Healthcare Hot Topics - August 2022

In a time where the UK and Europe's governments and private businesses alike have embarked upon unprecedented data-driven digital innovation and transformation initiatives, healthcare in the metaverse is projected to be worth USD 5,373 million by 2030. The pharmaceutical industry has already started hosting conferences and creating virtual learning centres in the metaverse.

What opportunities are there beyond this? Building a virtual healthcare facility in the metaverse is no longer unaffordable. There is an opportunity for the healthcare industry to create a virtual accessible environment for patients. This would allow patients to learn more about treatment options specifically tailored to their needs. Activities could include engaging patients on advanced care and care concepts such as paediatrics and oncology. Healthcare facilities have the option of expanding their reach in telehealth towards a universal audience and providing a fully immersive experience beyond that of a Zoom call. Read Partner, Nathalie Moreno's article 'Balancing the power of data in digital health innovation'.

The NHS has launched a new offering, the NHS Innovation Service. This is operated by the NHS Accelerated Access Collaborative (AAC) and has been created to provide access to support and guidance from organisations with expertise in the development and adoption of HealthTech. Supported by key organisations including NICE, the MHRA and NHS Supply Chain, its aim is to provide the right support for individuals and companies at all stages of their innovation journey, including steps on the evidence required to introduce a new innovation, and the NHS procurement and reimbursement processes. The NHS Innovation Service is a replacement for HealthTech Connect.

What should a health and social care workforce strategy look like? This week's cross-party parliamentary report on the NHS and social care workforce paints a bleak picture. The NHS and social care face the greatest workforce crisis in their history, compounded by the absence of a credible government strategy to tackle the situation, say MPs. In the NHS, persistent understaffing poses a serious risk to staff and patient safety in routine and emergency care. The committee points out that the NHS has struggled with 12,000 hospital doctor vacancies and more than 50,000 nurse and midwife vacancies. Many thousands of these cannot be filled with temporary staff. The situation, in most respects, is worse in social care. In the words of the committee, “it is time to stop photographing the problem and deal with it.” To do so, the report is clear that credible NHS and social care workforce strategies are necessary.

The UK Government is seeking views on the design, development, evaluation and use of medical devices. An independent review has been commissioned, which aims to establish where potential biases may arise in the entire lifecycle of medical devices. The definitions of medical devices are in accordance with the Medical Devices Regulations 2002 (SI 2002 No 618, as amended) (UK MDR 2002). A medical device is any type of physical device or software that is used for diagnosis or therapeutic purposes. The review focuses on all types of medical device including devices employing infrared light or imaging that may perform differently depending on skin pigmentation of the patient, as well as artificial intelligence (AI) enabled applications used in diagnostics and for making decisions about healthcare.

The Government intends to make recommendations for more impartial solutions. The review will collect existing data and evidence, as well as information on ongoing data collection and research projects. This will be of interest to those who engage in any way in the design, development, evaluation and use of medical devices. The consultation closes on 6 October 2022.

The Department for Business, Energy and Industrial Strategy (BEIS) has published its first Annual Report on the National Security and Investment Act 2021 (NSIA) since it came into force in January 2022. The Secretary of State for BEIS has issued the first-ever order under the regime preventing the acquisition of certain intellectual property by a Chinese company on national security grounds.

The University of Manchester and Beijing Infinite Vision Technology Company Ltd. (Beijing Infinite), a Chinese technology company specialising in 3G rendering technologies, had entered a licence agreement that would enable Beijing Infinite to use vision-sensing technology developed at the University of Manchester. The technology revolves around a 'vision chip' that could enable the next generation of autonomous robots with both civilian and military applications. However, the order states, "there is potential that the technology could be used to build defence or technological capabilities which may present national security risk to the United Kingdom". This was ultimately deemed a potential national security risk, and the final order had the effect of preventing the licence from proceeding.

Addleshaw Goddard Partner, Stephen Mcloughlin, published an article which takes the view that the Oireachtas missed an opportunity when amending the Regulated Professions (Health and Social Care) (Amendment) Act 2020. The Act was enacted by the Oireachtas in late 2020 to streamline the legislative processes for five of the major healthcare regulators in the State, the Medical Council, the Pharmaceutical Society of Ireland, the Dental Council of Ireland, the Nursing and Midwifery Board of Ireland, and the Health and Social Care Professionals Council (CORU).

The Oireachtas missed an opportunity to reform the structures of the existing fitness-to-practise processes, having regard to the increasing number and complexity of cases. In particular, the Oireachtas failed to address the role of the FTP/inquiry committee and the role of the Council/Board in sanctioning professionals, which is considered anomalous and places a significant burden on the Council/Board in the performance of its functions. The article also sets out an alternative approach, which would potentially work more effectively for regulators and enable the regulatory process to run more efficiently and effectively for all participants in the inquiry process.

From July 2022, nurses, occupational therapists, pharmacists and physiotherapists can all legally certify fit notes, reducing the pressure on NHS doctors and scrapping unnecessary bureaucracy. Updated guidance to health care professionals has been published, setting out how to support people to remain in work while managing a health condition. This has been agreed with health professionals and the Department of Health and Social Care to ensure these changes deliver benefits for both patients and clinicians.

This significant change recognises the importance of supporting people to remain in work, while managing a health condition by providing advice to an employer about how to support someone. The change, which applies across England, Scotland and Wales, will empower better conversations about work and health between employers and staff by making it easier to get advice certified by the most relevant healthcare professional. Read Associate, Anita Mulholland's related article 'UK healthcare professionals can now certify fit notes'.

The government has published guidance on the preparation of integrated care strategies. This guidance has been developed by the Department of Health and Social Care, Local Government Association and NHS England, in partnership with the Care Provider Alliance. It explains how integrated care providers and adult social care providers are expected to work together.

Throughout England, considerable work on integration has already taken place, including through health and wellbeing boards to develop strategies that support more integrated approaches to delivering health and care. The integrated care strategy should build on that existing work and momentum to further the transformative change needed to tackle challenges such as reducing disparities in health and social care; improving quality and performance; preventing mental and physical ill health; maximising independence and preventing care needs, by promoting control, choice and flexibility in how people receive care and support.

NHS England has created an updated national strategic framework containing principles for health emergency preparedness, resilience and response (EPRR) for NHS-funded organisations in England (Framework). The aim of the Framework is to enable the NHS in England to ensure effective arrangements are in place to deliver appropriate care to patients affected by an emergency or incident (i.e. to inform the planning for, and responding to, health service incidents and emergencies). The Framework itself sets out guidance, which is applicable to: NHS Trusts, Foundation Trusts and Care Trusts; NHS-funded primary care providers; NHS-funded independent and third sector providers; and NHS commissioners (including NHS England and Integrated Care Boards (ICBs)). The Framework may also be applicable to other arm's length bodies providing NHS services.

The updated Framework reflects the changes introduced by the Health and Care Act 2022, the dissolution of Clinical Commissioning Groups and establishment of ICBs in their place. The objectives of the Framework are: to prepare for the common consequences of incidents and emergencies rather than for every individual emergency scenario; to have flexible arrangements for responding to incidents and emergencies, which can be scalable and adapted to work in a wide range of specific scenarios; to supplement this with specific planning and capability building for the most concerning risks as identified as part of the wider UK resilience; and to ensure that plans are in place to recover and learn from incidents and emergencies and to provide appropriate support to affected communities.

NHS England has published directions relating to the establishment of the Healthcare Safety Investigation Branch (HSIB) from July 2022. The HSIB was originally part of the NHS Trust Development Authority, which was abolished by the Health and Care Act 2022 on 1 July 2022. These directions relate to continuing the promotion in England of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England, and in the prevention, diagnosis and treatment of physical and mental illness. The NHS carries out investigations into patient safety incidents. Their investigations are delivered through two programmes, national and maternity. There are differences in how the investigations are carried out and how reports are published but the aims are to share learning and to make safety recommendations that improve safety at a national level.