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

By Integrated Care Journal

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

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

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

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

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

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

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

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

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

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

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

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

Digital Implementation, Featured, News December 5, 2024

There is no integrated care without cross-sector data sharing

By Hannah Barnett

Integrated care systems strive to provide seamless, equitable healthcare by coordinating services, but fragmented data sharing remains a major challenge. Strong data partnerships are vital for continuous care, addressing health inequities, and optimising resources. Yet, technology, governance, and collaboration gaps hinder progress, disconnecting patients and providers.

Why data sharing matters in integrated care systems

The success of integrated care systems (ICS) relies on robust, strategic data sharing across multiple care settings. Effective data partnerships enable more coordinated and continuous care, empower population health management and self-care, tackle health and access inequalities, and drive informed resource allocation.

In today’s diverse, fragmented healthcare system, patients often navigate multiple providers across sectors. However, their data does not always follow, and this is disempowering as much as it is frustrating. Many ICSs still lag in adopting comprehensive data sharing practices and infrastructures, posing a significant barrier to achieving greater system efficiency, transparency, and supporting patients effectively.

Current limitations in data sharing practices

When data sharing does occur, it often flows in one direction. For example, NHS commissioners frequently rely on activity and service-user data provided by Voluntary, Community, and Social Enterprise (VCSE) organisations or primary care network (PCN) systems data to evaluate the impact of funding. This narrow focus excludes data on service users’ interactions with other health and care services, creating blind spots in patient outcomes and hidden needs, while undervaluing how these services reduce pressure on the broader system.

Comprehensive data sharing partnerships could transform this dynamic, enabling full tracking of patient pathways and better identifying access inequities across services and sectors. This shift would not only improve service delivery and resource allocation but also foster shared purpose and cross-sector accountability, while promoting consistent data collection and truly evidence-based evaluation practices.

Overcoming barriers to consistent and effective data sharing

Achieving this vision requires overcoming several cultural, technological, operational, and legal challenges. Patient data remains fragmented across multiple management systems, complicating access, aggregation, and sharing. While some advocate for a unified data capture system, the diversity of digital maturity across delivery partners makes this impractical. Instead, ICSs should prioritise system interoperability and shared care platforms, the latter being widely considered the cornerstone of integrated data sharing. When anonymised and aggregated, these shared databases become invaluable resources for population health management by enabling healthcare leaders to identify and anticipate care gaps across geographies and demographics.

All technical advancements, including the integration of artificial intelligence (AI), must be accompanied by centralised guidance on data collection, coding standards, and sharing agreements. Currently, many providers hesitate to share patient data due to confidentiality concerns and unclear information governance, GDPR or AI guidelines, which often vary across contracts and care settings. Clear protocols and governance structures are essential to balance privacy requirements with healthcare planning needs, ensuring both patient confidentiality and system efficiency. A cohesive system with transparent data processes would not only build public trust in data use but also reduce the frustration and fatigue patients often experience when navigating multiple disconnected care providers. Such structures must be clearly communicated to patients as the primary owners of their data.

Relationships, capacity, and power diffusion

Despite government mandates, limited progress in ICS investment in data infrastructure reveals the persistent barriers posed by entrenched organisational cultures and practices. As the King’s Fund observed in a 2022 report, “Good technology is not enough for interoperability to succeed; relationships between staff and organisations are vital for success.” Persistent power imbalances within ICSs can undermine enthusiasm for data sharing partnerships, especially when the benefits of integration appear unclear or unevenly distributed.

To foster trust and collaboration, health, social care, and voluntary sector leaders must work as equal partners in planning and delivering services. By setting, understanding, and contributing to shared priorities and agendas, all sectors would be mutually recognised as key contributors to progress. This approach would also increase buy-in for data collection at the local level, ensuring that digital infrastructures are viewed as enablers of collaboration rather than isolated technologies.

Many health and care providers currently lack the capacity or funding to dedicate staff time to data collection. Short-term contracts further limit incentives to build data sharing capabilities or use data beyond immediate funding requirements. Longer-term contracts would support consistent delivery, sustainability, and capacity building across sectors, while substantially reducing data fragmentation. Building a sustainable ecosystem requires trust and ongoing investment through collaborative, long-term partnerships, rather than transactional, repeated contracting cycles.

The NHS must lead this transformation by embedding information technology, governance, AI, and analytics at the heart of system implementation while supporting partners with varying levels of digital maturity. This includes equipping the workforce with the technical skills required to effectively collect and utilise data. Recognising the current strain on workforce capacity, the NHS must leverage resources and time for upskilling (including from its own suppliers), and ensure the transition is backed by ongoing investments in accessible analytics.

Conclusion

As patient pathways become increasingly dispersed across care settings, robust and proportionate data sharing infrastructure grows more essential for tackling health inequities, streamlining cross-sector resource allocation, and empowering the system to better empower patients. A sustained commitment to technological and cultural innovation, coupled with workforce upskilling will reshape how providers collaborate and deliver care, enhancing population health outcomes and building a more responsive, equitable healthcare system.

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Scaling the workforce to meet MSK demand is unrealistic. We need new solutions

By Finn Stevenson

Digital pathways can transform access to care and ensure that those with the greatest need receive the care their conditions require, writes Finn Stevenson, Co-Founder and CEO of Flok Health.

According to recent projections, more than 7.2 million Brits will be living in chronic pain by 2040. With almost a million people already forced out of work due to musculoskeletal (MSK) issues, the welfare bill for back pain alone currently stands at £1.4 billion a year.

As our population ages and demand for treatment increases, one of the key challenges policymakers face is how to ensure patients can continue to access the care they need. With waiting lists for MSK treatment up 27 per cent from January 2023 to March 2024, we need to do more to deliver timely care to those who need it.

Hiring and training more physiotherapists can help make MSK treatment more accessible. It’s no secret that the workforce as it stands is chronically understaffed, and senior figures from the Chartered Society of Physiotherapy (CSP), along with politicians, have underlined the need to boost training and recruitment in the service. Since coming to power in July, Labour has already announced that it will be publishing a new Long Term Workforce Plan in 2025, with leaders signalling their ambition to go beyond the previous government’s commitments on NHS training and recruitment.

But it’s naive to think that simply hiring more people will be enough to service soaring MSK demand. As it stands, staff are so overstretched that the NHS would need to increase the number of physiotherapy positions in England by at least 7 per cent every year, just to keep up with current demand. Reaching this target seems unfeasible, especially considering the fact that physiotherapist numbers in the NHS increased by just 4 per cent from 2022 to 2023, and by only 0.7 per cent the year before. In fact, data collated by the CSP reveals that the annual rise in staffing levels has consistently fallen short of the required 7 per cent, with the largest increase in NHS physiotherapists across the last seven years standing at just 5.2 per cent, in 2019-2020.

With this in mind, it’s clear that any drive to hire and train more colleagues must come alongside a commitment to find new, innovative ways to improve patients’ access to MSK care.

Digital pathways can transform access to care

In September 2024, there were almost 350,000 people on MSK waiting lists in England, with some being forced to wait months to begin treatment. Not only is this frustrating for patients, it can also exacerbate their health problems. Studies show that longer wait times can lead to worsening pain, increased risk of disability, and a hugely detrimental effect on mental health and quality of life. By integrating novel digital pathways, we can deliver care to these patients as soon as they seek help, reducing the risk of deterioration, and accelerating recovery.

Effective digital pathways are already out there. At Flok Health, for example, we’ve developed the UK’s first AI physiotherapist, delivering at-home MSK appointments in a CQC-approved digital clinic on behalf of the NHS. Our system allows patients to be triaged, assessed and treated through a smartphone app, without ever having to wait for a traditional appointment.

Data from the work we’ve done so far shows that 94 per cent of patients describe their experience using Flok’s automated pathway as being “better” or “the same as” the care they would expect to receive from a human physio, with 88 per cent reporting that their symptoms had improved as a result of AI treatment. Crucially, all of these patients were able to access same-day care, with 24/7 appointment availability.

AI-operated digital pathways can also offer major benefits to clinicians. Managing high volume pathways (like back pain) in an AI clinic frees up capacity in the traditional services, allowing staff to focus on the cases where face-to-face appointments matter most. This alleviates pressure on the workforce and ensures those with the greatest need receive the dedicated time and resources that their conditions require.

Bringing care to the community

Another way to improve patient access to treatment is to extend MSK services out into new community settings. There are examples up and down the country where local Trusts have found innovative ways to meet their patients closer to home.

Sussex MSK Partnership introduced community appointment days (CADs) in non-clinical settings in a bid to deliver more scalable care and improve outcomes. These CADs act as a one-stop shop where patients can discuss their health issues with staff, before accessing a range of clinical solutions and other community services. The results of this programme were hugely encouraging, with 50 per cent of attendees discharged immediately and just one third requiring follow-up appointments. On top of this, waiting times for MSK treatment saw a 5-week cut, while staff morale was boosted as a result of seeing the immediate impact of their work.

Time to embrace change

In most NHS settings today, all patients with MSK conditions are funnelled down the same pathway for face-to-face appointments, leading to enormous backlogs, overburdened staff, and compromised care. Training and recruiting more MSK staff is of course important, but insufficient. Solving these issues will mean offering patients a choice of different care pathways. By running novel services like Flok’s AI clinic and Trust-run CADs alongside traditional pathways, we can transform patient access and outcomes while freeing up capacity in the existing services. These newer forms of care delivery are also significantly more scalable and resource-efficient than traditional models, which in today’s NHS is more important than ever.

Local authorities join initiative providing digital support to carers

By Integrated Care Journal

1 million carers across England are benefiting from tech-powered support, as 1 in 4 (25 per cent) local authorities across the country have joined an initiative providing essential, digital services for all those who look after loved ones in their communities over the course of this year.

Nine local authorities across Cheshire and Merseyside have become the latest to join a new initiative aiming to provide digital support to carers. The service is being delivered by carer-led digital community, Mobilise, and can be accessed remotely via Mobilise’s online hub by anyone caring for a loved one in regions where local authorities are participating in the initiative.

Under the Care Act 2014, local authorities have a duty to promote and provide services to unpaid carers in their area, to put support the wellbeing of carers and reduce the risk of carer burnout.

The digital support services include:

An online peer community of thousands of fellow carers from across the UK – with the chance to share advice and experiences through a community forum and during regular events, such as the ‘virtual cuppa’
Easy-to-use, self-service tools outlining the different forms of support which carers may be entitled to – including Carer’s Allowance – and guidance on how to navigate eligibility criteria and access various benefits
Tailor-made support guides on everything from how to balance caring with full-time work, to managing personal health and wellbeing while looking after someone else
Information on carers’ rights and relevant social care law, in line with the latest government guidance

An AI-powered ‘assistant’ is also available to help carers quickly and easily find the specific information, resources or support that they need.

Cheshire and Merseyside is home to some of the UK’s highest density areas of unpaid carers, with more than one in ten residents living in St Helens, Knowsley and Halton providing some form of unpaid care.

“It’s reassuring to know that my experience as an ‘unofficial’ carer for my husband is valued, and that there is support and advice available from Mobilise if and when I need it.”

Sheila Walsh, a carer in St. Helen’s

Chair of the Adults and Health Committee at Cheshire East Council, Councillor Jill Rhodes, said: “By joining this initiative, we’re taking a significant step towards recognising and supporting the invaluable contribution of our local carers. The Mobilise digital tool will empower unpaid carers to access the help they need, when they need it.”

Cheshire and Merseyside councils follow thirteen local authorities in the North East, who joined the same initiative earlier this year through a similar collaboration. This saw over a quarter of a million carers living in the North East alone gain access to additional digital support. The North East is home to the largest proportion of people supporting relatives or loved ones in any region across the UK.

With Cheshire and Merseyside onboard, a total of 38 local authorities across England have provided added support for carers so far this year as part of the tech-enabled initiative with Mobilise, on top of existing provision. The free on-demand services are aimed at supporting individuals across the UK with the day-to-day realities of caring.

Suzanne Bourne, Co-Founder and Head of Carer Support at Mobilise, commented: “It is amazing to see all nine local authorities across Cheshire and Merseyside coming together to harness the power of technology, and widen access to support for unpaid carers. They join many other local authorities across England in this mission. And, with Cheshire and Merseyside onboard, a quarter of all local authorities across England are now providing additional, digital support for carers. We can’t wait to see the impact for all those who provide care across Cheshire and Merseyside, and beyond.”

Councillor Del Arnall, Cabinet Member for Adult Social Care at Knowsley Council, said: “Through joining this initiative, carers in Knowsley can use Mobilise to easily access a range of support services on-demand and link in with their peers across the UK to share advice and reduce isolation.”

For more information about the support now available in Cheshire and Merseyside, see here. To start accessing support today, the Mobilise app can be downloaded via the Apple App Store or Google Play, with more information available on Mobilise’s website.

London’s Universal Care Plan recognised for support to care for sickle cell disease

By Integrated Care Journal

Use of digital care plans for sickle cell disease hailed for giving healthcare providers visibility of patients’ unique medical history and preferences, enabling more compassionate and personalised care.

The introduction of the Universal Care Plan, OneLondon’s shared care planning solution powered by Better, has been hailed as a key improvement in the care of sickle cell patients, a group historically disadvantaged by misconceptions and poor-quality care.

The personalised care plan is designed to address individual patient needs, ensuring that preferences are documented in advance, which is particularly crucial for those who may experience severe pain and struggle to advocate for themselves.

Dr Subarna Chakravorty, Consultant Haematologist at King’s College Hospital NHS Foundation Trust made the comments during a recent event in London for Better’s user community. Dr Subarna, added: “What matters to the patient should be just as important as the medical diagnosis itself.”

The Universal Care Plan facilitates seamless access to essential patient information for healthcare providers, ensuring that critical details, such as oxygen saturation levels, are readily available during treatment. Developed with input from patients, the plan employs the ACT acronym—Analgesia, Compassion, and Trigger Testing—to guide providers in delivering appropriate care.

While currently available only within London, there is a drive to extend digitalised care plans for people with Sickle Cell Disease nationally, supported by training programmes for healthcare professionals to ensure effective use of the system. The project represents a collaborative effort to enhance the quality of care for sickle cell patients and sets a precedent for similar improvements in other areas of healthcare.

During the event, Solome Mealin, a PhD student and patient advocate, shared a deeply personal account of her battle with sickle cell disease, emphasising the vital role technology can play in improving care. “All I’ve known is pain, every day,” she said, recalling her experiences where, in the midst of a sickle cell crisis, her only lifeline was an off-duty nurse who understood her condition. Desperate and in agony, Solome had to rely on this nurse to call her colleagues at the hospital to ensure she received the correct care.

“One of the hardest things is not always being listened to by healthcare professionals. They say things like, ‘it can’t be that painful,’ leaving you feeling alone and helpless,” Solome explained, highlighting the emotional and physical toll of constantly having to advocate for herself.
Solome stressed the importance of personalised digital care plans, which give doctors immediate access to critical patient information, even in unfamiliar settings. “Every time I move or even go on holiday, I have to think about whether there will be a hospital nearby that understands my condition,” she explained.

With accessible digital care plans, healthcare providers can offer more consistent, compassionate care by understanding her unique medical history and preferences. “I believe that with better care plans and universal support for conditions like sickle cell, we can truly transform patients’ lives,” Solome said, her message clear: better systems mean better futures for countless people like her.

Dr Subarna and Solome were joined by the Head of the Universal Care Plan programme, Nick Tigere, during a panel discussion on the plan which highlighted the importance of collaboration between clinicians and digital systems, particularly in prioritising care needs for conditions like sickle cell disease. The panel stressed the necessity of incorporating clinician and patient feedback into the Universal Care Plan pathways to enhance usability and effectiveness and the plan’s utility, particularly during urgent care scenarios.

Looking forward, Nick Tigere confirmed plans to measure the UCP’s impact on patient outcomes, aiming to continue learning and sharing insights with integrated care systems (ICSs) throughout the UK.

Half of UK adults struggling to access trusted health information, report finds

By Integrated Care Journal

Research by PIF and Ipsos reveals inequalities in access to health information and the impact of misinformation, calling for greater signposting towards credible health information.

The Patient Information Forum (PIF) and Ipsos have today published new research into health information access across the UK. The Knowledge is Power report offers new insights on information access, trusted sources, communication with healthcare professionals and the impact of misinformation on patient awareness of health.

The report is based on a cross-sectional, nationally representative survey of 2,003 adults in the UK from May to June 2024 using the Ipsos KnowledgePanel.

It reveals the demand for the NHS to signpost trusted information and wide support for the verification of health information.

Key findings include:

Half of adults in the UK are struggling to access trusted health information, with 55 per cent feeling they cannot trust health information they find online
1 in 10 adults in the UK have been affected by misinformation, rising to 1 in 5 for ethnic minorities
8 in 10 adults in the UK agree access to trusted health information would help them manage their health
1 in 6 say adults in the UK say their views are not taken seriously by their health professional. This rises to 1 in 4 for ethnic minorities
Only 1 in 10 adults with long term conditions in the UK are signposted to patient organisations, yet these are highly trusted by their users
2 in 3 adults in the UK state independent verification of health information would increase trust
There is already recognition of the PIF TICK – the UK’s only independently-assessed certification for both print and digital health information – among the UK population

Melissa Moodley, UK Head of Healthcare Research, Ipsos, said: “This timely research reveals a critical gap in access to trustworthy health information, with half of UK adults struggling to find reliable sources. This challenge is particularly acute for those with long-term conditions and minority groups.

“The impact is clear: 8 in 10 adults believe better access to credible health information would improve their health management. These findings underscore the urgent need to improve the provision of verified, accessible health information. Doing so is not just beneficial, but essential for enhancing overall health outcomes across the UK.”

Knowledge is Power makes five recommendations on the right to health information, aligned with the three shifts proposed in the NHS 10-year plan. In summary they are:

A right to health information – Health information is provided as a core part of patient care
Tackle misinformation – Through robust content standards and effective signposting of credible health information via health professionals and the NHS Apps
Tackle inequality – Health information must be accessible and appropriate for all
Lived experience as a metric – Embedding patient experience as a measure of NHS performance using the NHS Apps and single patient record
Dedicated leadership – A mandate for the effective delivery of health information with a named lead in all NHS organisations

Sue Farrington, chair of PIF, said: “Credible information supports people’s health decisions, from childhood vaccinations to joint replacement surgery. For people with long term conditions, it is a core element of care.

“Our 2024 survey gives a clear view of how people want to access health information and the challenges they face. Resolving these issues will ensure everyone gets the information they need, supporting the prevention agenda and contributing to the delivery of positive health outcomes for all.”

View the full Knowledge is Power report here.

Public Policy Projects’ Patient Safety Programme

In partnership with the UK-based charity, Patient Safety Learning, Public Policy Projects (PPP) is developing a new programme, Harnessing technology to enable a system wide approach to patient safety, to position patient safety as a core purpose of integrated care systems. The programme is taking a collaborative approach, bringing together health system leaders, industry experts and patient/end-user representatives to discuss patient safety through the lens of technology, digital innovation and data-driven transformation.

To find out more about the programme and to register for the next roundtable, Safety design and user engagement: the power of digitally enabled people, please visit the website here or contact Samantha Semmeling on samantha.semmeling@publicpolicyprojects.com.

RPS calls for government action to tackle medicines shortages

By Integrated Care Journal

Endemic medicines shortages need urgent action, says RPS, as supply chain woes and manufacturing consolidation drive worsening outcomes for patients and extreme pressures on pharmacy sector.

A new report from the Royal Pharmaceutical Society (RPS) has called on the Government to create a national strategy to manage medicine shortages and to change legislation to allow community pharmacists to amend prescriptions when medicines are in short supply.

Backed by charities and patient groups, the Medicines Shortages: solutions for empty shelves report explains how medicine supply chains are global and complex, with shortages caused by manufacturing problems and disrupted, less resilient supply chains. The report finds that supply chain issues are in part due to the consolidation of manufacturing outlets and cost-driven pressures.

The report calls on the UK Government to create a national strategy to both prevent and manage medicine shortages that would streamline efforts across the NHS, reduce inefficiencies caused by duplication of effort and ensure information and guidance for professionals and patients is available as soon as shortages occur.

The findings also highlight that supply chain vulnerabilities have combined with unplanned spikes in demand, such as shifts in prescribing practice or increased diagnosis of some conditions, to create a perfect storm of unstable supply.

This has made it harder for patients to access treatment, causing frustration, anxiety and in some cases, harm to patient health. The report cites high profile examples of patients being unable to access hormone replacement therapy, antibiotics, diabetes drugs, and medicines used to treat epilepsy and attention deficit hyperactivity disorder, among many others.

“Taking a new approach to medicine shortages is essential. A properly resourced UK-wide medicines shortages strategy that helps prevent and manage shortages would greatly improve the resilience of the supply chain. This would relieve stress and anxiety for patients and free up time for pharmacists to focus on patient care rather than constantly chasing down supplies.

James Davies, RPS Director for England and co-author of the report

The report also urges the Government to legislate to allow community pharmacists to make minor amends to prescriptions when medicines are in short supply. This simple change would enable a different quantity, strength or form of the medicine to be provided. For example, changing tablets to a liquid version of a medicine, or substituting a pack of 20 mg tablets with 2 x 10 mg packs when necessary.

At present, patients have to return to their GP to get their prescription amended, delaying access to medication, increasing bureaucracy and intensifying pressure on an already overburdened system. This move already has support from medical organisations, patient groups and other pharmacy bodies.

Frontline pharmacy teams are also under added pressure due to medicines shortages; A 2024 Community Pharmacy England survey found that almost three-quarters of community pharmacy staff report spending one-two hours or more daily trying to obtain medicine stock or source alternatives. One acute hospital trust also reported that the number of staff required to manage medicines shortages has increased from one person to five in the last five years – a situation “likely to be reflected in trusts across the country”.

Ohter recommendations in the report include:

Improve reporting by manufacturers: prompt alert of the risk of shortages would transform the impact on patients, and those consistently failing to report should be fined.
Build supply chain resilience: strengthen NHS procurement contracts to ensure manufacturers can meet supply demands and respond to shortages quickly.
Improve data connectivity: Use better demand forecasting and share information across the supply chain to prevent stock issues before they happen.
Enhance systems for life critical medicines: improve collaboration across the health service to coordinate access to specific medicines.

James Davies, RPS Director for England and co-author of the report, added: “Community pharmacists must be allowed to make minor changes to prescriptions during shortages. The current outdated system inconveniences patients, wastes time and causes frustration. The Secretary of State for Health should give pharmacists the authority to act in the best interests of their patients, rather than remain subject to ‘empty shelf syndrome’.”

Bruce Warner, Chair of the advisory group for the report, said: “This report provides a comprehensive assessment of what is causing medicines shortages, their impact on patients, pharmacists and healthcare professionals, and what more can be done to mitigate and manage shortages.”

Sharon Brennan, Director of Policy and External Affairs at National Voices, a coalition of 200 health and social care charities in England, said: “We urge the Department of Health and Social Care to recognise the serious and worsening impact medication shortages are having on patients, and to commit the same level of urgency to improving the situation as it has to other NHS access-to-care issues such as diagnosis and waiting lists.”

New study underway on joint clinical trials between health tech and primary care

By Integrated Care Journal

A groundbreaking feasibility study in Northumbria is exploring the potential of collaborative clinical trials between health tech providers and primary care, with early results showing significant lifestyle and self-management improvements.

A first-of-its-kind randomised control trial in Northumbria is exploring the feasibility of cost-effective collaborative clinical trials, using digital interventions to support people with hypertension and depression and/or anxiety. Over a 12-week period, the Innovate UK-backed research project is involving patients by using Holly Health’s digital coaching service at home, emulating the real-world use of the service.

Cardiovascular conditions are the biggest cause of early deaths worldwide and over 19 million UK adults are affected by hypertension. However, as stated in the NHS Long Term Plan, “cardiovascular disease is largely preventable and the single biggest area where the NHS can save lives”.

Managing and preventing hypertension through lifestyle changes, including an improved diet and increased exercise, is critical. However, for many patients, self-managing the required changes becomes more challenging when combined with conditions such as anxiety and depression. For this reason, the need for innovative and integrated solutions that address both physical and mental health aspects is paramount.

Holly Health’s digital tool has the transformative potential of addressing the challenges posed by the comorbidity, enhancing self-management, reducing NHS costs, and improving national health outcomes.

Dr Justine Norman, Clinical Director for Quality and Research at Northumbria Primary Care, expressed excitement about participating in this unique feasibility study, highlighting the team’s interest in understanding how patients engage with and benefit from an innovative digital approach that address both physical and mental health conditions. Dr Norman added,

“The response from patients to take part in the research has been really encouraging. Now, we’re looking ahead to the study which has concluded this month and analysing the outcomes which will form a bigger six-month trial to measure the longer-term impact for our patients.”

The main outcomes of the study indicate strong patient engagement and positive lifestyle impacts. After using Holly Health for 12 weeks, 64 per cent of patients found the service useful, 69 per cent said they benefited from the service and 92 per cent found it acceptable as a digital health intervention. The app has helped improve participants’ lifestyles in the following ways, including:
●      Changes to eating habits
●      Reduced alcohol intake
●      Increased physical activity
●      Using the app to prompt better behaviours/habits

One participant finds the app very valuable and has become an integral part of her daily routine. She finds the ‘discovery’ resources and the notifications extremely useful. She also enjoys the reward feature and being able to tick off/complete a “habit” once she has done it. As an exploratory analysis, the study will look into changes in GP appointments and prescriptions after six months of using Holly Health. As an exploratory analysis, the study will look into changes in GP appointments and prescriptions after six months of using Holly Health.

Daniela Beivide, Chief Science Officer at Holly Health pointed out that prior studies for isolated conditions have demonstrated the positive impact of digital interventions, including a reduction of demand on services. She commented,

“We’re just as excited as our study partner, Northumbria Primary Care, to be investigating whether the same impact can be applied to supporting people with physical and mental health comorbidities.

If successful, there is huge potential to efficiently and cost-effectively scale the service for large populations to reduce strain on NHS services and create significant change in the economy of the country. We’re proud to be part of this cutting-edge approach where digital health companies and the NHS can partner to research and implement solutions at low cost and an accelerated pace”.

Holly Health’s intuitive app provides intelligent AI-powered coaching, habit reminders, education, and in-the-moment support to encourage regular actions for blood pressure and mood management, which empower individuals and improve self-management abilities.

The feasibility study is part of a Future Economy 12-month project funded by Innovate UK that has also enabled Holly Health to develop innovative features within its app, such as the Ecological Momentary Assessment (EMA) feature that gathers real-time user data for current mood and stress levels which can then be used to provide a more relevant and personalised coaching experience.

Addressing NHS productivity could unlock billions to deliver neighbourhood NHS, says IPPR

By Integrated Care Journal

Restoring NHS productivity to pre-pandemic levels would have freed £19 billion more in 2023/24, enough to build a new health centre in almost every neighbourhood, according to a new report from IPPR.

Billions worth of extra care could be unlocked if NHS productivity problems and high staff turnover are addressed, according to a new paper from IPPR, From the frontline: Empowering staff to drive the NHS reform agenda.

Analysing the “twin crises” hitting NHS performance – low productivity and poor staff retention – the report establishes that in 2023/24, the NHS in England had a budget of £171 billion, but productivity was 11 per cent lower than before the pandemic, according to NHSE’s own estimates. If productivity had matched 2019/20 levels, the report finds, the NHS could have delivered an extra £19 billion worth of care – enough to build 900 new health centres, and almost enough to deliver the Labour Party’s manifesto promise of building a ‘Neighbourhood NHS’ in one year alone.

The new Labour government has now announced a major uplift to NHS spending in the 2024 autumn budget, taking the planned daily expenditure budget to £192 billion by 2025/26. Increasing productivity will be crucial to ensuring maximum benefit for patients. The NHS has a target to improve productivity growth to 2 per cent per year by 2029/30. Achieving this goal next year could deliver an additional £3.8 billion worth of care – enough to more than triple the numbers of MRI and CT scanners in the NHS.

“After years of mounting pressures, the NHS is facing two major challenges: high levels of frustration among staff, and low productivity which is taking a toll on patients.”

Dr Annie Williamson, IPPR research fellow and current NHS doctor

Exacerbating the issues around poor productivity, the report argues that the NHS is facing a parallel crisis of staff frustration and departure. It notes that between 2010 and 2023, the average annual NHS leaver rate was 11.2 per cent, meaning one in nine staff members left each year. This is compared to 2009/10, when the rate was 9.5 per cent, just over one in 11 staff.

If the leaver rate had been kept down at 9.5 per cent, IPPR estimates that an average of 12,000 NHS staff could have been retained each year since 2010. Holding the number of new entrants constant, this would equate to around 150,000 additional staff retained cumulatively.

IPPR argues that the two major crises facing the NHS – low productivity and poor staff retention – reinforce each other. High staff turnover increases costs and impacts care delivery, while inefficiencies, such as outdated equipment, deepen staff dissatisfaction and lower productivity levels.

Low autonomy for NHS workers is a key underlying issue, the report finds. Decision-making in the NHS often lacks information and insights from frontline staff, leading to the wrong priorities and missed improvements. Money may be spent on hiring locum doctors when staff feel new computers are what is needed, or on top-up winter crisis funding rather than community services to keep people well.

IPPR argues for a new approach to NHS reform. Unlocking staff insights and giving them a greater voice could lead to meaningful changes at every level, the report says.

IPPR calls for reforms to incorporate staff voices in clinical service design and national policymaking including:

Empowering frontline staff by establishing channels for service improvement led by Trust-level specialists, with protected time for all staff to participate
Setting up representative staff boards in each NHS trust to put forward ideas from the wider workforce and consult on all matters affecting staff wellbeing, with a duty on main NHS trust boards to consult them
Giving a staff voice in national workforce policy by reforming pay review bodies to include negotiation or embed a formal duty to consult with staff

Dr Annie Williamson added: “By addressing these issues [of low productivity and retention], we could unlock billions worth of better healthcare. More importantly, this would create a more efficient and sustainable health service, where staff voice is central to improving the quality of decisions throughout the NHS.”

Dr Parth Patel, Associate Director of Democracy and Politics, said: “We all know the NHS needs reform, but we keep getting distracted by the same red herring debates. The real issue is that we’re struggling to get the NHS firing on all cylinders again.

“Too many decisions are made at the top, while those on the front lines—who truly understand what’s needed—are left with little say. The status quo isn’t working. We need to empower NHS staff with a genuine voice and a real stake in the decisions that affect them. Only then can we unlock the NHS’s full potential again.”

The full report can be accessed here.

Operational management: The invisible backbone of NHS success

By Phil Bottle

Phil Bottle, Managing Director of NHS workforce planning specialists, SARD, discusses the unsung importance of operational management to the NHS, including how effective management can be the remedy for a system straining under the weight of misaligned capacity and demand.

Penny Dash’s recent comments cut straight to the heart of a critical issue within the NHS: the absence of robust operational management. Her observation that adding staff has not translated into the anticipated impact is a stark reminder that people alone, without the right systems and processes, cannot untangle inefficiencies or improve outcomes.

But what exactly is operational management in the NHS context? At its core, it’s about ensuring that the vast resources—people, time, and technology—are strategically aligned to deliver the best care for patients. It’s the art of transforming effort into efficiency, of turning plans into practical, measurable outcomes. It’s also about creating a culture of accountability, where teams understand their roles, adapt to challenges, and continuously seek improvement.

The cost of missing discipline

Operational management is not a glamorous term. It doesn’t grab headlines like breakthroughs in medical research or new funding announcements. Yet its absence is felt every day:

Empty outpatient clinics sitting next to overcrowded ones
Elective surgery lists under-utilised due to inflexible staffing
Temporary fixes taking precedence over sustainable solutions

These aren’t isolated problems; they’re symptoms of a system straining under the weight of misaligned capacity and demand. And they highlight the critical need for something often overlooked in healthcare: discipline.

“Dr Dash’s call for more ‘ops managers’ is a recognition that leadership matters.”

Operational discipline doesn’t mean rigid adherence to plans. It’s about creating the flexibility to respond dynamically to real-world challenges. It’s about having clear, standardised processes that still leave room for human ingenuity. It ensures the right people, in the right roles, supported by the right tools, are empowered to adapt and improve.

It is something clearly missing and sorely needed. Yet as unglamorous as this work may seem, these are the hard yards that need to be made for meaningful progress.

Unlocking potential through workforce planning

Workforce planning is one of the linchpins of effective operational management. Done well, it provides the foundation for aligning capacity with demand. It highlights inefficiencies and opportunities, offering clarity on how resources can best support service delivery.

However, traditional approaches to workforce planning often fall short. Data may be fragmented or inconsistent, job plans may fail to reflect actual service needs, and staff often feel excluded from decision-making. The result? A process that stalls and fails to deliver the needed impact.

What’s needed is a shift in focus:

From fragmentation to integration
Workforce data should tell a cohesive story, not present conflicting narratives. This requires shared frameworks, clear language, and accessible tools that translate data into actionable insights.
From top-down to collaborative
Operational management isn’t a one-person job. It’s a team effort that thrives on engagement at every level—from senior leaders to frontline staff. Collaboration fosters ownership, ensuring that changes are not only implemented but embraced.
From short-term fixes to long-term sustainability
Quick fixes may alleviate immediate pressures, but sustainable operational management looks ahead, anticipating future challenges and building resilience into systems and processes.

Leadership and accountability

Dr Dash’s call for more ‘ops managers’ is a recognition that leadership matters. But perhaps even more critical is focusing on the processes those leaders oversee. Operational management isn’t just about systems; it’s about the people who run them. Effective leaders don’t simply keep the cogs turning—they identify inefficiencies, question the status quo, and work collaboratively to drive meaningful change.

This may mean rethinking whether current processes are fit for purpose or innovating entirely new ways of working. For example, underutilised elective services or ‘dark hours’ in clinical spaces could be addressed by flexing traditional staffing models or introducing creative solutions such as cross-team task-sharing.

Equally, accountability plays a pivotal role. As Paul Corrigan pointed out, the NHS must create environments where success and failure are acknowledged and acted upon. However, accountability should not equate to punitive measures like league tables. Instead, it should foster collaboration between trusts, encouraging the sharing of best practices and lessons learned. Data is crucial here—not as a blunt instrument, but as a tool to illuminate areas of strength and opportunities for growth.

A moment of opportunity

The challenges are clear, but so too are the opportunities. Meeting today’s demand is as critical as planning for the future. Predictive analytics can help model upcoming needs and support proactive decision-making, but current demand models are just as vital. These tools allow teams to allocate resources efficiently, manage capacity in real time, and ensure patients receive timely care. Balancing immediate pressures with future-proofing is the operational challenge of our time—and one that must be tackled head-on.

Operational management is more than a behind-the-scenes function. When strengthened, it unlocks efficiency, empowers teams, and transforms patient care. The time to focus on “ops, ops, ops” isn’t years away; it’s now.