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HIN Project Managers Hilary Moorhead and Dr Antonio Ruiz-Gonzalez share insights into how horizon scans and market access reviews can support NHS teams. They explain the difference between the two approaches, when each is most useful, and highlight examples of past work that demonstrate their practical impact.
At the Health Innovation Network (HIN) South London, we’ve completed over 40 horizon scans and market reviews in recent years, examining more than 1,400 innovations across 20+ clinical and non-clinical themes. These reviews have ranged from cardiovascular disease and cancer pathways to AI in diagnostics and process automation.
With the 10 Year Health Plan setting out the government’s ambitions for achieving significant transformation within the health and care sector, the need to select the right innovations and understand what the medium-term future for innovation in particular areas looks like is increasingly pressing.
Horizon scans and market reviews are two key tools which can be used to strategically guide innovation selection, helping NHS services to make decisions which maximise impact in the short term and value for money in the longer term. In this article, HIN Project Managers Hilary Moorhead and Dr Antonio Ruiz-Gonzalez explore why they matter, and when they can be most useful for NHS teams. The article also includes examples of past work to illustrate how these tools can support better decision-making and innovation adoption.
A horizon scan looks ahead to identify innovations that could transform service delivery in the next 2–5+ years. It is intended to give decision-makers confidence about the timing and scope of investment into innovation.
For example, it could help services to understand whether the most promising innovations are relatively early-stage and suited to pilots and developmental partnerships, or whether the market is relatively mature and innovations are likely to be ready for large-scale implementation.
Future-focused and broad in scope.
Evidence-based insights aligned with NHS priorities.
Highlights emerging technologies and new care models.
Information on innovations from academia and industry.
Potential new models of care enabled by technology.
Demand signalling to innovators about future NHS challenges.
A market access review focuses on the here and now, identifying companies and solutions that can address immediate challenges. They provide actionable insights for immediate and near-future market positioning and procurement.
Current market analysis and competitor mapping.
Detailed product specifications, deployment information, and interoperability.
Recommendations for procurement and implementation.
Market analysis and competitor landscape.
Commercial and technical information to support decision-making.
Recommendations and insights to support successful adoption and implementation.
The HIN’s role at the interface between commercial innovation and health and care delivery teams makes us uniquely well-placed to analyse the innovation landscape. Through our Innovator Support programmes including DigitalHealth.London and Mindset-XR, we work with hundreds of the most promising innovators in the UK – and internationally – each year.
We also work hand-in-hand with frontline NHS and social care teams on transformation and improvement projects across a broad range of clinical areas and service configurations.
In a fragmented and fast-moving environment, our teams are able to utilise their extensive networks and tried-and-trusted research frameworks to provide comprehensive and reliable assessments of the innovation landscape – allowing our partners to make decisions with confidence.
If you’re considering a horizon scan or market access review, get in touch with our team to discuss how we can support your goals.
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The latest TeleRehaB Decision Support System (DSS) Market Access Report provides a strategic overview of the telerehabilitation market across five key European countries, examining opportunities for UK-based innovators working in digital rehabilitation. The Health Innovation Network (HIN) South London) has coordinated a series of focus groups to shape the development of the project and, most recently, produced a market access report.
Nearly 394 million people across the WHO European region could benefit from rehabilitation services. This demand continues to grow as populations age, and more people live with chronic conditions. The HIN partnered with the TeleRehaB DSS research programme to explore how artificial intelligence and augmented reality technologies can help meet rehabilitation needs, both in the UK and abroad. This blog highlights international expansion opportunities for UK innovators, drawing on insights from our new market access report and accompanying country profiles.
Many of the challenges we face in the UK are shared across Europe. This includes: ageing populations, a rising demand for rehabilitation services, and workforce pressures. By 2050, more than 30% of the population in many EU countries will be aged 65 or older, creating significant demand for rehabilitation and long-term care services. This means that rehabilitation innovations developed in the UK often have strong potential to succeed abroad. International expansion is an opportunity to contribute to better health outcomes across Europe by making rehabilitation services that are accessible to all.
The following clinical areas driving demand across Europe stand out in the report:
Stroke
Incidence is rising due to ageing populations. Costs are projected to reach €86 billion by 2040. Home-based rehabilitation is proven to be cost-effective and improves outcomes.
Long COVID
Studies show that around 10–20% of people infected by SARS-CoV-2 may go on to develop symptoms that can be diagnosed as Long COVID. Millions across Europe continue to experience persistent symptoms. Digital tools are being adopted to support recovery, but access to these services is not the same everywhere.
Vestibular disorders
Affecting up to 30% of adults, particularly older populations, these conditions carry high costs due to falls and lost productivity. Tele-rehabilitation and app-based solutions are emerging to fill gaps in care.
These areas represent not only clinical need but also strong demand for scalable, digital-first solutions.
Demonstrating that a solution can reduce costs or improve patient outcomes in the UK provides a foundation for conversations abroad. Building credibility early supports this. Health systems across Europe are cautious adopters, and evidence of effectiveness (both clinical and economic) remains the strongest currency. However, innovators should also be prepared to adapt their approach to local contexts. What convinces decision‑makers in Germany may differ from what resonates in Italy or the Netherlands, and understanding these nuances is key to successful expansion.
International markets are complex, and innovators rarely succeed alone in unfamiliar markets, therefore highlighting the importance of partnerships. Collaborating with universities, rehabilitation centres, or local distributors can accelerate adoption and provide valuable insights into cultural and clinical differences. These relationships are beneficial for practicalities such as navigating regulatory and procurement systems. However, they also create opportunities for co‑production, ensuring that solutions are tailored to the needs of each market. The report identifies key markets where partnerships with academic and clinical organisations can support UK innovators to expand internationally.
UK innovators are well-placed to lead in the digital rehabilitation space. With strong expertise in digital health and rehabilitation, and growing demand across Europe, now is the time to explore opportunities beyond our borders.
To find out more about tele-rehabilitation innovation or the TeleRehaB Decision Support System (DSS) project, get in touch with us.
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The prospect of Artificial Intelligence use in corporate communications can feel overwhelming for some. For others, the process of a new tool being identified, used, and then integrated - to the point of it's use being "business as usual" - feels familiar. Kerry Beadling-Barron, Director of Communications and Corporate Affairs at the Health Innovation Network South London, shares her perspective on the rise of AI use in communications, informed by lessons from the era of "new media".
In communications, one of our roles is to segment our audience. We could segment comms colleagues between those who can remember what "new media" was, and those who don’t. "New media" was the term used to describe Facebook and Twitter around the time they were emerging into popularity. In other words, "new media" was an umbrella term used to describe the internet broadly and the emerging social media platforms within it at the time. This was before the term "social media" was widely adopted around 2004.
Social media was different from the traditional media of newspapers, radio, and television, which had been the mainstay of communication for decades. It was disruptive in terms of length of content and timescales of publication - it felt seismic for anyone in public sector comms. In your organisations, if you were able to get past the argument about whether it should be used at all, there would've been discussions arising around how to respond to users online and who was responsible for that. Prior to the existence of the social media roles we have today, new media sites were blocked on work devices and networks, and special permission had to be sought from IT to grant access to these sites. Any of this sound familiar? These are the same conversations currently taking place around AI.
The early adopters of social media tested roles and types of content - then led the way in sharing best practices with their more wary colleagues. In innovation, we typically see a cycle of discovery, testing, and roll out. Then, the use of the innovation becomes common place, "business as usual". This is what happened with social media. By 2014 the Guardian was reporting that four in five NHS organisations were using at least one social media channel, but in a state of low maturity commenting: “Social media is no longer a “nice to have” option for the NHS.”
We can see this evolution happening now with the use of AI in comms. Across the NHS, there is a growing feeling that communications colleagues should be the trailblazers for the adoption of AI. With the responsibility of showcasing AI to colleagues within our organisations increasingly falling on the shoulders of comms professionals, it is key to build confidence in its use. A starting point would be familiarising yourself with the work of the NHS Confederation which has published its report on insights, risks, and recommendations for safe adoption of AI. It’s a great place to start if want to know more about AI.
From colleagues across the NHS, I hear legitimate concerns about how AI could impact on our roles and skills. A lot of the AI tools I see now only work well when there is a human in the loop checking outputs and making sure there hasn’t been hallucinations. For example, a 2023 article shows that 47% of the references used in ChatGPT-generated medical content were fabricated. In comms work, it is comms professionals who need to be that human intercepting made up information.
So, to those who are worried, I point them towards the fact that we have been here before. We've identified risk and concerns, developed policies, and now have an additional channel - social media - which on the whole has increased our ability to communicate directly with stakeholders. AI is a new bit of technology that we should embrace to enhance what we do, allowing us to focus on the skills it cannot do, such as building relationships.
A national fund which supports people with respiratory conditions has announced Merton Health as one of only nine winners.
Merton Health, which is the lead provider of primary care in Merton, has been awarded £300,000 from the Government’s Pathway Transformation Fund (PTF). It plans to use the money to support the diagnosis and treatment of people with asthma and chronic obstructive pulmonary disease (COPD).
The Pathway Transformation Fund (PTF) can help providers overcome practical obstacles such as:
Pathway redesign.
Providing funding for specialist nurses and clinical staff needed to implement a new part of the procedure.
Covering double running costs.
This work is a six-month project that forms part of the national Respiratory Transformation Partnership, which is a two year programme that the Health Innovation Network (HIN) South London is helping deliver.
Get in touch to find out more about our work transforming care for respiratory conditions.
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The health economics team at the Health Innovation Network (HIN) South London is welcoming its newest member, Becca Naylor.
Becca Naylor has joined the HIN from the renowned York Health Economics Consortium. She worked on various projects including: an early value assessment for NICE on the digital management of COPD, pharmacological interventions for weight management and the impact on inequalities, and a cost-carbon analysis for a clinician support tool in primary care.
“I’m passionate about working in the public sector to use my skills to quantify the impact of changes on health inequalities and help decision makers understand the wider significance of their choices.”Becca Naylor
Becca is joining at a time of increasing focus on health economic evaluations in the NHS. Recent HIN projects which have included this are:
Virtual Wards
The team worked with the NHS England London region and the York Health Economics Consortium to develop a virtual wards economic cost model. It can be used by local NHS decision makers to understand the economic consequences of virtual wards, and consider the overall economic viability of the service to guide commissioning decisions. This led to the development and publication of package of resources alongside the Virtual Wards Economic Cost Model.
There is limited evidence on the impact of artificial intelligence (AI) for brain MRI scans. Working with King’s College London, the HIN developed an early budget impact analysis to inform future research on the national adoption of a commercially available AI application. It is designed to support clinicians reviewing brain MRI scans for suspected stroke and melanoma brain metastases across NHS radiology departments in England.
Dr Andrew Walker, Programme Director for Insights and Evaluation sumarised:
“Efficiency, productivity and value for money have become a huge focus for the NHS over the last few years and so any decision to implement innovation must understand the impact on these areas as well.
Becca’s experience further strengthens our skills and it’s great that she is joining us at this exciting time.”
NHS Navigator Karla Richards reflects on a recent roundtable, hosted by DigitalHealth.London and the Health Innovation Network South London. The discussion brought together representatives from London’s Integrated Care Boards (ICBs), hospital trusts, and primary care with representatives from industry to look at the rise in use of Ambient Voice Technology in clinical practice.
Ambient Voice Technology (AVT) refers to AI powered tools that capture and process spoken conversations, converting speech into text. Operating under human supervision, the AI component can analyse the spoken words, provide overviews of conversations and automate tasks like writing patient clinical notes, drafting referral letters, and taking down actions.
As AVT continues its entry into clinical spaces, the integration of this new technology highlights the complexities of driving the shift from analogue to digital in healthcare while safeguarding quality, safety and trust. The current situation is marked by a mix of excitement and uncertainty, with a clear need to clarify regulation and safety.
Healthcare inherently operates with an accepted baseline of risk. Measured risk and accepted levels of human error are facts of daily practice, from prescribing decisions to communication breakdowns.
AVT enters this space with the obvious potential to reduce avoidable transcribing and documentation errors and reduce the cognitive load on clinicians, allowing them to focus their attention on making decisions that matter.
AVT is moving from pilots to roll outs. The question isn’t ‘if’ but ‘how’—governance, safety, and proof. We work in partnership with clinicians on the ground and the C-suite decision makers to ensure every aspect of an enterprise deployment, safety, ROI, implementation, works for all stakeholders. The barrier to do this well is high, but you only need do it once if done right. “As fast as we can, as slow as we need” - that’s the TORTUS way.Dr Dominic Pimenta, CEO of TORTUS
However, AVT also brings its own set of risks – risks where unfamiliarity understandably breeds caution. Whether this caution is fully justified is harder to quantify; one participant at our roundtable queried how often human-written patient notes are audited for accuracy or errors and wondered what audits of AI-written notes are being compared to.
Recent guidance from NHS England on ambient scribe technology (an umbrella term for related technologies including AVT) offered a timely nudge for more cautious and informed adoption. It sets out some basic considerations around implementing AVT, including advice on functionality, safety and information governance protocols.
NHS England does not typically offer guidance on individual classes of innovation. However, given the nascent state of regulation for these technologies and the lack of local organisational guidelines, the reality is that AVT use is being shaped by individual clinician preferences. Across care settings, clinicians are increasingly engaging with AVT tools independently, often without formal governance, IT oversight, or awareness from leadership. This raises important questions: Does the technology work as intended? How is benefit quantified? And critically, how are patients and their data being kept safe? This lack of clarity risks scenarios where tools are deployed beyond their capabilities or without adequate staff training, potentially undermining patient safety and clinician trust.
Primary care and secondary care differ significantly in their digital readiness and awareness of safety standards. The absence of a codified approach to AVT implementation and training leaves gaps that could be filled through standardisation efforts. As one roundtable participant put it: "We treat a large trust and a single GP the same for procurement - this approach is not helpful. The ICB doesn't have a formal role in compliance for products procured at the practice level."
As the landscape of AI-driven technologies continues to evolve, AVT is beginning to find its place within existing regulatory frameworks. The current recommendation is that AVT for use in the NHS should be at least a Class 1 medical device, which is a self-certified designation intended for medical technology products with low risk of harm to patients.
However, as capabilities grow and clinical impact deepens, the risk profile shifts, potentially warranting reclassification to Class 2a, requiring assessment from a notified body before it can be marketed for sale.
If AVT is going to deliver against its promise for patients and clinicians, the Medicines and Healthcare products Regulatory Agency (MHRA) and other bodies will need to keep pace to avoid innovations being stuck in regulatory limbo.
Efforts are underway to modernise the 2002 medical device regulation to formally include software-based technologies, yet many guidelines still need reshaping. Oversight needs to be flexible and willing to learn and adapt, with concepts like the “AI Airlock” offering room for safe experimentation and iterative learning.
Questions like post-market surveillance and oversight are also important. Can we deploy tech into clinical environments swiftly but safely, with ongoing evaluation to ensure patient care isn’t compromised? The ambition is clear: “Get AVT into use, but in a safe and effective way.” But how do we work together to ensure agility doesn’t come at the cost of accountability and patient safety?
As Ambient Voice Technology (AVT) becomes more integrated into clinical environments, questions have been raised about who is responsible for the technology, and ultimately liable if something goes wrong.
To ensure safe and ethical deployment, it is important to determine the difference between clinical and implementation risks and the universal approach to liability. Traditionally, clinicians have been accountable for reviewing and signing off notes transcribed by administrators. Should the same standard apply to AVT-generated documentation? And how do we safeguard against overreliance?
Following current guidance, clinicians are ultimately responsible for the information they add to patient notes or referrals. However, as the use of AVT spreads and develops, should liability be shared?
Three areas of responsibility began to emerge from discussions during the roundtable:
Clinicians, who must still exercise judgment and ensure AVT remains the assistant rather than the master.
AVT Providers, who bear responsibility for system integrity, transparency, and continuous improvement based on lessons learned.
Regulators need frameworks that not only protect patients but guide procurement and deployment.
As with anything else AVT-related, there are new nuances to contemplate regarding accountability. Who bears responsibility for making sure AVT products work well in different dialects, or if clinicians mumble? What are reasonable expectations around an AVT that can differentiate between clinical jargon or acronyms that can have drastically different meanings depending on context? There remains much uncharted territory to cover.
So far, there have been no landmark liability cases surrounding AVT – but the general feeling during the roundtable was that regardless of the checks and safeguards in place, these were certain to come.
Perhaps an interesting counterpoint raised in a recent MPS Foundation whitepaper is whether a time will come when a clinician is held accountable for not using available AI tools. The implication is clear: as AVT becomes more capable, choosing not to use it could eventually be considered negligent.
Culture is often identified as a significant barrier to the adoption of innovation in the NHS. Clinicians, in particular, are often sceptical of technologies which offer the world and deliver little beyond added administrative burden.
Our roundtable admittedly over-indexed towards enthusiastic early adopters of AVT – but their testimonies providing promising examples of clinical staff working with technology still slightly rough round the edges rather than rejecting it outright. From vocalising the physical cues of conversation to talking through every element of the consultation (rather than relying on entering notes later), there is some evidence of clinicians accepting that the benefits are worth the added effort of adapting to AVT.
Concerns from clinicians discussed during the roundtable centred around creating an over-reliance on AVT for note-taking capabilities (an important skill still needed in situations where AVT may not be feasible). It was also acknowledged that taking typing out of consultations was a novel and potentially uncomfortable change requiring clinicians to consciously adjust their style of patient interaction.
From the patient perspective, the culture change required seems to be more linked to understanding the benefits that AVT can provide to them, while also clarifying the protection of their privacy. Early pilots show promising levels of trust on behalf of patients for the results produced by AVT. If patients are kept informed of the use and benefits of AVT, for example in appointment letters or explanations posted in waiting rooms, these levels of trust may be sustainable.
The benefits of AVT for patients are not necessarily cash-releasing or cost-saving directly, but improvements such as the standardisation of notes, patient information being presented without jargon and in an easy to understand format, and information following consultations being available immediately for patient review could help to improve engagement with treatment.
And for providers, the consensus was that those developing AVT cannot afford to rest on their laurels. Built-in systems are needed to monitor AVT in real time to ensure data quality, accuracy and safety as well as monitoring clinician use in order to support guidance and the measuring of impact. Work needs to continue on improvements relating to environmental challenges such as noisy clinical settings, accents, multiple speakers and quiet speakers.
AVT providers promise significant benefits, and these need to be quantified for business cases. Will the use of AVT mean additional patients can be seen, or that staff can go home on time at the end of their shift? How can we quantify the improved quality of life and reduced cognitive burden on clinicians? Can the quality of notes be shown to be higher than with previous dictation methods? What will be the outcomes that are the most valuable for business cases and that will drive procurement?
Of the myriad potential uses of AI in healthcare, AVT seems to have established one of the firmest initial footholds.
The technology being used is not yet perfect, but the measured success of early implementations and long-term promise has bought enough goodwill among clinicians that wider spread and adoption appears sensible rather than speculative.
However, securing the long-term benefits of AVT requires funnelling some of that enthusiasm towards less immediately satisfying endeavours – ensuring that the technology is adopted in a safe and sustainable way.
Critical to this long-term future will be collaboration and a collective ability to act in the best interests of AVT as an emerging technology. Providers will sometimes need to be prepared to steer interested clinicians towards proper information governance and procurement pathways at the expense of cashing in on contracts; regulators will need to flex their rules to allow technology to continue to progress at pace.
At the Health Innovation Network South London we are proud to have played a role in facilitating some of the critical collaboration that has helped AVT start to deliver real benefits – and we’re excited to see what comes next.
Contact us to find out more about Ambient Voice Technology in clinical practice.
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In this edition, we catch up with Rebecca Allam, co-founder and CEO at PreActiv. PreActiv's platform widens access to tailored and accessible prehabilitation, with the aim of removing barriers to effective preventative care and lowering the risk of digital exclusion.
Current job role: Co-founder and CEO
Name of innovation: PreActiv
Tell us about your innovation in a sentence.
PreActiv is a cost-effective solution, aligned with NHS perioperative care goals, preparing patients before surgery using smart technology to create individual prehabilitation programmes that can help to reduce complications and hospital stays.
What was the ‘lightbulb’ moment?
As NHS clinicians with over 25 years' combined experience, my co-founder, Dr Alec Snow, and I saw firsthand the huge impact poor preparation before surgery has on patients. However, if prehabilitation were implemented, the risk of complications could be reduced.
Moreover, due to a lack of preparation during wait times, some patients deteriorate and may have a worse outcome.
Recognising this gap, we saw an opportunity to make a difference. There was a clear need for affordable, individualised prehabilitation to improve patient outcomes and ease pressures on NHS trusts. That’s why we created PreActiv: a scalable, equitable solution designed to drive widespread change.
What three pieces of advice would you give budding innovators?
1. Focus on implementation.
Even the best innovations will fail without proper implementation. Clear planning, effective integration and training, and interoperability are essential to ensure successful execution.
2. Rigorous PPIE and user testing.
PPIE and user testing with patients, the public, and hospital stakeholders is vital to ensure your product meets their needs, ensuring strong product-market fit and better outcomes in real-world use.
3. Demonstrate your return on investment (ROI).
Health economics are crucial for success. Proving your innovation’s financial and clinical ROI is essential to gaining stakeholder buy-in and ensuring your solution delivers long-term value to healthcare systems.
What’s been your toughest obstacle?
For us, and for a lot of HealthTech companies, procurement has been a tough obstacle. There’s real excitement among clinicians around innovation, especially in preventative care and prehabilitation, however, the NHS procurement process can be lengthy and fragmented. It’s been a steep learning curve for us, as each ICB and Trust has its own unique procurement process.
There are ways to navigate it, and we’ve found frameworks especially helpful, alongside innovation funds and grants. The NHS is amazing, and once you are implemented within a site, it is lasting and reliable.
What’s been your innovator journey highlight?
There have been many highlights. Most notably, the patient feedback and the social impact of our innovation, especially in relation to the results of our clinical trial. Evidence-based medicine is a core value of ours, and knowing we’re making a real difference is incredibly rewarding. It’s the reason I stepped away from medicine to run PreActiv.
Beyond that, the accelerators and programmes we've been awarded have been significant for us. As someone who has always championed women and female founders, winning the Women in Innovation award was a personal highlight. Recognition from prestigious accelerators like DigitalHealth.London and the NHS Innovation Accelerator was also a stand out moment for us. All of these were highly competitive processes, and receiving this recognition for what we are doing was a real highlight for me.
What is the best part of your job now?
There are many perks to owning your own company, but I’d say there are two key things I really value in this role. Firstly, the incredibly rewarding ability to see the tangible impact of our innovation on both patients and the healthcare system.
The other equally best part of my role now is the ability to achieve a healthy work-life balance, which I believe is crucial. I have the autonomy to curate that balance not only for myself, but also for my employees. As someone who’s passionate about advocating for working mothers, I make it a priority to create a supportive environment for parents in the workplace. Being able to foster a culture that values both professional growth and personal well-being is something I’m truly proud of.
If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?
I believe streamlining the procurement process is one of the key changes that could make a real difference. The NHS often gets a lot of bad press for being difficult to sell into, which leads many innovative companies to focus their solutions on private systems or look to markets like the U.S. instead. It’s a real shame, as working with the NHS is incredibly rewarding.
We need to rethink not only how we represent innovation within the NHS, but also how we can create more efficient procurement processes, especially for start-ups and new innovations. I believe this would accelerate health innovation and generate a lasting impact on UK healthcare at scale.
A typical day for you would include…
You can find PreActiv on their website, LinkedIn, and Twitter/X.
Trying to implement Artificial Intelligence (AI) in the same way as other tech doesn’t work. Dr. Rishi Das-Gupta, CEO of the Health Innovation Network (HIN) South London; Dr. Dominique Allwood, CEO of Imperial College Health Partners; and Dr. Chris Laing, CEO of University College London Partners explore why a new model is needed for a new technology.
The traditional quality improvement model of trialing technology can be described as “crawl, walk, run”. This approach, which starts small but then accelerates, tests an idea and steadily refines it with support. At each phase of work, problem solving allows for progressive scaling up - up to five times the size of the previous phase. It has the advantage of being a proven and safe way to improve healthcare.
However, this model might not be the most appropriate for rolling out AI technology. As AI products evolve quickly, technical expertise is spread across multiple people in a healthcare organisation. It becomes inefficient for each organisation deploying technology to repeatedly answer all technical, safety, and security questions. Moving this slowly leaves patients and clinicians holding risk.
A new model, offering the necessary flexibility, might be more accurately described as “run, walk, drag”.
The first “pilot” phase is often fast.
Developing a product and deploying prototypes tends to happen quite quickly in a closely supervised environment. This is also helped by the fact that pilots are often run with local support from AI enthusiasts who help to demonstrate a proof of concept. Hence, projects often start off at a “run”.
A recent example is the use of ambient voice technology in General Practice. Although products are not yet well integrated into the workflow or GP software packages, as they need local adaptation to get them to work seamlessly, tech-savvy GPs have been early to adopt them because they see benefits to staff and patients. They have developed workarounds for themselves and trained their colleagues directly where needed. They have “run” with the solution during pilots.
The early scale-up phase typically sees a decrease in pace.
Here, solutions are being deployed in a wider range of services with more staff involved. Close supervision by the enthusiasts is no longer enough to carry an idea through. Typically, integration into workflows and training staff is needed. All these problems can be overcome but they require time and effort.
We typically see unexpected challenges surface at this stage - particularly when a product changes staff roles in a patient’s care. For example, using AI to interpret CT scans at an NHS Trust in London has meant an early indication of abnormal findings is available almost immediately when the scan is completed. This put radiographers who performed the scan in the position of having to reassure patients, or break bad news. This isn’t a role that they have done traditionally. Some of them have rightly asked for training and support on how to sensitively deliver the news, to provide appropriate care for the patients they treat.
We should expect early roll-out to be slower and, sometimes, more expensive than pilots. The use of mixed-methods evaluation of the roll-out, together with knowledge sharing, can support scaling AI and technology solutions in this phase. This support from health innovation networks accelerates this phase and provides valuable inputs for the final phase.
As technology diffusion continues, it then becomes important to engage those who are reluctant to use it. Although we sometimes see this reluctance due to unfamiliarity of technology or a general reluctance to change, more often it is that the product offers less benefit in their specific practice. General services and primary care might find that some product innovations would only benefit a very small proportion of their patients. Therefore, it’s often easier to roll-out new products in specialist centres where most patients would benefit from the innovation.
For the groups showing reluctance, it isn’t necessarily enough that a solution is widely used. They will often demand that all potential risks and issues are worked through, and every potential downside is mitigated, before a change is made. Doing this requires more time and a sustained effort by transformation teams and local champions - hence this being the ‘drag’ phase. In the programmes we have run in our health innovation networks, simple activities such as sharing stories and impact from earlier adopters, are critical to maintaining momentum in roll-out.
Eventually, when many staff are on a platform roll-out, it starts to accelerate again. When using the solution becomes the norm, staff expect to have access to it and the benefits it offers. At this stage, services which haven’t adopted it often have technical or financial reasons for not proceeding with changes, and these can be addressed directly.
With the deployment many technologies and AI solutions over the coming years, we believe we need to look at our processes and culture for innovation, as well as the products and solutions. Our thinking around this comes from discussions at a London AI roundtable that explored ideas on how to accelerate the adoption of AI. We recognised that the majority of healthcare providers are in the early stages of AI adoption. In creating an understanding around the processes and culture of innovation, we can help accelerate the adoption of innovation - benefiting patients and staff, while reducing costs at a critical time for the health and care system.
There's an important question around what is done at the national level (once) and what is done at local/regional levels. This is especially important given the reshaping of functions currently housed in NHS England. For example, we believe we would benefit from a national team focusing on general aspects of safety and compliance, such as the Digital Technology Assessment Criteria (DTAC) compliance and data security. However, deployment needs to be tailored locally which is where Health Innovation Networks (HINs) can play a critical role.
Technology adoption often has many components which are best handled locally because they depend on interactions with other operational processes and local technology solutions. The Health Innovation Network South London can support the rapid adoption of technology and new ways of working by helping to solve problems, evaluating roll-out, and sharing good practices across the network.
In London, there is an ongoing pilot for ambient voice technology which is due to report back soon. As part of this, London has agreed to adopt a framework called “T.E.S.T.” (Technology, Evaluation, Safety, Test) to rapidly and objectively evaluate readiness for spread. It focuses on:
We believe using the above framework mitigates the risk of the current system in that it transparently looks at the impact on inequalities, acknowledges that a clinical mistakes will happen in both current and future practice (but should be managed), and appreciates the need around data security and the likelihood of poor co-ordination leading to inefficiency.
Our experience suggests five key learnings:
AI deployment can be done quickly and safely as can be demonstrated with the roll-out of AI and automation in primary care.
A regional/national approach to “whitelisting” products could accelerate testing products.
AI enthusiasts at the service front-line should be enabled and supported to test products in a safe way to identify what should be spread.
Risks surrounding deployment can be mitigated and managed and we should move quickly so that patients and clinicians are not left holding risk.
Support to deploy widely is best delivered locally dependent on the context and programmes to share learning during deployment are key to accelerating change.
The Health Innovation Network (HIN) is the innovation arm of the NHS and the collective voice of the 15 health innovation networks across England.
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In this edition, we catch up with Steve Roest, CEO at PocDoc. PocDoc's 'Healthy Heart Check' smartphone-based technology can be used to provide patients with a full cholesterol profile check - at home, at work, or in their communities.
Current job role: CEO
Name of innovation: PocDoc 'Healthy Heart Check'
Tell us about your innovation in a sentence.
PocDoc’s Healthy Heart Check enables people to undertake a comprehensive cholesterol profile from their smartphone, directly into the NHS app, which includes: BMI score, calculated heart age, and a ten-year risk assessment for heart attacks or strokes - all in under 10 minutes.
What was the ‘lightbulb’ moment?
My passion for this business stems from a deeply personal experience. When my dad suffered a major stroke caused by undiagnosed cardiovascular disease (CVD), it was a wake-up call. I realised that it not only had an emotional impact on my family and I, it had a significant financial impact on the healthcare system too.
The cost to the NHS for looking after him likely exceeded seven figures - an excessive cost that could have been avoided with early detection and treatment. The World Heart Federation reports that around 80% of CVD, including heart disease and stroke, are preventable.
This realisation drove home the critical importance of early diagnostics, particularly digital tools that make screening more accessible. This personal journey ultimately led to the creation of PocDoc, a British born digital diagnostics company designed to address the growing burden of chronic diseases, including CVD, which affects over 7.4 million people in the UK.
PocDoc's Healthy Heart Check aims to increase access to cardiovascular disease screenings to help ease the pressure on the overwhelmed healthcare systems in the UK. It is estimated that each digital health check could save 20 minutes of NHS time — freeing up thousands of GP appointments and helping cut NHS waiting times.
We’ve been delighted with our growth to date and the support we’ve received from our investors - which includes the only NHS-anchored venture capital fund. In addition to the NHS, PocDoc has nationwide partnerships with some of the largest community pharmacy chains including: Asda, Well Pharmacy, and the UK’s biggest online pharmacy, Pharmacy2U. Our Healthy Heart Check is a fundamental tool in the preventative care journey.
What three pieces of advice would you give budding innovators?
1. Begin with a valid problem statement that can turn into a mission.
History is littered with health technology innovations that have no buy-in from customers because they solve problems people don’t have or won’t pay for. Always remain focused on developing a product or service that genuinely meets the needs of your target audience, whether that’s for patients, clinicians, or another community. To achieve this, involve them at every stage of the process. Their feedback will not only ensure your offering is relevant and effective but will also help you identify areas for improvement.
2. Be prepared to adapt to changes within the industry.
The healthcare sector is constantly evolving, so it’s essential to stay informed and up to date. Be open to feedback and ready to adjust your overall strategy in response. Embracing change and listening to those around you will help ensure your approach remains relevant and effective in an ever-changing landscape.
3. Be humble and seek to learn.
You will find healthcare is full of people who care about making an impact and want to help others. If you are humble and ask for guidance, people will go out of their way to help you.
What’s been your toughest obstacle?
Bringing the physical, digital, clinical, and interoperability together with the NHS system in a highly scalable, usable platform has been one of the major challenges. Our Microfluidic Assay Platform is proprietary, so we knew keeping operations and manufacturing in-house would work best for us.
From day one, we set out to fully understand the unmet clinical needs in cardio, metabolic, and renal disease prevention. Our goal was to address these entire needs, not just a fraction of them. This involved hundreds of hours of talking with clinicians and patients before we even started development.
We also spent a lot of time understanding why screening outside of a GP surgery hadn’t scaled effectively. We realised that if we could create a digital-first technology that delivered equivalent clinical value and interoperability as the NHS System gets from GP-led screening, we would be able to unlock community, workplace, and home screening for three of the largest cost centres for any healthcare system.
The other major obstacle has been keeping up with demand for the Healthy Heart Check - which is a good problem to have!
What’s been your innovator journey highlight?
There are highlights at every stage. Introducing our Healthy Heart Check to market was huge, as was creating an amazing team across several specialties that can deliver for our customers, day in and day out.
Building relationships with the teams at Health Innovation North East and North Cumbria and NHS North East and North Cumbria, who were the first to roll us out as part of an Small Business Research Initiative (SBRI) funded project.
Seeing people use the Healthy Heart Check in every UK region is fantastic! It’s always nice to receive patients' and clinicians' feedback, showing we are having a real impact on our overall mission of helping identify people at risk of chronic illnesses earlier, so we can treat and/or prevent their condition, before it develops.
A major highlight of my innovator journey to date has been reading the results of our Health Economic Analysis, co-authored with the NHS. It shows the huge economic benefits of using PocDoc.
What is the best part of your job now?
The most rewarding aspect of my role is witnessing the positive impact the Healthy Heart Check has on patients' lives. It is incredibly fulfilling to see how many high-risk individuals we’ve been able to reach - many of whom were previously unaware of their underlying health conditions.
Through these checks, we’ve empowered individuals to take proactive steps in managing their health, which is a truly powerful outcome. The testimonials we receive reflect the value of our work, highlighting the tangible difference we are making. They not only validate our efforts but also serve as a constant source of motivation for both me and my dedicated team, many of whom have been personally affected by CVD. This personal connection fuels our collective drive to ensure the business's success.
As we continue to expand, our goal is to make these life-changing, accessible health checks available to even more people, helping to prevent heart-related issues before they arise and improving overall public health on a larger scale.
If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?
I’d like to see a stronger collaboration between the NHS, its clinicians, innovators, and the investors who fund them - whether at the early, mid, or later stages of venture capital. We’ve been very lucky to have had such success in raising capital, and our investors are deeply aware of both the value and the challenges of the UK healthcare system.
More broadly, there is a growing lack of understanding from institutional investors about how the NHS works and what types of business can succeed. What investors don’t understand, they view as risk, and what they view as risky, they won’t fund.
The NHS is also frustrated that businesses are building products and technology that, while “innovative”, don’t solve clinical problems in their entirety or are no better than the incumbent process. In this situation, the NHS won’t adopt these solutions.
There needs to be a recognition that this is a symbiotic relationship - if investors know what the single largest customer in the UK will buy, they can adjust their decisions accordingly. If the NHS can guide investments into innovations it knows will scale, adoption will go much faster.
A typical day for you would include…
I’m an early riser - usually up between 4am and 5am - driven by excitement for what we’re doing and the huge amount we must deliver in 2025. The first two hours of my day are focused on tasks that require deep concentration. However, if I’m training for a sporting event, I might split that time by doing an hour of focused work followed by an hour at the gym. Then it’s breakfast with my three children before getting them off to school and nursery.
Mornings are spent catching up with my key team leads - Commercial, Marketing, Operations, Tech/Product, and R&D - while afternoons are dedicated to meetings with major clients, both existing and potential. Once a week, I sleep on a camp bed in the HQ factory, working late with the night shift operations team and then having breakfast with the early shift team. Every other Tuesday, I host my live show, HealthTech Hour, which now has 300,000 streams a month. I like to be well-prepared for it! I work until 6pm, then unwind with some exercise.
Right now, I’m really into jujitsu - I’m a white belt, and my goal for 2025 is to get close to blue.
Are people obese or do they have obesity? Here Dr Rishi Das-Gupta, CEO at the Health Innovation Network (HIN) South London and Kerry Beadling-Barron, Director of Communications and Corporate Affairs explain why the language around weight management matters.
Obesity is not currently classified as a disease in the UK. Why is this significant? Because it allows obesity to be viewed as a behavior that individuals could change but choose not to, placing the emphasis on personal responsibility (such as eating differently or exercising more) rather than on external factors. These include: genetic predispositions; the availability of fresh versus processed food; access to green spaces; or financial constraints that make gym memberships and exercise classes unattainable. A parallel can be drawn with the discussion around cigarette use – do we see individuals as smokers or as nicotine addicts? When considering this, does it change your view of those who smoke?
Plus how we measure whether someone is obese is problematic. The Body Mass Index (BMI) which uses your height and weight to calculate how underweight or overweight you are is the tool of classification in the UK. However, it does not take account of where in the body fat is stored; the type of fat (white or brown); or weight of muscle mass, often leading to a simplistic outcome. For example, using this tool means most rugby players would be classed as obese because of their high muscle mass.
In America obesity was labelled as a disease in 2013 to recognise the impact on overall public health, potentially increasing funding into research and reduce the stigma attached.
And it’s important to recognise there is a stigma. We have recently been awarded funding from the National Institute for Health and Care Research (NIHR) to undertake a three-year study to determine the clinical and cost-effectiveness and implementation of a digitally enabled tier 3 weight management platform in south-east London. As part of this application, we included views from patient and public representatives where they were clear about the emotional impact of obesity.
We also know by talking to partners that others are looking to test digital care in weight management, and of course, there is the increase in new GLP-1 weight loss drugs (such as Ozempic). The MHRA approved the use of semaglutide (Wegovy) for the treatment of obesity and weight management, and the NHS is already seeing a surge in people contacting clinicians for what was once a treatment for type 2 diabetes only.
In our view, not classing obesity as a disease - keeping the focus at an individual level - harms our ability as a system to look at the overarching factors which make people obese and leaves individuals open to abuse. We welcome the discussion on how obesity should be reclassified at this crucial point, and our role in how digital innovation and pathway redesign can help.
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In this edition, we catch up with Nitin Parekh, CEO at YOURmeds. This medication management solution uses the latest technology and mobile communication to prompt patients to take medicines correctly - and alert their carers if a dose has been missed, or the wrong medication has been taken.
Current job role: CEO
Name of innovation: YOURmeds
Tell us about your innovation in a sentence.
YOURmeds helps people to take the right medication at the right time with support from their network of family and friends improving health outcomes whilst reducing costs for primary and secondary care.
What was the ‘lightbulb’ moment?
When I realised my mother needed help, and I was 274 miles away! My mum was a type 2 diabetic, had high blood pressure and early-onset dementia. My father tried to support her but had an active life, so technology was the only viable answer.
The idea of a smart blister pack came to me when I saw my mum trying to manage a standard dosette box from Boots. I marveled at the random opening of the tabs and thinking ‘there has to be a better way, so that I know what she is taking!’ My mum was my first real world case study.
The World Health Organisation and NHS widely recognise that only 50% of people take their medication as intended. I realised that this was a global problem - if addressed, it could lead to a positive impact on people’s long term health and wellbeing.
What three pieces of advice would you give budding innovators?
1. Test the market for your product thoroughly. An innovation can work at many levels, but most are in reality either extremely narrow, or simply not scalable. Those that work best are the ones which 'add a few grains of sand to the beach', rather than 'inventing a new beach’.
2. Be patient. Adoption in healthcare will take a lot longer than you expect. There are too many vested interests that will not accept your invention; remember that if you are being disruptive, you are also disrupting peoples’ pre-conceptions.
3. To help your business stay solvent, look outside of the UK. Innovating in healthcare costs a lot of money, and most of that is spent on trying to stay solvent until you get traction.
What’s been your toughest obstacle?
Being a political football between the NHS and social care. In 2022/23 the NHS spent £10.4 billion on medicines in the community but it does not see medication adherence as a priority. Adult social care recognises that getting people to take their medication has an impact on how much long-term care they would need in the future, but the Care Act only allows care to be commissioned if a person requires support with two or more daily living tasks (e.g. eating properly, going to the toilet). Therefore, someone requiring only medication support will often have 4 visits from a carer per day, with a requirement that support for personal care is provided to justify these visits. Without providing a means to improve medication independence, it is very difficult to reduce the number of visits a carer needs to make. If the medication piece was supported with a digital technology as soon as they become known to adult social care, as is done in Stoke-on-Trent City Council, the data collected can be used to evidence a care call when the service user can no longer manage their medication.
Our biggest problem is the lack of joined up thinking between health and social care and too many people sitting in silos, worried about their own budgets and unable to see the bigger picture. With a growing elderly population, the NHS and adult social care need to work smarter. Digital technology is the way to increase capacity in the system, whilst increasing the independence and health outcomes of patients and/or service users.
What’s been your innovator journey highlight?
Our first adult social care client, Manchester City Council, taking us on. From there we have been really lucky to work with some forward thinking adult social care teams in Stoke-on-Trent City Council; Bridgend Council; and the Cwm Taf University Health Board. Recently we’ve managed to join up the conversation with some councils and ICS’s in South Yorkshire with Sheffield City Council and Bristol, that has given us hope that a joined up conversation around adherence is finally gaining traction.
What is the best part of your job now?
Seeing how the technology impacts the service users. With a little bit of support around adherence, our service users talk about how it’s helped them to feel better; manage their long-term condition; become more independent; and reduce the burden on the primary carer.
If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?
Work together, remove silos, and stop re-inventing the wheel. Every large organisation needs to agree a clear strategy that involves putting people at the centre. In our area, it would be really easy to identify the 20% of people who cost the NHS 80% of spend, let’s give them a digital medication adherence system based on their need, and then use the adherence data to understand what impact the medication taken is having on their long-term conditions.
Our phase 2 project in Bridgend City Council and Cwm Taf Morgannwg University Health Board has been funded by the SBRI, and we’ve done some development work to bring the medication information into the reporting dashboard. So, for the first time, clinicians will know what medication was taken in each round and how to advise around missed or wrongly taken medication.
We also need a hard look at systems and processes across all the health and social care landscape. Often, the only way social care teams, GPs, and pharmacies know someone has gone into hospital is due to the non-adherence on the YOURmeds systems. Trying to get data sharing agreements between health and social care is a major challenge.
A typical day for you would include…
Walking the family dog, Dylon, in the morning before I get to work!
Everyday is different but generally includes: fundraising, product development, capturing our “user gold” from service users on how the technology supports them on a daily basis, and developing our team. Recently we’ve been doing a lot of development work with the SBRI bid - so lots of catching up with the IT team.
HIN Project Support Officer, You Tae Jeon, writes about the stand-out theme at the multi-day HETT conference this year: the inclusion of caregivers in the development of digital tools and innovations.
Caregivers are people who help others with their health needs. They are a growing but sometimes hidden group – every year 4.3 million people become unpaid carers in the UK.
With up to three out of four Londoners using digital tools to interact with GPs, apps and websites are increasingly becoming important tools for helping people to manage their health, or to manage the health of others in the case of caregivers. Unfortunately, digital exclusion is a significant issue faced by carers. A significant proportion of carers are older adults, who are more likely to have trouble accessing digital tools due to not having access to internet at home or not having the digital skills to use these tools effectively. However, an issue for carers that do have access to these tools, is that they aren’t always designed with caregivers in mind, which can make it hard for them to use services and access the information they need.
One of the main problems is that digital tools in healthcare are mostly designed for patients, not caregivers. Caregivers play a big role in managing health tasks like appointments, reminders, and understanding treatment plans. By not providing easy access to allow caregivers to use these tools, we effectively make the patient digitally excluded.
More generally issues with user experience design (which may also impact caregivers negatively) includes information being hidden behind complicated menus, and difficulty understanding technical language. Caregivers often feel left out, frustrated, and unable to find what they need quickly.
Another big issue contributing to digital exclusion is confidence. Some caregivers, especially older ones, may not be very familiar with smartphones or computers – this can make using apps or websites difficult. When digital tools aren’t designed with these challenges in mind, caregivers struggle to understand and use them efficiently.
Listening to caregivers’ feedback: According to a Medisafe survey for caregivers, 80% of respondents reported using digital health tools to manage information with physicians and monitoring medications. Whether it is booking GP appointments via their website, or remote patient monitoring via a smartwatch, involving caregivers in the design stage of these digital tools is important. This means asking them what features they need, what confuses them, and how the tool could work better. By understanding caregivers' needs, designers can make tools that are more user-friendly and helpful. Involving caregivers in the process of creating and testing new tools could significantly impact the future usefulness of these tools, a process we refer to as “user experience design” (often referred to as “user centred design”) for healthcare.
Making the NHS work for everyone: The NHS is the main healthcare provider for everyone in the UK. This is unlike some other countries where people might have several different healthcare provider options to choose from. The NHS setup is a helpful one because it means there’s just one main system to improve. However, it also means that integration and usability are more important, as one system needs to be designed to work well for everyone across every part of the population. While there is a wealth of data collected on patients and their caregivers, research has shown that there are significant issues with the quality of data being collected. Therefore, we should develop localised datasets in collaboration with local communities, while ensuring that all caregivers—regardless of age, background, or familiarity with technology—can use NHS tools easily and without confusion.
Simplifying tools: Many healthcare apps are too complex. Simplifying these tools means making them easy to use, with clear instructions and less confusing options. By doing so, it would help caregivers to find important information more easily. Making the language easier to understand is also part of simplifying these tools. Healthcare specialist terms can be hard to understand, so using simpler words and providing definitions would make digital tools more accessible for everyone.
Using local languages: A recent report by The Digital Poverty Alliance suggests that inadequate language support is a key barrier faced in global majority communities. In the NHS, for example, messages are often sent in English. Caregivers who don’t speak English as their first language may struggle to understand important notifications. Having the option to send these messages in multiple languages would help make sure that everyone can understand and respond to them, which could be especially helpful in diverse communities where unpaid caring is often more common.
Caregivers are important figures in healthcare – they help patients with everything from managing appointments, to understanding what treatments are needed. When digital tools are easier to use, caregivers can get the information they need quickly and provide better support. By making digital tools more accessible, we can help caregivers feel confident and empowered, which also benefits the people they are caring for.
With the NHS being the sole healthcare system for the entirety of the UK, it was acknowledged how much of a challenge it can be to make improvements that accommodate every person. Caregivers are increasingly becoming a demographic who urgently need greater involvement in how digital services are delivered.
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