NHSX Adoption Fund: winners to watch

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HSX, the branch of the UK NHS responsible for setting policy and best practice regarding technology, digital and data, has launched a £6.5m Adoption Fund to support 35 projects across the country that are using digital technology to improve the delivery of services.

The fund was set up to support innovations with the potential for rapid, NHS-wide rollout, which can support the organisation’s priorities around elective recovery and meet NHS standards on factors like clinical safety, data protection and interoperability. It has targeted projects in the gastroenterology, musculoskeletal and perioperative spaces, as well as initiatives to support digital inclusion and develop new cardiac networks.

In an online statement, NHSX director of innovation Lisa Hollins said: “NHS and care services have been using digital technology in new ways to find creative solutions to the pressures, backlogs and waiting lists created by the Covid pandemic.

“Virtual wards have enabled people to recover at home with remote clinical supervision, creating inpatient capacity for those that need to stay in hospital. Digital and video-based tools are already helping to ensure any post-op rehab programme and exercises are completed correctly and that the rehab plan is clear ahead of the day of surgery.

“Building on these sorts of innovations will play a key part in the restoration and sustainability of services. Digital transformation is also driving entirely new care pathways that are better for patients and that save time for clinical and administrative teams.”

NHSX expects that, over the next three years, high-volume specialties will develop an established digital pathway which can offer choice for patients and allow clinicians to concentrate on more complex cases. The organisation also predicts that more complex long-term conditions will be able to be monitored digitally and patients will be supported to monitor their own health at home with access to self-care support.

These changes will all be supported by enhanced data flow between clinical systems, allowing clinical teams throughout different stages of the care pathway to have access to the information they need to make the best clinical decisions possible.

Here we take a look at some of the most exciting projects supported by the NHSX Adoption Fund and their potential applications across the UK.

The NHS Derby and Derbyshire Clinical Commissioning Group (CCG), in partnership with the University Hospitals of Derby and Burton and the Chesterfield Royal Hospital Foundation Trust, will be delivering a pilot project using IBDoc, a home-use diagnostic device to determine faecal calprotectin levels in stool samples.

Calprotectin is a protein biomarker that can be found in faeces when intestinal inflammation occurs. The goal of using IBDoc is to reduce the number of outpatient appointments and instead promote self-management and increase medication compliance in patients with inflammatory bowel disease (IBD).

IBDoc utilises a lateral flow test (LFT) similar to those used to diagnose Covid-19. A diluted stool sample is applied to this, which is the patient then photographs and uploads to the IBDoc smartphone app. The platform then analyses the strength of the LFT reaction to give a traffic light result of either normal, moderate or high calprotectin levels.

Patients and clinicians will be able to access the results of the tests through an online portal, which can be used to determine the best health plan for the patient.

Two cardiac network projects are being supported by the NHSX Adoption Fund – one with the Cheshire and Merseyside Cardiac Network and a second involving several integrated care systems (ICSs) across London.

In Cheshire and Merseyside, which already has a strong telehealth infrastructure, the funds will be used to enhance cardiac service pathway collaboration and digital collaboration across providers. The initiative will use existing telehealth infrastructure for monitoring, support, education and alerting to Mersey Care NHS Foundation Trust by expanding the use of Docobo, a patient monitoring and demand analytics tool already operational in the Merseycare NHS Foundation Trust.

As Docobo’s effectiveness as a telehealth solution has already been established, NHSX says it will be able to focus on the benefits the platform can bring to staff and patients, rather than having to also establish its basic credibility.

The programme will attempt to address healthcare inequalities by supporting access to specialist care for all patients, delivered directly into their own homes, scaling active one-to-one patient-staff interactions, with supplementary passive and active one-to-many interactions to enhance patients’ journeys.

Meanwhile in London, funding has been granted to allow the care partnerships and ICSs involved to seek out a remote monitoring platform that can be implemented across the network in elective cardiac surgery and cardiac lists.

Once procured digital solutions prove successful, these will be rolled out across other national Cardiac Pathway Improvement Programme (CPIP) priority pathways.

The NHSX Adoption Fund is supporting several initiatives across the country attempting to reduce digital inequalities, as part of the Digital Inequalities Pioneers Project jointly delivered by NHSX’s Innovation Team and NHS England’s Health Inequalities team.

Ten ICSs will work with Thrive by Design, an inclusive digital design consultancy, to learn how to design digital pathways that can reduce health inequalities and be accessible to all patients.

Notable examples include Cambridgeshire and Peterborough ICS, which will be working with local maternity and neonatal system midwives to identify what the main barriers are to accessing digital maternity services. The project will also assess how access to the services is influenced by social deprivation and patient ethnicity.

Meanwhile, Surrey Heartlands ICS will be working with an external contractor to carry out analysis into digital inclusion gaps to maternity services faced by asylum seekers and their families.

Surrey Heartlands also plans to develop and implement a digital inclusion plan for patients accessing early intervention in psychosis services in East Surrey, who may be at risk of digital exclusion and miss out on the benefits of digital tools.

C2-Ai is an artificial intelligence (AI) risk stratification tool which utilises machine learning to help hospitals reduce avoidable harm. The system has adapted and automated existing systems in use in the NHS and globally for 12 years now and will now be used in the Cheshire and Merseyside Health and Care Partnership to identify patients at risk of deterioration or in need of individualised rehabilitation on NHS waiting lists.

The care partnership will also be using Sapien Health, a digital prehabilitation service for elective surgery, to deliver remote health coaching for patients ahead of their operation following their risk stratification.

The programs are being deployed to optimise the clinical care pathways available and allow patients to participate in managed self-care before, during and after surgery. It is hoped that digitally individualising care and improving patients’ education about their condition will ultimately reduce occurrences of avoidable clinical harm in the service.

The Midlands Partnership NHS Foundation Trust is working with Keele University, the Royal Wolverhampton NHS Trust, University Hospital of Derby and Burton, the Dudley Group NHS Foundation Trust, the University of Glasgow and University Hospital North Midlands to support digital self-management of lower back pain.

Back pain is an incredibly common complaint and many patients are advised to maintain an active lifestyle and do exercise to manage their condition, but often find these changes difficult to implement without support.

Low-to-medium risk patients will be given access to two dedicated platforms, SelfBack and STarTBack, to help them manage their conditions at home. SelfBack is a self-management tool that gives users a personalised self-management plan, including a personalised exercise program, which uses AI to update and adapt weekly to their abilities and progress.

In an initial study of 461 participants, 32% experiences a better outcome compared to patients not using SelfBack. Participants also achieved 39% pain reduction on average compared to when they started using the platform.

The STarTBack screening tool, developed by the University of Keele, works differently. A simple prognostic screening questionnaire, STarTBack matches patients to the most appropriate treatment by helping clinicians identify modifiable risk factors that can minimise the degree of disability they experience from their back pain.

Together, the tools will be used to provide patients with information about physical activity, strength and flexibility and deliver daily educational messages to try and help them reduce their pain and promote their mobility.