Slide deck for ILN symposium

Tom Lindley
Founder, Inspiring Leaders Network
#ILNsymposium

Chris Bain
CEO, Rotherham Doncaster & South Humber NHS Foundation
Trust
#ILNsymposium

Morning Session 1
The Importance of Integration for Innovation
#ILNsymposium

Carol Wilby
Head of Commercial & International Innovation, NHS England
#ILNsymposium

www.england.nhs.uk
Innovation in
healthcare
Carol Wilby
10 March 2015

www.england.nhs.uk
• The 5 Year Forward View identified a number of priorities to accelerate useful
health innovation including new treatments and diagnostics and new ways of
delivering care specifically through “combinatorial (integrated) innovation”.
A manifesto for the NHS

www.england.nhs.uk
• Sustainability & viability in delivering care that is “best in
class”
• Developing the NHS as an innovation incubator - doing
more of the same is not an option!
Why should we innovate?

www.england.nhs.uk
The power of innovation

www.england.nhs.uk
What’s stopping us?

www.england.nhs.uk
• Data & information
• Innovation Scorecard
• NHS Exchange
• Innovation Connect
• Financial Incentives
• Innovation tariff
• CQUIN
• Leadership
• Leadership & accountability framework
Key programmes

www.england.nhs.uk
Reward & Recognition
• Challenge Prize Programme
• NHS Innovator Accelerator
System Architecture
• AHSNs
• NICE Implementation Collaborative
• Office for Innovation
Tools & Capability
• Innovation Compass
• AHSNs
• National Clinical Director for Innovation
Key Programmes

www.england.nhs.uk
Tools & Capability
Reward and Recognition
Access to data
• Uptake & Utility
• Profile & Priority
• International Blueprint
• Improved relationships
System Architecture
Financial levers
Culture
How are we doing?

www.england.nhs.uk
High volume of redundancies
1. Policy Framework for innovation is well regarded
2. Give it time, be patient – no overnight solutions
3. The more data you have the better
4. Need the right policy, regulatory and financial environment
5. Must collaborate
6. Need support at grass roots level
7. Finance is the elephant in the room
8. Need patient demand for innovation, top down won’t work
LearntLessons learnt

www.england.nhs.uk
A new industry council puts industry
at the heart of policy development
More routine and systematic dialogue
with AHSNs, and reduce the number
of cotact points
A ne signposting and support
service for industry
What might the future hold? look like?

www.england.nhs.uk
• Deliver partnerships with patients, social care, local authorities,
citizens and technology industries to:
• Use technology to increase social inclusion
• Develop processes that are clinically supported and have
patient consent
• Deliver personalised care/fully interoperable care record
• Assist with the delivery of the digital health agenda
• Delivery of high impact innovations
Further work to be done

www.england.nhs.uk
• Partner with the EU to deliver more “bang for the buck” that:
• Utilises incentive based innovation funding that galvanises the use of ground-
breaking innovations in the NHS
• Creates incentivised technology adoption in the NHS
• Transforms the lives of individuals and families and enable people to stay healthy
and prevent hospital admissions
Increasing the size of the funding pot

www.england.nhs.uk
• Making Innovation everyone’s business, will significantly
change the culture, the NHS’s greatest asset is its staff, but
we do not harness their skills, ideas or knowledge as
effectively as we could
“you need every brain in the game to win”
(Jack Welch , Business Executive and former CEO at GE)
The NHS has 1.3 million brains
Whose business is it?

Andrew Riley
MD, Yorkshire & Humber Academic Health Science Network
#ILNsymposium

Adopting Excellence, Creating Opportunity
www.yhahsn.org.uk @AHSN_YandH
AHSNs Innovation
Andrew Riley MBA
Managing Director Yorkshire & Humber AHSN

Outline
• Brief introduction to AHSNs
• Spotting innovation
• Due Diligence
• Building Partnerships
• Improvement and Change
• Evaluation and Evidence
• Summary

National AHSN Picture
North West Coast North East and North Cumbria
Greater Manchester
Kent Surrey and Sussex
Yorkshire and Humber
East Midlands
Eastern
UCL Partners
Imperial College Health Partners
Oxford
Wessex
South LondonSouth West Peninsula
West of England
West Midlands

The Yorkshire and Humber AHSN
• Population covered 5.8m
• Annual Budget £5.2m
• 47 NHS Members
• Regional NHS budget £12bn
• >180 Health related SME
• >20 health related MNO
• 2/8 English Core cities
• Regional economy £80bn

15/16 Strategic Objectives &
Programmes
Population Health
Empowering Citizens to manage their own health
Healthy Active Ageing
Improving Healthcare
Across Systems
In Organisations
Economic Growth
Accelerating Industry/NHS Partnerships
Accelerating Spread and adoption
Maximising International Growth

Spotting Innovation
• Innovation Scouts
• Partnership with HEI and Business
• Open Innovation
• Investment and sponsorship, Dragons Den
• International liaison and Partnerships

Due Diligence
• Search for Evidence, JED (Just Enough to Decide)
• Due Diligence;
• On the company
• the concept
• the market
• benefits
• Market Analysis; New, “me too”, cost
• Health Economics

Building Partnerships
• AHSN + HEI
• Translating research output into service impact
• AHSN + Business
• Developing ideas
• Proof of concept
• Funding
• Navigating the system
• Connecting to the NHS
• AHSN + NHS
• Innovation Scouts
• Communities of best practice
• Open Innovation Workshops, Show casing, workshops, conferences
• AHSN + Patients
• Patient pull, early engagement and co-creation
• Right Organisations
• Right people
• Clearly defined need
• Safe Environment
• Time and Space
• Leadership
• Results

Improvement and Change
• Proven Techniques for improvement and change
• Stick to the process
• Education and Training
• Cross cutting/system
• Develop organisations to become change ready/ eager
• Build team confidence, coach and support in choppy waters
• Rapid feedback
• “Dare to try” culture

Evaluation and evidence
• Credible reviewers/auditors; HEI academic rigour
• KPI/ Outcome measures
• Return on Investment
• Patient Outcome Measures
• Scalability
• Spread and Adoption

Summary
• AHSN’s role in innovation
• Making innovation real

Morning Session 2
Structuring successful Integration: What does good
look like?
#ILNsymposium

Professor David Welbourn
MD, Eutropia
Visiting Professor, CASS Business School
#ILNsymposium

Eutropia Limited © 2015 Company registration no. 7551009. Registered address 132 The Street, Rushmere St Andrew, Ipswich, IP5 1DH
Structuring Integrated Care
David Welbourn

Eutropia Limited © 2015 10 Mar 2015 37
“We must find and create tensions—force people
into different space for thinking...This is not just
a performance issue but a survival issue,
because managing paradox helps foster
creativity and high performance.”
Paul Polman,
Unilever CEO

A resourced
plan to achieve
defined goals Illustrated
experience of
the journey
Tasks Behaviours Imagination & feelings
The way things
are done
Framing the goal

A strong narrative provides:
Total clarity of a compelling purpose
A powerful picture describing outcomes
An enticing invitation to join the journey
A basis for distributed power & influence
Reason to be fully engaged
Inspiration for social movement to flourish
Offer of shared ownership and ambition
Flexibility to be resilient and sustainable

Gen Stanley Mcchristal
Former commander,
International Security
Assistance Force,
Afghanistan
“We had to change our
structure to become a
network…. Instead of
decisions being made
by people who were
more senior – the
assumption that
senior means wiser –
we found that the
wisest decisions were
usually made by those
closest to the
problem”

Redefining purpose
The NHS system was designed
to make sick people well
30% of the population have
health conditions from which
they can not be cured
70% of the NHS budget is
spent treating failure to manage
their known conditions

Enabling communities to flourish
and everyone to live fulfilled lives to the
greatest extent possible with their conditions.

Alan Lafley
CEO of Proctor & Gamble
“The firms with the
greatest capacity to
win, will be those
whose strategic
choices extend out to
networked
stakeholders,
suppliers and even
competitors in the
right circumstances”

Different problems:
differing solutions
Help 30% of population
live more effectively
with their conditions
A coherent approach to
urgent care
Encourage people to
take more
responsibility for
healthier lifestyles
Deliver “routine” acute
care via best protocols
Concentrate complex
and specialist care
around very best
expertise

The business model
Governance
Model
The set of structures, processes and relationships
within which decisions are made, resources
deployed and accountability is managed to
achieve agreed purpose.

The business model
Governance
Model
Contracting
Model
Addresses how co-ordination is achieved for the
service user. Defines how commissioner exerts their
influence, and the manner in which the relationships
within the supply chain are managed.

The business model
Governance
Model
Contracting
Model
What is valued in the process? What will be paid for?
How is each member of the supply chain paid?
How will payment be channelled?
How will delivery be measured?
Reimbursement
Model

The business model
Governance
Model
Contracting
Model
Describes how the services are constructed and
experienced by the service user. For best value
and resilience, ownership should rest within the
provider supply chain, NOT with the commissioner
Service
Model
Reimbursement
Model

The business model
Governance
Model
Contracting
Model
Service
Model
Reimbursement
Model

Systems no stronger than weakest link
Acute &
Specialist
health
Primary &
community
health
Mental
health
Welfare &
Housing
Social care
Value of
voluntary
care
£300bn
Healthcare
Social
Volunteers
9m People

Integration - contracting model
Commissioner Alliance
Independent
Integrator
Accountable
Care
Integrated
Organisation
Network of peers act
collaboratively to
deliver common goals
Traditional model
Commissioner lets
and manages all
discrete contracts
Specialist independent
integrator manages
supply chain
subcontracts
Single organisation
has capacity and
capability to deliver full
solution
Special
purpose
vehicle
Partners invest equity
to share ownership in
a single organisation
as a joint venture
Single provider takes
lead to be accountable
for all the supply chain
partnerships

Aligning the model
Help 30% of population live more
effectively with their conditions
A coherent approach to urgent care
Encourage people to take more
responsibility for healthier lifestyles
Deliver “routine” acute care via best
protocols
Concentrate complex and specialist
care around very best expertise
Integration,
Partnerships
Peer networks,
Partnerships
Public Health
& education
Hub & spoke
networks
Integration,
Partnerships

Quality – A system response
The vast majority of failures occur at boundaries!
Reduce number
of boundaries
Reduce risk of
failure at
boundaries
Reduce impact of
failure at
boundaries
Stronger standards
Better information
Mutual respect & understanding
Better communication
Redesign care to eliminate waste steps
Reduce fragmentation
Focus on outcomes
Greater oversight/ assurance
Shared risk and reward
Common leadership

Quality – a person response
Reduce
frequency of
exacerbations
Reduce severity
of exacerbations
Rapid and
appropriate
intervention
Better use of personal record
Early detection
Regular monitoring and diagnosis
More appropriate intervention
Increased self awareness
Changes in lifestyle
Better monitoring and diagnosis
More accessible care support
Joined-up planning
Rapid access to right care
Wider range of interventions
More use of intermediate care
Focus on outcomes that matter!

“If you are not
confused about
current events, you
are not paying
attention”
Bob Johansen
Former President.
Institute for the Future

Further details
David Welbourn
07889 175396
David@Eutropia.co.uk
•Disclaimer
In keeping with our values of integrity and excellence, Eutropia Limited
has taken reasonable professional care in the preparation of this report.
Although Eutropia Limited has made reasonable efforts to obtain
information from a broad spectrum of sources, we cannot guarantee
absolute accuracy or completeness of information/data submitted, nor
do we accept responsibility for recommendations that may have been
omitted due to particular or exceptional conditions and circumstances.
•Confidentiality
This report has been prepared for the client within the terms of our
contract, and contains information which is proprietary to Eutropia and
confidential to our relationship. This may not be disclosed to third
parties without prior agreement.
Except where permitted under the provisions of confidentiality above,
this document may not be reproduced, retained or stored beyond the
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Additional materials

Mark Moore – strategic triangle
Authorising
environment
Legitimacy – is
there political
& regulatory
cover?
The
practical reality
– is it possible?
Operational
capability
Public value
proposition
What matters
– is the uniting
purpose valuable?
After Mark Moore, Creating public
value – strategic management in
government, published by Harvard
University Press, 1997

Draw on widely
diverse
perspectives
Adopt open
enquiring
mindset
Go out of your
way to make
connections
Tasks
& ideas
Relationships
& behaviours
Be Clear
Be Curious
Be Courageous
Invest in
promoting
values
Establish
compelling
vision
Embrace
uncertainty
Distribute
leadership &
decisions
System leadership characteristics
© 2012 Prof David Welbourn, Prof Dean Fathers

VUCA
Chaos &
Paradox
If it were only complexity….
Uncertainty
Volatility Complexity
Ambiguity
Paradox:
not susceptible
to logical analysis
high frequency,
multi-dimensional
turbulence at scale
past experience is no longer
a reliable predictor
cause & effect
relationships
are indiscernibleeven experts fail
to make sense
of conflicting signals

Systems leadership
Shared Vision and Values
Burning platform vs burning ambition
Powerful narrative to energise/ motivate
An authorising environment
Ceding power for greater good
Magnanimity, humility, servant leadership
Cooking the conflict – managing the paradox
Information rich, deep engagement

Governance
Structures Processes
Agreed outcomes
achieved
Accountability
Decisions Actions
Resources
deployed
What...“Stuff”
Ethos...“Style”
Governance: Stuff ’n ’Style
Relationships

Peter Crow
Executive Director, Quarry Group
#ILNsymposium

What does good look
like?
Peter Crow | Quarry Group | New Zealand

Important considerations
• Islands of excellence
• Social, political and economic demands
• Acceptable rate of change

Conclusions
 “Together” trumps “apart”
 A commitment to a higher purpose
 Active engagement of the board

Questions?
peter@petercrow.com | +64 21 611 635 |
@petercrow1

Coffee
Back at 12.00
#ILNsymposium

Case Study
Sheffield Hallam University Health & Wellbeing
Programme
#ILNsymposium

Hanna Leahy
Business Development Manager, SHU Wellness
#ILNsymposium

Workforce Health and Wellbeing Project
Hanna Leahy, MSc

www.yhahsn.org.uk@AHSN_YandH
Project Background
• Chronic disease and health inequalities are rising in an
ageing population.
• Absenteeism and a decline in productivity associated
with chronic disease costs the UK an
estimated £100 billion every year
(Nice, 2009).

Productivity
Absenteeism
• Short-term
• Long-term
Presenteeism
• Inconsistent quality (service/product)
• High staff turn-over
• Poor customer satisfaction
• Temporary staff
• Low levels of efficiency

The NHS
• UK's largest employer
• Health and health behaviour of employees is poorer
than national averages... reflected by absenteeism
rates
• Improving staff wellbeing is crucial
for delivering improvements in
patient care

Workforce Wellbeing Programmes
• Absenteeism and a decline in productivity associated
with chronic disease costs the UK an estimated £100
billion every year ...
with a large proportion of this attributable to
physical inactivity in the workforce (NICE, 2009).
• Lifestyle changes that result from an effective workforce
health programme can equate to at least a 400% return
on investment for employers (Pricewaterhouse Coopers, 2008).

Workforce Wellbeing Programmes
Workplace
Wellbeing
Programme
Behaviour
Change
Improved
Health and
Wellbeing
Improved
Productivity
• "Good health is good business" (Dame Carol Black, 2008)

SHU Wellness - The Model

SHU Wellness
•Multicomponent programme:
– 1-to-1, hour long annual health and fitness assessment.
– Includes measurement of blood pressure, cholesterol, blood
glucose, lung function, aerobic capacity, body composition.
•Motivational Interviewing (MI)
– Directive client centred collaborative
approach to facilitate lifestyle related
behaviour change goals.

SHUWellness STH Pilot
• Representative cohort (N=50)
• Can be delivered and achieve same health impact in the NHS... in 6
months
• Significant improvements in total cholesterol, waist circumference,
aerobic capacity
• 96% staff rating the experience as excellent or very good and 71%
increased physical activity levels.
• ROI between 302% and 571% (YHEC, 2013)

www.yhahsn.org.uk@AHSN_YandH www.yhahsn.org.uk@AHSN_YandH
Regional Pilot
N= 277 (out of 300 at baseline) completed the programme

Results: Cardiovascular Risk
– Cardiovascular disease risk significantly improved, with
observed improvements in the following:
• Blood pressure (systolic and diastolic)*
• Resting heart rate*
• Total cholesterol*
• BMI and body fat (%)*
• Aerobic capacity
• * denotes statistical significance

Results: Cardiovascular Risk

Results: Self-Report
– Improvements in staff quality of life:
• Physical function*
• Vitality*
• Role Emotional*
• Mental Health*
– Improved Diet: Increased fruit and vegetable consumption*
– Increased physical activity* *statistically significant

What next? Regional roll-outProduct 1. Organisations who want
external wellness service to
staff
SHU/AHSN Spin-out
company
2. Organisations who deliver
SHUWellness to their staff
TTP Model
3. Organisations who deliver
SHUWellness to their staff
and their clients
TTP Model
4. Roll-out across other
AHSN's
TTT Model
Fees Delivery of service Staff software licence Staff software , Client ,
Community Licence
TTT licence (franchise)
Examples SME's, Schools NHS, Councils Sheffield Utd community
foundation
Other Universities
Product/
Services
Annual individual health
check and lifestyle review
Online follow-ups
Online workshops
Individual and company
wellness reports
Complimentary services
As product 1, plus
Yearly refresher course
Quality assurance/sharing
practice workshop
(SHUWellness network)
As product 2 The whole SHUWellness
offer

Regional Roll-out
• Train the practitioner
– 5 day training course for suitably
qualified staff
• SHU delivery via a spin-out company
– affordable labour via SHU graduates
"The tutors had an obvious passion
for the subject and a great
communication style."
"A great training course! The
facilitators were patient,
knowledgeable and approachable
which made it an enjoyable
programme."
"I liked how the trainers adapted the
programme flexibly to suit us to
meet our needs."

The 'Offer'
• Y&H AHSN fund organisations to receive FREE:
– Wellness taster sessions for up to 3-5 organisation
'opinion leaders'
– Delivery training via the 'train the practitioner'
course

Additional Services
Wellness Software Active Challenge

What are the costs?
Cost
Start-up kit Approx. £5000
Cost per head Approx. £15
Delivery staff Approx. £25k p/a
Cost per head, delivered
by SHU
Approx. £70

Uptake
• NHS
– Engagement events
– Tasters
– Train the practitioners
– Challenges
• Non-NHS

Summary
• The justification for workforce health and wellbeing
programmes appears unambiguous... on an individual,
employer, business and national basis.
• Yorkshire and Humber AHSN and SHU provide an
example of an evidence-based, scalable and sustainable
programme.
• Implementation is challenging without a profound
culture change.

"In the early 90’s I used to smoke at my
desk; now can you imagine anyone smoking
at their desk now? It’s just so completely
out there. It would be nice to look back to
this time in 20 years and say can you
imagine someone sitting for 6.4 hours a
day?
Can you imagine that?”

Any questions?
Hanna Leahy - h.leahy@shu.ac.uk
LinkedIn - Hanna Leahy

Results: Staff Feedback
"The programme was excellent- the assessment
appointments and report were very thorough and
gave me a great understanding of how lifestyle and
diet affect my wellbeing.
The information I was given empowered me to take
charge of my own health.
The guidance provided me with the insights on
what I could do to improve my health and how
different things affect me - not just nutrition and
exercise, but general lifestyle, work and home life
balance and stress management. I was given the
knowledge to help address the issues that are
affecting me and how to tackle them. I would highly
recommend this programme!"
"I am really pleased that I took part in the
programme as it gave me the motivation
to finally do something positive.
It also highlighted a health problem that I
wasn't aware of which could have
potentially led to more serious health
problems."
"This programme really did motivate me to stop
smoking. Overall I found the programme really
rewarding and the assessors were great too."
"I found the whole project very interesting.
It enabled me to improve my exercise plan,
making it more achievable and realistic."
"It would be great if this programme could
be extended. I would certainly welcome
repeating the assessment in a year or so to
enable progression. Maybe this could be
something that could be partly funded in
the same way as the iChoose scheme?"

Afternoon Session 1
Provider Organisation and Public Sector Integration
#ILNsymposium

Sir Andrew Cash
CEO, Sheffield Teaching Hospitals NHS Foundation Trust
#ILNsymposium

Integration - the key to true
‘patient centred care’
Sir Andrew Cash
Chief Executive, Sheffield Teaching Hospitals NHS
Foundation Trust

• Sheffield Teaching Hospitals NHS
Foundation Trust is one of the UK’s
busiest and most successful NHS
Foundation Trusts (Est 2004)
• Above all, patients lie at the heart
of everything we do
• 16,000 staff, 1960 beds, 2 campus
sites, 5 hospitals and multiple
community locations
• With a turnover approaching £1
billion
• Adult Community Services joined
April 2011
About Sheffield Teaching Hospitals

Local and system wide Integration is proving critical
to the delivery of these objectives

Integration is the key to true ‘patient
centred care’.
National Level:
• NHS Five Year Forward
• Dalton Report
• Financial Climate
• Patient expectations

Trust Level:
• Adult Community Services joined 2011
• Opportunity to re-think how we
delivered care across the pathway and
across the local health system
• 3 years later we have combined acute
medicine and community services into
a Combined Directorate.
• New culture, approach and significant
patient and organisational benefits.
• Discharge to Assess, virtual wards,
joint social care and community care
teams
centred care’.

City Level:
• Right First Time Partnership formed in
2011
• Acute care, primary care,
commissioners, Local Authority working
together with a common set of goals
• Significant benefits achieved
• Phase 2 – Better Care Fund, Acute
Provider Board, GP Provider Board,
Health and Wellbeing Board
• Prime Minister’s Challenge bid
centred care’.

Regional Level:
• Working Together Partnership – 7 acute
Trusts across South Yorkshire and North
Derbyshire
• Clinical and non clinical benefits realised
since inception in 2012
• Vanguard bid - Exploring a Federated
approach which will enable providers to
explore the different options identified
through the Dalton Review
• Aim is to support the sustainability of local,
clinical and non clinical services and
determine how best the different
organisational models can facilitate wide
scale change
centred care’.
Working
Together

Professor Dean Fathers
Chair, Nottinghamshire Healthcare NHS Foundation Trust
#ILNsymposium

115
“Provider Organisation &
Public Sector Integration”
Inspiring Leaders Network (ILN)
Annual Symposium
Presented by:
Dean Fathers
Chair, Nottinghamshire Healthcare &
Professor in Practice of Healthcare
Management, Cass Business School

116© 2012 Prof Welbourn and Prof Fathers Cass Business School
Draw on
widely diverse
perspectives
Adopt open
enquiring
mindset
Go out of
your way to
make
connections
Tasks
& ideas
Relationships
& behaviours
Be Clear
Be Curious
Be Courageous
Invest in
promoting
values
Establish
compelling
vision
Embrace
uncertainty
Distribute
leadership &
decisions
Desired leadership
characteristics

117
Contact Details
Thank you for listening, if there are any questions I’d be
delighted to answer them but if you wish to contact me
later please do so. My contact details are:
• E-mail: dean.fathers@nottshc.nhs.uk
• Mobile: +44(0)7970 183780
• Skype: DeanFathers1
• Twitter: @DeanFathers1

Julian Hartley
CEO, Leeds Teaching Hospitals NHS Foundation Trust
#ILNsymposium

Lunch
Back at 14.15
#ILNsymposium

Afternoon Session 2
Integration with Industry: Delivering successful
partnerships
#ILNsymposium

Richard Stubbs
Commercial Director, Yorkshire & Humber Academic Health Science
Network
#ILNsymposium

Industry Integration – Powering UK plc
Richard Stubbs
Commercial Director, Yorkshire and Humber AHSN

Life Science UK – A Snapshot
Pharma MedTech & BioTech
UK Jobs 70,000 96,000
UK companies 477 4,400
Annual Turnover £30bn £20bn
The UK has a uniquely powerful combination of:
• World-leading universities
• Established industrial R&D, manufacturing and supply chain
• Translational research infrastructure and clinical network
• Globally renowned research charities
• An NHS with 60+ million patients and access to unrivalled health data
• A firm commitment to partner with industry and establish access points
for industry to the UK life science base

Our Challenge
The NHS is facing its biggest ever challenge:
• £20 billion productivity shortfall
• a global economic crisis
• a growing and ageing population
• increasing costs of new drugs and
technologies
• growing public expectations

Expectations
Technology and medicine are changing fast, as are people’s
expectations:
• Technology – smart phones and wearable devices; “internet of
things” and remote monitoring; outbreak of online transactions;
smart medical tech; the Cloud and pervasive big data
• Medicine & Discovery – genomics; proteomics; personalised and
stratified medicines; regenerative medicine; the end of blockbusters
and the rise of niche-busters; the return to translational medicine;
the challenges to “big pharma”
• Services – rise of social media; 24/7 access taken for granted; highly
personalised and customised services; brands as purveyors of
meaning and value

129
Reduce variation in the NHS, and
drive greater compliance with NICE
guidance
Create a more systematic delivery
mechanism for innovation
“If we always do what we
always did, we will always
get what we always got”
And that means
increasing financial
pressure on an already
hard pressed service

What are Academic Health
Science Networks?
• In May 2013, England became the first country in the world to create a nationwide system
of Academic Health Science Networks (AHSNs)
• Each of the 15 AHSNs has a five-year licence to deliver against four broad objectives:
• Focus on the needs of patients and local populations
• Build a culture of partnership and collaboration
• Speed up adoption of innovation into practice
• Create economic prosperity

2015/16 Strategic Objectives
& Programmes
Population Health
Empowering Citizens to manage their own
health
Healthy Active Ageing
Improving
Healthcare
Across Systems
In Organisations
Economic
Growth
Accelerating Industry/NHS Partnerships
Accelerating Spread and adoption
Maximising International Growth
Across Systems
In Organisations

Economic Growth
The healthcare sector contributes to economic growth in a number of ways:
• By making people better and keeping people well
• Through working in partnership with academia and industry to grow
research in healthcare
• Through accelerating the adoption and diffusion of innovation and best
practice
• Through promoting services, innovations and expertise overseas

Economic Growth
Examples of the AHSN contribution to economic growth:
• Improving the health, and thereby productivity, of the population
• Improving productivity of healthcare providers
• AHSNs as market makers
• Making UK healthcare an attractive place to invest and do research
• Promoting UK healthcare expertise

Health and Wellbeing Programme
• Sheffield Teaching Hospitals, Bradford Teaching Hospital, Airedale Hospital – staff
employed > 26,000.
• Exercise & fitness a competitive advantage.
• Evidence;
• ROI for every £1 expect between £3-8
• STH potential savings up to £2m pa not including productivity gains
• Nationally £350m savings pa
• Improved Staff satisfaction
• Improved patient satisfaction
• Phase 1: > 750 staff recruited onto program
• ↓ BP, ↓ Cholesterol, ↓ Waist circumference, ↓ BMI
• ↑Aerobic Fitness, ↑ Staff satisfaction, 7:1 ROI to date
Rapid spread and
adoption
Commercialisation
through Franchising
model
Significant return on
investment

Supporting Y&H SMEs
RD Biomed: New innovative diagnostic device
adopted by AHSN
AHSN support enabled:
• Validated cost consequence models
• Focussed business cases
• Networks of key clinicians, GPs and support
agencies
Outcomes:
• Engaged with CCGs to start crucial audit studies
• Engaged with key hospital clinics
• Major collaborative study in London, Leeds and
Newcastle.
• Networked across North of England AHSNs
• Future International work

Open Innovation Programme
• Digital Health for Healthy Ageing
• 24 UK/China SMEs/Academics in Open Innovation programme
• Potential £2m in China funding for UK participants
• AHSN 7.5% equity stake in UK/China partnerships
• Funding provided by Guangzhou Development District
• 2015 – China part 2, Canada, India, Mexico

International Activity
• Close partnership working with other Government agencies including Healthcare UK, UKTI & Office of Life
Sciences
• Seeking projects bringing increased export opportunities and creating inward investment
• Quebec/Ontario
• Mexico
• Arab Health 2015
• UbiFrance Trade Development
• Africa Healthcare Summit 2015

The Ask From Industry
• Relationships based on trust not transaction
• Quicker adoption of new ideas
• Failing faster
• Better understanding of each others business
• Less criticism and more collaboration
• Co-development of patient-centred solutions
• Fewer access points
• Consistency of decision making
• Commitment to “do once”

Richard Stubbs
Commercial Director
Richard.Stubbs@YHAHSN.com
@Richarddstubbs

Kevin Kiely
CEO, Medilink
#ILNsymposium

1. Medilink integration
2. Technology integration
3. Cross sector integration
4. Cross national boundary integration
5. Brokerage & Translation

Clinical
Business
Academia
Où est le
marché pour
cette nouvelle
technologie ?
¿Cuál es la necesidad?
Y ¿cuál es el modelo
de negocio?
How can we
solve this
clinical need?
Medilink Integration

Cross National Boundary Integration

Brokerage & Translation
NOCRI
NICE
NHS England
DoH
NIHR
CLAHRC
HTC
DEC
AHSN
CCG
SMEs
LEPs
Local
Enterprise
Partnerships
BGH
Business
Growth Hub
UKTI
Innovate UK
Universities
KTN
Embassies &
Consulates
Innovation
Patient Benefit
BBSRC
EPSRC MRC
WHO
FCO
Healthcare
UK
Further
Education
Northern
Healthcare
Alliance
Catapults Creative
Sheffield

Case Study
3M & Nottingham University – Lymphoedema
Project
#ILNsymposium

Professor Christine Moffatt CBE
Professor of Clinical Nursing Research, Faculty of Medicine &
Health Sciences, University of Nottingham
#ILNsymposium
Carol Aries
Head of Strategic Partnerships, 3M

Ingenious
SolutionsTransforming Health
3M Confidential – Internal Use Only
Yorkshire and Humber AHSN Inspiring
Leaders Conference – 10th March 2015
Chronic Oedema Programme
Carol Aries
Head of Strategic Partnerships
3M Health Care Limited
Professor Christine Moffatt, CBE
Professor of Clinical Nursing Research / Nurse Consultant
University of Nottingham / Royal Derby Foundation NHS Trust

3M Confidential.156 23 April 2015. All Rights Reserved.© 3M
Chronic Oedema Programme
 Background
 Chronic Oedema and scale of problem
 Knowledge Transfer Partnership Programme
 Progress so far
 Alignment to integrated care
 Key learns
© 3M 2015. All Rights Reserved.

Background

Chronic Oedema Management
 Coban 2 and Coban 2 Lite:
― Saves valuable clinic time
― Supported with clinical evidence and cost effective
Key challenge - No clear national standard or care pathway

3M Critical & Chronic Care Solutions
Knowledge Transfer Partnership in Chronic
Oedema – Supporting Service Transformation

Knowledge Base Partner
Professor Christine Moffatt C.B.E.
― Awarded a CBE in the 2006 New Year's Honours List
― Life Fellow of the Royal College of Nursing
― 2008 Nursing Times Diamond 20 Award (20 most influential nurses in the last 60 years)
― Experience in transferring care to community nurses
The KTP Associate - Rebecca Gaskin
- Skilled, motivated, enthusiastic, eager learner!
- Project manager

Chronic Oedema: An international problem…an international approach
© 3M 2012. All Rights
KTP project to develop a
chronic oedema community
pathway
International epidemiology
Study LIMPRINT funded by
research grant from 3M and
using electronic platform
10 countries participating
European Grant to define size
and impact of CO and disease
mechanisms (LIMPRINT)
Development of Coban
system from venous
disease to chronic
oedema
Evaluation of system in RCT and
observational studies (UK and
Canada)
Qualitative assessment of patient
impact and professional
challenges
Cost effectiveness study
Understanding
Coban
Within specialist
services

 Only 60% of sufferers being treated. Care provision limited by:
― Nos. of trained specialists
― Resources in specialist clinics
― Leading to ad hoc management in the community
Background on chronic oedema
“…identification at general practice
level… more specialist nurses….and
also the communication
factor…(professionals) not being
able to talk to each other because of
different trusts, or whatever it may
be, it seems totally farcical…”
Patient Feedback

Prevalence and impact of Chronic Oedema
 x 3 higher than previously
estimated using the same
methodology 10 years ago
 Mean age of sample – 72.6
years
 Leg ulceration in 50% of
community patients
 With 31% having an ulcer
for more than 5 years
 9% had previously quit
work due to condition
3.99/1000
Overall
Prevalence
10.31 /1000
65 - 74
28.57/1000
80+
Study in Derby, 2012

 Chronic oedema is a life long condition
 Related to long-term conditions including: obesity ,aging ,immobility and cancer
Prevalence and impact of chronic oedema
 NHS Five Year Forward View
 2/3 of us are overweight or obese
 Long-term health conditions = 70% NHS budget
 Sickness absence costs estimated £22 billion a year
 2/3 patients admitted to hospital are over 65
 1/6 people over 85 live in care homes

Prevalence and impact of chronic oedema – hidden costs:
 Limited data – data acquisition is a key output of this project
 Cellulitis is a common problem associated with chronic oedema
 London study:
 53% chronic oedema patients suffered an acute infection since swelling commenced
 Average frequency of infection per chronic oedema patient = 7.4
 9% of which required hospital admission
 Average length of hospital stay for cellulitus = 11 days
 HES 2011 / 2012 more than 25,000 acute admissions 65+ age range for Cellulitis (circa 24,000
in 19-64 age range)
Better management and earlier intervention can prevent incident progression
reducing acute admissions and antibiotic prescriptions

Knowledge Transfer Partnerships
 Collaboration between Universities and industry for a specific project with
positive financial outcomes for the company
 Co –funded by Dept of Business, Innovation and Skills (50%) via Technology
Strategy Board
 Scheme running since 1976 with 800 ongoing in the UK across wide range
industries
 Graduate Associate appointed full time to project for 2 years
 Academic lead commits 10% time to project

KTP Stakeholders:
KTP
University
Industry
Graduate
SpecialistCommunity
Social Care
Patient

Project aims
Deliver a “consensus care pathway”
“ An agreed, multi-disciplinary practice based on guidelines
and evidence... for a specific patient group”
Implement a shared care model with appropriate training
Collect data for CCG consideration
Publications in leading journals
Provide business opportunity for Coban II

Project steps…2 year plan and
programme deliverables
• Plan
• Consensus
meeting (Oct.)
• Review pathway
Develop care
pathway
• Embed in systems
• Education
• Data collection
Implement in
community care • Publications
• Tool kit
• HE case
• Implementation ££
Build business case
for CCG adoption
2014 2015 2016

Stakeholder group
Pathway draft and
consensus
Data collection
Training and education
packages
Pathway pilot
Data analysis and
dissemination
Progress so far…

Expected programme benefits
 Better control of chronic oedema
 Improved experience of care and quality of life for patient e.g. Mobility
 Reduced incidence of secondary complications e.g. leg ulcers
 Reduced acute admissions with severe oedema
 Better understanding and control of/reduced use of antibiotic prescriptions
 Improved practitioner confidence and skills in delivering care.
 Big data – better understanding of condition and causes
 UK reputation enhanced as we are leading the way globally on understanding
and treating this condition
 Cost saving to the NHS

Alignment to integration agenda
 Project engaging all key stakeholders from primary, secondary and social care
and across all hierarchies and clinical expertise
 Anticipated care pathway will be patient centred drawing on appropriate clinical
and social care experts to manage cause and symptoms – move to a fully
effective networked care management system.
 Engaging full suite of relevant suppliers to ensure treatment solutions and care
pathway are fully aligned.

International interest in chronic oedema management
Japan
 Japanese 5th ILFJ conference in Sapporo, September 21st 2015.
 Integration with Dr. Kobayashi at Hokkaido University
France
 Invitation to present project details and support similar prevalence n
Montpellier France, October 2015
 Integration with Prof. Isabelle Quere at University of Montpellier, France

Key learns/observations
 KTP pathway project approach is ideal for med tech products and care pathway
design
 Critical to make sure have strong stakeholder group – take time to research,
engage and decide team
 Ensure front line staff appropriately represented
 Regular project reviews – iterative process – amend project plan accordingly if its
not working.
 Manage widespread interest – say focused on the project and deliverables whilst
supporting wider interest e.g. this conference.
 Draw on expertise of all partners to help deliver the project e.g. commercial
facilitators.

Thank you
3M.co.uk

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