The AI in Health and Care Award: accelerating testing and evaluation of the most promising AI technologies

The AI in Health and Care Award: accelerating testing and evaluation of the most promising AI technologies

The AHSN Network welcomes the launch of the new Artificial Intelligence (AI) Health and Care Award. This will make £140 million available over three years to accelerate the testing and evaluation of the most promising AI technologies that meet the strategic aims set out in the NHS Long Term Plan.

The Award is run by the Accelerated Access Collaborative (AAC), of which the AHSN Network is a key member, in partnership with NHSX and the National Institute for Health Research (NIHR).

Guy Boersma, AHSN Network Digital & AI Executive Lead, commented: “We welcome the launch of this new fund to fast track the implementation of the most promising AI innovation into frontline care.

“It is an exciting development following the publication of our AI State of Nation report, supporting the creation of the Code of Conduct and now contributing to the distribution of funding to accelerate testing and evaluation of AI technologies.

“AI has the potential to address the many challenges impacting services today, such as those around workforce and the ageing population. As part of the Accelerated Access Collaborative, the AHSN Network looks forward to supporting this programme through the adoption and spread of AI across our strong research and innovation network.”

About the AI in Health and Care Award

The Award will support technologies across the spectrum of development: from initial feasibility and conception through to initial NHS adoption and testing of the AI technology within clinical pathways.
Initially, it will focus on four key areas: screening, diagnosis, decision support and improving system efficiency.

The AI Award is part of the £250 million funding given by the Department for Health and Social Care to NHSX to establish an AI Lab aimed at improving the health and lives of patients. The Award forms a key part of the AAC’s ambition to establish a globally leading testing infrastructure for innovation in the UK.

A call for applications for the Award will run at least twice a year through an open competition to identify appropriate AI technologies for support into the NHS.

The call for applications for the first Award is now open. A second call will be launched in summer this year.

First competition – application information

The application process for the first competition opened on 28 January 2020 and closes at 1.00pm on 4 March 2020. Applicants will be able to identify which phase they should apply for using the self-assessment criteria. Full details are available here.

Support from the AHSNs
Innovators interested in applying for the AI in Health and Care Award are encouraged to talk to their regional AHSN for advice and support. Find your nearest AHSN on our Innovation Exchange digital gateway here.

AI Event – 3 February 2020
The Accelerated Access Collaborative, NHSX and NIHR are holding an AI Event in London on 3 February. This will provide information about opportunities and support available to AI innovators and technologies at all stages of development.
Come to the event to find out more about the most recent developments and upcoming opportunities, hear about the experience of an SME developing an AI product in the NHS, and find out about organisations such as the AHSNs that can support collaborations. In addition, there will be the opportunity for networking and establishing new connections.
Book your place here.


A series of webinars are being organised to provide more information to potential applicants:

Initial information session: 31 January 2020, 11-12.00 Join here
Applicant Webex: 4 February 2020, 11:00-12:00 Join here
Applicant Webex: 11 February 2020, 11:00-12:00 Join here
Applicant Webex: 18 February 2020, 11:00-12:00 Join here
Applicant Webex: 25 February 2020, 11:00-12:00 Join here

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In the quest for healthcare innovation, there is no Holy Grail.

In the quest for healthcare innovation, there is no Holy Grail. Messiness prevails over methodology, and that’s OK.

Health Innovation Network’s Director of Patient Safety and Experience, Catherine Dale, and Deputy Clinical Director (Musculoskeletal) and Evaluation lead, Andrew Walker, debunk the myths and share the joys of a flexible approach when innovating in health.

As AHSNs, we’re often asked ‘What’s your innovation methodology?’, ‘How do you do it?’, ‘What framework do you use?’. It can feel like a relentless search for some sort of Innovation Holy Grail. Take this cup, drink from it and thy team will be innovative forever more.

The reality is that simply transmitting a good idea does not work, no matter the time you will potentially release or the money associated with it. In terms of what does work, well, there isn’t a single approach that will cut it. From the perspective of the person who has the good idea and wants others to use it, this can be deflating. But that’s part of the issue. Innovation is traditionally looked at from the perspective of the innovator. If we stop looking at innovation from the perspective of the innovation or product and start looking at from the perspective of the local system that has to adopt the new idea, it’s a lot easier to understand how scale up works in practice and what you really need to do to achieve true spread and adoption.

Step one – take everything you thought you knew about spreading innovation and challenge it.

Debunking the myths of spread

MYTH ONE: Data and evidence will win people over.
This myth is about the belief that if you present people with convincing enough evidence they will be persuaded to change what they do. There are multiple reasons why it is not as straightforward as that. Data and evidence are a starting point for discussion and evidence is justification for a solution, but this happens after the complex process of decision-making. Behavioural science informs us that increasing complexity of decision-making leads humans to take cognitive shortcuts also known as ‘gut instinct’: Does this feel good or bad? Do I like it or not like it?

Even when evidence is clear and strong, as humans our decisions are multi-faceted. This means that while resistance to new innovation does often result from resource issues or a lack of time to implement change, it can also come down to more complex behavioural factors.

MYTH TWO: ‘Simple’ innovation exists in healthcare.
While an idea itself may be simple, the act of spreading that innovation is always complex. Take the case of mobile ECG devices. These new mobile devices easily and quickly detect Atrial Fibrillation (AF), the most common type of irregular heartbeat, which is directly linked to higher risk of stroke. In 2018, we embarked on a project to roll these devices out across south London to detect more people at risk of AF and prevent strokes. The concept was simple and so was the device. It takes a matter of minutes and can be used in a range of settings, from primary care and pharmacies, to the home and workplace. But while the device was simple, the roll out was not.

Training was vital – particularly on communication when a positive finding is discovered. Consider the pharmacy setting. It’s one thing to walk into a pharmacy to buy some shampoo. It’s quite another to walk out having been told you have AF and have a high risk of stroke. Staff needed to be trained not only on the device but on how to deal with this situation, not to mention any IT aspects. As the devices went into more novel settings (mental health, podiatry, therapy teams), more AF was detected but the innovation became even more complex to spread successfully. Pathways needed redesigning to ensure that treatment followed detection. If you are tested in a GP surgery then there may be a GP on hand to initiate treatment, but if you are tested at work, a library or in a prison then the next step is more complicated.

What’s easy to shout about as a no-brainer still involves enormous amounts of graft and change to make it work.

MYTH THREE: Innovation always saves time. We hosted a number of London-based Chief Nursing Officers recently for a conversation specifically focused on how digital innovation in healthcare could save them time. They called this out straight away. Taking the time to use new electronic record systems and document every single aspect of a patient’s care properly will take their teams more time than previous suboptimal paper approaches, at least initially. Saving them time is not only a potentially unrealistic promise, it wasn’t the main motivator for change for the nurses we spoke to. They were more interested in how it made care safer and enabled colleagues in other teams to access the data more easily.

This messiness of transformation, which is not unique to digital innovation, is often glossed over. New systems can be a step in the right direction but in the short-to-medium term may also create confusion. Even safety is nuanced. New innovations can reduce existing safety risks at the same time as bringing about new ones. Innovative new pathways or systems can solve one problem while unintentionally creating another for a different set of professionals or staff group. It takes time and effort to understand and address the knock-on effect of new innovations.

Messiness, models and methodologies

Innovation is complex. In healthcare it’s never a linear journey. We don’t stick to one methodology here at HIN and to pretend otherwise would be too simplistic. We do have a framework. Our approach is based on the insights of clinical academics in Implementation Science and NHS England’s Change Model and these concepts underpin all our projects.

Our answer to the messy reality and the myths above is this: the detail of our approach is different every time. It depends on the unique circumstances facing the healthcare teams we are trying to support. Teams have their own set of barriers, enablers, level of knowledge, risk appetite, culture and funding mechanisms. Our silver bullet is our flexibility. Our expertise is our ability to analyse individual team scenarios, to collaborate and tailor our approach to their need. We don’t look at the problem only from the perspective of the innovation or the product, we look at it from the perspective of the local system that will potentially use it.

When we start with the perspective of busy local teams, we are able to build trust, help in genuine ways rather than pushing products, and ultimately, affect change. This process is dynamic, iterative and nonlinear. In technical terms, it operates on a Complex Adaptive System model, which prioritises flexibility and agility. This is a new way of working for a lot of our partners, who are more familiar with having a clear project plan with fixed milestones and a clear route from A – B, and as such, part of our role is to help the system understand the complexity of implementing innovation so they don’t get disheartened by the non-linear route. Insight (both data-driven and from experience), relationships, judgement and tenacity are some of the most important parts.

We don’t stick to one methodology here at HIN and to pretend otherwise would be too simplistic.

The joys of persistence

Our responsiveness and agility may mean that we can’t produce a perfect gant chart for every step of every project. But it works. Persistence pays huge dividends.

In the case of AF alone, as a national AHSN Network we’ve directly contributed to anticoagulation therapy being provided to 150,000 more people who are at high risk of a stroke. We’ve seen innovations and products adopted at scale: in just two years, an innovation that prevents cerebral palsy in pre-term labour has been adopted at 96% of maternity units – avoiding an estimated 24 cases of cerebral palsy with associated lifetime savings in health and social care costs of £19.6 million. In the same time period, an innovation for people with chronic hip and knee pain has spread from 50 to over 250 sites across England, a 5x increase in sites and a 15-fold increase in the number of patients benefiting – so far almost 8,000 people with osteoarthritis have taken part.

So perhaps the greatest and most dangerous myth of all is that innovation’s complex, messy nature means that the NHS is not making fair progress. There may not be a Holy Grail, but every day, health and care teams are proving that they are inherently and passionately innovative. Their efforts are ensuring that people live well, for longer and that the NHS remains one of the greatest, most successfully spread innovations of all time.

About the authors

Catherine Dale has nearly twenty years’ experience in the NHS in London, including more than fifteen years in service improvement and transformation roles; a Masters in Business Psychology and expertise in Experience-Based Co-Design.

Andrew Walker is a physiotherapist by training and has a PhD in implementation science. Andrew’s role involves helping to build the evidence and practice of implementing innovation and evidence-based interventions across health and care in south London (and across England). He is a Board member for the UK Implementation Society.

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ESCAPE-pain trains 1000 trainers

ESCAPE-pain trains 1000 facilitators to help people living with osteoarthritis in boost to out-of-hospital care

By Professor Mike Hurley, Clinical Director MSK Programme, Health Innovation Network and creator of ESCAPE-pain.

If we are serious about achieving the goals of the NHS’ Long Term Plan, physical activity should be prescribe-able on the NHS and we need to facilitate its delivery through leisure centre and community halls.

It is well documented that people in our communities are now living far longer but they are more likely to live with multiple long-term conditions. Osteoarthritis (chronic knee/hip pain) is a major cause of suffering, physical and mental ill-health in people in our country. It is estimated that in England 4.11 million people (18.2 percent of people aged over 45 years) have osteoarthritis of the knee and 2.46 million people (10.9 percent of people aged over 45 years) have osteoarthritis of the hip.

Typically, these patients are managed in primary care. Despite the risk of side effects and high costs, treatment for osteoarthritis is all too often the prescription of painkillers, typically non-steroidal anti-inflammatory drugs, with little to no practical support. Many people with these conditions mistakenly believe that physical activity will make their condition worse, when it can actually benefit them.

Physical activity and reduced pain

There is unequivocal evidence that physical activity can reduce pain, improve mobility and function, quality of life, makes people feel less depressed and gets people up, out and about, while simultaneously improving other health problems. Yet it can’t be prescribed like a drug and there is limited access to this effective treatment inside the NHS.

ESCAPE-pain is an innovation that integrates self-management and coping strategies with an exercise regimen individualised for people living with osteoarthritis. It is an evidence-based, group rehabilitation programme, delivered to small groups of people twice a week, for six weeks (total 12 classes). It was adopted as a case study in NICE’s Quality, Innovation, Productivity and Prevention programme [2013] and delivers the NICE core recommendations of exercise and education for the management of osteoarthritis.

The Academic Health Science Network (AHSN) identified ESCAPE-pain as a national programme for 2018-2020 and so currently all 15 AHSNs are supporting it across the country.

Scaling up
Originally facilitated by physiotherapists in hospital outpatient departments, in 2017 we moved to widen our pool of facilitators to include fitness and leisure centre instructors. We have now trained a total of over 1,000 people to facilitate this programme (629 clinicians and 380 fitness instructors). The widening of our approach to training; going beyond physiotherapists and into the leisure sector, has enabled the programme to be delivered at over 200 locations across the UK, including leisure centres and community halls, to over 4000 people.

Essential to reaching the millions more people who could benefit from this programme is having enough facilitators trained to deliver the it in local communities. Now that over 1000 people have been trained there is a trained facilitator of the programme in every region of England.

Delivering this programme in the community and outside of traditional hospital settings, is a great example of how we can deliver on the Long Term Plan’s ambition to boost out-of-hospital care. I hope the success of this model is, as it could be, replicated in many other areas of care.

Got 30 minutes to learn more about the NHS Innovation landscape? Listen to our AHSN Network Innovation Exchange podcast in which NHS Clinical Director for Older People, Martin Vernon talks Healthy Ageing, featuring Prof Mike Hurley.

Or find out more about ESCAPE-pain and it’s impact here or contact us at to get involved.

World Mental Health Day: A story of a burning platform for change

A burning platform for change

By Breid O’Brien, HIN Director of Digital Transformation

Today is World Mental Health Day; a day observed by over 150 countries globally to raise awareness and reduce stigma around mental health. In the 17 years since the day was first conceived, society has come a long way in its understanding of mental health. However, even today, people with serious mental illness are still likely to die approximately 15-20 years earlier than other people.

So this World Mental Health Day we would like to highlight some of the incredible progress being made by mental health teams around the world, to bring about parity of esteem in this area by reflecting on a recent roundtable event we held to share learning internationally, where Martin Davis, a Clinical Nurse from New South Wales’ Mental Health Emergency Care division (MHEC), presented on the successful implementation of a virtual consultation system in a rural and remote mental health setting in Australia.

This is a story of a small team that led the way. MHEC was kick started by a government cash injection at a time when the team needed to deliver a better, more cost-effective system of care to its rural and remote population in rural Australia. Before the MHEC service was introduced remote and rural ambulances (and often other emergency services) were transporting patients hundreds of miles just for an acute mental health assessment; taking them from the comfort of their home, family and friends when they were in a vulnerable state, and often leaving their hometown without any emergency provision. Imagine living somewhere where if there was a fire, there would be no one to put it out, simply because they are effectively acting as a patient taxi? Their situation provided a clear rationale for change – a burning platform, if you will. By using virtual consultations, they could save time, save money and deliver faster patient care.

Starting with an 1-800 number 12 years ago and progressing to an online video system just under a decade ago, MHEC now prides itself on answering calls within three rings, and being able to assess patients on a video call within an hour during daytime hours. The stats continue. Every year since its inception, they have saved the combined services over $1,000,000 AUD a year; and 80% of the patients they see are discharged back into their community within a day, a direct reversal of the 20% of patients who were able to go home under the previous system.

“All just geography”

Despite the obvious differences between MHEC’s setting (their ‘patch’ is the size of Germany but has only 320,000 residents), and our urban south London area where almost three million people reside in an area a fraction of the size, when Martin shared his story the similarities were immediately apparent. In London we have a diverse population who speak an estimated 250 languages, requiring a need for numerous cultural sensitivities; the MHEC team have a large aboriginal population – almost 40% of their mental health in-patients identify as aboriginal.

Patients in New South Wales were having to travel miles away from their families to receive acute mental health care; we too have examples of this happening in acute mental health care in the UK, and while the distances in Australia may be greater, the impact on the patient and their family will be the same. The Australian health system also faces an increasing demand for acute mental services against a backdrop of challenges with staff recruitment; turns out, Julia Roberts had it right in Pretty Woman; it is “all just geography”.

The question our roundtable guests discussed cut to the heart of the complexities of digital transformation: if we have so much in common, why, over a decade later, are we still not embracing virtual consultations in the same way that they are? Distance and cost were MHEC’s burning platform, pushing them to make changes ten years ago that other services are only just catching up with. We seemingly are yet to find our burning platform, despite the pressures on our services and the progress being made in many areas.

As our roundtable participants moved the discussion on to the inevitable complexities of implementation, many of the usual barriers made an appearance; procurement, interoperability, money, time. But a few more situation-specific ones also livened the debate; what are the implications for information governance? How do you prevent reprisals of misdiagnosis? How do you train people to deliver virtual care? How do you ensure that changing a pathway won’t affect patient safety? How do you empower your teams to step outside their role? How do you get buy-in from all the organisations needed to deliver the change?

The need for systems to talk

For Martin – and MHEC – all the barriers to change raised were not only a stark reminder of how far they have come, but also how much work is still to be done. We delved into the extensive stakeholder engagement the MHEC team undertook (they visited all the GP practises in person because face-to-face meetings achieved better buy in from clinicians – an irony that wasn’t wasted on them), and listened to how the accountability process was redefined, before unveiling a key area of distinction between our two situations; how joined up their IT systems had become. A steely silence answered Martin’s assumption that we’d managed to fix the interoperability of medical records in the 20 years since he’d served at Homerton, Enfield and the Royal Free. Sadly, Martin, we have not but it is high on the agenda of NHSX and others so perhaps this time we will.

And therein lies part of the problem. The collaborative nature required to implement the MHEC system between mental health, emergency departments, General Practitioners, community mental health teams and even the police (they have supplied local police with digital tablets to ensure they can get the virtual consultations to people in their own homes, not just the local emergency department) is a testament to the power of joined-up care systems, but working together was undoubtedly made simpler by the support of a joined up technology system, something the various LHRCEs are still working hard to crack.

From the discussion, it became clear however that no one issue of technology, procurement, change management, organisational boundaries or geography on its own poses enough of a barrier, but the cumulative effect of them all risks putting off too many commissioners, clinicians and managers from implementing digital transformation. The risk made all the more terrifying by the fear that it might go wrong and that safety could be compromised.

Martin was incredibly open and forthcoming about the fact that MHEC is not yet perfect. When they started the technology didn’t work; not everyone was bought in to the system; it was not – and still isn’t – an overnight success, but none of that mattered. They were trying something new that, at its heart, was trying to improve patient care and support emergency services to deliver better support to people in a mental health crisis, whilst also saving the overall system money. It is clear that really innovative organisations are willing to tolerate failure and see it as an opportunity for learning and doing things even better. Whilst we can’t tolerate failure in terms of compromising patient safety, it does feel that perhaps sometimes this fear also stops us from implementing proven innovations. So why does the fact that something won’t work perfectly first-time round make us in the NHS feel so uncomfortable? Perhaps this is our inherent fear of failure?

We heard from some present about the fabulous work they are doing to implement similar technology and different ways of working, however, to really impact care we need to do this at scale. And to achieve anything at scale, risks will have to be taken. Perhaps our burning platform is just not hot enough. Yet.

About the author
Breid O’Brien leads HIN’s digital consultancy function. She has extensive improvement and digital transformation experience supported by a clinical and operational management background in acute care within the UK and Australia. She has supported major system level change and has a strong track record of delivering complex programmes of work whilst supporting collaboration across varied teams and organisations. With a Masters in Nursing, an MSc in Healthcare Informatics and as an IHI improvement Advisor, Breid is especially interested in the people, process and technology interface.