A view from the front line of healthcare services

Emergency ambulance outside Birmingham Medical School
Dr Liz Sapey

How much of the burden of ill-health is really 'unexpected', and can we take more people from 'unplanned' to 'planned' healthcare?

Dr Liz Sapey

Last week Birmingham Health Partners – and the future Birmingham Life Sciences Park – was awarded Life Sciences Opportunity Zone status by  the Department for Business, Energy and Industrial Strategy (BEIS).

In a new series of blogs, we have asked BHP experts to provide their view on the four key elements of the Life Sciences Industrial Strategy which we will deliver on as an ‘LSOZ’: improving UK clinical trials capability; supporting the growth of life science clusters; linking businesses directly to the NHS; and delivering data-enabled healthcare innovation. 

Today, Dr Liz Sapey, Director of PIONEER, writes for us on integrated health data and cross-sector working within the LSOZ. 

This month, ‘Health Equity in England: the Marmot review 10 years on’ was published, highlighting that many people can expect to spend more of their lives in poor health, especially those from our poorest communities. This is reflected in our current use of healthcare services.  The NHS is under relentless and increasing pressure to meet the health needs of our nation and nowhere is this felt more than in acute care. 

Acute care is any unplanned healthcare contact, when a person seeks ‘unexpected or unplanned medical advice or treatment’.  Each year, the NHS provides more than 110 million acute care health contacts – more than 200 each minute. The financial cost is huge, estimated at £17billion per year, but the societal cost is even higher.  

Many acute care consultations are the first diagnosis of a chronic disease at a late stage, when the disease is severe – for example, a quarter of cancer diagnoses are made in acute care, often with advanced disease. Additionally, a high proportion of presentations represent acute flares of chronic disease which may have been sub-optimally managed. Approximately 5% (more 5 million acute care contacts) reflect adverse drug reactions. 

But how much of this burden of ill-health is really ‘unexpected’, and can we take more people from ‘unplanned’ to ‘planned’ healthcare?

Part of the challenge acute care faces, is that it is provided by traditionally siloed healthcare services.  A patient can access unplanned healthcare from many different sources (a pharmacist, their GP, an out of hours GP, the ambulance service, and different hospitals and minor injuries units) with little sharing of data between organisations. This limits our ability to understand how health problems have arisen and few opportunities to intervene sooner and, perhaps as importantly, intervene smarter.

We urgently need innovation in how patients access medical help; the medical assessments they undergo; the therapies they receive; and how they are monitored. 

We need technologies which help people receive the care they need in the most suitable setting, which may not be hospital.

We need to empower patients to monitor their own healthcare needs, and through smart technology, to intervene sooner.  

We need computer software that helps healthcare professionals make earlier diagnoses by recognising complex patterns of illness across time and geography.  

But to achieve all this, we need integrated information about people during acute illnesses to ensure the innovations we design are useful and valued.

PIONEER, working within the Birmingham Life Sciences Opportunity Zone, intends to deliver this joined up health data, creating a complete map of innovation need in acute care and closing the health data loop from home to community services to hospital services to the community. 

 

PIONEER Health Data Research Hub logo

PIONEER is the HDR-UK Health Data and Research Hub in acute care. Specific ethical permissions will permit linkage of an individual’s acute care journey across community/ hospital providers, allowing us to understand for the first time how, where and why people seek unplanned medical help. Understanding this journey, their disease burden and outcomes will provide critical insights into where we can change practice. And by linking data across primary and secondary care providers, and across regional and national settings we can understand acute care in depth and at scale.

These data provide an incredible opportunity, but one which can only be realised with cross-sector working, and this is what the Life Science Park and LSOZ will provide. The Life Science Park is ideally situated in close proximity to one of the most digitally advanced hospitals nationally, includes engaged and research-active NHS healthcare professionals to provide advice and early testing, clear patient voices to help prioritise workstreams, discovery scientists to advance mechanistic understanding, over 40 deeply phenotyped patient cohorts, one of the largest clinical research facilities nationally, a HTA approved biobank, internationally recognised trials units, cutting edge bio-informatics and computer science and a diverse but stable population which represents 10% of the UK.  

One of the most exciting prospects for PIONEER within the Life Science Park  and LSOZ is seeing how this community of expertise can work together with innovators from different academic institutions and industries to make a real change to the choices patients have and the outcomes they experience.

And given the stark words of the Marmot report, we need to start this together, and now.

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