Until tackling health inequalities becomes business as usual, innovation is our best chance of equity. By Dr. Stuart Monk

This blog post was originally published on the Health Innovation Network website

Dr Stuart Monk, National Programme Director for the Accelerated Access Collaborative (AAC) Programmes at the Health Innovation Network, talks about the pivotal role of innovation tackling healthcare inequalities in the NHS.

At the Royal Society of Medicine’s Tackling Inequalities conference last month, it was clear from the passion in the room that great progress has been made across the system to better support some of our most under-served communities. To maintain this momentum, we must not just embed tackling health and healthcare inequalities in all that we do, but keep making greater strides towards equity, through intentional, tailored, local innovation programmes.

Ten years of innovating in the NHS has demonstrated that successful innovation adoption isn’t about taking an off-the-shelf product and delivering it to colleagues in health and social care. It’s about collaboration and adaptation. At the Health Innovation Network we always deliver geographically-tailored approaches in partnership with local systems and wider ecosystem partners. This level of flexibility in approach becomes even more significant when it comes to tackling healthcare inequalities.

As a Network, we deliver NHS England’s Innovation for Healthcare Inequalities Programme (InHIP), in collaboration with the AAC, Healthcare Inequalities Improvement Programme team, and Integrated Care Systems (ICSs). The programme was designed to support ICSs to test new approaches that aim to improve access to innovation in under-served communities, with a view to using the learning acquired to continue locally-led initiatives and work in tackling healthcare inequalities at a system level.

Instead of designing one programme for the whole country, this approach enables each local system to focus on a clinical area most relevant to their population. Through the programme, 38 unique ICS projects have been funded across England to improve access to latest health technologies and medicines in line with the Core20PLUS5 approach. So far, these projects have had direct engagement with over 20,000 people in under-served populations across the country.

The East Midlands focused on identifying un-diagnosed atrial fibrillation (AF) and hypertension (HTN) within black African, black Caribbean and South Asian communities, using a handheld AF-detection device called Docobo alongside some heart health education. It was co-developed with the ICS’s Population Health team and Northamptonshire Black Communities Together, Health Innovation East Midlands, public health and social prescribing services, in collaboration with eight community partner organisations. To date, 424 people have been tested, with the identification of potentially 25 with AF, 19 with other cardiac issues, and 138 with high or very high blood pressure.

In Ilfracombe in North Devon, where there is a 15-year lower life expectancy than in more affluent areas of the region(1), a primary care outreach service is improving access to routine healthcare assessments, including colorectal cancer testing, for residents at high risk of ill health and premature death. Using an innovation called a faecal immunochemical test (FIT), which can help detect signs of colorectal cancer early in a non-invasive and cost-effective way, they are making a crucial step in reducing disparities in the area, improving early cancer detection – and ultimately saving lives.

And in Greater Manchester, a pilot launched at the Royal Oldham Hospital (ROH), is taking an innovative whole-household approach to tackling asthma, that sees young people offered fractional exhaled nitric oxide (FeNO) testing, with a repeat test offered in a community-based setting as part of a follow-up consultation, and further family support. The works sets a blueprint for joined-up services designed around the needs of the whole family, and hopes to reduce the thousands of children and young people attending A&E due to asthma.

Taking proactive, innovative approaches like these help us to go further, faster in tackling healthcare inequalities, while delivering locally-tailored approaches across England also creates the conditions for rapid learning across the whole Network.

Moreover, introducing innovations with a focus on those in greatest need, based on building partnerships at a local level, including with our voluntary, community, faith, and social enterprise (VCFSE) sector, supports local systems to really understand the barriers communities are facing, and how innovation can break those barriers down, which can then inform day-to-day approaches and eventually become business as usual too.

Our Health Innovation Network team are working closely with regional and ICS health inequalities leaders across England. For more information, please visit www.thehealthinnovationnetwork.co.uk.

Stuart is the Network’s National Programme Director for our programmes delivered as part of the Accelerated Access Collaborative, focused on the spread and adoption of NICE recommended technologies.

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Author

Photo of Stuart Monk

Dr. Stuart Monk

Stuart has research, innovation and improvement experience across academia, sports governance, mobile phone product development and now healthcare innovation and improvement. His key principle is to embed an improvement culture and growth mindset in each team and organisation that he has worked with and alongside. His experience in Health Innovation Network has involved supporting innovators from all sectors, and facilitating adoption and spread of proven innovations across the NHS in England. He is passionate about turning the principles and theories underpinning implementation and scale into equitable patient access to care pathways and innovations.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none

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