2021-22 Rapid Uptake Products: Improving the diagnosis and treatment of asthma through innovation

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The Health Innovation Network’s Head of Innovation Lesley Soden makes the case for two NHS-endorsed innovations improving the diagnosis and treatment of asthma.

As a person with asthma who was diagnosed in childhood, I have realised over the past few years that the management of my asthma hasn’t changed in decades. My condition is controlled through medication, and the only part of my treatment that has changed over the years is the trade name of my ‘blue reliever inhaler’ from Ventolin to Salbutamol. With 5.4 million people in the UK living with asthma and the NHS spending an estimated £1.1 billion on treatment annually, it seems hard to believe that patients do not have more access to innovative technology and products that could help their treatment and improve their quality of life.

Through the NHS Accelerated Access Collaborative’s Rapid Uptake Products (RUP) programme, the NHS has endorsed products that improve the diagnosis of asthma and the treatment of severe asthma. The 2021/22 RUP programme has included two innovative asthma products and fast tracks patient access to these products. They are approved by the National Institute for Health and Care Excellence (NICE) and support the NHS Long Term Plan’s key clinical priorities but have had lower uptake within England than expected.

As an Academic Health Science Network, the Health Innovation Network (HIN) supports the local adoption of these products in south London by raising awareness of their efficacy, facilitating clinical pathway changes and providing education and training for how to embed and use them.

2021/22 RUP innovations that improve the diagnosis and treatment of asthma

FeNO testing is a method of diagnosing asthma by measuring fractional exhaled nitric oxide (FeNO) in the breath of patients with suspected asthma, alongside other respiratory tests. It measures the levels of inflammation in a patient’s lungs through the nitric oxide in their breath. There is evidence that asthma is widely misdiagnosed. Overdiagnosis leads to unnecessary treatment and a delay in making an alternative diagnosis. Underdiagnosis risks daily symptoms, and potentially serious exacerbations1. The FeNO test can provide a more accurate diagnosis of patients suspected of having asthma when a diagnosis is unclear and can be used with other diagnosis tests such as spirometry and peak flow test. Additionally, FeNO can also be used to improve the management of patients with asthma by using FeNO monitoring to adjust the dosage of steroids or guide biological agent treatment.

Asthma Biologics, the second RUP asthma product, are four biologic therapy drugs taken to improve and reduce asthma attacks in people with eosinophilic asthma or severe persistent allergic asthma. Biologic therapies work in a different way to traditional asthma treatments. Xolair (Omalizumab) is for people with severe allergic asthma. It targets a chemical in your blood stream called IgE which is involved in the allergic response to an asthma trigger. Nucala (Mepolizumab), Cinqaero (Reslizumab) and Fasenra (Benralizumab) are for people who have severe eosinophilic asthma. This is asthma driven by high levels of a type of white blood cell called eosinophils causing the lungs to become inflamed, leading to asthma symptoms and asthma attacks.

Only 10.8 per cent of eligible severe asthma patients have access to biologic medicines today in the UK. The low referral rate could be due to many healthcare professionals being unaware that their patients could benefit from biologics. Increasing the use of biologics appropriately would reduce use of oral corticosteroids (OCS) associated with long term side effects, as well as exacerbations and hospital admissions2.

These asthma products could significantly improve care patients receive, with the potential to transform the lives of people with difficult/severe asthma, prevent asthma attacks, and save lives.

NHS organisations in south London can access financial help to roll out these products, as both innovations are eligible for the Pathway Transformation Fund. The deadline to apply for this fund is midday 30 April 2021, and we would welcome health professionals, including pharmacists interested in supporting patient identification and accurate prescribing, to apply. Within the Health Innovation Team our RUP lead is really keen to help you to devise your project and help to complete your funding application.

Applications should be developed and submitted with the support of your local AHSN RUP lead, and we can help you get started.

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Contact the HIN’s RUP team if you are from an organisation based in south London requiring more information or interested in beginning an application process.

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Patients set to benefit from world-leading innovations on the NHS

Patients set to benefit from world-leading innovations on the NHS

3D heart modelling to rapidly diagnose coronary disease and an advanced blood test which can cut the time it takes to rule-out a heart attack by 75% are among a raft of technological innovations being introduced for patients across the NHS.

New innovations have already reached 300,000 patients, and speaking at the Reform digital health conference in London today, NHS England chief executive Simon Stevens will announce that over 400,000 more will benefit this year from new tests, procedures and treatments as part of the Long Term Plan.

This includes pregnant women getting a new pre-eclampsia test, and cluster headache sufferers getting access to a handheld gadget which uses low-levels of electric current to reduce pain.

The new treatments and tests are being delivered as part of the NHS’ Innovation and Technology Payment programme, which is fast-tracking the roll-out of latest technology across the country, building on progress in the past two years.

The programme’s latest innovations include a cutting-edge blood test which can detect changes in protein levels in blood, allowing emergency doctors to rule out a heart attack within three hours – nine hours faster than the current rate – meaning people get quicker treatment and avoid admission to hospital.

NHS England has also confirmed that funding for 10 other new tests and treatments as part of the programme – including a computer programme that creates a digital 3D model of the heart and avoids the need for invasive procedures – will be extended, allowing more patients to benefit.

From this year, thousands of pregnant women will be offered a test on the NHS which can help rule-out pre-eclampsia – a serious condition linked to labour complications, acute pain and vision problems – and allow women either to get extra care faster, or avoid the need for further hospital trips during pregnancy.

Simon Stevens, chief executive of NHS England, said: “From improving care for pregnant women to using digital modelling to assess heart conditions and new tests to prevent unnecessary hospitalisations for suspected heart attacks, the NHS is taking action to ensure patients have access to the very best modern technologies. It’s heartening to see the NHS grasping with both hands these rapidly advancing medical innovations.”

Plans to speed up the uptake of proven, cutting-edge treatments is being overseen by the Accelerated Access Collaborative (AAC), a joint NHS, government and industry effort which aims to make the NHS the world’s most innovation-friendly health system.

Dr Sam Roberts, chief executive of the Accelerated Access Collaborative and director of innovation and life sciences for NHS England, said: “This programme has been amazingly successful at getting new tests and treatments to patients, with over 300,000 patients benefitting already, and this year we have another great selection of proven innovations.

“We will build on this success with our commitments set out in the Long Term Plan, to support the latest advances and make it easier for even more patients to benefit from world-class technology.”

As set out in the Long Term Plan, the NHS will introduce a new funding mandate for proven health tech products so the NHS can adopt new, cost saving innovations as easily as it already introduces new clinically and cost effective medicines.

Innovations being supported include:

  • Placental growth factor (PIGF) based test: a blood test to help rule‑out pre‑eclampsia in women suspected to have the condition who are between 20 weeks and 34 weeks plus 6 days of gestation, alongside standard clinical assessment. Read more here.
  • High sensitivity troponin test: a blood test that when combined with clinical judgement can help rapidly rule-out heart attacks. Read more here.
  • Gammacore: a hand-held device that delivers mild electrical stimulation to the vagus nerve to block the pain signals that cause cluster headaches. Read more here.
  • SpaceOAR: a hydrogel injected between the prostate and rectum prior to radiotherapy, that temporarily creates a space between them so that the radiation dose to the rectum can be minimised, reducing complications like rectal pain, bleeding and diarrhoea. Read more here.

Lord Darzi, chair of the Accelerated Access Collaborative, said:“As Chair of the AAC, I am delighted that four of the seven technology areas currently receiving AAC support have been selected for this NHS programme.

“This is a vital step in helping patients receive rapid access to the best, proven innovations being developed in our world-class health system.”

This is the third year of the drive to identify and fast track specific innovations into the NHS, which has already benefitted over 300,000 patients across the NHS.

The NHS’ own innovation agencies – the 15 Academic Health Science Networks across England – will take direct responsibility for accelerating uptake locally.