Healthcare Scientists- a call to action Fiona Carragher Deputy Chief Scientific Officer East Midlands HCS Summit 9th October 2013 NHS | Presentation to [XXXX Company] | [Type Date]

Challenges for the NHS to the NHS Challenges Population Ageing Diseases Chronic Co-morbidities Many Late diagnoses expectations of Public Greater Mobility & Advances Technology Discoveries/ Scientific Inequalities Health

The NHS- Reflecting on 65yrs If the NHS is to survive another 65yr it must change www.england.nhs.uk Have your say

Addressing the Challenges Creating CCGs with a ‘new DNA’ with added clinical value Developing new integrated pathways of care with quality outcomes at its core Taking a patient AND a population focus Shifting care outside of hospital and closer to home, providing more choice

Innovative models of provision – at the centre of new NHS thinking From Everyone Counts – 2013/14 planning guidance from the NHS Commissioning Board “Our National Medical Director will establish a forum that includes national and local commissioners, providers and regulators to identify how there might be better access to routine services seven days a week and report in the autumn of 2013. “As a first stage, the review will focus on improving diagnostics and urgent and emergency care. It will include the consequences of the non-availability of clinical services across the seven day week and provide proposals for improvements to any shortcomings.”

NHS Outcomes Framework

Premature mortality- the challenge for HCS Britain has worse record for premature death than comparable countries – and the gap is rising 1 A key issue is the late diagnosis of disease Government has identified the need for more and earlier diagnostic activity, particularly in primary care 1 The Lancet, 5 March 2013 doi:10.1016/S0140-6736(13)60355-4

Long term conditions- the challenge for HCS Around 15 million (28%) people in the UK have a long term condition, and the number is increasing People with LTCs account for 50% of all GP appointments 70% of all bed days 70% of budgets Co-existing conditions can produce confounding diagnostic results and complicate interpretation Remote and other forms of monitoring needs to be developed to support self and directed management approaches

Acute and episodic care- the challenge for HCS Preventing admission and readmission – diagnostics supporting risk modelling Reducing length of stay and supporting early discharge Responsive emergency care with embedded diagnostics 24/7 provision of diagnostics with the intervention – eg interventional radiology and cardiology 7 day service provision especially linked to areas of higher mortality at weekends

Improving the patient experience – The challenge for HCS Providing services at accessible locations Further reducing waiting times Effective measures that relate to the experience of HCS services ( eg friends and family test) Patient Information on which to base choice and quality of provider Open and accessible test results and support to understand them

Ensuring safe care – The challenge for HCS Global Antibiotic resistance – Highlighted in the CMO report (pub. May 2013) Continued focus on HAI and VTE prevention Safety and side effect monitoring of drug therapy Safety of blood products and tissues

Science will be crucial research informing new ways of working Genetic profiling Personalised medicine Enhanced Point of Care Testing Portable and home monitoring Smart homes Data fusion & bioinformatics Virtual physiological human Multi-modality imaging

Think about the changes in your career

Healthcare Science Specialisms Laboratory (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 Bioinformatics Genomics and Clinical Bioinformatics Health Informatics Pathology 50+ scientific professions delivering over 150 different services that cost the NHS approximately £8bn. The workforce of 55,000 informs 80% of all diagnoses and is involved in the delivery of over 1 billion tests and investigations per annum. They have multiple impacts on all patient pathways through the specialist diagnostic, therapeutic and equipment services they provide.

Transition from paediatric to adult with long term hearing loss Respiratory scientists leading high quality spirometry within the community for COPD Monitoring anti-coagulation therapy in the primary care Engineers supporting Augmentative and Alternative Communication Implementing telehealth to support patients with LTC Biochemical screening for diabetes in Sikh community Neurophysiology monitoring of treatment in X-ALD Rehabilitation engineers support for wheelchairs and prosthetics

Challenges for HCS here and now Commissioning and improvement Commissioning models not well described or understood with services often ‘hidden’ in block contracts Areas for improvement not well recognised and best practise not adopted Lack of integration across sectors and limited offer in primary care Advice and expertise Knowledge and advice provided by HCS is a resource that the NHS still isn't using to the full Patient and public engagement Limited engagement with patients and public Lack of quality information for patients particularly to understand test results and support self-care Quality and Safety Significant variability in quality and access/waits for some services Patient safety issues uncovered Lack of robust assurance frameworks for all services

High quality care for all, now and for future generations CSO team: Key aims We aim to drive a whole health system approach to providing high quality, innovative patient centred scientific services integrated across all delivery sectors with influential scientific leaders, aspirational providers and informed commissioners. High quality care for all, now and for future generations

Healthcare Scientists- call to action Break the stereotype Always remind yourself why you became a HCS Don’t loose your passion and commitment Think about how you can play your part in this challenge ‘enthusiasm is contagious…..’

…Be Innovative Unleash your entrepreneurial spirit Think creatively Collaborate and build relationships with; Clinical colleagues Industry Academia Other Scientists

….Be a champion of quality Understand what quality means in your area Be proactive not reactive Don’t be complacent, always look to improve Use data to target problems and then show improvement Think end to end

…Always put the patient first How do your actions impact on patient care Not just a test result Think about patient experience and safety Work with patient groups Include them in your user survey

…Communicate your science Patients, public and professionals understand the value you add Think about language- make it accessible Opportunities as STEM ambassadors www.stemnet.org.uk We need to engage the workforce of the future

…Take your place in the team Multi-professional networks essential Part of clinical decision making Bringing expertise and scientific thinking Making a real difference to patient care

And be fearless ! Think about how you can make a difference Challenge when things are not right Be a leader whatever grade you are Others may come with you!