Fellows in focus: Clinicians as innovators – what’s the point?

Dr. Venothan Suri, GP in South Hillingdon, reflects on his time at ICHP as a Clinical Innovation Fellow, providing clinical expertise and support to the North West London Mission-led approach to Cardiovascular Disease.  

As a GP, being on the frontline has given me real insight into challenges for both patients and clinicians in North West London, and into ways the system could adapt to meet these. Often in busy clinical surgeries there is isn’t dedicated time to think about innovation. However, in my role as a Clinical Innovation Fellow at ICHP, embedded in their team focused on Cardiovascular Disease (CVD), I’ve had the the head space to think about how we do things differently in our patch, for the benefit of patients, colleagues and the system.  

Connecting and supporting innovators

One of my key roles as a Fellow is to connect with and support innovators and colleagues from industry. I’ve worked closely with innovator colleagues to advise on how their product can be best implemented into the system – particularly where they align with local priorities. I’ve provided clinical expertise and feedback on a number of innovations, including whether their solutions meets the needs or challenges of our system, and worked with colleagues to undertake horizon scanning, with a view to developing and implementing effective solutions that we can scale across NW London. It’s crucial that this clinical expertise, from someone with real-world experience, is part of the process from as early as possible – this supports innovators in ensuring that their solution is optimised for provider uptake.  

I’ve collaborated with over ten companies in this way and have been able to apply my experience across the innovation journey, from conception to implementation. I’ve been able to share my experience of patient pathways which are aligned to specific products, to ensure that any addition is only “positively disruptive”. 

Working with industry colleagues has given me insight into the challenges that innovators can often face – including barriers in how the system can access funding for innovation. With the current financial constraints the system is facing, and a focus on efficiency,  if the NHS is to truly adapt and evolve, clinicians need to be given dedicated time out of their day jobs to focus on innovation, as well as a streamlined process to for companies to access funding for innovation. 

It’s crucial that this clinical expertise, from someone with real-world experience, is part of the process from as early as possible

Putting patient safety at the heart of the work 

A key benefit of this role to the system of this is my ability to bring a strong understanding of clinical governance to the table, and ensuring that patient safety and a high burden of evidence remains a priority. I’ve been able to interrogate the evidence base proposed by certain innovators, advise them if their evidence argument can be strengthened or reframed, and ultimately make recommendations to system colleagues based on this interpretation. This role as an honest broker is key to supporting our innovators to develop the most compelling arguments for their product’s benefit to system, and to allow our system and patients to be reassured about the value-add of any new implementation.  

A notable achievement has been the recent roll out of a lipid point of care test locally which has started to generate data. This was satisfying as a lot of preparatory work had been undertaken to aid with the implementation. From assisting with funding to ensuring clinical governance, I realised the depth of requirements needed to take a product to market and implementation. 

Learning from other healthcare systems 

This role has also given me insight into how international healthcare systems structure Cardiovascular pathways and use technology. I recently attended a Heart Failure course in Vienna which allowed me to compare different healthcare systems: from Sudan where you needed to be airlifted to another country for a Coronary Artery Bypass Grafting, to Germany where one hospital alone carries out more insertions of left ventricular assist devices than the entirety of the UK!  

Working at the coal face allows me to appropriately advise European innovators, on how best to engage with the NHS. I ran an innovation surgery for a non-UK based innovator whose cost saving model for Heart Failure diagnosis was based on reduction of need for a certain type of imaging (CT Coronary Angiography). It was clear that in this other health economy, this imaging modality was much more routinely used in heart failure diagnosis. I explained, in the UK, CT scanning is not a necessary part of the heart failure diagnosis pathway, which made their pathway and technology a challenge to implement here. Here I was able to provide the innovator early feedback prior to NHS engagement, saving the system time and resource. 

A focus on fostering innovation expertise amongst clinicians 

As a Clinical Innovation Fellow, I’ve felt embedded in the Mission team at ICHP, working alongside colleagues with a broad range of experiences and expertise, where I’ve felt well supported. As part of the team, I’ve been able to utilise my contacts in the system where additional input would support the Mission – for example engaging with Cardiologists where the Mission would benefit from additional secondary care input.  

Annually, the Mission team host a CVD Innovation Forum – an in-person event connecting key stakeholders and partners, including patients and innovators, across the system, and harnessing all that collective expertise and experience. Presenting at this forum has been a great opportunity for feedback on some of the innovations I have been assisting on. In April, I presented our local work on Hypertension case-finding initiatives – it was wonderful to hear what colleagues in surrounding boroughs were implementing as a basis for further ideas. The forum is also an opportunity for innovators and providers to collaborate with the hope that further connections occur beyond the forum itself.  

Exciting, different, novel, challenging, and a steep learning curve is how I would sum up my experience. A year on, although I feel I’ve familiarised myself with the role, there is plenty of evolution and diversity and always new areas of knowledge and skills to be gained. In my second year as a Fellow, I am particularly looking forward to the outcomes of the innovations I have supported with and hope I’ll start to see how they tangibly improve patient care. And I’m pleased to see continued commitment from ICHP and the system to ensuring that clinical expertise stays at the heart of each of the Missions.      

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