Guide to the AHSN Network 2018 - Our collective impact and future plans
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Guide to the AHSN Network 2018 Our collective impact and future plans
Over the last five years, the 15
Academic Health Science Networks
(AHSNs) have pioneered new
ways to spread and adopt
healthcare innovation.
First licensed by NHS England in 2013, we
have rapidly become a vital part of the country’s
health economy, connecting and brokering
partnerships between health and care,
academia, the third sector and industry.
We bridge the gaps to respond to the diverse
needs of our patients and populations through Foreword from events; the positive influence we’ve The AHSN Network will continue to
partnership and collaboration. had on changing work cultures and host the 15 regional Patient Safety
Mike Hannay, Chair of practices; and the incredible insights Collaboratives (PSCs), commissioned
AHSNs benefit from a dual regional and national the AHSN Network we’ve encouraged from patients and by NHS Improvement. The PSCs are
perspective. Each AHSN is embedded in its the public in co-creating new solutions playing a vitally important role in
regional health and care community, understanding and redesigning existing services. creating safer systems of care.
the system and patient needs on the ground. It’s been quite a journey since the
Each AHSN is also part of the national AHSN 15 AHSNs were first licensed by Partnership working is essential And funded by the government’s Office
Network, linked into a unique collaborative NHS England back in 2013. to driving innovation. At a national for Life Sciences, we are coordinating
of expertise and experience, sharing learning, level, we work strategically with NHS a national network of Innovation
pooling intelligence, and benefitting from a There have been challenges and England, NHS Improvement, NHS Exchanges, building on our unique
pipeline of emerging and proven solutions obstacles along the way, countless Digital, government departments expertise and cross-sector connections.
from around the country. lessons learned, and some and many more to ensure innovation
memorable highlights. is at the heart of the healthcare and With what seems like a current
life sciences agenda. And regionally explosion of innovation and new
There are of course the big ticket too, every AHSN plays a pivotal role technologies, the role of the AHSNs
achievements: the bold examples in bringing together the NHS, social isn’t simply to support the NHS in
of healthcare innovation and care, academic, industry and voluntary identifying those in which to invest, but
transformation that AHSNs have sectors. No-one is better placed than also in helping to build health and care
helped spot, nurture and embed AHSNs to understand the ‘push and ecosystems, with cultures, leadership
into our systems. In the last five pull’ of demand on innovation. and pathways ready to accept and
years, we’ve made some significant work with these new solutions.
impacts. Over 22 million patients In our new licence from NHS England,
have benefited from our work so the 15 AHSNs will operate as the This is where most change needs
far, while we have managed to key innovation arm of the NHS; to happen, and so innovation is not
introduce over 330 innovations supporting our health and care just about new technology; I like to
into the health service. partners to deliver improvements think we’re as much in the business
that lead to better patient outcomes, of social innovation.
We don’t do any of this work alone. drive down the cost of care and
We are catalysts and connectors. stimulate economic growth. Of course, this year we are celebrating
We bring the right individuals and 70 years of the National Health Service,
organisations together to make A number of programmes developed and the NHS is in itself an incredible
change happen. or piloted regionally have been example of social innovation. I’m proud
selected for national adoption and that in the AHSNs this spirit is strong,
And this is why there are countless spread across the AHSN Network and that together with our partners we
‘hidden’ success stories: the invaluable during 2018-2020. You’ll find more on are evolving our health service fit for
introductions made at our connection these in the following pages. today and another 70 years to come
2 3
The AHSN
Network
in numbers Over Over Hundreds Over
22 million £330 million of commercial 500
patients benefited leveraged by AHSNs innovators supported jobs created
Since the 15 AHSNs
from AHSN input to improve health and
were first established support NHS, care and
in 2013, our collective industry partners
impact has been
significant. We
are catalysts for
innovation. Through
our communities and
collaborations, we
are proud to make
things happen.
Over Over Over 1,242 67%
330 innovations 11,000 locations 150 companies NHS sites using reduction in AKI† mortality and
introduced through actively developing supported by our innovation NHS Innovation Accelerator sepsis mortality down by 24%
AHSN influence and using innovations development programme, SBRI* solutions through our Patient Safety
supported by AHSNs Healthcare – delivering over Collaboratives in partnership
£19 million annual recurring with NHS Improvement
savings to health and care
* Small Business Research Initiative
† Acute Kidney Injury
4 5
What our
partners say “
AHSNs really do bridge the triangle
“
I am pleased to be working
closely with the AHSN Network.
AHSNs are NHS Improvement’s
“
I think the AHSNs give us
the opportunity to work
strategically together on
about us
between industry, healthcare
“
delivery partners for the Patient priorities for the NHS and
and academia, and bring them
Safety Collaboratives, which that is really starting to
together as a really powerful
seek to improve patient safety, build momentum. The
force. And that’s what we need
facilitate quality improvement AHSNs are helping us really
to see transformation happen.
and create a learning system understand how we can
As a clinical innovator,
“
Francis White, VP of Sales across the NHS. The AHSNs deliver system benefits
the AHSNs have been as well as patient benefits.
“
& Business Development, are ideally placed to drive
instrumental in facilitating
innovation and improvement
AliveCor the adoption and spread Mike Thompson,
across the system with their
of our innovations across Chief Executive, ABPI
strong relationships across
“
AHSNs are experts in best the NHS which I believe
all sectors of healthcare,
would be all but impossible
“
I don’t think there’s a more practice – and that can be academia and industry.
incredibly diverse. Working without their support. They
important question that the
with them you benefit not Celia Ingham Clark, proactively help innovators
NHS faces right now than how
only from that expertise to develop their inventions
can we get better at curating Medical Director for
but also the strength of The question with innovation is and support trusts to adopt
and spreading innovation? Clinical Effectiveness, NHS
those local relationships. how do you take small instances new best practice and are an The AHSNs are a fantastic link
And who will serve as the
of brilliant innovation and get England, and Interim NHS ideal link between the two. to what is happening on the
NHS distribution network for
Lindsay Lambeth, them round the system? That’s National Director of Patient ground, providing support and
innovation? I think the answer Dr Maryanne
Principal Programme what I think AHSNs can do. expertise to nurture health
is the AHSNs as they enter their Safety, NHS Improvement
They find and work with people Mariyaselvam, Clinical and care innovation. They’ve
next phase and increasingly Manager for Service
who’ve got those brilliant ideas Fellow, Queen Elizabeth established their network to
work together as a single Design, Age UK and give them exposure and enable ideas to be sought out,
national network of networks, Hospital Kings Lynn and
get them round the system. championed or challenged -
helping to destroy NHS ‘not University of Cambridge
Then the stuff that really works providing a stable platform in an
invented here’ syndrome.
we can get nationwide. otherwise complex landscape.
Ian Dodge, National
Lord O’Shaugnessey, Juliet Bauer, Chief Digital
Director, Strategy and
Health Minister Officer, NHS England
Innovation, NHS England
6 7
Navigating
The innovation pathway Innovation Exchanges together to develop, test and
spread proven innovation.
We have developed the ‘innovation AHSNs support the regional ‘import
the healthcare
pathway’ which illustrates the range and export’ of healthcare innovation Through our Innovation Exchanges,
of specialist support available through our national network of AHSNs will identify products with the
from AHSNs to help ensure new Innovation Exchanges – processes most potential to make a national
innovations achieve both patient that bring together health and care impact for review by the Accelerated
innovation landscape
benefit and commercial success. partners with industry and third Access Collaborative. Each year
Our starting point is working with sector innovators to match health this national group (made up of
the NHS to articulate what it needs needs with potential solutions. partners including NHS England, NHS
from industry so we can support Improvement, the government, NICE,
product and service development Funded by the government’s AHSNs and patient representatives)
from ideas through to implementation. Office for Life Sciences, Innovation will select a small number of the
Exchanges build on AHSNs’ innovations put forward to spread
AHSNs work at the interface between healthcare providers, commissioners and AHSNs’ in-house knowledge and unique expertise and cross-sector and adopt across all 15 AHSNs.
skills are complemented through connections, enabling us to identify
industry to ‘bridge the gap’ and connect the sectors, creating an innovation our work with partners on a number common challenges and quickly www.ahsnnetwork.com/
pipeline from research and product development through to commercialisation. of national programmes. bring people and organisations innovation-exchanges/
SBRI Healthcare
We invest time and resources into SBRI Healthcare supports the
collaborating with industry to support co-development of innovative
and develop value propositions for solutions for identified health needs.
proven products and services, and to Funded by NHS England and run
make introductions to the NHS. This helps by the AHSNs, SBRI Healthcare
patients benefit from better products and has supported over 150 companies
services faster, and supports economic to develop their innovations
and bring them to the NHS.
growth by making it easier for industry Success
to do business with the NHS.
Finance www.sbrihealthcare.co.uk
Adoption
In 2017/18 we worked with over 2,000
companies and helped more than 1,000 NHS
organisations use new products or services, NHS Innovation
benefitting more than 250,000 patients.
Markets Accelerator (NIA)
Brokering
Brokering relationships between the life The NIA supports the uptake
sciences industry, research and healthcare, £ and spread of high impact,
we help the NHS find and filter new products. evidence-based innovations across
We work as a national network to speed up the England’s NHS, benefitting patients,
Commercialisation
spread and adoption of the ones with proven populations and NHS staff. An
impact and value that meet genuine need. NHS England initiative delivered
Clinical in partnership with the AHSNs,
Our work with industry is all about patient Trials it currently supports 36 ‘Fellows’
Intellectual
benefits from products and services representing 37 innovations.
that are evaluated and supported by
Property
Evaluation
evidence. Consultation and co-creation www.nhsaccelerator.com
Ideas
with patients and the public is vital
to our approach.
Culture Innovation Technology
Payment (ITP)
Through the ITP, NHS organisations
are supported to adopt innovative
products and technologies by
removing the financial or procurement
barriers. This NHS England scheme
is delivered in partnership with
the AHSNs, sponsors, national
and international experts
8 9
Spread and Transfers
adoption of
of Care
Around Medicine Atrial
(TCAM) Fibrillation
innovation: Help for patients who
(AF)
national
need extra support taking
Sharing learning and
prescribed medicines when
spreading best practice
they leave hospital.
from across the 15
programmes
AHSNs to reduce
AF-related strokes.
These seven programmes, PINCER -
developed regionally, have preventing
been selected for national prescribing errors
adoption and spread across PReCePT
Supporting pharmacists and
the AHSN Network during Working with maternity units GPs to identify patients at
2018-2020. to use magnesium sulphate risk from their medications
to prevent cerebral palsy and taking the right action.
in preterm labour.
Emergency
ESCAPE-
Laparotomy
pain
Collaborative Serenity
A group rehabilitation
A collaborative approach Integrated programme for people
to improving standards
of care for patients
Mentoring (SIM) with knee and/or hip
osteoarthritis, providing
undergoing emergency Bringing together police and self-management support
laparotomy surgery. healthcare professionals to in the community.
make a positive difference
to the lives of people
with complex mental
health needs.
10 11
Atrial Fibrillation: detect,
protect and perfect
Atrial fibrillation (AF) is the most common type of irregular heart
rhythm. In England a large number of individuals are unaware they
have AF, and some people with known AF do not receive optimal
treatment, resulting in avoidable strokes. AF-related strokes represent
a significant burden to patients, carers, the NHS and social care.
Understanding demand
pharmacies and other community commissioned to deliver virtual range of resources to improve the
settings across England. This clinics in primary care, to support detection and treatment of people
An estimated AF is responsible for technology detects irregular heart the GPs with evidence-based with AF.
1 million rhythms quickly and easily, enabling decision making regarding
people in England are 400,000 people 1 in 5 strokes NHS staff to refer patients for the anticoagulation for patients with AF. Find out more at
with survivors likely to appropriate follow-up and treatment. www.bit.ly/AF-toolkit
diagnosed with AF. are unaware they have AF, Scaling up this local pharmacist-
as not everyone experiences live with debilitating led model across England, could
Protect Ambitious targets
the symptoms. consequences. prevent an estimated 3,000 AF
We are increasing anticoagulant related strokes and save 750 lives. By the end of 2019/20 we aim
therapy, in those diagnosed with to have detected an additional
AF and who are clinically indicated, Perfect 134,000 people with AF across
The AHSNs collectively identified adoption through our national Detect to reduce the risk of stroke. England, with an additional
that the spread and adoption of AF programme, supported We are optimising anticoagulation 100,000 people with AF being
AF best practice across the AHSN by our community of practice We are rapidly increasing the A ‘virtual clinic’ approach targeting therapy in people newly diagnosed newly prescribed appropriate
Network could make a stepped of regional AF clinicians and detection of AF through the use AF patients on GP registers who and those with existing AF. anticoagulation therapy.
improvement in care outcomes, managers to share learning of manual pulse checks or mobile were not receiving anticoagulation,
leading to a reduction in AF- and amplify impact. ECG devices. Early detection of AF initially led by Lambeth and The three London AHSNs have Our interventions will:
related strokes across England. will allow the initiation of protective Southwark CCGs and King’s College worked collaboratively with the • Prevent over 4,000 strokes.
Spanning the AF clinical pathway, anticoagulation therapy. Hospital, is now being rolled out London Clinical Network to develop • Save over 1,000 lives.
Based on proven best practice our national programme by a number of AHSNs. an online interactive toolkit. This • Represent NHS cost savings
across the AHSNs in recent is drawing on this shared AHSNs are distributing more than guides healthcare professionals of over £84 million.
years, 14 initiatives have experience and intelligence to 6,000 mobile electrocardiogram In this model, specialist and commissioners through the • Represent social care cost
been selected for spread and ‘detect, protect and perfect’. (ECG) units to GP practices, anticoagulant pharmacists are entire AF-pathway, providing a savings of over £100 million
12 13
Community pharmacist
support for patients
leaving hospital
When some patients leave hospital they can need extra support taking their
prescribed medicines. This may be because their medicines have changed
Preventing prescribing
or they need a bit of help taking their medicines safely and effectively.
The transfer of care process is Many AHSNs, including Wessex Through our national implementation
errors with PINCER
associated with an increased risk of and the West of England, have of TCAM in 2018-2020, each AHSN will
adverse effects. 30-70% of patients worked with trusts and Local support their local trusts to establish
experience unintentional changes to Pharmaceutical Committees to help a TCAM pathway. This will enable
their treatment or an error is made set up a secure electronic interface all suitable patients to be referred
because of a miscommunication. between the hospital IT systems and to their community pharmacy or GP
Prescribing errors in general practice are an expensive, preventable cause of PharmOutcomes, the community pharmacist where appropriate.
safety incidents, illness, hospitalisations and even deaths. Serious errors affect This is what the Transfers of Care Around pharmacy system used in their
one in 550 prescription items, while hazardous prescribing in general practice Medicine (TCAM) project aims to address. area. This has further enhanced AHSNs have high level targets to
TCAM by providing patient data improve the number of hospitals
contributes to around 1 in 25 hospital admissions. When patients discharged from hospital quickly and seamlessly to their and discharges implementing
are identified as needing extra support, community pharmacist. TCAM referrals.
Outcomes of a trial published in out to more than 360 practices prescribing for indicators associated they are referred through a safe and
The Lancet showed a reduction in across the East Midlands between with gastrointestinal bleeding, heart secure digital platform for advice from Wessex AHSN developed an Nationally, with rapid adoption across
error rates of up to 50% following September 2015 and April 2017. failure and kidney injury. their local community pharmacist. awareness campaign to encourage all 15 AHSNs, TCAM has the potential
adoption of PINCER - a pharmacist- people to seek help with their to save £13.8 million, reduce length
led IT intervention for reducing This involved: A number of AHSNs have now Original work in the North East showed medicines, featuring a character of stay by 56,704 days and achieve
clinically important errors in general • Using software to search clinical also implemented PINCER in their that patients who see their community called Mo in a series of animated 1,004 fewer readmissions in 2018-19.
practice prescribing. systems to identify patients at regions, including Wessex AHSN pharmacist after they’ve been in films and accompanying poster In 2019-20, savings of £28.8 million
risk of hazardous prescribing who have introduced it to 235 GP hospital are less likely to be readmitted resources for pharmacies. The are projected, based on a reduction
These original PINCER indicators • Conducting clinical reviews of practices and are an early adopter and, if they are, will experience a films have been viewed almost in length of stay of 113,406 days
have been incorporated into patient notes and medication of PINCER 3. shorter stay. 64,000 times. and 2,007 fewer readmissions.
National Institute for Health and • Carrying out root cause analysis
Care Excellence (NICE) Medicines and providing feedback to PINCER is one of the Medicines
Optimisation Clinical Guideline the practice Optimisation projects selected for
(May 2015). • Establishing action planning to national adoption and spread across
improve systems and reduce risk the AHSN Network in 2018-2020.
The PINCER intervention is led • Scale up PINCER using a large-
by primary care pharmacists and scale Quality Improvement A more detailed evaluation of the
pharmacy technicians. It involves Collaborative approach. PINCER rollout linked with Hospital
searching GP clinical systems using Episode Statistics and ONS mortality
computerised prescribing safety More than 2.9 million patient records data is being undertaken as part of a
indicators to identify patients at risk were searched, and 21,617 cases £2.43 million NIHR Programme Grant
from their medications and then of potentially hazardous prescribing for Applied Research (PRoTeCT).
acting to reduce the risk. were identified.
It is anticipated that use of PINCER
With funding and support from Preliminary results show that as will result in fewer medication-
the Health Foundation and East a result of the study there was a related hospital admissions and
Midlands AHSN, PINCER was rolled significant reduction in hazardous cost savings to the NHS
14 15
PReCePT
The PReCePT project has so far prevented around seven cases of cerebral palsy in
the West of England, representing potential lifetime healthcare savings in the region
of £5 million – and substantially more when including loss of productivity and social
care costs over a lifetime.
Babies born too early (preterm) was compelling, with the low cost from the Health Foundation so that
are at an increased risk of dying and low risk of administering it can be introduced to a further
in the first weeks of life, and magnesium sulphate to eligible 10 hospital trusts.
those who survive may suffer mothers reducing the risk.
from varying degrees of cerebral This evaluative study will compare
palsy, blindness, deafness or Designed in partnership with the effectiveness of different levels
physical disabilities. patients and staff, PReCePT of funding and QI involvement
(Preventing Cerebral Palsy in on magnesium sulphate uptake
Antenatal magnesium sulphate PreTerm Labour) is a quality rates. This is a key element of
(MgSO4) given prior to preterm improvement project, designed to important learning to understand
birth for fetal neuroprotection increase antenatal administration how to maximise the effectiveness
prevents cerebral palsy and of magnesium sulphate to in the adoption and spread of
reduces the combined risk of mothers during preterm labour. good practice.
infant death or cerebral palsy.
The intervention was adopted by And now as part of our national
Karen Luyt, a neonatologist at all five maternity units in the West adoption and spread programme,
University Hospitals Bristol NHS of England. Projection modelling PReCePT will be implemented
Foundation Trust, noticed that the indicates that since the launch of by all 15 AHSNs across England
uptake of magnesium sulphate the project in August 2014, phase during 2018-2020.
as a neuroprotector for preterm one of PReCePT has prevented
babies was very low in the UK. seven cases of cerebral palsy Between 4,000 and 5,000 babies are
This was despite strong evidence across the region. born before 30 weeks’ gestation
of its efficacy in preventing in England per year and stand
cerebral palsy. Following the successful rollout to benefit from full national roll-
of PReCePT to all five acute trusts out of the PReCePT programme.
Karen approached the West of in the West of England in 2016, Successful scaling up of PReCePT
England AHSN with a proposal to the project is benefitting from is likely to prevent several hundred
address this. The case for change £0.5 million in ‘Scaling Up’ funding cases of cerebral palsy per year
16 17
ESCAPE-pain
Chronic joint pain, or osteoarthritis, affects one in five
of the population over the age of 50, and one in two
over 80. This condition causes considerable suffering
and distress, and is a life-inhibiting disease.
Only a small proportion (about participants are signposted to ESCAPE-pain has already spread to
5% of the eight to ten million services to help them continue over 70 sites nationally, benefitting
sufferers in the UK) proceed to to progress. more than 6,000 people. It will
surgical intervention. Most are continue to spread across the
managed in the community, The ESCAPE-pain programme is country as the AHSN Network
usually with painkillers, which are now increasingly being delivered supports its wider spread during
Emergency Laparotomy
both unpopular with patients and to people in leisure centres and 2018-2020.
potentially harmful. One in four other community venues and even
GP appointments are estimated workplaces, offering easier access Arlene Rowe, an ESCAPE-pain
to be related to joint pain. away from clinical settings. participant, said: “Since being
Collaborative
on the ESCAPE-pain programme,
Through its member organisations, It is less costly than usual care my life has changed massively.
the Health Innovation Network plans, and generates savings in both My first goal was just to stand
(AHSN for South London) identified a primary and secondary care. The straight. Now, I’m not hunched
need to be able to support patients robust evidence for ESCAPE-pain over, and I’m beginning to
with joint pain to self-manage their shows that people achieve a marked walk properly.
Emergency laparotomy is a major surgical procedure, with 30,000 to 50,000 conditions in their localities, and improvement in mobility and pain
performed every year in the UK. However, around 15% of patients are reported provide education and exercise reduction, and are better able to “I’m still stiff, I’ve still got arthritis,
support, as recommended in achieve the activities of everyday but what I don’t have is the pain.
to die within 30 days of surgery. Over 25% of patients remain in hospital for NICE guidance. life. There is also a marked impact Occasionally I get twinges, but
more than 20 days after surgery, costing the NHS over £200 million a year. on mood based on anxiety and nothing that makes me miserable.
Building on the work of ESCAPE- depression score improvements. Being able to sleep at night is
pain’s originator, Professor Mike Notably, results from the original wonderful. I’m not afraid to go out,
Hurley, who is an NHS Innovation trial have been replicated in clinical I’m not afraid to cross the road,
Funded by the Health Foundation, This has involved the spread when comparing baseline period Accelerator fellow, the Health practice, which demonstrates I can get on and off the bus okay,
the Emergency Laparotomy and adoption of the evidence- with improvement period. In Kent Innovation Network is promoting the the programme’s efficacy. and I can get on the train.”
Collaborative was established in based Emergency Laparotomy Surrey Sussex alone, we estimate spread of ESCAPE-pain. This is an
2015 to use a quality improvement Pathway Quality Improvement that 79 lives were saved during evidence-based, group rehabilitation
(QI) approach to tackle this. The Care (ELPQuiC) bundle within the 24-month programme. programme for patients with knee
Collaborative brings together the NHS trusts. The programme and/or hip osteoarthritis. The AHSN
28 hospitals and 24 NHS trusts has brought together dozens A health economics analysis provides training on the programme
across three AHSN regions: Kent of staff at collaborative learning suggests every £1 spent will to physiotherapists or exercise
Surrey Sussex; Wessex; and West events from across the trusts – result in approximately £4.50 professionals, who deliver it with
of England. from emergency departments, benefit to the wider health and the support of their local clinical
radiology, acute admission social economy. commissioning group (CCG),
The Collaborative has worked to units, theatres, anaesthetics hospital or community provider.
improve standards of care for and intensive care. Emergency Laparotomy
patients undergoing emergency Collaborative has been identified The ESCAPE-pain programme
laparotomy surgery, reduce mortality Initial results show that the roll- as one of the highest impact comprises 12 supervised sessions
rates, complications and hospital out of the care bundle across 28 programmes developed by all for a group of 10 to 12 participants
length of stay, while encouraging hospitals successfully reduced 15 AHSNs. Following this, we who receive education and take part
a culture of collaboration and average length of stay by 1.3 days are now in advanced stages in a tailored exercise programme.
embedding QI skills to ensure and reduced crude in-hospital of planning for exporting this The programme measures a range
sustainability of change. 30-day mortality rate by 11% programme nationwide of clinical outcomes, and the
18 19Serenity Integrated
Mentoring (SIM)
Across the UK, emergency and healthcare services respond every minute to people in
mental health crisis. Mental health crisis calls are increasing consistently each year. But
there is also ‘a problem within this problem’ because in every community, up to 40% of this
demand is caused by the same patients; a small number of repeat callers who struggle
to manage highly complex behavioural disorders and who, as a result place intensive
operational demands on police, ambulance, A&E departments and mental health teams.
Recognising that this small colleagues. Together they learn different, but the best results
number of repeat callers were about the trauma and triggers so far have seen crisis calls and
responsible for such a significant that lead to high intensity demand reduced by up to 90%.
proportion of the demand and behaviour, they discuss how
that NHS staff alone were not best to manage risk and how to Based on its success to date,
equipped to manage some ensure that the service user does in 2016 SIM was adopted by
of the most extreme levels of not keep on repeating the same the NHS Innovation Accelerator
behaviour, specialist, integrated high risk, high harm behaviour. programme, and in 2018 it was
mental health care and policing It is demanding and intensive selected for national scaling and
teams were formed to provide work but can bring significant spread across the AHSN Network.
a unique blend of nursing care breakthroughs in the lives of
and behavioural management. people whose behavioural AHSNs across the country will
These new teams work alongside risks are likely to result in them partner with mental health trusts
the patients and encourage even entering the criminal justice and police services to roll out the
the most challenging of clients system or even worse, dead SIM model. Nine mental health
towards more consistent and from accidental suicide. trusts have already launched
healthy coping strategies. teams, another 13 are in the
Health economic analysis has process of setting up a team
These SIM teams were demonstrated that this type and a further 12 are actively
developed by Paul Jennings, a of intensive crisis behaviour considering starting. This
former mental health sergeant can cost police, ambulance, accounts for over half of mental
from Hampshire Constabulary. emergency departments and health trusts across the country.
Such was the success of this mental health services between In addition, SIM is also live in
approach that in 2017, Paul left £20,000 and £30,000 a year per the Netherlands and is being
the police service to work full patient. It is estimated that there planned in Sweden, USA,
time for NHS England, leading are around 2,000-2,500 people New Zealand and Australia
the delivery of new teams all across the UK who place these
across England. repeat demands upon services.
More information about
SIM carefully selects and trains SIM intervention teams slowly SIM can be found at
police officers and police reduce this pattern of high www.highintensitynetwork.org
staff alongside their clinical cost behaviour. Every patient is
20 21AHSN Atlas
Atrial Fibrillation (AF) House of Memories
Data Landscape Tool
of Solutions
The AF Data Landscape Tool aims
to reduce AF-related strokes by
365 per year – that’s one stroke a
day. It was initially created at Health
in Healthcare
Innovation Manchester and then
further developed for national use
and launched by Imperial College
Health Partners.
It is a unique tool bringing together GiH has recruited
all publicly available data about AF over 80 graduates
prevalence, stroke incidence and across 30 trusts,
The AHSN Atlas is an online resource that shares some of the very best anticoagulant treatment, from datasets commissioners, GP surgeries,
examples of how AHSNs are spreading high impact innovation across the for every Clinical Commissioning Group third sector, and system wide
(CCG) in England, in an easy-to-use organisations, offering an innovative
health and care system. Here are some of our most successful solutions… dashboard format. time saving service. The programme
has a 96% retention rate and saved
Each CCG has timely and accurate over £340,300 in staff time.
access to their own data and can House of
Medic Bleep and support on adoption of their Silhouette®: easily compare their local information www.bit.ly/GiH-ahsn Memories
innovation, including guidance on 3D wound imaging with national, regional and RightCare
The Medic Bleep app is a clever appropriate evaluation. The overall matched averages. The tool provides
alternative to the traditional pager aim of the app is to improve patient Improving patient House of Memories is a pioneering
It is vital that all patients with insights to enable commissioners to project making a real difference to
for hospital staff. safety and release time for staff to diabetic foot ulcers receive regular better direct resources where they involvement in
care for patients. people living with dementia, their
treatment and check-ups. These are most needed. diabetes management carers, families and communities.
Many hospitals rely on a pager system. generally take place in hospital
However the communication method A time and motion study showed a Developed by National Museums
outpatient clinics, placing a The tool has been adopted by seven Good diabetes management and Liverpool, it has now spread UK wide
is one-way, the recipient is unaware statistically significant improvement severe strain on the service of the 15 AHSNs, and it has wide
who is bleeping, why, or the level of when using medic bleep instead of improving lifestyle factors such as with help from the Innovation Agency,
and patients might travel long applicability across the UK. It is weight and activity levels can reduce the AHSN for the North West Coast.
urgency. Work is interrupted, time is a traditional pager. It saved nurses distances for appointments. also part of both London and
wasted, and prioritisation is difficult. 21 minutes and junior doctors 48 the risk of what can be devastating
Manchester-wide AF improvement and costly complications. However, It brings together an innovative
minutes per shift. East Midlands AHSN worked with programmes, in collaboration
The Eastern AHSN is working with while structured education courses dementia awareness training
Entec Health and Aranz Medical with Public Health England’s (PHE) can help people to manage diabetes, programme and an app called
Medic Bleep to provide advice www.bit.ly/bleep-ahsn to spread Silhouette®, a new 3D initiative, to improve AF management attendance rates are very low. My House of Memories. Originally
wound imaging and information and reduce the number of avoidable developed for health and social care
system, which means routine AF-related strokes. The North West London CCGs in staff, House of Memories has been
diabetic foot ulcer treatment can partnership with Imperial College expanded for family and carers. It uses
now be delivered in the community. www.bit.ly/AF-landscape-ahsn Health Partners, who carried out an the power of museum objects to help
www.bit.ly/af-ichp independent evaluation, are working build positive communication between
David Hawkins, a patient from Ripley, with OurPath, Oviva and Changing carers and people living with dementia.
said: “Being able to have my Graduates into Health Health to provide digital solutions for
check-ups at my local clinic is patients with diabetes to improve self- The app provides access to hundreds
great. I have less distance The NHS struggles with entry level management. of fantastic social history objects
to travel and it makes recruitment, while talented graduates from museum collections. It is
getting to appointments aren’t always aware of non-clinical The results demonstrate impressive designed to be intuitive and easy
much easier.” career opportunities. That’s why levels of patient adherence and to use, featuring images, videos
the Health Innovation Network set engagement, with reductions for and audio to stir memories and
www.bit.ly/ up ‘Graduates into Health’ (GiH) to all key indicators such as weight and stimulate conversations. The app
silhouette-ahsn build capacity and support NHS blood glucose levels. was developed by Damibu, whose
providers with recruitment into MD, Dave Burrows, is now an NHS
business function teams, such as The three companies have been Innovation Accelerator Fellow.
HR, procurement and IT. supported by the DigitalHealth.London
Accelerator programme, a partnership User involvement has been key to
GiH teamed up with the Graduate between London’s three AHSNs, the success of the project, and was
Management Trainee Scheme to along with MedCity, CW+, and a feature from initial scoping through
recruit talented graduates from their Guy’s and St Thomas’ Charity. to co-design and testing.
20,000 annual pool that don’t make it
Medic Bleep on to one of their scarce 200 places. www.bit.ly/diabetes-ahsn www.bit.ly/memories-ahsn
22 23Taking time to listen and in kidney function. In the UK, up to Life QI The materials use the films to stimulate These SPACE: Safer Provision
100,000 deaths each year in hospital are a reflective session, allowing staff to factors and Caring Excellence
learn: medication reviews explore what is important for people can make it
associated with AKI. Up to 30% of these Life QI is an online platform that assists
could be prevented with the right care. frontline health and social care staff at the end of their life. challenging
Clinical commissioning groups (CCGs) for positive
have identified funding and resources in running quality improvement (QI)
The South Tees AKI programme includes projects. It was originally developed as The resources have been highly rated safety practices
as barriers to making sustainable by trainers, and learners have reported to be cascaded and
improvements to problematic a national electronic alerting system, part of the South West Patient Safety
an intensive trust-wide awareness Collaborative in partnership with the an increase in confidence as well as a embedded within the
‘polypharmacy’ or overuse of multiple positive impact on their practice. organisational culture.
medicines. campaign, education workshops, South West AHSN and SeeData Ltd.
teaching package, clinician guidelines
and a clinical quality assurance platform Life QI supports teams to plan, monitor www.bit.ly/EOLC-ahsn Led by the West Midlands
Kent Surrey Sussex AHSN supported a Patient Safety Collaborative,
project to examine the benefits of level to track patient level co-morbidities. and report the progress of their
improvement projects, as well as connect Organisational change SPACE is an innovative improvement
3 medication reviews through a seven programme working with care homes
month pilot with Brighton and Hove CCG. The programme is now being rolled out with other members of the quality roadmap
to trusts across the North East and the improvement community, facilitating across the region. It aims to improve
rest of the country. collaboration and shared learning. safety culture and reduce the incidence
Holistic, level 3 ‘gold standard’ face to Wessex AHSN have developed a of adverse safety events.
face medication reviews were carried one-page visual roadmap to help
out with residents and patients in care www.bit.ly/AKI-ahsn Following its success in the South West those involved in supporting or
region, the platform has been further Through SPACE, care home staff The Faecal
homes and other care settings, with a leading organisational change in are developing service improvement
focus on listening and shared decision Improving hydration developed and enhanced, giving access to any clinical area. Calprotectin Pathway
the member organisations of all 15 AHSNs skills, while the Collaborative is
making. The reviews were carried out in care homes supporting care homes to introduce
by an experienced pharmacist and across the country, and is being used Based on established quality The new Faecal Calprotectin Pathway
internationally too across 28 countries. changes to practice. helps GPs make the difficult distinction
pharmacy technician, working closely Fewer residents are suffering urinary improvement methodology, the
with GPs, hospital colleagues and Age tract infections (UTIs) following the roadmap has been developed to between irritable bowel syndrome (IBS)
As a result of AHSN support, the A recent Care Quality Commission and inflammatory bowel disease (IBD).
UK, and aimed to improve patient introduction of a hydration programme offer an ‘at a glance’ checklist, and (CQC) inspection report highlighted the
outcomes and quality of life. in care homes, led by the Oxford number of organisations using Life QI in outlines useful areas to consider when Because distinguishing IBS from IBD
England has grown from 375 to 1,400, valuable contribution played by the is tricky, as many as 19 out of 20
Patient Safety Collaborative. planning or undertaking improvement SPACE in helping Walsall’s community
In addition, this approach was shown with 10,100 individual users running work. It comprises 12 steps iterating patients are unnecessarily referred
5,700 quality improvement projects. services achieve a ‘good’ rating. to secondary care, while diagnosis
to reduce hospital admissions and was UTIs are closely associated with the central elements required for
well received by patients and carers, dehydration. The project encouraged successful change. for other patients is delayed.
www.bit.ly/life-ahsn www.bit.ly/space-ahsn
while offering savings to CCG prescribing residents to drink more fluids with
budgets. The findings will now be used to the aim that this would lead to fewer Alison Griffiths, roadmap author The pathway was introduced
inform similar work in a different locality, UTIs requiring medication or hospital End of life care education and Wessex AHSN’s programme Sharing the NEWS by Dr James Turvill, Consultant
at the end of which the AHSN will produce admission. This approach involved manager for mental health, said: Gastroenterologist at York Teaching
a toolkit to help other organisations introducing structured drinks rounds UCLPartners have developed innovative “The improvement journey is rarely All too often healthcare professionals Hospitals NHS Foundation Trust.
implement similar projects locally. seven times a day, designed and educational resources for teaching End smooth, and knowing where to don’t speak the same ‘language’. This
delivered by care home staff. of Life Care (EOLC) to non-specialist begin can feel daunting. However, a can cause problems at the handovers The Yorkshire & Humber AHSN
www.bit.ly/atlas-ahsn staff across all health and care settings. supportive approach and perseverance of care when patients are passed from supported its spread by funding
The initial focus was in four care homes can have a huge impact on service one healthcare setting to another. an economic impact analysis and
with higher than average UTI admission The aim is to improve conversations users and their family, and on staff, Inconsistency can lead to delays in creating implementation packs for
Limiting patient injury detecting and treating seriously ill trusts, Clinical Commissioning Groups
to hospital rates. To date the overall between staff and patients in their last by reducing variation whilst promoting
from AKI reduction of hospital admissions due weeks and days of life, so that more better and evolving care.” patients who are deteriorating rapidly. (CCGs) and primary care. A number
to a UTI is 61%. The number of UTIs people get to die in their preferred of AHSNs across the country are now
The Patient Safety Collaborative North requiring antibiotics has also fallen place and unnecessary hospital www.bit.ly/roadmap-ahsn Since 2015, the West of England Patient working to implement the pathway
East and North Cumbria is helping from an average of one every nine admissions are avoided. Safety Collaborative (PSC) has been in their areas.
to spread an effective approach to days to one every 52 days. working on a major programme to
recognising and promptly treating SPACE: Safer Provision introduce the National Early Warning Use of the pathway in one region
Each set of materials includes a short
Acute Kidney Injury (AKI). www.bit.ly/UTI-ahsn film, teaching slides and activities. The and Caring Excellence Score (NEWS) at every handover of has resulted in a 40-57% reduction
first film, Milestones, depicts a patient’s patient care – primary care, ambulance, in new hospital outpatients’
A team at South Tees experience in an acute hospital, Most care home residents have high hospital, community and mental health. appointments, with a 21-50%
Hospitals NHS Foundation Trust while You Matter shows support needs, such as dementia, NEWS was developed by the Royal reduction in colonoscopies. Projected
in Middlesbrough first developed the experience of a confusion, challenging behaviour, College of Physicians and checks six savings to each CCG using the
the programme, resulting in a man dying in his incontinence, hearing or visual vital signs. pathway are up to £100,000 a year.
sustained reduction (36%) own home. impairments or reduced mobility
in AKI cases within - or a combination of these needs. Building on the success of this work in www.bit.ly/fcp-ahsn
surgical wards. the West, the National Quality Board
The care home sector is also is encouraging the adoption of NEWS
AKI describes characterised by frequent policy across all NHS acute care. NEWS and
when a person and regulatory changes, heavy NEWS2 are now fully endorsed by NHS For more on these and many
suffers from workloads, high staff turnover and England and NHS Improvement. other AHSN supported innovations,
a sudden End of life care difficulty recruiting and retaining visit atlas.ahsnnetwork.com
reduction education competent staff. www.bit.ly/NEWS-ahsn
24 25The AHSN Network
Eastern Kent Surrey UCLPartners
(East of England, excepting Sussex (north east and north central London,
west Bedfordshire, south Essex, www.kssahsn.net south and west Hertfordshire, south
west and south Hertfordshire) E: enquiries@kssahsn.net Bedfordshire and south west Essex)
www.eahsn.org.uk @KSSAHSN www.uclpartners.com
E: enquiries@eahsn.org T: 0300 303 8660 E: contact@uclpartners.com
@TheEAHSN @UCLPartners
T: 01223 661 500 T: 0207 679 6633
North East &
East Midlands North Cumbria Wessex
www.emahsn.org.uk www.ahsn-nenc.org.uk
www.wessexahsn.org.uk
E: emahsn@nottingham.ac.uk E: enquiries@ahsn-nenc.org.uk E: enquiries@wessexahsn.net
@EM_AHSN @AHSN_NENC @WessexAHSN
T: 0115 748 4235 T: 0191 208 1326 T: 0238 202 0840
Health Innovation Manchester Innovation Agency West Midlands
(including East Lancashire (Cheshire, Merseyside, www.wmahsn.org
and East Cheshire) South Cumbria E: info@wmahsn.org
www.healthinnovationmanchester.com and Lancashire) @wmahsn
E: info@healthinnovationmanchester.com www.innovationagencynwc.nhs.uk T: 0121 371 8061
@healthinnovmcr E: info@innovationagencynwc.nhs.uk
T: 0161 509 3840 @innovationnwc West of England
T: 01772 520263 www.weahsn.net
Health Innovation Network E: contactus@weahsn.net
(south London) Oxford @WEAHSN
www.healthinnovationnetwork.com www.oxfordahsn.org T: 0117 900 2604
E: hin.southlondon@nhs.net E: info@oxfordahsn.org
@HINSouthLondon @OxfordAHSN Yorkshire & Humber
T: 0207 188 9805 T: 01865 784944 www.yhahsn.org.uk
E: info@yhahsn.com
Imperial College South West @AHSN_YandH
Health Partners (Somerset, Devon, Cornwall T: 0192 466 4506
(north west London) and Isles of Scilly)
www.imperialcollegehealthpartners.com www.swahsn.com
E: ea@imperialcollegehealthpartners.com E: info@swahsn.com
@Ldn_ICHP @sw_ahsn
T: 0333 077 1707 T: 01392 247 903 www.ahsnnetwork.com
info@ahsnnetwork.com
26 27@AHSNNetwork The AHSN Network www.ahsnnetwork.com info@ahsnnetwork.com
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