PinPoint Data Science Executive Chair, Dr Nigel Sansom, reflects on his experience of developing innovation in the NHS
The author Simon Winder once wrote of the Hapsburg Emperor, Charles V: “He was always reading up on constitutions and mottos and being drilled on the membership and peccadillos of dozens of prickly aristocracies and urban oligarchies in different bits of Europe. At every turn he had to face rebellious townsfolk, Ottoman pirates, annoying Protestants, double-dealing German princelings, and problematic family members”
When I first read that passage I thought to myself, ‘I bet that’s how the CEO of the NHS feels!’.
As the third largest organisation in the world (next to the US and Chinese armies!), the NHS has no shortage of ‘prickly aristocracies’, ‘princelings’, and ‘problematic family members’. The autonomy of regions and functions within regions can be testing for central, coordinated management but can also result in differences in approach to policy across the system.
For start-ups and SMEs attempting to innovate in the UK healthcare space, those differences can be hugely challenging in terms of knowing where to start. Yet if you are able to navigate its complexity, the NHS can be a great place for developing innovation and adoption by the NHS is universally seen as a stamp of approval from one of the most respected healthcare systems in the world.
What are the challenges for an SME engaging a giant?
Navigating the NHS is not so much hard, but complicated. It is populated by organisations, many of which sound like they do the same thing but don’t, and others that do the same thing but sound like they shouldn’t. And there is a language to learn: everything, absolutely everything, has an acronym and just to keep you on your toes, those acronyms are in constant flux.
NHSE is now NHSE&I, STPs were briefly ICSs but are now ICBs, and CCGs are now populated by numerous PCNs. With support from the NIHR, MHPRA, ABHI, BIVDA, AMRC, BIA, NICE, BEIS, and the DH, the AAC now sponsors the AHSNs, the NIA, SBRI, EAMS, and the ITP programme. GPs are still GPs!
Perhaps the most important consideration for SMEs trying to engage with the NHS is that it is effectively a confederation of constituent organisations across primary, secondary and tertiary care, mental health, ambulance, and large numbers of support organisations. It’s tempting to believe that approval from one part of the NHS automatically translates into a green light in another, but the reality is more bumpy than that.
If your innovation involves dealing with patient data, for example, Information Governance can become a big hurdle. Procedure is not currently harmonised across regions, so ‘Data Sharing Agreements’ and ‘Data Impact Assessments’ are different for almost every Trust; they are not digitised and are not directly transferrable. For a small company without the necessary resources, this can represent a real barrier to entry.
Studying the stakeholder landscape and fostering the right relationships is critical. If you know the specifics of your NHS target, getting to the correct decision maker doesn’t need to be difficult. A good starting point for a technological innovation is always the key clinical user. If you get them to love your ‘thing’, then everything else may just fall into place.
How the NHS is reaching out to capture early-stage innovation
If you don’t know quite where to turn, all hope is not lost. The NHS recognises that there is good technological innovation out there and it has developed an ecosystem to help it identify where the good ideas are. There are in fact many organisations who can be helpful to innovators.
The Academic Health Science Networks (AHSNs), of which there are 15 around the country, form the interface between the NHS, academia, and industry. If you are a UK-based innovator with a technological innovation you feel is destined for the NHS, your local AHSN is most definitely your first port of call. They have the local contacts to help you reach your target audience and can facilitate meetings.
The National Institute for Health Research (NIHR) has funding available in the form of grants and actively sponsors organisations to support innovators to develop technologies and attain real-world evidence prior to tackling inevitable regulatory hurdles. For example, NIHR-sponsored MICs (Medical Device and In Vitro Diagnostic Collaboratives) are dotted around the country. Collaboration with the right NIHR-MIC may even help an SME to decide where to locate their primary business.
The PinPoint experience of innovating in the NHS
My company, PinPoint Data Science, has developed an affordable, AI-based blood test designed to optimise NHS urgent cancer referral pathways. The PinPoint solution will help prioritise symptomatic patients based on their individual risk profile for cancer, reducing backlogs and supporting the NHS in its goals for early detection and faster diagnosis. Our early-stage collaboration with the Leeds NIHR- MIC was transformative in shaping the final product and connecting us with clinicians. It was one of the main reasons we based ourselves in Leeds.
PinPoint is typical of a small data science company in that we’re agile and tend to move at speed. The NHS, like it’s cousins elsewhere in the public sector, is not set up to do the same. Whilst it can be frustrating, an innovator needs to have realistic expectations about timescales, but know that ‘the juice is worth the squeeze’. The best relationships between SME technology providers and NHS organisations are collaborative ones, where the company is working ‘with’ the NHS and not against it.
Scaling up through collaboration
PinPoint has been working closely with the West Yorkshire & Harrogate Cancer Alliance and Yorkshire & Humber AHSN for a number of years now. Their support and the involvement of the University of Leeds helped secure buy-in from NHS Trusts and Primary Care Networks across the region so that we are now engaged in both a large-scale service evaluation in West Yorkshire and an SBRI Health- care-sponsored programme across a much larger territory in England. We are working with the NHS to generate ‘real-world evidence’ and ultimately to achieve clinical deployment and reimbursement.
In our experience, the single most valuable factor in successful engagement has been individual champions of the PinPoint Test from within the NHS. From that amazing Innovations Programme Manager in the Yorkshire & Humber AHSN to that fantastic Cancer Genomics Programme Manager in Lancashire. Their voices can open the door to opportunities across an entire region.
This work is licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.
