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

Advancing the analytical capability of the NHS and its ICS partners

Advancing the analytical capability of the NHS and its ICS partners
The Strategy Unit October 2021

• This report describes how analysts, teams, regions and national bodies can:
• organise themselves to deliver strategic analysis;
• develop their analytical skills and provide opportunities to simplify career pathways for analysts;
• appreciate and utilise the full range of analytical possibilities at their disposal; and
• connect with peers through networks.

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.

NHS Digital Data Security and Protection Toolkit

Data Security and Protection Toolkit
NHS Digital updated 21 October 2021

• The Data Security and Protection Toolkit is an online self-assessment tool that allows organisations to measure their performance against the National Data Guardian’s 10 data security standards. All organisations that have access to NHS patient data and systems must use this toolkit to provide assurance that they are practising good data security and that personal information is handled correctly.
• · Part of NHS Digital Cyber and data security services and resources

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

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.

What Good Looks Like: Seven success measures for successful digital transformation

What Good Looks Like: Seven success measures for successful digital transformation
NHSX 31 August 2021

• The What Good Looks Like framework has seven success measures which are applicable to all care settings - Well led; Smart foundations; Safe practice; Supported people; Empower citizens; Improve care and Healthy populations. Tools will include an assessment framework to measure digital maturity and an online knowledge base with blueprints, standards, templates, real-life examples and best practice. The Framework outlines what good looks like for ICSs and other organisations.

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.

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, 23 August 2021

• Advice to the Prime Minister on how government can increase the contribution of science and technology for the sustainability of the UK’s health and care system
• In a letter to the Prime Minister sent in June 2021, the Council for Science and Technology (CST) explores how the government can increase the contribution of science and technology for the sustainability of the UK’s health and care system.
• The UK health and care system currently faces the challenges of increasing demand and pressure on services and siloed systems, and the letter proposes three recommendations focused on two opportunities for change:
• supporting a step-change to improve and maintain population health, centred around new ways of engaging and supporting individuals and communities, enabled by data and evidence
• re-engineering the health system to support integrated ‘pathways’ for prevention, treatment and care to provide better outcomes for individuals

The ‘double whammy’ of low prevalence in clinical risk prediction

The ‘double whammy’ of low prevalence in clinical risk prediction
BMJ Evidence-Based Medicine Published Online First: 13 August 2021. doi: 10.1136/bmjebm-2021-111683 [NHS OpenAthens registration required]

• This article describes two principal reasons why the nature of developing clinical prediction rules in low prevalence scenarios will almost invariably result in concerns about performance, on standards by which this is usually judged. The authors focus primarily on suicide prediction, but these points apply more generally to other low prevalence clinical areas, some examples of which are also discussed.

COVID-19 admission risk tools should include multiethnic age structures, multimorbidity and deprivation metrics for air pollution, household overcrowding, housing quality and adult skills

COVID-19 admission risk tools should include multiethnic age structures, multimorbidity and deprivation metrics for air pollution, household overcrowding, housing quality and adult skills
BMJ Open Respiratory Research 2021;8:e000951. doi: 10.1136/bmjresp-2021-000951

• Ethnic minorities exhibit higher multimorbidity despite younger age structures and disproportionate exposure to unscored risk factors including obesity and deprivation. Household overcrowding, air pollution, housing quality and adult skills deprivation are associated with multilobar pneumonia on presentation and ICU admission which are mortality risk factors. Risk tools need to reflect risks predominantly affecting ethnic minorities.

Decision‐support tools via mobile devices to improve quality of care in primary healthcare settings.

Decision‐support tools via mobile devices to improve quality of care in primary healthcare settings.
Cochrane Database of Systematic Reviews 27 July 2021, Issue 7. Art. No.: CD012944. DOI: 10.1002/14651858.CD012944.pub2.

• A systematic review identified 8 RCTs (none from UK) of examining the effect of decision‐support tools on mobile phones on primary health care, but the evidence is not clear about the effects of these tools on patients' and clients' behaviour and on their health.

What has been the effect of the coronavirus pandemic on key population health outcome measures?

What has been the effect of the coronavirus pandemic on key population health outcome measures?
The Strategy Unit 9 July 2021

• This report begins by explaining the different sources of information on Covid-19 deaths before comparing approaches to estimating ‘excess deaths’ — a better, more complete measure of the coronavirus pandemic’s overall mortality impact. In the second half of the report, we implement a set of actuarial and public health metrics — standardised death rates, years-of-life-lost and life expectancy — that offer a different perspective on the pandemic’s effect on population health.

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).

Projecting the effect of easing societal restrictions on non-COVID-19 emergency demand in the UK

Projecting the effect of easing societal restrictions on non-COVID-19 emergency demand in the UK: Statistical inference using public mobility data. 

Int J Health Plann Manage. 2021 Jul 1. doi: 10.1002/hpm.3265. Epub ahead of print. PMID: 34212400.

• A study using activity data for A&E attendances and emergency admissions for all hospitals within the Bristol, North Somerset and South Gloucestershire healthcare system were regressed upon publicly available mobility data obtained from Google's Community Mobility Reports for the local area. The models were used to predict non-COVID-19 emergency demand under the UK Government's plan to sequentially lift all restrictions. 
• The study concludes that non-COVID-19 emergency demand associates with the level of societal restrictions, with rates of public mobility representing a key determinant.

Reducing preventable admissions to hospital and long-term care – A High Impact Change Model from LGA

Reducing preventable admissions to hospital and long-term care – A High Impact Change Model
LGA

• This High Impact Change Model aims to support local care, health, and wellbeing partners to work together to prevent, delay or divert the need for acute hospital or long-term bed-based care.
• The model focuses on two goals and five high impact changes that help realise one or both goals.
• The two goals are:
• Goal 1: Prevent crisis: Actions to prevent crises developing or advancing into preventable admissions
• Goal 2: Stop crisis becoming an admission: Actions to divert or prevent an attendance at A&E becoming an admittance to hospital or long-term bed-based care
• The five high impact changes and the goal or goals they relate to:
• Change 1: Population health management approach to identifying those most at risk (Goal 1)
• Change 2: Target and tailor interventions and support for those most at risk (Goal 1)
• Change 3: Practise effective multi-disciplinary working (Goals 1 and 2)
• Change 4: Educate and empower individuals to manage their health and wellbeing (Goals 1 and 2)
• Change 5: Provide a coordinated and rapid response to crises in the community (Goal 2)
• Case studies and supporting materials are included as appropriate.

Progressing digital transformation in healthcare 2021

Progressing digital transformation in Healthcare 2021
BT June 2021

• Working with iGov Survey, BT surveyed decision-makers from 69 UK healthcare providers to find out what they see as the biggest opportunities and barriers to delivering improved digital healthcare in the wake of the pandemic.

Modelling tool to support decision-making in the NHS Health Check programme

Modelling tool to support decision-making in the NHS Health Check programme: workshops, systematic review and co-production with users.
Health Technology Assessment 2021;25(35)

• This report discusses how delivery of the NHS Health Checks programme could be improved, in particular by the use of a web-based tool - workHORSE (working Health Outcomes Research Simulation Environment). A series of workshops with commissioners resulted in a useful ‘real-world’ tool for local commissioners that can calculate the current and potential future benefits of different programmes. The study examined different delivery programmes and their benefit in health and value and impact and reducing inequalities.