6 March 2019


CONNECTED HEALTH CITIES


FUTURENORTH


Transforming lives across the North of England


Greater Manchester: Building Rapid Interventions to reduce antimicrobial resistance and over-prescribing of antibiotics (BRIT)


Antibiotic resistance is one of today’s most pressing healthcare concerns with England’s chief medical officer warning of ‘an antibiotic apocalypse’. Manchester CHC research has found that the current use of antibiotics is highly variable across the NHS, identifying northern, social-econom- ically deprived regions as antibiotic prescribing ‘hotspots’. The BRIT team have analysed


anonymised data from more than 20 million consultations across 400 GP practices, A&E departments and out-of-hours clinics to understand the drivers behind antibiotic prescribing across the UK. The research team, based at the University of Man- chester, worked with Public Health England to make this data available through the National Antibiotic Pre- scribing Dashboard. This dashboard offers healthcare stakeholders and policy makers insight into factors impacting the decision to issue anti- biotics to patients, such as practice location, duration of consultation and staff shortages. By providing access to this data, the dashboard empowers policy makers to develop more effective, evidence based, targeted anti- biotic optimisation strategies.


Greater Manchester (GM)


North West Coast (NWC)


North East and North Cumbria (NENC)


Connected Yorkshire (CY)


The recent launch of a second


dashboard co-designed with GPs (GP Antibiotic Prescribing dashboard) offers prescribers a data-driven understanding of their own practice’s prescribing behaviours. This tool provides practices with the informa- tion that they need to compare their own antibiotic prescribing patterns to national and regional prescribing rates, whilst seeing whether their patients are considered ‘high-risk’ or ‘low-risk’ of developing infection- related complications, to support the optimisation of antibiotic prescribing.


The National Antibiotics Prescrip- tion Dashboard is now open to public sector professionals working in a healthcare, government or research institution. To register, go to http:// britanalytics.uk.


North West Coast: Identifying admission patterns and targeting interventions in Chronic Obstructive Pulmonary Disease (COPD)


Chronic Obstructive Pulmonary Disease (COPD) is a long-term condi- tion that affects around three million people and leads to progressive breathlessness. In fact, its recurring flare-ups are the second most common cause of emergency medical admission in the UK. However, symptoms and severity vary from patient to patient, and managing the condition requires support from both clinicians and social support services. As part of the NWC CHC, a Data


Laboratory has been established at the University of Liverpool to identify admission patterns and targeted interventions in COPD. Researchers are performing clinical analysis on data from emergency admissions for COPD across the North West Coast. They have developed new clinical algorithms to help healthcare profes- sionals identify patients with COPD flare-ups. The Data Lab produces reports for


each hospital catchment area, allowing clinical teams to understand patterns of COPD admission. For example, COPD hospital admissions are more frequent in deprived areas where there are higher rates of smoking. Researchers are also using


geo-mapping techniques to illustrate COPD ‘hotspots’ where there are high hospital


admission rates. Together, the reports and geo-mapping tech-


niques provide valuable insights to local clinical teams, allowing them to see where resources such as primary care, emergency access, ambulances and community sup-


port networks should be allocated. This leads to improved planning of


services and targeting of social and NHS resources, as well as a much bet- ter experience for patients.


Yorkshire and the Humber: Supporting community care and reducing demand on A&E services


The UK has seen increasing pres- sure and demand on emergency services resulting in stretched resources to deliver the care needed for patients. Currently large amounts of data are collected on patients which remains in silos and is not used to improve their care. A programme to support com-


munity care and reducing demand on A&E services is linking routine data from the ambulance service, NHS 111, Emergency Departments and Hospital Trusts from across the Yorkshire and Humber region. The linkage produces a picture of the whole journey patients have from call to discharge from care. The data exists now for over 15 million patient contacts and the research team have tapped its potential. Analysis of the linked dataset


suggests that between 1 in 6 and 1 in 7 adults attend the Emergency Department with conditions that could easily be managed elsewhere. It has also found that a minimum of 1 in 6 ambulance journeys are avoidable and that around 20-30% of acute hospital admissions could be avoided lead- ing to huge cost savings for the health service. This dataset provides invalu-


able insights into how the NHS could be configured to save money whilst also delivering more appropriate care for patients. This will have direct benefit for local and national commissioning and policy direction by enabling the NHS to plan ahead and deliver services more effectively. The data used will, over time, tell a story that will help deliver better and more targeted care.


NHSA: a vision for a healthier, wealthier North


In 2015 the Northern Health Science Alliance (NHSA) had a vision for a healthier, wealthier North created by using the assets of the region to create a better future for its people. Health North: Connected Health Cit-


ies was born of that ambition. A project to use the North’s deep expertise, in a number of areas including health data, to create innovative solutions to solve real-world problems. The project caught the imagination


of many of those involved in it and the NHSA was allocated “Health North: Connected Health Cities” funding by the Government. The Northern Powerhouse is home


to 21% of the total UK life science sec- tor workforce and has grown by more than 9% to over 50,000 employees since 2012. Latest figures for 2017


show the value of this sector in the North to be over £13.6bn. The NHSA is an alliance of the top


research universities, NHS hospital trusts and the four Academic Health Science Networks across the North of England. Dr Hakim Yadi, its founding CEO, set about mapping the consider- able assets that these organisations comprised of. He said: “It soon became clear that


there were a number of unique fea- tures to the health research landscape across the North of the UK that could be used for a great project to help improve the lives of the people living there – and then scaled up across the UK and further afield.” Working with leading academics


such as Professor Iain Buchan, now at the University of Liverpool, Dr Yadi


discovered that there was a unique expertise in health data academia – with these academics ideally poised to work in an interdisciplinary manner with their local NHS Trusts, third sec- tor providers and other institutions in the area. The North’s population is also stable,


people who live in an area tend to stay there making it an ideal place to carry out research into improving patient health. Dr Yadi continues: “We spoke to


people across the alliance and soon dis- covered that not only was there unique expertise across the North’s cities and regions but also that it had region- specific issues that needed tackling. “Our thought was – why don’t we har-


ness the excellent minds and facilities we have here to tackle the problems


that the population needs addressing? This is where the idea of ‘connected health cities’’ came up. A system which continually used the information it was getting to improve itself.” The award-wining Connected


Health Cities is now a flagship project of NHSA which continues to deliver new projects under its Health North agenda. Recently it launched its Health for


Wealth report, commissioned by six of its top academics, which looks into the relationship between health and pro- ductivity and discovered poor health in the North means the UK misses out on £13.2bn a year in lost productivity. The NHSA has been awarded a


Northern Powerhouse in Health Research Science and Innovation Audit by Government, due to be


published shortly, which maps out the considerable assets across the region. And the NHSA has also been named


in the UK Industrial Strategy Life Sciences Sector Deal as a key driver for health innovation in the North of England - where it has uncovered £1.6bn of planned industry investment in the North’s life sciences sector. The success of Connected Health


Cities demonstrates that when invest- ment in placed into the North of England its clinicians, academics and support staff have the ability to deliver – and at scale – opportunities which build the health and wealth of region.


For more information on the Northern Health Science Alliance visit www. thenhsa.co.uk and follow us on Twitter @the_nhsa


North East and North Cumbria: Predictive Modelling for Unplanned Care in the North East and North Cumbria


The NHS is facing unprecedented policy and funding changes, ever-increasing workforce pressures, and an ageing population. NHS staff need to be able to plan ahead to best tackle these chal- lenges and to this with a strong evidence base to inform their decision making. In the North East and North Cum-


bria region, embedded within Durham University in collaboration with local GPs, councils and Trusts, predictive modelling for unplanned care has been providing the evidence for exactly this problem. The team are deliver- ing statistical models that can be used by analytics teams in healthcare and local authorities to produce daily A&E forecasts up to six months in advance, highlighting uncertainties and varia- tions in both urgent and emergency care, whilst facilitating planning and management in hospitals, walk-in centres and GP practices in a way that hasn’t been done before. The impact is research informed planning to meet changing patient population needs. Two apps developed provide practi-


cal modelling, scenario planning and decision-support tools for A&E and GP practices. These apps are being used by GPs in Darlington to better understand their patients’ current and future needs; planning staff allocation and recruitment to accommodate a growing and ageing population. This represents a long-needed move from reactive and silo-based planning to proactive population health planning. The A&E app provides local Trusts


with a better understanding of the types of emergencies and patient flows in A&E throughout the month, potentially allowing them to be better prepared to cope with periods of high demand. The impacts include an improved capacity to predict demand which can serve to both improve patient care and inform effective staff deployment.


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