The document discusses the challenges facing the UK healthcare system and outlines a vision for the future outlined in the NHS Five Year Forward View. It identifies three gaps - in health/wellbeing, funding/efficiency, and care/quality - that could undermine the future system if not addressed. The Forward View proposes new models of integrated care, greater investment in primary care, empowering patients, and preventative health. Realizing this vision will require diverse local solutions, aligned national leadership, a modern workforce, exploiting technology/data, accelerating innovation, and driving efficiency. Healthcare science professionals can help achieve better outcomes through prevention, earlier disease detection, and improved treatment options.
4. What has shaped the journey
NHS Plan High Quality Care
for All
2000-2007
Build capacity
2007-2010
Focus on quality
2010-present
Deliver better outcomes
Equity and Excellence
Liberating the NHS…
6. Why things must change significantly
Health &
wellbeing gap
- if health gains stall
- if inequalities widen
Funding & efficiency gap
- if fail to build funding
- If fail to make (controversial)
system efficiencies
Care & quality gap
- if fail to reshape care delivery
- If fail to harness technology
- if fail to tackle variation
Forward View identifies
3 gaps that can
undermine the future
7. Key elements of the Forward View
• Improving integration of services – breaking down barriers
between services and developing new integrated structures
• New structures for delivering care to integrate services
– more care delivered locally,
– some specialist centres organised to tackle comorbidity
– England is too diverse for a ‘one size fits all’ care model
• Improving the NHS’s ability to undertake research and innovation
& raising the game on health technology
• More investment in primary care
• Patients given far greater control of their own care
• A radical upgrade in prevention and public health
Financial sustainability is possible provided action is taken on new
care models, social care, prevention & system improvements
8. What must the future look like
The NHS as
a social
movement
with a new
relationship with
patients and
communities,
and a focus on
prevention
New models
of care
• Multispeciality
providers
• Primary and
Acute care
systems
Improving
existing
models
• urgent and
emergency
care networks;
• maternity
services
• enhanced
health in care
homes
Utilising
technology
&
information
• large scale
initiatives
• care closer to
home
• telehealth &
monitoring
Sustainable resourcing, prototyping and assessment
9. New care models - MCPs and PACS
Hospital-led outpatient
and inpatient services
GP-led primary care
services
New care structures providing
greater range of diagnostic
and more specialist services,
nearer to patients
Multi-
speciality
Care
Providers
– based on
alliances of
GPs
Primary and
Acute Care
systems
– ‘vertically
integrating’
hospital
services with
primary care
Urgent &
Emergency
care
networks
Modern
maternity
services
Enhanced
health in care
homes
10. How will the system get there?
• With diverse solutions and local leadership
• By ensuring an aligned national leadership
• Through a modern workforce
• By exploiting the information revolution
• By accelerating health innovation inclusive of research (both
translational and operational) - including embracing the
4 Ps of precision medicine
• Through driving efficiency and productive investment
11. The heart of the changes –
the challenge of improving outcomes
• Each year ~ 103,000 deaths of
people u75 every year could
have been avoided
• Healthcare science is central to
tackling the three main causes
– Better prevention of illness
– Improved access diagnostics,
catching disease earlier
– Monitoring disease states and
progression
– Improving options for & access to
the highest quality treatment and
care
12. Life Sciences
• Analytical Toxicology
• Anatomical pathology
• Blood transfusion
science/transplantation
• Clinical biochemistry including
paediatric metabolic
biochemistry
• Clinical genetics/Genetic
Science
• Clinical embryology &
Reproductive Science
• Clinical immunology
• Cytopathology including
cervical cytology
• Electron microscopy
• External quality assurance
• Haematology
• Haemostasis and thrombosis
• Clinical Immunology
• Histocompatibility &
immunogenetics
• Histopathology
• Microbiology
• Molecular pathology of
acquired disease
• Phlebotomy
• Tissue banking
Physiological Sciences
• Audiology
• Autonomic neurovascular function
• Cardiac physiology
• Clinical perfusion science
• Critical care science
• Gastrointestinal physiology
• Neurophysiology
• Ophthalmic and vision science
• Respiratory physiology
• Urodynamic science
• Vascular science
Physical Sciences and
Biomedical Engineering
• Biomechanical engineering
• Clinical measurement &
Development
• Clinical Pharmaceutical Science
• Diagnostic radiology & MR physics
• Equipment management & clinical
engineering
• Medical electronics &
instrumentation
• Medical engineering design
• Clinical photography
• Nuclear medicine
• Radiation protection & monitoring
• Radiotherapy physics
• Reconstructive Science
• Rehabilitation engineering
• Renal dialysis technology
• Ultrasound & non-ionising
radiation
Many of these disciplines require small workforce numbers and
provide highly specialist services. These specialisms are within the
health and social care system in the UK inclusive of the NHS, Public
Health England and the NHS Blood &Transplant service and in the
private & third sector delivering NHS services for patients
Bioinformatics including
• Clinical Bioinformatics and Genomics
• Computer science and modelling
• Health Informatics
Sep 2013
Building the Perfect Storm –
the specialisms of Healthcare Science
13. Why HCS is an invaluable
and unique resource
• Breadth and depth of the basic
scientific knowledge and expertise
• Scientific methodology
• Attention to detail and to risk aversion
• Low level of reported safety and
performance related issues
• Contribution to innovation and working collaboratively and
developmentally with industry ( Med Tech and Pharma)
• Basic and applied research
• Technology adoption
• Criticality to the patient pathway
14. Delivering the forward view:
Diverse solutions & local leadership
Build upon and continue
• Involvement in clinical advice & governance structures of
new system (Clinical Senates, Strategic Clinical Networks,
AHSNs, LETBs)
• Local Healthcare Science networks
• Working with other specialisms & teams
Strengthen & develop
• Relationships with commissioners
• Advice & input into local models of joint commissioning
• Joint working and service delivery with PHE
• Engagement in patient and public partnerships
15. Future scientific and diagnostic provision
– the distributed model & diverse solutions
FUTURE
PROVISION
At home
or in the
High Street
Tele-
monitoring
& new
technologies
Local
Hubs
Tertiary
Care
Tele-
reporting &
image/ data
sharing
Specialist
Centres
24/7 & 7day
Multimodal and
Multifunctional
Specialist care
& services
16. Delivering the Forward View:
National Leadership
• Build upon and continue
• Quality in service delivery & making the quality framework a
reality ( in line with NQB)
• Compliance with national information strategy and work of
national information board
• Input & involvement in workforce advisory structures eg HEEAG
• Professional partnerships particularly Academy to ensure representative
and strong voice
• National Scientific Leaders Network
Strengthen & develop
• Partnerships with other professionals
• Leadership in healthcare science
17. First intake of HSST
started 2014
Extra numbers funded to
support genomics activity
ICS project
Scientist Training
Programme attracting
the brightest and best
science graduates
MAHSE appointed
as doctoral
provider for HSST
Introductory
qualifications now
available at Assistant
and Associate levels
ICA supports
Clinical Academic
Career
development
CPPD Accredited
Scientific Practice
programmes support
employer driven areas
of workforce need
21 HEIs providing 64
accredited Practitioner
Training Programme
courses
Delivering forward view – Workforce
Building on what we have achieved
Supporting
infrastructure
18. Delivering the forward view:
Developing our workforce
Build upon and continue
• Modernised Scientific Careers & its implementation
• Embracing the five characteristics of future workforce
1. Informed support to help people prevent ill health
2. Provide co productive care
3. Responsive to evidence and innovation to enable holistic care
( whole person care)
4. Provide safe and high quality care wherever & whenever the patient is
5. Care and compassion informed by knowledge and skills
Strengthen & develop
• New programmes to meet service needs (eg Mol Pathology STP) & blurring
of boundaries
• New roles based on skill requirements to deliver new models of care
• Interprofessional education & training – especially around diagnostics
19. Delivering the forward view:
the information revolution
Build upon and continue
• Excellence in knowledge management, Computer science,
modelling and clinical bioinformatics - emerging specialism
within the profession
• Integrated Laboratory systems
• Role of the National Laboratory Medicine Catalogue and LTOL
Strengthen & develop
• Maximising use of performance data for each specialism and audit
• NHS accredited health apps
• Links with broader clinical and diagnostic data
- learning& analysing
• Compliance with NIB strategy
• Supporting patients
20. Build upon an extraordinary track
record in innovation & research
Scientists are: Translational problem-solvers
Creating wealth through worldwide
markets
Entrepreneurial spirits
Patient-focussed innovators
Working in partnership with major
corporations
21. Delivering the forward view:
Accelerating innovation
Build upon and continue
• Role at the forefront of delivering innovations – such as novel
radiotherapy & new diagnostics
• Genomics & NHS GMCs crucial – coupling WGS with analysis
and link to clinical & diagnostics data,
drive for molecular platforms
• Work around 4 Ps of precision medicine - prediction and prevention of
disease, precise diagnosis & personalised treatment
Strengthen & develop
• Scientists spinning out innovations for broader patient benefit
• Contribution to new and emerging fields eg theranostics and
prognostics personalised care & targeted treatment
• Applied research – capacity & capability
• Involvement with NICE about commissioning through evaluation
• Accelerating adoption and use of technology, testing
innovations through AHSNs
22. Delivering the forward view:
driving efficiency and productivity
Build upon and continue
• HCS had led the fall in waiting times over last 5-10 years
– particularly around diagnostic access
• Improvements in efficiency & productivity in all areas eg pathology
• Meeting rising demand and CIP targets
• Managing demand through HCS involvement in screening and
prompting secondary prevention
Strengthen & develop
• Pathways and news ways of delivery and new ways of managing demand
• Further Efficiency gains
23. Shaping up the new structures
‘Big
Science’
and data
Health
Priorities
Technology
& Innovation
Personalised
& stratified
medicine
New
models of
care
SUPPORTING FRAMEWORK:
Including Patient Involvement, Commissioning, Procurement
- finance & efficiency
Quality
24. The leadership skills needed
Vision & drive Resilience
Patience
Commitment
Conviction
Mediation
..and being a bit
thick-skinned!
Alliance-
building
Stamina
A chameleon
25. Where healthcare science
must be stronger
Create
• Cross-cutting
Partnerships to
break down silos
• Academic
appointments
and research
foundation
Assess
• Evaluate high
impact actions
• Where to let go
of the past and
embrace the
future
• Assess
opportunities for
development &
profile
Uptake
• Focus your
challenge
within the
system
• Link with system
leadership to
inform, advise
and influence
Spread
• Build networks to
share knowledge
and approaches
• Communicate
your science
across the system
and to society
INVENTION EVALUATION ADOPTION DIFFUSION
26. Recent profile and achievements
Recognition for
Healthcare science
achievements
Healthcare
Innovation Award
Wolfson
Research
merit award
Top 100
practising
scientists
UK
Honours
system
Top 100
clinical
leaders &
inspirational women
Appointment
to senior
roles
27. Building the perfect storm – the HCS
contribution to delivering better outcomes
• Engaging up, out & around
• Building understanding in commissioners
• Working with employers
• Building links with partners such as AHSNs
• Building commonality not silos in the
• Consolidating the ‘sell’ and interaction across healthcare
science
28. Healthcare science meets
the perfect storm in health & care
• A health and care system that has
identified the need for profound change
• The potential for science & technological
advances
• The workforce will the skills to deliver
new approaches and ways of thinking
• The leaders with the vision, analysis and cool heads to identify
potential and possibilities and harness these opportunities
Perfect storm (n):
A confluence of factors which, together, significantly potentiate
the eventual outcome (from meteorology)
