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Understanding the NHS’s mental health priorities: insights for innovators

Published and last updated by George London
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The Innovate UK Mindset-XR Innovator Support programme (delivered by the Health Innovation Network South London) aims to catalyse the development of extended reality mental health solutions to help improve the mental health of people across the UK. These solutions include technologies such as virtual reality, augmented reality, mixed reality and haptics.

While there is no shortage of possible use cases for immersive technology in mental health, aligning development plans with clinical and system priorities is important if these emerging innovations are to deliver maximum impact as quickly as possible.

Following a recent Mindset-XR roundtable event involving clinicians from across the UK, HIN Head of Mental Health Aileen Jackson reflects on the key priorities which innovators need to be aware of.

It is no secret that mental health services across the UK are under significant pressure. In England, a report into the state of the NHS published last month by Professor Lord Darzi set out the stark reality of a “perfect storm” impacting our mental health, with surging demand following the Covid-19 pandemic being exacerbated by long-term staffing issues and bottlenecks in the system.

Mental health is a key focus of the Darzi report, being mentioned more than 100 times. For those who have worked within the system for some time, many of the statistics highlighted by Professor Lord Darzi around unacceptable waiting times and the increasing prevalence of mental ill-health are shocking, but not unsurprising.

Indeed, part of the rationale behind the Innovate UK Mindset-XR programme which we deliver is that mental health as a sector could benefit considerably from transformational change. Tweaking and tinkering with existing approaches simply isn’t going to make the difference that is needed.

But with so many challenges and complexities to navigate, where should extended reality innovators start if they want to maximise their positive impact on the mental health of the UK?

Our Mindset-XR programme recently brought together senior clinicians from a variety of specialties and settings to discuss this question, amongst others. From those discussions, we saw three key themes emerging for innovators to bear in mind:

Whittling down waiting lists

By April 2024, more than a million people in England were on waiting lists for mental health services. Waiting times for diagnosis or treatment in Scotland, Wales and Northern Ireland have also increased significantly in recent years.

We know that the longer people have to wait to access the right mental health treatment, the worse their health outcomes. 80% of people experience a decline in their mental health while waiting for treatment.

The converse is also true; we know from the HIN’s work supporting FREED, an early intervention model for eating disorders, that speeding up access to diagnosis and treatment improves long-term health outcomes and saves the NHS millions of pounds.

Figuring out how to reduce the number of people waiting for assessment, diagnosis or treatment is a top priority for almost all mental health clinicians, services and commissioners. Addressing a bottleneck in a system is a sure-fire way to get stakeholders to pay attention to your innovation. During the roundtable, we heard about two clinical areas which could be a particularly good fit for immersive technologies:

• Children and young people’s mental health. Record levels of children and young people are seeking support with their mental health, with a rise in contacts with Child and Adolescent Mental Health Services (CAMHS) of 93% between 2019 and 2023. This in turn has led to significant backlogs; more than 250,000 young people were waiting for support in March 2024. Given the ubiquity of digital technology in young people’s lives already, this group may be especially receptive to the use of immersive innovations during diagnosis or treatment of mental health conditions.

• Autism and ADHD. Greater understanding of neurodiversity has led to a surge in people looking for conclusive diagnoses for autism and Attention Deficit Hyperactivity Disorder (ADHD). In the context of wider pressures on the system and a lack of general capacity, this increased demand has overwhelmed services and led to enormous waiting lists for diagnosis – with some reports of waits of up to 8 years for ADHD assessments. Any innovation with the potential to help increase the capacity to screen or assess patients is likely to be of great interest to services.

Supporting the workforce

Despite increases in the overall headcount of professionals working in mental health in recent years, it is widely acknowledged that the workforce presents the largest and most profound challenge to delivering against national mental health ambitions.

In September 2023, almost one in five mental health roles was vacant, with particular shortages in nursing roles. NHS mental health staff in England consistently report understaffing as a significant issue in the yearly NHS Staff Survey.

Overall staffing numbers are not the only issue, with gaps in senior psychiatry expertise emerging in some regions.

As with the issue of waiting times exacerbating underlying health conditions, these staff issues also create a vicious circle; the more stress and additional workload is placed on staff, the greater the impact on staff retention and sickness rates, and the worse conditions become for those remaining.

For innovators, two lessons to bear in mind are:

• The importance of helping clinicians save time. Innovations which allow clinical staff to do more with their limited time have the potential to improve the overall efficiency of the system.

• Recognising time as a barrier to implementation. Staff working in mental health services do not have the time to spend learning complex new systems or working through glitches in technology. Optimising usability and accessibility is key to get staff bought in to the potential of your innovation.

Health inequalities: leaving nobody behind

Some groups of society are significantly more likely to experience mental illness. Some groups are less likely to receive high-quality mental health care. Some – such as some people from the global majority – experience both of these types of inequalities.

Without careful planning and consideration, any technology-based innovation has the potential to worsen health inequalities. For example, it is not difficult to imagine how an NHS service switching to delivering some of their care using an app or digital platform might risk excluding people with lower digital literacy. Often people more likely to be affected by digital exclusion (such as older adults or people experiencing homelessness) also experience other forms of health inequalities.

For mental health services to invest in innovation, they need to be confident that the platform, tool or service provided is going to be effective across their service user population. Innovations which fail to consider digital literacy, socioeconomic factors or cultural appropriateness are unlikely to help them reach the groups in the greatest need.

For innovators, this means involving a diverse range of people with lived experience in the design and development of their innovations is crucial. This process should begin as early as possible; an innovative solution designed in true partnership with those affected by a particular mental illness is likely to be a much more compelling proposition for clinicians and commissioners than something created in isolation.

We are proud to be supporting innovators as part of the Mindset-XR programme who are already tackling some of these priority areas. If you would like to keep up to date with the latest insights from clinicians, commissioners and innovators focused on extended reality innovations in mental health, please do sign up to our newsletter.

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21 uses for AI and digital for 21st century NHS workforce management

Published and last updated by George London
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Much of the excitement around AI in healthcare has been focused on clinical uses of technology to improve patient outcomes. However, this narrow focus risks overlooking the fact that the health and care sectors are also major employers, with the NHS in England alone employing over 1.5 million people on a headcount basis. The size of this workforce means that the opportunity of using digital and AI to support and manage the wide range of staff working in the sector is immense.

Although health and care has been slow to adopt workforce innovation, the increasing pressure on staffing, coupled with a renewed focus on the NHS workforce in the light of the Long Term Workforce Plan, means that a coordinated effort to improve our workforce management is timely. Without significant transformation, we risk a shortfall of over 1 million NHS staff by 2036, according to the Nuffield Trust. The next generation of AI-enabled digital workforce solutions offers an opportunity to address some of the underlying issues impacting staff effectiveness, efficiency and morale across the sector.

In this article, our Chief Executive Rishi Das-Gupta explores 21 promising uses for AI enabled digital solutions in NHS workforce management that healthcare providers should consider.

In addition to obvious financial constraints, there are three important factors contributing to the slower adoption of workforce management innovation in healthcare than other industries.

 

Firstly, there is a complexity in defining staff skills, training and experience. Many HR professionals will have recent experience of this challenge, given difficulties in identifying appropriate cover during industrial action by NHS staff;  staff with outwardly similar job descriptions are not necessarily interchangeable in the same way that might be true for other sectors.

 

Secondly, it is difficult to capture context specific information that is relevant to workforce planning such as acuity levels of patients being cared for or the difficulties presented by the physical layout of healthcare facilities. This has resulted in many workforce planning functions being devolved or adjusted locally to improve safety.

 

Thirdly, the NHS is made up of many smaller organisations which has meant that local workforce management has been the default approach. The latest wave of consolidation and the formation of ICSs means that the NHS is now well placed to adopt workforce management innovations at scale.

 

AI-enabled digital workforce solutions are varied and have already been deployed across a range of industries. Learning from these, we have identified these 21 use-cases (in seven categories) as key to exploring how we can improve workforce management over the coming years.

Image showing seven categories of AI-based workforce innovation

Employee scheduling and rota planning

Several solutions offer the opportunity to plan rotas more effectively, integrating historic data and predicted demand for services. Others try to engage staff in choosing shift patterns that suit them, which has been highlighted as a cause of low staff morale. Some of the best workforce platforms also optimise routes to make jobs easier for mobile workforces (e.g. porters, community nurses).

These innovations can be grouped according to functionality:

1. Shift, route and rota management;

2. Dynamic scheduling, enabling staff to fill rota gaps/swap shifts;

3. Skill mix tracking and compliance reporting.

Performance analytics and feedback

AI can facilitate continuous performance management by gathering data from digital systems, to provide real-time feedback and performance insights for teams on activity and throughput:

4. Productivity or risk prediction. The digitisation of care processes provides much more data on activity levels and work patterns for staff, helping to identify periods where staff are performing at their best. AI can assess operational risks related to workforce performance, absenteeism, or compliance with processes, allowing organisations to take preventative actions.

5. Remote workforce management and collaboration tools. Many employers outside the NHS now routinely track performance of staff working remotely, both to monitor productivity but also to offer support where needed (e.g. training on activities which take some employees longer than their peers).

6. Objective evaluations. AI can be deployed in reducing biases in performance appraisals by using data-driven approaches for evaluations based on quantifiable metrics, and by making it easier to log achievements, activity and generate e-portfolios.

Learning and development

Given the need to stay up-to-date with skills and the complexity associated with training, the opportunities offered by modern digital platforms are among the most significant opportunities in the NHS for using digital in non-clinical applications. The ability to offer courses electronically (often by tablet or phone) means that training can be offered closer to the time it is needed and hence support staff better.

Key opportunities include:

7. Personalised training. Programmes can be based on job requirements or skill gaps identified during work or appraisal and make use of a mixture of formal training and on-demand lessons or ‘bite-sized’ support.

8. Adaptive e-courses. These vary the amount of time and training material based on the needs of the individual identified through performance during assessments or in the course of work.

9. AI-enabled intranet search. More advanced search tools offer an opportunity to improve the accessibility of existing materials by providing the ability to search intranets or learning resources to find appropriate materials.

Staff wellbeing and support

 

Sickness absence in 2022 reached 27 million days (up 27% from 2019) which is equivalent to 74,000 full time staff. The NHS is also subject to many of the same pressures as the wider workforce in the UK, with more staff managing long-term conditions while working.

In this context, opportunities to support staff include:

10. Staff engagement and sentiment analysis. Several companies outside the NHS undertake surveys of staff on a frequent basis (often shift-by-shift) to identify patterns in stress and workload and allowing leaders to intervene early where problems arise

11. Health and wellness monitoring apps. There are several companies offering health and wellness programmes targeted at both mental and physical health.

12. Automated Employee Assistance Programmes (EAPs). Trusts currently use a variety of EAP providers, and no single company is likely to be able to support the whole NHS workforce. However there is variation in how these services are accessed, with several EAPs already making use of apps and digital approaches to engaging staff.

Automation of workforce administrative tasks

Administration of HR tasks for the NHS workforce (including transfer of staff between organisations and payroll activities) has already been automated by NHS Shared Business Services using the Electronic Staff Records (ESR) system adopted by 134 NHS providers. In addition, several regions are introducing digital passports to facilitate staff working across sites/organisations.

Further opportunities to automate these tasks or link scheduling or rota planning to other processes could focus on:

13. Payroll;

14. Benefits administration;

15. Offboarding, including analysis of themes from exit interviews and related activities.

Predictive workforce analytics

Several providers are using AI to predict workforce needs, both in the short-term and longer-term. These focus on availability of staff groups and on skills mix within groups.

Some of the best systems outside the NHS link to activity data to provide additional insights in areas such as:

16. Forecasting staffing issues and challenges;

17. Skills gaps analysis and optimisation of skill mix both within shifts and across sites and organisations;

18. Demand forecasting for staff.

Recruitment and hiring

 

The annual rate of turnover among NHS staff improved in the year to June 2023 to 11.2%, but this still represents around 170,000 staff transfers. Each of these transfers involves a number of processes including advertising, shortlisting, checking of documentation, DBS checking, onboarding and offboarding. With a competitive job market, many services are also experiencing higher-than-average levels of applicants, which in turn drives higher numbers of candidate interactions.

Some trusts have streamlined these interactions and many have moved to using Trac jobs (provided by Civica). In addition, HR passporting within regions has reduced the burden of administration. However, some HR service providers in other industries offer additional services, including:

19. Automated CV and candidate matching. This is usually based on skills listed on application forms or CVs, and in some cases informed by previous shortlisting outcomes. These solutions offer the opportunity to reduce bias in shortlisting (if deployed well) and to offer feedback to unsuccessful candidates.

20. Chatbots. Chatbots allow for the automation of routine interactions with candidates (such as questions around recruitment processes) and to schedule interviews and assessment centres.

21. Onboarding and document checking. Some modern systems are able to check the validity of documents such as passports or visas.

From ideas to implementation

We have identified that solutions are developing quickly across the range of workforce management activities. The large number of NHS staff, and the turnover rate within individual Trusts and services means that significant benefits can be realised relatively quickly.

Currently, there are multiple providers offering elements of AI and digital workforce solutions to the NHS, and many more demonstrating best practice in other industries. We recognise that there is an inherent tension between realising benefits across the entire NHS and innovating in smaller units. Few HR service providers have the capacity to cover the entire NHS, and while NHS Shared Business Services and large providers such as Civica have been able to offer scale, other smaller providers have driven innovation in specific areas such as learning and development, wellbeing and staff support.

 

To drive innovation in this sector (and hence productivity and cost reduction) across the NHS, some regions/ICSs may wish to accelerate and focus on workforce solutions and their deployment as part of their overall strategy. There may even be opportunities for the development and integration of services within tools such as an NHS staff app.

The HIN has supported several companies in this space and helped the NHS implement digital and AI solutions. We are interested in hearing from ICSs or regions aiming to invest in improving HR solutions, and from companies interested in joining our innovator support programmes such as DigitalHealth.London Accelerator.

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Mindset-XR: Stimulating investment in extended reality for mental health

Published and last updated by George London
Man trying on a VR headset

The Health Innovation Network (HIN) South London and Innovate UK are currently delivering Mindset-XR, a multi-year innovator support programme focused on the use of immersive technologies for mental health. Following recent engagement with investors and the publication of our 'Stimulating investment in extended reality for mental health' report, HIN Executive Director for Digital and Transformation Dr Amanda Begley discusses the areas where progress needs to be made if we are to match the global need for transformative technologies in mental health with investor appetite.

I was very privileged to be invited by the Coalition for Mental Health Investment to attend an ‘invest in mental health’ event last month, which brought together funders (including philanthropists and investors), researchers and innovators, lived experience experts and global network conveners. The Coalition – formed by Wellcome, McKinsey Health Institute and Kokoro - is a network forming to ensure that, within a generation, investment for mental health matches the scale of global need. 

The inspiring speakers and networking resonated with many of the points highlighted during our recent roundtable: ‘Stimulating investment in extended reality for mental health’. So, as we publish our report, I wanted to share a few reflections inspired by the people I’ve spoken to and learned from about the importance of investing in mental health.  

Timing  

There is a growing passion and sense of moral duty around increasing investment in mental health, with a focus on collaborative effort and innovative financing models. A number of investors I’ve spoken to said they’d lost money investing in immersive tech 10 years ago. However, most added that the case for investment is far more compelling now - although some do remain more sceptical.

In part this is due to the technological advancements. For example, the ability to combine immersive tech with artificial intelligence and bio/neuro feedback to drive greater personalisation and measurement of impact. A recent PWC report on immersive technology trends in 2024 predicts a proliferation of immersive tech offerings alongside the ability to tap into generative AI’s power, which could create new business models for organisations. 

The focus and roadmap  

I don’t think anyone could argue against the need for further investment in mental health. The financial gap is well articulated in the United for Global Mental Health report which references that almost one billion people globally are living with a mental health condition, including around one in seven teenagers. 

However, we still need to provide assurance to investors (whether public or private) that any investment made will be well made. As experienced investor and HIN Chair Hitesh Thakrar pointed out in his previous blog on investor attitudes towards immersive technology, delivering demonstrable impact and reliable returns is the foundation for any sustainable investment activity, and investors are understandably cautious. For immersive technology, building investor confidence requires greater clarity on where we should focus our innovation efforts and also the provision of a roadmap that lights the path from feasibility studies to adoption and scaling.  

This is a big focus for our Mindset-XR Innovation Support Programme, where we are working with Innovate UK to support immersive tech projects to navigate their innovation path, drawing on our experts in involvement, evidence generation, regulation and business development.  

We will be holding a roundtable in the Autumn focused on identifying the ‘use cases’ for immersive tech in mental health, which will be chaired by Dr James Woollard, CCIO at Oxleas NHS Foundation Trust, National Specialty Adviser in Digital Mental Health at NHS England and a member of our Mindset ISP Advisory Board. So do sign up to our newsletter if you’d like to receive a copy of the write up. 

 

Business models and payment model reform 

Thirdly and linked to the above, the need for new business models and payment model reform have also been frequently cited as key enablers. This includes approaches that are considered to be underutilised in mental health, such as, social impact bonds as well as the formation of private and public collaborations, such as, UKRI’s investor partnerships. 

To facilitate new models, more focus is needed on quantifying impact and the return on investment. There are obviously challenges to overcome on this, including, reaching consensus on impact metrics (including how holistic and longitudinal the measures need to be); access to inclusive and high quality data; and the confounding variables at play in real world delivery. On the positive though, we have seen significant investment in UK data infrastructure which will provide further opportunities to use data in safe, secure, and innovative new ways via, for example, DATAMIND (specifically for mental health) and the Secure Data Environment for NHS health and social care data research and analysis.  

I hope you enjoy reading our investor roundtable report and that it leaves you – as it does us - with a sense of optimism. There is a growing collaborative effort to drive innovation that will benefit those affected by mental health conditions, and we hope to play our part in turning that effort into real results.

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International Women’s Day: Innovation in action

Published by George London

Anna King is Commercial Director for the Health Innovation Network South London. In this blog she reflects on learnings from the Royal College of Obstetricians and Gynaecologists' International Women's Day event and the opportunities to maximise the impact of innovation on women's health.

This week, the Health Innovation Network had the privilege of participating at the Royal College of Obstetricians and Gynaecologists (RCOG) International Women’s Day event. The theme of the event was ‘Innovation and Action in Global Gynaecological Healthcare’, which shows the important that the College is placing on innovation to improve the health and care for women globally.

The whole event was inspirational, with speakers talking to how they are testing and implementing innovations to their clinical colleagues, whether new medical devices, diagnostics or digital solutions.

The event was a fantastic opportunity to catch up with some of the alumni innovators from our DigitalHealth.London Accelerator programme – which support companies to spread and scale. I was particularly proud that the team from the South West London Integrated Care System were able to highlight how they are using GetUBetter to support the women’s pelvic health in the gynaecological pathways, in addition to the other muscular offering.

The Health Innovation Network was delighted to specifically partner with Professor Asma Khalil, Vice President for Academia and Strategy as well as Consultant in Obstetrics and Fetal Medicine and St George’s University Hospital, on the last session of the day ‘Celebrating the innovation driving women’s health improvement’.

This session gave the audience an opportunity to hear about some fantastic innovators, many of whom have benefited by working with their local health innovation network. I was pleased to have an opportunity to draw out many of the lessons we have learnt supporting innovators.  Highlights included:

  • Hearing about their continued successes of PLEXaa, who participated the the Accelerating FemTech Programme we ran for InnovateUK, in partnership with RCOG and others. Plexaa is helping breast cancer patients in the US and UK benefit from better wound care healing was a personal highlight.
  • Learning about The Tydeman Tube, which was developed at St Thomas’s hospital to assist with the caesarean delivery and is being launched to the market soon.
  • Professor Angie Doshani, founder of the JanamApp, discussing how partnering with your target audience can lead to co-designed and co-produced innovative health solutions. In the case of JanamApp, this kind of partnership led the development of a pregnancy information app for the south Asian community in a completely different direction to what had originally been envisaged

Listening to our FemTech alumni and some other brilliant innovators in this space also prompted me to reflect on some of the commonalities associated with success. A great idea is of course a fairly essential prerequisite for innovation. But one of the foundational understandings of our DigitalHealth.London programmes is that a good idea in and of itself is rarely enough to make an impact on patients or health and care systems. Innovation is a team sport, and often it is collaboration which makes the difference between a great idea and a truly impactful product.

Many healthtech innovations are the brainchild of clinicians. But regardless of individual brilliance, there will be times where you need to bring in a wider team, different perspectives, or a new connection to make the most of your innovation.

In a week where we launched applications for our latest DigitalHealth.London Evidence Generator Bootcamp, it seemed particularly timely that a number of innovators reflected on the challenges of evidence generation and regulatory approval. Finding the right expert partners is essential for navigating these complex but entirely necessary areas of innovation.

This is also where the programmes of the health innovation networks, like DigitalHealth.London or Accelerating FemTech, can help by introducing you to the range of experts needed, whether regulator, governance, or other specialism. The good news is that the UK innovation sector is full of partners ready and willing to help turn good ideas into real-world impact. From world-leading professional institutions with a tradition of progressive thinking such as RCOG through to a variety of new funding opportunities becoming available through UK Research and Innovation and other sources, the sector is primed for global success.

Dr Ranee Thakar, RCOG Chair, closed the IWD conference by urging delegates to “harness the potential” of innovation. I feel confident that through the Health Innovation Networks nationally, and the exciting programmes of innovator support we have planned locally like Accelerating FemTech and the DigitalHealth.London Accelerator, we can use partnerships to harness innovation to improve health and care.

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Regional success sees south London brand go national

Published by George London

We are thrilled to announce that as part of our new five year licence with NHS England and the Office of Life Sciences, that the AHSN Network has been renamed as the Health Innovation Network.

Our national partners were so pleased with the level of impact we have delivered in south London and beyond in health and care, that when they were relicensing all 15 AHSNs they asked that our name be used for the national co-ordinating office, previously known as the AHSN Network.

And it’s not hard to see why – when we asked teams across the health and care sector that we work with for their views on us we received some fantastic feedback, including a net promoter score of 50 (which is considered “Excellent”) and comments such as:

  • “The HIN really helped to accelerate our project becoming nationwide, which was excellent and opened doors we didn't even know were there to knock on.”
  • “The HIN meant we got extra funding, doors to different political spaces, and support to navigate the NHS systems locally not only within the local teams, but also the wider NHS systems those local services sit within. This was invaluable.”

At a local level we have secured £1m of additional funding for the south London local health and care system so far this year. Across London we completed evaluations on Pan London Remote monitoring and led approaches to London-wide system learning including webinars on Cardiovascular Disease, Autism, Novel therapies, MSK and Anti-racism.

Nationally our FemTech accelerator is helping 12 early stage entrepreneurs improve conditions which disproportionately impact on women and the FREED programme, which helps young people with eating disorders get early treatment has been shortlisted for a national award. Plus this quarter we have begun working with NHS Fife in Scotland on addiction, and with colleagues in North Ireland to provide leadership support. Internationally we have joined the TeleRehaB project which is looking at how AI and augmented reality can help people with balance problems after strokes.

Dr Rishi Das-Gupta, Chief Executive of the Health Innovation Network (HIN) South London said: “Our ethos has always been on collaboration with a focus on the spread and adoption of innovation which benefits patients and NHS staff. We’re so committed that we’ve now successfully spread our name to the national team!”

The other networks have already started changing their names to be known as the health innovation network for their area, e.g. Health Innovation East Midlands and all 15 will continue to work together as part of the national Network.

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HIN appoints permanent Director of Digital Transformation

Published and last updated by George London

Following a competitive recruitment process, the Health Innovation Network (HIN) South London has today (1 November 2023) announced the appointment of Amanda Begley as permanent Director of Digital Transformation.

Amanda originally joined the HIN South London in June 2022 on secondment from Guy’s and St Thomas’ NHS Foundation Trust (GSTT), where she was Director of the Centre for Innovation, Transformation and Improvement (CITI).

During her time as interim Director of Digital Transformation at the HIN, she has been instrumental in work to support the implementation of virtual wards across the capital, and through supporting NHS England’s London region to understand the patient experience of digital transformation by surveying over 2,000 people.

Previously, Amanda co-founded the award winning NHS Innovation Accelerator (NIA), and helped to establish the Health Data Research UK Hub for Cancer (DATA-CAN), where she worked as Director of Strategy and Partnerships.

Following her PhD in psychology, Amanda joined the NHS as an Assistant and Trainee Clinical Psychologist. She has also worked as a commissioner and senior manager across primary, community and secondary care in south west London, as Head of Innovation at London’s Strategic Health Authority and Director of Innovation and Implementation at UCLPartners.

Reacting to the appointment, Amanda said: “I’m passionate about how digital can enable the transformation of health and care in a way that is inclusive, improves patients’ lives and takes pressure off stretched staff. To be able to continue to do this at the HIN is fantastic.”

Dr Rishi Das-Gupta, CEO of the HIN said: “Implementing digital transformation and demonstrating its impact can feel daunting, particularly for stretched and stressed health and care staff. Having a permanent Director for Digital Transformation means we are committed to supporting our partners in south London and beyond with this and I am thrilled that Amanda will be in this role for us.”

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Are virtual wards sustainable?

Published and last updated by George London

With the current pressures on the NHS, helping staff to manage the unprecedented demand they are facing is a top priority. One exciting development gaining traction is Virtual Wards (VWs), which could help to maximise resource usage while improving patient experience. Here Amanda Begley, Director of Digital Transformation at the Health Innovation Network, describes how a recent event showcased to her how VWs offer a safe and well received alternative to traditional inpatient care, potentially relieving some of the pressures on our healthcare system.

VWs are a new model of care which is still under design and testing, so the evidence is not yet robust enough to support a traditional business case. In addition, ring-fenced national funding for virtual wards is coming to end, and so ICBs need to decide whether and, if so, how to continue funding them. In this context, the question arises: how do we build a business case and ensure sustainability for VWs?

To answer this question, the Health Innovation Network South London and NHS England London brought together key financial, clinical and operational stakeholders from across the capital along with national representatives to seek a consensus around the benefits of VWs that could best drive business cases. The goal was simple: to reach a consensus on why VWs matter and how that can drive investment decisions.

The event buzzed with energy, and discussions were so engaging that attendees willingly stayed beyond our planned 5:30pm close to keep the discussion going. I was struck by the enthusiasm for doing the right thing for patients, thinking through how we enable people to be cared for in the place of their choosing. The insights from the session will be invaluable in guiding systems deciding where to prioritise investment.

Some key system and financial benefits highlighted at the event were:

  1. Reducing admissions and re-admissions: Implementing VWs can help minimise avoidable non-elective admissions and re-admissions, leading to better patient experience, outcomes and use of resources. This shift also frees up physical beds for unavoidable non-elective and planned elective care.
  2. Decreasing Emergency Department wait times and improving flow: VWs can play a crucial role in reducing ambulance handover times, decreasing ED waiting times, and streamlining the "decision to admit" process. They allow for patients to be discharged from the ED to a VW and earlier discharges from inpatient beds, ensuring smoother patient flow through the hospital.
  3. Making the most of limited resources: VWs have the potential to optimise resources by reducing the cost per patient stay compared to inpatient beds. They also allow for a more efficient use of the workforce, thanks to the ability to safely deliver care at a lower staff-to-bed ratio. This is particularly so for tech-enabled virtual wards.

In a world where demographic changes mean pressure on services is only increasing, the VWs event was about finding innovative solutions, by creating an atmosphere of collaboration, meaningful conversations, and shared purpose. The journey ahead may still be under construction, but the destination promises a healthcare system that's even more patient-focused, sustainable and future-proofed.

Our recent virtual wards event also included reflections on patient experiences of virtual care. Click here to read our summary blog focused on patient experience.

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Supportive, spiritual or secluded – what is the actual experience of receiving virtual care?

Published by George London

Imagine being unwell and having the comfort of your own home as your healthcare setting—an idea that is becoming a reality with the concept of virtual wards. NHS England London Region and the Health Innovation Network South London (HIN) recently held a patient and people involvement group to delve into the experiences of individuals who have been a part of this innovative healthcare approach. Here Amanda Begley, Director of Digital Transformation, and Joe Barker, project manager in digital transformation at the HIN describe the benefits, challenges and improvements highlighted by patients and carers.

Patients’ views and experiences are central to any new models of care, and so we were keen to hear how it feels being cared for on a virtual ward, and to share these insights with those leading the planning and operational delivery of virtual wards.

During the discussion patients and carers highlighted a range of benefits they had experienced by being able to be stay in a home environment. Three key themes that came up in the discussions were around:

  1. Emotional wellbeing: One of the most heartening takeaways from the discussion was the profound impact of emotional support. Participants emphasised that having loved ones around during their illness made them more determined to heal. As one patient aptly put it, "It's like you want to give up more when you're in a hospital bed." The familiar surroundings of one's own home, with the comfort of your own bed and the freedom to watch your favourite TV shows, contributed significantly to emotional well-being.
  2. Self-perception and quality of life: One carer highlighted how being in a familiar environment helped their loved one feel less like a "very ill" person. It allowed them to maintain a sense of normalcy in their life during their illness, which positively influenced their self-perception and overall quality of life.
  3. Praying and spiritual support: Another important benefit was the importance of spiritual support. One person spoke about how being at home allowed them to receive visits from people who could pray for them, and they could continue openly practicing their faith, like reading the Bible, which isn't always possible in a hospital setting.
"Having [friends and family] around you makes you want to recover more quickly. It's like you want to give up more when you're in a hospital bed."Participant

However, it was also clear that peoples’ individual circumstances meant that virtual care presented challenges. The three main challenges highlighted were:

  1. Isolation and mental health: Some people expressed concerns about isolation when recovering at home. They recognised the potential impact on mental health, as being alone for extended periods during illness can lead to feelings of loneliness and isolation.
  2. Carer commitments: Carers in the group shared their experiences, revealing how work commitments sometimes limited their ability to provide continuous care. This issue highlights the importance of integration with social and domiciliary care.
  3. Suitability and accessibility assessments: Accessibility concerns were raised as well, particularly for individuals living in multi-storey buildings with access challenges. The need for proper suitability assessments and emergency response planning was raised.
"If you're at home by yourself, that can be very isolating and could have an impact on your mental health."Participant

Practically there were some suggestions for improvements that resonated with the group as a way to ensure the model is as effective as possible:

  1. Patient choice: Participants stressed the importance of including patients in the decision-making process, particularly the decision to admit and discharge. They emphasised that patient views should be considered during multidisciplinary team (MDT) discussions. One specific issue that was raised was around the number of staff that would be visiting the patient’s home.
  2. Service branding and communication: Some patients found the term "virtual" off-putting, associating it with technology and not seeing anyone in person. They suggested a shift in branding, proposing that the term "NHS Care at Home" better reflects the essence of the service.
  3. Time to connect: Patients valued the personal connection with healthcare staff, continuity of care givers and highlighted the need for staff to have time for meaningful interactions. This human touch was felt to be particularly important for older individuals.
“If [the staff] don’t have time to interact, you don’t get that connection, and older people particularly like that connection, they like that same face.”Participant

In conclusion, our patient focus group shed light on the nuanced experiences of those involved in virtual wards. While the benefits are significant, addressing challenges and incorporating patient and carer views can further enhance the effectiveness of this evolving healthcare model. By continuously improving and adapting, we can ensure that virtual wards provide the best possible care while supporting compassionate and meaningful relationships.

The discussions and ideas from this focus group will contribute to the development of virtual wards in the London region, improving them and making them sustainable.

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Partnering with people: how experts by experience are helping to reduce restrictive practice in acute mental health settings

Published and last updated by George London
Group of people on an acute mental health ward

17 September marks World Patient Safety Day; the theme for 2023 is ’Engaging patients for patient safety’ in recognition of the crucial role patients, families and caregivers play in improving the safety of health and care.

As part of our celebration of World Patient Safety Day, we hear from HIN Project Manager Ayobola Chike-Michael about how her work on the Mental Health Safety Improvement Programme (MHSIP) has helped to bring together patients and professionals with the shared aim of improving outcomes.

It has been amazing to work as a patient safety project manager for the past four years. Looking back, I am grateful for the opportunity to live out my dream to make life better for both patients and staff through my skills as a project manager.

Much of this has been made possible through NHS England and NHS Improvement’s national patient safety improvement programmes, which form the largest safety initiative in the history of the NHS. These programmes have supported safety, continuous learning, and sustainable improvement across the healthcare system.

There are five major improvement programmes focusing on medicine, mental health, deterioration, maternity and adoption/spread. Each area has key ambitions that align with NHS England’s Long Term Plan.  My reflections in this blog centre on the Mental Health Safety Improvement Programme (MHSIP); my colleague Natasha has recently written about our work on the medicines programme (MedSIP).

What is MHSIP?

The aim of the MHSIP is to improve the safety and outcomes of mental health care by reducing unwarranted variations or health inequalities across a number of specifically-targeted topics.

The MHSIP programme began initially with its focus in areas of sexual health, suicide and reducing restrictive practices. These were all significant areas of interest, however it was not feasible to drill into all three areas concurrently. Ultimately Reducing Restrictive Practices (RRP) became the main focus for Patient Safety Collaboratives (PSCs) to lead on nationally. Using quality improvement methodologies and tools, MHSIP leads worked in their local areas but also collaboratively across England, coming together regularly to share best practice and challenges.

The Health Innovation Network (HIN) where I work, is one of 15 PSCs who led on the MHSIP work in their designated local region. The HIN covered South London and it presented a valuable opportunity for me to work with mental health professionals (particularly in inpatient care) across south east and south west London.

Using the patient perspective to Reduce Restrictive Practice

Our core HIN team – made up of project managers, quality improvement experts and in-house clinicians who provide valuable support in helping us interface with clinical colleagues – was hugely bolstered by having experts by experience working in partnership with us during the programme. These experts by experience were recruited to contribute their unique perspective to the programme; working effectively with people and communities throughout our work is one of the main aims of our Involvement Strategy.

The programme exemplified the elevation of patients’ voices through the partnership with six experts by experience. The HIN primarily acted as a convening force, facilitating continuous sharing of knowledge, experiences and learning opportunities through QI collaboratives and the Patient Safety Network. These were attended by a range of healthcare professionals including mental health nurses, QI professionals, psychiatrists, ward managers, project managers, healthcare assistants, doctors, service user involvement representatives, dieticians, psychologists, and senior managers. Our work meant that each of these groups had the chance to learn from the experts by experience, who often brought new ideas or insights to the table.

Sharing spaces and sharing ideas

One of the highlights of this programme for me has been the visits to various inpatient wards. As the project manager, I was accompanied to each ward visit by an expert by experience, who brought valuable perspectives to the conversations we had with staff and service users.

This collaborative approach fostered a well-rounded understanding of the wards’ dynamics and challenges. Discussions during the visits encompassed various aspects, including the ward’s culture, compassionate leadership, staff wellbeing, potential areas for improvement, and specific techniques for reducing restrictive practice such as the utilisation of safety crosses. We also took the opportunity to address challenges unique to each ward and proposed potential solutions, tailored to their circumstances.

Participating wards successfully tested and implemented some change ideas despite often facing significant barriers,  such as staffing issues or complex caseloads. As a team, we observed and supported the implementation of several change ideas aimed at improving patient care and experiences.

Some of the change ideas included:

  • Patient involvement in planning schedules;
  • Therapeutic and sensory interventions;
  • Staff skills training and use of tools;
  • Coproduction with patients and families in decision-making processes and jointly developing care plans;
  • Visual display of routines, preferences, and staff allocation;
  • Improved indoor and outdoor spaces;
  • Reduced blanket restrictions and unnecessary rules;
  • Negotiation with patients;
  • Increased focus on patient preferences and needs;
  • Open door polices to build patient relationships.

The work has generated significant improvements across a variety of measures of patient experience and safety. It has been incredibly fulfilling to be a part of sharing practical, patient-focused ideas between services; the input of our experts by experience has been vital for understanding the human context for these interventions and gaining a well-rounded view of how they might impact patients and their families.

We are grateful to work with the six experts by experience who through their partnership with us, elevated patients’ voices. We are also grateful for the full participation and contributions of the following wards across south London – Avery ward, Aquarius ward, Jasmines ward, Lesney ward, Norman ward, and Ruby ward.

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“We want to work in partnership” – World Patient Safety Day and MedSIP

Published by George London
Blister packs of medicines

On World Patient Safety Day, we hear the latest from the Pan-London Medicines Safety Improvement Programme Team on their dedicated efforts to include patients in the heart of medicines safety.

Key statistics

  • Around 15.5 million people in England (34% of the population) have chronic pain (Source: Public Health England (2020). Chronic pain in adults 2017: Health Survey for England. PHE, London)
  • Between January and October 2022, an average of 21,520 fewer people per month were prescribed oral or transdermal opioids (of any dose) for more than three months, compared with the baseline period of January 2021-December 2021 (Source: AHSN Network (2023). Supporting people to manage long-term pain without opioids)

The theme of this year’s World Patient Safety Day is engaging patients for patient safety. Chronic pain affects every aspect of health and well-being beyond the physical pain; therefore, it is important to work in partnership with patients to find out how we can best support their individual needs.

The Pan-London Medicines Safety Improvement Programmes (MedSIP) team have been working across England with the other 12 Patient Safety Collaboratives (PSCs) hosted by Academic Health Science Networks (AHSNs) to improve chronic (non-cancer) pain management by reducing harm from opioids. National Institute for Health and Care Excellence (NICE) guidance states that opioids should not be used to manage chronic non-cancer pain as harm outweighs the benefit.

Each London PSC has taken a different approach to engaging patients as key partners based on local needs for patient safety and opioid stewardship.

Natasha Callender is a Senior Project Manager (Registered Pharmacist) and Medicines workstream lead from the Health Innovation Network (HIN), who led an experience-based co-design (EBCD) project, working with the HIN’s Involvement team and HIN Lived Experience Partners using the Point of Care Foundation methodology. Natasha commented on the project:

“The aim of this EBCD project was to improve chronic pain management by bringing the lived and learned experiences of staff and patients together to prioritise and co-design solutions as equal partners.

“We co-produced recommendations for peer support and group education for people living with chronic pain to share with the system. We also developed a patient film and poster to raise the awareness of how connecting with activities, groups, and services in local communities can support people to live well with chronic pain.”

You can read more about the HIN’s project in this blog and an overview of their progress and next steps with the EBCD project by clicking here.

Lucie Wellington is a Senior Innovation Advisor and Opioids Programme Manager, Imperial College Health Partners (ICHP). ICHP is supporting the North West London (NWL) Integrated Care Board in using a systemwide model to reduce harm from opioids. The programme is being delivered via two workstreams; improving opioid stewardship across the care interfaces and PCN opioid optimisation review. Both workstreams put patient and public engagement at the heart of their efforts. Speaking about their work, Lucie said:

“In line with our unwavering commitment to delivering high-quality care, our latest strategic initiative is aimed at involving patients and the public in shaping the direction of our programme. We are seeking experts by experience to contribute invaluable insights on programme strategy and patient and clinician facing resources. Collaboration with our local polypharmacy initiative further promotes shared decision-making through a behaviour change campaign, empowering patients in structured medication reviews.

“Guided by NWL co-leadership and our shared dedication to making an impact, our programme has cut high-dose opioid prescriptions by 57 patients monthly, reflecting patient centred-care.”

For more information about the ICHP programme, click here.

Jess Catone is an Implementation Manager leading the Medicines Safety Improvement Programme at UCLPartners . UCLPartners has formed a core working group and an Opioids Network with representation from patients, Primary Care Networks (PCNs), community pharmacy, secondary care and mental health trusts across North Central and North East London. The aim of the Opioids Network is to provide a platform for patients, healthcare professionals, and voluntary/charity sectors to engage, share learning and develop better ways to manage chronic non-cancer pain. Jess briefly summarised some of the key elements of the UCLPartners programmes:

“We have produced an implementation guide for group education sessions, which was co-developed with patients and clinicians and includes a suite of material to support the work. These sessions, called ‘Feeling ALIVE: I cAn LIVE well with pain’, provide patients with information on ways to better manage their persistent pain and incorporate a follow-up consultation with a healthcare professional. The sessions also give patients an opportunity to meet and converse with other people who are experiencing similar issues with managing persistent pain.”

For more information on the work underway at UCLPartners, click here.

We are delighted to work with NHS England Patient Safety Team, PSCs across England and Pan-London system partners to improve the lived experiences of patients living with chronic pain. Let's continue work together to empower patients, enabling them to play a vital role in enhancing safety and minimising opioid-related harm within chronic pain management.

 

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Health Innovation Network joins international consortium harnessing AI and augmented reality for clinical rehabilitation

Published and last updated by George London

The Health Innovation Network (HIN) has today (July 26 2023) announced it will join the international TeleRehaB Decision Support System (DSS) project.

TeleRehaB DSS is a partnership developing AI-based telerehabilitation solutions for people experiencing balance problems after a stroke, delivered via augmented reality (AR). The technology can also be used with people experiencing Mild Cognitive Impairment (MCI) or long Covid-19.

Balance problems causing falls are one of the most common complications after strokes, with up to 73% of people who have had a stroke experiencing a significant fall within one year. Falls related to balance issues are often also associated with other conditions causing changes in cognitive ability such as MCI. These falls can cause physical injury (especially in older people) and may lead to the loss of self-confidence and depression.

Balance physiotherapy is a key intervention for falls prevention, but access to specialist falls prevention services is limited in many countries due to lack of appropriately trained clinicians and the complexity of effectively diagnosing and treating the underlying causes of the condition.

The TeleRehaB DSS project uses AI technology to make balance physiotherapy more available to non-specialist practitioners, through the introduction of guided diagnostic tools and personalised intervention-selection aids. These interventions are then delivered in the patient’s own home, with an AR “physiotherapist” guiding the patient through a tailored rehabilitation programme.

Supported by Innovate UK funding, the HIN’s primary role will be to provide expert guidance on facilitating the spread and adoption of new technologies and ways of working associated with the project. The HIN will also help TeleRehaB DSS engage with healthcare professionals and patients across the UK and further afield to localise its work.

The HIN joins a prestigious group of academic institutions, NGOs and research and development centres working on the project, with representation spanning Europe and Asia. Current members include:

  • University College London
  • Chulalongkorn University (Thailand)
  • National University of Athens (Greece)
  • Universitae Klinikum Freiburg (Germany)

Anna King, Commercial Director at the HIN said: “We are delighted to be joining the TeleRehaB DSS consortium and working on such an exciting use of a virtual reality solution in rehabilitation, to target a major health challenge where technology has a significant potential to improve care.

“I look forward to bringing our deep expertise in the spread and adoption of innovations in healthcare to bear on this international project; together we have a chance to explore how this emerging area of technology can best meet the needs of patients and clinicians.”

UK participants in Horizon Europe Project TeleRehabilitation of Balance clinical and economic Decision Support System are supported by UKRI grant number 10070260.

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Remote monitoring: embracing cultural change and developmental partnerships to enable patient choice

Published and last updated by George London

The Health Innovation Network and NHS England (London Region) recently held a series of procurement roundtables focused on remote monitoring. In this blog Dr Sanjay Gautama, Clinical Informatics Lead for the London region and consultant anaesthetist, discusses why it is crucial for suppliers and services to change their ways of working if they want to deliver change for patients.

At the heart of the promise of remote monitoring is the ability for patients to exercise greater choice as to where they receive safe and high-quality care. Remote monitoring is already starting to deliver on that promise, and enable people to be cared for in their own homes – a giant leap forward for digital technology in healthcare.

Whilst the early signs are that many patients are adapting well to this brave new world, commissioning, designing, and implementing these new technologies has been challenging for many of the professionals involved.

A particular impediment to progress thus far has been navigating existing procurement processes; a topic some of my colleagues discussed last month.

I am pleased that we are now in a position to share the in-depth outputs of recent collaborative work, bringing together perspectives from industry, commissioning, procurement and implementation teams to suggest a new way forward, focusing on developmental partnerships.

Getting the way we work together right has huge implications, not just for the initial procurement of digital infrastructure, but also the ongoing flow of data between different systems and ability to maintain interoperability as our requirements and ecosystems inevitably evolve over time.

Ultimately, it is the collegial and collaborative relationships between suppliers and services which will be vital if we want to see the pace of improvement to patient outcomes keep up with the potential speed of technological advancement in remote monitoring.

Technology should make doing the right thing for the patient the easiest option for the clinician – and developmental partnerships seem the way to achieve this.

Our report covers practical insights into key elements of establishing successful developmental partnerships, such as choosing who to involve, and advice on how to nurture these partnerships over time through effective engagement and contracting.

We hope that you will find it useful.

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View our full roundtable report containing expert insights into how developmental partnerships may help to improve the commissioning, design and implementation of remote monitoring solutions.

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New NHS Innovation Service streamlines national support for innovators

Published and last updated by George London
Doctor using tablet device

HIN Chief Executive Rishi Das-Gupta has hailed this week’s launch of the NHS Innovation Service as an important step forward in delivering life-changing innovation more quickly.

Coordinated by the NHS Accelerated Access Collaborative (AAC), the service has been developed to support the UK’s Life Sciences Vision and accelerate the uptake of promising and impactful innovations into the NHS.

The NHS Innovation Service provides access to guidance and coordinated support from AHSNs and other organisations who have experience, knowledge, and expertise in developing and supporting the spread and adoption of healthcare innovations.

Innovators working with the service will be provided tailored guidance to help them complete processes which will help “unlock” adoption and spread within the NHS, including:

  • Regulations and service standards relevant to innovations
  • Demonstrating evidence of efficacy
  • NHS procurement and reimbursement processes

The service enables innovators to access support from expert organisations through a single coordinated platform. Organisations currently part of the NHS Innovation Service include:

  • The AHSN Network
  • Department for International Trade (DIT)
  • Medicines and Healthcare Products Regulatory Agency (MHRA)
  • National Institute for Health and Care Excellence (NICE)

Innovators create an account and complete an innovation record, which contains detailed information about their innovation. This enables an expert team to determine the requirements for the innovation to be adopted and put the innovator in touch with the right organisation at the right time. At each stage, organisations offering support have access to the innovation record, which will accelerate the process and avoid duplication – saving innovators having to reintroduce their concept and progress to each organisation.

The NHS Innovation Service is currently in public beta – a public testing phase. Users will be able to provide feedback on the service based on their experiences, creating opportunities for it to improve with further testing. The service replaces the HealthTech Connect platform.

Dr Rishi Das-Gupta, HIN Chief Executive said: “The NHS Innovation Service will further bolster the expert support already available to south London innovators through our own Innovation team and the DigitalHealth.London programme.

“I am particularly pleased that this new service will allow streamlined engagement with national bodies such as MHRA and NICE, who can often be crucial players in facilitating the spread and adoption of the most promising innovations. Reducing the complexity of interfacing with these bodies will undoubtedly mean patients benefit from innovations sooner.

“This work is another powerful demonstration of our sector’s commitment to collaboration as a driver of world-class health innovation in the UK.”

Inclusive innovation: 5 things you can do to make healthtech better for the LGBTQI+ community

Published and last updated by George London

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To celebrate Pride Month 2022, we’ve teamed up with DigitalHealth.London NHS Navigator Brett Hatfield to look at some practical steps anyone working in health and care can take to make health tech more accessible and inclusive to the LGBTQI+ community.

The LGBTQI+ community is affected by disproportionately worse health outcomes and experiences of care. Health technology and innovation can play an important role in tackling these long-standing inequalities, with progress already being made through movements such as Queertech – but it is important we keep up this momentum.

Whether you are a clinician or commissioner, member of the LGBTQI+ community yourself or aspiring ally, any person working in the health and care system can contribute to making health and care technology better for people who identify as lesbian, gay, bisexual, transgender, queer or intersex.

In this blog we’ll be looking at 5 steps anyone can take to get started with LGBTQI+ inclusive innovation – if you’ve got additional ideas or resources we’d love to hear from you.


1. Learn about the health experiences of LGBTQI+ people

People from the LGBTQI+ community have faced – and continue to face – specific barriers and challenges when it comes to health. In recent years, progress has been made on understanding some of these challenges and starting to address some of the underlying issues that have resulted in health inequalities.

• Read Stonewall’s “LGBT in Britain Health Report” (PDF)

On the other side of the therapeutic relationship, many LGBTQI+ NHS staff also sadly continue to experience discrimination, with one recent survey revealing that more than a quarter of lesbian, gay or bisexual staff had received bullying or poor treatment from their colleagues.

• Read The King’s Fund blog “Supporting LGBTQ+ NHS Staff”

2. Join a community

The LGBTQI+ community has a long tradition of connections spanning geographies, languages and backgrounds. Many thousands of communities and forums now exist in helping to bring together people who identify as LGBTQI+ (and allies) with specific interests. Many of these intersect with the worlds of health and technology, making them the perfect place for incubating ideas, discussing challenges, or simply listening and learning more about the experiences of LGBTQI+ people.

We’ve listed a handful of relevant communities below, but many more can be found by searching the web:

• Intertech
• Lesbians who Tech
• Guy’s and St Thomas’ LGBT+ Network
• Pride in STEM
• LGBT+ Future NHS workspace


3. Be data-savvy

A particularly relevant inclusive innovation topic for people working in the design and deployment of NHS technology services is the importance of getting monitoring and data collection right.

Monitoring refers to the collection of consistent data about service users to help identify population health risks, inequalities, or opportunities for service improvement. In many instances, having information about characteristics such as sex, gender or sexual orientation provides vital insight that makes a real difference to service users.

Whilst monitoring (or data collection for other purposes, such as for clinical risk management) is important, the way that this monitoring is conducted is also important to consider for inclusive services. For example, if required, methods for collecting data around sex and gender should be designed inclusively to avoid excluding people who identify as trans or non-binary.

• Read “If we’re not counted, we don’t count” (PDF), a guide from the LGBT Foundation about monitoring best practice
• Read NHS Digital guidance on monitoring
• Read “Let’s talk about sex*”, a blog from former NHS Digital service designer Emma Parnell about how her personal connection to the trans community helped to shape a more inclusive Covid-19 vaccination booking service


4. Get inspired

The future looks bright for innovations that may tackle health inequalities within the LGBTQI+ community, or improve health outcomes for people who identify as gay, lesbian, bisexual, transgender, queer or intersex. We’ve picked a few innovations that are already making waves:

• LVNDR, who are pioneering a new approach to inclusive and personalised healthcare that integrates with existing services
• Love Positive, who are exploring new approaches to more inclusive and body positive relationship and sex education programmes
• Plume, who are improving access to gender-affirming therapies and supporting trans people in the US
• Helsa Helps, who deliver Empathy VR (virtual reality) training combined with psychological mechanisms to immerse users in stories depicting stigma and discrimination towards minority people, experienced through the eyes of the stigmatised, addressing homophobia, transphobia, racism, and sexism
• Kalda, who offer a smartphone app for LGBTIQ+ mental wellbeing. They provide users with access to on-demand LGBTQIA+ courses and mindfulness sessions addressing some of the stressors that come with being LGBTQIA+

Note: these apps and services may have not been formally evaluated or assessed by the Health Innovation Network and their inclusion in this article should not be considered an endorsement for use.

Don’t forget that if you’re an innovator looking for support, you can get in touch with us!


5. Challenge yourself

Helping your workplace become as inclusive as possible could start with something as simple as changing your language slightly, or thinking about using your pronouns to introduce yourself. Whether you identify as LGBTQI+ yourself or you want to become an ally, what could you do to help LGBTQI+ colleagues thrive?

• Read “Challenging the default“, an NHS Employers blog from Dr Michael Brady
• Read “Why pronouns matter“, an NHS Confed blog from Dr Jamie Willo
• Read “7 ways you can be an LGBTQ ally at work“, an article from Stonewall