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How the NHS is ahead of Apple

John Craig, chief executive of Care City, highlights the many impressive developments taking place as part of the NHS England test bed.

One of the surprises of the new Apple watch is a dramatically better heart monitor. However, Care City is already helping the NHS to go one better – to use similar technology from AliveCor, which can identify atrial fibrillation (AF) in 30 seconds. It’s a major advance, but perhaps just in time – getting the NHS ready for this technology being on every wrist. 

Care City delivers no services, but this month launched a new pathway using AliveCor’s technology. We worked with commissioners and providers in Waltham Forest to develop an approach to finding and treating AF that can save lives, quickly and cost-effectively. 

Our approach puts AliveCor’s Kardia Mobile device (pictured overleaf) in community pharmacies to screen over-65s. Those who need further attention are referred directly to hospital, to attend a one-stop anti-coagulation clinic within two weeks, where their diagnosis can be confirmed and, if necessary, anti-coagulation initiated: 

• Screening around 1,300 people in Waltham Forest over six months will find new cases, and prevent strokes. In London, almost half of those with AF are unaware that they have the condition
• Our independent evaluators – University College London (UCL) – say that this pathway is cost-effective and has the potential to prevent 1,600-1,700 strokes nationwide
• Streamlining the pathway reduces appointments and the time to treatment, from an average of 12 weeks nationally, down to two weeks 

We are proud to launch this new pathway, as part of Care City’s work as an NHS England test bed. The programme has been championed by Simon Stevens, who recently reiterated his support for this at NHS Expo on 12 September. 

Care City is an innovation centre for healthy ageing, founded by the London Borough of Barking & Dagenham and North East London NHS FT. We research, innovate and educate to help local people to have a happier, healthier older age. In the process, we aim to help to integrate health and social care services and to regenerate our part of London. 

Our first step has been to establish ourselves as an innovation partner to our local health and care system, building strong working relationships with commissioners, providers and patients. We have also become an innovation partner to East London Heath and Care Partnership, our local sustainability and transformation partnership (STP). 

Another example of this approach – cited at NHS Expo by Stevens – is Care City’s work on gait analysis to prevent falls. We are working with a health technology start-up to spot people at risk of falling – before they fall over – so that we can target falls prevention help on those who will most benefit. 

Again, we have applied this innovation within community pharmacy. Customers who are over 65 are invited to wear clever sensors for a five-minute test, walking up and down the aisles – past the shampoo and the throat sweets – while the sensors compare their walk to thousands of others, so that those at significant risk can be referred for support. 

In Barking & Dagenham, we have gone one step further, working with another partner to use gait analysis not only to assess people’s falls risk, but to help to reduce it. Healthcare assistants assess patients’ gait at the GP practice, enabling a physiotherapist working remotely to use the data to create personalised exercise plans. These plans describe, based on their particular walk, the exercises that will best protect and prolong patients’ mobility. 

Being an NHS England test bed is a fabulous opportunity not only to make a difference for local patients, but to change the health and care system for good. The test bed project has helped Care City to build with its partners an innovation capability that can continue to strengthen and prove new approaches to saving lives and money for many years to come. 

Care City’s job is to sustain that process – to continue to attract ideas, talent and resources to its part of London, and to build its profile as the ‘test bed’ for ambitious innovators and researchers. 

Momentum is already building, and we are proud to have created partnerships with Health Education England, UCLPartners and NHS England’s Healthy New Towns programme. In collaboration with UCL, UCLPartners and the Bayswater Institute we have also been selected by the Health Foundation to be part of its £1.5m Efficiency Research Programme. 

The WORKTECC study, led by UCL’s Dr Sonya Crowe, who is also part of the test bed evaluation team, will identify the scope for transformational efficiency gains in home-based NHS care in Barking & Dagenham and Redbridge. NHS staff who provide home-based care spend a lot of time travelling, and co-ordinating the care delivered by different professionals and organisations is complex. We will use operational research, mathematical modelling and systems analysis to identify innovative and more efficient approaches used in other industries that could deliver improvements for patients, professionals and healthcare commissioners.

 So you see, it’s not just Apple with the power to innovate – and we get to save lives!

FOR MORE INFORMATION

W: www.carecity.london 

To find out more about the Health Foundation research programme, visit:

W: www.health.org.uk/efficiencyresearch

Top Image: © Barking Riverside Limited