Podcast Episode 65: What is the Academic Health Science Network

Hello and welcome to this episode of the Lindsay Ledcliffe Foundation podcast series. My name is Dan, I'm one of the Ledcliffe Industry Partners and I'm joined today by my colleague Pamela Penn who's also part of the Ledcliffe Industry Partners and Tim Robinson who's a commercial director from the AHSN in East Midlands. So Tim do you want to just introduce yourself for our listeners please? Hi Dan, yeah hi Pam, nice to meet you today. Thanks very much for that intro. So, as Dan said, I'm commercial director for East Midlands Academic Health Science Network. What that means is that we are part of a network of 15 academic health science networks that cover England. And our role within the UK is to support the introduction of innovation and technology into the NHS and care system. We've got quite a unique space, so we sit between NHS and care organisations, academics and industry and support all of the different partners to be able to get the most from innovative ways of working, new technologies, all around improving patient care. Fantastic. Fantastic overview. So, in terms of some of the projects that you're sort of working on at the moment within the AHSN, Tim, can you sort of elaborate on some of those, please? Yeah. So, the way the AHSNs work is that our work's roughly split into two different types of work. So, we have work that we do to support innovations that have been selected nationally and are being rolled out across the country. So, that may be through the Accelerated Access Collaborative. That may be through programs of work that NHS England have run. And it can also be for innovations that have started within a local geography within the HSN network and then been amplified out to a national scale. So, in terms of the programs that we do nationally, we have a set of programs. So, we're doing work in mental health space. We're doing work in cardiovascular. And within those themes, we've got medicines, devices, and digital solutions that we're supporting. In our local program, that's more driven by the needs of the ICSs within our geography. So in East Midlands, we cover quite a big geography. We've got five ICSs. So, starting at the north, we've got Lincolnshire, and then we've got Derbyshire, then Nottinghamshire, Leicester, Leicestershire and Rutland, which is one, and then Northamptonshire. So, we've got a big geography that we cover, about five million people. And so, we've got a good percentage, about 10% of the population that covered within that geography. And we've We've got a big variation. So in that East Midlands, you've got coastal communities, you've got inner city communities, you've got rural areas. You've actually got some of the most deprived areas in terms of deprivation index in the country. So you've got two wards, three wards that I think are in the top 15 in terms of deprivation. And you've got some really affluent areas as well. we've got a very broad range of socioeconomic communities that we're supporting. In terms of one of the programs that I thought would be useful to talk about from this podcast, it might be of interest to listeners is that we are working with the National Wound Care Program to support the reduction in variation on wound care pathways, look at ways to improve wound care management skills, and part of that is increasing patient self-management, and also looking at the use of point-of-care technology and analytics in support of improving the way in which leg ulcers are managed within England. And that's been driven by the fact that the prevalence of wounds in the UK increased by 71% between 2012 and 2017, which is a huge increase. And that's come through from a cost perspective. It's about a 48% increase in the management costs for, or the cost of managing those wounds. So, the transforming wound care program, which we're talking around, is focused on non-diabetic lower limb wounds. The overall aim is to improve patient care and reduce the prevalence or the number of those wounds. So, there are some specific measures that have been set out for that program, and they're quite ambitious. So they're looking to try and find a 30% reduction in annual leg ulcer prevalence, trying to find a 15% reduction in the annual costs for managing leg ulcers. And that's through both more efficient ways of using staff and looking at the way in which dressings are used within those pathways. And the way that that program is doing that is through three things. It's looking at people, processes, and technology. So, in terms of people, it's about looking at delivery of training for staff, new processes, implementing new evidence-based model of care, and from a technology perspective, looking at supporting data collection and provision of care using digital wound care tools. So, there's been seven first tranche implementation sites that have been leading the way to basically test out the theories and generate the evidence for what the standard of care should look like, which digital processes and tools work best in what environments, and looking at the training plans that you need to put in place to make sure that you can maximize those tools. So, in the East Midlands, we're on wave two, so we are supporting the learning from those national or from those first tranche sites to come into the East Midlands. And the first area we're going to be working in is Lincolnshire. So, our role in that is to provide linkage between that national program and the local teams that are going to be doing the transformation within the Lincolnshire pathways and we'll be supporting that with bringing those resources. So there's communications resources, there's best practice, there's a learning from those seven sites and we'll be supporting those people in Lincolnshire who are implementing that. So what that should do is mean that we deliver the new model of care in an efficient way, in a time-effective way that's going to have a benefit to patients. On the other side, it should hopefully generate some savings for the NHS, who can then reinvest that into services to support more patients and improve things in different ways. Fantastic overview there, Tim. Really, really insightful stuff. From what I gather, it seems that the AHSN is really part of the integrated care system and the way the NHS is looking to operate going forward. Is this something that's likely to be replicated across the rest of the UK, and are you linking in with AHSN areas across the UK to try and replicate some of the work you've done already? So, on Mooncare specifically, we're kind of second phase, so there's work already been done through other HSNs and we're bringing that, so that's a good example of where we're importing proven innovation into the East Midlands, which is part of our role. I think the first part around the ICSs, yeah, I mean, the direction of travel is that the ICSs are getting more autonomy and responsibility. So I think they both go hand in hand. And that's, we're now starting to see kind of a year on from their formal creation or getting towards a year that there's very much more movement towards ICS level strategy and working. And we're starting to see some of the practical manifestation of that so that there are programs of work that we're supporting and linking in with. Sometimes we are doing a quite simple job but very valuable of just brokering connections between different teams in the ICS, different teams across ICSs within the East Midlands and also using our networks to link into work that's happening nationally. So sometimes it's not that we are are bringing a new innovation in, we are just making people aware of what might be happening elsewhere. There's a really, brokering is a real key part of what we do. And I mean, ICS, as we said about the size, I mean, the cover large geographies, sometimes we're connecting people within the same geography because of our position, we see things happening and somebody's already doing something similar in another part of Lincolnshire and we're kind of helping to bring some of that together or any of the other counties that we're working on. Increasingly, our local programme work is driven by the ICS needs. And we work hard to understand what their needs are and how we can help them. We can't help with everything. And we're on a more of an innovation path than just general support. but we offer a range of services. So one of the things that we do quite often is go away and do an innovation scan. So somebody who's got a particular problem in a particular pathway, and we'll go out and see what else is happening in that space and bring back them a list of, ideally a list of innovations or improvements that they might want to consider. And if they want us to connect them in with those other projects, we'll do that. So that's something that we do quite often. And our involvement may not go any further than just signposting to that. On other occasions, we will take innovations to an ICS and say, this is what you might want to consider. You've signaled previously that you've got a problem in PathwayX. We've seen some great technology or a great solution that's been implemented elsewhere. It's got good evidence behind it. You might want to consider it. and our involvement might be a little more deeper in those circumstances. We've got 10 years of combined expertise around, we know what it takes to introduce innovation into a system. So we try to shortcut some of those local processes by bringing that knowledge forward so that the ICSs and the organizations within it can use us. In a way, I suppose it's a little bit like consultancy. So it's like internal consultancy within the NHS around innovation. And so we don't necessarily do the transformation on behalf of, but we support that transformation by bringing forward knowledge and experience, which will help their projects. I've definitely learned something new today. There's a lot of fantastic information there. Pam, is there any questions you want to ask while we're on the call? You know, I just wanted to comment on that last point, Tim, because I've seen the brokering that you've done as an AHSN network, and also the way that you've been able to deliver, you know, one region will then tell the national AHSN network about work particular ICS or trust are doing, sharing the best practice, sharing the gold standard work. And I think it's such a valuable part of the work that you guys do because I think that will really help expedite great work that's being done so that everyone can be aware. So I think that that's just such a key part and so important. Yeah, I mean, I think that one of the things that is, we've got no shortage of innovative companies, solutions, teams within the NHS. What we try to do is support them with their ambition. If we implemented every solution that was available, then we'd have quite a long implementation path. So, it's about finding the ones that have got the right evidence that support the right, support in the right way and purely really do generate benefit. So, we kind of come from a perspective of what is the benefit that's going to be derived rather than, well, that's just the right thing to do because that's not what drives change. There isn't the time and resource within the NHS to do everything that it probably knows it needs to do. It's got to be selective. So, you've got to use those limited resources in the way that's going to get the biggest value for that particular organisation or community. And it's always going to be a challenge because we'd all want everything to be kind of gold standard, but the reality is that it's hard to achieve that. And I think for any organisation, the best organisations in the world don't have gold standard in every department and there will be some that aren't quite where they need to be and that's a reality of the life that we the world that we operate in and so we have to recognize that and we have to do the best in the with the resources that are available and maximize that benefit. I think that's a fantastic point to leave it at so I think you know very grateful Tim for the updates there. It's been, like I say, very insightful. I've learned a lot. I'm sure Pam's learned a lot as well. I'm sure our listeners have learned a lot. And so, yeah, thanks, everyone, for listening. Tim, if you're happy for us to pop your contact details in the show notes, if anyone has any questions, if they're able to reach out to you directly. And yeah, we can leave it there. And thanks very much for listening.