Deloitte Future of public health report series

The future of public health report series: Building a fairer and sustainable system for the UK
Deloitte October 2021 -

• The future of public health report series features six reports on the crucial role of public health and the actions needed to optimise the link between health and productivity to drive economic recovery and positive societal impact. 
• Narrowing the gap: Establishing a fairer and more sustainable future for public health (October 2021)
• An executive overview of the key findings from the series, examining the current challenges and future requirements for a resilient public health system in the UK.
• Identifying the gap: Understanding the drivers of inequality in public health (November 2021)
• Evaluating the pre-existing and current challenges and solutions to tackling the ‘wicked problems’ affecting public health, including the impact of COVID-19.
• Negating the gap: Preventing ill health and promoting healthy behaviours (not yet published)
• Exploring how investment in prevention and health promotion can help increase healthy life years and reduce health inequalities.

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study
The Lancet 1 November 2021 DOI:https://doi.org/10.1016/S0140-6736(21)01595-6

• Analysis of data compiled by the National Maternity and Perinatal Audit (women with a singleton birth between 1 April 2015 and 31 March 2017) indicate that socioeconomic and ethnic inequalities were responsible for a substantial proportion of stillbirths, preterm births, and births with fetal growth restriction in England. The largest inequalities were seen in Black and South Asian women in the most socioeconomically deprived quintile.

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study.
Lancet 1 November 2021

• This research quantifies the magnitude of socioeconomic and ethnic inequalities for adverse pregnancy outcomes at the population level in England. Using data from the National Maternity and Perinatal Audit. Results indicate that socioeconomic and ethnic inequalities were responsible for a substantial proportion of stillbirths, preterm births, and births with FGR in England. The largest inequalities were seen in Black and South Asian women in the most socioeconomically deprived quintile

Looking Glass Bringing the future of healthcare delivery into focus

Looking Glass: bringing the future of healthcare delivery into focus
Thoughtworks October 2021

• Earlier this year, Thoughtworks created its first Looking Glass report, examining more than 120 technology trends through six 'lenses' to help businesses understand what those trends could mean for them. This report looks specifically at what some of these trends could mean for the health and care sector, and how they’re shaping the future of health care delivery. In particular the augmentation of human capabilities and experiences, and the evolution of human-machine interactions. 

The Bridge Building Model: connecting evidence-based practice, evidence-based research, public involvement and needs led research.

The Bridge Building Model: connecting evidence-based practice, evidence-based research, public involvement and needs led research.
Res Involv Engagem 7, 77 (2021). https://doi.org/10.1186/s40900-021-00320-y

• The Bridge Building Model combines different concepts in healthcare research that the authors suggest belong together. The concepts are; Evidence Based Practice, where healthcare is based on the best research evidence, Evidence Based Research, where new research is developed in the context of what research already exists, public involvement in research, where service users, carers and health and social care professionals engage with research, and Needs Led Research, where new research addresses the needs of people that use healthcare services.

A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance

A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance
BMJ 2021; 374 doi:n2061 30 September 2021 https://doi.org/10.1136/bmj.n2061 

•  A framework for researchers and research funders on developing and evaluating complex interventions originally published by the UK Medical Research Council in 2000 and revised in 2006 has been updated. The framework divides complex intervention research into four phases: development or identification of the intervention, feasibility, evaluation, and implementation. Each phase has a common set of core elements—considering context, developing and refining programme theory, engaging stakeholders, identifying key uncertainties, refining the intervention, and economic considerations.
• See the new framework here.

Good Machine Learning Practice for Medical Device Development: Guiding Principles

Good Machine Learning Practice for Medical Device Development: Guiding Principles
MHRA 27 October 2021

• Ten guiding principles that can inform the development of Good Machine Learning Practice (GMLP). These guiding principles will help promote safe, effective and high-quality medical devices that use artificial intelligence and machine learning (AI/ML).
• Press release: UK, USA and Canadian regulators identify 10 guiding principles to be addressed when medical devices use AI or machine learning software - GOV.UK (www.gov.uk)

Ethical considerations in the use of Machine Learning for research and statistics

Ethical considerations in the use of Machine Learning for research and statistics
UK Statistics Authority 26 October 2021

• This high-level guidance explores ethical considerations associated with the use of machine learning techniques for research and statistical purposes. This guidance is not exhaustive, but aims to assist and support analysts, researchers, data scientists, and statisticians navigating the ethical issues surrounding machine learning based projects. Links to further resources are provided if you would like to read about particular aspects in more detail.

Regional Scale Programme and National Innovation Collaborative - technologies that enable remote monitoring

Evaluation of the Regional Scale Programme and the National Innovation Collaborative
NHSX 21 October 2021

• The Regional Scale Programme (RSP) is leading work across England to accelerate the deployment of new care pathways supported by technologies that enable remote monitoring. The RSP is supported by the National Innovation Collaborative (NIC). This is a programme of support that aims to enable collaboration and, in turn, the rapid sharing of learning and best practice in digital transformation across the NHS and care system. This evaluation was carried out by Ipsos MORI, working in partnership with the Strategy Unit. 
• Key findings describe self-reported digital maturity levels; levels of adoption; tools for successful implementation; barriers to delivery; effects of regional devolution; awareness of available support; short term benefits and future plans and risks.

Contextual inquiry - how to do it

Contextual inquiry [Guidance]
UK Health Security Agency 19 October 2021

• How to use a contextual inquiry when developing a digital health product. Contextual inquiry investigates how potential users interact with their natural environment rather than just focusing on the digital product. Contextual inquiry involves in-depth granular exploration of a small sample of people.
• Part of the Evaluating digital health products collection

Online services in general practice: patterns of use and barriers to uptake

Online services in general practice: patterns of use and barriers to uptake
PHE 30 September 2021

• The aims of the project were to achieve a better understanding of the needs of segments of the population through:
• reviewing the evidence relating to the effectiveness of online services to support general practice
• using the Mosaic Public Sector Tool to segment the Surrey Heath CCG population according to their use of online services, thereby identifying groups that are more and less likely to use these services
• analysing the use of online services by the Surrey Heath CCG population to identify any associations between patterns in usage and demographic factors
• conducting insight gathering work to explore barriers and enablers to the use of GP online services

Digital Clinical Safety Strategy

Digital Clinical Safety Strategy
NHSX , NHS Digital and NHS England and NHS Improvement 17 September 2021

• The strategy is an addendum to the NHS Patient Safety Strategy, outlining the case for improved digital clinical safety across health and social care. The aims of the strategy are to improve the safety of digital technologies in health and care, now and in the future and to identify, and promote the use of, digital technologies as solutions to patient safety challenges.

Clinical and care professional leadership in integrated care systems

Clinical and care professional leadership in integrated care systems
NHS Confederation 3 September 2021

• A thematic report from engagement events in March 2021 and mini literature review to inform guidance to support embedding system-wide clinical and professional leadership in all integrated care systems.

NHSX Multi-Agency Advice Service (MAAS)

NHSX Multi-Agency Advice Service (MAAS)

• MAAS is a collaboration between National Institute of Health and Care Excellence (NICE), Care Quality Commission (CQC), Medicines and Healthcare Products Regulatory Agency (MHRA) and the Health Research Authority (HRA). It aims to give innovators and health and care providers a one stop shop for support, information and guidance on the regulation and evaluation of AI technologies.

Harnessing technology for the long-term sustainability of the UK’s healthcare system

Harnessing technology for the long-term sustainability of the UK’s healthcare system
Council for Science and Technology, Government Office for Science 23 August 2021

• The Covid-19 pandemic has exposed the limitations of the current health system, highlighting health inequalities, the challenges to integrated health and social care and the shortcomings in our approach to public and population health. It has also led to further pressures on the system, with a backlog of treatment requirements that may take considerable time to clear. This report presents recommendations aimed at creating system change to improve outcomes for patients and support health care professionals, focusing on the successful integration of existing health care technologies to enable health system leaders to radically reshape the model of health and care delivery.

Listening to digital health innovators - first and second reports

Listening to digital health innovators report 2021
NHSx 20 August 2021 

• The second listening to digital health innovators report, compiled in the spring of 2021, reflects the impact of the pandemic for companies who have been working closely with the NHS and social care. This report picks out five themes that innovators have highlighted over the course of the pandemic and how NHSX is addressing them.

Listening to digital health innovators

NHSX 15 October 2019

• Results of a listening exercise by NHSX with digital innovators suggested five key priorities for NHSX. The key themes are Standards, Procurement, Approach and scale, Engagement and Digital capability.

Learning from patient safety incidents involving acutely sick adults in hospital assessment units in England and Wales: a mixed methods analysis for quality improvement

Learning from patient safety incidents involving acutely sick adults in hospital assessment units in England and Wales: a mixed methods analysis for quality improvement
Journal of the Royal Society of Medicine 4 August 20201
https://doi.org/10.1177%2F01410768211032589 

• Analysis of patient safety incident reports (10 years, 2005–2015) collected from the National Reporting and Learning System which described severe harm/death in acute medical unit (n=377) found that the most common incident types were diagnostic errors (n = 79), medication-related errors (n = 61), and failures monitoring patients (n = 57). To improve patient safety the authors recommend introduction of electronic prescribing and monitoring systems; forcing checklists to reduce diagnostic errors; and increased senior presence overnight and at weekends.

The challenges in implementing digital change

The challenges in implementing digital change
National Audit Office 21 July 2021

• This report sets out the lessons for the centre of government and departments to learn from the experience of implementing digital change. It sets out these lessons in six categories, which are essential to get right at the outset understanding aims, ambition and risk; engaging commercial partners; legacy systems and data; capability; delivery methods; and funding mechanisms. This report assesses good practice, following consultation with experts from industry, academia and think tanks to highlight the nature of the challenges and understand why government has found it hard to apply the lessons of experience.

Mental Health Technology Landscape Review

Mental Health Tech Landscape Review
Future Care Capital 12 July 2021

• This research explores the tech startups deploying solutions for the mental health care market. We describe the technologies contributing to the solutions as well as specific implementations, and the benefits they bring to citizens and the mental health care workforce. The research identified 56 technology companies developing solutions for the mental healthcare technology market. The technologies include active monitoring, talking therapy, non-talking therapy and productivity tools.

Health and health-related behaviours of Lesbian, Gay and Bisexual adults

Health Survey England Additional Analyses - Health and health-related behaviours of Lesbian, Gay and Bisexual adults
NHS Digital 6 July 2021

• This report presents findings on the health and health-related behaviours of the Lesbian, Gay and Bisexual (LGB) population in England. These are analysed by age, sex and ethnicity. The data are based on a representative sample of adults, aged 16 and over, who participated in the Health Survey for England from 2011–2018. 2% of adults surveyed in 2011-2018 identified as lesbian, gay or bisexual (LGB).