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.

Lucida Medical and Hampshire Hospitals NHS Foundation Trust 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 8 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, is 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. Lucida Medical is demonstrating Pi at its booth AI-37 in the AI Zone.

New national data shows improved respiratory outcomes with digital therapeutics

By Integrated Care Journal

Toolkit has driven significant reductions in reliever inhaler usage among asthma and COPD users, with biggest improvements seen in socioeconomically deprived areas.

A respiratory digital therapeutics toolkit is improving outcomes and reducing health inequalities for people with asthma and chronic obstructive pulmonary disease (COPD) in Wales.

The toolkit, which has reached full adoption across 100 per cent of GP practices and hospitals in NHS Wales, is providing a personalised, digital care plan that empowers hundreds of thousands of people to take control of their condition and stay well in the community.

Professor Simon Barry, National Respiratory Clinical Lead at NHS Wales (2016-2024), explained the impact the toolkit is having at a national scale: “Overall, we’re seeing patients showing a significant improvement in wellness scores in as little as three months. The biggest improvement is among patients using the asthma app for four months or more who are seeing their wellness score increase by 41 per cent. Users in socioeconomically deprived areas, and young people are seeing the greatest improvements in their Royal College of Physicians (RCP) 3-questions score.”

In addition, the toolkit has driven significant reductions in the use of reliever inhalers, an important marker of disease control:

Asthma app users have a statistically significant improvement in their reliever inhaler usage, with 35 per cent having improved reliever use within one year, and 20 per cent of patients going from some reliever use to no reliever use.
COPD app users’ reliever use improved after one year, with the percentage of users making use of relievers decreasing substantially from 67 per cent to 38 per cent.
Patients using the app are 42 per cent more likely to be using Dry Powder Inhalers (DPIs) than the general population, accelerating the NHS Wales priority to increase the proportion of low global-warming potential inhalers (DPIs) used vs pressurised Metered Dose Inhalers
Improvements are particularly pronounced in socioeconomically deprived areas.

The successful rollout has enabled many more outcome improvements, including reductions in GP visits and A&E admissions to alleviate pressure on overstretched services. The Respiratory Health Improvement Group (RHIG) in Wales will present new national datasets at an upcoming event, showcasing years of progress and population-level improvements.

Chris Davies, Principal and CEO at The Institute of Clinical Science and Technology, said: “Unfortunately, chronic diseases are common and expensive. Right now, £7 in every £10 of UK health and social expenditure goes toward chronic disease management, so it’s time for a new approach. We are delighted to work alongside NHS Wales in transitioning from traditional healthcare delivery to a patient-driven, digital-first model that eases the pressure on the healthcare system and future-proofs the NHS. This approach enables individuals across large populations to have better agency, better empowerment and more confidence when they navigate their health.”

Co-produced with patients, policymakers and clinical experts from within stakeholder groups, including the National Respiratory Audit Programme (NRAP), Asthma and Lung UK (ALUK), NHS Wales and NHS England, the toolkit uses the proven COM-B (Capability, Opportunity, Motivation-Behaviour) model to drive behaviour change. The app provides tailored support, including a personalised care plan and progress tracking, to help individuals manage their health.

The toolkit is expanding to other disease groups, offering a scalable model to meet rising care demand without overburdening healthcare professionals.

Members of the Respiratory Health Improvement Group (RHIG) in Wales will outline how the successful outcomes were achieved across Wales during a webinar on 13 March, chaired by Dr Lia Ali, Clinical Advisor, NHS Transformation Directorate for NHS England. Join the National Transformation of Respiratory Outcomes through Digital Therapeutics event by registering to attend here.

Millions to benefit from expanded Universal Care Plan, improving choice and care

By Integrated Care Journal

The expansion of the Universal Care Plan will see new planning sections added for patients with dementia, frailty, learning disabilities and autism, boosting choice and personalised care for patients in the capital.

Millions of patients across London will now receive improved, personalised healthcare as part of a major expansion of the Universal Care Plan (UCP), a shared care planning solution powered by Better. The move marks a major step towards a more holistic, personalised approach to healthcare planning, ensuring patients receive coordinated care that aligns with their individual needs, preferences, and goals.

Enhancing care for more patients

The expansion beyond the UCP’s initial focus on end-of-life and palliative care planning introduces new care planning sections for patients with dementia, frailty, learning disabilities, and autism. It also includes enhanced support for children and young people, as well as contingency planning for carers. This follows an earlier expansion to support people with sickle cell disease.

“This latest expansion moves us beyond disease-specific planning to a truly personalised care and support plan, where what matters to a patient is just as important as what is the matter with them,” said Nick Tigere, Head of the UCP Programme.

Improving patient outcomes and NHS efficiency

The UCP has already demonstrated success in improving outcomes for end-of-life care patients, with 70 per cent achieving their preferred place of death, compared to the national average of 50-55 per cent. Additionally, unplanned hospital admissions are reduced to 30 per cent, significantly lower than the national average of 46 per cent.

By providing a single, integrated care plan, the UCP streamlines care for patients with multiple long-term conditions, ensuring a more coordinated approach across services. This helps to free up NHS resources, reduce hospital admissions, and create capacity for elective procedures, ultimately supporting the NHS’s strategic goal of delivering more care outside of hospital settings.

“Where patients have a UCP, we see fewer unnecessary hospital admissions and a greater likelihood of receiving care in their preferred location. This supports both patient choice and NHS capacity,” said Nick Tigere.

The UCP integrates with social care, care homes, acute care, community hospices, and primary care to ensure seamless information sharing across healthcare providers. It is also connected to the London Care Record, enhancing accessibility for healthcare professionals across different settings, and the National Record Locator, enabling the care plans of Londoners and patients seen in London to be accessed nationwide.

Empowering patients through digital access

As part of the expansion, patients can now view their care plans via the NHS App, with plans to introduce editing functionality in spring 2025. This will allow individuals to update their non-clinical information, such as personal preferences and daily routines, reducing the burden on clinicians while empowering patients to take an active role in their care.

Dr Francesca Leithold, Global Service Delivery Director at Better, highlighted the importance of accessibility in this expansion: “The restructure of the forms is intended to create a clearer interface, structuring information in a better way. Making the care plan editable for patients over the next two quarters will enhance patient engagement and autonomy.”

Additionally, an upcoming GP Connect integration is set to enhance clinical safety by ensuring automatic access to GP medication and allergy records, reducing duplication and administrative workload for healthcare providers.

A future-focused approach to care

The UCP expansion follows a thorough evaluation process assessing digital maturity, readiness, and business case feasibility. The primary aim is to ensure that more Londoners have access to personalised, accessible care plans.

“This expansion marks a significant milestone in the evolution of the Universal Care Plan,” added Dr Leithold. “It demonstrates our commitment to making personalised care plans accessible to more people, providing tailored support that adapts to the needs of every individual. By expanding the scope of the UCP, we are empowering patients, improving outcomes, and supporting a healthcare system that’s more efficient and responsive to the diverse needs of the public.”

Digital Implementation, News, Workforce February 18, 2025

AI, simulation and innovation: Navigating the future of healthcare education

By Integrated Care Journal

AI and digital simulation are reshaping healthcare education, offering new opportunities for efficiency, training, and patient care. At the Council of Deans of Health’s Digital Summit 2025, experts explored the promise and challenges of AI integration, from regulatory concerns to the ethical implications of its use in clinical decision-making.

On 28th January 2025, the Council of Deans of Health’s Digital Summit 2025 welcomed 130 attendees from across leadership and academic roles within the healthcare sector, to discuss and debate the current and future direction of digital health.

Following a virtual welcome from the Chair of the Science, Innovation and Technology Committee, Chi Onwurah MP, JISC Director of AI, Michael Webb, discussed the rapidly evolving state of AI adoption within education and healthcare, and the need for regulatory and legislative frameworks to keep pace. Webb argued that we are now into the ‘early reality’ stage of AI adoption, and despite numerous teething problems, AI tools are now so embedded within many digital services that people often do not realise they are using them.

A key aspect of the government’s focus on AI has been efficiency, with the Department for Education a major early investor. The Department is currently exploring the possibility of coding the entire national curriculum, estimating that this could increase the accuracy of automated marking from 30 per cent to 90 per cent, saving teachers a substantial amount of time that could be better used elsewhere.

However, as AI moves into mature operational use, and its input into human lives and decision-making processes increases, it will be increasingly critical to reach a consensus regarding its ethical and responsible use, as well as ensuring that those tasked to use it are able to do so safely and ethically. Webb called on leaders and regulators to set clear boundaries to enable safe exploration of AI, and to create cultures that value curiosity, critical thinking, and progressive human development.

Embedding digital transformation in the future health workforce

This panel examined the need to embed digital literacy into healthcare education to create a healthcare workforce equipped to use technology effectively and meet the future needs of the NHS. Professor Natasha Phillips, Founder of Future Nurse, argued that the pace of technological innovation has outstripped that of pedagogical practice, often placing digitally native students ahead of educators in terms of digital capability. Professor Phillips called for action from regulators to address this disparity, ensuring that the future workforce is prepared to deliver digitally led healthcare.

“We need to weave digital transformation into everything we do and pay attention to people and processes; technological transformation can’t happen without people.”

Professor Natasha Phillips, Founder, Future Nurse

Stating that we stand “on the cusp of the fourth industrial revolution”, Professor Sultan Mahmud, Director of Healthcare at BT Group, made the case for a cultural shift at leadership levels to truly embed digital tools and methods. He observed that a key driver of innovation with NHS trusts is often the personal attitude and culture of those in leadership positions, which can vary substantially from person to another, arguing that “board members not knowing anything about health technology can’t be acceptable”.

(L-R) Professor Natasha Phillips, Founder, Future Nurse; Professor Sultan Mahmud, Director of Healthcare, BT Group; Ed Hughes, Chief Executive, Council of Deans of Health

“The only way is ethics”

Much time was devoted to discussions concerning AI – including the ethical implications of using AI to facilitate and deliver healthcare, alongside its use as an educational tool. Sundeep Watkins, an Education Advisor to the Chartered Society of Physiotherapy, said that AI must be there to supplement and inform, not replace, humans’ clinical and critical judgement. With AI promising to play a critical role in diagnostics, treatment, communication and education, ethical considerations must be at the core of AI’s use and embedded in the way that technology users are taught to ensure that data biases or deficits do not translate to unequal or inequitable care delivery.

“In AI datasets, critical information is often missing – and if you don’t know what’s missing, you don’t know what’s missing.”

David Game, SVP Global Product for Medical Education, Elsevier

Regulatory organisations have started to consider how they might apply the right levels of oversight to this rapidly changing environment, confirmed Jamie Hunt, Head of Education at the Health and Care Professions Council. Paul Stern, a Senior Researcher and Policy Officer at the General Osteopathic Council, reiterated the importance of regulatory oversight of AI to ensure equitable access in education. He added that regulators are now working together with a view to developing a cross-sector regulatory framework for AI’s use in education to reduce regulatory overlap.

AI and associated technologies have the potential to be ubiquitous within simulated medical education and training within the next decade, underscoring the need for effective regulation to render their use safe, effective and equitable. Professor Paula Holt MBE, a Senior Adviser for Nursing at the Nursing and Midwifery Council, explained that for nurses-in-training, 600 of the 2,300 training hours required to register can be completed through simulated training, “allowing students to practice and reflect in a safe, and psychologically safe, environment.” Students like simulated training, added Professor Holt, as they feel it offers an equitable practice environment, and can help them learn to deal with difficult, real-world situations like receiving abuse or racism, or a medical emergency.

Panel covering *The pedagogy of AI: implications for healthcare education*

Professor Sharon Weldon, Professor of Healthcare Simulation and Workforce Development at the University of Greenwich, argued that simulation could be a key tool for attracting a newer generation of healthcare professionals, saying that “fewer and fewer, especially young people, want to go into healthcare. Simulation and AI are their worlds, and we have to embrace it to attract these people.”

“AI is now being incorporated into simulated practice learning – this will change quickly, but the driving fundamentals need to be embedded.”

Professor Sharon Weldon, Professor of Healthcare Simulation and Workforce Development, University of Greenwich

Professor Weldon confirmed that in the US, simulated training has reduced the length of training programmes for private nursing students by up to one-third on some cases – something that could be key for workforce pipeline acceleration globally. Simulated training is now being mandated across all nursing training in India, but Professor Weldon argued the need to work collaboratively with industry partners to ensure that these tools truly add value to a medical education.

The final session saw of the day saw NHS England’s National Chief Nursing Information Officer, Helen Balsdon, join National Chief AHP Information Officer, Prabha Vijayakumar, for an audience Q&A. While both were optimistic that innovation will lead to great strides in predictive analytics, prevention and reducing health inequalities, both cautioned that major progress remains difficult without the fundamental basics of data infrastructure and education in place.

“Good technology is one thing, but too much of implementation focuses on the technology and not on people, and then we wonder why implementation is so poor.”

Helen Balsdon, National Chief Nursing Information Officer, NHS England

“Nurses and midwives collect the most data,” said Balsdon, “but we don’t really harness it. We know we’ve got a shortage of nurses, and we need to work differently to address this – digital can help.”

Critical to this is bringing education and practice close together – in simple terms, to ensure that new entrants into the workforce are equipped with the confidence and minimum foundational understanding needed to use technology effectively.

The overriding note from the Digital Health Summit was optimism that AI and associated technologies offer an unprecedented opportunity to transform healthcare delivery and education for all. However, there was evident caution that the pace of technological change has outstripped the ethical, regulatory and legal frameworks that govern our use of them, and there is a clear need to address this lag. To truly harness the potential AI in healthcare, and digital transformation more broadly, collaboration between educators, regulators, and industry leaders must remain a priority—ensuring that technology enhances, rather than hinders, the delivery of safe, ethical, and equitable care.

The Council of Deans of Health have released a Performance Report following the conclusion of the 2025 Digital Summit, which can be viewed here.

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The human element in digital transformation: Insights from a CNIO

By Janet Dodd

Building trust, empowering teams, and balancing innovation with patient care are key to successful digital transformation in healthcare, writes Janet Dodd, Chief Nursing Information Officer at Sheffield Children’s NHS FT, who will speak at Digital Health Rewired 2025

As the NHS continues its digital transformation, it’s clear that the promise of technology to improve patient outcomes and streamline processes hinges on more than just the systems themselves. From my experience leading digital initiatives in paediatric care, I have come to understand that successful implementation lies in relationships—relationships between clinical leaders, frontline healthcare workers, and our children and young people and their families. At the heart of this transformation is the recognition that digital systems must not only enhance healthcare processes but must also support the people who use them.

The critical role of clinical leadership

Effective digital transformation cannot be led solely by IT specialists or senior executives; it requires engagement and ownership at all levels, from the clinical team to design and build, to testing and implementation. This engagement ensures that systems are fit for purpose and improves engagement, manages expectations and enables systems to be used to their optimum.

When leadership is inclusive and collaborative, it makes digital transformation feel less like it is being enforced; it should be a change done with colleagues rather to colleagues. This reduces the risk of resistance to change and suboptimal usage, as digital systems are only as good as the people who use them, and the data entered.

Visibility and support are key to trust

One of the most valuable lessons I’ve learned throughout my career is that visibility is paramount. During the rollout of new digital systems, it is really important that the clinical digital team are present, visible, and approachable. This means showing up during early mornings, late nights, and being available for troubleshooting at the bedside when needed. By committing to support our teams in real-time, we can ensure that our clinical colleagues feel safe and can address issues quickly and effectively, enabling them to continue with clinical care. This not only solves immediate problems but also helps build confidence in the system and allow its full potential to be realised. Our superusers have enabled us to provide support over night shifts and weekends which ensures equitable support across all shifts.

Balancing digital innovation with the human touch

While digital tools have great potential in healthcare, they don’t replace the human element of care. One of the most significant challenges in digital transformation is that the clinical decision-making support built into digital systems will not take away all risk of error. It is vital that we remind ourselves that these tools should enhance, not diminish, our clinical knowledge, judgement and ability to care for patients.

We need to ensure that digital innovation supports our ability to focus on what matters most: the well-being and outcome of our children and young people.

The path to complete digital integration

Full digital integration has been a phased approach within our organisation. The aim is to create a system where digital documentation and systems integrate into daily workflows, improving both clinician efficiency and patient outcomes. While we are not there yet, we have laid great foundations for a future where data is easily visible across teams and systems to improve communication, coordination and care delivery.

I have seen how digital documentation can improve communication, streamline processes and reduce errors, but it requires a consistent commitment to embed and optimise how systems are used, to realise their benefits and potential.

Harnessing the power of emerging technologies

As we look toward the future, emerging technologies such as AI and transcription tools offer tremendous promise. AI has the ability to generate patient information, automate administrative tasks, and even transcribe meeting notes, all of which save time and reduce human error. But with great power comes great responsibility. To unlock the full potential of these tools, we must ensure that they are governed by strong policies, used ethically, and continuously improved to meet the needs of clinicians and patients alike.

This means rigorous training, oversight, and a commitment to iterative learning. It’s not enough to introduce these technologies; we must work alongside them, including well after implementation, to ensure they complement the work of our clinical teams.

Collaboration and overcoming resistance

Collaboration is essential for digital transformation to be successful. Networking across trusts or within individual organisations, the sharing of best practices, lessons learned, and strategies for overcoming challenges, are invaluable. Paediatric care, in particular, benefits greatly from collaboration, as it allows us to ensure consistent standards across the NHS and learn from each other’s successes and lessons learnt.

One of the biggest barriers to digital adoption remains anxiety among clinicians who are accustomed to paper-based systems. This is especially true for experienced professionals who have worked for many years with paper processes. The key to overcoming this resistance is providing training, hands-on support, and clear communication about how digital systems will enhance—not replace—their roles. Building trust at the executive level and conducting thorough safety and risk assessments will also go a long way toward making digital adoption feel safer – less of a threat and more of an opportunity.

Looking to the future

As we move forward, I am optimistic about the future of digital transformation in the NHS. In the next four to five years, I believe we will see AI, integrated systems, and enhanced digital tools redefine workflows and improve patient care delivery. But the key to this transformation is balance—ensuring that technology enhances the work of clinicians without undermining and taking away from the personal touch that defines patient care.

The journey ahead will be iterative, and the challenges will remain. But with strong leadership, collaboration, and a commitment to putting people first, the digital future of healthcare is one we can all embrace.

I look forward to sharing more of these insights and experiences at the upcoming Digital Health Rewired Conference on 18-19 March 2025.

Janet Dodd is Chief Nursing Information Officer at Sheffield Children’s NHS FT

AXREM publishes AI manifesto

By Integrated Care Journal

Association for Healthcare Technology Providers for Imaging, Radiotherapy and Care calls for collaboration on clear and consistent AI innovation to reduce duplication and risk while maximising benefits.

AXREM, the Association for Healthcare Technology Providers for Imaging, Radiotherapy and Care, has called for policymakers, NHS leadership, and AI developers to collaborate on clear, consistent innovation pathways that support the responsible scaling of AI technology in healthcare. In its AI manifesto, AXREM calls on the NHS to avoiding duplication in compliance and validation and to take a balanced approach to risk stemming from the use of AI.

AXREM is the UK Trade association representing the interests of suppliers of diagnostic medical imaging, radiotherapy, healthcare IT and care equipment including patient monitoring in the UK. AXREM members supply the majority of diagnostic medical imaging and radiotherapy equipment installed in UK hospitals. Its member companies and their employees work alongside Radiologists, Radiographers and Practitioners, Oncologists and a wide range of healthcare professionals in delivering healthcare to patients using its technologies.

AXREM’s members have always driven innovation in imaging and oncology. Since 2020, the AI Special Focus Group have been champions of promoting the responsible adoption and upscaling of artificial intelligence and machine learning enabled diagnostics. The group comprises most of the AI providers in the radiology market who innovate by providing research and development to improve accuracy and workflow in the diagnostic portions of care pathways.

The challenges of healthcare delivery are well known, including workforce shortages, increasing demand for services and a real risk of staff burnout. In their 2023 census, the UK Royal College of Radiologists calculated that there are 30 per cent fewer radiologists than needed to meet demand, estimated to rise to 40 per cent by 2028. These are placing immense pressure on healthcare systems. Innovation is needed, not for its own sake, but to help address these challenges and to enable healthcare professionals to focus on higher-value caring tasks instead of wrangling large amounts of information.

The manifesto recognises the UK healthcare system is currently complex, with much duplication of effort. A more consistent approach to innovation for AI is needed if it is to be adopted at scale. The manifesto touches on Innovation: bridging the gap, Ensuring Trust and safety, Regulation and compliance Protecting information, Policy and data access challenges, Practical deployment – balancing risk and more.

Graham King, Solutions Architect at Annalise.ai, Convenor of the AXREM AI Special Focus Group, and one of the authors of the document, said upon its release: “We welcome many positive moves forward on AI in radiology and oncology from the NHS across the UK nations. Our manifesto addresses areas where our members are still experiencing duplicated effort and proposes solutions to help scale the much-needed adoption of AI assistance.”

AXREM Chairman, Huw Shurmer, said: “AI is a powerful tool that will undoubtedly support and address many of the pressures facing the health service. I am pleased to see our members taking on responsibility to set out a clear understanding on how this solution can expand in a safe, regulated and consistent way.”

Sally Edgington, AXREM Chief Executive Officer, said: “I am really pleased the AI SFG have worked collectively, so hard on this manifesto. The group have been very active since we launched it and this manifesto makes clear that we need to work with NHSE, DHSC, MHRA and many other organisations to collaborate and ensure safe adoption, but adoption at scale, as this really can help create efficiencies in the system, at a time when the NHS really needs them.”

You can read the manifesto in full here.

AI software tool aims to use high street eye tests to spot dementia risk

By Integrated Care Journal

First-of-its-kind collaboration offers potential for “step change” in the early detection of dementia, using routine eye scans to gain deeper insight into brain health and monitor cognitive decline.

Data scientists and clinical researchers are working with high street opticians for the first time to develop a digital tool that can predict a person’s risk of dementia from a routine eye test.

The NeurEYE research team, led by the University of Edinburgh, with Glasgow Caledonian University, has collected almost a million eye scans from opticians across Scotland, forming the world’s largest data set of its kind.

The scientists will then use artificial intelligence and machine learning to analyse the image data, along with relevant patient data on demographics, treatment history and pre-existing conditions. This data is anonymised and patients can’t be identified, but it allows researchers to find patterns that could indicate a person’s risk of developing dementia, as well as giving a broad picture of brain health.

Permission to use the data comes from the Public Benefit and Privacy Panel for Health and Social Care, a part of NHS Scotland.

The project is the second funded and supported by NEURii, a first-of-its-kind global collaboration between the pharmaceutical company Eisai, Gates Ventures, the University of Edinburgh, the medical research charity LifeArc and the national health data science institute Health Data Research UK. Together, the partners are giving innovative digital projects the chance to become real world solutions that could benefit millions of patients with neurodegenerative conditions like dementia. The first NEURii project, SCAN-DAN, is using brain scans and AI to predict dementia risk.

Retired mechanical engineer, David Steele, 65, whose mum has Alzheimer’s, said predictive software like this could have saved his family ten years of heartache and struggle. He said:“It took ten years for my mum to be diagnosed with Alzheimer’s.

“She was initially diagnosed with dry macular degeneration, but this masked the underlying issue that we now know to be cerebral blindness linked to Alzheimer’s. The connection between brain and eye was the missing link in her case.

“The missing diagnosis meant that my late father, who was also elderly, cared for mum throughout a difficult period without knowing what was wrong.

“If we had known, then we would have had help with the additional and demanding support that became necessary. Preventing the cliff edge, when it becomes too late for the person to understand what is wrong with them, is so important.”

Professor of Clinical Ophthalmology at the University of Edinburgh and NeurEYE co-lead, Baljean Dhillon, said: “The eye can tell us far more than we thought possible. The blood vessels and neural pathways of retina and brain are intimately related. But, unlike the brain, we can see the retina with the simple, inexpensive equipment found in every high street in the UK and beyond.”

Optometrists will be able to use the software subsequently developed as a predictive or diagnostic tool for conditions such as Alzheimer’s, as a triage tool to refer patients to secondary health services if signs of brain disease are spotted, and potentially as a way to monitor cognitive decline.

Identifying people at risk of dementia could also accelerate the development of new treatments by identifying those who are more likely to benefit from trials and enabling better monitoring of treatment responses.

And being aware of a risk of dementia could also help individuals and medical professionals modify the risk through lifestyle changes such as physical activity and diet, according to a Lancet Commission, which added vision loss this year as one of its dementia risk factors.

Optometrist Ian Cameron, who runs Cameron Optometry in Edinburgh, said: “Optometrists as primary carers is not a new thing, and in Scotland we’re becoming an increasingly allied part of the NHS. We see the same people year on year, whether they’re ill or not, we have all the right equipment, so it makes sense for us to be the GP of the eyes and monitor as much health as we can see.

“What is new is that, with AI, we can see even more, and that is extremely powerful.”

Professor of Computational Medicine at the Usher Institute and NeurEYE co-lead Miguel Bernabeu said: “Recent advances in artificial Intelligence promise to revolutionise medical image interpretation and disease prediction. However, in order to develop algorithms that are equitable and unbiased, we need to train them on datasets that are representative of the whole population at risk. This dataset, along with decades-long research at University of Edinburgh into ethical AI, can bring a step change in early detection of dementia for all.”

Dr Dave Powell is Chief Scientific Officer at LifeArc, one of the NEURii collaborators. Speaking on behalf of the partners he said: “Harnessing the potential of digital innovations in this way could ultimately save the NHS more than £37m a year because the hope is that it will speed up the diagnosis and treatment of neurodegenerative conditions like dementia.

“The UK, with its single healthcare provider, is also well placed to become a global leader in the development of new tests that use health data. This is why we are collaborating to advance promising digital health projects that have the potential to improve millions of lives.”

The data will be held safely in the Scottish National Safe Haven which provides a secure platform for the research use of NHS electronic data. This resource is commissioned by Public Health Scotland and hosted by the Edinburgh International Data Facility through EPCC at the University of Edinburgh.

Unlocking the potential of NHS data: A vision for a unified health data platform

By Ruth Holland and Mark Kewley

By Ruth Holland, Director of Data & Analytics, London Secure Data Environment, OneLondon Health Data Portfolio, and Mark Kewley, Programme Director, London Secure Data Environment, OneLondon Health Data Portfolio.

The landscape of healthcare is increasingly being shaped by the effective use of data, yet the journey towards realising the full potential of NHS data is fraught with challenges. At the core of this transformation is the OneLondon programme, an ambitious initiative that seeks to overcome the fragmentation of health data across the capital and, ultimately, improve patient care, operational efficiency, and research outcomes.

The origins of OneLondon: Addressing fragmentation

The OneLondon programme was born out of a need to address a longstanding issue within the NHS: the fragmentation of health data. Historically, patient information has been scattered across various care settings, making it difficult for both healthcare providers and patients to access a complete picture of an individual’s health. This fragmentation not only hampers the delivery of efficient care but also limits the ability to derive meaningful insights from the data.

In response, London’s healthcare leaders embarked on a journey to create the London Care Record, a unified platform that allows for the sharing of relevant patient data across care settings. Initially focused on providing a ‘view-only’ access to patient information, the programme has now evolved into a more sophisticated data platform capable of generating actionable insights for both direct care and research purposes.

Building a comprehensive data platform to support integrated care

Our efforts have now moved beyond simply making data accessible. The goal, which is supported by funding from the NHS England Data for R&D Programme and London’s integrated care systems (ICSs), is to create a London-wide data platform that can provide insights that inform care decisions at both the individual and population levels. The transition from a ‘view-only’ system to a dynamic data platform represents a significant milestone. It allows us to harness data from across London’s health system to support integrated care, drive proactive care strategies and facilitate advanced research.

In North West London ICS, for example, we’ve seen the success of integrating data across different care settings. Clinicians now have access to a comprehensive view of their patients, enabling them to deliver more informed care. The next step is to expand across London and incorporate data from all other care settings for the population of 10.6 million people.

Leveraging advanced technologies

Central to this transformation is the integration of cutting-edge technologies like Federated Learning Interoperability Platform (FLIP) and AI tools. These tools enable us to bring together different types of data, such as electronic patient records and radiology images, into a single, interoperable platform. By doing so, we can develop predictive models that not only support clinical decision-making but also enhance the accuracy and efficacy of research.

The use of natural language processing (NLP) to convert unstructured data into structured formats is a significant advancement. With approximately 80-90 per cent of healthcare data stored in unstructured formats, such as clinical notes and images, NLP allows us to unlock a wealth of information that was previously inaccessible. This capability is crucial as it significantly increases the insights we can derive from our data, paving the way for more personalised and effective healthcare solutions.

Ruth Holland will be the Chair of a Spotlight session with Dr Jessica Morley at Digital Health Rewired 2025, taking place 18-19 March in Birmingham.

Overcoming challenges through collaboration

The scale and ambition of the OneLondon programme are unprecedented, and so are the challenges. Integrating data across multiple care settings, ensuring stakeholder alignment and navigating complex information governance (IG) issues are just a few of the hurdles we face. However, these challenges also highlight the importance of collaboration.

We’ve worked extensively with the public to understand their expectations around data use, and this feedback has been invaluable in shaping our approach to IG. The public’s support for data integration across care settings has provided a strong mandate for us to push forward with this initiative. Additionally, our collaboration with data controllers, particularly GPs, has been critical in ensuring that the platform brings tangible benefits back to the practitioners who contribute to it.

A vision for the future

The vision for OneLondon is clear: a comprehensive, interoperable data platform that not only supports the immediate needs of patient care but also drives long-term improvements in population health and research. While we recognise that we are still at the early stages of this journey, the progress we’ve made thus far is encouraging. The successful integration of data in North West London serves as a model for the rest of the city, and with continued investment and collaboration, we are confident that we can achieve our goals.

The OneLondon programme represents a bold and necessary step towards a future where data is used to its fullest potential to improve health outcomes. By overcoming the challenges of data fragmentation, leveraging advanced technologies, and fostering collaboration across the healthcare ecosystem, we are laying the foundation for a more integrated, efficient, and patient-centred NHS.

Ruth Holland will be the Chair of a Spotlight session with Dr Jessica Morley at Digital Health Rewired 2025, taking place 18-19 March in Birmingham.

*Ruth Holland, Director of Data & Analytics, London Secure Data Environment, OneLondon Health Data Portfolio*

Harnessing data-led approaches to patient safety: a case study

By Jonathan Webb, Head of Safety and Learning at NHS Wales

Jonathan Webb, Head of Safety and Learning at NHS Wales, relates two data-led approaches aimed at reducing avoidable harm and litigation costs across Wales, demonstrating the success of unified and standardised approaches to patient safety.

NHS Wales faced growing challenges in improving patient safety and reducing harm across its healthcare system. Rising litigation costs, inconsistent training, and fragmented data across health boards limited the ability to identify trends and implement evidence-based improvements. Specific issues, such as preventable harm in maternity services and the lack of a unified approach to handling incidents, complaints, and claims, highlighted the need for systemic solutions.

These challenges created opportunities to:

Implement a unified training programme to improve outcomes in maternity services (PROMPT Wales).
Develop centralised data systems to connect incidents, complaints, and claims and workforce data, enabling shared learning and improvements (Once for Wales Concerns Management System).

The solutions

PROMPT Wales

This initiative introduced a structured, multi-professional training programme for maternity teams across NHS Wales. Designed to improve safety, teamwork, and communication, PROMPT Wales delivered:

Standardised, scenario-based training for all staff.
Data-informed guidance to address identified risks, such as postpartum haemorrhage.
Comprehensive engagement, with 93 per cent of maternity staff trained within a year.

Once for Wales Concerns Management System (OfWCMS):

Led by the Welsh Risk Pool, part of NHS Wales Shared Services Partnership, this platform centralised incident, complaint, and claim management across all health boards. By unifying disparate systems:

Data could be analysed holistically, identifying trends across complaints, incidents, and claims.
Integration ensured consistent national approaches to handling patient concerns and improving quality of care.

Collaboration between healthcare teams, Welsh Government, and RLDatix ensured that initiatives were implemented with consistency and aligned with national safety goals.

Scalability

The scalability of these initiatives lies in their structured and integrative approaches.

PROMPT Wales: Its team-based training model and use of data can be adapted to other clinical specialities or regions. The methodology ensures alignment with local needs while maintaining national standards.
Once for Wales: The centralised framework can be replicated in other healthcare systems to unify and optimise incident management, feedback collection, and data analysis.

Enablers:

National buy-in and strong governance frameworks.
Robust technology platforms for data collection and integration.
Proven impact, such as measurable safety improvements and cultural change.

Constraints:

Initial investment in technology and training.
Variation in local infrastructure and staff capacity.
Need for sustained leadership and stakeholder engagement.

Evidence of success

PROMPT Wales, along with the sheer hard work of staff within services, delivered significant clinical improvements:

33.8 per cent reduction in severe postpartum haemorrhage (≥2500mL).
43.5 per cent reduction in term APGAR scores <7 at 5 minutes.
Enhanced safety culture, as evidenced by improved staff safety attitude scores.

Once for Wales outcomes included:

Uniform data collection across all health boards and trusts.
Real-time insights into patient and staff feedback, enabling proactive safety measures.
Improved learning from incidents and claims, contributing to better service quality and reduced harm.

Quantitative data from PROMPT Wales shows statistically significant improvements in clinical outcomes (P-value <0.0001). Feedback from OfWCMS users highlights enhanced decision-making due to integrated data systems.

Lasting benefits

Patients receive safer care and improved health outcomes across maternity and broader services.

Staff benefit from greater confidence, reduced stress, and better training support.

Systems benefit from enhanced efficiency, reduced costs, and a model for future healthcare improvements.