In the latest episode of our Innovation Insights series, our Co-Founder and CRO, Jonny is joined by Phil Jennings the Chief Executive Officer at Innovation Agency.
Innovation Agency is one of 15 academic health science networks in the UK uncovering and actioning new innovations in the healthcare sector. Phil’s background is as a physician cardiologist and a primary care doctor, and throughout his career in different types of leadership and management roles he has been actively involved in change management and quality improvement initiatives. In his current position at Innovation Agency he spearheads the process of getting new innovations, be it clinical pathways or a new clinical drug, through the pipeline of discovery and into the hands of frontline clinicians quicker and with more precision.
This episode is rich with insights, ranging from Phil’s perspective on the main innovations that have accelerated in the last year due to the pandemic through to exciting innovation projects in the pipeline at the Innovation Agency. The interview provides great details into the innovation management process that Innovation Agency has in place, how they have overcome the challenges and grasped new opportunities during the unprecedented times, and how they have cultivated a great culture of innovation. Impactful lessons to be learned and filled with a hopeful and invigorated outlook on the future of health in the face of the current pandemic.
Below is a transcript of this episode of Innovation Insights with Phil:
Jonny: Have you seen a shift or an acceleration in innovation because the world is in turmoil? How has that impacted how you’ve been able to move things forward?
Phil: It’s been a really challenging time for all of us. I think one of the only comforts that we can take from the Covid pandemic is that it has allowed us to rapidly roll out a number of new innovations. Which I think under normal circumstances would have taken years but we’ve rolled out in weeks or months.
At home digital consultations
The practice of medicine has changed and much like this interview today over Zoom, we’re both in our homes, we’ve been consulting with patients in their homes rather than them coming up to surgeries or hospitals. In the UK we’ve seen the deployment of two kinds of digital platforms to assist staff to be able to do that. One in primary care and one in secondary care which have allowed digital consultations to take place.
Restructuring booking appointment system to provide the best possible care
As well we’ve seen the kind of general format of booking an appointment with a doctor or a nurse change so most places now have moved on to a total triage model so you tend to have a conversation with someone first who explores what your needs might be before directing you to the correct professional. That’s not always a doctor and again increasingly now it’s a much broader workforce especially in primary care.
Working with Safe Steps to repurpose app technology for Covid tracking
So we’ve seen that rolled out, and then equally I think in response to Covid-19 itself, there’s some initiatives that have been really helpful. We’ve been working with a company called Safe Steps. They initially produced an app for use in residential homes and it was a false risk assessment tool, but the company managed to rapidly repurpose that during Covid and it’s now also a Covid tracker. We’ve been helping to get that deployed across our region so that care homes can more easily collect data on their residents, and we can see patterns and trends emerging. That helps us to target treatment and now more likely vaccinations.
Redeploying Needle Smart technology to track patients through to vaccination in Covid journey
Another example would be something called Needle Smart. Needle Smart has been around for a little while it’s actually a sharps disposal device. It’s very neat, you put your needle in the top of it after giving an injection and the needle is superheated in a matter of seconds. What’s happened over Covid is that’s now coupled with a digital vaccination service. The actual process of putting the needle into the machine sends a message about who’s been vaccinated by which vaccine. It’s allowing us to digitally track patients through that journey.
At home or the hospital, technology old and new is being applied in new ways to improve care
Finally my last example is a couple of really big initiatives that we’ve been involved in. One’s called Oximetry@home, and this is where we are now distributing pulse oximeters – little machines that sit on your finger and measure your oxygen levels – out to patients who’ve been diagnosed with Covid allowing us to monitor them in their own homes. Then the kind of opposite to that is another initiative called Virtual Wards, and this is for patients who are in hospital but it allows us to get them discharged back to their homes sooner than they would otherwise. Again that’s with some remote monitoring and daily check-ins to see how they’re getting on.
It’s been really busy during Covid trying to get all of that repurposed and certainly a lot of our routine work has been postponed but rightly so. We as an organisation have had to pivot to address the Covid need
Jonny: That’s fascinating. It sounds like a lot of the innovations or the fast-deployed innovations were things that were already there and there’s been a utilisation or a repurpose. And that pace has come from need hasn’t it? Which is quite understandable. Do you think that pace will continue or do you think that people will see how quickly you can move and hopefully this will maintain some of that sort of speed in the future?
Phil: I hope so, and it’s been a powerful demonstrator of what can be done when it’s really necessary. Obviously there’s a limit in terms of how hard people can work and again a lot of people have put in extra time and effort so there’s a personal toll that it takes. We’ve also had a set of emergency legislation which has helped us to overcome some of the barriers that would have stalled some of the innovations under routine operating. Particularly around some of the data regulations, it has allowed us to move a lot further and faster under this emergency period.
Perhaps to carry on and this pace is unrealistic. But it does at least show what can be done when we put our minds to it. There’s no doubt that we can become much quicker and slicker at that process from discovery to deployment.
Jonny: It’s nice that technology can be used more effectively and deployed. It sounds like a lot of the stuff will actually continue to be used.
Phil: I hope so. A lot of the stuff that we’re doing now with the oximeters is a demonstrator about long-term conditions. Covid might go away but asthma and COPD and heart failure are here and some of the technology that we’re using for Covid will be directly applicable to those long-term conditions.
I very much hope we can carry some of that learning from Covid forward into our more routine practice in the future.
Jonny: It would be great to better understand if you have an innovation management process within the Innovation Agency itself?
Phil: We are now trying to become a bit more structured in terms of how we address innovation. One of the reasons for that is there is no shortage of innovation. There are literally hundreds of thousands of good ideas out there and one of our challenges is trying to pick out the ones that have got real potential that we can sponsor and get through the system as quickly as we can.
Sources of innovation at Innovation Agency
I think it’s worth considering where the innovations come from. Generally speaking there are a number of routes where we tend to meet innovations or innovators. First of all that’s from the product of academic research or through one of our research partners. The next route would be from entrepreneurs. That’s both clinical entrepreneurs so that might be a doctor or a nurse or other healthcare professionals who have got a great idea that we can help to develop. Both that person and also their idea, but also entrepreneurs in the community.
The final source of our innovations comes from the commercial sector and that can be a tiny start-up, someone with a great idea. Or it could be an established med tech firm or a pharmaceutical partner.
We deal with all of those different approaches and what we try to do now is take those thousands and thousands of ideas through a pipeline where we gradually refine each one and end up with probably two or three great ideas that we can then try and roll-out each year.
Sometimes that’s just a process of looking at whether we need for instance some additional clinical advice. We’ll bring clinical experts to bear and give advice on a particular product or programme. Sometimes that’s regulatory advice, so again particularly if you’ve got a new device that will need to go through the various different regulatory frameworks to be able to be used.
Often the other thing that new innovations are lacking is some form of evidence. Most innovators haven’t a randomised multi-centre, multinational trial behind them so increasingly we’re trying to use a rapid evaluation cycle so we can gain some early patient safety and efficacy data, and then use that to build on slightly larger programs of research and evaluation.
Finally for those two or three we use our networks. In my region, we’ve got networks into our local healthcare system. We’ve got people we can approach in our GP surgeries or Hospital Trusts. In terms of trying to scale up innovation my organisation, the Innovation Agency works in partnership with another 14 academic health science networks across England and we have a very strong AHSN network where we meet regularly to share ideas. We put forward innovations to our national commissioners to become national programmes that all 15 can then roll out. That’s the key to getting real pace in terms of spreading adoption across the country.
Jonny: Have you seen much experience or evidence of ideas that have come through locally and undiscovered, deployed, tested and then had sort of a national framework adoption? Is that starting to become more commonplace?
Phil: Certainly in the last few years we’ve had a series of national, both programmes and products, and again there’s examples there in both elements where there are commissioners who are NHS, England, NHS Improvement and the Office for Life Sciences. They’ll task the network of AHSN’s to roll-out particular programmes or products. And again that spans the big and the small, so it could be a single device that we’re working with the commissioners to accelerate the adoption or it could be a big programme of change again around the long term conditions.
Jonny: Presumably with such a large and complex infrastructure within the healthcare network, what are the main challenges you face? We just mentioned nationally but on a regional basis actually getting those ideas implemented, are you struggling to get a share of voice in those organisations? Particularly at the moment as they are so operationally-focused, is it hard to get the ideas into those businesses and being used?
Phil: It’s a challenge yes, because there’s not really ever a quiet day in the NHS and clearly during Covid. NHS staff have worked harder than ever and so creating the space for innovation is a challenge.
Operational pressures are a source of challenge to new innovation
It’s difficult when there are such obvious operational pressures. If you look outside of Covid and into more routine work, most of our NHS partners now recognise the importance of innovation. Most of our Hospital Trusts will have an innovation lead at the very least and in fact some of our trusts are much more developed and they have a whole team which is tasked with innovation.
For a Hospital Trust who can promote its own ideas that becomes potentially a commercial investment opportunity for them and we have Trusts at various different stages in our patch and I suppose that’s the same across the country.
Moving over into primary care again there’s a lot of reorganisation happening at the moment. Rather than individual surgeries working alone, they’re working now in groups of practices that we call primary care networks and again for primary care networks it’s really key that we can link in with innovation leads there so we’ve got a route into primary care which after all is where most of the activity of the NHS occurs.
It’s really important that they don’t lose out on the development around innovation.
Jonny: A question on innovation is interesting as we obviously work in innovation as well. When innovation is in your company description and your job title and everything you do it, it almost loses a little bit of its impact at times. But it’s trying to understand within the Innovation Agency that you run Phil, how do you create that ethos and culture of innovation with your own staff? Because it’s easy to talk about it, but they’re going through lots of challenges and change as well.
Phil: I’m really fortunate. We’ve got a great team and they’re very diverse so there are obviously as you might expect people with an NHS background, like myself, but then looking at the rest of the team we have people who’ve got all kinds of different backgrounds. Including commercial and research backgrounds because unlike other NHS organisations AHSNs are specifically tasked with generating economic growth in their areas and clearly there’s a very strong link between the economic vibrancy of a region and its health. And we’ve understood that for a long time and in fact often the best medical intervention is giving someone a job if we’re working in an area where there’s very high deprivation.
Diverse skill-sets, backgrounds and experiences accelerate innovation at Innovation Agency
It’s particularly important in my area in the Northwest of England. A very strong component of our work is around economic investment regeneration and trying to attract people to come and set up companies in the Northwest of England or for us to attract large research initiatives into our hospitals and primary care.
In order to do that I do need a team of varying different skills and backgrounds and we’re really fortunate because we haven’t got a clinical duty so we’re not operationally active seeing patients and again we all recognise how fortunate we are to have that time and space to think about which innovations might potentially help our college best. That’s what makes it such a good place to work and it creates that kind of great atmosphere. We need to try and take some of that and instil it into our colleagues on the clinical, but again from my experience you know clearly working with colleagues who are operationally active they see the value of innovation and it’s just a case of sometimes being able to show them what’s out there and what their potential for change might be.
Jonny: Final question from our side. You’ve talked about some of the innovations that have currently been deployed. Is there anything that you’re really excited about, something very new and different, that we’re going to see in 2021 that you think is going to change how your world operates?
Phil: There are clearly themes emerging which will shape the course of the near to medium term. The first one is digital. Digital is a bit of a misnomer because it incorporates all kinds of things. So if I was to unpack that slightly as part of digital is just the electronic way of doing our business. We’ve talked about remote consultations for instance but equally there’s many other ways that digital platforms or information can help people look after themselves and support their own care. That’s going to be an increasingly important factor moving forward.
Tapping into the power of data and trends will fast-track new innovations
But the other thing that digital means for me is data and we’re in a very data-rich era and the amount of data that we’re generating is just increasing exponentially every single day. But we don’t really utilise that. We already in the NHS hold vast quantities of data across our population, from birth to death, but the insights are largely locked away at this point in time. As time evolves as we get better at using large data sets we’ll be in a position where we can predict the course of the disease much more accurately and then that will get us on the front foot, and we will be able to take preventative action in many cases. As we start to share data better and again that involves a conversation with the public in terms of how much of their health data which, which is particularly important to most people, are they willing to share. That’s a challenge for us. But I think if we can get to a point where we do share lots of routine, probably anonymised data, that will create enormous insights for researchers and for frontline commissions
You could see in the future how your computer system rather than just recording what you’re doing with the patient would be flagging things up to you to say well actually you know based on the experience with others this person is at risk of one thing or another and you may wish to make this intervention or prescribe that medicine. I think that will really change how we practice.
My second theme would be the genomic revolution that we’ve seen over the last few years. We were very much involved in something called the 100 000 genomes project here in the UK, which was an initiative to map 100 000 genomes in the first instance in cases of cancer and rare diseases. It was a very large UK initiative and again has given us one of the largest genome databases anywhere in the world, and that technology is becoming ever more rapid and widespread and affordable. In future we’ll regularly see genomic sequencing perhaps not a whole genome but certainly targeted sequences which will help us to inform care. I think people will be coming in routinely having parts of their genome sequenced.
My final point would be personalised medicine. At the minute we’re in an empirical phase of medicine so we conduct large studies and we look at the evidence that shows us. But unfortunately that doesn’t always translate to the patient who we have in front of us and actually you know the chances of us replicating the results in a trial are fairly low. Even when I prescribe the medication in good faith, you know a third of the time that might get the effects that I’m expecting, another third it maybe doesn’t have any effect and in the worst case scenario perhaps I even do harm.
I think as we progress with better understanding of how drugs are metabolised, how the genes that we all have code for drug metabolism will be able to start to tailor bespoke prescriptions of doses and medications to individuals in a far more advanced way than we do at the moment.
Again that’ll be a radical change to how we currently practice and that’s not too far away so again you know that’s not technology that we’re going to see in the next few years, but hopefully within my lifetime of practice in medicine we’ll start to see some of those changes taking effect.
