the Università Cattolica del Sacro Cuore and Chair of Department of Diagnostic Imaging and Radiotherapy at the Policlinico Universitario A. Gemelli, IRCCS in Rome.

Pi is available for use in the UK and Europe to support the diagnosis of prostate cancer.

At ECR 2025, Dr Giganti’s presentation, AI-powered prostate cancer detection: a multi-centre, multi-scanner validation study, took place in session CTiR 16 – Clinical Trials in Radiology: spotlight, in Room N on Feb 28 at 16.00 CET. The research is also published in European Radiology at https://doi.org/10.1007/s00330-024-11323-0.

New national data shows improved respiratory outcomes with digital therapeutics

By Integrated Care Journal

Toolkit has driven significant reductions in reliever inhaler usage among asthma and COPD users, with biggest improvements seen in socioeconomically deprived areas.

A respiratory digital therapeutics toolkit is improving outcomes and reducing health inequalities for people with asthma and chronic obstructive pulmonary disease (COPD) in Wales.

The toolkit, which has reached full adoption across 100 per cent of GP practices and hospitals in NHS Wales, is providing a personalised, digital care plan that empowers hundreds of thousands of people to take control of their condition and stay well in the community.

Professor Simon Barry, National Respiratory Clinical Lead at NHS Wales (2016-2024), explained the impact the toolkit is having at a national scale: “Overall, we’re seeing patients showing a significant improvement in wellness scores in as little as three months. The biggest improvement is among patients using the asthma app for four months or more who are seeing their wellness score increase by 41 per cent. Users in socioeconomically deprived areas, and young people are seeing the greatest improvements in their Royal College of Physicians (RCP) 3-questions score.”

In addition, the toolkit has driven significant reductions in the use of reliever inhalers, an important marker of disease control:

Asthma app users have a statistically significant improvement in their reliever inhaler usage, with 35 per cent having improved reliever use within one year, and 20 per cent of patients going from some reliever use to no reliever use.
COPD app users’ reliever use improved after one year, with the percentage of users making use of relievers decreasing substantially from 67 per cent to 38 per cent.
Patients using the app are 42 per cent more likely to be using Dry Powder Inhalers (DPIs) than the general population, accelerating the NHS Wales priority to increase the proportion of low global-warming potential inhalers (DPIs) used vs pressurised Metered Dose Inhalers
Improvements are particularly pronounced in socioeconomically deprived areas.

The successful rollout has enabled many more outcome improvements, including reductions in GP visits and A&E admissions to alleviate pressure on overstretched services. The Respiratory Health Improvement Group (RHIG) in Wales will present new national datasets at an upcoming event, showcasing years of progress and population-level improvements.

Chris Davies, Principal and CEO at The Institute of Clinical Science and Technology, said: “Unfortunately, chronic diseases are common and expensive. Right now, £7 in every £10 of UK health and social expenditure goes toward chronic disease management, so it’s time for a new approach. We are delighted to work alongside NHS Wales in transitioning from traditional healthcare delivery to a patient-driven, digital-first model that eases the pressure on the healthcare system and future-proofs the NHS. This approach enables individuals across large populations to have better agency, better empowerment and more confidence when they navigate their health.”

Co-produced with patients, policymakers and clinical experts from within stakeholder groups, including the National Respiratory Audit Programme (NRAP), Asthma and Lung UK (ALUK), NHS Wales and NHS England, the toolkit uses the proven COM-B (Capability, Opportunity, Motivation-Behaviour) model to drive behaviour change. The app provides tailored support, including a personalised care plan and progress tracking, to help individuals manage their health.

The toolkit is expanding to other disease groups, offering a scalable model to meet rising care demand without overburdening healthcare professionals.

Members of the Respiratory Health Improvement Group (RHIG) in Wales will outline how the successful outcomes were achieved across Wales during a webinar on 13 March, chaired by Dr Lia Ali, Clinical Advisor, NHS Transformation Directorate for NHS England. Join the National Transformation of Respiratory Outcomes through Digital Therapeutics event by registering to attend here.

Millions to benefit from expanded Universal Care Plan, improving choice and care

By Integrated Care Journal

The expansion of the Universal Care Plan will see new planning sections added for patients with dementia, frailty, learning disabilities and autism, boosting choice and personalised care for patients in the capital.

Millions of patients across London will now receive improved, personalised healthcare as part of a major expansion of the Universal Care Plan (UCP), a shared care planning solution powered by Better. The move marks a major step towards a more holistic, personalised approach to healthcare planning, ensuring patients receive coordinated care that aligns with their individual needs, preferences, and goals.

Enhancing care for more patients

The expansion beyond the UCP’s initial focus on end-of-life and palliative care planning introduces new care planning sections for patients with dementia, frailty, learning disabilities, and autism. It also includes enhanced support for children and young people, as well as contingency planning for carers. This follows an earlier expansion to support people with sickle cell disease.

“This latest expansion moves us beyond disease-specific planning to a truly personalised care and support plan, where what matters to a patient is just as important as what is the matter with them,” said Nick Tigere, Head of the UCP Programme.

Improving patient outcomes and NHS efficiency

The UCP has already demonstrated success in improving outcomes for end-of-life care patients, with 70 per cent achieving their preferred place of death, compared to the national average of 50-55 per cent. Additionally, unplanned hospital admissions are reduced to 30 per cent, significantly lower than the national average of 46 per cent.

By providing a single, integrated care plan, the UCP streamlines care for patients with multiple long-term conditions, ensuring a more coordinated approach across services. This helps to free up NHS resources, reduce hospital admissions, and create capacity for elective procedures, ultimately supporting the NHS’s strategic goal of delivering more care outside of hospital settings.

“Where patients have a UCP, we see fewer unnecessary hospital admissions and a greater likelihood of receiving care in their preferred location. This supports both patient choice and NHS capacity,” said Nick Tigere.

The UCP integrates with social care, care homes, acute care, community hospices, and primary care to ensure seamless information sharing across healthcare providers. It is also connected to the London Care Record, enhancing accessibility for healthcare professionals across different settings, and the National Record Locator, enabling the care plans of Londoners and patients seen in London to be accessed nationwide.

Empowering patients through digital access

As part of the expansion, patients can now view their care plans via the NHS App, with plans to introduce editing functionality in spring 2025. This will allow individuals to update their non-clinical information, such as personal preferences and daily routines, reducing the burden on clinicians while empowering patients to take an active role in their care.

Dr Francesca Leithold, Global Service Delivery Director at Better, highlighted the importance of accessibility in this expansion: “The restructure of the forms is intended to create a clearer interface, structuring information in a better way. Making the care plan editable for patients over the next two quarters will enhance patient engagement and autonomy.”

Additionally, an upcoming GP Connect integration is set to enhance clinical safety by ensuring automatic access to GP medication and allergy records, reducing duplication and administrative workload for healthcare providers.

A future-focused approach to care

The UCP expansion follows a thorough evaluation process assessing digital maturity, readiness, and business case feasibility. The primary aim is to ensure that more Londoners have access to personalised, accessible care plans.

“This expansion marks a significant milestone in the evolution of the Universal Care Plan,” added Dr Leithold. “It demonstrates our commitment to making personalised care plans accessible to more people, providing tailored support that adapts to the needs of every individual. By expanding the scope of the UCP, we are empowering patients, improving outcomes, and supporting a healthcare system that’s more efficient and responsive to the diverse needs of the public.”

News, Thought Leadership February 19, 2025

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 10-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.

From hospitals 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.

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