Associate Feature: Enabling recovery, reform and sustainability in health and social care

Across the world, research, development, and the application of innovation is transforming how we access and deliver healthcare. Data, analytics, cutting-edge technologies and treatments are transforming how we diagnose, treat, cure, and perhaps even more importantly prevent a range of diseases. Artificial intelligence and machine learning are supporting faster, more accurate and less invasive diagnoses. Devices and applications are collecting health data to help monitor patients and support treatment delivery. All the above modalities belong to what we currently describe as precision medicine or precision prevention.

The pandemic taught us what could be achieved through collaboration and the focused application of scientific innovation in a national crisis. The rapid development of new diagnostics, vaccines and therapeutics saved lives. 

We must maintain that momentum if we are to address backlogs in care, meet the ongoing healthcare needs of people across Scotland and begin to tackle the long-standing health inequalities in our communities. 

The benefits are clear but to advance the opportunities in Scotland; and ensure research, development and innovation plays a central role in the recovery and modernisation of our NHS, bold and co-ordinated action is required.  

As Scotland’s new Chief Scientist for Health, Professor Dame Anna Dominiczak explains:

“Scotland has huge potential as a world-leading location for research and innovation, but we must get everyone working together to truly maximise the opportunities and address the pressures and challenges facing health and social care.

“Our pandemic response demonstrated what could be achieved through a heightened spirit of collaboration and innovation, underpinned by brilliant science and radically different ways of working. 

“Going forward, I want to see this agility and commitment sustained, as we work to develop and implement innovative healthcare solutions that can transform outcomes and experiences for our patients, unlock the full potential of our workforce; and support a modern and sustainable health service that can better face both current and future pressures.”

Thinking differently and thinking innovatively is in our DNA. Scottish-led healthcare innovations include MRI scanners, ultrasound, and antibody therapies. These discoveries originated in Scotland and transformed healthcare globally. 

But the coming years will see an even greater explosion in potentially game-changing healthcare innovations. To seize these opportunities, the research, development and innovation capabilities of the nation must be centre stage.

With a unified health service that can operate at scale, renowned research institutions, world class medical experts, and high-quality electronic health data - Scotland has all the attributes to be the destination of choice to co-create, co-develop, and deliver the best healthcare innovations.

This is strengthened by our triple helix collaboration between the NHS, academia and industry working in partnership. This includes our world- leading life sciences sector in Scotland as well as many international partners, and has already resulted in significant inward investment in Scotland’s research and innovation infrastructure. Examples include the Industrial Centre for Artificial Intelligence Research in Digital Diagnostics, known as iCAIRD, and the UK’s first Medicines Manufacturing Innovation Centre.

Such recent infrastructure investments complement a legacy of support for research and innovation. For nearly 50 years the Chief Scientist Office (CSO) of Scottish Government has provided the supporting infrastructure for clinical research delivery across Scotland, supporting commercial, academic and charity funded studies.

This is being bolstered through new CSO initiatives to further improve collaboration between the NHS, industry and academia under the Scottish Health and Industry Partnership. This includes a new NHS Scotland Innovation Fellowship Programme which will support the development of an entrepreneurial approach and encourage cross sector collaboration. 

The new Accelerated National Innovation Adoption pathway, launched in June 2022, will deliver a once for Scotland approach to the identification, assessment, and adoption of innovative technologies. This brings together expertise from across the NHS and will focus on innovations which can deliver transformative change in areas of national priority. 

These efforts support the strategic and operational challenges to the delivery of the NHS Recovery Plan and align to bold actions set out to expand research and innovation capabilities and grow the life science sector. They are fully in step with Life Sciences Strategy for Scotland 2025 Vision, and form part of a collective, unified effort to build back better and support the NHS in delivering cutting edge healthcare for patient benefit.

Yet it is not all strategies and structures as Professor Dame Anna Dominiczak confirms:

“The drive to provide new prevention and treatments as well as efficient care pathways for our communities is a shared ambition. We are doing this on a once for Scotland basis – it is a highly collaborative, whole-system approach, and it is the model we need to achieve the speed and scale of adoption we want to see. 

“We are drawing on a strong pool of leading experts and already considering and assessing a strong pipeline of innovative propositions that could deliver significant improvements to the lives of people across Scotland.” 

Innovative solutions in development are ripe to support NHS challenges.  

• A digital tool to auto schedule theatre lists based on algorithms that work out anticipated time per procedure could improve theatre utilisation and provide opportunities to reduce long backlogs for surgical procedures. 
• Artificial Intelligence (AI) to support the prioritisation of high-risk images related to lung cancer could accelerate diagnosis and help reduce late-stage presentation of the disease. 
• Photo acquisition by GPs to allow some skin disease referrals to be managed virtually without the need for an outpatient appointment, and reduce waiting times for those that do.
• A new medical device to adjust insulin dosing in a dynamic manner and help control blood glucose levels, could reduce the risks of long-term complications such as blindness, amputation, kidney failure and premature death. 
• Medical drones to help critical medical supplies be delivered more efficiently, resulting in reduced waiting times for test results, timely provision of short life medicines such as chemotherapy medication, and equity of care between urban and remote rural communities.
• A digital service which transforms the end-to-end heart failure pathway resulting in better patient experience, shorter waiting times, waiting list reduction and improved clinical productivity.
• A new procedure using tiny cameras, within a vitamin sized capsule, to take highly accurate images of the lining of the bowel to look for signs of problems or diseases and a safe alternative to traditional colonoscopy. 
• A new diagnostic test, using a small capsule attached to a fine string, to identify cell changes in screening for oesophageal conditions and a more patient friendly test than endoscopy. 
• A genetic test applied before prescribing drugs that prevents adverse reactions to medicines in genetically predisposed individuals. 

Developing a culture of new, innovative thinking is fundamental to unlocking the potential of research, development, and innovation which will help to transform lives across Scotland. We must maintain the legacy of the pandemic and continue to accelerate science - driven innovation to support NHS recovery and deliver better care for people in Scotland. 

Doing so has the potential to support our growing life science sector and create new and exciting employment opportunities. Collaboration across the NHS, academia and industry will be critical if we are to succeed. However, the potential benefits are enormous and could lead to longer, healthier, happier lives for the people we care about, and exciting possibilities to place Scotland at the forefront of healthcare innovation.

This article is sponsored by the Chief Scientist Office