Associate Feature: The environment of creative thought

GRAHAM Watson wants to hear some ideas.

Not just any old idea, but ideas that have the potential to be “transformative” for patients, for clinicians, and for the health service. 
The veteran corporate finance expert spent most of the last four decades working with start-ups and SMEs, ferreting out the brightest of proposals and taking them from the notepads of entrepreneurs to real world applications.

He’s worked with FTSE 100 companies, and there was a stint living and working in Silicon Valley.

But for the last five years he’s been in charge of Scottish Health Innovations (SHIL), a private company formed twenty years by Scottish ministers to protect intellectual property generated from NHS Scotland employees. 

The press has over the last two decades often described SHIL as the “commercial arm” of the NHS in Scotland, but that’s not quite right.

The process is relatively straightforward. If someone in the health service has an idea for a device, a process, or a piece of software or piece of equipment that can make life for patients or clinicians a little bit easier, they can approach SHIL. 

And if SHIL think it has potential they can help find funding for it, secure and protect the intellectual property rights, ensure regulatory requirements are met and provide all forms of project management, development, business planning and commercialisation expertise. 

So far, over 2,000 ideas have been submitted to SHIL, and a number of the resulting devices, products and technologies are now in use internationally across hospital and care settings. From the simple Rhinopinch which helps staunch nose bleeds, to surgical instruments, software and more.

They’ve also formed seven new spin-out companies, negotiated multiple commercial license deals with companies both within the UK and internationally, and protected the intellectual property, trademark, copyright and design rights for over 250 NHS inventions.

A new strategy ‘Innovating Together’ launched in March 2021. 

“Our approach is very much to work with the health service, with academic institutions, with startups, with innovators, wherever they’re located so that ultimately, we can see the opportunity to benefit patients in Scotland, and secondly, benefit the NHS financially,” Watson tells Holyrood.

“That’s kind of the mantra of SHIL,” he adds. 

He describes the company as an “interface between the idea and the health service” able to collaborate in a way “in which the health service not only ends up with, hopefully, ideas that can be used in the clinical setting but also provide social and economic advantages to Scotland. ”

“There’s no point in the NHS using its muscle and its network and its talent and not benefiting financially if that exists as an opportunity,” he adds.

Much like every corner of the health service, Watson and his team have been massively impacted by the COVID pandemic. 

But it’s also left the organisation facing maybe the biggest moment in its history. 

While the NHS has been stretched, it’s also been transformed. Developments that would have been unthinkable in January 2020 – telemedicine, fast-track regulation processes – have now become the norm.  

Patients have accepted a decade of technological progress in six months.

“If you think pre-COVID, would people have been comfortable with telemedicine delivery of service, virtual pharmacies, and all these sorts of things?” Watson asks. 

“You see it throughout the world,” he adds. “You’ve seen many, many cases of transformative delivery of care through the last 18 months.” 

The pandemic has also led to a spike in the number of ideas coming to SHIL. 

“I think it’s partly because of people thinking of things that could alleviate the challenges of COVID,” Watson says. “But it’s also clearly in other areas where perhaps clinicians have had less of the normal day to day job because there haven’t been the normal volumes of elective procedures taking place for example, that they have time. 

“Time’s typically the critical factor here. People have ideas but they have no time to work on them, and therefore often they just get parked and subsequently we find someone comes to us with an idea, they’ve had it for ages but they’ve just never had the opportunity, the time, the support to actually bring it forward and have it considered.” 

Traditionally, he says, health boards supported SHIL “conceptually,” but were perhaps reluctant to give busy clinicians the time away from delivering patient care to develop their ideas.

The pandemic has been "transformative" says Graham Watson of SHIL

But in recent years there’s been an acceptance of the long-term benefits of supporting staff to work on projects with SHIL – the benefits of working together to accelerate innovations from within the health service are increasingly recognised. 

What also makes the timing optimal, Watson says, is where the technology is. 

“We’re seeing the growth of telemedicine, we’re seeing new models of delivering care in different settings, what more can you do in the home, what more can you do in local settings rather than perhaps big speciality centres?

“So, you know, the environment of creative thought, to use the assets that we currently have more efficiently, more effectively, take advantage of trends that are beginning to become accepted and do more with that means throughout the service in Scotland, leadership at all levels recognises that impactful innovations matter. 

“We need to create the environment where people are encouraged to come forward, people are supported, given time, given resource, and given expertise so that the ideas can flourish.” 

The pandemic has also, he says, provided an impetus to get things done. Watson points to a recent project, a resuscitation hood that reduces the risk of COVID for first responders. 

The SARUS-CPR hood – invented by Professor Peter Stonebridge, NHS Tayside’s medical director – is a small lightweight hood made from transparent fabric which creates a barrier between the patient and the individual performing resuscitation.

It’s due to be rolled out across the UK later this year.

“The idea was put together very rapidly, commercialised within less than nine months. Certainly at a pace which would have been difficult to anticipate pre-COVID,” Watson says. 

“I think it would have taken at least double the time because there wouldn’t have been the impetus, there wouldn’t have been the surrounding circumstances where people just got on and did things.” 

At the heart of SHIL’s new strategy is collaboration, working across the sector, bringing the right people together to ensure innovations of substance and scale can be expedited onto the market. 

Part of this involves working with partners across the NHS to identify specific challenges and to call out for specific ideas. 

In August they launched a “frailty” innovation call. It’s worth noting here that frailty doesn’t just mean elderly, though with one-fifth of Scots being over 65, our ageing population is undoubtedly one of the biggest challenges facing health care professionals in Scotland.

Rather, the term is used to describe how someone might be able to recover following health problems. A frail person might be someone with a disability, or who needs long-term care or has long-term health conditions such as COPD, asthma, epilepsy or diabetes.

Timely identification of people living with frailty can help the health service plan for future health and care needs, it can reduce inequalities in care and reduce the risk of harms. It can ultimately mean fewer admissions into A&E and better continuity of care for patients.

“The notion that there must be more that can be done to create an environment where these sorts of things are happening we feel has been under-tapped within Scotland,” Watson said.

“We’re seeing occasional local examples where clinicians are giving a priority to frailty, so they’re putting certain processes in place to give better advice and getting better results as a consequence.

“Everything we’ve seen over the last few months has led us to conclude that if you could encourage new, innovative ideas in delivering solutions to frailty challenges, then you will be helping patients, you’ll be reducing costs in the system, and you’ll be achieving better outcomes.”

This, Watson suggests, could be wearable tech, something that could predict falls in vulnerable people, orthopaedic implants that could improve or prevent systems of osteoporosis, gadgets that could monitor for macular degeneration, a form of sight loss. 

“I think there’s a significant technology component again, it meets the moment because technology is playing a greater role. We’ve seen it around telemedicine, and the digital health agenda, more generally. 

“So, tech solutions that enable improved condition management, all of these things seem to us to be ready for investing and support.” 

“We’ve heard from the people we work with that there’s a need. They want to see better solutions. And so we’re pretty sure that clinicians and others out in the frontline will have plenty of thoughts.

“Of course it takes funding to go from idea to market launch,” he adds. “But Scotland, both directly through its very well developed Business Angel networks, through its private equity community, and other sources certainly has access to and an appetite to fund good ideas. 

“The international market for capital for healthcare is also buoyant.

“Funds are not the limiting factors, quality of ideas, is the limiting factor, and time.” 

It is where SHIL comes in – they work with the clinical teams, add the commercial expertise – intellectual property, medical device regulation, product development, business planning, funding and commercialisation – to expedite products onto the market. 

To submit to the latest innovation call visit www.shil.co.uk/frailty 
This article was sponsored by SHIL.