Summary slides Thursday 6 November 2025
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Decision making in NHS trusts is too slow
Aswini Misro
Discussion summary: ● Aswini discussed the problems faced trying to introduce innovation into NHS organisations. ● He highlighted the significant delays that are built into the system with multiple meetings with various stakeholders with little clarity on who the decision makers are. This varies from trust to trust and there is no standard. Next steps: ● It was felt pathways needed to be clearer with processes streamlined and aligned. It was felt this would benefit from a nationally guided process that is accepted by all. ● This would include regulatory bodies which should includes a ‘passport’ process for regulatory and safety assessments that could be accepted by all reducing repetitive process for innovators.
It's too hard to safely implement AI into primary care Asad Ashraf
Discussion summary: ● Primary care practices are faced with an array of AI tools, but ensuring these are implemented safely is challenging given limited staff with the required expertise to oversee this and limited funding to do so. ● We want ensuring compliance with the requisite standards to be meaningful and not just a tick box exercise, and to allow autonomy and flexibility/agility to take on new AI tools. Next steps: ● Consider creating “digital champions” to complement the role of CSO’s, share ownership of the issue and avoid ‘single points of failure’. Partner with other organisations to enable training (eg health innovation networks). ● Embed reporting and hazard spotting within everyday systems, feedback results as regular agenda items at practice meetings. ● Map tools currently used and prioritize actions related to this. Identify other teams who may have complementary expertise. ● Report back progress to BMJ FH, share best practice (publishing)
The turnover of international nursing recruits into the NHS is too high Dina Paoloni Discussion summary: ● Up to 30% of international nurses plan to leave within three years, with pay/benefits and physical/mental health strain cited frequently ● There are many core challenges, including different communication styles and ways of working, workplace isolation, financial pressures and visa precariousness Next steps: ● Brief leadership on IEN retention as a patient safety issue; identify an executive sponsor per trust ● Run Dina’s cultural integration and career recognition pilot with one willing trust or directorate ● Redesign onboarding to prepare and integrate IENs and their teams better ● Provide better training in digital tools ● Track qual and quant evidence of IENs’ experience and retention
Mental health professionals aren't trained to deal with how young people act online Zoë Haime Discussion summary: ● Carefully curated resources already exist such as www.digitaldialogues.co.uk ● Young people have already been involved in research on this topic ● Which health outcome would show us this has been a success? We would hope to see a reduction in harmful online use. ● Could this be training be integrated into clinical training for doctors / clinicians? The issue is this would require a big evidence base to be added to the curriculum Next steps: ● It seems there is already a solution but clinical validation may be needed first ● Clinicians need to know why they should use this training - often people don't engage with this topic unless they know someone who has been affected by this. Stories are powerful.
● Medical professionals are already bombarded with training. ● Could they be motivated by achieving an accredited certificate? ● Convince stakeholders on the ROI
Few of the people who need them are accessing the available lifestyle change interventions that could help Helen James
Discussion summary: ● Nutiri is a social enterprise which focuses on weight ‘neutral’ and thinking about the behavioural changes required which lead to overall improved outcome of health. They have online content and have also supported a hybrid model in their local PCN. As part of the clinical entrepreneur programme Nutiri are looking to understand what they need to do next. Next steps: ● Clarify/focus Nutriri’s mission for the future: wanting to influence evidence and policy OR to deliver a service. ● The importance of evidence in their work / product and what outcomes they are measuring. ● It was suggested to get an advisory board – and consider who this needs to be. What are they ‘selling’? What research is needed? Who is the target market? Via healthcare / via schools. ● Consider working with education establishments – thinking about training of healthcare professionals (GP, Nurses, university establishments, schools). ● Thinking about accreditation of their content.
Children with cancer struggle to access clinical trials Emily Hall, Pamela Kearns & Eleni Syrimi
Discussion summary: ● Pediatric oncology trials struggle to start because national leadership lacks insights into workforce planning. ● These trials are incredibly complex, and while scoring tools exist to help predict the needs they are inconsistent and scoring is difficult.
Next steps: ● Predictive modelling from other industries
● Collaboration with CROs e.g. Lindus Health, Medidata, Evinova ● Obtain and clean up the data – set up a broader challenge ● HRA Study Setup Advisory Board * AI / Data Scientists – CROs – Predictive workforce modeling
The NHS hasn't achieved end-to-end closed loop medicines management Amna Khan-Patel Discussion summary: ● The goal is to track product from manufacturer to patient and to remove manual processes ● Challenges are ○ Infrastructure in each trust is different ○ Lack of interoperability ○ Absence of barcodes on products
○ Different providers of systems are not incentivised to talk to each other ○ Different trusts use different systems and so lack market leverage ○ Unit dosing not happening in UK
Next steps: ● Piloting will be key and will provide evidence of wider system benefits ● Need to get a supplier and organisation working together and developing interoperability ● Need to share work with the wider NHS when this is done
Summary slides Friday 7 November 2025
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Maternity staff training is ineffective Andrew Darby-Smith
Discussion summary: ● There are lots of quality problems in maternity care - these are expensive ● Current methods of training are expensive and not greatly effective ● Training can affect care as it takes people away from clinical care delivery ● A digital educational intervention that follows best practice in education could be an improvement ● Challenges in evaluation Next steps: ● Deliver and evaluate the training ● Aim for 100 completers ● Consider follow up survey focused on practice change ● Consider stage 2 - looking for sustained improvement in quality makers ● Publish the results according coreq standard ● Consider cost analysis of training ● Consider stage 3 - responsive and dynamic training based on local needs
Primary bone cancer is diagnosed late too often Silvia Kraft
Discussion summary: ● Silvia discussed the problems faced with diagnosis of rare bone tumours often missed on first presentation with, on average, diagnosis taking 6 months, which can have significant impact on treatment success. ● Lack of access to data and education was highlighted. Next steps: ● Silvia is to work with The Health Innovation Network Y&H to develop a campaign to spread awareness of the signs and symptoms and use the community diagnostic centres to help promote this to clinical teams giving them more rapid access to diagnostics. ● This will also allow us to see how secure data environments could be utilised to give more access to data.
It's really difficult to work out what we need from smart new hospital buildings while we also move care closer into homes Sarah Ferguson
Discussion summary: How do we make the changes so they are future proof. ● Consideration to workforce planning. ● Infrastructure required – both for elective / emergency care as well as community based care - Understand flow and key spaces needed – thinking about flexible use of spaces. ● Use of digital tools as a point of access, IoT. Next steps: ● Considerations to other regions / localities who have delivered care in a more community setting – thinking about vanguards. ● Looking at workforce planning – hybrid working, how do you accommodate a workforce and encourage retention. – Self rostering in some areas works well. ● Digital infrastructure – what is in place, what is needed ● User feedback – what matters to patients? What do clinicians feel will work in their area?
Pulse oximeters can be dangerously inaccurate, and the problem is worse with brown and black skin Nick Gompertz
Discussion summary: ● Current standardisation tests are inadequate and pose health risks ● The main issue is around raising awareness and engaging with key stakeholders ● Solutions are already being made and tested e.g. www.earswitch.co.uk Next steps: ● Highlight and raise the alarm on the risks, making more people aware of the shocking statistics
There is a poor leadership culture in NHS emergency departments Liyah Sharma Discussion summary: ● Nursing staff within the emergency department are experiencing a lack of perceived leadership. ● There is poor communication, resistance to change and a lack of psychological safety. This has led to a lack of collaboration, adaptability, staff morale, and continuous innovation in care delivery. ● There is also increased burnout and impact on wellbeing, as well as high staff turn over. Currently the team do not know who to go to with issues and do not feel they can raise these without repercussions. ● A mentorship scheme is in place, but mentors are not formally trained and are not always available to junior colleagues. Learnings from industry were discussed and the need for formalised training, safe spaces and dedicated team time (even if limited). ● Examples of empowering through communication, acknowledging concerns and delivering action were offered as opportunities to improve the leadership visibility. A cultural shift is needed to priorities leadership development and understanding of the value of change. Next steps: ● Team Huddles or Anonymous Box to be introduced to give people a platform to share concerns ● Role model leadership – Be the leader you want to see, offer support to others and increase visibility ● Ask the team – what change do they want and how do they think it can be achieved
The gap between surgeons' awareness of AI and willingness to adopt is too big Hasan Asfour Discussion summary: ● A survey of surgeons at UHL NHS trust showed that although 72% believe AI can transform care, only 4% use AI daily ● Surgeons want to engage, but there is no clear pathway, limited support, no safe learning, and a generation gap to overcome ● A phased rollout by institutions would enable training and networking, experimentation, integration and optimisation Next steps: ● Systematic training programs, not ad-hoc awareness sessions
● Communities of practice, not isolated enthusiasts ● Safe experimentation, not premature deployment ● Senior engagement, not bypassing leadership ● Evidence generation, not blind adoption ● Available tools, not theoretical discussions
Postnatal care for women and babies is poor Dhiviya Tharan
Discussion summary: ● Postnatal care for women and babies is extremely poor ● Multiple systemic and cultural factors cause this. ● Point of care access for pregnant women is marginal and different from practice to practice Next steps: ● Intervention at different levels
○ Midwives: Inform px of all checks, educate and empower ○ Hospitals: Pregnancy notification workflow to reception (PC) ○ GP’s: Set up a system - SMS within NHS app to send patient for healthcheck ○ Start small ○ Gather data from GP’s/Hospitals where maternal and newborn healthcare outcomes are better ○ Prove evidence to PCNs/GMC of how the intervention will work ○ Use the “Health Economic” lense to prove long term impact of good postnatal care and how it would reduce burden on NHS funds
#BMJFutureHealth #BMJFH
futurehealth.bmj.com
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