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Annual Report 2016 - 2017
Annual Report2016 - 2017
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CONTENTS
Chair’s introduction
Chief Executive’s statement
Highlights of the year
What our partners say about us
How we operate
How we supported local, regional and national NHS objectives
How we delivered against our goals for 2016/17
European programmes
Organisational capabilities
Partnerships with other organisations
Looking forward
Financial performance
Our Executive team
Contact details
Appendices
Appendix 1
Appendix 2
Advancing Quality Alliance (AQuA) programmes
specifically commissioned by the Innovation Agency 2016-2017
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CONTENTS
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CHAIR’S INTRODUCTION
I am proud to chair the Innovation Agency, even more so at a time when our partnership working with colleagues throughout the region and nationally is showing positive results and, as evidenced by our latest independent survey, is obviously valued.
The past year has been significant for many reasons, not least for our new, improved approach to engagement with patients and residents. We now have a dedicated patient and public involvement lead and a Senate of patients and residents who meet regularly and are involved in our programmes of work.
The Senate plays a particularly important role in Connected Health Cities, a major Department of Health funded programme which we are co-ordinating on behalf of the region. This will pilot the use of data to identify how to improve health and care services in three key clinical services for the region. Helping the public to understand the value of shared data is critical to the programme’s success.
Our strong connections with system leaders are leading to more involvement in transformation planning and we welcome the opportunity to support the changes ahead. Having been part of the system transformation process from the start, we will be helping with the adoption and spread of innovations and service improvements, which are enablers to future changes. To support system transformation we have grown our workforce, using the money from a successful funding bid to grow our business support team and developing posts into our two Sustainability and Transformation Partnerships to support the adoption and spread of innovation over the coming years.
Switching to digital solutions isn’t just happening at service and system level; individual citizens are being urged to go online and use apps, to help manage their own care. Bridging the skills gap both in our health and care workforce and in our local population is something we all know is needed. We have supported a project to address this need in Lancashire and South Cumbria; and will be supporting our four Global Digital Exemplar trusts in Merseyside.
The region is becoming a powerhouse for digital health systems and solutions and a magnet for investment; we have some of the country’s most innovative companies and clinicians and we are delighted to work with them in creating a health and care system fit for the future.
Gideon Ben-Tovim OBE
Chair
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CHIEF EXECUTIVE’S STATEMENT
This has been a fantastic year for the Innovation Agency; I am delighted that our work with partners is showing an impact both on health and on the local economy.
It was heartening to see the results of our annual stakeholders’ survey; it shows that we have made great progress in establishing ourselves as a valued partner, as you will read below.
We are very proud of the results of our collaborations with organisations in different sectors; it is great to be playing a part in such a vibrant, entrepreneurial region.
You will read in this report how we are working closely with system leaders on the changes necessary to meet the challenges facing the NHS, through the whole system transformation programmes, test bed, Global Digital Exemplars, vanguards and Healthy New Towns.
We have helped organisations around the region to introduce or develop innovations which are improving care and achieving efficiencies. We have provided our own funding to support the creation of seven new innovation centres in our region, where innovations can be developed, and to fund adoption of proven innovations across the region.
We have brought substantial investment to the North West Coast through funding for business support and digital innovations by securing £3.5m European funding plus £3m match funding, to improve the health of our residents by supporting local businesses that have developed innovative healthcare products
I would particularly like to highlight our continuing success in preventing strokes through our multi-strand reducing Atrial Fibrillation programme. In 2016/17 we estimate that we have prevented 256 potential stokes through atrial fibrillation detection potentially saving c £5.6m in NHS resources.
I am extremely proud of our success in launching the £4 million Connected Health Cities programme, which we are leading in the North West Coast, to plan future services for those residents with COPD, epilepsy and issues with alcohol.
We have continued our sponsorship of patient safety leadership programmes and have built up our network of patient safety champions across the region. We have successfully led a national Sepsis Cluster, with a particular focus on detecting sepsis and deteriorating conditions in care homes.
In addition to focussing on our regional partners, we have been a strong supporter of national AHSN Network programmes, which bring great benefit to our region. As Chair of the national AHSN Network I have been privileged to be involved in shaping the Accelerated Access Review; Test Bed Wave 2 programme; and Innovation and Technology Tariff. The Innovation Agency has been a key partner with a number of other AHSNs in delivering the National Innovation Accelerator programme; the Clinical Entrepreneurship programme; and a joint campaign to reduce strokes due to atrial fibrillation, across England.
As our fourth year ends, we are looking forward to continuing our work to meet the aspirations of the Five Year Forward View and to help our region through these challenging times.
Dr Liz Mear
Chief Executive
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HIGHLIGHTS OF THE YEAR
These are summarised below.
• 256 potential stokes avoided through atrial fibrillation detection, potentially saving around £5.6m in NHS resources:
There are more than 10,000 people with atrial fibrillation (AF) who are not receiving optimal treatment in the North West Coast. People with AF who are untreated or whose treatment is not effective are at a five-fold greater risk of having a stroke compared with the rest of the population.
• Through public campaign work in Merseyside and Lancashire and use of innovative technology, abnormal pulses were detected in more than 60 people.
• More than 60 patients are now receiving treatment to preventing stokes, predicted to save at least two extra visits to clinic (120 clinic visits per year). This work is estimated to have saved up to £24,000 per person or £1.4m in NHS care costs in the first year alone.
• 130 AliveCor Kardia devices have been distributed to GPs and nurses in the region and 30 MyDiagnosticks are now in GP surgeries, pharmacies and in adult social care. MyDiagnosticks can screen about 100 patients per month; the Kardia can screen about 50 per month per user.
• For every person identified with AF out of this screening, the research shows that one in 25 would have had a stroke in the given year.
• More than £250,000 worth of matched investment has been pledged by partners including LGC, Bayer, Boehringher-Ingleheim, Pfizer and Diiatchi-Sankyo and Bristol Myers-Squibb.
• Genotype guided dosing has brought personalised medicine to more than 100 citizens, establishing the correct dose of warfarin for patents with AF. Three hospitals have introduced genotyping into their clinics and more have been identified. Acceptability to patients and staff is high. A health economic evaluation is underway and will report in September 2017. We estimate that using this test avoids two clinic visits per person – saving 200 clinic visits for patients receiving the test
• £6.5 million secured to support small and medium sized (SMEs) life science businesses to develop health innovations from which citizens across the region will benefit.
• Six staff have joined the Innovation Agency commercial team, and partners have recruited a further six staff, to help 282 SMEs access the healthcare market; key outputs will include:
− 34 new products launched;
− 74 new products in development;
− 49 new SMEs will be supported
− 4.1 million citizens in the North-West Coast region will benefit from health innovations.
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• Investment by the Innovation Agency of around £1million has enabled £100 million of additional funding to be attracted to build innovation hubs and business incubators across the region so that life sciences SMEs can locate in the region, develop products, create jobs and improve health
This additional funding has come from NHS, universities, industry, EU and UK Government. This investment led to the development of the following facilities:
• Health Innovation Campus, University of Lancaster, due to open in 2019
• Liverpool Bio-Innovation Hub at University of Liverpool - opened February 2016
• Alder Hey Research and Education Centre - opened October 2015
• Alder Hey Innovation Hub for digital and sensor technologies - opened March 2016
• Centre for Integrated Health Science, Chester, Countess of Chester NHS Foundation Trust and Cheshire and Wirral Partnership NHS Foundation Trust - opened April 2015
• Accelerator Hub, Royal Liverpool & Broadgreen University NHS Trust – due to open in 2017
• Chorley Digital Park – due to open in 2018
• £4m external investment gained in the development of a Learning Health System – the Connected Health Cities programme. Emergency unplanned care (COPD and epilepsy) and alcohol related care are the care pathways that we are focusing on in the region. The work comprises:
• A collaboration between the Innovation Agency, University of Liverpool, Lancaster University and AIMES Grid Services, plus Lancashire Teaching Hospitals NHS Foundation Trust and the Royal Liverpool and Broadgreen University Hospitals NHS Trust
• The development of linked health related data sets
• Analysis of the care pathways to identify improvements across the system
• An integrated plan for the workforce to support digital education
• Public engagement and patient and citizen collaboration
• Create a sharing environment that enlists the trust and active involvement of NWC citizens through the Northern Citizen Jury and the North West Coast Public Involvement and Engagement Senate.
• Keeping people out of hospital by gaining funding to increase domiciliary care technology investment by £612,000 for Liverpool City Council as part of the Sustainable Technology for Older People – Get Organised (STOPandGO) project.
This is a Public Procurement of Innovation pilot project co-funded by the ICT Policy Support, European Union programme. The goal of STOPandGO is to produce and validate data that will support the development of improved procurements across Europe, of innovative healthcare and social services enhanced by technology, for elderly people. It is hoped that the project will benefit more than 5,000 citizens and service areas will include integrated care, domiciliary care and dementia.
• Through our business support, innovation spread and European funding bids we have had a significant impact on the local economy, helping to secure £2m from grants, revenue and venture capital funding for local small and medium size businesses (SMEs). We were responsible for the creation of 17 additional jobs in our region; and we played an active role in helping to secure a total of 49 contracts for businesses and NHS Innovation Fellows.
• We have continued to support partners in their ongoing journey towards digital interoperability. In the Lancashire and South Cumbria region we have supported the Lancashire Person Record Exchange Service (LPRES), which through its electronic sharing of data is improving the quality of care for residents and saving around £2 million per year by joining up regional clinical record systems. We supported applications for the Global Digital Exemplars, gaining four in the Merseyside region, with a total investment of £40 million. Our 5YFV Transformation Fund and digital investment fund awarded funds to our Alliance region partners to further develop their digital solutions for outpatients. We started a programme to develop a North West Coast Digital Strategy, to position the region as a hub of digital innovation and magnet for investment.
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• We supported an electronic transfer of care system in East Lancashire NHS Foundation Trust which led to a reduction in readmissions of 0.8 per cent, or 60 patients in a year, saving the trust £200,000. We have now been engaged by NHS England to spread electronic transfer of care systems to 12 trusts in our region, in a pilot study which will be evaluated by a university partner.
• Our community of Innovation Scouts has grown from 50 to 70, including a new cohort of mental health Scouts and senior staff from local authorities and universities. One of our Scouts programmes has involved spreading the use of 3-D printing of organs before surgery, which is now adopted by three of our hospitals, reducing anaesthetic and surgery time for patients.
• We supported the bid for the Lancashire and Cumbria Innovation Alliance Test Bed and have been involved in the rollout of technology into residential homes, with 100 residents already benefiting from these digital home solutions. We support the communications function of the programme, have a seat at the Test Bed Board and on the national adoption and spread steering group.
• We were successful in our application for the region to be a three-star European Active and Healthy Ageing Reference Site – this will allow us to enhance services for our older and frail residents, drawing together our existing programmes to support active and health lives for our citizens.
• We have been an active supporter of our two Sustainability and Transformation Plan regions, sitting on Boards and working groups, offering a menu of support options and funding for region-wide programmes such as the development of health coaching. We have worked with these regions to develop two roles for innovation adoption and spread. The postholders will be co-funded by the Innovation Agency and local organisations and will work across both regions to ensure the adoption/adaption and spread of innovative practice.
• We have continued to support the rollout of the 100,000 Genomes programme which in 2016/17 has sequenced the genes of around 350 patients with cancer and 1100 patients with rare diseases across seven hospitals in our region; with an eighth hospital due to go live in April 2017. We have established and funded an Genomics Ambassador/ Project Manager post and our CEO is Vice Chair of the programme Board and sits on the national 100,000 Genomes Steering Board.
• We have worked in a supportive role to all our Local Enterprise Partnerships (LEPs) and our jointly funded post with Liverpool LEP has enabled us to be a part of shaping the life sciences and health strategy for the region and supporting more than £140 million of investment in the Liverpool City Region over the past year.
• Our work supporting NICE Guidelines in relation to reducing alcohol harms in our region and understanding the barriers to uptake, was published.
• We have significantly increased our investment in patient and public involvement, establishing a Citizen Senate and supporting a number of programmes in the region.
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WHAT OUR PARTNERS SAY ABOUT US Stakeholders Survey 2016
The second independent survey of our stakeholders was conducted by YouGov on behalf of NHS England. There were great results in all areas, endorsing our partnership approach. Key findings were that 82 per cent would recommend working with us; and 72 per cent of stakeholders agree that our priorities are aligned to local priorities.
There was a very positive response to the questions, have we provided valuable support on the following:
• Identification, adoption and spread of innovation: 82 per cent
• Facilitating collaboration: 84 per cent
• Providing leadership to the local health economy: 83 per cent
In the future, stakeholders asked for a clear path for new and small businesses to engage with CCGs and local authorities; help for CCGs and the wider NHS to understand and adapt to change and transformation in the NHS; and support for new ways of delivering education and training.
Ten comments from those surveyed:
Dave Sweeney, Halton CCG: “They are the epicentre of innovation, this has been achieved through hard graft, getting out to the partners, bringing in external funding, delivering visions and enabling fizzy innovators to achieve their dreams by breaking through barriers.”
Dave Horsfield, Liverpool CCG: “We have excellent working relationships with the staff, aligning our strategic direction and most importantly an ability to effectively communicate and share key activity and data.”
Mandy Dixon, Lancaster Health Hub, Lancaster University: “Given the large geographic area covered by the Innovation Agency, there is always a danger that areas such as Lancashire are overlooked in favour of larger cities. However, the Innovation Agency’s ambition to focus on development hubs across their patch is encouraging and I hope this will continue going forward.”
Joe McArdle, Strategic Economic Development Unit, University of Chester: “The AHSN has been very good at identifying engagement points to extend reach beyond Liverpool, looking at how we strengthen association, and collaborating with Manchester AHSN. We are still to develop links with West Midlands but it is a future direction and collaboration that could support Local Digital Roadmap developments.”
Mr Iain Hennessey, Clinical Director of Innovation at Alder Hey Children’s NHS Foundation Trust: “I feel like our organisation dovetails with the AHSN, it’s always great to work with them. We feel very well supported and prioritised. I have always found the AHSN to be an excellent organisation; well led and full of enthusiastic individuals willing to go above and beyond.”
Brian O’Connor, European Connected Health Alliance: “We believe that the senior leaders of the Innovation Agency provide clear and decisive leadership in a complex sector and embrace collaboration.”
Mark Jackson, Liverpool Heart and Chest Hospital NHS Foundation Trust: “Great people to work with, very supportive. Scout movement very good.”
John Whaling, Liverpool City Region Local Enterprise Partnership: “Excellent partners in all regards, combining strategic leadership with delivery focus.”
Andrew Michaelson, Care Innovation (Nationwide) Ltd: “Most valued: Fantastic networking and engagement.”
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Andy Beesley, Medication Management Solutions: “Most valued: breaking down barriers between secondary care and small businesses.”
Mike Leaf, Turning Over: “Without bodies like the AHSNs, the spread of good practice and the engagement of private sector/academia/ NHS in a collaborative manner would not happen...it would be spasmodic and piecemeal rather than coordinated and integral.” The full survey report can be found on our website.
HOW WE OPERATE
The Innovation Agency is governed by a Board of 40 representatives from the following areas:
• Provider trusts
• Commissioners – CCGs and NHS England
• Strategic Clinical Network
• Local Enterprise Partnerships (LEPs)
• Public Health England
• Health Education England and Local Workforce Education Groups (LWEGs)
• Universities
• NIHR Clinical Research Network: NWC
• NIHR Collaboration for Leadership in Applied Health Research and Care North West Coast
• Association of British Pharmaceutical Industry (ABPI)
• Association of British Healthcare Industries (ABHI)
• Healthwatch
• Research research and innovation centres
The Board meets at least five times a year and members are expected to attend at least three out of five meetings to ensure that the Innovation Agency achieves its goals and objectives and complies with all relevant performance metrics.
Expert groups
In the last year we have set up expert groups to provide direction on key areas of our work; economic growth; patient safety; and digital health.
Public and patient engagement
In 2016 we established a Patient Involvement and Engagement Senate (PIES), with membership consisting of 25 patients and patient advocates, meeting regularly and getting involved in different aspects of the Innovation Agency’s operations. The strategy is to involve the patient voice in our programmes of work through the Senate and through direct contact with patients in hospitals and through patient charities, on relevant work programmes.
The Senate focuses on patient safety and on the North West Coast Connected Health Cities programme, resharing data to improve health and future health infrastructure; and members are helping to support a Citizens Jury for the wider North of England Connected Health Cities programme.
Senate members also sit on Innovation Agency staff recruitment panels; and on shortlisting panels for our NWC Research and Innovation Awards.
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One Senate member sits on our Patient Safety Steering Group and another two belong to a panel which scrutinises submissions to our online platform for showcasing innovations - the Innovation Exchange.
Our Patient and Public Involvement (PPI) Lead works within various groups including the AHSN PPI Network; 100,000 Genomes PPI board and Operational Management Group; INVOLVE Diversity and Inclusion sub-group; Connected Health Cities work streams; AQuA PPI Member and MY Data patient group member among others.
Our values and culture
We have adopted the values in the NHS Constitution:
Working together for patients; respect and dignity; commitment to quality of care; compassion; improving lives; everyone counts.
In addition, we have identified further values which reflect the way we work:
Doing things differently
Enabling partners to think creatively
Being courageous in change
Co-creating, co-designing, co-producing
Team working
We were delighted to be awarded Investors in People Gold Award after just three years of operation. This reflects a dynamic programme of staff development including monthly skills and knowledge sessions; weekly learning sessions; regular appraisals and relevant training and monthly surveys of how well we are demonstrat-ing our values.
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HOW WE SUPPORTED LOCAL, REGIONAL & NATIONAL NHS OBJECTIVES
Collaborating locally
We have been an active supporter of our two Sustainability and Transformation Plan regions, sitting on Boards and working groups, offering a menu of support options and funding for region-wide programmes, eg the development of Health Coaching. We have worked with these regions to develop two roles for innovation adoption and spread. The postholders will be co-funded by the Innovation Agency and local organistions and will work across both regions to ensure the adoption/adaption and spread of innovative practice.
We support some of the clinical work streams closely, for example with our work around cardiovascular disease (CVD) and we were a founder membership of the CVD Collaborative. We are actively working with their teams to understand their challenges and offer support.
Our business plan for the coming year is focused on the needs of both programmes; and our latest funding competition asked for bids which would help to meet the aims of the programmes.
Test bed and vanguards
We were integral to the bidding process for the test bed in our region, the Lancashire and Cumbria Innovation Alliance. We sit on the test bed board and also support and fund communications and stakeholder engagement. We have a seat on the Test Bed Steering Board and the SRO for the programme is the Chief Executive of our host organisation, Lancashire Care NHS Foundation Trust.
We support local new models of care sites with bespoke products, which have included system modelling tools, leadership development and coaching for the new vanguard leaders, workforce planning of new roles and a networking and sharing event for all Northern vanguards. A summary of all vanguard sites in our region can be found in Appendix 1.
The Fylde and Wyre Vanguard is looking at new, proactive ways of caring for elderly and frail patients with two or more long term conditions. We sponsored their use of SIMUL8,a computer simulation tool to model projected financial and resource expectations following the introduction of new care models.
This pioneering work is expected to reduce visits to emergency departments by 27 per cent; non-elective admissions by 27 per cent; and outpatient visits by 40 per cent.
Andrew Harrison, Finance Lead, Fylde Coast Vanguard, said:
“The simulation allowed us to experiment very quickly with models of care in terms of types and numbers of contacts to fit with our budget predictions.
The real benefit will be in refreshing the simulation data regularly with service usage data, which will quickly tell us whether our predictions are right and enable us to predict performance trajectories; in this way we can act quickly to ensure that the new models of care are working as we expect.”
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In addition we have two Healthy New Town sites. There are 10 sites across the country covering more than 76,000 new homes with potential capacity for around 170,000 residents. This is an opportunity for the NHS to shape the way these new sites develop and to test creative solutions for the health and care challenges of the 21st century, including obesity, dementia and community cohesion.
The two sites in the North West Coast are Halton Lea in Runcorn with 800 homes, and Whyndyke Farm in Fylde, Lancashire with 1,400 homes. We have been working with these sites to identify digital health technologies which can be used to improve the health of residents.
Collaborating across the North of England
Northern AHSNs forum
Executive teams from the four Northern AHSNs meet regularly; we work together on delivering the Connected Health Cities programme across the North; and we have run joint events such as the ‘Vanguards of the North’ meeting, ‘Better Conversation’ health coaching launch; and Diagnostics Showcase to share learnings across our region.
We import many AHSN-led programmes from other networks and also host visits from other AHSNs who wish to learn from our programmes, especially our commercial work.
We work closely with the Northern Health Science Alliance (NHSA), on a range of areas to strengthen our economic growth and research offer in the North. Our CEO Dr Liz Mear is a Director of the NHSA Board, representing all four AHSNs and our Commercial Director Lorna Green sits on the Operational Board.
Well North
The Innovation Agency is a supporter and contributor to the Well North Project and our Chief Executive is a Director of the Board of Well North, which is funded by Public Health England and local regions. This project seeks to promote a move from a high cost medical model to a high value healthcare system, by harnessing the strengths of local citizens. The aims of the programme are to:
• Address inequality by improving the health of the poorest, fastest
• Reduce levels of worklessness, a cause and effect of poor health
• Reduce premature mortality
• There are three Well North sites in the NWC area - in Sefton, the Halton CCG area and West Lancashire CCG area.
• We have supported innovation projects in all of these regions, which are based on the needs of local people e.g. a troubled families coordination tool in Sefton, a social prescribing app in West Lancashire, the CATCH app to improve children’s health in Halton and also funding for a social prescribing platform for the ‘Baby Box’ programme to support expectant mothers across Halton.
Collaborating nationally
We contribute extensively to shaping and coordinating the national AHSN Network, particularly through our Executives’ time; our CEO is Chair of the AHSN Network; our Commercial Director is vice chair of the Commercial Directors Forum; and our Communications Director leads on Patient Safety Collaborative communications. Our Chair or our Vice Chair has been present at every AHSN Chairs meeting.
We continue to support national NHS priorities, such as the National Innovation Accelerator (NIA), which we have funded, supported and sat on the Board since the launch of the NIA. Some of the Innovation Fellows we have supported are as follows.
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Dr Penny Newman
We organised a large event for stakeholders in the North of England and led on communications to launch Innovation Fellow Dr Penny Newman’s health coaching initiative, Better Conversation. We have put in funding to enable the programme to be adopted across Lancashire and South Cumbria.
Dr Penny Newman said: “The Innovation Agency have been invaluable in supporting ‘Better Conversation’ and health coaching. From initial endorsement at the NIA programme board to help with writing resources, filming, communications and event management this led to a highly successful launch event in September in Liverpool and scaling locally and nationally.
“Thousands of clinicians are now using health coaching skills to better enable people to self-manage and help the NHS save costs. The programme is growing in Leeds, Lancashire, West Suffolk, Norfolk, Hertfordshire, Cambridge, London, Bristol and Somerset.”
Francis White
Francis White is the UK promoter of AliveCor mobile ECG monitors, which identify possible atrial fibrillation, a leading cause of stroke. We have promoted AliveCor along with another device, MyDiagnostick; and have invested £15,000 in devices which have been given to GPs, nurses and community staff as part of our AF stroke prevention programme in the North West Coast. In the last year, around 10,000 screenings were carried out, potentially identifying as many as 500 cases of atrial fibrillation and preventing an estimated 20 strokes, with a predicted saving to the NHS of £240,000.
Francis White said: “The support of the Innovation Agency has enabled AliveCor to reach increasing numbers of GPs and CCGs both in their region and nationally. Selling a low cost innovation presents unique challenges in getting the message across without large investments in teams and marketing (that would, in turn, put up prices).”
Maryanne Mariyaselvam
Maryanne Mariyaselvam has spoken at our events; and we promote the Non-Injectable Arterial Connector (NIC) in our presentations and also by including samples in our iBags.
The NIC improves the safety of all patients requiring an arterial line in operating theatres and intensive care by preventing wrong route drug administration.
It is being used in the following trusts in our region: Royal Liverpool and Broadgreen University Hospitals; The Walton Centre; Lancashire Teaching Hospitals; and University Hospitals of Morecambe Bay; and we are actively spreading it to other trusts through our personal contact with medical directors.
Clinical Entrepreneurs
We helped to design the Clinical Entrepreneurs programme and have continued to support the entrepreneurial junior doctors, through invitations to speak at our events and introductions. We hosted a Clinical Entrepreneurs pit-stop event on behalf of Professor Tony Young.
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National Innovation Programmes
We supported the development and announcement of the Innovation and Technology Tariff; and have been an integral part of the small national AHSN Network team, working with the Office for Life Sciences and the Department for Business, Energy and Industrial Strategy on the Accelerated Access Review.
Our work on the national clinical priority areas includes: • A health coaching programme, to change the way clinicians talk to patients, empowering them in
decisions about their care;
• A diabetes event focused on the health of haulage workers, who are a prominent part of the workforce in our region;
• Sponsorship of a number of technologies to support improved mental health;
• A mental health innovation learning set for our five mental health trusts;
• Sponsorship and promotion of an app for those caring for people with dementia that has been downloaded by 10,000 users.
We have funded and supported a number of innovations into the child and maternity vanguard including Episcissors, the Common Approach to Children’s Health (CATCH) app and a social prescribing platform for Baby Box.
Genomics
We have been a key supporter in the rollout of the 100,000 Genomes programme locally and nationally. At the beginning of the programme we supported bid-writing and pitching; and we sponsored the establishment of robust governance arrangements for the region-wide programme, with a view to rapid adoption and spread across the region. Liverpool Women’s NHS Foundation Trust lead the programme and we support them in a number of ways;
Our CEO is vice chair of the regional board, which monitors adoption and spread of the work. We sponsor the Programme Manager/ Adoption and Spread Ambassador role in the North West Coast Genomic Medicine Centre, for which we adopted a model used by the West Midlands AHSN; and our CEO sits on the Genomics England Steering Board.
In addition to supporting the national programme we have sponsored a pioneering, personalised medicine project in three hospitals involving genotyping of patients who are using warfarin, in anti-coagulation clinics.
The gene testing is carried out by simple mouth swabs which are analysed within minutes using desktop equipment provided by LGC, a life sciences measurement and testing company.
The results enable staff to prescribe accurate doses of warfarin, which reduces visits to outpatient clinics and improves the quality of care for patients. The work is led by Professor Sir Munir Pirmohamed of the University of Liverpool’s Wolfson Centre for Personalised Medicine and funded by the Innovation Agency and the NIHR CLAHRC NWC. A total of 113 patients were recruited and a study of results is due to be published in September 2017.
Our work supporting NICE Guidelines in relation to reducing alcohol harms in our region – understanding the barriers to uptake.
In 2015, we recognised the need for the development of a programme to reduce alcohol harms in our region and developed a range of activities to support this. One of the projects within the programme was working to support the NICE Implementation Collaborative (NIC) which looks at the barriers in uptake of the NICE Technology Appraisal (TA 325) relating to nalmefene – a product which helps high risk drinkers to reduce
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their intake of alcohol along with ongoing psychological support. Working in this area is challenging and we needed to understand the barriers to uptake of evidence-based information in the complex area of alcohol misuse. We were keen to ensure that insights into this issue were captured from our region in order to provide recommendations for commissioners in the field of alcohol misuse.
Key project objectives were to:
• Understand the key issues surrounding implementation of NICE TA325 and the steps required to overcome them
• Take stock of barriers to commissioning, service design, and implementation and prescribing
• Assess clinician awareness of nalmefene, TA325, and the supporting policies and pathways
• Highlight best practice where possible through case studies.
Participants in our area were:
• Liverpool CCG
• Blackburn with Darwen CCG
• Wirral CCG
• St Helens CCG
• St Helens Council
• Wirral CCG
• Wirral Metropolitan Borough Council
We were very pleased to publish the final report (in 2017) which the two contributing AHSNs (Oxford and Innovation Agency) shared with the national AHSN Network, regional CCG Medicines Management Leads, Local Authority Public Health Leads and stakeholders involved in alcohol services. This report also gives indicators into how patients can gain benefit from future innovations that are clinically effective and bring long term value and cost benefits to the NHS and social care.
Industry associations
We work closely with industry associations; both the Association of British Healthcare Industries (ABHI) and Association of British Pharmaceutical Industry (ABPI) have places on our Board. We worked closely with ABHI throughout the year and jointly organised a ‘Big Brains’ breakfast event to feed into the ‘grand challenges’ of the Industrial Strategy.
We presented to the ABPI patient and public involvement forum; and we worked closely with ABPI on the Closing the Gap programme. This involves working with three other AHSNs and Queens University Belfast, to embed clinical pharmacists in GP practices in order to review patients with multiple medications. We are working with two practices in Kirkby, Merseyside and Pendle, Lancashire, who have recruited more than 80 patients onto the programme. Early indications show successful interventions by the pharmacists in reducing inappropriate medications. The evaluation report will be published in autumn 2017.
A secondee from Bayer is currently working with us on the AF Collaborative.
With our regional partners BioNow and Medilink, our work includes sponsoring their annual awards and working together on regional programmes.
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Our work with universities
Since our inception we have worked very closely with our academic partners. In 2016 they asked us to move away from networking and into supporting them with funding and roles within the healthcare system. We have done this by involving them in:
• Evaluation of key regional programmes • Investment in Innovation Hubs on their sites, providing support for businesses who are tenants and
networking the hubs to share good practice
• Supporting them with funding bids, being a key partner in these and networking them with potential partners
• Supporting specific training programmes, e.g Post Graduate Medical Programmes
• Involving them in key programmes, e.g Connecting Health Cities
• Delivering programmes on behalf of the Innovation Agency e.g digital health programmes for health professionals and our regional evidence-based commissioning programme
• Five out of our nine universities are now represented on our Board, helping to shape our work plan
Our work with Local Enterprise Partnerships (LEPs)
We have a strong relationship with the four LEPs in our region. Since the inception of the Innovation Agency we have invested funding into our LEPs and 12 months ago co-resourced a post with Liverpool LEP, which has yielded great results.
The post holder was responsible for:
• Leading the work to obtain Interreg Europe infrastructure funds worth more than £300,000 for Liverpool City Region partners and around £1.7m for all partners across Europe;
• Aligning Living Lab activities in the Liverpool City Region and improving health innovation economic policy
• Supporting potential inward investment in health and life sciences across Liverpool City Region worth more than £140m over the past year
• Establishing a Liverpool City Region Life Sciences and Health Board to oversee the industry growth strategy and associated implementation plan for the region
• Delivery partner for the Liverpool City Region ERDF funded business support project.
“The Innovation Agency is a key partner for the Liverpool City Region Local Enterprise Partnership. The organisation’s willingness to collaborate and co-fund activities, has meant that we have been able to support the region’s health and life sciences sector to a far more significant level with demonstrable commercial
Our public and patient involvement (PPI)
In 2016 we recruited a lead for patient and public involvement, Debbie Parkinson, who established a Patient Involvement and Engagement Senate (PIES), meeting regularly and getting involved in different aspects of the Innovation Agency’s operations.
PIES membership includes ten patients with conditions including COPD; four patient governors from Lancashire Teaching Hospitals; Blackpool Teaching Hospital and Liverpool Heart and Chest Hospital; patient advocates from British Lung Foundation and Dementia Care; and local residents with an interest in different health topics.
The strategy is to involve the patient voice in our programmes of work, through the Senate and through direct contact with patients in hospitals and through patient charities, on relevant work programmes.
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PPI: Connected Health Cities
The Senate focuses on the North West Coast Connected Health Cities (CHC) programme, about sharing data to improve health; and members supported a Citizens Jury for the wider North of England Connected Health Cities programme.
They have been learning about the use of healthcare data and different approaches to gaining patient consent. Guest speakers have included commissioners from Liverpool CCG; CEO of AIMES Grid Services; University of Liverpool CHC Project Manager; CHC Programme Lead and Innovation Agency senior staff.
Various Breathe Easy support groups have been visited and patient stories have been written and published on the CHC website; as well as a blog and a PIES newsletter.
PPI: Changing how we work
The Innovation Agency now embeds the voice of the patient in its programmes of work and involves Senate members operationally, for instance:
• Patients are invited to speak at Innovation Agency events such as hackathons and Ecosystem events;
• Senate members join our staff recruitment panels;
• A Senate member joins the panel for shortlisting NWC Research and Innovation Awards;
• A model of patient consent for CHC has been directly informed by Senate members;
• Patient and public feedback is now included on all new products showcased on our Innovation Exchange.
PPI: Other programmes of work
The Senate is involved in patient safety and members have been helping to review our Patient Safety Collaborative strategy.
The PPI Lead helps to provide public feedback on new technologies. An example is the development of a mobile phone based self care technology in our European funded ENSAFE project, which benefitted from feedback from a focus group organised by the PPI Lead.
Other focus groups have been formed through working with patient centred organisations such as Genie in the Gutter, to gain views on data sharing as part of the Connected Health Cities work.
The PPI Lead attends outpatient clinics relevant to CHC programmes, to talk to patients about their views on shared data – and to explain the benefits of joining up information systems.
She has been called on by senior nursing staff at the Royal Liverpool and Broadgreen University Hospitals. to help set up new patient groups – for ME sufferers; and for alcohol related brain injury patients.
She regular provides presentations to community groups around the North West Coast and is helping to strengthen our involvement in important work streams in our region.
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PPI: Widening our networks
The PPI Lead belongs to various groups including the AHSN PPI Network; 100,000 Genomes PPI Board and Operational Management Group; INVOLVE Diversity and Inclusion sub-group; Connected Health Cities work streams; AQuA as a PPI member; and the MY Data patient group.
Comments from colleagues:
Andy Shakeshaft, Associate Director:
“The patient’s voice is heard on innovations which have been implemented across the North West Coast which are included as case studies on the Innovation Exchange. This has enabled us to sense check our innovations and ensure they are in line with patient expectations.”
Dr Julia Reynolds PhD, Associate Director, Connected Health Cities programme:
“Our PPI Lead has sought the views of locally based groups such as the Breath Easy groups (COPD), Whitechapel and Genie in the Gutter (alcohol service users) and epilepsy support groups in Preston. These relationships are crucial in helping us develop our model for implementing patient information sharing preferences in our region.”
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HOW WE DELIVERED AGAINST OUR GOALS FOR 2016/17Our regionally agreed goals were to:
• Accelerate delivery of safer, better care
• Develop a network of health innovation centres
• Support economic growth through small and medium-sized enterprises (SMEs) and industry
• Drive digital innovation, empowering citizens and workforce
Goal 1: Accelerate the Delivery of Safer, Better Care
The Innovation Agency forms part of the network of Patient Safety Collaboratives across England funded by NHS Improvement. Each network empowers local patients and healthcare staff to work together to identify safety priorities and develop solutions.
Our Patient Safety Expert Group meets quarterly to review progress and develop the strategic approach to patient safety for our region.
We have commissioned and delivered leadership programmes for patient safety, further developing our network of patient safety champions.
Recognition of Sepsis and rapid access to treatment is a national priority. We have led the national AHSN sepsis cluster and commissioned a report of the readiness of provider trusts to adopt the NICE sepsis guidelines. Our work has also included the development of an e-learning tool aimed at care home staff to facilitate the early detection of sepsis. Working with the Sepsis Trust and others we are coordinating efforts to standardise and deploy early warning scores system wide.
We organised a hackathon focused on care of deteriorating patients, in collaboration with the Royal Liverpool and Broadgreen University Hospitals and the University of Liverpool. This resulted in several ideas which we are now supporting, including the winning idea for a campaign to improve hydration in acute care.
Former sepsis patient Julie Carman, a volunteer with UK Sepsis Trust, spoke about her experience at the hackathon. She said: “A series of seemingly small failures led to delays which almost cost me my life. I know that no one involved in my care deliberately meant to cause me harm but never the less my recovery was very slow with massive personal cost to me, my family and additional financial costs for the NHS.
“We can all do something… increase awareness of sepsis; ensure a care plan is in place to treat sepsis promptly; and offer ongoing support to patients.”
We have sponsored a project in care homes to highlight to carers, family and potential care home residents what they should be looking for in a care home. Our care home guide is available to the public through HealthWatch.
In addition to the above we have sponsored work to prevent falls in an elderly population, building on the award-winning Steady On Programme.
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Preventing atrial fibrillation-related strokes
We continue to promote diagnostic and treatment innovations in atrial fibrillation (an irregular or fast heart rhythm), which has been part of our successful programme of work to reduce strokes since 2013.
We calculate that this work has led to 256 potential stokes being avoided, potentially saving around £5.6m in NHS resources:
There are more than 10,000 people with atrial fibrillation (AF) who are not receiving optimal treatment in the North-West Coast. People with AF who are untreated or whose treatment is not effective are at a five-fold greater risk of having a stroke compared with the rest of the population.
Through public campaign work in Merseyside and Lancashire and use of innovative technology, abnormal pulses were detected in more than 60 people. More than 60 patients are now receiving treatment to preventing stokes, predicted to save at least two extra visits to clinic (120 clinic visits per year).
130 AliveCor Kardia devices have been distributed to GPs and nurses in the region and 30 MyDiagnosticks are now in GP surgeries, pharmacies and in adult social care. MyDiagnosticks can screen about 100 patients per month; the Kardia can screen about 50 per month per user.
For every person identified with AF out of this screening, the research shows that one in 25 would have had a stroke in the given year.
More than £250,000 worth of matched investment has been pledged by partners who include LGC, Bayer, Boehringher-Ingleheim, Pfizer and Diiatchi-Sankyo and Bristol Myers-Squibb.
Working in collaboration with Greater Manchester AHSN we rolled out an AF landscape tool in a dashboard format dashboard which summaries outcomes of people with AF in each CCG area.
North East and North Cumbria AHSN have produced the Atrial Fibrillation – a step by step guide, simple guidelines for GPs and other clinical staff detailing what to do when a patient presents with AF. This has been a useful support guide for our AF Collaborative community and we have distributed 500 copies.
This year has also seen the start of genotype guided dosing for warfarin patients in anticoagulation clinics. This is a ground-breaking programme and is supported by our region’s expertise in pharmacogenetics. We rolled out this pioneering programme to three hospitals – the Countess of Chester, Warrington and the Royal Liverpool. It is led by the Wolfson Centre for Personalised Medicine at the University of Liverpool in partnership with ourselves, the NIHR CLAHRC NWC and international life sciences measurement and testing company LGC. An evaluation is being carried out by the University of Liverpool and Lancaster University.
Through our Medicines Optimisation work stream we have supported the ‘Closing the Gap’ project which is trialling the role of embedded pharmacists in GP practices. We are supporting two GP practices in our region which are part of this project, Wingate Surgery in Kirkby, Liverpool and Pendle View Surgery in East Lancashire. We are one of three AHSNs in England (with Wessex and East Midlands) participating alongside Northern Ireland; this project is being evaluated by Queens University, Belfast.
Electronic transfer of care
In the last year, we have supported an electronic transfer of care project at East Lancashire Hospitals, based on the system Refer to Pharmacy.
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This enables electronic transfer of discharge information to community pharmacists and GPs, to improve safety and reduce medicine wastage.
Based on evidence from the last year, the hospital has reduced readmissions by 0.8 per cent or 60 patients, saving £200,000.
We have now been funded by NHS England to roll out electronic transfer of care systems to 12 trusts in our region, in a pilot study which will be evaluated by a university partner.
So far, we have enrolled two sites which will be adopting different IT systems, PharmOutcomes at Countess of Chester Hospital and Refer to Pharmacy at Mid Cheshire Hospital. Ten other trusts have expressed an interest in participating and roll out plans are being developed for the coming year.
In 2016 we hosted a successful Diabetes Summit which focused on patients who hold HGV licences and have associated life-style issues, which cause diabetes.
We supported Lancashire Healthwatch’s ‘Enter and View’ programme which led to the production of a toolkit to help care homes plan service improvements; and the production of a ‘Mum’s Test Checklist’ to help families choose a care home for a relative. The work provides insight for the care home providers into how their services are perceived and at the same time provides assurance to commissioners regarding the quality of services on offer in this sector.
One of the main aims of our patient safety programme is to build capability and capacity for safer care. We have supported leaders in our region and we commissioned our improvement partner, AQuA to deliver leadership and improvement courses.
This included 13 bursaries for senior NHS colleagues to take part in an Accelerated Patient Safety Programme hosted by AQuA and delivered by the Institute for Healthcare Improvement.
One of the 13 was Dr Maryam Crews, Royal Liverpool and Broadgreen University Hospitals:
“(As a result of the learning) We’re looking to change the way we change….encouraging greater staff engagement in the process across the board, allowing enthusiasts to lead their own projects but with help from those with experience of enthusiasm in QI and using PDSA methodologies to undertake small tests of change. It’s a large scale and ambitious change in the way we do things, but we have the perfect environment to undertake QI initiatives so it’s welcomed.”
We funded training to develop middle managers as leaders of quality improvement and safety, with 25 people on each of two cohorts on a five day development programme. The course covered understanding safety data, leading patient safety reviews, culture and organisational development and lessons from outside the NHS.
Following the success of a ‘skills for safety improvement’ course the previous year, we funded a further three cohorts of 30 people to undertake this course, which included practical skills in resilience, human factors and appreciative inquiry using action learning.
In the coming year, we have partnered with the Health Foundation to recruit individuals from our region to the Q community, to improve health and care quality.
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Active and healthy ageing
The Innovation Agency was one of four Northern health organisations which received international recognition for work on active and healthy ageing, after applying to be a three-star ‘reference site’ for the European Innovation Partnership on Active and Healthy Ageing.
The European Commission defines a Reference Site as ‘regions, and cities, integrated hospitals/care organisations that implement a comprehensive, innovation-based approach to active and healthy ageing and can give evidence and concrete illustrations of their impact on the ground’.
The four also included Greater Manchester AHSN, North East Coalition for Active and Healthy Ageing, and Yorkshire and Humber AHSN. The Innovation Agency was recognised for an ‘innovative and comprehensive approach to healthy ageing with concrete evidence of the impact of their work on patients’ health’.
John Farrell, formerly from the Department of Health, Social Services and Public Safety, Northern Ireland, said:
“I would like to congratulate the Reference Sites in the North of England on their recognition as being among some of the most advanced Reference Sites in Europe. Their collaborative approach in engaging health and care providers, government, industry and researchers in the development and adoption of innovative solutions have helped to improve health and care outcomes for patients, and offered new models and approaches which will help transform the way services are delivered. This recognition along with the technological and innovative solutions being developed will help to open new commercial markets across Europe and beyond.”
Our work over the next year will focus on reducing frailty and increasing the number of healthy life years for our older citizens.
Goal 2: Develop a network of health innovation centres:
Each year the Innovation Agency earmarks funding to invest in projects or initiatives to stimulate change and to support its partners and local economy. To play our part in addressing limited infrastructure to support the health and life sector in the region, in 2014/15, we invited all regional partners to apply for funding to support innovation infrastructure development.
We provided investment totalling £956,000 which in part, enabled these projects to secure significant funding from other sources including the NHS, universities, industry, EU and UK Government.
This led to the development of the following innovation facilities:
• Health Innovation Campus, University of Lancaster, due to open 2019
• Liverpool bio-innovation hub, the William Duncan Building at University of Liverpool, opened February 2016
• Alder Hey research and education centre, Institute in the Park, opened October 2015
• Alder Hey Innovation Centre for digital and sensor technologies opened March 2016
• Centre for Integrated Health Science, Chester, Countess of Chester NHS Foundation Trust and Cheshire and Wirral Patnership opened April 2015
• Accelerator Hub, Royal Liverpool & Broadgreen University NHS Trust due to open summer 2017
• Chorley Digital Park, planning permission granted and development due to complete 2018
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These investments have helped establish a sustainable regional infrastructure, creating jobs, developing skills and attracting research funding and inward investment over the long term.
Subsequently we have worked with each of the centres to showcase their key assets and develop their strategies and collaboration networks.
• Where the funding was used to provide match for much larger funding bids we supported the writing of bids
• Where needed for collaboration we introduced partners
• We engaged local SMEs so they could input to the design phase based on their needs for incubation space
• We introduced project leads to other established incubators for advice and inspiration
• We have showcased to key stakeholders (eg DIT, KTN and Innovate UK) to support inward investment and funding applications.
For large, capital projects such as the William Duncan Building in Liverpool; and the Institute in the Park at Alder Hey Children’s Hospital, our funding was used as part of the match required to secure significant EU funding.
With the Innovation Hub at Alder Hey we funded the development of a 1000sqm space underneath the new hospital which enabled the trust to leverage ‘in kind’ contributions from developers and industry partners. The centre is now open and has hosted hackathons, supported by the Innovation Agency, to develop ideas with local SMEs and academics to address problems faced by the staff. One of these ideas is now becoming a reality; with the Innovation Agency’s support, a local SME recently secured €50,000 to develop the solution.
Funding of £25,000, matched by Chorley Borough Council, led to a successful proposal to develop a digital campus that will house smart homes and an SME incubation centre; this secured £4.1m ERDF funding towards the £8.4m development.
For Lancaster University our support was provided in the form of funding for an Entrepreneur in Residence post to provide dedicated resource to develop the business plans for the Health Innovation Campus. This development has now secured £41m.
More than £100m of investment into the region has been leveraged by these projects. The support of the Innovation Agency has had a significant influence on this achievement, whether this has been financial support or as a resource to work with the various centres, to become operational and establish partnerships.
Cath Burns, Employment Skills and Business Support Manager, Chorley Borough Council, said: “By working in partnership with the Innovation Agency, and using both their expertise and funding, we have been able to significantly advance our vision for Chorley to become a key hub for digital health business growth in the UK.”
Some of the innovation centres we have supported will facilitate patient and public involvement. The digital hub in Chorley will include a living lab, in which residents will be involved in developing Internet of Things-enabled smart homes solutions alongside SMEs.
Similarly, the Innovation Team at Alder Hey Children’s Hospital have secured ERDF funding to work with local SMEs to co-create innovative solutions in the Innovation Hub.
Co-creation of products with end users will lead to the right products being developed for specific needs, which in turn will improve performance and outcomes of care.
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During 2016/17 we have continued to work with each centre and have agreements in place with each of them including;
• Provision of ongoing support to all centres to secure further funding and shape strategies
• Supporting SMEs within the facilities to drive development and adoption of new healthcare technologies
• Continuing to grow the regional infrastructure, creating jobs, developing skills and attracting research funding and inward investment
We established an Economic Growth Steering Group in 2016 including representatives from local universities, the Knowledge Transfer Network, Local Enterprise Partnerships, and regional business networks Medilink NW and Bionow. This group is now supporting us to deliver a region wide strategy, building on the combined strengths and complementary strengths of all health innovation centres in the region.
Goal 3: Support economic growth through SMEs and industry
Innovation Agency Business Connect programme
Part of the role of the Innovation Agency and the AHSNs nationally is to support the health and economic wellbeing of our populations by supporting the adoption and spread of innovative healthcare products and solutions at scale and pace into the NHS market. A large proportion of this support is delivered to SMEs, a sector which employs more than 85 per cent of all employees nationally.
In the last year the intensive support we have provided to small and medium size businesses in our region has led to funding of £2m, the creation of 17 additional jobs; and we have played an active role in helping to secure a total of 49 contracts for businesses and NHS Innovation Fellows.
The AHSNs are unique in being able to offer a healthcare specific range of business support interventions including:
• Clinical input to product development
• Procurement and tenders
• Clinical evaluation
• Real world validation
• Access to clinical experts
• Establishing collaborations for co-development of new products with end users
• Driving the adoption of new technologies in the NHS
• Developing the business case for adoption
• Help with tailoring marketing for the NHS
• Support to target finance (grants, venture capital etc.)
It is very difficult for a small business to ‘sell’ their healthcare innovation into the NHS, yet it is well known that many of these organisations have the technology to support the transformation of services.
AHSNs have a pivotal role in supporting trusts and CCGs to innovate in the way their services are provided in order to meet the challenges of the gaps identified, by driving the adoption and spread of relevant healthcare innovation. This in turn supports SMEs to grow and to employ more staff, and to develop new healthcare innovations.
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A strategic decision was taken to look for ways to expand the capacity of the Innovation Agency to meet the demand for support from healthcare SMEs across the patch. We identified funding opportunities within the European Regional Development Funds (ERDF) that could be used to support health and life science SME growth, product commercialisation and job creation and submitted three SME support bids (as lead delivery partner in two bids and in collaboration as a delivery partner with a third bid).
We were successful in gaining all three bids which cover three of the four sub-regions within the Innovation Agency footprint, leveraging a total of £3.5 million of European Regional Development Funds to support at least 282 SMEs over the next three years. This is supplemented by £3 million match funding from our partners, making a total investment of £6.5 million
This means that we can offer a much larger programme of healthcare SME business support. In summary:
• We will support 282 healthcare SMEs
• SMEs will recruit 156 additional members of staff; jobs will be created due to expansion through successful funding applications, investment and product commercialisation
• 34 SMEs’ new products will be launched into the healthcare market
• 74 new products will be developed to address unmet healthcare needs
• 49 start ups will be supported to innovate and access the healthcare market
This builds on a successful record of working with small businesses to bring innovative healthcare products into the NHS, creating jobs and improving care provision.
Dr Jonathan Day, Leanvation, said: “It is only as a result of the intervention of the Innovation Agency’s commercial team that we were able to break through barriers to joining NHS frameworks. It was the breakthrough we were waiting for; there is strict governance in the health service which means that only a limited number of approved companies are allowed to provide supplies.”
Dave Burrows, Managing Director, Damibu: “Our connection with the Innovation Agency is a core part of our business. As well as general support through EcoSystem events and newsletters, we’ve had specific support which resulted in gaining funding for what is going to be one of our key future products. I am continually surprised about how open and helpful all staff members are.”
Damibu were given help to apply to the European Institute of Innovation and Technology (EIT) Health Accelerator fund, successfully securing €50,000 to develop an idea into a market ready product. The idea came from an Innovation Agency-sponsored hackathon; an interactive dashboard display to guide medical teams when resuscitating patients in life threatening emergencies.
Henry Pinchbeck, CEO, 3D LifePrints: “Thanks to the support of the Innovation Agency in the last year, 3D LifePrints have maintained our existing workforce and hired an additional two staff members in the region. Once the (Transformation Through Innovation) grant from the Innovation Agency is received it will enable 3D LifePrints to hire a further two staff to work in and around the Royal Liverpool and Liverpool Heart and Chest hospitals.”
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SBRI
We support the Small Business Research Initiative (SBRI), ensuring local businesses are aware of the opportunities and supporting those which are successful in securing funds. We also assess funding grants so that this gives us the knowledge to support our companies who are submitting applications.
Transformation Through Innovation Fund
To support our NHS partners to achieve their 5YFV ambitions, we offered the opportunity to bid for a grant through a Transformation through Innovation Fund in 2016/17.
There were 64 applications and an external expert panel of judges reviewed those shortlisted. Twelve projects were funded, with a total spend of £483,000. These are projects which will improve treatments, monitor health remotely and reduce hospital admissions:
• Video consultations at home for outpatient appointments at St Helens and Knowsley Teaching Hospitals NHS Trust – reducing pressure on outpatients and decreasing inconvenience for patients;
• Using 3D printed models of organs to support surgery preparation at two Liverpool hospitals, this work is a regional adoption and spread programme;
• Expanding a teletriage programme in Wirral care homes;
• Spreading the CATCH app from Cheshire to improve children’s health in Halton;
• Spreading the successful ‘Baby Box’ programme to expectant mothers across Halton with additional online support;
• A social prescribing app to help GPs support their patients to change lifestyles and reduce reliance on health services in Skelmersdale;
• Portable technology to improve the care of patients with atrial fibrillation, in East Lancashire;
• A falls prevention programme in Lancashire residential homes;
• A Lancashire and South Cumbria health coaching initiative to give patients more control of their own health and care;
• A gaming app for childhood asthma;
• Lancashire wide capability for digital connections between any member of staff and the general public, to support new models of care; alongside alignment of NHS Lancashire email systems enabling secure email between health and social care staff and citizens;
• Suppport for the implementation of the Warrington Care Record
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Partnerships
We set ourselves the challenge to establish collaborative partnerships with larger companies and international organisations to support pathway transformation and now have agreements and / or collaboration plans in place with the Massachusetts Institute of Technology, Pfizer, Bayer, Roche, Amgen, Diiatchi Sankyo, Lundbeck, Medtronic and Boehringher-Ingleheim.
We are also in discussions with two pharmaceutical companies regarding collaboration and support for further collaboratives in other disease areas in 2017; these are chronic obstructive pulmonary disease (COPD) and heart failure. We also have plans to apply for further funding in 2017/18.
We host an Industry Expert Group, which meets quarterly to share our activity updates and consider future work together.
Organisation Nature of CollaborationMassachusetts Institute of Technology Co-design and facilitation of health and care
hackathons and a National Innovation Leadership Summit due to conclude in 2017
Lundbeck Funded report for National Innovation Centre on barriers to uptake of drugs to reduce alcohol consumption. Completed Oct 2016
Roche Supporting the roll out of self-monitoring of warfarin patients in Lancashire alongside the Innovation Agency. Exploring potential collaborations in Europe through EIT Health partnership
Amgen Funded Pharmacist to work with GP practices to identify patients with osteoporosis
Medtronic A programme manager sits on steering group of the LinQ project
BMS-Pfizer Awarded £100k from Medical and Educational Goods and Services (MEGS) AHSN innovation fund, to support the development of innovation in the anti-coagulation pathway
Bayer Joint working agreement has been signed enabling us to obtain access to audit and case finding support and a project manager who has been seconded to the Innovation Agency to work on our North West Coast AF Collaborative
Boehringher-Ingleheim Diiachi-Sankyo
We are working to identify opportunities to collaborate through MEGs and possible joint workin arrangements
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We are also in discussions with two pharmaceutical companies regarding collaboration and support for further collaboratives in other disease areas in 2017; these are chronic obstructive pulmonary disease (COPD) and heart failure. We also have plans to apply for further funding in 2017/18.
We host an Industry Expert Group, which meets quarterly to share our activity updates and consider future work together.
Goal 4: Drive digital innovation that empowers citizens and the workforce.
Digital technology is a crucial enabler in the transformation of health and social care and throughout the last four years the Innovation Agency has supported digital innovation at a number of levels:
• We have sponsored the adoption of individual atrial fibrillation diagnostic digital technologies such as AliveCor and MyDiagnostic in a range of settings including playing a role in the Cheshire Safe and Well service led by the Fire and Rescue Service;
• We are funding a pilot study in Lancashire of Diasend for patients with Type 1 diabetes to self-monitor at home. It consists of a small transmitter device, plugged into a standard electricity socket, enabling test results stored in patients’ blood glucose meters to be automatically uploaded to a secure web server;
• We provided funding for the roll out of 500 licenses for the Lincus app in Liverpool City Region, to allow people to monitor their mental health and wellbeing;
• In East Lancashire we funded a project with MyHealth targeting nine GP practices which are monitoring patients using warfarin, to create a system to support self-monitoring. Patients self-monitor by using devices such as the AliveCor Kardia plus the app MyHealth, which feeds information back to the clinic and ultimately saves frequent clinic visits;
• We have funded the spread of a free health app, CATCH, for parents of children aged 0 – 5, to reduce dependency on NHS services in Halton. During August and September 2016, Eastern Cheshire CCG received 122 survey responses from 1,535 users, which indicate high satisfaction by users and a cost saving to Eastern Cheshire CCG and Southern Cheshire CCG of £2,889, with a total estimated saving of £23,556, within the two month period;
• We are supporting the trial of FebriDx, a point of care test which distinguishes a virus from bacteria;
• We have promoted the use of apps and web-based tools as a means of accessing healthcare services, such as House of Memories, which was developed in Liverpool and now has 10,000 users nationwide;
• We have supported My mhealth who have supplied 5,000 licences for myCOPD, myDiabetes and myAsthma to Knowsley CCG;
• We have supported partners in their ongoing journey towards digital interoperability, notably the Lancashire Person Record Exchange Service (LPRES) and data sharing.
• We supported the applications of Global Digital Exemplars and we will support their work throughout the life of the programme.
• We have networked digital entrepreneurs with our NHS organisations through our quarterly Ecosystem events and other events, for example a round table discussion at the Liverpool City Region Health is Wealth conference; and individual introductions.
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Connected Health Cities is a £20 million, learning health system across the North of England. The Innovation Agency leads the North West Coast programme. With our partners in the region we have established a team who will create insights, from routinely collected data in multiple organisations, into care pathways in the areas of alcohol misuse and use of unplanned care services, COPD and epilepsy.
During the year, a data ‘ARK’ has been constructed by AIMES Grid Services on their Liverpool site which is ready to receive data, having been tested and found to meet the necessary information governance and data security requirements.
In Lancaster University, four PhD students have been recruited to the project who will explore areas including human/computer interaction and models of consent.
Meanwhile in the University of Liverpool the Analytics Hub Team has been recruited into the department of Biostatistics, ready to generate the algorithms to analyse the aggregated dataset. This is the first project of its kind in our region and we have started to engage the public and a number of charities and groups to build on our conversation around data sharing and patient information sharing preferences. We have also facilitated this through our participation in citizen juries, which helps us understand in depth how people understand data and public services.
In other work, we are developing a Regional Digital Strategy for which an expert group has begun to meet during the year. This blueprint will build on the local CCG digital roadmaps and incorporate the major areas of interoperability work that is already established in the region such as LPRES in Lancashire, iLINKS in Merseyside and the Wirral and Cheshire shared record programmes.
We have supported bids towards Global Digital Exemplars and are delighted that three of our local trusts have been awarded this status. Their contribution will be integral to our digital strategy and our strategy will be partly based on their programmes.
In Lancashire and South Cumbria we provided £50,000 which was match funded by Health Education England, to explore the potential for developing a Digital Health Skills Academy and this was used to:
• Set up and deliver an Academic Digital Health Module for students delivered by Cumbria University to 25 health and social care professionals;
• Undertake an audit of patient generated social media profiles across all practices;
• Support Healthwatch Lancashire with a review of digital needs across primary care in Lancashire;
• Develop a programme across primary care to support the development of staff and patients with long term conditions to use ‘low tech’ solutions as well as increase uptake in online services;
• Review the current landscape in relation to the delivery of digital health learning resources and provide a demonstrator design for a Virtual Digital Health Skills Academy to address any gaps in current provision and to prepare the regional workforce for the future.
This work has highlighted that a Digital Health Skills Academy could be of great value to the region not only in terms of workforce development but also to support wider investment programmes designed to increase online access and promote self care.
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EUROPEAN PROGRAMMES
We are key partners in a number of European programmes, mainly focused on digital innovation and active and healthy ageing.
Sustainable Technology for Older People – Get Organised (STOPandGO)
STOPandGO is a Public Procurement of Innovation pilot project co-funded by the ICT Policy Support Programme of the European Union. The goal of STOPandGO is to produce and validate reference material that will support the development of coherent procurements across Europe regarding the provision of innovative healthcare and social services enhanced by technology, for elderly people.
The STOPandGO procurement process focuses on the integration and the simultaneous improvement of models of care and cure, to provide services augmented by a coherent set of interoperable technologies. It is hoped that the project will benefit more than 5000 citizens and service areas will include integrated care, domiciliary care and dementia.
There are multiple partners across four countries - UK, Netherlands, Italy and Spain. The Innovation Agency is one of the knowledge partners in the UK together with procurement partner Liverpool City Council.
The domiciliary care services proposed in the UK will benefit a significant number of citizens in our region. The €4m procurements from the project receive a generous contribution from the EU, further supporting the providing partners in the region. We have secured an initial £612,000 for Liverpool City Council and we hope to secure more funding for the region from this programme.
Elderly oriented, Network based Service Aimed at independent liFE (ENSAFE)
ENSAFE - is a European Ambient Assisted Living programme which aims to trial technology interventions with older people with mild to moderate care needs to improve their life outcomes.
Following extensive end-user consultation and subsequent technology development, four pilot testing sessions are due to start in different EU countries to trial a variety of smart phone and sensor-based systems. In the UK, we are collaborating with Riverside Housing and a local SME, Ice Creates, to provide a mobile phone-based system of monitoring health, connecting users to a wider care network, to promote independence.
Horizon 2020 funding for Liverpool Heart & Chest NHS Foundation Trust
We helped Liverpool Heart and Chest Hospital to secure almost £1million EU Horizon 2020 funding to enable an innovative way to procure technologies which will help patients with bradycardia, a slow heartbeat.
This is part of the Ritmacore programme, which aims to deploy an innovative service for patients with bradycardias in a number of hospitals across Europe.
We are working to secure opportunities for other hospitals in the North West Coast to participate and benefit.
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EIT Health KIC
The Innovation Agency is an Associate Partner of the European Institute of Innovation and Technology Health Knowledge and Innovation Community.
EIT Health promotes entrepreneurship and innovations in healthy living and active ageing. It enables citizens to lead healthier and more productive lives by delivering products, services and concepts that improve quality of life and contribute to the sustainability of healthcare across Europe.
In the last year we have received funding from the EIT Health Accelerator programme, through which we will provide support to SMEs from six European countries to bring their health-related products to new markets. We hope to support up to three new businesses to establish new companies in the UK.
In 2016 one of our local SMEs, Damibu, was awarded €50,000 EIT funding after their involvement in one of our hackathons. We continue to promote funding and partnership.
Digital Hospital Transformation Short Course (SHiFT)
We have been approved as a partner in developing and delivering a four day intensive course for senior healthcare professionals about digital hospitals, in Budapest, August 2017.
With 30 places available, the course aims to support and develop leaders of the future in transformational digital health technologies. We have secured 12 fully funded places on this programme for professionals from our region.
Assistive Living Technology and Skills – ALTAS
We are a partner in this EU project to develop online learning for health and social care staff that will ultimately enable their clients to benefit from smart solutions to live independently, self-care and improve their health and well-being.
Once completed this package of e-learning will be rolled out across Europe. Our role is to disseminate the learning to stakeholders.
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ORGANISATIONAL CAPABILITIES
We developed three core capabilities to drive delivery of our principal Goals, as follows:
Capability 1: A broker of collaborations and networks
We do not work alone; achieving the objectives of our region and nationally always involves collaborations, so our networks are essential. We have set up and are organising or supporting the following groups of health professionals in our region.
Innovation Scouts
We now have 70 Innovation Scouts, largely across the NHS but increasingly, also in local government and university sectors. In the last year we have set up a new sub group of Scouts for mental health.
We have engaged across the health and care ecosystem with a clear focus on using digital solutions and developing an innovative culture to achieve improvements and better value. We have offered skills and resources through expert knowledge, mentorship, coaching and virtual learning opportunities.
In the past year, the Scouts have taken part in workshops, networking and visits to innovative organisations in this country and internationally. Innovation Scouts are selected by Chief Executives and typically are directors, senior managers or clinicians.
What the Innovation Scouts say
Scouts were surveyed about the benefits of the network and asked, ‘What has been the biggest benefit to you?’ They answered:
“Broader, wider networking, sharing (and pinching) ideas.”
“A new innovation competition launched in my hospital.”
“Connections with health/academia/industry that were not otherwise possible.”
“The Scouts programme combats the potential feeling of loneliness that accompanies innovators.”
Innovation Scout Awards
We presented a total of six bronze and ten silver awards at the Innovation Scouts’ second anniversary event; and one gold award, to consultant paediatric surgeon Mr Iain Hennessey, Clinical Director of Innovation at Alder Hey Children’s Hospital in Liverpool.
The awards recognised the contribution made by Scouts to their own organisations and to the wider health system, spreading knowledge and introducing innovative technologies and approaches which they see working well elsewhere.
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Collaborating on 3D printing of organs
A collaboration between surgeons at three North West Coast hospitals started with an introduction at an Innovation Scouts event. They were connected after a Scout from Liverpool Heart and Chest Hospital was introduced to 3D printing of organs by a Scout in Alder Hey Children’s Hospital, where they have been pioneering the use of 3D models.
The models are rendered using images from MRI and CT scans and are 3D printed on site in a variety of materials by 3D LifePrints. The collaboration has now extended to the Royal Liverpool and Broadgreen University Hospitals, following a successful bid to the Innovation Agency’s Transformation Through Innovation Fund.
One of 3D LifePrints’ productions was a heart with a blocked pulmonary artery, which helped the surgeon to plan the first incision and to brief his team, leading to a successful operation to remove the blockage.
Specialist cardiology registrar Dr Rob Cooper said: “If by using a 3D model of a heart we reduce surgery time by just 30 minutes, we avoid complications, improve the chances of success and reduce costs.”
OD leads network
We have facilitated meetings of organisation development leads from across the region to form a network through which they can support the innovation agenda and connect with like-minded colleagues.
Quality improvement network
We sponsored an ‘Ignite’ event which led to the creation of a clinical network of 170 quality improvement enthusiasts and specialists; and a system-wide hackathon incorporating human factors, from which the outcomes were a number of solutions which have the potential to improve patient safety.
Q community
The Innovation Agency has partnered with the Health Foundation to grow the Q community in the North West Coast. Q is a connected community working together to improve health and care quality and connects people with improvement expertise across the UK.
We are leading on recruitment in our region during March and April 2017 and we will be creating opportunities for people to come together as an improvement community – sharing ideas, enhancing skills and collaborating to improve health and care.
AF Collaborative
We have established an AF Collaborative to share best practice and provide training and peer support for GP practices with an interest in the effective identification and management of patients at risk of a stroke due to AF. This approach combines best practice and quality improvement techniques, alongside innovative case finding and detection technology such as the AliveCor Kardia device.
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Events
We run events throughout the year which bring together partners from different sectors with whom we are collaborating, to address clinical priorities and to encourage the uptake of innovations.
We have increased the impact of our events through improved communications to share resources following events, such as videos and presentation slides, promoted through social media. In 2016/17 we ran 27 events, including hackathons; and sponsored or had stands at a further 17 events focused on showcasing innovation and good practice.
An example in the last year was our diabetes summit for employers of long distance haulage drivers. This attracted large businesses including Eddie Stobart and Biffa Waste Management, and led to a pledge from the companies to raise awareness of Type2 diabetes. They will promote ways of avoiding the risk of developing diabetes; and the need to manage the condition, particularly among those who drive for a living where the impact of collapsing at the wheel of a lorry has the potential to cause multiple fatalities.
We sponsored an ‘innovation challenge’ on mental health and hazardous drinking behaviour at Edge Hill University. The challenge took place during October half term and more than 50 students volunteered their time to contribute. The teams will present their solutions in April 17.
Once a quarter we hold a Digital Ecosystem event, which brings together digital and med-tech health businesses, health care organisations, local authorities, universities and service users to build understanding of the needs of the NHS and wider public sector and to showcase and promote adoption of digital innovations which are already having an impact in improving the lives of residents. In March 2017 we held our 11th Ecosystem event. These events evaluate very positively and truly represent ‘the triple helix’ concept in our region.
Awards events
Awards events are a useful way to highlight best practice and we organised our own North West Coast Research and Innovation Awards event collaboratively, with NIHR CRN NWC and NIHR CLAHRC NWC.
It was our second annual awards event, presenting a total of 15 awards, five for each partner with our own categories highlighting and celebrating successful innovators in health care.
The winning nominations were promoted through our social media channels – Twitter, Facebook and LinkedIn; and they received good media coverage, with a total of 16 articles in local press. This event is now an established highlight in the North West Coast health calendar.
We also sponsored external awards events which highlighted best practice in our region, as follows:
• Excellence in Supply Awards, hosted by North West Procurement Development
• Bionow Awards, showcasing the best of the Northern life sciences sector
• North West Medilink Healthcare Business Awards celebrating innovation, growth and commercial success in the Healthcare Technologies and Life Sciences sector
• NW Informatics Awards, hosted by the Skills Development Network
• NW Adult Learner Awards, innovation in health category
We also sat as judges on a range of national awards including HSJ Awards, Patient Safety Awards, BMJ Awards, Association of Healthcare Communications and Marketing Awards.
The AHSN Network’s presence at national events was organised or supported by our event management and communications team, including Patient Safety Congress, NHS Confederation, NHS Expo and Patient First.
Hackathons
We imported hackathon expertise from the Massachusetts Institute of Technology (MIT) Hacking Medicine team to the North West Coast.
Having taken part in an MIT Grand Hack and worked alongside their trainers in our own first two hackathons, we now have a team of experts qualified to deliver CPD accredited training in hackathon methodology.
The demand for training has increased as people become aware of the power of hackathons. Our hackathons energize people and encourage them to think differently about ways to improve quality and efficiency, helping to spread a culture of innovation.
Innovations emerging from hackathons in the past year include: sensors for early detection of skin damage, a hearing screening app and a campaign to improve hydration of patients.
We have developed a supportive network of trained hackathon facilitators who keep in contact and help each other when they run their own hackathon events.
Participant’s feedback:
Michelle Cloney, Deputy HR Director, East Lancashire Hospitals NHS Trust: “Fantastic creative training event – a really great opportunity to engage better with front line staff and service users to reshape and co-produce what we need for future health and social care services.”
Communications Strategy
A strategy for communications and engagement was implemented to maximise the reach of our communications through social media and e-newsletters.
Inspired by the Mayo Clinic Social Media Network, we launched a community of health care professionals interested in championing the use of social media to improve health care.
An ‘#EngageWell’ event was attended by 80 individuals, with a magnified reach to more than 110,000 Twitter users. Presentations were later viewed on SlideShare more than 5,000 times.
The frequency of e-newsletters was increased from bimonthly to monthly; and a Business Connect newsletter was launched to business stakeholders every six weeks.
A Facebook company page was set up, to engage with all partners, public and patients.
Key outputs and results for 2016/17:
Eight stakeholder newsletters and five Business Connect newsletters issued
45 press releases and 20 blogs published
Twitter following increased by 55 per cent from 2,700 to 4,200
SlideShare uploads: Presentation views: 6,560 Presentation uploads: 44
Media coverage: 116 press cuttings and one BBC local radio interview
LinkedIn: 336 followers
YouTube: Channel now holds 196 videos35
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Capability 2: Showcasing high impact innovations
We have adapted an online Innovation Exchange which was initially developed by our colleagues in Yorkshire and Humber AHSN.
The Innovation Exchange connects health and social care professionals, businesses, organisations and individuals who are looking for improved and more effective and efficient ways of working.
It includes case studies and supporting resources provided by around 60 entrepreneurs, with about 180 active users as at March 2017.
Submissions to the Innovation Exchange are assessed by a panel using a standardised protocol to choose innovations which have the greatest potential to contribute to the delivery of Innovation Agency goals.
Our team then promotes the innovations to our network, by matching the product with our database. The next phase of development will involve collaborating with Yorkshire and Humber AHSN more closely, by merging the innovation assessment panels.
iBags
A very popular feature of our presentations developed in 2016 is our ‘iBags’ - branded shoulder bags containing a range of innovative products, so that participants at events and meetings can see and feel some of the products which are transforming care. This ‘show and tell’ method of sharing innovation always brings a presentation to life and has been adopted by Wessex AHSN.
The bags contain:
AliveCor Kardia; Arc Angel; Leanvation latex free gloves; the Hydrant; Living It Up activity tracker; MyDiagnostick; Non Injectable Arterial Connector (NIC); Episcissors 60; 3D models of a child’s heart, partial brain, skull, and kidney; carbolic soap to promote House of Memories app; leaflets re Better Conversation health coaching toolkit; and the CATCH app.
We have also produced files of ‘iFacts’ – cards for each of the items, describing what it is and how it is being used; these have been distributed to our staff and to the 70 Scouts.
Our Innovations Scouts promote innovations by using the iBags and the iFacts; and by promoting PIP – see below.
Capability 3: Improving skills in adopting and evaluating innovations
Putting Innovation into Practice
We have developed a Putting Innovation into Practice programme (PIP) which is available on our website to support health care partners. This is a self-guided online tool to develop capability for innovation adoption.
PIP covers all elements of the innovation pathway: Creating a culture for innovations to thrive; identifying ideas; gathering evidence of what works; tools to support implementation; evaluating their effectiveness; supporting further adoption; and rewarding success.
PIP is complemented by our Innovation Exchange, (see Capability 2).
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Evaluation
Evaluation is a key part of our work. We have commissioned a number of specific evaluations to support the development of our programmes and our partners’ programmes which allows us insight into what works where and for whom. This supports our spread and adoption agenda and also gives us insights into the development of programmes:
• An economic model for identifying hypertension (delivery partner HCD Economics)
• A survey of GPs and other staff using Kardia Alive Cor devices (internal)
An evaluation including economic evaluation of implementing the genotype testing service (Liverpool and Lancaster universities – in progress)
• An evaluation of the patient consent model of the 100,000 genomes programme (University of Central Lancaster UCLAN)
• Report on implementation of innovative medical technology in hospitals (internal)
• An evaluation of MyDiagnosticks in a variety of settings (UCLAN – in progress)
• Evaluation of self-monitoring for warfarin (UCLAN – in progress)
• An evaluation of implementing the Heart Failure Evidence into practice programme (MSD)
• Evaluation of StartBack (internal)
• Evaluation of Dry January campaign (Liverpool John Moores University)
• Evaluation of Evidence for Innovation into Practice programme (internal)
• Economic model for self-monitoring to support business case (internal)
• Evaluation of the AF pathway in hospitals (NHS trusts/UCLAN)
• Evaluation of AF Collaborative (UCLAN – in progress)
• Audit of Diabetes Summit (internal)
• Evaluation of Steady On falls programme (UCLAN)
• Audit of osteoporosis medicines optimisation programme (internal)
• Evaluation on our point of care testing programme (Edge Hill University).
We have also provided support for evaluations for our partner organisations through the commissioning process, supporting them with the development of logic models and other tools to help them identify evaluation goals and to assess suitable providers to commission the evaluations. Commissioning can take a formal or informal approach. Our evaluation partners are a range of academic institutions with active in the field of work, through to private providers with specific expertise.
We have a range of approaches from light touch, which may be a survey or some audit measures to establish if a project is delivering its objectives, through to academic work, using more rigorous research methods and statistical techniques. Outputs vary from internal reports to academic papers in peer reviewed journals.
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PARTNERSHIPS WITH OTHER ORGANISATIONSNHS England
NHS England is the main funder of all AHSNs and assure themselves on a quarterly basis that the Innovation Agency is meeting its duties in accordance with the Innovation, Health and Wealth principles, and in line with the objectives of the Five Year Forward View.
The Innovation Agency has a close working relationship with NHS England North and the sub-regional teams as well as a strong relationship with colleagues on a national level.
Our vision of reducing health inequalities and contributing to a vibrant local and national economy are consistent with the principles of NHS England.
NHS Improvement
NHS Improvement funds the Patient Safety Collaboratives which are run by the AHSNs and we work with their patient safety team at a national level, through the Patient Safety Leads Forum. We hosted a visit by NHSI National Director of Patient Safety Dr Mike Durkin in August 2016 at which we described the highlights of our patient safety work.
NIHR CLAHRC NWC
Collaboration between the Innovation Agency and the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) NWC is underpinned by our membership of each other’s Steering Board, regular meetings of relevant staff and a joint annual awards event for the region.
We are working together on implementation of genotype-guided dosing of warfarin; on the North West Coast Connected Health Cities Programme; and more recently on a ‘Health system approach to improving and innovating in the management of people with atrial fibrillation through medication optimisation’.
The implementation of genotype-guided dosing for warfarin in patients with atrial fibrillation to improve anticoagulation involves collaboration with industry partners (LGC Ltd) and has been ongoing since 2014 and should finish by the end of June. The medication optimisation project was a joint bid to Pfizer and follows on directly from this successful genotype-guided dosing collaborative project.
In the Connected Health Cities programme, we will be collaborating over the next three years on a series of projects that will impact on the lives of citizens who have COPD and alcohol issues.
Looking to the future, 2017/18 will be an exciting year for CLAHRC NWC as several larger studies end or near completion, such as: Psychological support for people with stroke (ADOPTS); Improving access to support for perinatal women through peer facilitation: a feasibility study (PEARS); genotype guided dosing; and Improving access and coordination of care for adults presenting to emergency care with seizures: Care Pathway for Seizures (CAPS); the first wave of implementation projects through the Partners Priority Programme progress with a second wave starting in the autumn of 2017. These studies provide lots of opportunities to collaborate around adoption and spread of evidence-based new ways of working.
NIHR CRN North West Coast
The Innovation Agency and the Clinical Research Network (North West Coast) have a strong and collaborative relationship that is pivotal to driving forward research excellence across the region.
This year, the Clinical Research Network (North West Coast) surpassed a major milestone in recruiting over a quarter of a million patients to clinical trials since 2008.
The Innovation Agency plays a key role in creating the right environment to spread health technology and innovation and together, both organisations have helped improve health outcomes for the local population.
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Along with the Innovation Agency and NIHR Collaboration for Leadership in Applied Health Research (CLAHRC NWC), the Clinical Research Network organised the second joint NWC Research and Innovation Awards event. For the CRN in particular the evening was an opportunity to celebrate research excellence through collaboration and say thank you to all the front-line researchers and wider multidisciplinary teams and especially patients across the NHS.
Patient and public involvement and engagement in clinical research remains an area of joint focus and collaboration. Sharing of best practice has ensured the region successfully engages with many stakeholders. The region boasts research ambassadors embedded in the NHS who are pivotal to help the CRN NWC in the delivery of research and the adoption and diffusion of innovations and new technologies. Only by joint working has this been achieved in a number of clinical areas of unmet need.
Furthermore, the Innovation Agency has provided much needed innovation funding to researchers within the Clinical Research Network, playing a critical and enabling role for clinical trials to reach their successful end points.
During the year, cross representation on boards of both organisations and productive relationships at all levels of the partnership have continued. The region remains committed to continuing joint working that will secure improvements in the health of the population we jointly serve.
Strategic Clinical Network and Senates
The Strategic Clinical Network (SCN) for the North West Coast is now a neighbour of the Innovation Agency, in Vanguard House, Daresbury, which is helping to strengthen relationships between our two teams. We are working more closely and meeting more often, formally and informally.
We continue to work together on cardiovascular disease; and we share some resources – for instance our European programmes manager has been helping with bid writing; and the SCN Associate Director was a judge on our patient safety hackathon.
The SCN successfully bid for a grant in our Transformation Through Innovation Fund, to introduce health coaching in treating patients with diabetes.
Additionally we sit on the board of the Cheshire and Merseyside and Greater Manchester and Lancashire Clinical Senate; and the SCN Associate Director is a member of our Board.
Advancing Quality Alliance (AQuA)
Rather than charging a fee for service, the Innovation Agency asks for this fee to be paid to AQuA for them to deliver Quality Improvement programmes that provide the foundation for a culture of innovation. In addition the Innovation Agency commissions bespoke programmes, from AQuA for the Patient Safety Collaborative. For 2016/17, the Innovation Agency commissioned the Advancing Quality Alliance (AQuA) to deliver two programmes of work as part of our Patient Safety Collaborative (PSC). This was the second phase of programmes that were designed and delivered on behalf of the Innovation Agency by AQuA.
Recognising the need for continuity and development from the previous year, AQuA created programmes that built up from earlier introductory approaches, allowing staff and organisations to expand and enhance their knowledge and skills in supporting and delivering safer care.
These programmes were provided to organisations from the NHS and wider public sector within the Innovation Agency footprint.
An appendix describing the programmes is attached to this annual report (Appendix 2)
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Northern Health Science Alliance
The Northern Health Science Alliance Ltd (NHSA) is a partnership established by the leading universities and NHS hospital trusts in the North of England to improve the health and wealth of the region by creating an internationally recognised life science and healthcare system.
Our CEO Dr Liz Mear is a director of the NHSA Board, representing the four Northern AHSNs.
The NHSA links eight universities and eight NHS teaching trusts with the four Northern AHSNs. This represents a patient population of over 15 million people. The NHSA acts as a single portal bringing together the strengths of the North around research, health science innovation and industry to provide benefits for researchers, universities, hospitals, patients as well as commercial partners.
In the last year, we have worked together on Connected Health Cities; and on promoting the north of England to national stakeholders.
Partnerships with academia
Evidence based commissioning – the Evidence Champions programme
We launched a Postgraduate Certificate Evidence Champions Programme alongside our commissioned partner, Lancaster University. This programme teaches commissioners to make the best use of evidence in making decisions about new products and service improvements in their areas. The first cohort includes leaders from across health and social care. We have developed this programme based on the successful work of West of England AHSN.
Evaluation: We have involved university partners in various evaluation programmes (see Capability 1)
Digital health learning
We sponsored Cumbria University to deliver a digital health programme and 20 health professionals took part in a course which included an overview of what technologies are available, how they can be used and success stories from those who have used them in frontline clinical practice. This was followed by sessions on how to evaluate the benefits, how to present a business plan for change and practical support to plan your own digital health or social care service.
Students will be publishing work-based digital project case studies that will be made available for the benefit of the wider health and social care economy; and a series of workshops will run through 2017 highlighting the learning and development experienced by the cohort and identifying where they may be able to use their skills to support the region’s transformational programme. A further cohort is being recruited for 2017.
We are working with the Liverpool Life Sciences University Technical College (UTC) to support the creation of a new Life Sciences UTC in Wigan, which is due to open in September. The plans for the education programmes will be aligned to match the needs of our future life sciences workforce.
We signed a collaboration agreement with the Massachusetts Institute of Technology Hacking Medicine team which was the first of its kind, creating opportunities to work with world leading experts in innovation. The collaboration will culminate in a national Innovation Leadership Summit during 2017.
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University research hubs
We are integral partners of two research hubs in the region, Lancaster Health Hub and Liverpool Health Partners.
Lancaster Health Hub
The Lancaster Health Hub, led by Lancaster University, is a strategic partnership involving a range of public and private sector health organisations across Lancashire and Cumbria. It enables partner organisations to work together to drive locally-led research and innovation, to enhance evidence-based, high quality healthcare, and to support local economic growth and job creation. The Health Hub is represented on the Innovation Agency Board.
The partnership draws upon skills and expertise in all academic departments at Lancaster University, which is rated within the top 10 UK universities, plus: University of Cumbria, Blackpool Teaching Hospitals NHS Foundation Trust, Mersey Care NHS Foundation Trust (Calderstones site); Lancashire Care NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancashire North CCG, NHS Fylde and Wyre CCG and Healthwatch Lancashire.
The Health Hub has achieved considerable success in driving and supporting a wide range collaborative research and innovation initiatives across the area, and in attracting significant resource and investment, including the NHS England Test Bed, which is being delivered through the Lancashire and Cumbria Innovation Alliance.
The Health Hub is a partner in the Innovation Agency-led European Regional Development Funding (ERDF) business support programme in Lancashire, working with more than 100 Lancashire SMEs with innovative healthcare products and services which will benefit both patients and healthcare professionals.
Building upon this and other developments, a major current initiative is the planning and development of the Lancaster Health Innovation Campus, with Phase I scheduled to open in 2019, offers opportunities to extend significantly the scope and impact of the partnership. As part of this, the Innovation Agency has funding the post of Senior Manager for Business Engagement, Health & Medicine to support initial work in business engagement and the establishment of partnership working with the sector.
Liverpool Health Partners (LHP)
We work with LHP in the Liverpool Alcohol Research Alliance (LARA) which delivers successful bid submissions and specialty expertise; plans are now underway for a Liverpool Alcohol Research Institute.
The Liverpool Health Genomics Laboratory, funded by Liverpool Health Partners, formally opened in July 2016. This is an important part of the NWC Genomics Medicine Centre. Our Medical Director sits on the Genomics and Translational Medicine Steering Group.
Liverpool Health Partners are developing an informatics strategy for health data science, with an ambition of establishing an Integrated Health Informatics Platform for the Liverpool City Region. We were part of their strategic launch event, Digital Frontiers.
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We sponsored a major event organised by Liverpool Health Partners, ‘Health is Wealth’, attended by 300 delegates over two days. It was the second Health is Wealth conference and this is now an established annual event, bringing together healthcare professionals, academics and businesses involved in transforming healthcare in our region. The Innovation Agency organised an ‘Innovation Exchange Zone’ exhibition area for SMEs being supported through their ERDF funded business support programme; and a round table discussion for health informatics leaders and SMEs, to explore opportunities for closer working, especially with the Global Digital Exemplar trusts.
Our CEO is a member of the LHP Board and senior LHP staff attend our Board meetings.
Local Enterprise Partnerships (LEPs)
We have representation on our Board from Cheshire & Warrington, Liverpool City Region and Lancashire LEPs. The support from all three was instrumental in shaping our bids to secure £3.5m ERDF funding, with partners, for the new business support programmes and we will work closely with the LEPs and their growth hubs to deliver these.
We jointly fund a health and life science growth sector post with Liverpool City Region LEP and our Commercial Director is on their Health and Life Sciences Board.
Liverpool Health and Wellbeing Board
Our Chair Gideon Ben-Tovim OBE is a Board member.
North West Learning and Development Collaborative
The North West Learning and Development Collaborative includes the Innovation Agency, Greater Manchester Academic Health Science Network, AQuA, the North West Leadership Academy and Health Education England.
Our collaboration has created a connected set of partners who have well established, formal and informal relationships. The depth and breadth of these relationships enables alignment of combined skills and resources to tackle the challenges facing the North West health and social care economy.
The Collaborative provides development for boards, leaders, managers; it supports coaching skills, mentoring skills, Lean methodology and improvement methodology for front line staff.
Creating this climate supports a culture of innovation across the North West Coast.
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LOOKING FORWARDOur business plan for 2017 to 2018 is focused on five goals, which were established following consultation with Board members and workshops to identify priorities for the region.
They are:
Goal 1: Support system transformation through the adoption of innovations that enhance quality & value
Goal 2: Support innovation clusters and SMEs to drive economic growth
Goal 3: Drive adoption of digital innovation
Goal 4: Deliver NHS Improvement Patient Safety Collaborative programme
Goal 5: Collaborate with the Network of AHSNs
FINANCIAL PERFORMANCE(to follow when accounts are finalised)
OUR EXECUTIVE TEAMChief Executive: Dr Liz Mear
Commercial Director: Lorna Green
Director of Innovation and Research: Lisa Butland
Interim Medical Director: Dr Phil Jennings
Director of Communications and Engagement: Caroline Kenyon
CONTACT DETAILSwww.innovationagencynwc.nhs.uk
@innovationnwc
01772 520263
Innovation Agency
Vanguard House
Keckwick Lane
Sci Tech Daresbury
Halton
WA4 4AB
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APPENDICES
Appendix 1
Vanguard sites in the North West Coast region
Fylde Coast Local Health Economy
A new community-based service called ‘extensive care’ is providing proactive support for people aged 60 and over, who have two or more long-term conditions. Under the service, patients benefit from a harmonised team of health and care professionals working together to provide the support they require to keep them out of hospital. This includes helping people to understand and manage their health conditions but also other aspects of their life which might impact upon their general wellbeing.
Complementing the extensive care service are locally based neighbourhood care teams which provide support to people who require the ongoing management of one or more long-term conditions. These teams see GPs working with community and other care services across ten neighbourhoods on the Fylde Coast to provide better coordinated care closer to home for patients.
Shared electronic care records and a single point of contact for all out of hospital services on the Fylde Coast ensure seamless care regardless of a person’s support needs.
Healthy Wirral
The partners are focused on shaping local services around what really matters to everyone in Wirral.
To do this, the organisations are working much more closely together, commissioning services jointly, supporting joined-up local services, and working in partnership with the large and diverse local communities and voluntary sector.
The vanguard is using support from the national new care models programme for working with new technologies to develop a new system where electronic patient records are shared across all health providers – creating Europe’s first ‘population health management digital infrastructure’.
The information that can be gained from the system – such as the numbers of people with certain health conditions and any trends or patterns in who becomes unwell – can be used to better plan the services that people need and improve the efficiency of the health and care system.
Better Care Together – Morecambe Bay
Twelve new health and care teams are being created, including professionals (nurses, doctors, social workers) from across primary, secondary and community care. These teams have a mix of different health and care skills.
They will be based in local areas and called ‘integrated care communities’. These professionals will work together, across the area, in three clinical networks.
The aim is to deliver consistent care for individuals but with priorities localised (for example the priorities for the people of Kendal will be different to those for the people of Barrow-in-Furness). Care will be provided as close to home as it can be with people going to hospital only when they need the specialist care that only a hospital can provide.
Key to success is that whole communities become much more involved in better managing their own health and wellbeing, as improved population health cannot be achieved just through service delivery.
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West Cheshire Way
This vanguard is showing how the national programme’s support for organisations to empower patients and to better integrate the buying and delivery of services can make a difference to patients while also easing pressure on NHS services.
There will be easier access to more joined-up services in the community through new health and social care teams, wellbeing coordinators and direct access to physiotherapy for patients.
By working together with clinicians to design self-care plans, where appropriate, individuals, their families and carers will be given the tools and confidence to understand and manage their health condition themselves as far as possible.
GPs and community teams will act as the first port of call for accessing coordinated support for children and young people. Adults with long-term conditions will be identified and supported to minimise the impact of their conditions on their daily lives, again with care models designed together with clinicians.
Vulnerable older people who are most at risk of poor health and wellbeing will be identified by GPs. They will then work with that person’s nominated care coordinator (who works with health and social care teams to help people obtain care, understand their options and make care decisions) to develop care plans and ensure care is provided by teams with members from the specialties needed.
The Neuro Network – The Walton Centre
The programme will build on the vanguard partners’ extensive history of working together in networks to deliver neurology (help for problems within the nervous system) and spinal services.
The Walton Centre will work closely with other hospitals, GPs and community services to improve the quality of care and reduce variations in standards, ultimately benefiting patients with neurology and spinal conditions.
It already provides neurology services at district general hospitals across Cheshire, Merseyside, Cumbria and North Wales, holding clinics and helping look after patients on the wards. The vanguard will use the national support available to develop joint working further across Cheshire and Merseyside.
The aim is to deliver improved results for patients and better use of resources within the local Merseyside and Cheshire area, as well as strengthening the acute support available in hospitals on a seven-day basis.
This way of working across a network is one that can be followed across the NHS as a whole to benefit patients nationally. It is recognised that there are too few consultant neurologists to provide a self-sufficient service in every district general hospital, and working together in this way allows local care to be available while still using resources efficiently and effectively.
The team is planning to establish a spinal network to further improve services for patients spinal conditions, increase the specialist support and advice currently given to GPs and local hospitals.
The Neuro Network will also standardise care for patients with back pain. At present, treatment can be inconsistent and patients often experience significant delays in getting the right care for their needs.
There is currently considerable variation in the surgery that is offered, and this will be addressed through different services working together as a regional spinal network for both urgent and planned spinal surgery, closing a gap in care and quality.
As well as the benefits the vanguard work will bring for patients, staff will benefit thanks to the opportunities it offers for engaging in innovative service development. This will include using modern technology within their working environment and the chance to undertake new roles such as the advanced neurology nurse posts that are being developed.
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Cheshire and Merseyside Women’s and Children’s Services
The vanguard is addressing the challenges facing services for women and children locally by creating a new approach between commissioners (those organisations that plan and buy services), clinicians and providers that goes beyond organisational boundaries.
These challenges include a greater demand for services and an increase in patients with more complex needs as well as variation in quality of services. No single organisation, commissioner or provider working alone can resolve these issues and this vanguard will also enable organisations to work together to tackle challenges around workforce like recruitment, retention, retirement and the skills available in the workforce, as well as overall financial sustainability.
In addition, the vanguard is engaging more with the people who use services, so it can better understand their needs and create more personalised or targeted support, improving health and wellbeing.
APPENDIX 2Advancing Quality Alliance (AQuA) programmes specifically commissioned by the Innovation Agency 2016-2017
For 2016/17, the Innovation Agency commissioned the Advancing Quality Alliance (AQuA) to deliver two programmes of work as part of their Patient Safety Collaborative (PSC). This was the second phase of programmes that were designed and delivered on behalf of the Innovation Agency by AQuA.
Recognising the need for continuity and development from the earlier PSC, AQuA created programmes that built up from earlier introductory approaches, allowing staff and organisations to expand and enhance their knowledge and skills in supporting and delivering safer care.
These programmes were provided to organisations from the NHS and wider public sector within the Innovation Agency footprint and are described below.
1. Safety Leadership for Middle Managers
This programme was specifically designed to provide middle managers across the footprint with the opportunity to develop technical and non -technical skills that will help them understand the issues they face daily to monitor, challenge and improve safety within their organisations.
Developing and harnessing these skills enable staff to develop their role, and understand the approaches they can take to increase impact within their own sphere of influence and beyond. The programme is designed to help stretch and expand the critical thinking of attendees and to provide them with greater insight into the role of safety across health and social care. Attendees were encouraged to reflect on their learning and to share how they have applied their learning both during the classroom elements and since the programme ended.
Programme overview
• Two cohorts with a total of 46 participants underwent the five day programme
• Programme workbook was developed including resources, references, reflection pages and further reading
• Attendees were encouraged to use reflection throughout each module of the programme
• Directed actions and action learning approach for self-improvement and development
• Support and networking throughout and beyond programme
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Feedback from delegates:
“Everything will be looked at in a new light due to the result of this learning programme.”
“All of the modules provided their own key messages that safety is integral to quality improvement initiative. Also, safety is everyone’s responsibility.”
2. Network Spread and Sustainability
This three-day programme was designed to offer participants the opportunity to learn, develop, practice and understand the ‘softer skills’ that support safety improvement.
By combining Individual Resilience, Human Factors and Appreciative Inquiry this programme enabled staff to understand the emotional and interpersonal approaches that influence their own and the behaviours of others. It included follow-on coaching support and engagement to encourage attendees to embed changes, assess the implications of their learning and sustain any impact within their organisations.
Programme overview
• Three cohorts with a total of 68 people took part in the three-day programme
• Attendees encouraged to access their organisation’s ‘Sign up to Safety’ plan and connect their learning from the programme to support their local delivery of these
• Support and networking throughout and beyond programme
Participant feedback:
“Makes you think about yourself and your interaction. Good insight into resilience and understanding how to improve my resilience and recognise teams’ resilience.”
