Primary care collaborative launches COPD early detection clinic
By Integrated Care Journal
Wirral Primary Care Collaborative and Chiesi partners have launched the community-based COMET clinic to accelerate COPD assessment and diagnosis, reduce system burden and improve patient outcomes.
A primary care collaborative has launched a new initiative aimed at improving early diagnosis and management of Chronic Obstructive Pulmonary Disease (COPD) in the Wirral area. Wirral Primary Care Collaborative (WPCC) and Chiesi UK and Ireland have collaborated to deliver the COMET clinic (COPD Targeted Management, Early Intervention and Treatment) in an effort to ease pressure on primary care and A&E services by offering early diagnosis and evidence-based interventions to at-risk populations.
COPD is a leading cause of emergency hospital admissions, with an average stay of seven days. It is estimated that up to 5,000 people are living with undiagnosed COPD on the Wirral, where prevalence is more than 40 per cent higher than the national average.1
Individuals identified as high risk of COPD will be invited to attend a community diagnostic centre (CDC) for spirometry assessment and then a diagnostic clinic for immediate management (if diagnosed). These services will be delivered directly within the community, ensuring timely access to care.
A patient in consultation at the COMET clinic
Rachel Voller, Advanced Nurse Practitioner at Moreton & Meols PCN, said: “An estimated two million people live with undiagnosed COPD in the UK, with symptoms like breathlessness and chronic cough often mistaken for fatigue or ageing. These delays in diagnosis lead to reduced quality of life for patients, costly emergency hospital admissions and irreversible lung damage.
“The lack of resources and funding across the UK means diagnostics in COPD, such as spirometry, are not always readily available in primary care. By establishing COMET, we’re equipping the NHS and supporting patients to take control of their lung health, improving early diagnosis and accelerating access to care.”
COPD is not only debilitating for patients, but also places a growing burden on the NHS, costing an estimated £1.9 billion annually in England alone. The UK continues to have some of the poorest respiratory health outcomes in Europe, with higher mortality rates from COPD than in comparable countries. Despite the scale and severity of the disease, COPD can often be overlooked, meaning opportunities for early diagnosis are frequently missed.
Many cases are identified incidentally, through initiatives such as NHS lung health checks, or during emergency admissions for other conditions, by which point irreversible lung damage may already have occurred. On the Wirral, where COPD prevalence is 2.6 per cent compared to the national average of 1.8 per cent, the COMET initiative aims to address this challenge by proactively identifying those at risk and providing timely access to spirometry and clinical assessment.
COMET enables those with symptoms and/or CT scan findings consistent with emphysema to be referred for spirometry at local Community Diagnostic Centres before inviting them to the COMET clinic for a full clinical assessment and follow-up. Designed to deliver equitable, community-based care to over 1,000 people, the programme aims to equip patients with the support they need to take control of their lung health while also helping ease the pressure on overstretched GP practices and emergency departments in the Wirral, while identifying feasible approaches that the NHS can embed in the future.
The partnership builds on insights from FRONTIER, a hospital-based programme in Hull which demonstrated that targeted screening can tackle underdiagnosed COPD by improving access to testing and care. By contrast, COMET brings diagnostic assessment and management into Primary Care for patients taking part in the NHS Lung Cancer Screening Programme on the Wirral, expanding early detection and intervention beyond the hospital setting.
Harriet Lewis, Senior Director of Public Affairs and Communications at Chiesi UK and Ireland, said: “At Chiesi, we believe early action is key to improving outcomes for people living with COPD. COMET has been designed to ensure access to diagnostic services is simple, breaking the cycle of delayed diagnosis and avoidable hospital admissions. By delivering care directly within the community, this partnership is integral to improving access to testing and care, easing NHS pressures and demonstrating how partnerships can drive scalable and sustainable change.”
1 Public Health Profiles: Public health profiles – OHID. Available at: phe.org.uk. Last Accessed April 2025.
Nearly half of trusts scaling back activity amid cuts, say trust leaders
By Integrated Care Journal
Cuts to clinical and non-clinical jobs will have consequences for frontline care according to survey of trust leaders, who will face competing priorities boosting performance while trying to balance the books.
NHS trusts are determined to protect patient safety as a new survey by NHS Providers reveals services are being scaled back and jobs cut as the demands of the NHS financial ‘reset’ become clear.
With the NHS looking to recover a predicted financial shortfall that reached nearly £7bn this year, trusts have been asked to drastically reduce running costs while improving performance against key targets.
With the 10-Year Health Plan due to be published in the coming months, nearly half of trust leaders (47 per cent) surveyed warned they are scaling back services to deliver tough financial plans, with a further 43 per cent considering this option. Virtual wards, rehabilitation centres, talking therapies and diabetes services for young people are among services identified at risk, demonstrating the extremely tough choices being faced by NHS leaders.
More than a third (37 per cent) said their organisation is cutting clinical posts as they try to balance their books, with a further 40 per cent considering this option. With trusts told to halve corporate cost growth, 86 per cent of trust leaders said their organisation is going to have to cut posts in non-clinical teams – such as HR, finance, estates, digital and communications – potentially risking efforts to deliver services, innovate, and improve productivity.
The scale of job cuts is becoming clear with a number of trusts aiming to take out 500 posts or more and one organisation planning to cut around 1000 jobs.
The interim Chief Executive of NHS Providers, Saffron Cordery, said “It’s really worrying to hear trust leaders tell us highly valued staff and services including vital work to address health inequalities and prevention could be among the early casualties of budget cuts. These decisions are never taken lightly and will always be a last resort.”
With further reductions to temporary staffing costs (91 per cent) and a recruitment freeze (85 per cent) also on the cards, the impact of these changes on hardworking and overstretched front-line teams is a major concern for trust leaders. More than nine in ten (94 per cent) said the steps needed to deliver financial plans would have a negative impact on staff wellbeing and culture at a time when morale, burnout and vacancies are taking their toll, and disquiet over pay and conditions is rising.
Now trust leaders have called on the government to recognise the difficult decisions and competing priorities trusts face as they try to improve patient services while trying to balance the books.
The survey by NHS Providers, which represents hospital, mental health, community, and ambulance services also found:
More than one in four (26 per cent) said they will need to close some services (a further 55 per cent are considering this)
45 per cent are moderately or extremely concerned their actions will compromise patient experience
Close to three in five respondents said patient experience (61 per cent) work to address health inequalities (60 per cent) and access to timely care (57 per cent) were most at risk of being impacted
Nearly nine in ten (88 per cent) said they don’t have enough funding to invest in prevention
Saffron Cordery added: “Trust leaders will always put patient safety and quality of care first. They’re acutely aware of pressures on the public purse, the scale of the challenge they’re facing and their duty to make the most of every pound that goes into the NHS. They’re working hard every day to find efficiencies, cut costs and make savings without compromising safety. They’re at the forefront of efforts to shift care from hospitals to the community, from analogue to digital and from treating sickness to preventing ill-health.
“Trust leaders have also heard loud and clear that overspending will not be tolerated and have made major inroads in tackling the huge financial deficit facing the NHS.
“But let’s also be clear: cuts have consequences. NHS trusts face competing priorities of improving services for patients and boosting performance while trying to balance the books with ever-tighter budgets. National leaders must appreciate that makes a hard job even harder.
“[Trust leaders] are committed to working with the government to build a better health service but fear immediate financial pressures could undermine plans to transform the NHS.”
Nearly half of NHS staff say role is affecting their mental health, charity warns
By Integrated Care Journal
Nearly half of NHS staff say their job harms their mental health, with many citing chronic pressure, staff shortages, and emotional strain. NHS Charities Together is calling for urgent support to expand vital mental health services for a workforce in crisis.
Nearly half of NHS staff (47 per cent) say their job is negatively affecting their mental health, according to a new survey of more than 1,000 NHS employees, carried out by NHS Charities Together. While this is a slight improvement from last year’s figure of 51 per cent, the prevalence of poor mental health among the NHS workforce remains stubbornly high, and highlights the urgent need for continued investment in staff wellbeing.
When asked which factors have negatively impacted their mental health in the workplace in the last 12 months, the most commonly cited causes among NHS staff surveyed included staff shortages (49 per cent), not feeling able to provide the best possible care (35 per cent), rising patient numbers (29 per cent), and exposure to traumatic situations at work (15 per cent). Despite this clear and growing need, just one in four (25 per cent) said they had accessed any form of mental health support in the past year.#
The survey findings also add to the existing evidence that the incidence of mental health problems is higher among NHS workers than it is among the general population. Half (51 per cent) reported experiencing anxiety, and nearly one in four (23 per cent) said they had experienced depression. By comparison, recent national data suggests that around one in six adults (16 per cent) in England met the criteria for a common mental disorder – such as anxiety or depression – within the past week.
Other health challenges experienced by staff in the last 12 months include exhaustion (44 per cent), burnout (35 per cent), and – perhaps most alarmingly – suicidal thoughts, reported by almost one in ten NHS employees (9 per cent).
In response, NHS Charities Together is calling for urgent public support to fund expanded mental health services for staff – services that are already making a difference, but are struggling to meet demand.
Ellie Orton OBE, Chief Executive at NHS Charities Together, said: “NHS staff are facing relentless pressure, working in some of the most challenging conditions the health service has ever seen. Chronic staff shortages, rising demand, and the emotional toll of not being able to deliver the care they want to give are seriously affecting their mental health.
“Given these daily pressures, it’s sadly no surprise that mental health issues among NHS workers are so widespread. If we want the NHS to thrive, we must take better care of the people who keep it running.”
Despite the growing pressure, almost four in five staff (78 per cent) say they’re proud to work for the NHS, underlining the passion and commitment of the workforce even in times of challenge, while 43 per cent would still recommend it as a career.
NHS Charities Together, the national charity caring for the NHS, helps provide vital mental health and wellbeing services to the NHS’s 1.7 million-strong workforce. Thanks to public donations, these services include staff psychologists, peer support programmes, wellbeing hubs, and more.
The charity has also announced a new Workforce Wellbeing Programme, including an initial investment of £6 million, with a further £5 million provided by NHS England. NHS Charities Together intends to raise a further £5 million over the course of the programme to drive much needed action across the UK and create positive, lasting change. Funds will be invested where there is the greatest need, and where charities can make the biggest and most sustainable difference to the workforce.
When asked what support they felt would benefit them most, nearly three in ten NHS staff (29 per cent) said access to psychological support or counselling services. Approximately a quarter (26 per cent) said respite or wellbeing sessions, one in five (22 per cent) said they would value access to a rest space or garden, and about one in eight (13 per cent) identified the need for intensive trauma-informed support.
Sarah*, a nurse who wanted to remain anonymous, said: “It was my ultimate goal to become part of the NHS, it’s an incredible institution and I’m proud to work there. However, nothing could have prepared me for my role. The pressure is unrelenting. Our patients and their loved ones are upset and frustrated because they have been stuck in the waiting room for hours. I wish I could do more, but I have no power to change the situation. We barely get breaks. We’re expected to power through, finish your shift, go home, and ‘pull yourself together’ for the next day. On my days off, I’m too drained to do anything but rest. I don’t want to socialise; I just want to switch off. It becomes a vicious cycle: work, home, and then back to another shift. It’s taking a toll on my relationships too.
“Due to funding cuts, we’ve lost our wellbeing hub – a safe haven for staff to take a moment of respite. Since it closed, I’ve watched many colleagues go on sick leave due to mental health issues. Skilled and experienced staff have left because the pressure has become too much, leaving us severely short-staffed. It’s heartbreaking to see team members becoming patients themselves. We need more support for staff, including training managers in how best to support their teams– things can’t go on as they are.”
Adam Kay, former doctor and bestselling author of This Is Going to Hurt, said: “Perhaps the most miserable part of reading these statistics for me was how unsurprising they are. It has never been tougher to work in the NHS than today, and there is simply not the support for staff. I welcome any efforts to support the mental wellbeing of NHS staff – this is a system in crisis.”
Ellie Orton OBE added: “Thanks to the generosity of the public, we’ve already been able to help over a million NHS staff with access to counselling, wellbeing spaces, and other crucial initiatives. But, despite their impact, these types of initiatives can’t currently be funded indefinitely; and the need is growing. With many staff struggling and unable to access support, we’re urging everyone who can to continue backing our work, so we can keep backing the NHS workforce.”
NHS Charities Together is the national charity caring for the NHS. To find out more or donate, visit nhscharitiestogether.co.uk.
The integration of AI into healthcare systems around the world represents one of the most significant technological shifts of our time. However, realising this potential while safeguarding against risks requires urgent and thoughtful government action, writes Clive Hudson.
Artificial intelligence (AI) is rapidly transforming healthcare systems around the world, offering unprecedented opportunities to improve patient outcomes, increase efficiency and reduce costs. However, as an innovator with over 40 years of experience in the field of AI, I believe we are at a critical juncture where governments globally must take decisive action to harness AI’s potential while mitigating its risks.
The current state of AI in healthcare is one of both promise and peril. While we’re seeing exciting applications emerge, from AI-assisted diagnostics to personalised treatment plans, there are also serious concerns around data privacy, algorithmic bias and the potential displacement of human healthcare workers. Governments worldwide, including the new UK administration, have a crucial opportunity and indeed a clear responsibility, to shape the future of AI in healthcare through thoughtful regulation and strategic investment.
The transformative potential of AI in healthcare
AI is already demonstrating its ability to revolutionise healthcare delivery. Machine learning algorithms are enhancing the accuracy of medical imaging analysis, natural language processing is streamlining clinical documentation and predictive analytics are helping identify at-risk patients before their conditions worsen. These applications are just the tip of the iceberg.
However, to fully realise AI’s potential, we need a robust regulatory framework that promotes innovation while protecting patients. A gold standard for global AI regulation in healthcare should prioritise:
Patient safety and privacy
Algorithmic transparency and accountability
Equitable access to AI-powered healthcare solutions
Interoperability and data sharing standards
Continuous monitoring and evaluation of AI systems
Such a framework would provide clarity for developers, build trust among healthcare providers and patients and create a level playing field for international collaboration.
The need for dynamic regulatory frameworks
Current regulatory approaches are woefully inadequate for the rapidly evolving landscape of AI. Traditional regulatory bodies move too slowly and often lack the technical expertise to effectively oversee AI technologies. We need a new paradigm.
I propose that governments need to create specialised AI regulatory authorities with a mandate to develop and enforce dynamic regulations. This authority would be empowered to adapt rules in real-time as technologies evolve, guided by core principles of:
Biodiversity
Ensuring AI systems support, rather than threaten, the rich diversity of life on our planet.
Sustainability
Promoting AI applications that contribute to long-term environmental and social well-being.
Transparency
Requiring clear explanations of how AI systems make decisions in healthcare contexts and establishing clear lines of responsibility for AI-driven outcomes.
Any nation’s regulatory body must be staffed by interdisciplinary experts who understand both the technical intricacies of AI and its broader societal implications. It should use AI technologies itself to stay ahead of the curve and offer proactive guidance to the healthcare sector.
Economic impact and strategic investment
The economic potential of AI in healthcare is staggering. By automating routine tasks, optimising resource allocation and enabling more personalised interventions, AI could dramatically reduce healthcare costs while improving outcomes.
However, realising these benefits requires strategic government investment and support. Governments should take a multifaceted approach, funding AI research and development in priority healthcare areas, incentivising AI adoption among healthcare providers, investing in robust data infrastructure and interoperability standards, and supporting AI startups and small businesses in the healthcare sector. These initiatives would create a fertile ecosystem for innovation, accelerating the development and implementation of AI solutions that can transform healthcare delivery and outcomes.
While pursuing these economic benefits, policymakers must remain vigilant about potential negative consequences, such as job displacement or the exacerbation of health inequalities. Government policies should aim to distribute the gains from AI equitably and provide support for workers transitioning to new roles.
Challenges and ethical considerations
As we push the boundaries of AI in healthcare, there are also significant ethical challenges to confront. Data security and patient privacy are paramount concerns. Current day AI systems require vast amounts of sensitive health data to function effectively, creating potential vulnerabilities to breaches or misuse.
Moreover, we must be vigilant about biases in AI systems. If trained on non-representative datasets, AI could perpetuate or even amplify existing health disparities. Governments must mandate rigorous testing and auditing of AI systems to detect and mitigate such biases.
Another crucial consideration is maintaining the human element in healthcare. AI should augment, not replace, human expertise and compassion. Policies should encourage the development of AI systems that enhance the capabilities of healthcare professionals rather than seeking to automate them out of the equation.
The concept of ‘super intelligence’ in healthcare AI
Looking to the future, we must grapple with the concept of ‘superintelligence’ in healthcare AI. By this, I mean AI systems that surpass human capabilities not just in narrow tasks, but in reasoning, problem-solving and even creativity across a wide range of knowledge domains.
Developing such systems requires a cross-disciplinary approach, drawing insights from fields as diverse as neuroscience, psychology, ethics and computer science. It is not simply a matter of scaling up existing AI models, but of fundamentally rethinking how we approach machine intelligence.
It is possible to draw important lessons from past technological advancements. The rapid rise of social media, for instance, brought unforeseen consequences for mental health and social cohesion. With healthcare AI, the stakes are even higher, making it essential to anticipate potential negative outcomes and build safeguards from the ground up.
A key aspect of superintelligent AI in healthcare would be its ability to reason ethically and align its goals with human values. This is no small feat and will require sustained collaboration between AI researchers, ethicists and healthcare professionals.
Recommendations for policymakers
First and foremost, governments should establish a specialised AI regulatory body. This agency should have the authority and expertise to develop and enforce dynamic regulations that keep pace with technological advancements. Such a body would be crucial in navigating the complex and rapidly evolving landscape of AI in healthcare.
Investing in AI education and workforce development is equally important. We need to build a workforce capable of developing, implementing and overseeing AI systems in healthcare. This requires significant investment in STEM education and interdisciplinary programs combining technical skills with healthcare knowledge. By fostering this talent pipeline, we can ensure that we have the human capital necessary to drive innovation and responsible AI adoption in healthcare.
Governments should also promote collaboration between academia, industry and government. Innovation thrives when ideas flow freely between sectors. Creating frameworks for data sharing, joint research initiatives and knowledge transfer between universities, private companies and public health institutions can accelerate progress and ensure that AI developments are aligned with real-world healthcare needs.
Embedding ethical guidelines in AI development is crucial. Ethics should not be an afterthought but an integral part of the process. Governments should mandate the integration of ethical considerations at every stage of the AI lifecycle, from design to deployment and ongoing monitoring. This approach will help build trust in AI systems and ensure they align with societal values.
Given the global nature of AI development in healthcare, supporting international cooperation is vital. Governments should work together to establish common standards, share best practices and address cross-border challenges such as data governance and algorithmic accountability. This collaborative approach can help create a more cohesive and effective global AI ecosystem in healthcare.
Prioritising explainable AI is another key recommendation. In healthcare, it is crucial that AI systems can explain their decision-making processes. Policymakers should incentivise the development of interpretable AI models and require transparency in high-stakes healthcare applications. This transparency will be essential for building trust among healthcare providers and patients.
Finally, governments should invest in robust testing and validation frameworks. Before AI systems are deployed in healthcare settings, they must undergo rigorous testing to ensure safety, efficacy and fairness. Establishing clear guidelines and supporting the development of standardised evaluation protocols will be crucial in ensuring that AI systems meet the high standards required in healthcare contexts.
Time for action
The integration of AI into healthcare systems around the world represents one of the most significant technological shifts of our time. Its potential to improve patient outcomes, increase efficiency and drive medical breakthroughs is immense. However, realising this potential while safeguarding against risks requires urgent and thoughtful government action.
We stand at a crossroads. With the right policies and investments, we can shape an AI-enabled healthcare future that is more effective, equitable and humane. But if we fail to act, we risk a future where AI exacerbates health inequalities, compromises patient privacy or makes critical decisions without adequate oversight.
My vision is for a healthcare ecosystem where AI enhances and extends human capabilities, where patients benefit from personalised and proactive care and where the fruits of AI innovation are shared equitably across society. Achieving this vision requires more than just technological prowess – it demands political will, ethical foresight and global cooperation.
The time for governments to act is now. By establishing dynamic regulatory frameworks, investing strategically in AI development and education and prioritising ethical considerations, we can ensure that AI becomes a powerful force for good in global healthcare. The decisions we make today will shape the health outcomes of generations to come. Let us seize this opportunity to create a healthier, more equitable world for all.
First Community Diagnostic Centre Value Partnership with Siemens Healthineers set to improve health outcomes across Teesside
By Integrated Care Journal
A first-of-its-kind seven-year Value Partnership will see Siemens Healthineers support Tees Valley Community Diagnostic Centre to deliver up to 104,000 checks, scans and tests a year on the high street.
North Tees and Hartlepool NHS Foundation Trust and South Tees Hospitals NHS Foundation Trust have announced the first Community Diagnostic Centre (CDC) Value Partnership to be collaboratively delivered with Siemens Healthineers. The seven-year partnership will set a gold standard for CDCs, placing efficiency, scalability and patient care at its core. Once fully operational, the CDC is set to deliver up to 104,000 potentially lifesaving checks, scans and tests a year.
An impressive fleet of nine imaging systems will be provided, including a variety of CT, MRI, X-ray and ultrasound equipment from Siemens Healthineers. Support includes maintenance of the systems and additional services to bolster prostate cancer pathways and productivity including digital AI, consulting, workforce planning and education. The CDC represents an important investment to improve healthcare outcomes across the region where the proportion of people with major health conditions is at least 10 per cent higher than the national average.
“Integrating advanced imaging systems and AI solutions enables us to provide quicker, more effective diagnostics and treatment while the community setting brings essential services closer to our patients,” said Gail Griffiths, Diagnostic Services Lead for Responsive Care at North Tees and Hartlepool NHS Trust.
Delivered by the North East and North Cumbria Integrated Care Board, the CDC supports efforts to address health inequalities in the area by ensuring a collaborative, community-based approach, and aligns with government ambitions to move more care away from hospital settings. Access to care outside of a hospital setting means patients can receive more convenient health checks closer to home. The central location in the heart of Stockton town centre alongside a library and leisure centre not only improves access to care, but also encourages a wider transformation of the high street.
The NHS’ 2024/25 priorities and operational planning guidance identifies the opening of new CDCs as a key action for systems, and the upcoming 10-Year Health Plan is expected to reaffirm the value of CDCs for delivering the government’s desire to further shift care in community settings.
Tees Valley CDC will benefit from digital AI solutions as part of the partnership. Utilising AI-Rad Companion from Siemens Healthineers, standardised reporting of the scans will enable quicker, more effective prostate cancer pathways, helping to support both productivity and patient throughput. Support from Siemens Healthineers Consulting includes a tailored transformation programme featuring a project to help increase the daily number of patients receiving MRI scans by up to 40 per cent.1 The partnership will also support upskilling the workforce with tailored training and education opportunities to meet the CDC’s unique requirements.
Among the range of CT, MRI, X-ray and ultrasound equipment from Siemens Healthineers are two SOMATOM X.cite CTs. Both systems are designed with patient experience in mind, equipped with the unique guidance of myExam Companion to automate results, as well as Tin Filter technology to optimise dose efficiency. Tees Valley CDC will also include two MAGNETOM Sola MRI systems, a YSIO X.pree X-ray and two ACUSON Sequoia ultrasound systems from Siemens Healthineers. The wide range of systems will support the delivery of care with the potential for one-stop clinics in the future for diagnostic tests conveniently based in the centre of Stockton.
Kelly Smith, Head of Radiology at South Tees Hospitals NHS Foundation Trust, commented: “In partnership with North Tees and Hartlepool NHS Foundation Trust and Siemens Healthineers we are making a significant step forward in improving healthcare outcomes across the Teesside region. By bringing imaging technology and comprehensive AI solutions to a community setting, we’re not only enhancing diagnostic capabilities but also ensuring more accessible healthcare for our patients.”
“Together with South Tees Hospitals NHS Foundation Trust and Siemens Healthineers we aim to transform healthcare delivery in our region and significantly improve outcomes, added Gail Griffiths.
Ghada Trotabas, Managing Director of Siemens Healthineers Great Britain & Ireland, stated: “This groundbreaking collaboration with North Tees and Hartlepool NHS Foundation Trust and South Tees Hospitals NHS Foundation Trust is the first of its kind for community diagnostics centres. Located in a high street setting, the centre will set a new benchmark for delivering efficient services outside of the hospital environment, bringing care closer to the patients who need it most.
“Our partnership ensures the CDC stays adaptable to the evolving needs of patients, contributing to the local healthcare delivery transformation initiatives across Teesside.”
1The statement by Siemens Healthineers Consulting described herein is based on projected results that may be achieved in the customer’s unique setting subject to all recommendations being implemented. Since there is no ‘typical’ hospital and many variables exist (e.g. hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.
Lead image caption: (From left to right) Lee Charlton – Regional Sales Manager at Siemens Healthineers Great Britain and Ireland, Gail Griffiths – Diagnostic Services Lead at North Tees and Hartlepool NHS Foundation Trust, Kelly Smith – Head of Radiology at South Tees Hospitals NHS Foundation Trust, Neil Lincoln – Head of Imaging Sales at Siemens Healthineers Great Britain and Ireland, with the new SOMATOM X.Cite CT scanner from Siemens Healthineers.
This article was kindly supported by Siemens Healthineers.
How combining data, curiosity and operational expertise is improving immunisation uptake
By Iona Rees and Harry Canty-Davis
By Iona Rees, Head of Improving Immunisation Uptake, and Harry Canty-Davis, Service Development Manager, Public Health Services, NHS South, Central and West Commissioning Support Unit (CSU).
Vaccination is one of the most effective public health interventions, but uptake is decreasing. It will require dedicated uptake improvement programmes to reverse this trend. Analysis and reporting of data is crucial in identifying vaccine eligibility and take-up, areas of highest need and potential barriers. However, in our experience of working with public health and NHS teams, operational insights – particularly around primary care – are essential to interpret that data accurately so that vaccination campaigns are appropriately targeted and resources are well spent.
Vaccinations reduce serious illness and hospitalisation, benefiting both individuals and health and care providers. The World Health Organization reports that childhood vaccines prevent between 3.5 and 5 million deaths every year across the globe and COVID-19 vaccines are estimated to have saved more than a hundred thousand lives in England alone. However, vaccination uptake was already in decline before the COVID-19 pandemic, and in the three years from 2020 to 2023, 67 million children globally were reported to have missed out on one or more vaccinations. NHS data for the UK showed that coverage for all 14 standard childhood vaccinations decreased in 2023/24, with uptake lower among children living in the areas of greatest deprivation.
To realise the benefits of better health and reduced burden on NHS services through improved immunisation uptake, it is necessary to understand what barriers exist and why, before deciding how best to direct staff and financial resources.
Key principles for vaccination programmes
Through NHS South, Central and West CSU’s work in delivering the National Immunisation Management Service, Child Health Information Services (CHIS) and wider operational and analytical support for public health, we’ve identified three core principles that can be applied across any geography to increase vaccination uptake while making best use of limited resources:
1. Making data meaningful
Regional screening and immunisation teams often tell us they are “drowning in data”. The challenge lies in making that data useful – getting, cleansing and interpreting the right data to enable robust, informed decisions. This requires regional teams, commissioners, GP practices and CHIS providers to collaboratively extract and process live data from operational systems to give a timely, accurate picture of vaccination status, rather than relying on information that may be several weeks out of date.
But we also need to ensure we are making recommendations and decisions on data that is accurate and complete. Building in mechanisms to fill gaps in data or improve how information is coded, such as insight reporting, can significantly improve an organisation’s ability to target the right cohorts in the right way. To improve quality of primary care ethnicity data in London, for example, we used a text message campaign to enable registered patients to select their ethnicity which was automatically coded into the practice record.
2. Understanding the issues
Being curious about what the data appears to show, and applying operational insights to inform interpretation, can make a significant difference to the direction – and ultimate success – of a vaccination programme. For example, when the East of England region was experiencing poor COVID-19 vaccine uptake among white working-class young males, it was easy to link this to typically low engagement with health services.
A contact centre campaign to call those who hadn’t responded to invitations revealed that the real issues were the high number of people on zero-hour contracts, who couldn’t afford to take time off work for appointments, and lack of access to transport to get to vaccination centres. By deploying vaccination buses to places of high employment, such as large warehouses and farms, take-up improved, benefiting individuals, health services and large regional employers who were able to avoid operational disruption.
Similarly, when COVID-19 uptake levels within the Chinese population in the North West were reported to be low, initial assumptions were that this was culturally motivated. By viewing the data through a primary care operations lens, however, we were able to discern that the issue was only among 20- to 30-year-olds, who had registered with practices near to universities, but had since moved areas or countries. It was a simple record-keeping issue rather than a more complex cultural issue, avoiding the need for a costly community engagement campaign.
3. Enabling multidisciplinary discussion
Real-time data and dashboards are useful tools but bringing together people to discuss and interrogate what the data means is incredibly valuable. Allowing time to talk though the ‘why’ helps to ensure that when organisations take action, it is productive and cost-effective. Useful questions to cover include: what are the key issues coming through? What are the continuing trends? Where is the evidence for this? What methodology is being used and is it sound? What could this mean operationally?
In the North West, the NHS England regional team uses monthly reports on the measles, mumps and rubella (MMR) vaccination campaign to bring together public health, screening and immunisation colleagues to share and work through the analysis, making time for important dialogue and collaboration on potential issues and interventions. This approach has proved so positive that it has now been commissioned for the entire 0-5s childhood immunisation programme across Greater Manchester.
Using limited resources effectively
Vaccine promotion must be targeted in the most effective way possible to benefit our patients and communities. This is as much about the activity organisations stop doing as it is the plans they pursue. In applying the above principles, we are seeing organisations develop cost and resource-efficient strategies based on a sound understanding of both the data and how it applies operationally.
Using this approach, Blackburn with Darwen ICS discovered that clinic locations and language were the main barriers to flu vaccine uptake among 2- to 3-year-olds in deprived and multi-ethnic areas. Adopting a collaborative approach with regional, ICB and GP practice colleagues, including arranging weekend clinics and sending out information in multiple languages, has helped to increase flu vaccine uptake by 10 per cent in 12 practices.
Bringing curiosity and operational expertise to data analysis has also avoided additional investment in a resource-intensive ‘call and recall’ campaign to improve MMR vaccination rates in young adults and teenagers. Although the data initially suggested the campaign was working, further analysis showed this was due to vaccination records being retrospectively updated within GP practices rather than vaccine uptake increasing.
The Darzi investigation urges the NHS to focus on furthering the shift from ‘treatment to prevention’. Ensuring our core public health interventions are optimised is a solid first step, and these principles apply not just to vaccines but also to screening and health checks programmes. More than 12 months on from the launch of the first NHS vaccination strategy, there is still much learning and best practice to emerge. But in our drive to progress, we must take time to challenge assumptions and fully understand what the data is telling us so that interventions are resource-efficient and deliver results.
Evaluation of NHS Artificial Intelligence Lab identifies lessons to shape AI’s future in health and care
By Integrated Care Journal
Review finds that the NHS AI Lab has been integral in advancing and scaling AI development in healthcare, with early evidence demonstrating returns on investment for taxpayers. However, researchers flag challenges in scaling and adoption of AI, and the need for stronger alignment with NHS system needs.
Researchers from The University of Edinburgh have released a report highlighting the ‘transformative’ impact of the NHS Artificial Intelligence (AI) Lab, a pioneering DHSC and NHS England initiative aimed at effectively integrating AI into the health and care sector.
The independent evaluation was conducted by a senior team of interdisciplinary researchers from The University of Edinburgh spanning public health, social science, informatics and business disciplines. With health economics support from NHS Arden and GEM Commissioning Support Unit, the report offers assessment of the NHS AI Lab’s achievements and challenges as well as identifying learning for future opportunities driven by AI.
The independent review was conducted between March and December 2024 using a range of evaluation techniques including document reviews, interviews, observations, analytics and outputs measurement. Key findings include:
Significant progress and learning: The NHS AI Lab has helped to advance AI development and scaling in healthcare, generating valuable insights and lessons that can help to shape future AI strategies for the NHS.
Return on investment: Early evidence indicates promising financial and patient care benefits, with health economics approaches demonstrating AI-driven technologies yielding substantial cost savings and improved health outcomes for some technologies supported by the NHS AI Lab. There is also early evidence of returns on investment for taxpayers.
Challenges in scaling and adoption: The report identifies barriers to widespread AI implementation and adoption, including procurement processes, integration with existing infrastructures and processes and the need for stronger alignment with NHS system needs.
Long-term impact: While some benefits are already evident, the full value of the NHS AI Lab’s work is expected to unfold over longer timeframes, requiring continued monitoring of emerging benefits and adoption processes.
Launched in 2019, with an initial investment of £143.5 million, the NHS AI Lab was established to accelerate the safe and effective adoption of AI in healthcare. Over the past five years, it has played a critical role in supporting and coordinating the development, testing and deployment of AI in health and care, as well as shaping regulatory frameworks. The evaluation explores the AI Lab’s contributions to AI policy, infrastructure and real-world applications, ensuring that the NHS remains at the forefront of AI-driven healthcare advancements.
One AI project cited implemented a diagnostic tool in a non-elective care setting across a range of regional networks within the NHS. The technology provided a set of decision support tools that aided frontline clinicians to make time critical treatment decisions, this resulted in efficiencies in longer term care and patient outcomes leading to a cost saving estimate of over £44 million across a cohort of 150,000 patients.
The evaluation report emphasises the need for sustained national support, strategic leadership and evidence-based decision-making to ensure AI’s full potential is realised in healthcare. It also highlights the importance of fostering positive collaboration between AI developers, policymakers and frontline healthcare providers.
Professor Kathrin Cresswell, lead researcher on the evaluation from The University of Edinburgh, commented: “The NHS AI Lab has been instrumental in positioning the UK at the forefront of delivering system-based change to promote AI-driven healthcare. This evaluation provides real-world empirical evidence and learning that can help to shape future efforts in the UK and internationally.”
Dom Cushnan, Director of AI, Imaging and Deployment, NHS England, commented: “The findings from this report will inform the ongoing development of AI strategies and approaches that can help the NHS to make the strategic shift from analogue to digital in health and care. Helping to shape a future where AI will enhance patient care, operational efficiency and overall healthcare outcomes.”
Rose Taylor, Executive Director Health and Care Transformation at NHS Arden & GEM, commented: “This evaluation demonstrates the important role that AI can play in the transformation of NHS services. The health economics approach taken in the review has enabled systems to demonstrate that AI technologies can deliver benefits for patients while simultaneously providing productivity and efficiency gains.”
Bridging the Gap: Connecting people with the stairlift grants they need
By Integrated Care Journal
Thousands may be missing out on stairlift grants worth up to £36,000. A new guide explains the eligibility criteria for accessing a grant, and how to apply.
Installing a stairlift into a property can provide residents with improved mobility, allowing people to continue to enjoy their independence as their mobility decreases.
The price to purchase and fit this equipment can put some people off investing in these mobility solutions though. According to a Which? survey of stairlift owners, the average sum that a respondent paid for a new stairlift as of December 2022 was £3,867.
Curved stairlifts provider Access BDD has created a guide, advising how to bring down the cost of these home modifications, by explaining who is eligible for any of these stairlift grants.
Disabled Facilities Grants
A Disabled Facilities Grant (DFG) is a source of financial aid that is available to disabled people across England, Wales and Northern Ireland when they need to make home adaptations so that a property can become more accessible.
Although it has been voluntary since 2010 for local authorities to submit annual returns to the Department for Levelling Up, Housing and Communities about their DFG activity, a parliamentary question posed to the Minister, Luke Hall, in February 2020 found that the estimated number of DFGs delivered increased from 40,645 in 2014/15 to 53,500 in 2018/19.
What financial aid is there?
Here’s how much applicants can apply for when it comes to receiving a DFG:
In England, a grant of up to £30,000
In Wales, a grant of up to £36,000
In Northern Ireland, a grant of up to £25,000
Applicants may receive more than these amounts from some councils, though how much you get will usually be determined by your household income and having household savings that are above £6,000.
Take note too of the following caveats when it comes to applying for a DFG:
Disabled children under the age of 18 are eligible for a DFG without their parents’ income being factored into the decision.
A landlord will not have their income or savings considered if they apply for a DFG to make adaptations to a property they own. If the current tenant moves out within five years of this financial aid being received though, a council may request that another disabled person moves into the property.
Who is elible?
Anyone looking to join the thousands of people who have successfully applied for a DFG will be eligible for this financial aid if someone in their household has a disability.
This individual must also intend to live in the property throughout the grant period, which is usually set at five years but may be adjusted for circumstances such as someone being terminally ill.
The council which provides the DFG must be satisfied that any work carried out is necessary and appropriate for the needs of the disabled individual too, as well as being able to be done on the property depending on its age and condition.
Once a DFG has been approved, all work should be completed within a year. However, do not start this work before the council states the application is approved – a grant can be turned down by the council in this type of scenario.
How to apply
Applicants can apply for a DFG through their local council by clicking here. A decision must be provided by councils within six months of the application being submitted.
Scotland: Scheme of Assistance
Scotland is not included in the section on DFGs. This is because local authorities across this country are responsible for providing its citizens with stairlift grants through what is referred to as the Scheme of Assistance.
According to the Scottish Government’s Housing Statistics 2022 and 2023 publication, a total of 6,353 Scheme of Assistance grants were paid to householders during the 2022/23 period. This is up by four per cent when compared to how many of these grants were delivered in 2021/22.
Financial help in the form of grants or loans can be provided through the Scheme of Assistance, so that private housing can be adapted because one of its occupants is disabled.
Grants must be at a minimum level of 80 per cent of the eligible cost, though recipients might get 100 per cent if you receive one of these benefits:
Income-based Jobseeker’s Allowance
Income-related Employment and Support Allowance
Income Support
The guarantee credit part of Pension Credit
Universal Credit
It is to the discretion of a local authority to pay a grant that is more than 80 per cent of the eligible cost to a person who is not legally entitled to 100 per cent though. Circumstances which lead to this decision will be set out by the local authority in its Scheme of Assistance statement.
Eligibility in Scotland
Local authorities throughout Scotland must provide help in the following situations:
A property needs to be adapted so that it becomes suitable for a disabled person to occupy it. When these home adaptations will assist an individual to gain access to standard amenities, this financial aid must come in the form of a grant.
To reinstate a property that has been adapted previously.
When an owner of a property has been served a work order or statutory order.
It is also within the law that any help provided through the Scheme of Assistance must not discriminate against an individual in any of these ways:
A cognitive impairment
A physical impairment
Gender reassignment
Pregnancy or maternity
Their age
Their race
Their religion or belief
Their sex
Their sexual orientation
Anyone can apply for financial help through the Scheme of Assistance by filling in an application form. These will be available for download from local authority websites or in physical format at local housing officers, with local Citizens Advice Bureau advisers available to answer any questions while applying through this link.
RABI Independent Living Grants and SSAFA Help With Mobility
Specific stairlift grants may also be available to applicants depending on the type of industry they have worked in.
The Royal Agricultural Benevolent Institution (RABI) Independent Living Grants for farming families and the Soldiers’, Sailors’, and Airmen’s Families Association (SSAFA) Help With Mobility for those who have served in the Armed Forces are just two examples to take note of.
RABI states on its website that it awards an estimated £3 million of direct financial support annually, while SSAFA’s Annual Report and Accounts for 2023 detailed that it provided support to over 53,000 individuals through its services in 2023 alone.
Both RABI and SSAFA can assist individuals across the UK with adapting their properties to make a home more accessible. This is how you can be eligible for a stairlift grant through either of these charities:
RABI Independent Living Grants are available to support low-income farming families in the UK, as well as possibly those in the farming industry when there is a financial crisis.
SSAFA Help With Mobility services are available to any individual who has received a minimum of one day’s pay from the British Army, Royal Air Force, Royal Navy or Royal Marines, which includes the Reserves. Immediate family of a person who has served for these Armed Forces are also eligible to receive these services.
How to apply
To find out more about the financial assistance available through RABI Independent Living Grants, contact the charity’s support team on 0800 188 4444 to start an application.
To begin applying for SSAFA Help With Mobility, get in touch with one of the charity’s advisors via their Forcesline service.
Whether it is through a government source or a charity, there is plenty of help available when looking to achieve enhanced mobility around a property.
After an extensive selection process, 23 finalists have been chosen across nine categories, each recognising the outstanding health heroes of the UK.
The selected finalists will be invited to attend the ceremony held in Central London on 22 May where the gold, silver and bronze award winners will be announced.
The finalists are as follows:
Individual categories
Apprentice of the Year, sponsored by SFJ Awards:
Nasser Mohammed, Service Desk Supervisor/Developer, Leeds and York Partnership NHS Foundation Trust
Tim Muttock, Business Administration Apprentice, Bridgewater Community Healthcare NHS Foundation Trust
Olivia Parsons, Clinic Manager, Beacon House
Healthcare Volunteer of the Year:
Andy Emery, Transport Volunteer, Royal Voluntary Service
David White, Patient Befriender Volunteer, Cardiff and Vale Health Board
Chris Wilson, Volunteer Community First Responder, Yorkshire Ambulance Service NHS Trust
Outstanding Life Contribution, sponsored by NHS Employers:
Caroline Dowsett, Clinical Nurse Specialist, East London Foundation Trust
Vedantee Shiebert, CAMHS Lead Nurse, Central and North West NHS Foundation Trust
Pauline Taylor, Children’s Complex Care Quality Assurance Nurse, Hampshire and Isle of Wight Healthcare NHS Foundation Trust
Operational Support worker of the Year:
Hayley Pedwell, Information Assistant, Macmillan Cancer Care
Brian Taylor, Ambulance Welfare Officer, North East Ambulance Service Unified Solutions
Lois Ward, Communications and Engagement Officer, Chesterfield Royal Hospital
Clinical Support Worker of the Year:
Lynette Cook, Ward Coordinator, Northern Care Alliance NHS Foundation Trust
Sam Desborough, Assistant Practitioner Occupational Therapist, Southwark Council
Sarah Haynes, Healthcare Assistant, Modality Partnership
Team categories
Best Healthcare Workforce Collaboration:
Personalised Independence Programme, Age UK HBW
The What Matters Team, Royal Berkshire NHS Foundation Trust
Dedication to Lifelong Learnt Culture:
Coventry and Warwickshire Training Hub
Patford House Partnership
Equity, Diversity and Inclusion Champion, sponsored by NHS Race and Health Observatory:
Wakefield Hospice
West Midlands Ambulance Service
Digital Innovation, sponsored by NHS Shared Business Services:
Paediatric Virtual Ward Team, Dudley Group of Hospitals NHS Foundation Trust
Recruitment RPA Project Team, Kent Community Health NHS Foundation Trust
Follow #OurHealthHeroes on X (formerly Twitter) and LinkedIn for all the latest updates. To find out more visit: www.skillsforhealth.org.uk/awards
Data solutions to solve the South West’s patient discharge crisis
By Professor Christos Vasilakis and Dr Zehra Onen Dumlu
Professor Christos Vasilakis, Founding Director of the Centre for Healthcare Innovation and Improvement – CHI²) and Dr. Zehra Onen Dumlu from the University of Bath discuss the IPACS project – a collaborative, data-driven approach to improving patient flow.
Delayed discharges, often known as ‘bed blocking’, is a serious operational challenge for NHS managers across the country. According to NHS England data, in February 2024 there were between 13,200 and 14,200 patients remaining in hospital each day who did not meet the criteria to stay. This accounts for more than one in eight general and acute beds in England.
While patients are deemed medically fit for discharge, they remain in hospital due to complexities in arranging necessary social care or community nursing support for a safe transition. The knock-on effects are significant, placing immense strain on acute bed capacity and negatively impacting patient flow and their experience.
The IPACS project: A collaborative, data-driven approach
To address the issue, the Improving Patient Flow between Acute, Community, and Social Care (IPACS) project was launched in 2020. This significant three-year initiative received funding from Health Data Research UK (HDRUK), an independent charity focused on using health data research to address major healthcare challenges.
IPACS brought together a diverse team, combining academic expertise with frontline NHS operational knowledge. Collaborators included the University of Bath, the University of Exeter Medical School, and significantly, the Bristol, North Somerset, and South Gloucestershire (BNSSG) Integrated Care Board (ICB).
The goal of the project was to develop an open-source computer simulation model capable of analysing the complex dynamics of patient flow. This tool would offer a potential blueprint for healthcare organisations nationwide grappling with delayed discharge pressures.
Central to the project was the application of Operational Research (OR) techniques – using advanced analytical models to dissect and solve complex systemic problems. Several team members brought extensive OR experience, with affiliations to The Operational Research Society, demonstrating the project’s robust methodological foundation aimed at enhancing healthcare efficiency.
A multidisciplinary, team-driving innovation
The success of IPACS hinged on its multidisciplinary collaboration. BNSSG ICB’s Head of Modelling and Analytics, Dr Richard Wood, and University of Bath Research Fellow Dr Paul Forte provided essential insights into real-world healthcare operations and ensured the project outputs were relevant and accessible to NHS decision-makers.
Academic leadership came from Professor Christos Vasilakis (founding director of the Centre for Healthcare Innovation and Improvement – CHI²) and Dr Zehra Onen Dumlu at the University of Bath, working alongside Professor Martin Pitt and Dr Alison Harper from the University of Exeter Medical School. This combined team undertook the intricate task of designing, developing, and validating the simulation framework.
Focusing on the critical ‘Discharge to Assess’ service
A key focus for the IPACS project was the transition of patients from acute settings into community care, specifically via the ‘Discharge to Assess’ (D2A) service. Optimising this service is key to improving hospital throughput. The project modelled the three core D2A pathways:
Pathway 1 (P1): Enabling patients to return home with domiciliary support.
Pathway 2 (P2): Providing bed-based rehabilitation for those needing more intensive recovery support post-discharge.
Pathway 3 (P3): Catering for complex care assessments, frequently leading to long-term care placements.
The IPACS model aimed to help optimise capacity planning and resource allocation across these vital pathways.
The BNSSG region: A relevant testing ground
The Bristol, North Somerset, and South Gloucestershire (BNSSG) region, serving approximately one million people, served as a practical case study. Its demographic mix and blend of urban and rural environments reflect challenges common across the NHS. The region’s D2A pathways were experiencing significant pressure, with high occupancy and discharge delays, providing a rich, real-world dataset and demonstrating the urgent need for the solutions IPACS explored.
Operational Research and simulation modelling in practice
Professor Vasilakis and Dr Wood pinpointed the core management challenge: the complex interdependencies between acute, community, and social care services. Bottlenecks in community and social care inevitably impact upstream services, contributing to emergency department pressures and ambulance handover delays.
The IPACS team used real-time data on patient occupancy and discharge delays to build their model. This allowed them to establish baseline performance and, critically, to run “what if” scenarios, varying parameters like length of stay and arrival rates to understand potential impacts of service changes.
Computer simulation modelling, a cornerstone of OR, was central to this. The model allowed the team to:
Simulate patient journeys through the D2A pathways in detail.
Test potential interventions virtually to assess their likely impact on flow and delays.
Analyse how best to allocate resources to mitigate discharge delays.
Account for time-varying demand patterns.
Built using the open-source ‘R’ programming language, the model prioritised accessibility and transparency.
Demonstrating real-world impact and future potential
The IPACS model provided valuable quantitative insights. Outputs clearly demonstrated the potential benefits of achieving target pathway splits and reducing lengths of stay within the D2A service. Significantly, estimates generated by the model were used to support a £13 million business case for enhancing the local D2A system – highlighting the project’s tangible value in informing strategic investment decisions.
The team acknowledged the model does have some limitations. It doesn’t yet capture every element of discharge, such as specific social care inputs, palliative care routes, or detailed post-D2A placement dynamics. Data completeness also needs some ongoing attention. Future work could involve expanding the model’s scope to incorporate social care elements more deeply, analyse the impact of acute capacity constraints, optimise home-based care models, and potentially develop faster analytical tools.
The ongoing challenge and strategic steps forward
Tackling delayed discharge requires effective strategies, and the IPACS project highlights the value of OR. Using OR methods such as simulation modelling allows NHS managers to better understand complex discharge pathways, evaluate potential solutions before implementation, and make more informed, evidence-based decisions about resource allocation to improve patient flow and reduce delays.
Dr Zehra Onen Dumlu, Assistant Professor, University of BathProfessor Christos Vasilakis, Founding Director, Centre for Healthcare Innovation and Improvement – CHI²
