Supporting the development of pioneering healthcare innovation

“For the foreseeable future NHS must meet increasing demands within ever constrained resources and at the same time continuously

improve quality”.

•Simply doing more of what the NHS has always done is no longer an option. •NHS needs to do things differently by radically transform the way it delivers services.• Innovation is the way – the only way – NHS can meet these challenges. •Innovation must become core business for the NHS.

Unprecedented Healthcare Demands

a growing population with an extending lifespan

an increase in its own capability, fuelled by advances in knowledge, science and technology

ever-increasing expectations from the public it serves.

Current NHS Health & Social Care System

• Services are struggling to keep pace with demographic pressures, the changing burden of disease, and rising patient and public expectations.

• Too much care is still provided in hospitals and care homes, and treatment services continue to receive higher priority than prevention.

• The traditional dividing lines between GPs and hospital-based specialists, hospital and community-based services, and mental and physical health services mean that care is often fragmented and integrated care is the exception rather than the rule.

• Current models of care appear to be outdated at a time when society and technologies are evolving rapidly and are changing the way patients want to interact with service providers.

• Care still relies too heavily on individual expertise and expensive professional input despite patients and users desires to play a much more active role in their care and treatment

Policy implications

NHS leaders need to take a strategic viewrather than focusing on short-term fixesdesigned to preserve existing services.

IHW is a policy initiative that will :– decommission outdated models of care; – support NHS organisations to innovate and

adopt established best practices; – recognise the potential of new providers as

an important source of innovation; – develop a culture that values peer support

for learning and innovation; – encourage development of infrastructure at

the local level to develop & support innovation and new models of care.

Your partner in nurturing pioneering technology innovation NIC Strategic Goals

1. Identify emerging innovative technologies relevant to the NHS at an early stage

2. Identify priority targets for innovation development support

3. Speed up development and delivery of technology innovations likely to benefit the NHS and Social Care

4. Provide and environment and infrastructure for true collaboration and partnership between health care professionals, industry and academia

5. Provide the right pre-commercial innovation support to innovators to minimise the risk of market failure

Your partner in nurturing pioneering technology innovation

Pre-commercial development support

Identifying & validating unmet needs

• The NIC care zone is designed to elicit first-hand knowledge of NHS based staff, patient and service needs.

• The fundamental principle is to encourage staff to discuss critical issues and challenges they face in their day to day clinical practice that are interfering with efficient and effective delivery of care.

Benefits of submitting a care need:

• Find out if the problem you’re looking at is a symptom of a different, larger one

• Find or involve other people to help find a solution

• Potentially discover existing ‘solutions’ you hadn’t thought of

• Help validate important clinical needs

• Articulate the need for an innovative solution that the NIC, Industry, Academia can respond to.

Universal

unmet need

Unmet need identified by small number of

organisations

Assess whether local needs/issues are a symptom of a larger problemStimulate further engagement and debate

Identify and validate shared unmet needs with formal review /appraisal and potential local collaboration

Stimulating the Inventiveness and Creativity of Frontline NHS Staff

Identifying and responding to Unmet Clinical Needs

High probability of need being universal

Low probability of need being universal

•Respond with collaboration in targeted priority area(s)•Select preferred innovation target•Launch Competition/Call to Action to find best solutions•Progress through jointly awarded funding and partnership development initiatives

Unmet needs identified by individual organisations posted on NIC website and

through engagement events run by NIC

NIC Knowledge Zone

Development Support

• Validate the viability of the proposed solution – rigorous health economics assessment, – market analysis and business plan development . – design of future evaluation studies to provide the right

evidence base for NHS decision makers.

• Validate the envisaged functional design with the potential user base – conducting option analysis, – producing design specifications, – product functional specifications and manufacturing

options. – Intellectual property advice.

• Selecting the design methodology • Linking the innovator up with partner organisations

to build a prototype• Reviewing how the results obtained may impact the

original business plan and user attractiveness. • Low volume manufacture and performance testing• Evaluating results against the original solution

specification

Development support• Broker access to potential investors with an

interest and track record in the relevant sector• support to demonstrate regulatory compliance, • Evaluation study design and creating the final

Business Plan/Value Proposition. • Adoption readiness assessment is performed • Identify likely barriers to adoption, identifying and

developing solutions to reduce the risk of market failure

• Support is provided to establish processes to manage successful production and distribution

• Manage any changes to the solution/product. • Connect to NHS Supply chain linking up the

innovation procurement process to secure forward procurement opportunities.

• A further economic assessment is appropriate at this stage to assess the impact of evaluation studies on clinical outcomes and service efficiency

Framing the convincing innovation case

How to convince the NHS to support the adoption of an innovative solution?

Clinical Case Financial Case Management Case

Unmet need Benefiting Population

Current Clinical PracticeExpected Outcomes

Your assumptionsBaseline comparison

No of patients affected/benefit

Articulate the problem and proposed solution

Impact on operationsRelevant impact indicators

Business ModelBaseline costs

Savings forecastROI/BCR

Proposed Clinical PracticeEvidence base

Clinical Champion

Impact on pathways and services

Barriers to adoptionKey risks

Your partner in nurturing pioneering technology innovation 3D Fusion Ultrasound (D2/D3)

Video: Left and middle: 2D slices of conventional 3D echo images showing chambers of the heart. These four images were acquired from the same subject from four positions. Right: Resultant image by the fusion of four images shown on left and middle. Anatomical information and image quality is increased.

Images and data stored in DICOM format

• Intelligent Ultrasound is an early-stage (pre-market) medical imaging software company

• Has origins in research conducted at the Institute of Biomedical Engineering (IBME) University of Oxford

• Image enhancement technology which aims to significantly reduce the number of patients who currently cannot be diagnosed using ultrasound

• Aims to provide a more cost effective alternative to MRI and CT scanning

• Software sits on existing hardware and will be made available to the NHS through OEM equipment providers

• Focus on Cardiology and Obstetrics

Your partner in nurturing pioneering technology innovation

Patient Carry Chair (D1-D3)

• Developed from unmet needs identified by paramedic staff

• Designed to reduce the risk of manual handling injuries , a major cause of sickness and absence in the Ambulance Service

• Device folds flat to enable safe and rapid pick up of patients off the floor

• Chair folds and unfolds using innovative powered mechanism

• Chair has novel skid enabling safe patient extraction down staircases

• Folds in half for storage and carrying

• Developed in partnership with West Midlands Ambulance Service and Canard Design

Your partner in nurturing pioneering technology innovation

•Developed in response to unmet need identified by users, carers and healthcare professionals for a Paediatric Transport System that:• promotes independence for children• addresses the lack of storage space on current

transport chairs• provides a system that enables equipment

integration • accommodates the changing requirements of

the child

•Partnership project between researchers NIC , 3rd Sector and a Design Consultancy

Comprehensive engagement and survey of users, professionals parents and carers (n=500) determined evidence base for detailed design specification

D1-D2 – Paediatric Transport Chair

Your partner in nurturing pioneering technology innovation FNoF Device (D1-D4)

• Developed to address an unmet clinical need in emergency care to stabilise patients with FNoF, reduce pain and the associated use of opiates

• Designed Canard Design with close consultation with East and West Midlands paramedics

1. Designed to remain on the patient until they go into theatre and can be used in x-ray, CT and MRI scanners

• Currently undergoing a clinical trial with EMAS and Queens Medical Centre in Nottingham with over 100 patients

• Additional applications with polytrauma patients

Your partner in nurturing pioneering technology innovation

(D3-D4) Live Therapies

•Developed in response to needs articulated by commissioners looking for innovative ways to reduce waiting times and extend access to, approved therapies

•Development of live online psychological therapies

•Partnership development between industry , NIC and an NHS Mental Health Trust

•Benefits include:- no more waiting lists as clients book their

sessions , - no need to travel or take time off work for

a session - clients choose their therapist and rate

them .

Your partner in nurturing pioneering technology innovation

FLOTE (D3-D4)• Compact , lightweight , portable instrument that

attaches to the end of any standard operating table

• Facilitates DAA to hip replacement surgery simplifying a difficult procedure for the surgeon

• Brings DAA into the same time frame as ‘traditional’ hip replacements - 45mins

• Allows an un-scrubbed technician to manipulate the patient’s leg as required by the surgeon in a stable, controlled, repeatable manner

• Provides for complete intra-operation imaging (X-ray)

• Minimally invasive, reducing damage to muscles , nerves and tendons promoting faster recovery (2.2 days LOS)

www.nic.nhs.uk