How can universities help shape healthcare for the future?

Health equity and access to care are challenged like never before. Access to care and life expectancy seem to depend on where people live and their net worth. Health equity has become the root and cause of social equity. Clearly, there is no “silver bullet” to solving this complex societal?problem that has evolved over decades, and, here in the UK, it is for politicians and policy experts to thrash out answers on the immediate questions such as pay for NHS staff and on what a sustainable funding model would look like in the future. What is clear to me is that we need new solutions for healthcare based on an ecosystem approach, comprehensive stakeholder alliances and digitalisation, to name a few.

I am interested in how universities can help relieve pressures on the National Health Service by creating better solutions for the future of healthcare. With a record high of almost?7.21 million people waiting for treatment ?and over?133,000 secondary care staff vacancies , this question is one of the grand challenges informing Aston University’s 2030 strategy and the conversations my team and I are having with local partners here in Birmingham and the UK more widely. To me, the answer to this question is multifaceted.?

1.??????Developing future healthcare professionals

The UK needs more?healthcare professionals . As a?recent report ?by?the think tank Policy Exchange set out, the case to expand medical school places and, by extension, students’ clinical placements, is compelling. Aston Medical School welcomed its first cohort of undergraduate medical students, backed by government funding, in 2018. A new type of Medical School driving diversity and inclusion in community healthcare. We have huge pent-up demand from hundreds of well-qualified applicants, and we hear from our colleagues in schools that some are looking to medical schools abroad to realise their ambitions. Medical schools are constrained in a way that no longer makes sense given the dire situation in the NHS. We are building the?School’s?capacity to respond to any further calls from the government to expand, and it is my hope that this call comes sooner rather than later. But it takes over a decade to?train a doctor , so vital though this is, it can only ever be part of the solution and does not address the more systemic issues and the immediate workforce pressures.?

So, from September of this year, Aston University will be launching a degree in adult nursing, where there are?significant vacancies ?yet?high demand from students , as well as recruiting its first cohort of physician associates. Physician associates are medically trained, generalist healthcare professionals, who work alongside doctors, for example by taking medical histories from patients, carrying out physical examinations, and seeing patients with long-term chronic conditions. I expect to see this rapidly growing new profession play a significant role in improving productivity and relieving pressure on the NHS, especially given how impactful this position has been on healthcare in the United States.

Another avenue for managing workforce pressures is upskilling healthcare professionals already in clinical practice. Through courses such as the Pharmacist Independent Prescribing Practice Certificate or the Advanced Clinical Practice in Ocular Health MSc, Aston is developing healthcare professionals already in the workforce who can take on a more complex range of cases.?

2.?????Applying educational technologies for new modes of learning?

Healthcare professionals such as pharmacists, nurses, mental health practitioners, optometrists and audiologists play a key role at the front line of patient care in communities, and with unprecedented hospital waiting lists, their roles will become ever more important. Investment in their training is crucial.?Technology developments supported by new investments, such as from the Office for Students ?in new simulation facilities at Aston, will better prepare students for the future of work. For example, the University’s optometry simulation suite, unique in Europe, will be further enhanced using simulated learning environments based on augmented reality and virtual reality, and similar educational technologies are used in nursing, medical imaging and other healthcare training. Students who learn and refine their skills in a realistic instrument environments are better prepared for the world of work.

This is not just about training university students; digital education technologies and approaches can also be used to enable the upskilling and reskilling of experienced practitioners, often remotely, at scale and pace.

3.?????Opening up expertise and facilities to serve the community

Meanwhile, as a key tenet of the Aston University 2030 strategy, we are developing a 21st?century, technology-enabled Health Services Hub on the Aston campus, involving a broad stakeholder alliance of local NHS partners, technology companies and business partners. The Hub will offer comprehensive health and wellbeing services for all our students and the local community, with a particular focus on young adults and children. The Hub will bring together new primary health services provision and existing optometry, audiology, medical imaging and dentistry clinics, providing a ‘front door’ to community health services on campus and delivering personalised health solutions that support our students and community towards healthy living. It will operate as a triage service in some areas to relieve pressure on the NHS workforce and reduce patient waiting times, whilst providing our health care students with essential clinical experience.?

Another way in which the Hub will directly support local NHS trusts is by creating a “living innovation lab” for co-designing, prototyping and testing innovative healthcare solutions and then translating proven solutions into mainstream practice.

Aston’s strategic NHS relationships will be critical to the success of the Hub: it is only by working together that we will create a centre of excellence that meets the unique needs of our students, the local community and NHS services in our city and beyond.

4.?????Improving healthcare productivity through digitalisation?

Innovation, with digitalisation at its heart, is critical to transforming healthcare and supporting the NHS to thrive. Over the past decade we have seen Industry 4.0 transformations across the manufacturing sector that have resulted in significant productivity gains through digitalisation. It is time for the healthcare sector to also embrace Industry 4.0 technologies and processes, and shift from a hospital-based model to a patient-centric model. We have seen throughout the COVID pandemic the benefits and potential of digital health, primarily through roll out of Telehealth solutions, online prescriptions and deliveries at scale. Artificial Intelligence (AI) is also making significant progress in enhancing diagnostics through medical imaging.?

In order to improve healthcare productivity through digitalisation, we need to approach healthcare as a complex service system with all the complexities of service delivery and supply chain issues. Like smart factories, we will be developing in the future smart hospitals using Cloud technologies, Internet of Things (IoT), sensors, mobile devices and automation to improve service delivery. This will allow us to achieve efficiencies in many areas, from triaging inquiries and managing demand, optimizing procurement of hospital equipment and supplies, and managing the ambulance service and emergency units, to the real-time remote monitoring of patients’ vital signs within and outside of hospitals. Intelligent data analytics, digital twins, augmented and virtual reality, and ultimately metaverse, will help?advance predictive diagnostics and empower patients to manage their conditions and lifestyles?in a timelier manner, thus reducing the scale of interventions required in hospitals.?

Embedded into the Aston University 2030 strategy is the Aston Digital Health Innovation Hub coupled with the new?Aston Digital Futures Institute , which will be exploring, developing and prototyping these innovative digital health solutions in partnership with NHS, digital tech companies, businesses, community and other stakeholders, and translating them into practice via a Clinical Trials Centre. This work is currently being scoped and will be embedded within the Aston Health Services Hub. It is this integrated and partnered approach that gives confidence in our ability to make substantial contributions to improving healthcare productivity and shaping the future of healthcare in Birmingham and the UK.?

This is the time for collaboration, innovation and digitalisation, if we are to improve our current healthcare models, heath equity and access.

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