Positive disruption: Encouraging innovation in the NHS

The NHS is ripe for disruption, offering innovative companies a variety of areas where they can make a difference. Anne Blackwood, CEO at medical technology innovation hub Health Enterprise East, explains how start-ups can drive innovation in the NHS.

Healthcare offers one of the biggest opportunities for start-ups looking to transform industries through technological innovation. The NHS is the largest single healthcare delivery system in the world. With an ageing population and increasing complexity of health and care needs, our health and care system needs to adapt and innovate to meet the challenges of tomorrow. 

With increasing demand, capability and expectations on the one hand, and decreasing finances and workforce capacity on the other, incremental change will not deliver the solutions we need. Instead “step change” innovation is required.    

Technological innovation is a key enabler of this disruptive change and the NHS needs to look both within (for ideas generated by front-line staff in response to identified unmet needs) and to industry to find innovative solutions to service redesign challenges.  

Transforming services through technological innovation

When a patient’s life is at risk, for example from severe respiratory distress or if they are in cardiac arrest, a delay of even a few minutes in receiving clinical treatment can significantly affect the outcome. In 2013, following the death of his father due to ambulance delays, Brendan Fatchett co-founded a technology-led, specialist private commissioning support service in healthcare transport, called 365 Response.  

The company developed a cloud-based connectivity platform that matches suitable NHS-funded transport and skills with a patient’s specific need - whether it is a taxi, ambulance or volunteer driver - in primary and community care. Through the platform’s smartphone app, users can specify the standard of care required and the skills needed by the driver. This is the kind of technological innovation that has the ability to completely overhaul how urgent care is managed.  

To date, around 17 clinical commissioning groups (CCGs) across Birmingham as well as groups in the north and south of the UK have adopted the ambulance booking service, with an Essex-based plan due to follow. Funded by the NHS England initiative SBRI Healthcare, the company has already achieved demonstrable results in generating cost savings for the NHS. 

Another example of transforming services through technological innovation is the EarFold implant invented by Norbert Kang, a consultant plastic surgeon from Hertfordshire. Earfold is an alternative procedure for correcting prominent ears which is thought to affect 1-2% of the UK population. 

The company developed a cloud-based connectivity platform that matches suitable NHS-funded transport and skills with a patient’s specific need.

The procedure works by inserting a material known as a shape memory alloy subcutaneously under the skin of the ear. Over time the cartilage re-forms around the implant and the ear is permanently bent into new shape. This quick and effective procedure, performed under local anaesthetic, has fewer side effects than conventional otoplasty surgery and is less invasive.

Kang came up with the idea after a young patient died under general anaesthetic using conventional otoplasty surgery just because she wanted her ears pinned back. With the help of medical technology consultancy Health Enterprise East, Kang formed a spin-out company with West Hertfordshire Hospitals NHS Trust called Northwood Medical Innovation in 2010. Five years later, the company was bought by global pharmaceutical company Allergan and the product is now selling widely across Europe. 

Other key technologies that are likely to play a huge part in leading innovation in healthcare in the next decade include artificial intelligence, 3D bio scanning and printing, precision medicine including biomarker based diagnostics and therapeutics, robotics and the Internet of Things

Overcoming barriers to innovation

Whilst the opportunity is large, there are inevitable tensions in the UK healthcare system. Patients want the best health outcomes available, are increasingly better informed about their conditions and may want to play an active part in how their condition is managed. The NHS wants to provide the optimum affordable health service available. Technology developers need a commercial return on their investment to re-invest in the next generation of products. 

To balance these potentially competing interests, technology developers need access to clinical experts within the health service to enable them to develop products that can deliver improved health outcomes at lower cost. In addition, unmet user needs drive innovation so gaining insight into unmet health needs from both the service and the patient’s perspective is critical in the early phases of product development. 

Future focus areas

Looking to the future of healthcare over the next few years and beyond, there are a number of drivers for change. There is an increasing need for new models of care including more patient-centered, personalised medicine, and better integration of services, for example, through better use of ICT/communication tools and the advent of the seven-day NHS. 

New treatments for chronic diseases such as diabetes, cardiac disease, stroke, lung disease and cancer will be needed, including new more targeted drugs, earlier and more accurate diagnosis, new technologies and health delivery systems. There will also be a drive for less invasive and more out-of-hospital care. 

Bringing together the respective service and patient needs, clinical insight and entrepreneurial technology developers from the UK’s thriving start-up community can bring greater rewards than innovating in isolation.  

The NHS will benefit by having products that are ‘fit for purpose’ and affordable, patients will benefit by having access to new treatments and services that are more personalised, more empowering to the individual and technology developers will save both time and cost during the product development phase.