University Hospital Southampton NHS Foundation Trust

Emerging therapies and technologies are revolutionising patient care. I am constantly impressed by the innovation and ambition of medtech around the globe.

However, there are many inventions that never reach the frontline. Often these promising devices fail in one or more of three crucial steps in their development:

- Relevance

- Effectiveness

- Implementation

A device can be prototyped and assessed but will not gain traction if it doesn’t have relevance in solving an acute real[1]world need. A technology can be relevant and identify a route to market, but it won’t be adopted if it doesn’t perform effectively. And pioneering innovations won’t reach patients if they can’t be integrated in clinical processes.

Focussing on Relevance

The first challenge is that when someone comes up with a new idea, they can become very attached to it. They work on it a lot and become much invested. It can feel like their child. But this doesn’t mean at all that it is going to be useful or relevant to anyone else.

It’s important in these early stages to get advice on relevance without it costing too much or overly committing people. It’s a time for very rapid scoping. This can be helped by being experienced in the environment and prioritising engagement so you can sense test some of the outlandish things.

Sometimes things will fall at the first hurdle because we don’t inspire people adequately. There are inventions that people don’t realise they need until it is there. Nobody knew they needed the iPhone until it was available. That’s the inventor’s challenge.

Gathering Evidence of Effectiveness

Once you know an idea will be useful, you will need evidence to drive its implementation. This is a difficult environment to navigate if you don’t know much about it. There are a lot of regulations that may or may not need to be abided, but also governance processes like ethics, HR or MHRA approval.

In the NHS, you will need clinicians with research experience or researchers that can write protocols for how you would test it. You also have to assess what level of evidence you need and how much evidence you need. You will need a delivery mechanism with coordinators, nurses and various other people to do it.

This step can become quite expensive quickly because every part of what you do is costed. There are innovative ways of working out funding but people have to believe in your product to give it the time of day.

Entering Clinical Service

Once an innovation has been tested and approved, the final step is to implement the device in the healthcare system. Quite often, the people implementing a technology are different to those that helped with the initial scoping and testing. Sometimes it will require one team, but others will need lots of teams. For instance, the new process may need to be adopted by clinicians, an IT department or governance managers.

Working on implementation is quite important from the start because you might be able to deal with some of the issues during your clinical trial. You can gather evidence of what implementation is going to be needed or use the process to help drive some of the future uses.

One of the complications when promoting uptake is scaling a technology from a single site to many sites. Processes can grow disconnected and adoption becomes complicated. There needs to be great care that communication is clear in this pivotal last stage.

Healthcare Technologies of The Future

University Hospital Southampton NHS Foundation Trust is focussed on smoothing this pathway so more technologies can transform patient care. We are launching the Southampton Emerging Therapies and Technologies (SETT) Centre to catalyse research and innovation on NHS needs in emerging areas. The Centre covers emerging therapies, data and AI, medtech and innovation.

We are going to simplify these three steps by doing things in a standardised way and directing people so that they don’t get caught in the wrong part of the process. We are determined to deliver services that will build clinical capability as part of research. Over time, this will shorten the gap between testing and implementing new medical technologies.

At the core of our research and innovation is the NIHR Southampton Biomedical Research Centre that takes new discoveries, treatments and technologies into the clinic. Our longstanding NIHR Clinical Research Facility is supporting these and other early-stage trials.

Southampton is a growing hub for medical technologies. Working together, we will drive the next generation of hospital services.