Akeso supported a non-UK based POC manufacturer to develop a market entry strategy to support bringing a number of their POC products across a wide-spanning disease portfolio into the UK, through a detailed opportunity assessment, commercial strategies and overall entry recommendation.
INSIGHT
Anbio (Xiamen) Biotechnology are a non-UK based manufacturer of laboratory diagnostics and point-of-care (POC) products, who experienced particular success with their COVID-19 LFD portfolio.
Anbio had identified a possible commercial opportunity to expand into the UK market with their wider POC portfolio and engaged with Akeso to seek support in conducting a market opportunity assessment and developing a strategy recommendation to implement this market entrance.
ACTION
Akeso developed the recommendation report via a two-phase approach:
Opportunity Assessment: Via utilisation of a top-down strategy, Akeso conducted a full UK POC market assessment reviewing overall performance/growth, industry trends and barriers, supplier landscape and disease segment analysis, to identify evidence-based disease-level opportunities. From this, Akeso short-listed further product prioritisation opportunities across each of the identified disease areas, reviewing both of Anbio’s Antigen Rapid Test and Chemiluminescence Instrumentation product portfolio (as requested)
Strategy Recommendation: Akeso documented a supporting disease- and product-specific commercial strategies across public and private healthcare and wider public sectors. These were supported by a market entry strategy, operating model and roadmap to establish a business within UK market.
RESULTS
Due to our in-depth understanding of UK healthcare, POC testing specifications, procurement and distribution, and market access, Akeso successfully:
Identified disease & product-level opportunities and potential revenue benefits, in addition to market and product developments recommendations
Documented commercial strategy roadmap supported by a number of key enablers to provide “quick win” activities to support successful entry
Scott has dedicated his career to performance improvement in healthcare and life sciences working both within a multinational consulting firm, and for the last decade as a co-founder of Akeso.
As a Managing Partner of the company, he has led the development of Akeso as an established boutique consultancy committed to improvement in UK health. His project specialisms and areas of interest are systemwide performance improvement, the national and international healthcare supply chain and the use of data to drive tangible and actionable improvement insights.
His approach is flexible, warm and fact-based and he is proud to have delivered numerous collaborative/ICS projects being able to engage positively across multiple stakeholders, specialisms and styles to achieve outcomes around aligned goals.
Outside of work his passions are almost all sports (mainly watching nowadays although can be found trying to find his wayward golf balls in the woods / long grass / water) and spending time with family, including Rump the cocker spaniel who is also the honorary office dog.
Working collaboratively with a global MedTech provider, we structured an implementation guide to support overcoming key barriers to implementation which were potentially limiting sales opportunities – this resource is now key material used in respected conferences such as HETT.
INSIGHT
Virtual Ward implementation were (and continue to be) viewed as complicated and involved, with a lack of clear guidance on how to implement them effectively.
The client suspected this was leading to lost opportunity / sales and required a required a solution that provided current and future clients with the support & piece of mind they sought. The solution needed to make it clear what needed to be done and when whilst, most importantly, showing how easy Virtual Wards are to implement- demystifying the process.
ACTION
Akeso was engaged to support in the development of this solution; a comprehensive Virtual Ward implementation guide.
We conducted a comprehensive discovery exercise to understand the Virtual Ward implementation environment, what was done well, what was done badly and what regulatory / funding processes providers had to complete.
Using an agile approach, we began to develop an implementation guide from the gathered information, breaking the process down into easily digestible chunks. The iterative style of our delivery allowed the method to be tested with clinicians and client stakeholders, adapting the material in real time.
We delivered a concise, clear and visually engaging Virtual Ward implementation guide which has now been distributed to over 10,000 industry stakeholders across the UK.
RESULTS
A comprehensive Virtual Ward implementation guide
Increased brand awareness and market interest
Improved internal implementation practices
Industry leading material and a competitive advantage
Adam has 18 years’ experience as a healthcare consultant, delivering change and transformation in the UK and overseas, with a focus on delivering improved productivity and efficiency. He has previously led healthcare consultancy teams at NECS CSU and Deloitte.
He has held a number of senior NHS positions with large London providers and with Monitor/NHS Improvement, and has served as a Non-Executive Director and as Chair with a number of local health and social care-focused charities.
Adam is a Chartered Management Accountant and a Prince2, MSP and Green Book Practitioner.
Akeso provided procurement and contracting services to support the delivery of core services for this newly established Scientific Research Charity.
INSIGHT
Our Future Health, a charity establishing the UK’s largest ever health research programme, designed to enable the discovery of more effective approaches to prevention, detection and treatment of diseases.
The aim of the programme is to recruit 5 million adult volunteers that will provide information about their health, lifestyles and a sample of blood for genotyping and analysis.
Our Future Health required the procurement of services for blood sample processing, Genotype assay design, manufacture, genotyping services and sample storage.
ACTION
Our Future Health were required to operate under PCR15 to procure and contract and without any in-house procurement expertise, the organisation needed to navigate all elements of this complex procurement including development of specifications and evaluation criteria and managing the tender process through to contract.
In addition, the volumes and timescales were still being developed and a solution was needed that could flexibly ramp up to meet the evolving needs of the programme but also needed to start within 8 months.
It was also recognised that some elements of the requirement were very specialist with limited providers. The client needed a solution that would provide the full service but allow for effective competition for all elements.
Akeso supported Our Future Health by coordinating its significant scientific expertise with a PCR2015 compliant foundation in order to deliver this large and complex procurement.
RESULTS
Our Future Health now has the infrastructure in place to be able to process and genotype 5 million samples from the UK population to deliver the largest research programme of its kind. A key objective was to avoid any legal challenge to the process, meet the ambitious timescale whilst ensuring SME participation.
Chris has spent almost 25 years working in the commercial and operations space, in both private and public sector across the automotive, financial services, telecoms, energy and healthcare sectors.
As a Managing Partner and co-founder of Akeso, Chris is passionate about the value that can be realised when an organisation takes a fresh look at how it can enhance the quality and cost efficiency of the services and products it delivers by leveraging third-party led innovation, technology and solutions and has worked collaboratively with many providers and suppliers to the Health & Care sectors in the UK and internationally to realise this objective.
Outside of work Chris enjoys spending time with family, watching Arsenal, running and doing DIY projects.
One of the first datasets of its type, pioneers within technology-enabled virtual wards West Hertfordshire Hospital in partnership with Masimo, used hospital grade digital health platform, Masimo SafetyNet to establish a robust clinical pathway to support early discharge and readmission avoidance for patients with heart failure. Key findings include, 36% reduction (3 days) in average acute LoS, 38% reduction in readmission and excellent patient satisfaction.
Background
Following the call by NHS England for ICSs to embrace innovation and establish technology-enabled Virtual Wards, a first-of-kind study has been released by early pioneers at West Hertfordshire Teaching Hospitals NHS Trust who have developed a Heart Failure Virtual Hospital using leading digital health platform, Masimo SafetyNet®.
Designed by a local Integrated Care Service consisting of representatives across the Acute Trust, Community Heart Failure Services and primary care, the West Hert’s Heart Failure Virtual Hospital was established to allow patients to safely receive care from the comfort of their home. In doing so, a study was conducted to quantify how this technology-enabled Virtual Ward could (1) safely reduce acute length of stay through early discharge and (2) deliver high patient outcomes through preventative readmission, all whilst maintaining positive patient experience.
To establish the Heart Failure Virtual Hospital, West Hert’s in partnership with technology providers, Masimo, developed a comprehensive clinical pathway and platform customised for eligible patients. At the centre a Virtual Hospital monitoring hub was formed to collate and monitor patient data, sent directly via Bluetooth from the Masimo monitoring app on the patients mobile device. Automated vital signs readings were recorded three times per day, as well as daily questionnaires and phone calls by a Virtual Ward nurse and daily Virtual Wards rounds by a heart failure consultant.
Key outcomes
The study, which is the first datasets of its type, collated data across length of stay, readmission rate and patient experience for 183 patients. Preliminary analysis collated the following key findings:
Acute length of stay was significantly reduced through early discharge
36% reduction (3 days) in average acute LoS – mean acute LoS was 5.8 days compared to 9.1 days for patients not onboarded into the Virtual Ward for the same period
68% of patients (125) were successfully discharged after a Virtual Ward stay
Preventative readmission indicated strong decline
11% reduction in readmission rate into the acute following 30-day follow-up with a primary HF diagnosis – 3.2% for Virtual ward vs. 3.6% for non-Virtual Ward group
38% reduction in readmission rate for all causes – 9.6% for Virtual Ward vs. 15.5% for non-Virtual Ward group
Patient satisfaction was excellent
83% of patients agreed that going home sooner from hospital aided their recovery
85% of patients agreed that they felt safe as a patient in the Virtual Hospital
88% of patients agreed that the frequency of contact and communication by the monitoring hub was about right.
Key success factors for implementation
Robust technology – Hospital grade technology that is both compliant and from a recognised and trusted provider, is a key driver to overcoming the potential barrier of both Clinician and patient acceptability. Due consideration should be given to the user experience and journey so to empower the patient and Clinician.
Clear methodology – As with any large clinical transformation which involves adoption of new technology, a clear plan that reflects a comprehensive understanding of the problem to be addressed is crucial. This includes identifying the appropriate use case and patient cohort.
Pilot approach – Avoid a ‘big bang’ approach. We recommend phasing Virtual Wards in, targeting two or three patient cohorts of highest priority / acceptability first.
How can we help you?
Masimo SafetyNet® is a Digital Health platform from Masimo, whose innovative monitoring products have been in use across the NHS for over 15 years, with a proven track record of success.
Key features of Masimo SafetyNet® include:
Continuous and spot check sensors to monitor patient vital signs remotely via Bluetooth connectivity in real-time
Over 150 live Customisable care programs, including training and educational material
Secure NHS NDG compliant network via AWS cloud, enabling 24/7 two-way audio and video communications with the capability for EMR integration
Dynamic dashboard and customisable alert limits to automatically notify and inform Clinicians as required
Masimo has a vision to support healthcare providers deliver effective and safe patient care from the comfort a patient’s home through hospital grade technology-enabled Virtual Wards. To support providers in rapidly implementing Virtual Wards, Masimo in partnership with Akeso have developed a suite of documents to achieve their goals, whilst ensuring quality patient care.
Adam has 18 years’ experience as a healthcare consultant, delivering change and transformation in the UK and overseas, with a focus on delivering improved productivity and efficiency. He has previously led healthcare consultancy teams at NECS CSU and Deloitte.
He has held a number of senior NHS positions with large London providers and with Monitor/NHS Improvement, and has served as a Non-Executive Director and as Chair with a number of local health and social care-focused charities.
Adam is a Chartered Management Accountant and a Prince2, MSP and Green Book Practitioner.
With an elective care backlog in excess of 7 million [1], record high workforce shortages [2] and decaying estates, our healthcare system is close to breaking point. Numerous tools have been deployed to try and combat these problems, but they continue to fall short of the mark. Not all hope is lost though. Driven by the global Covid-19 pandemic, we have seen a flurry of new techniques and solutions enter the market, promising to solve our problems and redefine healthcare nationally. One of these tools, Virtual Wards, has established such a strong base of supporting evidence that they can no longer be ignored. But are they the answer to our prayers? When deployed in a technology-enabled manner, following a structured implementation plan, they just might be.
In response to rising demand and in preparation for winter, NHS England (NHSE), Health Education England (HEE) and NHS Digital (NHSD) are collaborating to support ICSs in adopting Virtual Wards. Outlined in a two-year funded transformation program, the ambition is to have 40-50 Virtual Ward beds available in each Trust across the UK (24,000 beds in total). This is to be delivered in a tight time frame, with all Trusts required to meet the capacity target by December 2023.
With NHSE putting their faith in Virtual Wards, so too should we. But what is a Virtual Ward? What kind of benefits can they deliver and how can we ensure that our Virtual Ward is actually successful?
About Virtual Wards
Virtual Wards aren’t new, with the first examples deployed over 15 years ago [3]. At their core, they aim to move patients out of hospitals and into homes, whilst still delivering an acute level of care. Despite being used across the UK (and globally), their model of care remains largely unchanged, with little innovation or improvement seen in the space. That is, until now.
Many Virtual Wards currently in use are ‘traditional’ in their approach, with the care delivery model underpinned by telehealth services and routine home visits. This approach requires significant clinical time investment, proliferating systemic workforce problems and, in some cases, functioning to hinder the service rather than help it.
There is, however, a ‘non-traditional’ Virtual Ward model, one that uses state of the art remote monitoring technology to deliver acute level care to patients [cite]. These models are defined as ‘Technology-enabled Virtual Wards’, delivering quality care without the same workforce demand as traditional models.
Technology-enabled Virtual Wards
The NHS defines a technology-enabled Virtual Ward (TEVW) as ‘the management of patients via a digital platform’. A broad definition which could be used to describe any number of solutions currently on the market. It is also, a misleading one, as beyond the shared use of technology, there is very few similarities between the different solutions. App only, monitoring + app and telehealth platforms can all be considered as technology enabled Virtual Wards, but each has a unique set of benefits and delivers care in a novel way.
Although telehealth and app only solutions have their place, providers should be focused on deploying Virtual Wards that utilise hospital grade remote monitoring technology. These Virtual Wards are the new frontier of digital health, delivering a broader suite of benefits, to a greater patient cohort, than any other solution [4].
For the remainder of the article, when we refer to a TEVW, we refer specifically to one that is using hospital grade, remote monitoring technology.
Benefits of Technology-Enabled Virtual Wards
Not all TEVWs are built the same, with maximum (in terms of both breadth and depth) benefits only observed in those that integrate remote monitoring in patient care pathways. But what are these benefits? Where, how and by who will they be felt? To understand the potential impact of TEVW, we have conducted benefits modelling using leading technology within the Virtual ward space, Masimo SafetyNet as an example, to explore the following areas:
Average Length of Stay
Workforce efficiency
Readmission rate & admission avoidance
Backlog reduction
Release of acute bed capacity
Our analysis models the potential positive impacts that an average sized Trust (778 beds) could achieve by adopting a TEVW. This is not the only potential application though. With appropriate tailoring, TEVWs can be applied to any use case, with the technology being used globally to support the care of patients suffering from any number of conditions from cancer to heart failure.
In the context of the acute emergency and orthopaedics cases, we understand there to be two main applications for a TEVW respectively: avoiding admission and expediting discharge. The benefits of TEVWs will be discussed in the context of these primary applications.
1) Avoiding admission
TEVWs offer providers a way to avoid unnecessary admissions and re-admissions to the acute setting, instead delivering care to patients in the home environment. Acute patients, such as emergency department attendees, can be admitted to the Virtual Ward, rather than the physical ward, preventing the occupation of an acute bed.
Our benefits modelling indicates that for an average sized Trust of c.760 beds, up to 7,000 bed days could be released through readmission avoidance of acute emergency patients [5,6,7,8]. This would save an estimated £3 million in avoidable readmission costs [7,9] and release 63 hours of clinical resource back to patient facing activities [10]. In addition to financial and capacity benefits, research has shown that patients have a greater perceived quality of care and sense of empowerment when treated through a TEVW model [11].
In the context of acute emergency cases:
2) Early discharge
TEVWs enable postprocedural remote monitoring and encourage early discharge, releasing both clinical and bed capacity [12,13].
Wearable sensors alert clinicians to changes in a patient’s condition, in real-time, helping the remote management team to intervene sooner and ensuring patients receive the same quality of care within the Virtual Ward [12,13]. This functionality brings the home environment in line with the acute environment and provides clinicians with the confidence they need in order to discharge more acutely unwell individuals, earlier. 1/3 patients stay in hospital beyond the necessary point of care, the ability of TEVWs to reduce length of stay will be critical in reducing this number and expediting discharge. You can read more about this in our D2A technology article here.
Reducing length of stay will release clinical and bed capacity, allowing critically ill patients to be treated with fewer delays and removing a key bottleneck in care delivery. In the case of primary hip and knee procedures, the ambition is that technology enabled Virtual Wards will reduce length of stay by up to 3 days. This could release an estimated 900 bed days which could be utilised to addressing the current backlog for orthopaedic procedures.
In the context of orthopaedics patients:
Implementing technology-enabled Virtual Wards
The potential benefit of technology enabled Virtual Wards is clear and as a result NHSE calling for their rapid adoption [14,15]. However, without firm guidance on how to implement these solutions effectively, they may fail to deliver expected benefits and jeopardise patient care [16].
Learnings from previous Virtual Ward implementations have been distilled into a set of critical success factors which must be considered if the TEVW is to be delivered effectively. Sourcing the right solution, defining a clear objective, mapping the commercials and understanding the use case are all pivotal in achieving success. Steps to address these factors are outlined as part of our comprehensive Virtual Ward implementation guide.
Akeso’s methodology is based on Masimo SafetyNet which you can find here.
Sourcing the right solution, and partnering with the right provider, are essential in ensuring the Virtual ward is both clinically compliant and highly effective. Several providers claim to meet these criteria, but with only a few functioning examples of TEVWs locally, it is difficult to assess the validity of these statements. route of sourcing an effective, complaint TEVW is utilise the Sparks Dynamic Purchasing System (DPS) framework. Spark DPS categorises leading technology providers across a variety of sectors based on their capabilities and offerings. We have summarised these providers, and what they offer (based on the DPS framework), below.
When considering which TEVW supplier to use, it is important to consider future TEVW applications, beyond the current target. Many providers have Virtual Wards up and running, supplied by different organisations. This can lead to problems with integration, consistency and quality for both patients and clinicians. The aim should be to procure a single solution that is scalable and adaptable to all areas of your service. Masimo SafetyNet is a robust example of a TEVW solution that holds this capability.
The Future
We currently have a discharge problem in the NHS, with patients waiting up to 9 months to be sent home [cite]. Virtual Wards will support expedited discharge, reducing Length of Stay back toward national targets. Read more about it in our Discharge to Assess (D2A) technology enablement article ‘Turning homes into hospitals’.
Although current benefits are obvious, we should begin to think about what role TEVWs might play in the future of healthcare. Using the clinical information TEVWs provide, we could look to begin moving the discharge threshold, allowing higher acuity patients to be treated in an at home environment. Doing so would extend the benefits of Virtual Wards, beyond what current models (including our own) predict.
But the future of Virtual Wards doesn’t just lie in moving the discharge threshold. Traditionally, Virtual Wards were deployed to prevent patient admission- the opposite end of the care pathway to the current discharge focus. We believe technology-enabled Virtual Wards could eventually be deployed across every stage of the patient care journey, not just the bookends, supporting a movement toward personalised medicine and redefining care pathways completely. There is evidence of this globally already, with Virtual Wards across Australasia supporting entire cancer care pathways [17].
It is important to keep these opportunities top of mind as we deal with our current issues, continuing to innovate and adapt during a time of immense pressure. Doing so will ensure that solutions implemented can flex and change as our needs do, remaining relevant long into the future.
References
The British Medical Association. NHS backlog data analysis. 2022. [online] Available here.
House of Commons Committee. Workforce: recruitment, training and retention in health and social care. 2022. [online] Available here.
KingsFund, 2006. Case study: Virtual wards at Croydon Primary Care Trust. [ebook] Available here.
NHSX. A guide to setting up technology-enabled virtual wards. 2022. [online] Available here.
1.6 WTE/bed based on avg staff required to service a 40-bedded ward in hospital published on the VW Bed Benefit Tool from NHSEI available at https://www.future.nhs.uk
Nunan, J., Clarke, D., Malakouti, A., Tannetta, D., Calthrop, A., Hanson Xu, X., Berin Chan, N., Khalil, R., Li, W. and Walden, A., 2020. Triage Into the Community for COVID-19 (TICC-19) Patients Pathway – Service evaluation of the virtual monitoring of patients with COVID pneumonia. Acute Medicine Journal, 19(4), pp.183-191.
D2A pathways and associated practices are key tools in expediting patient discharge, relieving pressure on the acute environment and improving patient flow [1,2]. Although effective on their own, by applying technology in new and innovative ways, these pathways can be further enhanced to generate further benefits.
Supporting technology is best viewed as ‘catalysts’ for D2A pathways. When implemented effectively, they can amplify the benefits of discharge to assess such as: improved patient experience, faster discharge, and the release of capacity for other clinical need.
The role of technology enablement in D2A
The number of D2A enabling technologies is increasing continually, catalysed by the global Covid-19 pandemic. Solutions such as “Virtual Wards” and various health apps provide cost-effective ways of delivering care to more patients in a resource efficient manner [3,4]. With so many technologies, solutions, and providers now on the market, the space has become confusing. An understanding of what the technologies do, what benefits they may generate, and how they support more efficient discharge is not easily come by.
In order to help, we have clustered the current propositions into three main types: ‘alternative models of care’, ‘care management tools’ and ‘service augmenters’ which are explained below. Each of these enhances one or more of the D2A pathways as defined in our previous articles.
Extended models of care to include a patients’ home
Technology solutions labelled as ‘alternative models of care’ seek to fundamentally redefine the patient care pathway. Key solutions in this space include Virtual Wards and Telehealth Services, effectively turning our homes into hospitals.
Technology-enabled Virtual Wards are pioneering, demonstrating the ability to move patients out of the acute environment whilst maintaining the same quality of care [5]. In Masimo’s SafetyNet solution, for example, this is enabled by remote monitoring, allowing real-time assessment of patient “vital signs” and automated alerts when patients conditions begin to deteriorate [6]. When implemented effectively, these solutions can reduce length of stay and release clinical capacity.
Care management and enhanced communication between professionals
The second suite of D2A enabling technologies aim to consolidate the care management process, presenting a complete view of the end-to-end process. Patient discharge is managed by multidisciplinary teams, each uniquely involved in the movement of the patient out of the acute environment and their continued care in the community. Historically, communication between these groups has been limited, delaying discharge, and causing continuity issues in care delivery.
Innovative technology platforms such as ‘Hospital to Home’ [7] provide consolidated views of both the discharge process and the overall patient care pathway, in a way that fosters collaboration between clinical stakeholders. In the context of D2A, these platforms can enable faster, more consistent discharge practices, supporting clinicians to understand discharge stages, who needs to be involved and what needs to happen when.
Accessing national capacity as and when it is needed
Driven by the growing workforce shortage across the NHSE, several 3rd party clinical service providers have been established over the past few years. These providers offer access to clinicians, via telehealth platforms, to support with rate-limiting tasks such as triage. diagnostic and outpatient assessments. In doing so they expand a provider’s workforce, reducing bottlenecks and delays.
These services can diffuse pressure, such as during Winter, to mitigate against seasonal variation for the period when it’s needed. Virtual Lucy [8] and Medefer [9] are industry leading providers of these services, not only demonstrating the ability to reduce discharge delays but also preventing patients from unnecessary admission to acute services in the first place.
Ensuring the solution is successful
The implementation and management of digital transformations is rarely done well, but there are steps that can be taken to improve the chance of success. Each technology implementation is different, with unique challenges and success metrics. There are, however, key success factors, common to all implementations regardless of technology type or use. The programme objective, intended use case and commercial viability are all essential to consider if the technology implementation is to achieve success.
Programme objective
A single objective should be defined to drive progress and foster alignment across the delivery team.
Often, we see large programmes of work undertaken as a knee jerk reaction to changing pressures across our health landscape, resulting in ‘solutions’ that are naïve of the problem they attempt to solve [10].
Providers must be proactive in defining their programme objective, setting a clear goal before work commences. It should be easily understood and clearly linked to actions that support its realisation. Having a single, clearly defined objective (for example, enhanced patient experience) will align stakeholders, keep the project on course and ensure positive outcomes are achieved.
The clarity of this objective will then lead to Key Performance Indicators (KPIs – such as a relevant PROM, percentage of patients in an acute site beyond their point of need, and patients supported at home) which can be used to assess the success of the solution.
Intended use case
Technology should be aligned to where it is needed most.
Discharge processes differ significantly, not just between providers but between clinical pathways. It is unlikely, therefore, that there will be a ‘one size fits all’ technology solution across providers; adaptation is always required to tailor the needs of each unique situation. Many providers fail to consider this, deploying generalised rather than tailored solutions. Providers should focus on strategic deployment models, delivering technology solutions to highest need or highest-pressure pathways first, and then expanding these solutions across lower priority / lower risk pathways over time.
In defining the use case for the D2A enabling technology, an understanding of the underlying population should be developed. Demographic factors such as ethnicity, gender and comorbidity are known to influence the efficacy of healthcare interventions. Understanding these factors will support delivery of tailored, technology-enabled, discharge solutions.
Commercial viability
The commercial viability of the technology should be defined early in the project lifecycle.
The balance between costs and benefits (as captured in KPIs) underpins the commercial viability of a technology solution. Through defining a clear objective and understanding the intended use case, the benefits of a technology solution can be easily understood. The financial implications (both ongoing and upfront) of the technology should be modelled to support an equal understanding of associated costs.
Aside from Virtual Wards, which have £450 million in backing, there is no ring-fenced funding available for D2A enabling technologies. A formal business case will be required to secure funding for initial set up and continued use of these technologies. To complete the NHSE business case in full, clear definition of costs, benefits, and ROI time horizons will be required. Importantly, financial benefits must be shown to outweigh costs, with a robust evidence base established to support this conclusion.
What’s next
Having understood the D2A enabling technology landscape, and how to ensure these tools work to support you, the task of delivery comes next. This is where all the value is generated. The final article in our series will focus on setting up delivery programmes to succeed, demystifying the process by establishing the key elements for success.
References
[1] Rojas-García, A., Turner, S., Pizzo, E., Hudson, E., Thomas, J., & Raine, R. (2018). Impact and experiences of delayed discharge: A mixed-studies systematic review. Health expectations: an international journal of public participation in health care and health policy, 21(1), 41–56. https://doi.org/10.1111/hex.12619
[4] Shah, S.S., Safa, A., Johal, K. et al. A prospective observational real world feasibility study assessing the role of app-based remote patient monitoring in reducing primary care clinician workload during the COVID pandemic. BMC Fam Pract22, 248 (2021). https://doi.org/10.1186/s12875-021-01594-7
How hospital grade remote monitoring technology can enable the delivery of high-impact patient outcomes.
Technology-enabled Virtual Wards have arrived, are you ready?
The NHS must establish 24,000 Virtual Ward beds by December 2023 to support a targeted increase of 30% in elective care procedures by 2025. The delivery of effective ‘in-hospital’ patient care depends on reliable communication, monitoring, and alerts. Maintaining this level of care efficiently and effectively in a Virtual Ward, outside of the hospital, requires reliable, trusted, proven and privacy-compliant solutions for timely detection, prevention, and treatment. Masimo SafetyNet® is a Digital Health platform from Masimo, whose innovative monitoring products have been in use across the NHS for over 15 years, with a proven track record of success.
Masimo SafetyNet is an example of Virtual Ward enabling technology
For Patients: Technology-enabled Virtual Wards help assure higher-acuity patients that they remain under the watchful eye of clinicians even following discharge to their own home.
For Acute Care Providers: Masimo SafetyNet offers advanced automation features so institutions can more easily deploy home monitoring, track patient compliance, identify when intervention may be required, and prioritise patient needs whilst maintaining the ability to scale up to meet patient demand.
For NHS Leaders: Masimo SafetyNet is an effective, easily deployed turnkey solution designed to address the challenge of rapidly establishing and operating Virtual Wards whilst optimising use of clinical resources.
For an average sized2 NHS Trust, a robust technology-enabled Virtual Ward could…
Masimo offers an end-to-end approach to help NHS providers implement Virtual Wards with the Masimo SafetyNet app currently available at no charge for NHS Trusts.
Deployment launched across the NHS; contact Masimo to activate your site!
Akeso & Co have supported Tanner Pharma Group UK’s (TPGUK) successful delivery of over 300m units of lateral flow devices (LFDs) to the U.K. Health Security Agency (UKHSA) since October 2021.
Insight
The Coronavirus (COVID-19) Pandemic was an unprecedented global crisis that challenged the limits of Healthcare systems around the world. A nation’s testing ability represented the most effective way to monitor and limit the spread of COVID-19 whilst also navigating the imminent threat of a nationwide lockdown. Throughout the pandemic, TPGUK have been a key supplier of self-test LFDs to the U.K. Government via the UKHSA.
TPGUK were contracted by the UKHSA in October 2021 to supply LFDs through an intricate and complex global supply chain. Combined with the emergence of the Omicron variant and in the lead up to winter 2021, the project rapidly escalated in scale and scope. We, as supply chain and procurement experts, were contracted to support and oversee all elements of the logistics and delivery process.
Some of the key challenges identified included:
Planning the delivery schedule based on manufacturing capacity in China;
Identifying and managing the flight booking process;
Responding to the rapid escalation of demand for LFDs because of the Omicron variant and winter pressures; and
Monitoring the overall logistics schedule.
Action
Our first priority was to understand manufacturing capacity which would ultimately dictate the delivery schedule. We had numerous meetings with manufacturing partners in China to review their production capacity and plan the downstream deliveries accordingly. Additionally, we developed a flight tracker to balance flights booked against production capacity. In this way, we ensured cost effective utilisation of flights, while also maximising the capacity to inbound LFDs into the U.K. at a time of increased demand.
Initial support regarding logistics tracking and planning progressed to overall management and integration with flight planning elements. We led stakeholder engagement and management through the daily operations review calls schedule with Kuehne and Nagel (TPGUK’s logistics sub-contractor) and twice weekly contract progress report updates to UKHSA.
Results
We were able to support the process and delivery of over 300m LFDs to the UKHSA when there was greatest need for them. This involved the operation of over 150 flights via 27 different routes involving 13 Chinese and 10 U.K airports over four months.
We ensured that the pace of project delivery matched that of the project escalation, while reacting to numerous challenges that threatened to delay or derail the rate of delivery. The efficiency improvements from the development flight tracker meant that we were able to leverage our expertise more effectively. This helped to mitigate risk, minimise financial waste and ensure delivery KPIs were met.
In February 2022, UKHSA announced that TPGUK would continue to supply LFDs as the COVID-19 Pandemic progresses toward endemic status. Having recognised and implemented several improved ways of working, we have been able to further support TPGUK in their most recent purchase order delivery while achieving some key savings. With logistic operations simplification and improved planning, we delivered a relative reduction of 28% in flight costs, a 33% damage rate reduction and a 40% relative reduction in storage charges.
Scott has dedicated his career to performance improvement in healthcare and life sciences working both within a multinational consulting firm, and for the last decade as a co-founder of Akeso.
As a Managing Partner of the company, he has led the development of Akeso as an established boutique consultancy committed to improvement in UK health. His project specialisms and areas of interest are systemwide performance improvement, the national and international healthcare supply chain and the use of data to drive tangible and actionable improvement insights.
His approach is flexible, warm and fact-based and he is proud to have delivered numerous collaborative/ICS projects being able to engage positively across multiple stakeholders, specialisms and styles to achieve outcomes around aligned goals.
Outside of work his passions are almost all sports (mainly watching nowadays although can be found trying to find his wayward golf balls in the woods / long grass / water) and spending time with family, including Rump the cocker spaniel who is also the honorary office dog.