1. 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]

2. 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

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

4. 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

5. 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.”

6. NHS Outcomes Framework

7. 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: /S (13)

8. 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

9. 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

10. 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

11. 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

12. 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

13. Think about the changes in your career

14. 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.

15. 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

16. 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

17. 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

18. 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…..’

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

20. ….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

21. …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

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

23. …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

24. 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!