Integrated care systems: reaching disenfranchised communities

By Raj Purewal

Raj Purewal, UK&I Strategic Development Director at Tunstall Healthcare, discusses how technology can be adopted by integrated care systems (ICSs), and how care services can reach all communities and reduce health inequalities.

In October, Public Policy Projects (PPP) launched its ICS Roadshow in locations across the UK. The events endeavour to bring together health, social care and housing professionals and create a new forum for integrated care, which sees national policy delivered at a local level.

Setting the strategy with ICSs

ICSs have taken over the role of Clinical Commissioning Groups, who were previously responsible for commissioning the best health services for their localities. ICSs will also be responsible for implementing strategies across footprints to ensure patients and citizens can access the best services and care possible. They will be able to link the data and insight they have access to from the daily activities of the health and care sector, ultimately transforming the way care services are provided.

The integration of health and social care services will be a key enabler in the transformation of systems for citizens. ICSs, alongside local authorities, will be the driving force behind this as they have been specifically designed as the link between health and social care to improve collaboration, care provision and patient outcomes.

ICSs have also been tasked with ensuring the continuity of care in regions across England, so that national policy aligns with the needs of patients and citizens on a local level. The introduction of new legislation will direct local and regional health and care systems to improve alignment between service providers, while supporting, enabling and educating patients, and when appropriate, to manage their needs.

Tunstall is at a pivotal place when it comes to aligning services through ICSs and it’s crucial that we adapt our strategies as required. Tunstall’s services must support ICSs’ objectives and their focus on driving best practice, transforming services and increasing the use of digital capabilities for patients and citizens.

ICSs will foster closer working between health and care service providers. Tunstall’s longstanding role and remit shall continue, and we will also support providers, commissioners, partners and vendors to deliver the Triple Aim, ROI and best value for these sectors and the public sector pound.

Adopting technology

The importance of technology in service delivery across the health and care sectors shouldn’t be underestimated, particularly when it comes to monitoring and assessing citizens and patients when discharged, or in virtual wards, and when appropriate, pro-actively before a planned attendance. To adopt technology-enabled care services, we must help to educate both citizens and health and care professionals effectively, and leaders must coordinate this across ICSs.

Adopting and scaling the right technology will support many resources, increase utilisation, and improve capacity across the health and care systems, to provide effective care. ICSs will continue to increase the focus on building preventative and proactive care models, which will include investment in the continued advancement of technology.

Technology providers are working on solutions and platforms that will identify changes in patients’ or citizens’ vital signs, mobility or behaviour. For example, Tunstall Cognitive Care® will use advanced AI in combination with technology in the home to detect whether someone’s health could be about to deteriorate, spot a potentially undiagnosed condition, or resolve an immediate social care need.

Since before the pandemic, around 22 per cent of the NHS elective backlog for surgery is for orthopaedic conditions relating to the hip or knee, or cataract surgery; patients who are on these waiting lists can be identified and supported with remote monitoring. For example, if a particular behavioural trend for a citizen who is struggling with mobility can be seen, support can be offered quickly with an appropriate intervention at the right time to minimise the need for urgent, more expensive unplanned emergency care. This type of integration and use of technology will help to reduce stress and pressure on provider resources and service work plans.

As ICSs transform services, and move towards digitisation and digitalisation, the technology that providers deploy needs to facilitate strong foundations for the future of care provision, as ICSs will aim to optimise data and to generate insight. In helping to ensure that the infrastructure and systems are in place, Tunstall can start to have positive impacts on health and care services for all as health care services make these transitions.

Improving care services and reaching all communities

The overall experience of services for all citizens should be improved through the introduction of ICSs, as they will be tasked to ensure equality of care, which historically has not always been the case.

ICSs will also increase focus on improving value delivered for the public purse, improving efficiency by reducing the incidence of unattended appointments (DNAs) and ensuring a continuum of care for the patient and citizen from referral and after discharge. This is critical in ensuring healthcare services are optimised – ranging from effective patient communication, reducing the number of DNAs, and sharing insight with practitioners to inform best practice. ICSs will be able to take an analytical approach to the data they have access to and use this to both inform planning and to allocate resources.

To reduce health inequalities, it will be necessary to take a holistic view. For example, poor housing can have an impact on citizen health if there is a lack of insulation or if there is damp. There is no singular factor or reason that causes health inequality, but ICSs will bring bespoke approaches for their different localities to ensure gaps in health and care are lessened and minimised over time.

Other inequalities can cause communities to become disenfranchised with service providers, for example problems can arise because of travel, logistics and even linguistic challenges. Most recently, we saw an example of this as some communities were excluded from pandemic communications especially digital communications, including the messaging around measures put in place to reduce the spread of COVID-19.

The establishment and progression of ICSs will enable the alignment of technology-based health and social care services and improve health outcomes for every community across the UK.

As service providers and the workforce become increasingly invested in, and understanding of, the role of technology in supporting and empowering vulnerable people, we’ll see a reduction in health inequalities and upgraded services that are better able to meet the demands of our growing and ageing population.

Tunstall Healthcare launches tech hub in Manchester

By Integrated Care Journal

Global pioneering health and care technology firm Tunstall Healthcare has officially opened its new hub in St Peter’s Square, Manchester.

Tunstall Healthcare, which is celebrating its 65th year, is currently recruiting for a range of hybrid working positions that will be based in the new hub in St Peter’s Square, Manchester. Quality and testing, software development and business analysis roles are available to complement the existing tech teams based in Yorkshire, Sweden, Germany and Spain.

As well as mid-senior tech roles, there will be opportunities for graduates and apprentices to join the firm as part of Tunstall’s drive to mentor and train the very best talent in tech, in addition to positions that will offer support to those who wish to retrain or who have been out of work.

Emil Peters, Tunstall Group CEO at Tunstall, said: “This is undoubtedly a huge and exciting milestone for Tunstall as we open our latest UK office space, in the renowned business and technology hub of Manchester. Our new base is the perfect location to serve our customers across the country and in the north west, as well as attracting new talent to the Tunstall brand.

“A career at Tunstall gives candidates the opportunity to make a real difference in the health and care sector by realising the potential of technology to empower people to have more choice over how they live their lives. Our Manchester base will help us to attract some of the brightest talent in the sector to help us drive our exciting technology roadmap forward, and I’m looking forward to welcoming new colleagues to the business.”

Established in 1957, Tunstall has grown substantially and evolved from an equipment provider to a software solution and technology company that provides telecare and telehealth managed services. In this time, it has almost doubled the number of users supported by its systems, while increasing its geographic footprint across Europe.

Gary Steen, Chief Operating Officer at Tunstall UK, added: “At Tunstall, we put our people first and invest in their professional development. By expanding our base across the North, we will be able to continue our success as a business while forging ahead as the market leader in our sector.

“New technology solutions are vital if we are to support our ageing population effectively. Innovation and development in the health and care sector will allow us to continue moving towards a proactive and preventative model of care provision which improves the quality of people’s lives and enables valuable resource to be targeted where and when they are needed most.”

Tunstall Group works with health, care and housing providers around the world and supports more than five million people through technology. Its technology and service offerings allow its customers to deploy new models of community-based health and care delivery that are more integrated, personalised and proactive.

To find out more about Tunstall, please visit www.tunstall.co.uk.

Fujifilm primed for leadership in pulmonary solutions

By Peter Mansell

Pictured above: Samiran Dey, European Business Development Manager, Fujifilm Europe

An established pioneer in digital X-rays, flexible endoscopy, ultrasound and CT scans, Fujifilm Healthcare has been using these technologies to address pulmonary conditions for nearly two decades.

Yet, the company is better known in gastroenterology, and particularly for its advanced endoscopy products.

The acquisition of Hitachi’s diagnostic imaging business in March 2021 strengthened Fujifilm’s hand as a medical-imaging specialist and a comprehensive provider of healthcare solutions. Now, Fujifilm is leveraging cross-business synergies to pursue a bold new vision as a one-stop pulmonary solutions supplier.

That includes an expanded product portfolio, enhanced with innovations in fields such as image processing and artificial intelligence. With new additions such as the slim EB-710-P bronchoscope, Fujifilm offers a broad suite of pulmonology solutions extending right along the whole patient pathway, from screening to treatment planning.

Integrated, cutting-edge technologies that facilitate and clarify pulmonary screening and diagnosis can help improve patient outcomes in areas such as lung cancer, where survival rates still lag significantly behind other oncology settings. Streamlining patient pathways is also about tackling the capacity and efficiency issues that routinely confront time- and budget-constrained pulmonologists.

These issues, together with the inherent challenges of lung screening and diagnosis, are part of what has historically relegated lung-cancer detection to too little, too late. As Samiran Dey, European Business Development Manager for Fujifilm Europe, notes, hospital endoscopy units tend to have just one room out of five dedicated to bronchoscopy.

**Fujifilm’s booth at ERS Conference, Barcelona (click to enlarge)**

There are indications, though, that lung cancer is moving up the screening hierarchy. In its recent report on Strengthening Europe in the fight against cancer – towards a comprehensive and coordinated strategy, the European Parliament’s Special Committee on Beating Cancer called on the Commission and Council to consider including targeted lung cancer screening in this year’s updated guidance on cancer screening.

In England, lung-cancer screening pilots are being rolled out across the National Health Service in three phases under the Targeted Lung Health Check programme. Low-dose CT scans are available for anyone aged between 55 and 75 years who has ever smoked.

Unmet needs

This growing recognition of unmet needs brings the benefits of innovations such as the EB-710-P, or of 3-D visualisations to help plot a course through the lung to peripheral lesions, clearly into focus. Pulmonologists are also dealing with limitations of time and space, which is where Fujifilm assets such as faster image processing or compact, portable X-ray machines, come into their own.

Accessing all of this from a single supplier, with joined-up support services and data transfers, plus seamless transitions from disease detection through to surgical modelling, also underlines how important ease of use is to clinicians in the field. In Fujifilm’s experience, what matters most to pulmonologists is not so much technical ingenuity or image quality, but rather how these qualities determine useability.

As Dey comments, “it’s human nature, wanting things to run smoothly. Being able to have that integrated is the main issue for healthcare. Where things can talk to each other, especially the service side from industry, and they come from one provider, that makes it easier for clinicians to run their practice”.

It can also drive efficiency and, potentially, cost-efficiency gains. Fujifilm is not only offering distinctive products, such as the EB-710-P or its FDR Nano X-ray system, but offering them as part of an inclusive package of pulmonology solutions that helps clinicians to do more, better, and in less time.

New ambitions

Patterned on Fujifilm’s EndoSolutions strategy and its successful focus on gastroenterology, the new ambitions for pulmonology started taking shape more than a year ago, with the creation of a dedicated respiratory business unit and Dey’s appointment to head up European business development. Monthly R&D meetings followed, while expert meetings kicked off in September 2022.

A roadmap for the evolving business envisages Fujifilm as a unique solutions provider in a very substantial European pulmonology market. Along with Fujifilm’s one-stop offering, cross-business unit synergies will be a key differentiator in this respect. “What’s really unique is synergising what the cross-business units can offer,” Dey explains. “Over six months, I’ve found out that we actually do have a solution.”

That runs from screening with X-rays and CT scanners, to Fujifilm’s core diagnostics offering with bronchoscopy, and then on to software that facilitates treatment planning. “There are obviously many other companies out there doing many things,” Dey says. “But no one other company has that full solution. We are a one-stop solution for the lung-patient pathway.”

Something else that distinguishes Fujifilm in pulmonology is its commitment to training and education. The company’s mobile training hub, the Endorunner, “allows us to take our products and education to the respiratory community, as opposed to them having to come to us”, Dey observes. “We’re also kicking off two-day pulmonology courses, dedicated to training physicians and all of the staff in the bronchoscopy suite.”

Long-term vision

As Dey points out, “we’ve always been in pulmonology”. However, Fujifilm has realised that “with lung-cancer screening coming to light in European countries, the UK probably being the first, more focus is needed. We had a product range; now we have a broader product range, thanks to some new bronchoscopes. And we can offer solutions to the respiratory community.”

**The Fujifilm team at ERS Conference, Barcelona (click to enlarge)**

The long-term vision, Dey adds, is to be “the number one provider of pulmonary solutions to the healthcare market”, offering “the products, services and education physicians need for their lung patients”. At the same time, Fujifilm is determined to carry on innovating for even better pulmonology solutions.

That could eventually extend beyond treatment planning and into the surgical space. “We will never stop trying to find the full solution for the pulmonology pathway,” Dey says. “And, for these patients, surgery is still the gold standard.”

This is a sponsored article.

Devolution & health outcomes: Getting a seat at the table

By Gavin Bashar

Gavin Bashar, UK&I Managing Director at Tunstall Healthcare, discusses the importance of ensuring all key stakeholders, including citizens, get a seat at the table to link up care and ensure access to technology.

As a nation we are living longer and we have the information we need to make healthier and better-informed choices. However, having the right information is only the beginning. The next stage, which integrated care systems (ICSs) and their empowered integrated care boards (ICBs), will provide significant direction on, is using this information in the right way to meet the aims and objectives of our health and social care services.

As ICBs establish themselves, we will begin to see citizens and service providers become more engaged across the board and the beginning of the distribution of the £150m of additional funding to drive greater adoption of technology and digitisation across the health and care landscape. This in turn will create a more connected and intelligent world that enables a collaborative approach to the delivery of efficient, proactive and integrated health and social care services.

Engaging with citizens

If citizens are to have a seat at the table, with health and social care services centred around them, we must engage effectively and actively listen to their concerns and needs. Relationships should be based on partnership, flexibility and a commitment to citizen success, rather than one-off transactional interactions. A sustainable future for the long-term funding of essential services must be a priority if we are to realise a positive vision which puts people at the heart of delivery.

Before ICBs, many public commissioning and procurement processes were hampered by fragmented funding, a shortage of high-quality evidence-based services and a lack of involvement of the appropriate citizens’ voices in decision making. These challenges of course made it extremely difficult for professionals and care providers to fully engage with citizens and deliver effective care that would effectively prevent more complex requirements.

Engaging with citizens can help to ensure that valuable solutions involving technology are appropriate, accessible, practically useful and as such, less likely to be abandoned.

As services become more efficient and citizen outcomes are improved, it will become easier to deliver cost efficiencies. Improved condition management and medication compliance through greater engagement for example has a clear impact on decreasing GP visits, clinicians are able to target patients that need support, and early intervention can prevent future, often high cost, care requirements.

By engaging closely with citizens and their communities with the help of ICSs, it is possible to create an environment in which they have the freedom to live life to the full in a place of their choice, with the people and things that they love, doing the things that matter most, through care and support that is inclusive, accessible and innovative.

Collaboration to drive links

To drive links between social care, primary care and wider community services it’s important to consider the crucial role of collaboration. ICSs will help with the integration of services and drive collaboration between service providers. A large majority of the population have both health and social care needs, and it makes sense for a collaborative approach to become the norm as this will contribute to an improvement in health outcomes and cost savings.

Collaborative services will be the first step to start reducing the silos that currently exist between health, housing and social care and encourage care provision that is tailored to the individual who needs it. Through collaboration we’ll be able to deliver joined up care so that people accessing health and social care services can experience them as seamlessly as possible.

However, local authorities and health and social care providers continue to grapple with workforce shortages, case backlogs and an increase in the complexity and level of need of the population. This hampers the ability to drive forward with collaborative working as we are too focused on meeting these short-term challenges to have the time to consider longer term approaches.

ICBs have a number of aims, with one being to deliver transformation in order to improve how our systems operate. By focusing on this, they’ll be able to encourage collaboration between partners and professionals, with a strong focus and determination on delivering person-centred care and support.

Providing universal access to technology and software support

The integration of technology and its increased use have long been seen as a key part of transforming health and social care. However, the system has been slow to adopt innovations and tends to view technology as a way of managing people’s care. This is partly due to the growing number of solutions that are available, which make selecting, commissioning and implementing a complex task.

With the ICBs now holding statutory powers, we are at a pivotal time that will shape our services and the use and deployment of technology for decades to come. The ability to transition to a system that can provide universal access to new technologies that manage, analyse and harvest actionable intelligence will be crucial to the success of the health and care industry in the future.

Using technology to support people is relatively low cost, meaning citizens can stay at home for longer with an increased quality of life. Digital solutions can also empower staff to work more efficiently, reduce bureaucracy and enable them to spot changes in people’s behaviour.

Integration and investment in technology will enable the reconfiguration and integration of services. It’s essential that service providers and the service users are involved in the digital transformation if they are to innovate, embrace technology successfully, and deliver new approaches which create benefits for citizens.

By working closely with ICBs, technology providers will be able to citizens, their communities and the workforce to invest in value-generating digital solutions that improve lives and drive the prospects of businesses.

Moving forward

Through collaboration and investment in the right services and solutions, such as digital technology enabled care solutions, it will be possible to improve citizen experience and support improved quality and reliability of services, which are tailored to meet the specific needs of individuals. With the engagement of ICBs, there is the potential to move towards a system where it is standard practice to use technology to manage long-term health conditions and deliver efficient and personalised care.

A digital transformation will create a predictive environment that highlights behaviour changes and forecasts the need for extra support. It will join up stakeholders and provide a better opportunity for planning, giving a clearer picture of those with vulnerable needs.

I hope that ICBs will provide a new kind of leadership that can deliver change and tighten up governance, while at the same time improving the working lives and motivation of employees and the health and wellbeing of our population. The healthier the population becomes, and the more they learn about the benefits of technology within health and social care provision, the more able we’ll be to engage with citizens, give them a seat at the table and link up care.

This is a sponsored article.

For more information, please visit www.tunstall.co.uk.

‘Partners in Protection’: How Mölnlycke works with clinicians to prevent infections and support elective recovery

By Lucy Catlin

Lucy Catlin, UK OR Solutions Marketing Manager for Mölnlycke, tells ICJ how Mölnlycke works with clinicians to prevent infections and support elective recovery.

Research from the Healthcare Safety Investigation Branch demonstrates that the COVID-19 pandemic has made people increasingly concerned about contracting infections in hospital settings.¹ Ensuring that patients have confidence that their treatment is safe, especially in the operating theatre, will be important to the uptake of planned and elective surgery to help tackle the backlog in care.²

It is evident that breaking the chain of preventable infections in hospitals should continue to be prioritised in the wake of the crisis. Mölnlycke aims to support healthcare professionals (HCPs) to face these challenges by offering solutions to significantly decrease the risk of surgical site infections (SSIs) in patients.

Effects of COVID-19 on infection control in elective care

During the beginning of the pandemic, increased infection prevention and control protocols in operating theatres were introduced, which HCPs adapted to brilliantly. These additional measures required more preparation time, reducing the amount of time in the day available to complete operating procedures, and therefore resulting in fewer non-urgent patients being treated.³

However, as the pandemic has progressed over the last two years, COVID-19 related infection prevention protocols have been adapted to help return the volume of elective care procedures to pre-pandemic capacity.^3,4 With the focus now on elective care recovery, we must ensure that infection prevention remains a top priority to support patient safety which does not fall off the agenda, and clinicians are adequately supported to deliver this in the operating theatre.

How can Mölnlycke’s solutions help ‘break the chain of infection’?

Most SSIs are caused by contamination of an incision with microorganisms from the patient’s own body during surgery.⁵ While they can cause considerable harm to patients, up to 60 per cent of SSIs are preventable, demonstrating the need for the health system and its partners to actively work together to tackle the problem.⁶

Ashford and St Peter’s Hospitals NHS Foundation Trust is a notable example of how SSI rates can be reduced by assessing risk across the whole patient pathway. The Trust were able to put in place multiple changes simultaneously, from pre-operative chlorhexidine washing and patient pre-warming, through to an oozing wound protocol. Ashford and St Peter’s were successful in reducing their early infection rate from 5 per cent to 0.24 per cent, which GIRFT estimates saved the Trust £2m. This proved adopting a multidisciplinary approach, in collaboration with industry partners, can have a positive impact on infection rates.⁷

Additionally, creating an environment within clinical teams where there is open dialogue with patients, including providing education on SSIs, could be part of wider solutions. When patients are empowered with the information they need to prepare for surgery and to improve their chances of recovery, they can work collaboratively with clinical teams to make decisions about their own care. Ultimately, patient-centred approaches and patient safety should be at the heart of breaking the chain of infections.

This multidisciplinary approach with the patients’ perspective at its centre is critical in assessing both risks and opportunities along the pathway. Mölnlycke have a range of solutions across the patient pathway, from pre-operative to post-operative surgical care to help minimise the risks of SSIs. For example, the Mölnlycke BARRIER® EasyWarm® blanket can be used in line with NICE guidelines which recommend active warming should start at least thirty minutes prior to induction of anaesthesia, with an earlier start to active warming required if the patient has a temperature under 36 degrees to reduce the risk of perioperative hypothermia, which is associated with poor outcomes for patients.^8,9

Where are we heading next?

Beyond equipment to improve SSI prevention, there needs to be wider changes to the healthcare system to tackle the structural barriers to further reducing SSIs in the operating theatre. This includes the need for consistent, mandatory SSI reporting across all surgical categories.¹⁰ Acknowledging the clear challenge around SSIs, Mölnlycke developed a first-of-its-kind report, Time to Act, to explore the current landscape and recommend system-wide changes and partnership opportunities.

The report sets out a range of recommendations for stakeholders across the healthcare system, including policymakers and hospital teams. These include supporting investment in training and education of HCPs, as well creating infection prevention strategies across the UK, for example through a Preventable Infections Taskforce.

Hospitals should also support HCPs where possible to ensure they have the skills and equipment they need to perform surgery in a way that is safest for patients. It is vital that HCPs are engaged in a dialogue about safety, efficiency, and use of infection prevention solutions. This ensures procurement teams have all the right information about the safety and quality of products for them to make informed, value-based choices.

Conclusion

While we address the elective care backlog, we must ensure that patient safety is not compromised in the process. Healthcare professionals can be supported directly to put in place best practice solutions and processes, but there also needs to be wider system support to ensure that reducing the risk of SSIs is prioritised. Mölnlycke is committed to supporting healthcare professionals, hospitals, and policymakers to improve outcomes for patients.

¹ HSIB (2020) COVID-19 transmission in hospitals: management of the risk – a prospective safety investigation, https://hsib-kqcco125-media.s3.amazonaws.com/assets/documents/hsib-report-covid-19-transmission-hospitals.pdf

² Lee, G., Clough, O.T., Walker, J.A. et al. The perception of patient safety in an alternate site of care for elective surgery during the first wave of the novel coronavirus pandemic in the United Kingdom: a survey of 158 patients. Patient Saf Surg 15, 11 (2021). https://doi.org/10.1186/s13037-021-00284-8

³ NHS (2022), Delivery plan for tackling the COVID-19 backlog of elective care. p20. Available online: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2022/02/C1466-delivery-plan-for-tackling-the-covid-19-backlog-of-elective-care.pdf

⁴ GOV.UK (2021) UKHSA publishes new recommendations for COVID-19 infection prevention and control https://www.gov.uk/government/news/ukhsa-publishes-new-recommendations-for-covid-19-infection-prevention-and-control

⁵ NICE guideline NG125, Surgical site infections: prevention and treatment https://www.nice.org.uk/guidance/ng125/chapter/Context

⁶ Diaz et al (2015) Surgical Site Infection and Prevention Guidelines: A Primer for Certified Registered Nurse Anesthetists, AANA Journal, 83;1 https://www.aana.com/docs/default-source/aana-journal-web-documents-1/jcourse6-0215-pp63-68.pdf?sfvrsn=1ad448b1_6

⁷ GIRFT SSI National Survey 2019 https://gettingitrightfirsttime.co.uk/wp-content/uploads/2017/08/SSI-Report-GIRFT-APRIL19e-FINAL.pdf

⁸ Clinical study to assess the safety and efficacy of BARRIER® EasyWarm®, an active self-warming blanket used to prevent hypothermia. Data on file. 2012.

⁹ NICE guideline CG65 Hypothermia: prevention and management in adults having surgery https://www.nice.org.uk/guidance/cg65/chapter/Context

¹⁰ Mölnlycke (2020), Time to Act: A State of the Nation report on Surgical Site Infection in the UK. Available on request.

This is a sponsored article.

News, Tunstall Healthcare October 11, 2022

Redefining place-based care: facilitating system change

By Graham Brown

Graham Brown, UK&I Marketing Director at Tunstall Healthcare, discusses what the future holds in regards to service transformation and place-based care, and how technology can facilitate access to care and reduce health inequalities.

In order to redefine care and achieve preventative services that reduce health inequalities, it’s important to approach healthcare services both holistically and through targeted resolutions to specific areas of care provision.

By starting with place-based care and the role of technology, it is possible to approach issues around prevention and proactivity and the tailoring of care to individual people and communities. This in turn will help care providers to combat health inequalities and improve access to health, social care and housing.

Defining place-based care

Place-based care presents multiple opportunities, as well as some intrinsic challenges. In order to capitalise on the opportunities that are presented, we must first define ‘the place’ and what this means to the people both providing and receiving health and social care services.

When defining place-based care it’s important to consider the different demographic regions across the UK. There are disparities in the health and wellness of communities with different population characteristics, with affluent areas tending to be more well and living longer than those in poorer areas. Any attempts to tackle these inequalities must therefore be able to target different demographics, by taking into account disparities in access to technology, health and wellbeing, and life expectancy.

The local nature of ICSs will mean that the professionals involved are better placed to understand the needs of different populations and the communities in which they are based. This will then enable better collaborations so that place-based care can be defined, which will in turn support more tailored care that plays a key role in reducing health disparities between communities.

The majority of the population moves between different places, such as the workplace and home, on a daily basis, and this impacts our ability to deliver place-based services across a range of sectors. However, this presents significant challenges when it comes to health and care delivery. Consideration of how to adapt where and when care is provided to each individual that needs it is very important if services are to become proactive and preventative.

A key question is how to ensure that the right objectives, targets and outcomes to manage this are in place. For place-based care to integrate technology and be truly effective, it has to be mobile.

Person-centred and community care

Achieving personalised care will support the transition beyond a holistic approach to one where it is possible to deliver place-based care that targets specific areas, particularly those that require transformation.

Only by making person-centred care a reality can healthcare services be transformed to become flexible and have a place-based approach at their core. To look after a population as a whole in the right places, we need to look after individuals first, particularly through individualised health and care records.

Timings and the evolution of service provision will need to flex for different areas, and the skillset of the workforce will have to change accordingly. By bringing equilibrium to the living standards and available opportunities of our population, we will see an immediate and sustained benefit on health and wellbeing and a reduction in the need for severe elective activities.

Funding streams and ICSs

Changes in funding streams could precipitate a real system change that removes the silos that are currently placing barriers on delivering the most effective services with their own outcomes. However, it is first necessary to take a step back and define these outcomes, to keep the population healthy and deliver real change.

Considering single accountability and each step of an individual’s care journey will empower Tunstall to support ICSs in their role. For example, providing winter funding to social care services first, rather than straight to the acute trust, could have the potential to cut the numerous problems and pressures that the colder weather places on healthcare services and reduce the number of people requiring hospitalisation and other complex care services.

This will be further supported by real collaboration and integration across the system, with a particular focus on enabling data sharing. If issues and demand are addressed earlier, budgets and funding streams can be allocated to the specific areas that need them, and professionals will have peace of mind that there will be fewer significant hospitalisations of vulnerable people.

Falls protection is a particular point that places significant pressures on the health and care spectrum. For example, unaddressed fall hazards in the home are estimated to cost the NHS in England £435 million.1 If the right funding streams, people and technology are put in place, we can build on preventative and proactive approaches to reduce the number of people experiencing falls and the complex and often severe elective activities that can occur. This will in turn lead to a significant pressure being removed from the system.

The impact of technology

Technology’s role as an enabler can move the prevention agenda forward, however it is only valuable if it drives sustainable system change. In order to integrate technology effectively, we must bring the right skill sets into our services to ensure they can deploy digital solutions successfully.

Technology can have a significant impact on the citizen, particularly with the advancement of wearable technology. The ongoing progress that’s been made around data privacy is likely to continue, particularly as the next generation grows up in a digital-first landscape. This will lead to citizens being more comfortable with health and care technology and their data being fed directly into their health and care records.

Technology can provide a longitudinal profile of an individual instantaneously, which is particularly important for personalised care provision, and for making citizens feel more in control and responsible for their own health, wellbeing and care. The more that technology is integrated into care provision, the more empowered the population will become.

However, technology can also initially make people feel less empowered which has contributed to the uptake challenge. Providing education to citizens and care providers can help them to understand how and why they should use technology, which is ultimately to help people live freely and independently in a place of their choice.

Facilitating system change

Tunstall can facilitate system change by integrating technology into our services and considering big data, trends analysis and early indicators. Preventative services will develop effectively when individuals are willing and open to engage with technology and allow the right people to have access to their data. If this engagement is not driven forward, it’ll be more challenging to generate system change and the generational improvement that is needed.

The need to address short term pressures is one of the fundamental challenges within our services. Immediate pressures can become overwhelming and all-=encompassing, which then make it challenging to get to the root causes and tackle them in a systemic way. This is where technology can help, by increasing the bandwidth of the people who can make these changes happen. By giving them access to the right information in the right way they will have the ability to make the right changes at a place based and population level.

As a leading provider of technology, Tunstall is working closely with ICSs to understand the challenges that are faced by our health and care services and how these can be solved collectively. Technology leaders should be focused on breaking down barriers between organisations to help ICSs have the desired impact. Communication through the system, partnerships and problem solving will drive a central vision that ensures shared outcomes.

For more information, please visit www.tunstall.co.uk.

This article was kindly sponsored by Tunstall Healthcare.

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Ethicon showcases product portfolio in UK & Ireland hospital tour

By Ethicon

Ethicon, the Surgical Technologies Company of Johnson & Johnson MedTech, has launched its first-ever roadshow across the UK & Ireland, including a showcase that demonstrates the role of digital innovation in supporting the NHS to tackle the backlog of patients waiting for treatment.

Ethicon is committed in its mission to support healthcare systems to treat more patients and provide better experiences and outcomes, especially as recent announcements from the Department for Health and Social Care show how important digital transformation of the healthcare system is, with £2 billion earmarked from the spending review to help digitise the NHS and social care sector.

The Ethicon roadshow began in September and runs until early December. It is a unique opportunity for clinical and non-clinical healthcare professionals to speak to representatives and industry experts about how driving digital transformation is pivotal in this mission, outlining the importance of Ethicon’s Surgical Simulation Strategy and Services & Solutions offering which gives surgeons additional information to support their clinical decision-making.

The products being showcased on the tour bus cover specialties including Colorectal, Gynaecology, Thoracic, and Bariatric. Ethicon’s digital offering has the potential to drive the next surgical revolution, bringing together the value of Next Generation Robotics and Instrumentation, Advanced Imaging, and AI-powered Digital Solutions.

Learn more about Ethicon and its product portfolio here.

“We’re focused on creating a differentiated digital ecosystem including working in partnership with our dedicated account management team to support a successful implementation, data insights, and best practice sharing,” said Jenny Nagy, Ethicon’s General Manager in Great Britain. She continued to highlight the value the company sees in this collaboration:

“Our Ethicon roadshow will give customers the opportunity to discuss innovation in healthcare and witness our innovations first-hand with our product demos hosted on the bus. Our mission may have been accelerated by the pandemic, but we’re keen to connect with our customers in-person to demonstrate the value we place on working together to advance the use of technology in tackling the biggest healthcare challenges.”

The Ethicon tour bus is also hosting:

Science of Energy Training
Surgical Simulation Suite
Product Training Innovation Workshops
New Product Innovations

Clinical and non-clinical healthcare professionals can register their interest in attending and booking a slot at their chosen hospital location here.

This is a sponsored article.

Intelligent Healthcare: the tech transforming the NHS

By Gavin Wheeldon

Manchester-based technology company, Purple, is playing a vital role in the digitalisation of the NHS with its innovative ‘Intelligent Healthcare’ solution. Gavin Wheeldon, Chief Executive Officer, discusses the future of the healthcare sector and the vital tech required to drive this digital transformation.

This is a sponsored article.

As the world continues to recover from the crisis that is the Coronavirus pandemic, the healthcare industry is under immense pressure to catch up and keep up. With patient numbers reaching an all-time peak and 6.5m people on the waiting list for hospital treatment, healthcare providers are searching for solutions to stop the backlog growing even further.

Many are understandably resorting to people power to help solve the problem. As a result, a number of hospitals and facilities are continually inundated with waves of new, temporary and student staff. Staggering statistics show that hospitals in England spent more than £1.7billion on agency staff in the first three quarters of 2020-21 alone.

But what the healthcare sector needs are viable ways in which it can innovate, speed up and revolutionise its service to make things much more efficient – to ease the pressure on this growing employee base and to support the overall patient experience. The NHS 2022-23 business plan highlights an absolute dedication to “transforming care through harnessing information and technology”, with the overall strategy focussed on a “care […] to digitalise services, connect them to support greater integration and, with these foundations, enable service transformation.”

Driving the change

Purple are at the forefront of this digital transformation. Thanks to their ‘Intelligent Healthcare’ platform, Purple are able to help hospitals revolutionise for the long term. Their vital technology offers healthcare facilities large and small a range of different tech-led solutions; from real-time location of employees and wayfinding for patients to the launch of Purple’s innovative asset tracking technology.

Purple’s ‘Intelligent Healthcare’ platform

The latter was recently launched by the Purple team in order to provide staff with the ability to keep track of hospital assets such as drugs and apparatus in real time, through their phones. As an interactive ‘indoor Google map’, the platform’s integrated wayfinding hardware then enables them to navigate towards those assets in the hospital as required.

Speedy solutions and wayfinding tech

It is estimated that nurses spend at least one hour of every shift searching for critical pieces of equipment and medication, with only 31 per cent of their total time being spent with patients due to this admin.

As an asset tracking and navigation tool, Purple’s new digital capability will help increase efficiency, reduce costs and improve patient experience for healthcare organisations up and down the country, as well as in the US.

Not only will staff be able to closely monitor and reach their materials more quickly and efficiently, but hospital visitors and patients will also be able to find their way around the hospital much more swiftly, alleviating unnecessary stress and allowing them to focus on the priority of health.

Creating efficiencies

Using Purple’s technology, pharmacies and healthcare providers also have the option to track their medicines on site using mini tags which can help better manage their prescription services. By attaching a mini tag to either a medication bag or an individual vial, applying a BLE tag to a medication cart or by using individual badge tags on delivery personnel, medical providers can better understand where the medication, cart or personnel is located using a mobile device or portal. Upon arrival on site, pharmacies will be notified that medication has arrived by using Purple’s Geo Fences, which initiate notifications.

Purple’s asset tracking solution, combined with the wider intelligent healthcare package, has the potential to help the NHS address the £300m in lost medicine reported every year – money that could pay for more than 11,000 community nurses or almost 20,000 more drug treatment courses for breast cancer.

A trusted provider

With 60 per cent of British employees now using apps on their mobile phones to perform their duties to a higher standard, this shift to tech-first will be a key driver in the digitalisation and future of the healthcare sector.

Purple already provide Wi-Fi to a number of healthcare providers in the UK, including Croydon University Hospital and Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust. As well as providing connectivity for patients, staff and visitors, Purple’s service it goes beyond the limits of everyday Wi-Fi, allowing for real time alerts and information sharing.

In partnership with VCU Health, their team were able to harness its wayfinding solution to create a personalised navigation app for all eight buildings and the VCU Medical Centre as well as its corresponding parking decks. Vitally, Purple’s resource here offers patients a downloadable route which can take them from their front door right to their appointment.

Their app gives a turn-by-turn direction to the exact unit or clinic location allowing patients to arrive on time and anxiety-free. Patients are also equipped with the ability to manually search for facilities such as food and dining and shops on site – and even return to their car or other saved locations.

The future of the sector

Without doubt, the increasing support required by the NHS and wider healthcare community is staggering. Fortunately there is a straightforward solution at hand. These technological advances will serve to alleviate nurses’ valuable time, reducing unnecessary admin and relieving some of the additional stress encountered in the workplace.

If Purple’s Intelligent Healthcare platform can go even part-way to bridging the gap in staff shortages and waiting times, it will have succeeded in its aim. Equipping healthcare professionals with the tools they need, will allow them to focus on delivering vital care, transforming the patient experience for the better.

Gavin Wheeldon, Chief Executive Officer, Purple

Insource chosen as trusted data partner for NHSE reporting by Tower Hamlets GP Care Group

By Integrated Care Journal

Tower Hamlets announces Insource as managed services partner for automated data acquisition from EMIS and CSDS commissioner reporting.

Insource Ltd, a leading data management provider to the NHS, has been chosen by Tower Hamlets GP Care Group as its trusted data management partner. The first stage of the engagement will be to take data from the EMIS community system covering the 33 GP practices throughout the borough of Tower Hamlets, standardise it into a fully validated, single source of truth and automate the submission of Community Services Data Sets (CSDS) to NHS England.

Tower Hamlets GP Care Group is an independent healthcare group that brings together 33 GP practices and seven primary care networks to better support the local Tower Hamlets population. As a GP Federation, the group provide a number of primary care and community health services including 0-19 years Health Visiting and School Health, Out of Hours GP services, and the Urgent Treatment Centre based in the Royal London Hospital.

With the recent mandate from NHS England that all community providers formally complete the CSDS submissions, the GP Care Group found they were spending inordinate amounts of time doing searches on EMIS on their KPI activity and downloading CSV files to do the monthly reports for their 0-19 services.

Zainab Airan, Chief Financial Officer at Tower Hamlets GP Care Group CIC, commented, “Whilst we originally brought Insource on board to extract the data from EMIS for our CSDS reporting, we rapidly realised the value of that core data for our own performance and business management.

“The data tables from EMIS are all over the place. Insource takes that data, makes it clean and usable, and automates our monthly NHSE reporting. But now we also have near real-time activity data for our own use. We can sit our own systems, such as Power BI, on top of this unified data to get quite sophisticated analyses.”

This single version of the truth will also be shared with frontline staff, such as health visitors, so they can track where they are with their contractual KPI targets and see how many 1-year checks are due this week, or how many new birth visits are outstanding. It will give everyone from the executives to the frontline the same data at their fingertips. So all have better insight into how they’re performing and how to make service improvements.

The GP Care Group also recently won a tender for 0-19 services in the nearby London Borough of Waltam Forest, whose GPs also use EMIS. They now aim to mirror what they are achieving in Tower Hamlets, within Waltham Forest and ultimately do dual CSDS submissions to the two NHS Commissioners.

Insource are providing the data management and reporting solution as a fully managed service on the Microsoft Azure cloud platform, initially across Tower Hamlets then, when needed, across Waltham Forest.

Zainab Airan concluded; “With over 500 staff, we are a medium sized independent care organisation, but chose not to maintain in-depth data management skills in-house. We prefer to leave the data management to the experts and to get on with our core business of clinical care. We are very excited about this project and Insource are doing a fantastic job. They truly are a trusted data partner that will allow us to scale as our business develops.”

Lee Bellis, Sales Director B2B Partnerships for Insource, stated: “The GP Care Group are innovative thinkers and have some exciting plans in the offing including expanding their services and potentially linking to children’s centres. But the big breakthrough here is being able to access proprietary EMIS data and making it usable, as an application-independent data source, for KPI tracking and internal performance management. This is big news for all GP and Community providers and is an obvious next step for Insource.

“We are seeing more and more of our customers taking up our managed services options. Our ground-breaking data management solutions and deep NHS knowledge, developed over 20 years, is proving very attractive to clients. Our multitude of NHS-tested data feeds is growing all the time and we can get even complex sites operational within weeks rather than months.”

About Insource

Insource leverages powerful data to help healthcare organisations drive better patient outcomes, streamline operational efficiency, and extract essential insight by ensuring all foundational data is accessible for informed decision making – despite the legacy infrastructure.

Their leading elective care solutions suite supports the patient pathway management, statutory reporting, and capacity planning challenges of the whole organisation. With over 20 years’ expertise, more than 55 acute, mental health and community trusts, health boards, ICSs and independent providers currently use our services. The Insource data management platform enables informed trust-wide management, ICS insight and control, and partner solutions innovation.

For more information contact info@insource.co.uk.

About Tower Hamlets GP Care Group CIC

Tower Hamlets GP Care Group is an independent healthcare group that was formed in late 2013 to enable General Practices in the area to be more involved in the local commissioning of health services. It brings together 33 GP practices and seven Primary Care networks to better support the local Tower Hamlets population and to work alongside other healthcare providers in the Borough. As a GP Federation, the group provide a number of primary care and community health services including 0-19 years Health Visiting and School Health, Out of Hours GP services, and the Urgent Treatment Centre based in Royal London Hospital.

Employing over 500 staff, Tower Hamlets GP Care Group also leads the provision of innovative, high-quality, responsive and accessible health care services in the area and is one of six organisations that form Tower Hamlets Together, the borough’s health partnership. This brings hospital, community health, mental health, adult and children’s social services, public health, and the voluntary sector together to provide comprehensive health and social care to the community. This ensures a more coordinated approach to providing services, reducing duplication and improving the overall experience and outcomes for the patients who need them.

A waiting list approach flipped on its head

By Amy Bowen; Kaye Coholan

This is a sponsored article.

Making the Patient Tracking List (PTL) available to general practice in North Central London (NCL) is proving to be an effective approach.

When thinking about how best to address the backlog of patients, it’s natural to only consider the locations where the patients will be treated, but Amy Bowen, director of system improvement for NCL, says her team saw the value of involving primary care in the conversation. “Initially, everyone considered the PTL from secondary care, but we thought ‘let’s flip it on its head’,” she says.

The approach uses funding from the NHS’s elective accelerator sites initiative to form multi-disciplinary Proactive Integrated Teams (PITs) that can access the PTL using the elective recovery dashboard in the Cerner population health platform, HealtheIntent^®.

waiting list — Figure 1: Northern Central London (click to enlarge)

Like a Formula 1 pit crew supports a racing car driver, the objective for the PITs is to use data to optimise and maintain a person’s health while they await treatment. The need is very real across the NCL catchment area, with over 100,000 people having waited over a year for treatment and 300 waiting for more than two years.

The Patient Tracking List is a forward-looking management tool used by the NHS to monitor Referral to Treatment (RTT) and diagnostic waiting times for all patients across England. Even before the pandemic, demand for hospital treatment was outstripping capacity and, with the pressures on delivering care over the past two years, this has led to increased backlogs and longer waits. By April 2022 there were more than two million patients waiting over 18 weeks, with over six million in total waiting for treatment.¹

The effort leverages the holistic and long-term nature of the primary care relationship to support people on the PTL. “GPs get the concept easily and they welcomed the fact we were making bandwidth for this,” Bowen says. “This stuff floats my boat because it’s giving people a data-driven, health-inequalities-focused rationale for working together.”

The elective recovery dashboard utilises integrated data from across the system – including primary care – to provide a rich system-to-person view of the elective waiting list. This assists primary care and community teams to prioritise cohorts and more effectively manage patients on the waiting list.

The idea was conceptualised by Katie Coleman, clinical lead for primary care, who says that delivering person-centred and coordinated care is the aspiration of everything she does as a GP.

For Coleman, the PITs are primarily aimed at improving the health of individuals on the waiting list so they can “wait well” and be ready for the procedure when their turn comes up.

“If we can get upstream with their care and identify the things that might prevent them from actually having their surgery, we could then potentially ensure that when they do hit the top of the waiting list that they are in the best space possible,” Coleman says.

The second key element is looking at the wider determinants of health and how a person’s condition impacts their day-to-day life – for example, a person waiting for a hip replacement who is unable to work due to pain.

“If we identify those critical cases that if they don’t have their procedure, they might be at risk of spiralling down that social ladder, we would look to try and help to escalate them and to reprioritise their position in the waiting list,” says Coleman.

The approach is expected to lead to a number of benefits – not only improved health outcomes for the population, but also cost savings for the NHS.

“If you can maximise people’s wellbeing in advance of their procedure, then we know from the research that they have a shorter inpatient stay,” Coleman says. “They have a shorter rehabilitation period, so they’re able to get back up and doing what they need to do quicker.”

Enabling people to get back to work sooner reduces the need for social care and sick leave, and can lead to increased productivity in the workforce.

“Also if we support people to lose weight, bring their blood pressure under control, support them to achieve improved diet, sugar control if they’re diabetic, and so on, all of this over time will also help to drive down the risk of complications,” says Coleman.

“And that obviously has cost savings for the inpatient stay, but also cost savings potentially for the system as a whole.”

NCL’s five boroughs have identified priority cohorts and are working to improve the experience for both patients and care professionals. For example, Haringey is stratifying patients with a diagnosis of severe mental illness combined with two or more long-term conditions.

Jalak Shukla, clinical pharmacist and director of operations for the Haringey GP Federation, says the rationale for this was to provide additional support to patients who are less likely to attend for their procedure when they get to the top of the list.

“It’s a proactive approach, but we’re managing a caseload of patients identified for surgery, making sure they make it, looking after them after the surgery in the communications that they should be receiving, plugging them into the right services, and then putting them back into the care of general practice,” Shukla says.

“All of it’s proactive, all of it’s taken care of and then they can go back to business as usual, accessing the system when they need it.”

An additional benefit of the PITs is the relationship building between primary and secondary care, especially given the fact that post-COVID recovery work is a high priority across the system.

“We know secondary care can’t do it on its own,” Shukla says. “Looking at that list jointly is showing how the system is going to work better together, with primary care picking up what it can to ensure that patients are optimised in the interim.”

The proactive population health management enabled by HealtheIntent is encouraging clinicians to think differently about caseload management.

“We can actually do a one-size-fits-all review for patients and that’s only possible because we’ve got this shared platform,” Shukla says. “The filtering of which long-term conditions they have, their clinical context, their background, their age, the number of contacts that they might have had with the system – all of that data allows you to get a high-level view of what’s going on in your own PCN [primary care network].”

Moving forward, Shukla expects this type of approach to be adopted beyond elective recovery, particularly because of the holistic nature of the approach.

“I think it can make a patient’s journey a lot less fragmented,” she says. “Let’s deal with the long-term condition issues. Let’s deal with the social care issues. Let’s sort out the issues they have with referrals with secondary care. And let’s do it all at once.”

As systems continue to explore ways to meet the demand of the backlog of patients awaiting elective treatment, innovators across the country are using data to help prioritise, optimise and reduce redundancy.

To learn more about how Cerner solutions can support your organisation please visit their population health management solution page.

¹ Number of patients waiting over 18 and 52 weeks for consultant-led elective care and number of people on NHS waiting lists for consultant-led elective care | Source: www.bma.org.uk