Digital care homes model could save ICBs £14 million annually, report shows

By Integrated Care Journal

New report sets out a blueprint for transforming health and care in the community, with real-world evidence suggesting that scaling the model across an ICB could reduce the cost of healthcare by £14.2 million annually, and over £360 million nationally.

A validated, integrated model of care delivery is transforming health management in care homes, with the potential to reduce the cost of healthcare for the NHS by millions annually, according to a report published today.

Led by Kent County Council, the model provides the care sector with tools and skills to enable early detection of deterioration and management of health risks – such as infections, chronic cardiac and respiratory issues, and other common causes of falls and exacerbations – reducing unnecessary conveyances and hospital admissions. The approach could deliver £14.2 million in annual savings for local health systems if scaled across all care homes in the Kent and Medway ICB alone, with savings from national adoption exceeding £360 million.

Transforming care through digital innovation and proactive change management

The report, co-authored by Care City – a Barking-based centre for healthy ageing and regeneration – and healthcare consultancy Candesic, in collaboration with Kent County Council and Feebris, proposes a blueprint for integrating data and technology to improve care delivery in the community. The model is built around three key pillars:

Proactive health in care homes: Equipping care staff with advanced training and digital tools to detect health issues early, preventing avoidable deterioration and exacerbations
Integrated multi-disciplinary collaboration: Improving coordination between care homes, GPs and community health teams through a connected digital infrastructure, allowing for the delivery of joined-up, person-centred care for residents with complex needs
Hospital-level care in care homes: Ensuring residents receive the care they need in the most suitable setting, cutting down avoidable hospital admissions and supporting care homes to manage acute health needs where appropriate

Real-world impact: Improving outcomes while reducing avoidable utilisation of emergency services

Focusing on the first pillar, the report includes an evaluation of a 12-month initiative running in Kent and Medway. Through this project, the Feebris virtual care platform was deployed across 24 care homes to deliver early risk assessment and proactive monitoring for 1,000 residents.

The evaluation demonstrates the impact of the integrated digital model of care delivery proposed, with key findings including:

75 per cent of care homes adopted proactive health workflows, enabling earlier detection of deterioration
8x fewer care homes experienced high volatility in care needs, improving resource allocation
Over 50 per cent fewer care homes reported above-average ambulance callouts, with 70 per cent fewer reporting high hospital conveyance rates
Hospital admissions dropped by 20 per cent, reducing strain on the NHS and improving resident outcomes

For care home residents, this means receiving personalised care that allows them to remain healthier for longer in a familiar environment. By detecting deterioration early, the appropriate healthcare service can intervene sooner and reduce any potential distress and disruption caused by emergency admissions while also mitigating risk of deconditioning.

£530,000 in NHS savings for every 1,000 care home residents annually

Over the 12-month period, the reductions in hospital admissions and ambulance callouts resulted in an estimated £530,000 in NHS savings, with 860 bed days freed up for every 1,000 care home residents, leading to a 5.2X Return on Investment.

Helen Gillivan, Head of Innovation and Partnerships at Kent County Council, said: “We’re proud to have led this successful initiative at Kent County Council, which is making a real difference to care homes, care staff and some of our most frail residents across Kent and Medway. Care teams tell us this system has become part of everyday practice, helping them to deliver more responsive, person-centred care that benefits both staff and residents.

“Social care is critical to the sustainability of our entire health and care system. As this research shows, investing in the sector doesn’t just benefit care providers – it strengthens the wider system, improving outcomes for our staff and for residents while easing pressure on health services.”

Removing barriers to scale: What can we change today to drive long-term transformation

While the findings highlight the impact of digital innovation in social care, the report also puts the spotlight on key structural barriers preventing widespread adoption. It highlights a number of recommendations, including:

Restructuring financial incentives to enable social care providers to resource delivery of preventative interventions, given the impact demonstrated with the model adopted by Kent and Medway.
Strengthening the care workforce through greater investment in training and development, helping to attract and retain talent and recognising the vital role played in supporting ageing populations and reducing growing system pressures.

Matt Skinner, CEO of Care City, said: “This report is proof that social care can and must play a bigger role in the future of our health system. By empowering care staff with the right tools, training and trust, we can improve outcomes, reduce emergency demand and deliver more joined-up, preventative care. It’s been a privilege to support this work and co-author a blueprint for transformation that we hope will inspire action across the country.”

Dr Michelle Tempest, Senior Partner at Candesic, said: “This report represents a huge effort in gathering real-world data from across health, community and social care to showcase real impact and set out a proven model of transformation that meets the needs of our ageing populations. At a time when ICBs are under immense pressure and need support, this work provides an actionable roadmap to driving sustainability and impact.”

Tracy Stocker, Director of Operations at Medway NHS Foundation Trust, said: “We are pleased to see the results of our colleagues in Kent County Council and excited to say that we are aligned in our approach and looking forward to linking this work up with our Virtual Hospital vision. This is a springboard to building connected virtual ecosystems of care, centred on the patient, meeting them where they are, and coordinating our resources in the most efficient way.”

Dr Elina Naydenova, CEO and Co-Founder of Feebris, said: “It’s long been clear that transformational change is required to meet the growing challenges faced by the system, and as today’s report highlights, our partners at Kent County Council are leading the way with their approach. Given the tremendous financial pressures on health and care globally, now is the time for a grassroots movement of forward-thinking organisations to come together and evolve the care model to meet these challenges head-on.”

A summary and the full white paper can be accessed here.

For more information or to arrange an interview, please contact leo@feebris.com.

A broken process that is digitised is still broken – reflections from Rewired 2025

By David Duffy

Rewired 2025 offered a timely and valuable touchpoint for a healthcare sector still absorbing the shockwaves of seismic reform and uncertainty. Speakers struck a careful balance between optimism about the future and realism about what is possible in a resource-constrained environment.

A growing realisation is taking hold: there will never be enough money to meet every demand, so the key lies in driving system-wide improvements and enabling local innovators to lead the way. With this in mind, Rewired’s vast array of digital experts, NHS leaders and industry stakeholders put forward a cautiously optimistic vision of UK health and care’s future, with some using the platform to inject a dose of realism into the digital healthcare debate.

Abolishing NHS England – opportunity or risk?

Just days after the Prime Minister’s announcement to abolish NHS England, Rewired 2025 provided a platform for the sector to process the news and begin charting a path forward. Senior leaders, including NHS England’s Transformation Director Vin Diwakar acknowledged the gravity of the decision. However, he and many senior figures speaking at Rewired framed it as a necessary step to reduce barriers to digital innovation.

While uncertainty about the future was evident, the conference floor was abuzz with anticipation for the upcoming 10-Year Plan and how this can unlock innovation across health and care.

Diwakar also used his keynote to reassure innovators and tech suppliers that the Government remains committed to digital investment, with a stronger focus on interoperability and unified procurement. There is a sense that NHS England’s merge with DHSC presents an opportunity to free local innovators to drive implementation at pace.

Tech alone won’t solve the productivity crisis

NHS productivity fell by over 20 per cent in 2020/21, and bringing this back to pre-pandemic levels remains a monumental challenge. The government (much like every government in living memory) has claimed the solution lies in a digital future driven by AI.

There is no doubt that digital innovation and AI are part of the solution, but they are not magic bullets for this deeply complex issue. Increased digitisation does not automatically lead to increased productivity. As Pritesh Mistry of The King’s Fund put it:

“If you digitse a broken process, you get a broken digital process.”

The need to be realistic about digital was repeatedly borne out during discussions, with agreement that it is the job of sector leaders to tamper expectations and chart a realistic, iterative path to transformation.

Dr Marc Farr of East Kent NHS Foundation Trust highlighted the importance of reframing digital innovation to ensure staff buy-in. Technology should not only improve efficiency but also enhance staff satisfaction and happiness. All staff understand the need to be more efficient, but tech should also make the NHS a happier place to work. Stephen Powis echoed this in his keynote address, emphasising how effective digital tools can boost staff satisfaction and retention in primary care.

Getting a better deal on tech

Professor Powis also called for the NHS to drive better value from tech procurement, drawing comparisons with the NHS’s ability to negotiate favourable drug prices. A more strategic approach to tech investment could deliver better outcomes and cost efficiencies.

In a time where the NHS is being constantly told to live within its means and drive up productivity before receiving more funding, perhaps it’s time for tech suppliers to be held to account for extracting digital benefits. With such focus on short-term savings, the business cases for digital transformation are increasingly difficult to develop. It was suggested that suppliers who benefit from recurring funding from lucrative NHS contracts should take a more central role in ensuring trusts and systems are able to extract value from their solutions. Enhanced collaboration is surely good for business, good for the NHS, and good for patients.

True benefits of AI will be unlocked at system level

Dr Jess Morley of Yale University provided a refreshing dose of realism on AI in healthcare. In short, we have a long way to go before AI can transform our system.

The current impact of AI on NHS services is tiny, with significant limitations in infrastructure holding back its capability. As Dr Morley argued, “AI is a system level technology that allows us to redefine healthcare for the 21st century for modern populations, not simply address old problems with reskinned, age-old solutions.”

Healthcare is not just medicine, and the most important and impactful interventions (vaccines, testing, screening, etc) are made at the population level. In this context Dr Morley argued that the NHS is still only focusing AI on problems we already know how to solve, such as reading scans, rather than using it to transform systems. To harness AI’s full potential, it should be applied to developing population-level interventions.

Dr Morley went on to assert that our NHS approach to digital innovation is not yet centred on the right problems. The much-lauded potential of a single patient record across the UK, earmarked by many across the sector as the NHS’ key to future survival and sustainability, is “not a solution to modern problems”, and can never be paradigm-shifting as long as transformational thinking is based in silos.

What about social care?

One notable gap in the discussions for which I was present was the lack of progress in digital adoption within social care. There is a risk that, amid the current phase of NHS reform, social care could once again be left behind. Achieving digital parity between the NHS and social care remains a significant challenge and, if James Mackey’s new NHS England transition team is anything to go by, social care is going to be waiting a while before it receives the same attention for service transformation as the NHS.

Rewired 2025 underscored the need for both strategic investment and realistic expectations about what digital can achieve. The sector is moving towards a more mature understanding of tech’s role – not as a cure-all, but as a vital tool for improving both productivity and staff experience.

Lack of support causing ‘dangerous cycle’ of mental health readmittance, says CQC

By Integrated Care Journal

CQC report highlights shortfalls in mental health services, with young people, people from ethnic minority groups, and people from areas of deprivation facing the biggest barriers to accessing care.

Many people with mental health needs are not getting the care they need, the Care Quality Commission (CQC) highlighted in a report published last week.

As part of its monitoring activity in 2023/2024, CQC interviewed more than 4,500 people who were detained under the Mental Health Act or ‘sectioned’, covering 870 wards, and speaking to relatives and people who were previously detained. This year’s Monitoring the Mental Health Act report once again raises that a lack of staff, beds, and training, are leading to harmful gaps in care and treatment.

With demand far outstripping capacity, the report finds that there are not enough beds available, meaning people are placed far from home, their family, and their friends. One person interviewed reported being detained and placed five hours from home, and didn’t receive any visitors during her time in hospital as a result. Another woman had to wait hours in a police staff room, accompanied by two police officers, while a bed was sourced.

Jenny Wilkes, Interim Director of Mental Health at the Care Quality Commission, said: “Without timely access to necessary mental health support, people may find themselves being bounced from service to service without ever receiving the level of care that they need. This is a particular concern for children with mental health needs who risk missing out on school and their social life, and carrying their trauma and feelings of isolation into adulthood.

CQC’s report identifies a lack of sufficient staff numbers to support all patients, which is affecting people’s access to care and leading to people being restricted from going outside as there is nobody to supervise them, or in the most extreme cases, people being inappropriately confined.

While many people describe healthcare workers as “caring” and “wonderful”, the report identifies ongoing concerns with staff numbers and training. In particular, not all staff have undertaken the mandatory training to understand the needs of autistic people and people with a learning disability.

The combination of overwhelming demand and limited resources has led ward managers to feel pressure to discharge the “least unwell” patients. One woman reported being discharged before she was ready and without support to find her way home; she subsequently overdosed. Another person said, “I was only discharged because I was 18, not because I was better.”

Despite a legal entitlement to aftercare, overstretched general practice and community mental health services are not always able to provide a supportive transition back into the community, meaning people do not have the best chance at recovery. In nearly half of cases where a child or young person was detained, they had to be re-admitted within a year.

According to CQC, young people, people from ethnic minority groups, and people from areas of deprivation face the biggest barriers to accessing care and are sectioned at higher rates than the general population. Black people in particular are detained at 3.5 times the rate of white people. Meanwhile people from the most deprived areas are attending A&E services for their mental health at 3.5 times the rate of people from the least deprived areas.

CQC also registers concern that a lack of suitable community resources continues to lead to inappropriate hospitalisation of people with a learning disability and autistic people. However, the report cites CQC’s early work on Independent Care (Education) and Treatment Reviews, which has seen people move out of long-term segregation.

The regulator is calling for national action to tackle system-wide issues in community mental health. Better funding, improved community support, and a specialised and sustainable workforce are needed to ensure that people receive the care they need.

Jenny Wilkes added: “These issues will be all too familiar to people in mental health crisis, and their loved ones. We urgently need more community support and a better understanding of people’s needs to reduce the number of people being detained. And we know the situation is even starker for people from deprived areas, people from ethnic minority groups, autistic people and people with a learning disability. While the Mental Health Bill aims to address inappropriate detentions and improve mental health care, this can’t be addressed by legislation alone as there simply aren’t the resources to fix these issues.

“It is essential that the government addresses these significant gaps now to protect people for the future. With the right funding, a sustainable and well-trained workforce and enough beds to meet demand, we can break this damaging cycle.”

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The role of digital nurses in transforming healthcare

By Integrated Care Journal

Judy Sealey, Clinical Solutions Specialist at Altera Digital and former nurse, health discusses the evolving role of digital nurses in health and care and explores why their roles are so important.

Digital nurses are registered nurses who already have a wealth of clinical experience and have developed expertise in using digital technologies to improve patient care. They bridge the gap between traditional nursing practices and the modern digital healthcare landscape, ensuring technology is effectively integrated into clinical workflows to standardise and streamline processes to improve patient safety and enhance their healthcare journey.

How and why did you make the transition into digital nursing?

Judy Sealey: I have worked in the NHS for over 15 years mostly in emergency department (ED) and critical care (ICU) nursing, I have also dabbled a bit in specialist fields like infection control, tissue viability and cardiology as I searched for my true passion. At one time, nursing education was where I thought my passion lay, however, it was while I was a clinical educator in an ICU that was using an electronic patient record (EPR) that my passion for digital healthcare technology blossomed. I started off by making suggestions for optimisations, becoming more involved in refining some of the workflows and ensuring that staff were adequately trained and comfortable using the system. This led me to a variety of other opportunities and experiences.

For the last thirteen or so years I have taken on several roles within this space. My greatest passion and desire is continuous improvement to healthcare delivery and the huge role digital systems plays in this. I know firsthand the challenges of excessive repetitive documentation, time wasted searching for patient paper records, inefficient and clunky digital tools and workflows. I leverage my nursing expertise and wealth of digital skills to advocate for more user-friendly designs, less complex workflows that will enhance patient care and reduce clinicians’ burden and burnout.

How do digital nurses affect patient care and outcomes?

JS: Nurses are the largest workforce in health and care and are therefore the primary users of digital systems. Digital nurses bring a unique skill set to the table. They leverage their clinical knowledge and expertise to enhance digital tools like EPRs, mobile health apps and telehealth platforms. By doing so, they ensure the system is user-friendly, practical, efficient and safe. For example, at Bolton NHS Foundation Trust, collaboration between digital and clinical teams has significantly improved patient safety through better EPR configuration and optimisations.

It sounds like collaboration is key. Can you talk a bit more about what happens when there’s a disconnect between clinical and digital teams?

JS: Unfortunately, that disconnect can often be traced to a lack of clinical input in the design and development of digital tools. Without clinical input, digital solutions may lack the context needed to be truly effective, which can disrupt workflows and compromise patient safety. That’s why digital nurses are essential – their input at every stage of the project ensures collaboration and bridges this gap, ensuring the creation of a system that enhances patient care and patient safety while improving efficiency.

How can healthcare systems better support digital nurses and foster collaboration?

JS: To truly support digital transformation, we need to invest in the digital nursing profession to ensure nurses have the necessary training, skills and dedicated time to be successful in this very important role. Digital nurses should be involved in all patient-facing digital projects, from planning, testing, training to delivery and optimisation. Nurses, being on the frontline, are uniquely positioned to identify service gaps and act on opportunities to make impactful changes.

NHS England’s National Chief Nursing Information Officer (CNIO) advocates for CNIOs in every NHS organisation. What’s your take on this?

JS: That’s a fantastic initiative. CNIOs are essential for every hospital because they play a vital role in ensuring the nursing perspective is represented in all aspects of digital health and care transformation. It underscores the importance of nursing leadership in driving the digital agenda and aligns with the goal of embedding digital nurses in all areas of care delivery. Crucially, the CNIO bridges that gap between clinical and digital teams, translating nursing needs into technical requirements and ensuring technology truly meets the needs of supporting patient care.

Looking ahead, what role do you see digital nurses playing in the future of health and care?

JS: As health and care continues to evolve, digital nurses will play a central role in driving the change in successfully navigating the future of digital healthcare. They will become more involved in the entire process, from selecting the most suitable digital solutions, to designing, implementing, testing, training and, indeed, optimising them. From EPR rollouts to telehealth projects and beyond, they’ll be key in ensuring that digital transformation truly meets the needs of frontline staff and continuously improves patient outcomes. Their involvement will drive innovation, improve patient safety and create efficiencies across the board.

Do you have any final thoughts for organisations looking to embrace the digital nursing profession?

JS: Yes, invest in your nursing workforce and be sure nursing curriculums include some aspect of digital training. Involve digital nurses in all patient-facing projects and make collaboration between clinical and digital teams a priority.

Without this, organisations risk digital transformations that compromise patient safety, hinder rather than support care and increase nurses’ workloads, which can contribute to burnout. An approach that embraces the involvement of digital nurses will drive effective inter-organisational collaboration that will help unlock the full potential of digital transformation and ensure it delivers real value to patients and staff alike.

Judy Seeley, Clinical Solutions Specialist, Altera Digital Health

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Workforce planning programme underway at Countess of Chester Hospital NHS FT

By Integrated Care Journal

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

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

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

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

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

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

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

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

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

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

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

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

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

The project is set to be completed by April 2025.

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AXREM hosts event celebrating women in health and care

By Integrated Care Journal

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

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

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

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

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

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

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

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

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

Keep pushing boundaries.

Keep dreaming big.

Keep shining your light.

The world is better because of all of us”

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

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

Featured, Population Health, Thought Leadership March 6, 2025

The UK is losing the ageing medicine battle

By Oskar Wenbar PhD

Ageing medicine specialist, Dr Oskar Wenbar, explores the impacts of the UK’s hesitancy to tackle age-related health conditions, and what can be done to stem the flow of ageing medicine PhDs seeking opportunities abroad.

Through my years in academia and now working in tech-enabled healthcare delivery, I’ve noticed a concerning trend – the UK is steadily losing its ageing medicine specialists to opportunities in the US. Most of the PhDs in this field end up going to America – I’ve seen this within my own alumni group – and with universities facing funding cuts and reduced positions, this brain drain will most likely accelerate.

This actually reflects a fundamental difference in how these countries view and treat ageing – and as retirement age increases and our population ages, the corresponding expertise gap will become a critical issue for UK healthcare. When you look at the numbers, each patient properly treated with ageing medicine can save the NHS thousands of pounds annually – but in the UK, we’re losing the very specialists who can properly deliver this care.

Here is my take on what’s happening and what we can do to fix this situation.

A perception chasm

The UK and US have starkly different approaches to ageing medicine. When UK patients visit their GP with age-related symptoms, they’re often told “it’s just a normal part of ageing” with no treatment offered. In contrast, the US healthcare system increasingly views ageing as a condition that can be actively managed and treated. This growing cultural difference profoundly impacts both medical research and patient care. Here’s an example: while the UK readily provides hormone therapy to 2.6 million women for menopause, we have a major blind spot when it comes to men’s ageing. Research shows nearly 40 per cent of men over 45 would benefit from testosterone therapy based on their blood levels, yet less than 1 per cent receive treatment.

This isn’t because the treatment doesn’t work – rather, it stems partly from cultural stigma. While hormone therapy is widely accepted for women, testosterone treatment for ageing men remains taboo in the UK, despite its proven benefits for man age-related health issues such as muscular dysfunction. In the US, by comparison, these treatments are openly discussed and more readily available.

The real cost to patients and the NHS

Alongside the health implications, the UK’s hesitancy around ageing medicine carries significant economic costs. Research in health economics reveals that each patient receiving appropriate testosterone therapy saves the NHS approximately £3,000 annually. These savings derive from multiple health improvements – reduced obesity rates, lower cardiovascular risk, and better mental health outcomes. The benefits extend far beyond what most people associate with testosterone treatment.

The therapy plays a crucial role in maintaining muscle health through specific biological mechanisms. Research shows that testosterone therapy increases the number of satellite cells in muscles – specialised stem cells that are crucial for muscle regeneration and repair. These satellite cells remain present as people age, enabling better muscle maintenance and regeneration well into later life. Without proper hormone levels, many patients develop sarcopenia – age-related muscle degradation that triggers a downward health spiral. Studies show that up to 28 per cent of elderly males and 12 per cent of women will develop clinical sarcopenia. Once people become sedentary due to muscle loss, their overall health tends to decline rapidly, leading to increased cardiovascular risk and overall mortality. By maintaining healthy testosterone levels, we can help people stay mobile and independent well into their 60s, 70s, and 80s.

The prevention gap

The US healthcare system takes a markedly different approach, emphasising prevention rather than just treatment. This is visible in how they handle metabolic health; American doctors often prescribe metformin early on to prevent diabetes and maintain healthy blood sugar levels. In contrast, the UK system typically waits until a disease is fully developed before intervening.

This delayed intervention is particularly problematic because we know testosterone decline begins much earlier than most realise. Research shows levels start decreasing from age 25, with the steepest decline occurring between ages 30-40. By age 35, men typically have only about 76 per cent of the testosterone they had at 25. Yet our system typically waits until symptoms become severe before considering treatment.

This reactive approach can have cascading negative effects on ageing patients. Weight gain illustrates this perfectly: as someone gains weight, they become less mobile and exercise less, which dramatically increases their cardiovascular risk. For men, this creates an additional problematic cycle – excess fat tissue converts testosterone to oestrogen, leading to even lower testosterone levels. This in turn causes further muscle loss and decreased metabolic rate, often culminating in metabolic syndrome. Instead of preventing this cycle, our current system often waits until these issues become serious health problems before taking action.

Why specialists leave

70 per cent of UK PhDs leave academia and many of our ageing medicine PhDs choose to relocate to the United States. The situation in UK universities continues to deteriorate, with ongoing funding cuts leading to fewer academic positions. A recent report from the Office for Students (OfS) warns that 40 per cent of UK universities will be in financial deficit this year.

Additonally, when specialists leave, their workload is simply redistributed among remaining staff rather than new experts being hired. This creates a self-perpetuating problem; without a robust market for ageing medicine in the UK, specialists are naturally drawn to the US, where there’s both stronger economic opportunity and greater cultural acceptance of their work. Why stay in a system that doesn’t fully recognise your expertise when you can practice in one that does?

Reversing the brain drain: what the UK must do now

To address this growing problem, we need to tackle the cultural stigma around ageing medicine in the UK. By increasing funding and training GPs to better recognise age-related conditions, we can create the market needed to retain expertise here.

We also need to embrace technologies that enable regular health monitoring. New capabilities allow patients to track changes over time, enabling early intervention rather than waiting for conditions to worsen. Better utilisation of this data can help develop personalised treatment plans tailored to individual needs.

Of course I’m not talking about advocating unnecessary treatments, but we have to recognise ageing as a manageable condition and give our retirement the necessary support to maintain quality of life as they age. As retirement ages rise and people work longer, often in sedentary jobs, addressing these issues becomes critical for both individual wellbeing and healthcare system sustainability.

Every year we delay, we lose more specialists to markets that better value their expertise, and our growing ageing UK population suffers. The technology and knowledge exist – what’s missing is the cultural shift to implement them effectively. Addressing these issues becomes increasingly important for both individual wellbeing and our healthcare system’s sustainability.

About the author: Dr Oskar Wenbar holds a PhD in Ageing Medicine from the University of East Anglia. His unique background spans clinical pharmacy, academic research, and health technology, giving him firsthand insight into both the research and practical aspects of ageing medicine. His published research on hormone treatments and muscle health in ageing populations has appeared in the Journal of Cachexia, Sarcopenia, and Muscle, and he has observed the brain drain phenomenon both through his academic network and as a healthcare technology leader. He is also the COO and co-founder of Evaro, a digital health platform revolutionising access to healthcare.

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New data sheds light on NHS efficiencies challenge

By Integrated Care Journal

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

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

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

The top reported obstacles were:

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

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

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

Outdated systems obstruct NHS productivity

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

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

AI and automation: the keys to efficiency?

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

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

The solution to smarter public services

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

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

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

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

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

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

By Michelle Wheeler

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

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

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

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

The problem with managing demand

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

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

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

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

The role of technology in addressing healthcare demand

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

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

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

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

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

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

Using technology and policy to tackle demand

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

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

A new watchword for healthcare demand

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

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

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

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

By Integrated Care Journal

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

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

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

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

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

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

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

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

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

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