NIHR: Driving innovation

Source: NHE Sept/Oct 2018

The NHS is not just embracing the power of technology to improve patient care, it is actively driving innovation through the National Institute for Health Research (NIHR). Dr Matthew Hallsworth, head of external relations at the NIHR Office for Clinical Research Infrastructure, reveals how.

Digital technologies, including artificial intelligence (AI), can respond to unmet clinical needs, and potentially provide efficiency savings for the NHS. Yet, while the UK’s MedTech and digital health sectors are thriving, uptake in the NHS for these new medical devices and diagnostics can be slow.

Small companies, or inventors, often struggle to generate the evidence they need to convince NHS procurement teams to purchase their products. If the product is a new app or device that alters the care pathway of a patient, then companies need to demonstrate how it will be embedded into the way care is delivered to the patient. They will also need to model the health economics. Many inventors do not have the expertise to do this. They need help, and that’s where the NIHR comes in.

Working in partnership

The NIHR has a broad range of research and development expertise embedded in the country’s leading universities and hospitals, which is available to partner with companies. The Department of Health and Social Care invests over £0.5bn every year in this infrastructure so that it can work with innovators to accelerate the development of new healthcare solutions.

For example, researchers from the NIHR Moorfields Biomedical Research Centre, DeepMind Health and University College London have worked in partnership to develop a state-of-the-art AI system that can spot signs of eye disease as accurately as expert doctors. They hope that the technology could spot eye conditions earlier and make sure patients with the most serious problems are treated urgently before their eyes are irreversibly damaged.

The NIHR’s experts can help ensure inventors have the right clinical evidence to support adoption within the NHS. For example, the NIHR is supporting Mologic Ltd, a UK-based SME, with the development of a new diagnostic for acute exacerbation of chronic obstructive pulmonary disease (COPD). COPD is the second most common cause of emergency admissions in the UK, responsible for one in eight acute adult medical admissions. In developing a urine-based test for an early indication of exacerbation that is simple enough for patients to monitor their disease status at home, Mologic’s technology is enabling these patients to be cared for in the community, reducing A&E visits and admissions.

The NIHR’s Medtech and In Vitro Diagnostics Co-operatives (MICs) carried out health economics analysis and supported in the development of an early adoption plan. In collaboration with the NIHR MICs, Mologic prepared a successful application for government funding through Innovate UK to further develop the device and to generate the evidence required to get it through development to CE-marking and early adoption in the NHS.

Bridging the funding gap

It is not just through our vast networks of experts that the NIHR can help. We have also developed funding schemes specifically to help SMEs and inventors to speed up access to groundbreaking medical technology. 

We were aware that there was a gap in funding both in early-stage development and for completed projects that do not have all the data they need to access the follow-on funding. We launched our i4i Connect award scheme specifically to meet this need and to de-risk projects, making them attractive to follow-on funders and investors. This funding supports SMEs through either of these stages of development, which is vital for companies needing to maintain momentum. Our i4i Product Development Awards support any stage of the translational research and development pathway, including the clinical development of laboratory-validated technologies or interventions.

The first round of companies that received i4i Connect funding included Rapid Rhythm Ltd for its diagnostic ECG for rapid diagnosis and treatment of heart conditions such as atrial fibrillation, a major cause of stroke; MIRA Rehab Ltd, to help with the development of its virtual physiotherapy programme, which turns physiotherapy exercises into fun-to-play video games; and Therapy Box, to develop a speech articulation rehabilitation app for children and young people which gives them greater autonomy through an automated evaluation tool. We are supporting all of these companies with the development of their products so that they can reach a stage where they can benefit patients.

Running your clinical investigation in the NHS

Through the NIHR’s Study Support Service, companies can access a national network of research sites that span the country and are available for them to run their clinical investigations. This NIHR’s Clinical Research Network connects individual research sites to enable a ‘do once and share’ approach to study delivery. Companies can use this service regardless of location, study type, study size, or therapy area.

We can help companies to determine if their study is compatible with UK clinical practice and advise if it can be delivered successfully in the NHS. We can also help identify barriers to recruitment, and offer solutions and strategies to help overcome those barriers. Even if a company’s study is already underway, we can help troubleshoot issues and obstacles. Our aim is to increase a company’s chances of delivering its study on time and meeting its recruitment target.

This support was vital for MedTech SME Healum in its development of a digital solution that enables healthcare professionals to empower, support and motivate patients to make healthier choices to tackle chronic diseases.

The product is formed of two parts: an online software for use by GPs, which is then  linked to a mobile app for use by patients. The product enables the patient and GP to work together to manage the patient’s condition and co-create a customised healthcare plan. It has the ability to track key health indicators such as cholesterol, weight, blood pressure, blood glucose, sleep and exercise (if linked to a wearable). It also has the functionality to set goals and track metrics to measure progress and for the GP to recommend exercise classes and healthy eating plans. The result is a convenient, personalised, interactive healthcare plan which helps to keep the patient engaged.

With the help of the NIHR Study Support Service, Healum received advice about the feasibility of the clinical investigation to test the app and some potential problems were highlighted. They also received help finding sites and accessed the study set-up service to ensure that the pilot study was carried out according to budget. This support has meant that Healum has been able to quickly move onto the next stage of its product development. 

Developing the health technology of tomorrow

By working with the NIHR and accessing the support and funding that I have described, companies are able to develop and test their new technology with the clinicians and healthcare professionals who will ultimately be using their products. Equally, the clinicians who are at the forefront of their fields get to work with companies developing innovative healthcare products at an early stage and can test this new technology as it is being developed.

It is by bringing all of this expertise together that we can help to speed up the development process and generate the evidence needed to meet our ultimate goal of getting new treatments and products to patients faster.


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