Older patients and people with long term conditions and mental health problems will be among the first to benefit from a major new drive to modernise how the NHS delivers care, according to NHS England Chief Executive Simon Stevens speaking at the World Economic Forum in Davos on Friday 22nd January

Simon Stevens launched the first wave of NHS Innovation ‘Test Beds’. These collaborations between the NHS and innovators – including Verily (formerly Google Life Sciences), IBM and Philips – aim to harness technology to address some of the most complex issues facing patients and the health service.

Frontline health and care workers in seven areas will pioneer and evaluate the use of novel combinations of interconnected devices such as wearable monitors, data analysis and ways of working which will help patients stay well and monitor their conditions themselves at home.

Successful innovations will then be available for other parts of the country to adopt and adapt to the particular needs of their local populations.

For example, the plans announced in Davos include:

  • Patients with diabetes in the West of England being equipped with remote monitoring and coaching technology to allow them to better self-manage their condition;

  • Older patients in Rochdale who are most at risk of critical health events being identified using data analysis, and supported to use telecare and remote devices in their homes so that their doctors can provide timely and tailored help as soon as they need it, and;

  • People in Birmingham at risk of serious mental illness will be able to make use of technology and apps to manage their condition, linked to a hub which can despatch the right specialist staff at the right time to help if a crisis looks likely.

Addressing the 46th Annual Meeting of the World Economic Forum, which was themed ‘Mastering the Fourth Industrial Revolution’, Simon Stevens said: “Over the next decade major health gains won’t just come from a few ‘miracle cures’, but also from combining diverse breakthroughs in fields such as biosensors, medtech and drug discovery, mobile communications, and AI computing. Our new NHS Test Beds programme aims to cut through the hype and test the practical benefits for patients when we bring together some of these most promising technologies in receptive environments inside the world’s largest public, integrated health service.”

Public & Private Initiatives

A joint programme between NHS England, the Office for Life Science, the Department of Health and the Department for Culture, Media and Sport, NHS Test Beds will bring together local health bodies including Clinical Commissioning Groups, hospital trusts, primary and community care providers with a wide range of innovators from home and abroad.

The Government’s Life Sciences Minister George Freeman MP said: ” We are determined to ensure the NHS can remain a pioneer of new treatments and models of care so that UK patients will be amongst the first in the world to benefit from these hugely exciting medical advances, made possible by the life sciences industry in partnership with the NHS. “Not only does it demonstrate the NHS’s attractiveness as a place to test and develop revolutionary new products, it is also another important step towards creating a truly twenty-first century NHS”.

Each Test Bed will use a different combination of innovations, from both large and small organisations, to address a locally-identified clinical challenge. These include supporting people with diabetes and other long term conditions to manage their care better; supporting older people to stay independent at home; better support for people at risk of mental health crisis, and; improving how we predict care needs for both individuals and local populations.

The changes made will be rigorously evaluated, with the aim to provide evidence which will give more areas the confidence to adopt the innovations over the coming years.

The shape of things to come?

The first wave of Test Beds includes five health and care Test Beds and two ‘Internet of Things’ Test Beds. The sites will be spread across different areas of England, including the West of England, Surrey, Sheffield and Birmingham.

The five NHS Test Beds chosen are:

  • Care City Health and Care Test Bed – which will promote healthy ageing across a million-strong population in North East London.  Bringing together UCLPartners, Health Analytics, Orion Health and 9 other innovators, the partnership will test and evaluate combinations of innovative technologies that can help patients to manage their own health conditions and to remain as independent as possible, supported by carers who will receive the information and connections they need coordinate care. For example, this will include an online tool for those with dementia, a social network app which offers peer-to-peer support safely online with guidance from credible organisations and institutions, and a device which assesses falls risk and mobility.

  • Long Term Conditions Early Intervention Programme – which will see the NHS in Heywood, Middleton and Rochdale working with Verily (formerly Google Life Sciences), MSD (a trade name of Merck & Co., Inc., with headquarters in Kenilworth, NJ, USA), Health E Research and the Greater Manchester Academic Health Science Network to help healthcare professionals better identify and support patients at risk of long term conditions using the most advanced new predictive techniques. This will involve analysing trends and patterns related to conditions like heart failure and some lung diseases such as Chronic Obstructive Pulmonary Disease to identify patients who would most benefit from tele-health, tele-care and tele-medicine technology. These patients will benefit from a more personalised service, in particular being proactively offered additional physician support and access to technology.

  • Lancashire and Cumbria Innovation Alliance (LCIA) Test Bed – which will see the NHS, including two New Care Model Vanguard sites, partner with Philips and a number of SMEs and social enterprises to support the frail elderly and people with long term conditions to remain well outside of hospital and avoid unnecessary admissions.  They will test new approaches to identifying patients that can benefit from additional support and help them to self-care at home through improved education and telehealth technologies.

  • Perfect Patient Pathway Test Bed – aims to create the ‘perfect patient pathway’ to bring substantial benefits for patients in the Sheffield City Region suffering from long term conditions, such as diabetes, mental health problems, respiratory disease, hypertension and other chronic conditions. The Test Bed will keep patients with long term conditions well, independent and avoiding crisis points which often result in hospital admission, intensive rehabilitation and a high level of social care support. Working in partnership with GE Finnamore, IBM and 13 smaller innovators, the local health and care system will set up an integrated intelligence centre to help get people the help they need, when they need it most.

  • RAIDPlus Integrated Mental Health Urgent Care Test Bed – which will see Birmingham and Solihull Mental Health NHS Foundation Trust partner with Accenture to offer more proactive support for people at risk of mental health crisis. Patients across Birmingham and Solihull will have access to digital tools such as online support, risk assessments and crisis intervention plans that will enable care professionals to better support patients to manage their conditions in the community.  In addition the Test Bed will use predictive analytics technology to better identify those at risk of crisis, enabling mobile crisis workers and tele-triage workers to provide prevention support before a crisis arises.

The Internet of Things

The two Internet of Things (IoT) Test Beds are:

  • Diabetes Digital Coach – a project led by the West of England AHSN in partnership with Diabetes UK and technology companies including Hewlett Packard Enterprise. Bringing together mobile health self-management tools (wearable sensors and supporting software) with the latest developments in connecting monitoring devices (Internet of Things), the Test Bed will enable people with Type 1 or Type 2 diabetes to ‘do the right thing at the right time’ to self-manage their condition. It will also encourage more timely and appropriate interventions from peers, healthcare professionals, carers and social networks.

  • Technology Integrated Health Management (TIHM) – a collaboration between Surrey and Borders Partnership NHS Foundation Trust and an array of health technology providers which will help people with dementia to live in their own homes for longer. Individuals and their carers will be provided with sensors, wearables, monitors and other devices, which will combine into an ‘Internet of Things’ to monitor their health at home. This will empower people to take more control over their own health and wellbeing, as well as enabling health and social care staff to deliver more responsive and effective services.

The IoT Test Beds are part of IoTUK, an integrated £40 million, three-year Government programme that seeks to advance the UK’s global leadership in IoT and increase the adoption of high quality IoT technologies and services throughout businesses and the public sector.

Test Beds have been developing their proposals over the last nine months with support from the 15 Academic Health Science Networks (AHSNs). The successful projects were chosen on their ability to address local clinical challenges through innovation, at a large scale, and on the strength and commitment of their local leadership to be able to change established ways of working. They were also required to demonstrate their ability to evaluate and collect evidence of the improvements made for patients, which can then be used to support the spread of successful innovations to other areas.

Global Leadership in health technology

Given an unprecedented opportunity to demonstrate their solutions at large scale on a global stage, it is envisaged that successful Test Bed partners will deliver wider financial benefits to the NHS and the UK economy as they are rolled out in other areas at home and abroad.

Commercial technology companies are understandably enthusiastic about this Government initiative. Neil Mesher, Managing Director of Philips UK and Ireland, said: “Philips is proud to be involved in this pioneering new project. We believe this type of collaborative approach between industry and health & care providers is an excellent opportunity to improve patient outcomes whilst at the same time reducing the total cost of care. Supporting patients to meet their own individual goals is an objective Philips are delighted to be involved with.”

Andy Conrad, Chief Executive Officer of Verily, said: “This partnership between the NHS, MSD and Verily will determine if data analysis technology can help the NHS better prevent, detect and manage disease. Our hope is to help create a more preventative model for managing long term conditions like heart failure and lung disease.”

The ‘connected healthcare’ market – new technology that’s changing how people look after their health and access health services – is projected to be worth £37bn ($61bn) globally and £1.9bn in the UK by 2020, according to a recent PricewaterhouseCooper analysis. The analysis explores the megatrends collision between changing demographic and social patterns and today’s vast technological breakthroughs which are shaping how people live more connected lives.

According to Quentin Cole of PricewaterhouseCooper: “Significant growth in the ‘connected’ healthcare market is going to create huge opportunities. In the UK that could be worth almost £2bn. By 2020 we expect it will be worth £37bn globally, an average increase of 33% each year. Much of that growth will come from online prescriptions and an expansion in mHealth with both the public and private sectors making investments in this area.

“Technological advances open up enormous possibilities that will transform how we receive our healthcare as well as impacting life expectancy itself. But with technology comes issues around security of data, personal responsibility and even what constitutes a ‘healthy life’ that will challenge us as individuals and as providers.”
Making up this global market, the mobile health (mHealth) services market is expected to be worth £27bn ($45bn) globally by 2020, the mHealth devices market will grow to £8.5bn ($14bn) and the online prescriptions market will be worth £1.2bn ($2bn).

mHealth services
PwC forecasts that the global mHealth services market will grow at an average annual rate of 31% from 2014 to 2020 to £27bn ($45bn). The mHealth services market includes wellness, prevention, diagnostic and monitoring services.

mHealth devices

PwC forecasts that the global mHealth devices market will grow at an average annual rate of 37% from 2014 to become a £8.5bn ($14bn) global market in 2020. mHealth devices include blood glucose meters, cardiac monitors and blood pressure monitors, Pulse oximetry, neurological monoitoring, sleep monitors and wearable fitness and heart rate meters make up this segment. Blood glucose meters, and cardiac and blood pressure monitors will be the main drivers of growth.

E-prescriptions

PwC forecasts that the global E-prescriptions network will grow at an average annual rate of 40% from 2014 to 2020 to £1.2bn ($2bn). This growth is mainly driven by government-sponsored programmes enabled by better healthcare infrastructure and data storage facilities.

Quentin Cole concludes: “Change is coming to the healthcare industry. The connected healthcare market’s growth will come from increasing use of smartphones, easy and cheap internet access, and an increasing worldwide focus on preventative medicine. The sector needs to prepare for the new, more direct relationships with consumers – and develop capabilities and skills that look very different from those they operate with today. “We’re already seeing many tech-enabled new entrants disrupting the healthcare industry, so there is huge potential for growth in the sector. It raises questions as to who will be best placed to take advantage of the opportunities connected healthcare brings.”

Steve Iliffe, January 2016