Tara Donnelly on digital health solutions

The chief executive of the Health Innovation Network talks to Lyn Whitfield about how DigitalHealth.London and its Accelerator are helping to bring good tech ideas and the NHS together, ahead of this year’s UK Health Show, at which she is a speaker.

“I have not been in a supermarket for years,” says Tara Donnelly. “As soon as online shopping was set up, I started using it. My chosen supermarket gives me a bottle of wine for doing it, which is very nice. And because it knows all about me, it’s my favourite bottle of wine.”

The chief executive of the Health Innovation Network admits that it is “sometimes frustrating” that the health service does not make the same use of technology to interact with patients; or the same use of data to plan and adapt services for them.

Which is one reason she is heading-up an organisation that is taking practical steps to make it easier for companies to pitch good ideas to the NHS, and for the NHS to take them up.

Helping the NHS to find ‘the good stuff’
The Health Innovation Network is an academic health science network; one of 15 created by NHS England in 2013-14 to spread innovation at pace and scale. It works across 12 South London boroughs, with 14 themes clustered around healthy ageing, conditions such as diabetes, supporting change, and technology.

The Health Innovation Network is a founding member of DigitalHealth.London, along with the other two AHSNs in the capital, NHS England, and MedCity. DigitalHealth.London was created to support a London Health Commission ambition to put the city at the heart of the “global digital health revolution”.

Donnelly explains it has four areas of focus, of which the first is helping the NHS to find the right solutions. “There were 165,000 health and care apps on the market at the last count, and that was some time ago, so it is probably more like 300,000 now,” she says.

“That’s far too many for anybody to keep on top of. So, we are there to help people find the good stuff.” Just as importantly, DigitalHealth.London helps companies to understand the NHS.

Here, Donnelly says the organisation’s “secret sauce” is its health navigators; “people with strong clinical or provider experience, who really know the NHS, and can help others to find their way around.”

In addition, DigitalHealth.London helps build capacity within the NHS to adopt new ideas, and is helping to build a digital health community via its website, conferences, and other activities.

Helping health tech SMEs to pick up speed
The organisation also runs the DigitalHealth.London Accelerator, which has an additional partner, CW+, support from the Guys and St Thomas’ Charity and the Mayor’s Office, and funding from the European Regional Development Fund.

The Accelerator provides support to small and medium sized enterprises, and has been funded to run a year-long programme for them for three consecutive years. It’s first programme of 30 companies is just ending, and a second cohort of 30 companies has just been announced.

Donnelly says the Accelerator is doing what was hoped. “Earlier this month, we had a conference to mark the end of our first year. We had a map of the sites that are working with our companies. At the start of the year, it showed we had ten sites. Now, we have got 100 sites. So, it is really moving things on.”

Also, she says, the Accelerator is helping to prove that technology can help the NHS with some of its big challenges.

She flags up the digital booking system DrDoctor, which has been working with Guys and St Thomas’ NHS Foundation Trust, which has seen ‘did not attends’ in its maternity department drop by 40% since introducing the service. “It did that really, really quickly,” she says. “And 40% of your appointments is a lot of money.”

Tackling the funding barriers
Donnelly’s career puts her in a good positon to judge impact. She joined the NHS in 1992 and worked her way through a series of general manager jobs before becoming chief executive of the West Middlesex University Hospital NHS Trust in 2007.

Subsequently, she held a series of senior posts at University College London Hospital NHS Foundation Trust, where she was director of quality, efficiency and productivity before leaving to lead the AHSN in 2015.

Her background also puts her in a good position to judge the many barriers that still stand between the NHS and SMEs working together successfully on digital innovations.

For instance, she says there is no doubt that the NHS tariff, which determines how much providers are paid for what they do by their providers, can be an obstacle. “Under Payment by Results, there can be real issues with counting virtual activity as activity,” she says.

Interestingly, she adds that one reason some mental health trusts have been able to move faster on innovations like virtual clinics is that they tend to be paid on a “block contract” basis; giving them a bit more leeway over how to deliver what they are contracted to provide.

At last year’s Health and Care Expo, NHS England chief executive Simon Stevens also announced a national innovation tariff, to “bulk buy” proven innovations centrally. One of the innovations funded was MyCOPD, which helps patients with lung conditions to manage their condition.

“COPD is progressive, and MyCOPD is very good for helping patients to stay well for as long as possible. There are 25,000 people using it; so it is another tool that has made an impact very quickly,” Donnelly says.

Spreading ideas, fast
Stevens announced an extension to the innovation tariff at this year’s Expo. But Donnelly notes there are other barriers to getting good ideas into the NHS. “One we see a lot is that people seem to think that technology must be a big project, that will require a big procurement, and be terribly hard to implement.

“Whereas some of these tools are really quite cheap; and there’s a lot to be said sometimes for just putting things in front of people and seeing what they do with them.”

Although DigitalHealth.London has a focus on the capital, it’s work is spreading to other parts of the country. “Because a lot of our funding is EU regional development money for London, most of our companies are London-based; but some are not,” Donnelly says.

“Some, for example, have worked in other places and see London as the next step for them; while others have gone the other way, and are now on the NHS Innovation Accelerator, like DrDoctor.”

At the same time, the 15 AHSNs are increasingly working together as a national network. Each key area of their work is led by an AHSN chief officer and Donnelly is leading the digital component.

Adapting to pressure
Yet the NHS faces some pressing problems. At the Expo, NHS England director of operations and information, Matthew Swindells, urged the NHS was on top of its winter planning; and his boss, NHS England chief executive Simon Stevens followed up by warning that a ‘flu outbreak could be on the way from Australia and New Zealand.

Is any of the work that DigitalHealth.London or the Accelerator are doing going to help with that? Donnelly points to companies such as Babylon Health, which is in the second cohort of Accelerator companies, and which can be used for triage and remote consultations.

Or, in the longer term, MyCOPD, again, since chest conditions can be exacerbated by winter weather and lead to hospital admissions.

In the end, she says, the challenge remains to get these good ideas built into pathways and working; enabling technology to change healthcare in the way it has changed so many other services around us – not least shopping.