The role of nursing in driving digital change in the NHS

How are nursing professionals supporting the digital evolution in UK healthcare? How can new technologies be leveraged by front-line clinical teams to support improved patient care? And how can Medtech, Digital and Biotech innovators collaborate with the front-line nursing teams in the NHS to drive transformation?

Prof. Phil Richardson (Chair and Chief Innovation Officer, Mtech Access) speaks to Jennie Smith, registered nurse, Medtech launch specialist and our new Director of NHS Insight & Interaction at Mtech Access.

Phil and Jennie explore:

 - The transformative power of technology in the NHS; particularly on patient pathways
 - The role of nurses in digital transformation and the adoption and implementation of new technologies
 - Key nursing champions, including Chief Nurse Information Officers (CNIOs)
 - How industry can best support the NHS with digital transformation
 - Our plans to bring together NHS and industry for greater collaboration

This episode was originally broadcast as a live webinar in June 2023. Learn more at: https://mtechaccess.co.uk/nursing-driving-digital-change-nhs/

Learn more about our NHS Insight & Interaction services at: https://mtechaccess.co.uk/uk-nhs-insights/

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Transcript

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- [Presenter] Welcome to this Mtech Access Webinar. At Mtech Access, we provide health economics and outcomes research and market access services from strategy through to implementation. Our unique NHS relationships guide and validate everything we do in the UK. We work with over 80 NHS associates to bring our Pharmaceutical and MedTech clients authentic insights into the NHS. We can help you answer key questions related to the NHS, from how to communicate with integrated care systems, places and primary care networks, to how to capture pathways of care. Get in touch today to discuss your market access goals. First, though, I hope you enjoy the webinar.- Hello everyone, and welcome to NHS Whispers. I'm Phil Richardson and I will be hosting our webinar today, which is called From Nursing to Digital Health to Mtech Access. I'd particularly like to welcome our NHS associates who play a key role in the work that we do. And for those that don't know us, Mtech Access is a specialist health economics outcomes and market access consultancy with a track record of expert delivery. We provide specialist support to Pharma and MedTech clients, as well as work as a collaborative partner for the NHS. Today, we've got a specific focus on digital health and specifically, the role of nursing in digital health. And I'm delighted to welcome Jennie Smith today, who's the NHS director for Insight and Interaction. Welcome, Jennie.- Thanks, Phil.- So just to get us started, it would be really great if you could just give us a moment to introduce yourself.- Okay, yeah, absolutely. So, yeah, as Phil's already said, Jennie Smith, I'm the director here at Mtech Access for the NHS Insight and Interaction Team. I come from a very varied background of working in the NHS and with the NHS. So I am a qualified nurse and I spent kind of 15 years working both clinically and operationally within the NHS, working with the clinical teams, really at the frontline, but then progressing, working on service redesign, worked my way up to operational management. I managed both emergency and urgent care pathways as well as surgical services. I then dabbled a little bit in commissioning, so understand a lot of the red tape, and how to navigate that. Luckily, the last five years I spent working in digital health, so working very much in the community services and specifically looking at supporting patient demand and demand management in GP surgeries. But then kind of to give a whole holistic kind of aspect to my career. Then I decided to come and see what I could do in the Mtech space.- Brilliant, thanks. Thanks Jennie. So that's a really interesting lens of industry patients, frontline care, operational management, strategic management. If you were to step back and look at all of that, what would you see were the emerging themes that have been either consistent challenges or emerging big challenges that you see in delivering care for patients?- So I think that there's been an area of ongoing challenges, kind of marked by several consistent obstacles, to be totally honest. So firstly, you know, it's very much up there that at the moment, resource allocation poses a significant challenge as healthcare systems strive to balance both limited budgets and growing patient demands, we also have the challenge of ensuring a skilled and sufficient healthcare workforce. And it is still remaining challenging to recruit and retain the qualified professionals too actually due to the factors really around workload pressures, burnout, geographic disparities. So that's a significant challenge that we've come up against. On top of that, we've got the complex nature of healthcare in its own sense and healthcare delivery. And there is a significant amount of fragmented care with patient receiving services from multiple providers resulting in both communication gaps, but also coordination difficulties. From my background, specifically where I've been implementing and integrating new technologies and trying to bring innovations into existing healthcare systems, at times it's quite arduous, requiring real significant investment in both time and resource and finances, but also training and overcoming significant resistance to change in a lot of the services. I think going forward, addressing the health inequalities and the disparities in healthcare remains a persistent challenge. And we know that, vulnerable populations often face barriers in accessing, high quality of care due to social economic factors or cultural differences or even geographics that this isn't kind of new news, as it were we have the issue of maintaining sustainable change in the NHS. We're very good at innovation being brought in, but then it's not actually supported long term. You know, when new government comes in and plans change. And actually we're also very good at working in silos. I know we talk a lot about working in partnership and integrated care and things like that, but actually when we look at pathway redesign, for example, we are only looking at a part of the pathway and we just create bottlenecks further down the line or in different services. So we're not actually looking at things across the whole pathway, as it were. And, you know, we have an ongoing issue, with infrastructure and the ongoing challenge there without kind of the capital spend that's required to address some of the issues with the infrastructure and the sustained infrastructure challenges.- So I'd like to dig into some of these there,'cause you've covered quite a rich picture of key themes. And if I just go back to your early nursing career and think about digital, when did it start to become a thing for you? What was your sort of early steps into it? And then perhaps later I'd like to look at where you see it now and where you see it go, but we're just quite interested to see how you came into a nursing career and digital clearly played quite a key part more recently, but when did it first start?- So as most people applied to my nurse training when I was kind of 18 years old, and actually, my family come from a tech background. My dad's an IT consultant, things like that. And so I always had a little bit of an input into tech and understanding of it, but it wasn't until I started my nurse training actually that I was captivated by the technical side of healthcare and when I qualified, I went into intensive care, critical care and theatres, which is all was all very high tech and it still is. I think what what really kind of resonated with me, was literally the remarkable speed at which technology can aid patients to recovery or even eliminate the need for a person to need treatment to begin with. And that really ignited a deep fascination within me of actually how far could this go? And I think that actually that whole transformative piece and the potential of technology in healthcare became a real driving force behind my career aspirations. Although at the time I think I potentially didn't realise that, but looking back actually throughout my career, I have had this kind of more digital technology driven theme that goes through it, and it's quite interesting really because I know I did a lot of clinical hands-on various nursing roles and acquired invaluable experience and expertise through that. But it was actually through some of my work in more the commercial roles outside of the NHS that it kind of... it gave me a fresh perspective to be honest. And then it started to provide me with a whole holistic view of healthcare and it allowed me to identify areas that actually needed improvement and where I could potentially look to challenge conventional practises. So that's kind of how it all really started for me.- Yeah, that's really, really interesting. And if I think the sort of parallels in my experience with digital really being in the technical space, and it's the CIO or IT director or somebody of that would be the conversation. So that was my only experience, endorse it. And then more medics really taking a lead in the role of the chief clinical information officer and that being lauded both nationally and across systems, but really the unlocking that's happened with the chief nursing information officer and the role of nurses, and if we take your experience, what do you think the role of nursing now is or should be in that space? Can I get a sense from you that there's a huge amount to offer and we're probably only scratching the surface?- No, absolutely. And I think that, you know, the role of nurse has... you know, over the last few years, it's really kind of seen some significant transformation to be honest. And it's propelled by, yes we've got the rapid developments and advancements in technology and we've got the increasing digitization of healthcare generally. You know even looking back a few years, COVID actually in a way supported the digitization of healthcare, but we have to kind of think of nursing in a different way because nurses are no longer confined to traditional bedside care. You know they become pivotal players really in the adoption implementation of digital tools and technologies within a myriad of healthcare settings. And the great thing is with nurses is they do have, you know, really expertise in patient care, hands-on patient care and their ability to support patients in navigating the complex healthcare system. So they've kind of actually naturally embraced their role as a catalyst for digital adoption in my opinion. And they really serve as an advocate really for patient-centered care. And they leverage technology to enhance both communication but also collaboration amongst healthcare teams. And I think that actually with nurses embracing some of the digital platforms and a technology that's out at the moment, they can, you know, we've looked at, the efficiency that has been creating coordination of care plans, for example, or monitoring patient progress from a virtual ward perspective and actually being able to share some real critical clinical data with multidisciplinary disciplinary teams. And actually in my experience when I was looking at integrating digital technology into primary care services, the nurses in those practises were actively participating in the integration of that healthcare and the telehealth and remote monitoring solutions for patients. And from that and looking at video consultation, looking at virtual triaging and monitoring, remote monitoring, they extend their reach beyond the traditional healthcare settings. So they're ensuring access to care for patients in remote areas, people with you know, remote limited mobility. We're actually able to take healthcare to people now. And I think that nurses, again, they play a crucial role in educating patients and their families on utilising digital health tools and promoting self-management. And I think actually sometimes we as innovators actually have a little bit of oversight, not oversight. We, overlook nurses and their valuable insights ensuring that digital solutions are user-friendly, and practical and align with the needs of their patients locally, I think we try and fix the problem, but we don't talk to the people who are actually managing the care and how this actually fit into their life and how they've become advocates for that. And you know, I was working a time where we were very, very much involved in training peers in the use of new technologies. You know, we had some lovely older school consultants who were very technophobe, but actually you can bring them on board and outline how much you can support them from a clinical perspective as well as benefit the patients. And it's then you are bridging the gap between the technological advancements and actually the wider healthcare workforce.- So, I think what I'm hearing you say is that nurses have got a key role to play in the digital transformation space. This is not about just the tech, this is about the patient engagement, the patient experience, engagement, understanding local communities, understanding how things work, and that feels like that's a missing link in quite a lot of the bigger conversations that are happening, which tend to be a technology for a therapeutic area or a technology for a setting of care. And it's a bit like early support for junior doctors where the nursing workforce play a critical role in that peer development and learning in development piece. So, I think if we just then look at that for engaging with the NHS and engaging with service design, or service reconfiguration, what kind of insight could you give people who want to try and support change of service? How, would you just connect those two things together? The way you've looked at nursing and its role and service change and perhaps the way industry might engage?- Okay, so that's a webinar in its own right, but actually I think one of the key things to any kind of service change, let's start there, is around access to accurate and up to date data and research on the true unmet health needs of the population and the demographics of the local population. And that's absolutely crucial. That's the starting point for anything that you may want to bring in any kind of service change. Additionally, I think we talk a lot about collaboration and collaboration means a lot of different things to a lot of different people. And everybody talks about it, they know that what is, but not a huge amount of people actually know how, how do we collaborate with the NHS? How do we become a voice beyond just selling a product? How do we work above brand and as a trusted partner? And actually in my experience, we quite often get asked to look at experts from different areas and their insight, and a lot of people focus very much on, oh yes, I would like a specialist consultant in this area. And actually collaboration with professionals from diverse healthcare fields such as, yes, your doctors and nurses, public health experts, and even your administrators, your GP receptionist, your first touchpoint for patients can actually provide valuable insights and expertise into whatever it is you're trying to either, break into market or look at service redesign. Because these are people who are dealing at the front end. They understand the challenges and if you can kind of bridge that gap collaboratively of actually what you are trying to do is to make their lives better, and this is the impact on them, not this is something really shiny, we think all patients should use it. You already have a collaboration and people are much more willing to work with you to kind of move towards that implementation or utilising how you could do a case for change to bring certain services from secondary care into primary care, for example. I think also it's really important for anybody looking at service redesign to really understand the kind of the financial support. So when somebody is interacting with the NHS, it's actually understanding the NHS funding streams itself. So when you're talking about a device or you are talking about medicine, et cetera, it's understanding because the people necessarily in the services don't actually know what is available to them themselves. So you having that insight and being able to go in and say actually, I've had a look into this and we could look at the transformation budget that is coming out, or there's been a new mandate in the NHS and there's 14.1 billion pounds being put aside for innovation and we could fit into that. You are actually taking away a lot of the this is a great idea, but what do I do with it now? How do I get this signed off? Where does this fit in? And the budgetary considerations, they're essential to kind of ensuring the sustainability and viability of health services. So why shouldn't we be collaborating on that with people outside of the NHS to bring in their expertise. And I also think what the NHS is is always said they're very good at, but actually we're not, is that honest sharing of best practise sometimes, I only heard of best practise that was going on in the trust next door to me because I went to the HSJ awards and found out because they won something or they were nominated. And actually having that mentorship, that professional development programme, can really offer some guidance, knowledge sharing to really help services grow together. What I also heard a lot when I was kind of in the digital healthcare space was, well the tech's there, but the services just aren't ready. And I kind of think what we need to almost bridge a gap here, because there is this point of actually is that really true or is it just that the services are unaware of what it is that you are doing, what it is in your world and we're so good at asking for insights from the NHS and what's the NHS doing and what's the policy and how do we fit in with that and how do we align? But actually what we kind of need to be asking is, oh, I'm bringing this new something that's game changing, to the NHS and I'm going to be launching this in 18 months time. Wouldn't it be great as a service manager in the NHS to have somebody come to you and say, this is what we're doing. So if you are looking at designing your whole pathway, how about considering this? And that means as a service lead the NHS, I don't have to then redesign my pathway, then 18 months later spend all that resource again redesigning it to fit something that we have then, you know, kind of bought or decided that we want to implement because it is a game changer. So I think that there is a huge amount of work that we can do around properly collaborating between industry and NHS. And it holds a huge kind of potential to be honest, to actually revolutionise healthcare because we're talking about enhancing patient care. But we also by sharing some of this, we couldn't really leverage the expertise, resources and innovation of both sectors. And we talk about transformation, but actually if we brought that together, that could actually be achieved. And I think, and the other piece as well is this, industry brings cutting edge technology and research advancements and data analytics capabilities that can really break down some of the barriers in diagnostics, treatments and preventions. But a lot of people in the NHS don't know that they exist or that they're working on this specialised area, et cetera. And I just think that actually if we are capable of harnessing the strengths of both sectors, that both the NHS and industry really have a potential to create a true patient-centric healthcare system, which is something we've been trying to do for a long time. And I think in isolation, we've not been fully... we've not really got there. And I think that working together you can really create something that's more efficient that we need. It is properly personalised and actually at the end of the day, we'll be capable of delivering a much higher quality care of patients.- I'd like to come back to the bit about patients and patient voice in a second. I just want to test out what you are saying with something you are very familiar with, which is about urgent care, patient flow and discharge. And I know you have many years of fun trying to resolve those sort of things, but it keeps coming round as being an as yet unresolved piece. And I just wonder if you could maybe connect together for everyone the bit you've just said about transformation and think about, well, how won't we just apply it in there for once and for all. Let's finally crack this and sort it out. How might we do that?- Oh, well, I mean we keep hearing about it because, you know, it has been a priority for many, many years. And there's several compelling reasons to be totally honest with you. So firstly, the demand for urgent care services, it does continue to rise and we are putting immense pressure on the health facilities and that hasn't gone away. Secondly, you've got to look at actually optimising patient flow throughout the healthcare system and actually doing that is vital for effective resource allocation, timely access to services, et cetera. And again, I think some of these things have been attempted at national level, national... this is how the policy on patient flow and this is how we do it. And I think now I'm hoping with the kind of the neighbourhoods, the ICBs where people can really start to work in collaboration across the system, instead of trying to fix one area which is secondary care, we need more beds. It's around what is it that the wider community, you know, looking at industry as well as all of the different community services, primary care, et cetera. What is it that we can do to streamline, I did work in patient flow in a secondary care and you know, we were literally senior management pushing beds from A&E. We didn't hit the four hour weight targets and then the next day we were in meetings with social care colleagues talking about people who had got long lengths of stay and how could we cut that down? So, but with that, even in just that little example, you could already start to understand why the bottlenecks in the system could be. And the other side of this as well is real efficient, effective, and timely discharge planning because with that, you can create capacity within hospitals and facilitate an actual seamless transition to community-based care without the bounce backs the readmissions. But, you know on top of that we still have the impact for that, as I said before, experienced staff retention. You know, if you don't have the experienced staff who can navigate these pathways, then you're starting from scratch every time. And so the issue that was being fixed then goes all the way back to the beginning because somebody new come in and they've got to learn the ropes, et cetera. We do have an ageing and growing population that isn't going to go away anytime soon and all these amazing advances in technology and medicine is only potentially going to create more of an issue and how do we deal with that? And we know that a lot of that is actually social care and we know that that's a very big high agenda item. And it's been talked about a lot, but at the moment, as far as I can see, it's still actually, it's very politically charged, but it is an unsolved issue. So I think that in answer to your question is kind of in a nutshell that the area is really why it's still very much high on the agenda and how I don't think it is going to reduce at the moment to anything that kind of is a lower priority.- Do you get a sense though that the quite a lot of it's point solutions. So I've seen flow directors appointed to manage flow as the discharge lounge created, which sort of said, we'll get the problem off the ward and we'll put it somewhere else where some discharge person has responsibility, seen some saying, well we can't possibly manage TTOs until we know what we're discharging on. And yet 90% people go out on something very similar to what they came in on. And there there's all those different pieces. But if I think about what you were talked about nurses earlier, particularly the sort of the nursing ability to look at everything and see how everything just practically works and what could be done seems a bit at odds to what feels like a constant restating of the problem that I see. And do you think there, there is a way of maybe cutting through some of that, you start, you talked about the localisation I think of solving things, but do you think if we put some horsepower, if we could take the people who are listening to this webinar, get them in a room and put some horsepower with an enabled nursing workforce particularly and the right kind of technologies, we could maybe crack some of these things?- Oh, a hundred percent, I agree. And I think that's really I'm very focused and quite dedicated across the whole of my career around how we can become more efficient, how we can utilise technology industry's capability and actually bring, as you said before, bring the patient voice into this, you know, bring the frontline people who are working with patients into the mix because they are left out quite often. The other piece about this is that even in a hospital trust, you'll have departments all working to their own KPIs targets we can't do. And when they have service meetings, et cetera, not everybody who is part of a pathway is pulled into that. So the bottleneck is, oh, we're not going to be able to get TTOs today because oh, the pharmacist leaves at four o'clock. And actually, we are poor communicators. And I think that just doing, and what you have to obviously understand and we know it very much is that there is this constant firefighting that is going on at the moment, you know? And it has been for years, but you know, everybody is so head down in the day job trying to just manage and tread water. They've got all the ideas, they've got all, this is what we need to do, but they just don't have the resource and capability to actually do it. And I think that is the piece where, you know, external agencies, industry, MedTech can come in and say, actually let's have a look at your whole pathway and we're not just going to talk about this at this is what our digital capability could do for you. This is what our drug could do for you in this area. This is about above brand collaboration from many different areas saying to people, actually, "We've had a look at your pathway, this is where all the challenges are. So we don't need to fix your whole pathway, the whole pathway isn't broken. Let's have a look at these different fracture areas." And we could be saying, right, okay, so actually we know that this MedTech organisation here has been developing this piece of tech kit, digital technology that would solve a significant problem with you there. So we're going to bring them into the pathway conversation. And then actually over here, you know, we've got a Pharma company who's done a significant amount of research in this and actually can support you in a case for change, best practise, and look at different ways of managing patients in different settings. We're going to bring that into the mix of looking at your pathway and how would we design things. And that's kind of where I'm hoping things could get to because when you've got that, you are not just a service manager in a hospital with your own little piece of the jigsaw trying to fix it continuously. You are taking a step back, but you are bringing in people and partnerships internally across the local health economy, but actually wider, wider healthcare system to really tackle some of these big issues that are causing you a headache. Because unless you do that, you're taking a painkiller but the migraine isn't going.- Yeah, no, I can completely see that. And I think the bit about patients is really quite interesting, isn't it?'Cause the current language, certainly the NHS language is demand, so that is suggesting that patients are creating something that we have to deal with. But the reality of your patient point of view is that they have a needs that needs, they need help. And is there something about patient voice or patient language or is something missing in the jigsaw, because I think both industry focus on patients, but the conversation tends to be about almost a body part and a solution for a body part. And the NHS talks about patients, but then it drops down, as you say, into KPIs or queues or costs or something. And I just wonder if I think you're suggesting is if we just really truly put the...not the patient at the centre, 'cause that suggests an tension on the patient, but the patient need perhaps at the centre and we stop using things like demand management or discharge planning or queues or cost or price or something. And we start to truly think actually what's the problem we're trying to solve collectively? Is there something in that patient perspective?- I think absolutely a hundred percent. You know, we found, especially rolling out a digital technology to patients right at the beginning of the healthcare journey, so before they even contacted their GP. That to get patient, and public involvement engagement groups were actually crucial to the development in how that was rolled out and how that needs to be done. And if you take for example, oximeters that were used throughout the pandemic for monitoring, et cetera, actually they were insufficiently tested on darker skin tones, which resulted in incorrect readings and creating new health inequalities. So we didn't help ourselves in that. And actually when you talk to patient groups, it's amazing with what they come up with actually. But if we could actively involve them in the whole healthcare journey, we ask them about their experience and we ask them about their outcomes for their specific disease area. But if we look at them as part of this collaborative approach that that really empowers them to express their needs, their concerns, their preferences, and it's actually listened to, then the integration of technology from that perspective would then start to really play a pivotal role. It's already started in the kind of engagement communications piece, but now this is around, we are moving ever forward in what's capable on an iPhone, how people interact with the world. And so we've got to go past communication and we've got to really understand how people's preferences are not just go, this is what the tech does, so this is what we think it fits this actually. What is it people actually want? How do they want to be communicated with, you know, and bringing them to the forefront of the design of the technology, not what the technology can do. Does that make sense?- Yeah, it does.- Yeah-- I think what's really, well sorry, Jen, but I think what's really good in your passion here in making all this happen, it it feels like if you had access to almost infinite resource, you pretty much be able to crack on and sort lots of these out together. And I just listen to your journey from sort of frontline nursing through to operational leadership and then system level leadership, but whilst in parallel building your digital skillset. So that's absolutely fascinating. And now here you are joining Mtech, but could you just give us a bit of a sense of, was that a good idea? Why was that a good idea? And then a bit really about how you really want to continue this passion that you have for getting better health for the public and patients.- So yeah, this is a cold kind of, you know, Jennie wants to change the world kind of piece. And I actually think-- Yeah, it's great.- That you're in a position where actually we can have a significant impact. And I think that what really drove me to make the jump and come into to Mtech was the work that had already started around the collaboration with working with the NHS. And there's a whole team here at Mtech that is really passionate. It isn't just me that's really passionate about, you know, making these changes. How can we harness the capability of different industries, different sectors, and how can we make those work together? You know, how can we pull on all of this amazing expertise that's out there that just kind of sits in silos, how do we find it and how do we make it really, really work? And that was really, really exciting for me. And I think that as well, you know, we have got a rapidly evolving healthcare landscape. There's no two ways about it. And I really believe that the need for collaboration knowledge sharing between the NHS and industry's actually never been greater. And I think, as I said before we do have this tendency of information that's flowing one-sided with industry benefiting from the insights from the NHS, but we kind of never go back. And then there is a significant gap where the NHS lacks awareness of advancements and innovations that are happening. And actually that's the piece that really excites me because it's being at the forefront of trying to close that gap and actually, let's be blunt, revolutionising the way the NHS industry worked together. And I saw that as my real opportunity in coming to Mtech and kind of pulling that together and I think we could really do some amazing things.- Great, so where are we going to start?(Jennie chuckles)- We've already started.- What sort of things there, what do you really want to crack on with? What do you want to do immediately? What are the type of things that we can engage our listeners with on this call today? The type of things you think actually that would be great. Let's get started on there. Two or three things, what would that look like?- What would that look like, indeed? So I think there's a few areas that we've already started kind of having conversations around really. And I really wanted to push the collaboration and innovation that the NHS services aspire to, and actually support, Pharma, Medtech and the NHS in providing that quality care. But where I see us is really enabling and encouraging the open communication and the cross-functional collaboration and I think that, as we develop a comprehensive understanding of the healthcare landscape and enabling it to provide targeted support where it's needed, and I think that's part of this. You know, we are very, very lucky. We have lived NHS experience within our business, and we have people who can really understand and start to identify when unmet need is. And actually then we can start to have conversations above brand that are going... you know, we need targeted support in this area and you are the people that can help us do this. So we are taking solutions of critical and challenging issues that the NHS are facing at the moment and will be facing instead of kind of saying,"Oh, here's the revolutionary new drug, or here's a piece of kit and it's going to do all this actually, let's take it a step further. Let's start open doors and explore new frontiers in healthcare and let's look at the development and implementation of cutting edge technologies because that's something that I don't believe the NHS does very well. And I don't believe actually we as industry and NHS partners really support them on to actually embed things as business as usual in frontline services. Things get that rolled out in a hospital and a crisis hits and everything goes back to the way it was because it's just easier to manage that way. And I think that where we have to be is really starting to look at what are tangible and sustainable outcomes? What is it that we can do together? So Mtech are shortly launching a above brand academy, and the aim of this is to bring the divide between the NHS and industry a lot close together. And it strives really to open up a two-way flow of information, so both knowledge and expertise. And I want to empower my colleagues in NHS with the latest industry insights so they can start to leverage advancements in health technology research and best practise from within instead of everybody outside kind of saying,"Oh, this is what you need to do." We know we need to do it, but actually, you know, I need somebody to be supportive of me on this journey to do it. And I think that as well, we're not going to stop, the facilitation of the industry's understanding of the NHS and their unique requirements, but I think that we can really ensure that the innovative solutions that we come across, day to day are properly developed with a healthcare system and their specific needs in mind. So, I mean, I would envision the future Jennie's ideal world of where the NHS and industry work synergistically fostering true innovation and improving patient care. But also we need to look at driving a positive change with a lot of negativities that come out of the NHS and about the NHS and how things are. But let's look at really creating a culture of knowledge sharing. And I think then that we could really start to unlock the full potential of both sectors.- Well that sounds fantastic. I'm sure lots of people will be interested as you develop that idea forward and I think we saw NHS confed last week, lots of conversations heading into that space, which is what can we do together rather than what is the widget we're trying to sell, or the operational fire we're trying to put out, got to break down those type of barriers really. How would that play out though in a bigger context or you mentioned population health management earlier and that's obviously a key thing and you touched on the invert creation of inequality through the oximetry type work. What's your view on what that landscape might look like over the next 12 or 18 or maybe even 20, 24 months and how we might sort of connect some of these things together?- So I know that, you know, health inequalities, population health is a large focus at the moment, but it's not new news. So the NHS has long recognised that the pressing issue of health inequalities has actually has to be one of the key focus areas in its mission to provide equitable healthcare to all patients, to everybody. I think looking forward next 12 to 18 months, I think we can expect the NHS to start to intensify its efforts to address these disparities and improve health outcomes for, you know, marginalised and unserved communities. They're going to have to do this with a bit of a multifaceted approach though, to be certainly honest with you, including, some targeted interventions, true community engagement to do that, and alignment of the policies. So I think, and with that as well, you know, we have got the creation of the ICSs the Integrated Care Systems. And you know, starting, with the collaborations with local authorities, public health organisations and community groups, I think that's likely to strengthen now that we are moving into this more integrated system approach. And I'm really hoping that that's going to start to kind of foster a holistic approach to address some of the root causes of health disparities. I mean, NHS Confed last week, Steve Barkley kind of also said around that, you know, there is going to be investing, significant investment in data collection and analysis to better understand specific needs and challenges. And I think that that's going to actually enable more tailored interventions and allow proper allocation of resources much more effectively than we've potentially done it the past. And then on top of that, you know, we do have the core 20 plus five agenda, and that's high and it's a growing priority across the NHS and we've also had the children's version that's been published this year. So I think it's a great space to watch. I really think that it's going to be strengthened with the ICBs and that integrated network at a local level and I'd love to kind of sit and watch how they do it.- Mmh, and then if we think about the market access as market access to the NHS rather than market access into a particular therapeutic areas, it feels like building on the health inequalities bit. There are other areas that we should have in the conversation too, aren't there? So things like net zero and others, what's your view on the bigger picture as well as getting down to like an operational local view?- So I think that for too long people have seen the NHS as an organisation, they've seen it as a customer. The NHS is actually a market and there is 236 different organisations that sit under the banner of NHS. And I think that where we need to move to, as you've said before, is around not focusing on just a therapy area, but focusing your market access on how can I open doors to reach as many as those 236 organisations who may or may not have access to different funding streams or, you know work in different ways. How do we do that to support our market access and our market share? How do we reach all of these people? So it's switching the balance of viewing this is the pathway for this therapy area more, what can I do to widen my net as it were. I think from the net zero sustainability piece, I think again, organisations really need to understand the sustainability issue that NHS leaders are facing now and how they can support the different target areas. And that that's more, I mean that's very high up the local level on their agenda and it's a real challenge. So I think that as part of the strategy for market access is to really understand the wider sustainability issue and kind of interlink and offer, you know, how we could support, I mean sustainability is something that every organisation has to have a plan for and you know, why are we not sharing best practice again above brand of how potentially we could do this in a better way. I mean, we've also got the kind of the social weighting is something important not to kind of be disregarded here because you know, that's going to impact on supply chain decisions and you know, at the end of the day they may not select your product even if you're cheaper than other companies because actually the other company has got, you know, is net zero and has got sustainability or it shows more social value. So I think that there's that need to really scope out and understand that the kind of increased requirements, and really think about how you would demonstrate your net zero credentials. In fact, NHS they published a paper back in 2022 and it actually outlines how organisations can apply net zero and show social value. So I would potentially say that that would be a really good place to start. And then you have to consider that the NHS is an anchor institution. So you know, it's a large organisation whose long-term sustainability is completely tied to the wellbeing of the populations that they serve. So you need to be mindful of that as well when you're designing your market access strategies and how you can link back into real true localised population health and start to bring that into some of your strategies and some of your thinking when you're looking at market access.- So, I think what I'm hearing, Jennie, is that, there's obviously a lot to think about here, but there's a piece which says understanding your core strengths as an organisation and how you might help support. There is a bit, which is understanding a population health and locality type layer, but there's also a strategic layer, which is an anchor institution, the economic contribution, the social development contribution. I think in most counties in the country, the NHS is the biggest organisation in the county. And certainly my experience in do it was that it certainly was the biggest employer, but lots of engagement strategies tend to not to think about it as being a significant organisation in its own right. Locally as well as the the the national branding. But if you think about the conversations that we need to start and the type of things that you've started already, and I know you were doing that last week at confed and you've been doing that with a number of organisations already and certainly we've been working together on a number of NHS conversations having the same talk about the same thing. What are the topics you think we should be igniting right now if we were to do the perfect agenda, what kind of things would be on, I'm not expecting you to give it the precise thing, but just kind of the placeholders that we should have.- For NHS lead services or?- Yeah, doing the connection that you talked about, removing the barriers or the gap between NHS conversations and industry conversations.- So I think as I've said, you know, this is where the whole up of brand piece is really strong and needs to be really, really strong. There's a significant focus from the NHS on different areas that are seen as priorities for NHS England and they have that as part of the (indistinct) you know, different KPIs and targets that they need to support patients suffering with that. However, there is a significant issue with the identification of unmet need and there is a huge population out there that aren't getting access to the services they need for many, many different reasons. And I think that's one of the areas that would definitely be on my agenda. You know, how do we as a system, a whole healthcare system, how do we start to really look at truly bringing services to people or opening up access. And some of that maybe we need around what can we do to bring services into primary care? And potentially from a industry and NHS collaborative, the conversation there could be, oh, okay, so how could I get, this device that's been always secondary care or actually this drug that can only be prescribed by a consultant in a Trust, a specialist centre. What is it that we need to do to bring that into primary care? What are the roles that are required to do that? What would the framework need to be that would include in that? So I think there's a huge piece here around let's have a look as a whole system at the real bigger picture, the big challenges, and then start to kind of work through it. Literally do your pathway mapping of this as a whole, this is the gap analysis, this is where we've got the biggest issues and this is where we are failing patients in the biggest way. And how can we then collaboratively start those conversations around, well have you considered this and what about that? And that's why I say like, when you are doing pathway mapping, things like that. If you've got access to people who have real expertise either in research, academia in that space, the technology, the capability, and you can bring them in infront of the NHS as part of those conversations of real sustainable change and changing the whole pathway or the whole system in a locality. That's really where this agenda needs to start. So the agenda potentially will flex depending on which area and which challenge it is that we want to tackle. But I think that there is a significant amount. There's also, you know, in the NHS itself, there is a focus very much on certain disease areas and things like that. And we almost need to get them to come and take a step back above that and say, actually let's work with you on some of these bigger things and stop trying to get points so you can get funding for this next year. So yeah, I think it would be, it's going to be a very interesting next 12 months starting these conversations. And actually, and part of that is asking the conversation, asking the question to both industry and NHS to be totally frank and honest and say, what are your biggest blockers in actually communicating properly with each other so we can move forward and we can support and really make some radical changes. Because I think there's a lot of elephants in the room that aren't necessarily ever brought to life discussed. And I think that we need to really be the people that can really make those conversations happen and bring in the right people to have those conversations and make long lasting decisions.- Brilliant, thanks Jennie. I think you've done really well to help us. It feels like I've been on a rollercoaster with you this afternoon. Just going through kind of where you started, how you got into that operational bit, how you got into the digital space, you've got a clear view as to how to narrow the gap I think between the NHS and industry, and setting out some really great ideas as to how we might continue to do that. I think be a great point to finish on the elephant of the room, comment because there is a definite sense of redescribing something that's not really quite true. And yet if you just had the people with your type of thought process and experience and you had a composite group around the table, probably make a quite a big difference relatively quickly. And I think that's a great place to wrap up for this afternoon. So I just want to really thank you for your really candid, open answers. It's been absolutely brilliant talking to you today and I've really enjoyed it and I hope everybody who's listening to has also enjoyed it. So that's really good. Thank you very much.- Thanks Phil.- So what I'd like to do to wrap up the session this afternoon is obviously to thank Jennie for contributions today, also thank everybody for listening. And then just to flag that the NHS symposium for this year is planned for the 26th of September. Everybody who's registered for this webinar will get an invite to it and the session's going to be held in London and the focus is on NHS transformation. So it ties very nicely into what we've talked about today. Jennie's going to be hosting us for the day, so you'll have the opportunity to talk to Jennie in person. And we've invited some specialist speakers to come and talk to us. So we have an NHS, ICB chair and two other ICB directors from different ICBs. So we've got four covered all together. And then some special skills particularly about digital at home, what might happen about oncology, more complex diseases and then care in the community. So there's quite a mix of things, but as I say, you'll get the invite in the next week or two. So thank you all very much and obviously from Jennie looking forward to hearing about the Above Brand Academy and how that develops too. So thanks everybody for listening. I hope you all have a wonderful afternoon. Thank you very much and goodbye.- [Presenter] Thank you for watching. If you'd like to find out more about our work with the NHS or how we could support your market access goals, please email info@mtechaccess.co.uk or visit our website mtechaccess.co.uk.