Featured, News, Systems

From blame to learning: how digital incident reporting can transform patient safety culture

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Patient safety is a cornerstone of healthcare, directly affecting the well-being of individuals, the confidence of their families, and the overall trust in the healthcare system.


This content was kindly supported by Vatix.


Keeping safety at the forefront helps reduce serious incidents and prioritise the delivery of quality care.

A key way of ensuring patient safety within any healthcare organisation is to instil the right culture.

Traditionally, the approach to reporting patient safety events has tended to be blame-focused rather than learning-oriented. In recent years, however, a shift has been taking place. The introduction of the Patient Safety Incident Report Framework (PSIRF) and new innovations in digital incident reporting systems have encouraged a culture change.

But before discussing how things are set to change, let’s examine the underlying problem.

The problem: a blame culture in healthcare

A blame culture is when individuals are punished or blamed for mistakes, rather than looking at the bigger picture of why something went wrong. It’s particularly prominent in healthcare as mistakes are often very serious and can be life-threatening.

For example, this could look like blaming a nurse for a medication error without looking into the broader context to see if there could be an issue with unclear labelling or a lack of resources.

This also has a knock-on effect on reporting figures, as people may be wary of reporting events for fear of punishment. And often, the true root cause of the issue is not discovered, meaning that there’s a higher chance of incidents being repeated.

The Serious Incident Framework (SIF) was the old process for reporting patient safety issues in healthcare. It tended to zero in on how the actions of individuals, rather than systems or processes, resulted in mistakes. This emphasis on individual responsibility for a mistake bred a culture of punitive action within some organisations and shifted the focus away from learning and prevention.

Why a learning culture matters for patient safety

A learning culture is built around the value of shared and continuous improvement. Instead of blaming an individual when a mistake is made, organisations should look at the wider context and root cause of the incident.

Incidents should be viewed as a learning experience and encourage open and honest communication about why the event occurred.

The Patient Safety Incident Response Framework (PSIRF) was brought in to replace SIF, which was recognised across the healthcare sector as problematic. PSIRF moves away from blame and towards learning and improvement.

Some of the core benefits of implementing a culture of learning within healthcare organisations include:

  • Encouraging honest reporting of incidents.
  • Identifying patterns and trends rather than isolated mistakes.
  • Promoting proactive safety measures rather than reactive discipline.

However, cultivating a learning mindset doesn’t just happen overnight; effort needs to be put in to ensure it’s fully embedded into an organisation’s culture.

Best practices for creating a sustainable learning culture

Creating a learning culture that is truly embedded in an organisation’s values and operations must begin with a clear commitment from leadership. Leaders must encourage reporting, model transparency, and create an environment where everyone feels safe to speak up without judgment or repercussions.

Regular training and reflection sessions for staff also help keep learning front of mind. The key takeaways from any major incident should be circulated to avoid reoccurrence and assign any relevant corrective actions. During this process, there should be a focus on system-wide issues or the greater context that led to an event rather than individual fault.

Another very important element of creating a lasting safety culture is ensuring that there is an effective and user-friendly digital system in place for reporting and managing incidents.

The role of digital incident reporting in creating a learning culture

Typically, filing a report was paper based, meaning that information could be scattered over several different systems and that it was hard to keep track of learnings and outcomes.

Modern digital reporting tools make reporting incidents easier for staff, patients, and family members. People are more likely to report an incident if it’s simple and they know it will be followed up on.

Digital tools help organisations shift away from a blame culture in a number of ways:

  • Anonymity and psychological safety: Ensures staff feel safe to report without fear.
  • Real-time data analysis: Helps identify trends and root causes.
  • Standardised reporting: Reduces human bias and ensures incidents are reviewed fairly.
  • Automated feedback and learning: Digital tools can provide instant feedback, resources, or training suggestions based on reported incidents.

The future of patient safety through digital learning

Creating a learning culture in healthcare is vital for improving safety, transparency, and quality of care. Moving away from a culture of blame and towards one focused on shared learning allows staff to feel confident speaking up and participating in meaningful change.

Digital incident reporting systems like Vatix’s are key enablers of this transformation. Vatix makes it easy for staff, patients, and families to report incidents through a secure, user-friendly platform – removing barriers to reporting and encouraging early intervention. Its system supports real-time data analysis and customisable workflows that help organisations spot patterns, address risks proactively, and track actions taken.

With features such as reporting via QR code, mobile access, and seamless integration with other compliance tools, Vatix empowers healthcare organisations to meet safety standards and continually learn, improve, and deliver safer outcomes for everyone.

If you’d like to find out more about how Vatix can help embed a safety culture within your organisation, get in touch today.

How to build digital twins within healthcare

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As NHS waiting lists climb and pressures on healthcare delivery mount, digital twin technology offers a potentially transformative opportunity. Ram Rajaraman, Healthcare and Life Sciences Industry Leader at Quantexa, explores how creating real-time, data-driven digital replicas of healthcare systems and patient populations could revolutionise prevention, care delivery, and resource planning across the NHS – unlocking a smarter, more predictive approach to population health.


In May, the NHS announced that waiting lists for routine treatment in hospitals had risen for the first time in seven months, despite being out of winter pressure season. The waiting list sits at 7.42mn appointments at the end of March, a steep increase of 18,751 from February.

While it is wholly acknowledged that waiting lists tend to fluctuate with natural spikes in the system, this data comes at a time in which the Labour government finds itself under the spotlight to reduce waiting lists and improve overall NHS performance.

Wes Streeting, whose mission for this parliamentary term is to revamp healthcare efficiency, has already made some radical changes with a view to delivering on this promise. The new 10-Year Health Plan laid out the importance of making the NHS the most “digitally accessible” system in the world. Moves have been made in this direction by announcing promising upgrades to the NHS App that enable its use as a digital front door to the entire NHS.

The department has also teased its ambition to develop a ‘Single Patient Record’ for each NHS patient, using their appointment history and medical records across care specialties. The ambition is that each patient can then seamlessly access care providers across the NHS, without having to repeat their story.

I’d argue for taking this one step further and creating a 360-degree identity of each citizen within their context. Connecting their data across government departments, educational institutions and other public services will allow healthcare providers a full understanding of each patient case.

What are digital twins?

It’s not enough to address individual problem areas such as growing concerns about mental health or challenges with the demand and strain on the system. Instead, there is increasing pressure on government to tackle these systemic issues at their core – using patient data to create a 360-degree identity of each citizen within their context and improve overall population health.

One of the ways to meet these challenges effectively is by embracing digital twins. Digital twins are gaining significant traction as more industries recognise their value in identifying how we tackle complex problems. Put simply, a digital twin works by replicating a physical asset in a digital world, created using smart sensors and data from the original source to model and predict how something will or could behave.

System digital twins are a virtual representation of a real-world system. The twin is made first as a digital model of the real system, using simulations, 3D models or system diagrams. System data can then be integrated into the model continuously or at regular intervals, allowing it to update in real-time. People, places and concepts can be fed into the twin to mirror the current state of the physical system. That means if something in the real system changes, the twin can reflect this immediately.

Simulating society through data integration

Digital twins are currently most often used across supply chain industries to improve real-time insights around customer journeys, in-transit inventory and staffing, and modelling against supply chain variability (McKinsey). The technology is gradually becoming more commonplace – often used in the manufacturing industry to produce models – and Gartner projects that by 2034, global revenue for simulation digital twins will reach $379 billion.

The healthcare industry is starting to adopt digital twins, with pharmaceutical companies embracing them for shipment operations and forecasting in clinical trial labs. But their potential expands beyond clinical trials, and they can be implemented to forecast trends and make predictive analysis about population health. If NHS patient data is fed into the digital twin, data engineers can then model scenarios on the patient population, to gather patient-level insights in the case of unexpected scenarios. To unpack how we can use this innovation to improve health outcomes, it first needs to be understood.

For example, Britain’s life expectancy crisis is developing, with one community reporting male life expectancy on par with war-torn Syria. Digital twins would allow for analysis of why life expectancy is worsening, using a trial-and-error approach to solutions without the need to run studies on the public. Alternatively, if the UK sees a sudden rapid rise of immigration, engineers can simulate the effect on population health with a rise in the spread of foreign diseases and an increase in pressure on the NHS.

Digital twins can be used to develop clinical trials that will get quick and accurate results. Now that the government has announced it will be automatically inviting patients to join clinical trials based on their health data and additional insights, digital twins can map clinical trial outcomes to optimise design for ideal outcomes. This also allows researchers to scale drug discovery, as they can model patient data to get faster and more personalised research.

A third opportunity for digital twins to contribute to healthcare and patient wellbeing is through overall hospital management design and care coordination. By taking a more predictive lens on patient outcomes, hospital staff can staff their treatment centres accordingly and apply the right level of resource.

There is great opportunity for predictive analytics that traditional models of aggregated intelligence didn’t have. As one of the government’s key pillars is “prevention over treatment”, taking advantage of this technology will give the UK’s health service a leg up in the future of its population health.

Rethinking local healthcare with digital twins

The NHS’s regional split must also be used to the system’s advantage when dealing with population health. Integrated care boards (ICBs) and NHS trusts have access to a whole network of health data that applies to their local region, and regional health datasets can be instrumental to the national health ecosystem.

To paint the picture of why regional health data is important, regions with ageing populations may see patterns in diseases that affect an older age group and therefore may be disproportionately reliant on community care. Urban populations may see more illnesses spike from air and water quality issues than a rural population. While all patient data feeds into a wider system, it’s important for ICBs to understand their own geographical challenges.

Regional and local data is incredibly valuable, but currently underused. By beginning to implement digital twin technology at a regional level, ICBs and trusts can start analysing their regional health trends to understand resourcing through a predictive lens. This means that under increasing waiting list pressure or staff shortages, organisations within the NHS can see where they’re lacking, and apply more resources to specific care specialties that will be most valuable for their patients.

Digital twins can also be used to identify regional cohorts of patients that would benefit from prevention initiatives – for example the child flu vaccine, or a diabetes prevention programme. Through a digital twin simulation, local organisations can identify preventative programmes that will be beneficial for their population. And conversely, understanding the potential outcomes of these patients through a digital twin can help determine the cohort.

If able to tackle public health through greater predictivity and prevention, digital twins quickly unlock benefits and rapid innovation to begin improving outcomes at scale. The potential benefits for digital twins go beyond hospital management and improving the efficiency of patient care – there are additional benefits like drug discovery, R&D and disease prevention that have the potential to improve overall population health.

The National Digital Twin Programme has been developed to ensure that the digital twin market is built on secure, trustworthy and ethical standards, while maintaining interoperability and adaptability. There is still a lot of debate around the ethics of using NHS patient data. The way I see it, is that using patient data is not only acceptable – but necessary – when the outcome goes back into patient health. It’s not about arbitrarily collecting patient data, but the safe and secure management of patient data for good.

It is in all our interests to prevent the impact of the next global pandemic, or even just ensure that our neighbours are all receiving a high standard of care. The NHS is one of the largest banks of healthcare data in the world, and we need to use it to improve care for generations to come.


Ram Rajaraman is Healthcare and Life Sciences Industry Lead at Quantexa.

The 10-Year Health Plan: A win for community pharmacy?

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The government’s 10-Year Health Plan outlines a major shift in NHS priorities, aiming to move care closer to communities, emphasise prevention, and harness digital tools. Central to this vision is an expanded role for community pharmacy, raising questions about how the sector will adapt and whether it is equipped to meet these ambitions.


The government’s 10-Year Health Plan sets out an ambitious transformation for the NHS underpinned by three major shifts: hospital to community, analogue to digital, and sickness to prevention. At the heart of this transformation is the proposed development of a ‘Neighbourhood Health Service’, where pharmacy is set to play a vital role.

The plan outlines a clear transition for community pharmacy, from a predominantly dispensing to a more clinical, preventative and digitally-enabled role. Over the next five years, the government proposes that community pharmacies will:

  • Manage long-term conditions such as obesity, high blood pressure and high cholesterol
  • Deliver more preventative services, including vaccinations and screening for cardiovascular disease and diabetes
  • Support complex medication regimes and offer independent prescribing
  • Be linked into the Single Patient Record, enabling more seamless service delivery

These proposals build on the success of existing services like Pharmacy First and hypertension case-finding, both of which demonstrate the value of pharmacy in improving access and early intervention. However, this success hinged on public awareness, strong pharmacy leadership, and swift IT integration – which must be central strategies if ambitions for the sector are to be realised.

Pharmacies are critical for prevention as they are well-embedded in local communities, but particularly so in underserved areas that often face the highest burden of chronic disease. However, pharmacies must be equipped with the right tools and training. Innovative diagnostic technologies, such as point-of-care testing, can support early detection and intervention. Although there have been some promising pilots, they are not yet used at scale. Deploying such tools in tandem with workforce training will be essential to delivering preventative services in community pharmacies.

Public Policy Projects (PPP) has previously advocated for a more integrated role for community pharmacy, parity across primary care and a broader understanding of the sector’s role beyond clinical services and medicines optimisation.

Community pharmacies are hyper-local, highly trusted and universally accessible, offering huge potential to deliver social value. From providing culturally sensitive health advice, supporting marginalised populations, or acting as an informal hub for wellbeing, community pharmacies are ideal settings to form part of the emerging Neighbourhood Health Service.

However, unlike general practice, community pharmacies do not hold registered patient lists and often serve individuals who move across geographical boundaries. As such, new services must be designed around the needs of patients, not tied to artificial catchment areas. Primary care contracts which are complementary and integrated by nature, allowing providers to collaborate, not compete, will be essential to seamless service delivery.

The 10-Year Health Plan marks a pivotal moment for community pharmacy. It recognises many of the sector’s often overlooked strengths and proposes a more strategic role for pharmacies in health and care delivery. However, these opportunities must be matched with sustainable funding, contractual reform, and meaningful collaboration across all system partners.

Next steps

To further explore the implications of the 10-Year Health Plan and engage with PPP’s Pharmacy and Medicines work, please contact: Samantha Semmeling, Policy and Programmes Manager, Public Policy Projects (samantha.semmeling@publicpolicyprojects.com)

SAR pressures on the NHS: Why automation is now critical

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Subject Access Requests (SARs) are rising sharply across the NHS, placing increasing strain on trusts. With mounting regulatory pressure and limited resources, Bradford District Care NHS Foundation Trust has taken action, introducing automation to ensure timely responses and protect sensitive patient data.


The number of Subject Access Requests (SARs) being submitted to the NHS is mushrooming year-on-year, and if trusts are left to manage with their current technology set up, many run the risk of falling behind the one-month deadline to complete each request and falling foul of regulations because they have neither the time, nor capacity to keep up with demand.

With the NHS 10-Year Plan also now published, aimed at modernising the health service in England and ensuring it is fit for purpose, decisions must be made on how to streamline core processes and make the whole experience better for not only people working within the NHS, but crucially, the people using it: the patients.

Regulatory requirements such as the UK GDPR and the Data Protection Act 2018 are growing in complexity, and healthcare organisations need robust systems in place to protect sensitive data, and help them respond quickly and efficiently to demands.

Case study: Bradford District Care NHS Foundation Trust

Bradford District Care NHS Foundation Trust is seeing the number of SARs increase by around 100 a year, and has currently received around 700 requests in so far 2025.

Sarah Briggs, Data Protection Manager at the Trust, explains that the SARs were from mixed sources and varied, including from the patients themselves; a solicitor acting on their behalf; police officers that are carrying out investigations; or councils that might be looking into protection orders. They also come from regulatory bodies looking at the Trust’s fitness to practice within the NHS.

She says the Trust had seen an increase in people exercising other rights as well, such as the right to rectification, having things amended or removed completely, and reporting that their records have been accessed inappropriately.

The matter has been exacerbated by the inclusion of emails and email trails, which increases the number of documents needing attention, she added.

Drowning in administration

Briggs said the sheer number of SARs was beginning to weigh the team down and cause sleepless nights.

“The sheer volume of SARs and the different challenges for different types of requests is our biggest challenge,” she says. “We’re a mental health Trust, so some of the records we have on patients with a long history of mental health issues can mean their records are huge. The problems start with struggling to get the records out of the system due to the size of the file which crashed the systems.”

Briggs says the more requests that came in, the more the team were stretched, and the harder it became to hit deadlines.

“You’re not on top of your targets or your workload, and it is really flattening for people not being able to feel like they were doing a good job. As the requests increased, we were not able to spend the time we wanted and it often felt like we were just firefighting,” Briggs adds.

Finding a better alternative

It was the above challenges, and the need for a new approach to SARs, that spurred the Trust to start looking into alternative technology

Briggs says that when she and her team started using Smartbox.ai technology, the functionality it added helped to reduce stress among her team almost immediately.

“The fact Smartbox.ai could handle emails was a massive thing. As was one of the functions – de-threading – which meant we could get rid of duplicates and identify chains of emails,” she says. “It also meant we didn’t have to import Exchange files into our own Outlook, meaning that multiple people could be working on a SAR at the same time which helps to save time and allows us to swap and change tasks when we need to.”

Briggs says that one example of a SAR she received involved 19,000 emails, but by using Smartbox.ai’s technology to remove duplicates, it reduced the number down to a ‘more manageable’ 1,800 files.

“It made such a difference about my own approach to a task and made you feel better about doing it,” Briggs emphasises. “We can also split documents into manageable chunks with Smartbox, rather than feeling overwhelmed.”

Another feature that was a game-changer – the Dictionary function – allows users to create lists of words or ‘risk indicators’ that need to be removed/redacted and implement them immediately.

“With mental health records there is a lot of content in there and sensitive words such as suicide, assault, termination,” explains Briggs. “This tool will help us ensure we don’t miss anything that could cause somebody harm and distress.”

She added that the option to use different colour redaction highlighters was a useful function which made it easier to explain away the information underneath should questions arise.

Communication is key

Another key positive about working with Smartbox.ai is its willingness to listen to feedback and act on it, Briggs claims.

For example, when her Trust first started using the technology, redactions were in black, but Bradford District Care NHS Foundation Trust always redacts information in white, which could have been a serious issue. But after a consultation with Smartbox.ai, the Trust’s needs were taken into account, and that functionality was built into their version of the software.

Simply by listening to its customer needs and acting on it, Smartbox.ai made a big impact, Briggs concludes, leaving her happy to recommend the technology to other Trusts.

“If you are working with technology like Smartbox.ai that is more intuitive and is keeping up with and adapting to how you need to work, it is easier for us to bring on new staff to train and it is easier for them to learn. I would say it is worth other Trusts, particularly Mental Health Trusts, looking into Smartbox.ai.”


If you need help streamlining your SAR processes and are drowning in administrative paperwork, get in touch with Smartbox.ai today and see how we can help you.

News, Systems

New report launched to improve productivity measurement in healthcare

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The report calls on the NHS to adopt multi-faceted measures that better reflect long-term investment, patient outcomes and workforce resilience, alongside greater evaluative and technical integration to bridge the gap between local insights and national decision-making.


A new technical report on Measuring Productivity in Health Care has been published by NHS Arden & GEM Commissioning Support Unit (CSU). Commissioned by the Health Foundation, the report provides an in-depth examination of how productivity in the NHS is currently assessed and how it should evolve to meet the growing challenges facing the health system.

Set against a backdrop of increasing demand, constrained resources and post-pandemic recovery, the report looks at how we measure, and how we should measure productivity in such a complex system as the NHS.

Katie Fozzard, Senior Economist at the Health Foundation, said: “The government has placed significant emphasis on increasing NHS productivity – setting a stretching target for the health service to deliver 2 per cent annual productivity growth. The way productivity is measured, and whether it captures what matters most, is therefore of crucial importance. This report is a vital resource to help us understand the different ways that productivity is measured and areas for improvement.”

Drawing on a wide body of literature and engagement with stakeholders across government, academia, NHS England and local health systems, the report explores the current strengths and limitations of existing productivity metrics, also looking forward to recent developments in productivity measurement, as set out in the ONS recent Public Services Productivity Review. It highlights persistent challenges such as fragmented data, inconsistent coverage across settings, and a lack of tools to evaluate long-term investment, preventative care and workforce resilience.

Rose Taylor, Executive Director Health and Care Transformation at Arden & GEM said: “Understanding and improving NHS productivity is essential to delivering high-quality care with finite resources. This report provides a fresh lens on how we measure productivity in such a complex system, highlighting where current metrics fall short and where new approaches can drive meaningful change.”

The report highlights the breadth of reasons for measuring health care productivity and corresponding approaches. It proposes a new classification framework to better align metrics with their intended use, whether for system-level planning, local service improvement, evaluating resource allocation or national financial accountability.

Among its key areas for development, the report calls for:

  • The adoption of multi-faceted measures that better reflect long-term investment, patient outcomes and workforce resilience, to strengthen how measures align with future service needs
  • Greater integration of micro-level evaluative and macro-level technical approaches to bridge the gap between local insights and national decision-making
  • Investment in metrics that account for the value of preventative care beyond short-term costs
  • Improved tools to measure productivity across evolving care pathways and system partners, including social care and the independent sector

The Health Foundation will build on these findings in future work to support better long-term decision making across health and social care.

The full Measuring Productivity in Health Care report is available here.

NHS long-term plan, in the short-term: Where tech must help now.

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Strategic realignment over the next 10 years is important. But what are the practical, inarguable early wins the government must try to achieve for an NHS now? Dr Mark Ratnarajah, UK Managing Director of C2-Ai and practising NHS paediatrician, offers some answers.


As the unveiling of the long-awaited NHS 10-Year Health Plan rapidly approaches, the need for certainty and direction has never been more pressing.

Staff at the centre are already being reorganised, systems are being re-defined, and productivity and workforce pressures facing the frontline mean that new ways of solving pervasive problems are all but guaranteed to be heralded as the plan hits the shelves.

The Chancellor’s June spending review has earmarked £10bn for digital – but looking beyond the NHS App and a new single patient record, how might this money be used to respond to pressures with new care models, and what must be done much more immediately rather than over the decade?

Here’s seven priorities the new long-term plan must address in the short-term.

Managing electives, preventing demand escalation

A key election pledge, the elective backlog will undoubtedly be prominent in the plan. Though important progress has been observed, NHS Confederation’s recent annual conference reminded delegates that millions of people are still on waiting lists. Addressing the real problem is however more complex than counting numbers.

The underpinning matter is how to manage demand and serve those in greatest need when they need it, so that they don’t deteriorate and subsequently compound demand growth. That’s a complex question but it is possible to answer by a shift in thinking: one where systems respond to a complete individual’s risks and consider the wider human impact, so that we don’t just shift demand from outpatients to A&E or primary care, and inadvertently push patients into other costly parts of the health system.

An immediate opportunity is to learn from pioneers, who have put technology to good use in identifying patients at risk of harm or added complexity while waiting. Trusts and systems have responded with interventions in the community to prevent downstream escalations. In those examples entire patient cohorts have been better supported, and have shown reduced emergency attendances, complications, and lengths of stay.

The plan’s response must be about more than keeping things hanging together. It must be about supporting the customer: the patient; especially if the NHS is to manage an anticipated overall 40 per cent growth in demand in the next 10 years – suggested by compound growth metrics being observed.

Driving prevention, anticipatory health, new citizen responsibilities

Prevention too has sat on healthcare conference agendas for decades. Now it must become reality. In part that means surfacing hidden risks, targeting interventions in communities to avoid harm, and looking beyond boundaries: enabling collaborative data insights on risk across NHS and local government.

New anticipatory pathways are what this really means in practice: predicting health needs at the earliest point. Proactive, rather than passive, healthcare means reducing reliance on the reactive and ensuring fewer patients coming through the front door. We need to address individuals’ needs at-scale before they manifest themselves in expensive ways that are not optimal for the patient or system.

Giving patients agency with targeted data is a must so they are participants and empowered to direct their own health decisions; and to ensure better readiness for the inevitable encounters such as surgery.

As citizens we need to take more responsibility. In mental health services patients are sometimes asked to commit to a contract that includes their responsibility. We might see more of that in managing more long-term conditions. That can only work if we can understand what specifically we expect patients to do to make a difference – technology-driven insight can make that relevant for each patient’s risks. We might better alert patients to the community activities that can help them, and we might better ensure the provision of those facilities to move from medicalisation to a wellness and wellbeing focus.

Supporting the new ICS landscape to manage local demand

Organisations designed by nature to enable cross-organisation convergence around patients, integrated care boards are seeing systemic overhaul just a few years after their creation.

As budgets and headcount are cut, and ICS consolidation advances, they could benefit from technology more than ever in gaining the insights to understand local needs and organise health and social care service configurations.

These organisations will remain central  in enabling care to move closer to communities and in preventing downstream cost and pressure. Technology suppliers must support them during a turbulent time so that they can evidence decisions on where and how to deploy resource to address wider determinants of ill health, to respond to citizens and not just patient needs, and to avoid a refocus back on acute care.

Delivering the digital and data revolution

Digital to analogue is something that must now succeed to enable integrated care and decision-making.

New and innovative ideas must be able to scale where they show impact. And we must make a success where commitment has been made. Politics aside, imagine the conversations we could have been having about digital, rather than a focus on moving away from paper, if the National Programme for IT had actually succeeded.

We now need to focus on turning insight into action, on building optimised pathways of care, and on how we can make better decisions with amenable and accessible data that can change practice.

Improving maternity and peri-natal safety

Not in itself one of the three shifts, but maternity safety continues to hit headlines. The ability to deliver safe care here is the barometer for the health service. Well mothers and babies must expect to go in healthy and come out healthy. If we fail that, then we have a key confidence issue for the wider NHS.

Equally, if we can get maternity right, then we can probably get everything else right. In the short term the plan has an opportunity to bring about renewed transparency in quality and safety. That means more than investigations and reports that only shed light on matters after they have become scandals. It also means doing more than measuring compliance with processes through audit.

At least some of the billions being used for technology could be turned to address and prevent avoidable harm in maternity through data-driven insight, that allows early identification of service and system-level problems. There is an opportunity to create new intelligence, but only if we embrace a learning culture.

Building a learning, safe NHS

The fact that safety scandals continue to emerge shows there is more to do to ensure a culture of learning in the health service. Just as real-time insights could prevent harm happening for maternity, the same is true for other services across health and care. Reliance on reports that take place once every few years is not enough. A culture of ongoing transparency, where we can be open about mistakes, must be the direction of travel.

Some of the best performing hospitals in the world are already doing this. Karolinska University Hospital in Sweden, for example, delivers some of the best survival and complication outcomes in the world for severely injured and unwell patients. It has used UK grown technology to prove this, and in a relentless pursuit of quality, continuously works to understand and act on any sub-optimal outcomes. Such approaches could be equally impactful in the UK to allow us to both celebrate excellence and deliver support where it is needed most.

Health equals wealth, and vice versa?

There was a reassuring investment in health in the spending review. But with cuts to other government departments, and the need to respond to ever rising global insecurity, public spending is under closer scrutiny than ever.

To deliver best value, the coming plan might therefore ask: what must we stop doing in order to fund new models of care delivery.

It might also ask questions about the relevance of industries that sit around the NHS to GDP – notably health tech, pharma and life sciences. Could the globally competitive nature of these UK companies be of interest as a means of wealth generation for the country, and to ensure it can continue to afford a health service?

And with phrases like ‘wealth is health, and health is wealth’ being increasingly heard, the plan might consider how a thriving SME sector that invests in the communities it serves could be a positive source for tackling inequity that so often leads to costly ill-health – wealth being a driver of health, and indeed the resilience of the nation.


Dr Mark Ratnarajah, Managing Director, C2-Ai and practising NHS paediatrician

Government promises clinical trials boost ahead of 10-Year Plan announcement

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The government is pledging to increase access to clinical trials for millions under its Plan for Change, which will eventually see NHS App notify users of clinical trials based on their health data and interests.


The government has pledged to increase access to clinical trials for millions as part of its drive to modernise patient care in the NHS and drive economic growth. The Plan for Change, set to be released as part of the upcoming 10-Year Health Plan, will enable NHS App users to browse and find trials suited their needs and interests, via the NIHR Be Part of Research service on the App.

The plan also aims to increase access to new treatments by accelerating trial set-up times and turning the UK into a ‘hotbed of innovation’. Through the App, public reporting will show which NHS trusts are delivering on trials and which area falling behind, with future funding set to be prioritised for the best performing trusts.

Eventually the plan will see the NHS App automatically match patients with studies based on their own health data and interests, sending push notifications to users’ phone about relevant new trials to sign up to.

It comes as the National Institute for Health and Care Research (NIHR) launches a UK-wide recruitment drive for clinical trials – the biggest ever health research campaign – to get as many people involved in research as possible. Adults across the UK are being urged to register, with underrepresented groups including young people, Black people and people of South Asian heritage particularly encouraged to sign up, at bepartofresearch.uk.

The 10-Year Health Plan will aim to bring transparency over which NHS trusts are performing well in clinical trials, and which are not. All NHS trusts and organisations will need to submit data on the number of trials being conducted and the amount of progress being made.

Public reporting will show the number of trials sponsored by both commercial and non-commercial sponsors at specific trusts and other organisations, including universities or primary care sites. It will reveal to the government, patients, investors, and Trust boards which NHS organisations are performing well and which are falling behind. Government investment will only be prioritised for the Trusts that can prove they can support the NHS to deliver the treatments of tomorrow.

Health and Social Care Secretary, Wes Streeting, said: “The UK has been at the forefront of scientific and medical discovery throughout our history. Some country will lead the charge in the emerging revolution in life sciences, and why shouldn’t it be Britain?

“The 10-Year plan for health will marry the genius of our country’s leading scientific minds, with the care and compassion of our health service, to put NHS patients at the front of the queue for new cutting-edge treatments.”

In recent years, the UK has fallen behind as a global destination for these trials, with patients and the wider economy missing out. It takes around 100 days to set up a trial in Spain, but around 250 days in the NHS. The plan will see commercial clinical trial set-up times fall to 150 days or less by March 2026 – this will be the most ambitious reduction in trial set-up times in British history.

The government is now pledging to cut set up times for clinical trials. Currently, trials have to agree separate contracts with each part of the NHS they want to be involved. The plan will introduce a national standardised contract which can save months of wasted time, as well as simplifying paperwork to remove duplication on technical assurances.

This means if any authority asks for evidence from a study, they can provide it once without having to spend time reframing that evidence differently to meet a separate criteria for another authority.

In the coming weeks, the government will publish its 10-Year Health Plan. The plan aims to restore the UK’s position as a world leader in clinical trials, enabling it to attract global talent and drive investment into the UK. The government hopes that this will spur economic growth, improve the standard of care to support a healthier population, and make the NHS more financially sustainable.

Professor Lucy Chappell, Chief Scientific Adviser at the Department of Health and Social Care (DHSC) and Chief Executive Officer of the NIHR said: “We know the benefits of embedding clinical research across the NHS and beyond. It leads to better care for patients, more opportunities for our workforce and provides a huge economic benefit for our health and care system. Integrated into the NHS App, the NIHR Be Part of Research service enables members of the public to be matched to vital trials, ensuring the best and latest treatments and care get to the NHS quicker.

“Ensuring all sites are consistently meeting the 150-day or less set-up time will bring us to the starting line, but together we aim to go further, faster to ensure the UK is a global destination for clinical research to improve the health and wealth of the nation.”

Dr Vin Diwakar, Clinical Transformation Director at NHS England, said: “The NHS App is transforming how people manage their healthcare, with new features letting them see their test results or check when prescriptions are ready to collect – all at the tap of a screen.

“We’re making it easier to sign up for clinical trials through the NHS App so patients can access new treatments and technologies earlier, improving their quality of care.

“The Medicines and Healthcare products Regulatory Agency (MHRA) – which makes sure that medicines and healthcare products available in the UK are safe and effective – has already improved its performance.”

Nicola Perrin, Chief Executive of the Association of Medical Research Charities, commented: “Clinical trials are good for patients, the NHS and the economy. But both commercial and non-commercial trials in the UK have closed because of failures to recruit.

“It’s encouraging to see the government recognise that boosting access to clinical trials must be a key part of the 10 Year Health Plan. Transforming clinical trials is an important step in truly embedding research in the NHS, securing the UK’s position as a leader in life sciences and offering a lifeline to patients.”

 

News, Thought Leadership

From diagnosis to remission: Delivering results at scale with T2DR

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Diabetes and obesity cases in the UK are rising rapidly, putting increasing pressure on health and care services. But supported digital self-management tools are delivering measurable results, helping patients lose weight, increase physical activity, and in many cases, achieve remission, writes Keren Miller, Clinical Lead Dietitian for Diabetes and Diabetes Remission at Oviva.


Obesity and type 2 diabetes are among the most pressing health issues facing the UK. Today, around 12.5 million UK adults are estimates as living with obesity and more than 5.8 million with diabetes, numbers that are rising year-on-year. These conditions place a significant and growing burden on the NHS, both financially and in terms of long-term health outcomes. From heart disease to kidney failure, obesity-related complications are reducing quality of life and putting lives at risk.

A new way forward: evidence-based, digital-first care

We believe there’s a better way forward. As the obesity crisis escalates, scalable, evidence-based solutions are urgently needed, and digital programmes can play a crucial role. Oviva provides specialist digital type 2 diabetes and weight management programmes. Our mission is to empower people to make sustainable lifestyle changes, creating a healthier future for those living with weight-related conditions by offering highly accessible and effective technology-enabled support.

Delivering results: The NHS T2DR Programme

Through the NHS England Type 2 Diabetes Path to Remission Programme (T2DR), Oviva is supporting people living with diabetes to lose weight, reduce their need for medication and improve both their blood pressure and blood glucose levels.

An NHS assessment published in The Lancet showed that “remission of type 2 diabetes is possible outside of research settings, through at-scale service delivery”.

Oviva was proud to feature as a lead provider, delivering strong outcomes reporting:

  • 8.7 per cent average weight loss for patients
  • 37 per cent of patients who completed the programme achieved remission status
  • 18 per cent of patients lost at least 15 per cent baseline weight

This real-world evidence confirms that digital T2DR programmes can be an effective, scalable solution for people living with type 2 diabetes.

As the NHS continues to evolve in response to rising obesity and diabetes rates, it’s clear that effective, scalable solutions like NHSE’s T2DR programme are more important than ever. The results of the T2DR programme show that real change is possible, not just in research trials, but across the country.

Oviva is proud to support the NHS with programmes that work. Our digital model removes barriers to access, reaches underserved communities, and empowers people to take action in a way that feels achievable and sustainable.

Paul’s story: Transforming health, one step at a time

Paul, 59, from North London, was stunned to learn he had been diagnosed with type 2 diabetes and a heart condition – a wake-up call that inspired him to take action.

Like many, Paul’s weight had crept up during the Covid pandemic, made worse by a sedentary desk job. Determined to make a change, he joined the NHS T2DR programme and embraced the opportunity to transform his health.

Paul admitted the total diet replacement phase was challenging, but his perseverance and discipline paid off. Supported by Oviva coaches, Paul committed to the programme and saw incredible results. Even two months after completing the programme, he continues to use the Oviva App to track his progress and access learning content, keeping his motivation high.

Paul, 59, lost 50kg after 14 months on the T2DR Programme

After just 14 months, Paul’s progress has been remarkable:

  • Weight loss: 50kg, now maintaining a healthy weight of around 92kg
  • BMI: Reduced from 47 to 29 kg/m²
  • HbA1c: Improved from 81 mmol/mol to 38 mmol/mol, well into the target range
  • Activity: Paul is walking at least an hour a day, adjusted cardio due to his heart condition

Paul’s story is a testament to the transformative power of the T2DR programme, and a reminder that, with the right support, patients can take control of their health and reverse type 2 diabetes.

To find out more about how we’re empowering people to achieve lasting improvements in their health and wellbeing, visit oviva.com.

North West extends digital support for up to 275k unpaid carers

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The move sees Wigan Council join a growing number of local authorities aiming to better support unpaid carers through accessible, round-the-clock digital tools and resources.


Up to 275,000 unpaid carers living across the North West of England can now access an expanded range of support services, including an online community forum and tools to help claim financial support, as the region looks to boost help for this vital community.

This milestone comes as Wigan Council announces it has become the latest local authority in the North West to roll-out a tech-powered initiative designed to connect and support those looking after friends, family and neighbours. This support is being delivered in partnership with the UK’s largest community of unpaid carers, Mobilise.

This latest backing from Wigan Council takes the number of North West carers able to access the digital support to up to 275,000.

At least 31,442 people identify as unpaid carers in Wigan, comprising 1 in 10 of the local population. The new initiative will provide an added layer of on-demand support for anyone who looks after someone in the area, including those who may not identify as ‘carers’ or realise they are entitled to support.

As part of this, the initiative aims to uncover and widen access to support for 3,900 people who have not previously engaged with any support in Wigan.

Wigan Council follows nine local authorities in Cheshire and Merseyside who joined the same initiative in October last year. This saw 243,000 unpaid carers in Cheshire and Merseyside gain access to the tech-powered support. 8 in 10 (79 per cent) Cheshire and Merseyside carers had not accessed any support prior to the digital initiative rolling out across the region.

The new services can be accessed remotely via an online hub and include:

  • An online peer community of hundreds of thousands of fellow carers from across the UK, with a community forum and regular events to share experiences and advice
  • Self-service tools to help carers understand the different benefits they may be entitled to (including Carer’s Allowance), check their eligibility, and access different support
  • Tailored 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 ‘Mobilise Assistant’ is also available to help carers quickly and easily find the specific information, resources or support that they need, using their own words.

In Cheshire and Merseyside, the majority (51 per cent) of carers currently accessing these digital services rely on the support outside of working hours. Now also available to carers living in Wigan, the on-demand offering will supplement existing support in the region, including in-person services provided by local organisations such as the Wigan & Leigh Carers Centre.

Councillor Angela Coleman the Cabinet Member for Adult Social Services at Liverpool City Council, commented: “Our priority is ensuring that all carers living in Liverpool can access the support they need, when they need it. Partnering with Mobilise to offer on-demand, remotely available services have helped extend our ability to deliver this support. With more carers engaging with support for the first time, and the majority accessing the new services outside of working hours, the impact is already clear to see.”

The initiative in both Wigan and Cheshire and Merseyside is being funded by the Government’s Accelerating Reform Fund.

For more information about the support now available in Wigan, see here. For more information about the support available across 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.

Case study 1:

Alison and her husband

Alison Lodder, who cares for her husband in the North West, said: “My husband was diagnosed with MS almost thirty years ago, just two years after we got married. I’ve cared for him ever since. During my caring journey, I’ve found different forms of support have helped at different times. For example, my local carers centre has been a lifeline in the past, and a care worker now comes to the house to provide more regular support whilst I get ready for work in the mornings. Juggling part-time work with my caring role restricts the times that I can access wider support. But, since joining Mobilise, I’ve always had another carer to chat to when I find a moment for myself in the evenings, or an expert on hand to offer advice when I need it the most.”

Suzanne Bourne, co-founder and Head of Carer Support at Mobilise, commented: “As unpaid carers, it’s vital we get the support we need to protect our own wellbeing, and continue to look after our friends or family at the same time. But caring responsibilities don’t always start and stop in line with traditional working hours, or allow us to leave those in our care alone. This is where on-demand digital support can help.

“I’m grateful that, alongside local carers organisations like Wigan and Leigh Carers Centre, Mobilise is now able to help more carers across the North West access support whenever and wherever they need it. Our new partnership with Wigan Council, and our continued work with local authorities across Cheshire and Merseyside, will help ensure that no one has to navigate the daily realities of caring alone.”

Case study 2:

George, who cared for his mother in the North West

George Smith who cared for his mother and lives in Cheshire, said: “I moved in with my mum in 2023 after a nasty fall led to mobility issues and various complications that left her unable to look after herself.

“You don’t expect to become a carer. I certainly wasn’t prepared for how it would impact me physically and mentally. There were many times when I felt lonely, guilty, and like I was losing my sense of identity. Talking to other carers helped me realise it was okay to take time out for myself. The Mobilise community also helped me realise I wasn’t alone. They opened my eyes to how many of us look after loved ones who we might once have relied on ourselves, and how many of us will come to rely on those around us in future.

“I cared for my mum up until she passed away earlier this year. And I wouldn’t have had it any other way.”

Councillor Keith Cunliffe, Portfolio Holder for Adult Social Care at Wigan Council, said: “We are proud to be working with Mobilise alongside Wigan and Leigh Carers Centre in this innovative partnership to better support unpaid carers across Wigan Borough. Unpaid carers are vital to our communities and it is so important that we continue to find new and effective ways to support them. By embracing digital innovation, we are ensuring carers can access the help they need, when they need it and in a way that fits around their busy lives.”

Christine Aspin, Chief Officer at Wigan and Leigh Carers Centre, said: “As Chief Officer at Wigan and Leigh Carers Centre, I am announcing our partnership with Mobilise. This collaboration alongside our ongoing work with Wigan Council will enable better support for unpaid carers in the Wigan Borough. By utilising innovation and technology, we aim to address carers’ needs effectively, providing essential resources, support, and assistance at a time and convenience suitable for the carers.

“This partnership emphasises the importance of collective efforts in fostering positive community engagement and improving wellbeing. We aim to offer support beyond conventional hours, ensuring targeted assistance for working carers and those who cannot access daytime services. Caring does not fit a 9-5 model, so support will be available to carers as and when needed. Our goal is to ensure that every carer in our community has access to the help they need, precisely when they need it most.”

Community care critical for improving diabetes outcomes: ICB diabetes lead

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Dr Naomi Chinn, Clinical Diabetes Lead at NHS Humber and North Yorkshire ICB, sat down with PPP to discuss her advocacy of community-based diabetes care, its positive impact on both patients and the workforce, and the role of integrated neighbourhood teams, collaboration and networking.


2025 has ushered in a seismic shift across the UK health and care landscape. The abolition of NHS England is resetting the shape of health and care for the coming years. Integrated care boards (ICBs) are under increasing pressure following the mandate to cut costs by 50 per cent, anticipated mergers, and the publication of a new model ICB blueprint. Under this model, systems will be expected, among many other responsibilities, to commission new care pathways and services in support of the key strategic shifts outlined in the 10-Year Health Plan. The Plan, currently expected to be released at the beginning of July, is set to clarify several questions created by these reforms and how they will impact access and delivery of care, including diabetes.

Public Policy Projects (PPP) recently spoke to Dr Naomi Chinn, Clinical Diabetes Lead at Humber and North Yorkshire ICB. Dr Chinn, who took on her role in December 2024, has been working with her team on re-establishing the system’s diabetes work programme, and has long been an advocate for the strategic shift towards community-led care approaches.

Ahead of her appearance at PPP’s Diabetes Care Conference 2025, Dr Chinn shared some insights into current picture of community-led diabetes care within Humber and North Yorkshire.

The role of INTs and LESs

NHS Humber and North Yorkshire ICB is one England’s 42 ICBs, covering the second largest geography in the country and serving a population of 1.7 million people. According to the 2023/2024 QOF diabetes prevalence data, 117,062 people are living with diabetes in the region.

With regards to this demography, Dr Chinn states that both patients and workforce would benefit from a shift towards community-led diabetes care. She believes that integrated neighbourhood teams (INTs) can provide vital support to staff across the system, ultimately optimising the quality of patient care delivered. This approach has already shown positive results through a prevention programme implemented in the region.

“The programme is delivered in local community centres and is supported by trusted community figures and attended by individuals living in the same neighbourhoods,” explains Dr Chinn. “Through this programme, we are holding annual diabetes reviews regularly and they are easily accessible at a nearby health centre, with retinal screening available in the room next door. Where needed, patients can be referred to specialist services such as podiatry, ultimately creating a joined-up, community-based care experience.”

Recently, the ICB has also introduced a programme of Local Enhanced Services (LES) for patients with type 2 diabetes, accessible through general practice. LESs are locally developed schemes designed to supplement core practice services, with variations in scope and funding across the country according to local need. This targeted investment is a result of the ICB’s recognition of the value of delivering better care closer to home, bringing both clinical and social benefits through this ‘left shift’ in care. An additional advantage is the potential to relieve pressure on secondary care services, allowing them to prioritise patients who require more specialised expertise and facilities.

“We know that both hospital and community teams are working harder than ever,” Dr Chinn adds, “so, this has to be about more than simply shifting patients and populations between settings; prevention must also be a core and continuous part of our service from the very beginning.”

The need for collaboration

As ongoing reforms ultimately aim to deliver a more integrated approach to care, collaboration with wider partners is key to make this vision a reality. Dr Chinn emphasises the value of working closely with ICS stakeholders, including primary care, secondary care and Voluntary, Community and Social Enterprise (VSCE) stakeholders, and the importance of engagement with patients.

An example of this collaborative approach is a recent design workshop led by Dr Chinn, which convened system partners to identify barriers to accessing diabetes care, share best practice and generate new ideas. Alongside this, Dr Chinn and her team launched a patient engagement questionnaire, asking patients who might be interested to participate in the work going forward. The feedback, combined with insights from recent GIRFT reviews for both adults and children and young people, has directly informed the development of the region’s diabetes work programme.

To support delivery and ongoing development, the team is establishing bimonthly advisory groups, in addition to a broader network meeting. This approach aligns closely with the ICB’s core principles and wider strategic initiatives, including recommendations from Lord Darzi’s Independent Review, to simplify and innovate care delivery at the neighbourhood level, re-engage staff, and re-empower patients.

“A problem shared is a problem halved”

Given the large population and geographical footprint it serves, Dr Chinn highlights that regional variation is one of the biggest challenges facing Humber and North Yorkshire.

“We are an ICB with a large geographical area and a highly diverse population,” Dr Chinn explains. “Achieving continuity across these regions, while also meeting local needs, is probably our biggest challenge. In some places, like Hull, we face one of the lowest GP-to-patient ratios in the country, which makes workforce development even more difficult.”

Despite these challenges, Dr Chinn acknowledges the importance of connection and collaboration in overcoming them, through the integration of workforce, patients, and partners and underpinned by prevention and local knowledge: “Bringing people together makes a real difference.”

Dr Chinn adds: “Sometimes it’s as simple as remembering that a problem shared is a problem halved. A challenge in Whitby today might be something Willerby overcame last year. Within the ICB, we are a small team, so building connections and keeping communication open, whether it’s asking for help or flagging concerns, is essential. Through networking, we’re starting to achieve this.”

As publication of the 10-Year Health Plan approaches, local systems like Humber and North Yorkshire ICB are already demonstrating the value of prevention and community-led care. Dr Chinn’s vision offers a scalable blueprint for a collaborative, community-led approach to diabetes care, that will be further discussed at PPP’s Diabetes Care Conference 2025 on Wednesday 25 June in London.

Integrated Care Journal
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