annual review 2014-15 · during 2014-15 the health innovation network has made great progress in...

annual review20

14-15

Contentspages 4–5 Chairman’smessage

pages 6–7 ManagingDirector’smessage

pages 8–9 Overview

pages 10–13 Ecosystemdevelopment

pages 14–21 Patientandpopulationbenefits

pages 28–31 BoardMembers,SeniorResponsibleOfficersandClinicalDirectors

pages 22–27Valueimprovementandsupportingeconomicgrowth

What we do TheHealthInnovationNetworkistheAcademicHealthScienceNetwork(AHSN)forSouthLondon,oneof15AHSNsacrossEngland.

Weconnectacademics,NHScommissionersandproviders,localauthorities,patientsandpatientgroups,andindustryinordertoacceleratethespreadandadoptionofinnovationsandbestpractice,usingevidence-basedresearchacrosslargepopulations.

Workingascatalystsofchangeacrosshealthandsocialcareeconomies,weenablehealthimprovementsandeconomicgrowth.

TheHealthInnovationNetworkisactivelyworkingwithmemberorganisationsacrossthe12SouthLondonboroughstodriveinnovationandspreadbestpractice.

Ourmembersinclude:

2HealthInnovationNetwork AnnualReview2014-153

Chairman’s message The Health Innovation Network is proud to be supporting the health and care sector across South London. We are increasingly engaged with our members and are delighted to be seeing real improvements in health and care delivery through the accelerated adoption of innovation. The increasing national support for the Academic Health Science Networks (AHSNs) and the delivery of clear improvements in health and wealth from our projects mean that we are looking forward to delivering more improvements together with our members in the coming months and years.

TheHealthInnovationNetworkaimstoaddvaluetocomplexhealthecosystems,bothnationallyandlocally.InthewakeoftheFrancisandBerwickreports,ourgrowingrolesawAHSNsbeingaskedtoprovideleadershipofthelocalPatientSafetyCollaboratives.NHSEngland’sFiveYearForwardViewfurtherreinforcedtheroleofAHSNs,involvingthemintheNewCareModelsandTestBedProgrammes–someofthefirststepstowardssupportingimprovementandintegrationofservices.ThisisasignificantvoteofconfidenceintheAHSNs,andwearekeentobuildonthistrustinthecomingyear.

Wehavealsotakenamoreactiveleadershiproleinourlocalhealtheconomy.Forexample,weweredelightedtohelpbringtogetherthemajorprovidersofgeneticsservicesinSouthLondonintheirsuccessfulbidtobecomeanationallydesignatedGenomicMedicineCentre.TheHealthInnovationNetworkaddedvaluetothebidthroughdrawinginthirdsectorcolleagues,andbrokeringlinkswithKent,SurreyandSussexAHSN,recognisingpatientflowsintoLondoncentres.Onapan-Londonbasis,wesupportedtheMayor’sLondonHealthCommissionandhavebeencommissionedbyNHSEnglandtosupporttheirinteroperabilityprogramme.

Ourprojectsareallfocusedonimprovinghealthoutcomesandcreatingwealth.Thisyear’sprojectsaregainingrealtractionworkingwithourmemberstomakeimprovements.Ihavebeenparticularlypleasedtoseethenumberofpeople,bothinSouthLondonandfurtherafield,takingpartintheDiabetesImprovementCollaborative,usingourdementiatoolsandadoptingtheESCAPE-kneepainosteoarthritisprogramme.

MuchofoursuccesstodatehasbeenbuiltonChrisStreather’spersonalvisionanddrivetopromotetheHealthInnovationNetworkandthenationalAHSNNetwork.HisstrongrootsinSouthLondonmeanthewasknowntomembersandabletoengagemanyofyouactivelyinourwork.IwouldliketoexpressmyappreciationtoChrisashemovesontonewchallenges.WearegratefultoGuyBoersma,interimManagingDirector,fortakingonthisroleandguidingusskilfullythroughthistransition.WehavenowappointedasubstantiveManagingDirector,TaraDonnelly,whowillbringnewideasandenergytotherole,ablysupportedbytheexistingstrongmulti-professionalleadershipteam.

Ultimately,oursuccesswillbedeterminedbythecontinuedsupportandcontributionsofourmembers.Iwouldliketoexpressmythankstoallofyouwhohaveworkedwithusandsupportedourworkoverthepastyeartohelpdeliverprogrammesthatareeffectiveincontributingtoimprovingthehealthofourpopulation.Inparticular,IwouldliketoacknowledgetheroleoftheSeniorResponsibleOfficersforeachclinicaltheme,mostofwhomhaveadayjobasChiefExecutiveinoneofourmemberorganisations;andalsotheClinicalDirectors,whoworkforuspart-time,alongsideclinicalandacademicrolesacrossSouthLondon.Welookforwardtocontinuingtoworkwithyou,yourteamsandpatientsandserviceusersacrossSouthLondoninthecomingyearasweseerealimprovementsinhealthoutcomesfromourcollaborations.

Professor Richard Barker OBE Chairman


TheHealthInnovationNetwork,incommonwiththeotherAHSNsnationally,wasawardedalicencefromNHSEnglandbasedonthedeliveryoffourcoreobjectives:

1. Meetinghealthneedsoflocalpopulations

2. Buildingacultureofpartnershipandcollaboration

3. Speedinguptheadoptionofinnovationintopracticetoimprovepatientoutcomes

4. Creatingwealththroughco-development,evaluationandadoptionofnewproductsandservices

OurevolvingNetworkacrossSouthLondonstrivestomeettheseobjectivesinanintegratedway,drivingdeliverythroughasmallnumberofclinicalthemes(diabetes,musculoskeletal,alcoholanddementia)selectedasaresultofananalysisoflocalpopulationhealthneeds.Allindividualprojectswithinthesebroadthemeshavebeendevelopedandselectedwithinvolvementoflocalprofessionals,andwithinputfrompatientsandpublic,andthirdsectororganisations.Thisgivesusconfidencethatweareindeedmeetingthehealthneedsofourlocalpopulationsbytheinclusiveapproachthatwehavetakentodetermineourpriorities.

Allourprojectsinvolvemultiplepartners.Partnershipandcollaborationareintegraltoallthatwedo:bothcreatingaculturewherememberorganisationsvaluetheopportunitytolearnfromeachother,andthroughprojectsthatencourageworkingacrossboundaries,therebyhelpingtointegratefragmentedpatientpathways.

Manyofourprojectsarespecificallyaimedatincreasingimplementation,orspreadandadoption,ofevidence-basedinnovationstoimprovepatientoutcomes.Forexample,ourdiabetesteamwerekeentounderstandwhynewtechnologieswiththeabilitytotransformthelivesofthosewiththischronicconditionaresounderutilisedintheUK.Insulinpumps,firstdevelopedinSouthLondon,onlyreachasmallproportionofeligiblepatientswithtype1diabetes,basedonpredicteduptakefromtheNICEtechnologyappraisal.Ourdiabetesteambroughttogetherclinicalandmanagerialteamswithpatientsandinsulinandpumpmanufacturers,toforman‘ImprovementCollaborative’,takingteamsthroughastructuredprocesstoreviewandimprovetheirservices,inordertoincreaseaccesstonewtechnologiesincludinginsulinpumps.

OurmusculoskeletalthemehasalsofocusedonaSouthLondoninnovation,anexercise-basedinterventionforosteoarthritis(OA)kneepaincalled‘ESCAPE-pain’.Throughhighlightingthebenefitsofthisinterventionandprovidingsupporttonewsites,wehavesignificantlyincreasedthenumberofOApatientsbenefiting,andhavehighlightedsignificantpotentialcostbenefits.AlongsidethisworkwehavedevelopedanESCAPE-painwebsitetosupportprofessionalsinthedeliveryofESCAPE-paininamoresustainablemanner.

Creatingwealththroughco-developmentisourfourthobjective,andanexampleofourworkinthisareaisthepartnershipbetweenourdementiateamandacommercialdigitalcompany,IXICO.IXICOwasawardedfundingfromtheSmallBusinessResearchInitiative(SBRI)inordertoco-developanelectronicsupporttool(MyBrainBook)forpeoplewithdementiaandtheircarers.Followingaverypositiveinitialpilotsupportedbythirdsectorpartners,wearenowsupportingIXICO’sworkinLewisham,testingMyBrainBookingreaterdepth.

ThisAnnualReviewprovidesmoredetailabouttheseexcitingprojectsandothersuccessestodate,includinghowwearebuildingcollaborationswithourpartnerorganisations,suchasKing’sHealthPartnersandtheSouthLondonCollaborationforLeadershipinAppliedHealthResearchandCare(CLAHRC),toensurethegreatestpossibleimpactfromourcollectivework.Ourchallengefortheyearaheadistocontinuetodrivespreadandadoption,sowecandemonstratethatbest-practicecareandnewinnovationsareavailabletomoreandmorepeopleacrossSouthLondon.IamconfidentthatthenewlyappointedManagingDirector,TaraDonnelly,willleadtheHealthInnovationNetworksuccessfullytothenextphaseofitsdevelopment,makingadifferencetothepopulationofSouthLondonandbeyond.

Dr Chris StreatherManagingDirector(April2012toMarch2015)

Managing Director’s messageDuring 2014-15 the Health Innovation Network has made great progress in all programme areas, with tangible outputs being delivered by our multi-professional teams, supporting improvements in our member organisations and thereby touching the lives of patients and public across South London. I am delighted to be sharing highlights from the last 12 months in our second Annual Review.

AnnualReview2014-157

OverviewWhat we do In South LondonAcademicHealthScienceNetworks(AHSNs)servetoconnectacademics,NHScommissionersandproviders,localauthorities,patientsandpatientgroups,andindustryinordertoacceleratetheprocessofinnovationandfacilitatetheuptakeandspreadofresearchfindingsandbestpracticeacrosslargepopulations,improvinghealthandgeneratingeconomicgrowth.

Thereare15AHSNsacrossEnglandandweworkcollaborativelytogetherinordertoachievegreaterimpactfromourlocalinitiatives.

TheHealthInnovationNetworkistheAHSNforSouthLondon.Weareamembershiporganisation,embracingallhealthandcareorganisationsacrossthe12SouthLondonboroughs.Weworkinpartnershipwithindustry,patientorganisationsandthepublic,actingasacatalystandfacilitatorofchange.Ourambitionsaretoimprovepatientoutcomesandsupporteconomicgrowth,throughfacilitatingsystem-widechange.

Ourprogrammesfocusonlocalhealthpriorities,withclinicalthemesindiabetes,dementia,musculoskeletalandalcohol.WealsosupportimprovementsincancercaredeliveredbytheLondonCancerAlliance.Ourinnovationthemes–patientexperience,patientsafety,technologyandinformation,educationandtraining,andwealthcreation–underpintheclinicalprogrammes,aswellasprovidingdirectsupporttoourmembers.

Eachofourclinicalandinnovationthemeshasasmallnumberofspecificprojects,identifiedandshapedinpartnershipwithprofessionalsandexperts,andpatientsandpublicfromacrossSouthLondon.Ourphilosophyistopromoteself-careandencouragea‘wholeperson’approach,byintegratingphysical,mentalhealthandsocialcareacrosstraditionalboundaries.

In particularWe support greater uptake of proven innovations and best practice across whole populations, by:

• supportingprovidersandcommissionerstoidentify,adoptandspreadbestpractice,newtechnologiesandproveninterventions,toimproveoutcomesmorequicklyandatscale;

• developinganumberofeffectivetoolsandsharingtechniquesandmethodologiestosupportourmembersinqualityandserviceimprovement;

• activelyworkingtoalignourprioritiesandprojectswiththoseofourmembersandpartnerorganisations,inordertoachievegreaterimpact;

• encouragingandfosteringvalue-addingrelationshipswithindustry/commercialcompanies;

• shapingtailoredapproachesthatrespondtolocalneeds,forexamplebysupportingmeasurementanddataanalysis,capabilitybuildingforcontinuousimprovement,brokeringnewopportunitiesandrelationships,andevaluatingnewandproposedmodelsofhealthandcare.

We support system-wide working, and connect local initiatives and expertise, by:

• enablingsystem-wideproblemsolvingthroughouruniqueneutralfacilitatorrole,andourextensivenetworks,particularlyourbreadthofrelationshipsandknowledgeoftheexpertsandinitiativesunderwayacrossSouthLondon;

• usingourlocalchampionsandnetworkstobuildstrongclinicalengagement,andapplyingacademicrigourtosupporteffectivechange;

• creatingsystemcapability,andhelpingourmembershiprespondmorereadilytoregionalandnationalchallenges,opportunitiesandpriorities–thoseemergingfromtheLondonHealthCommissionandtheFiveYearForwardView–allowingSouthLondontobenefitfromtheexpertiseandresourcesthatsuchinitiativesbring;

• workingwithpartnerstosupportsustainabilitythroughembeddingbestpracticeandinnovationintoroutinecaredeliveryandcommissioningprocesses,supportedbyskillsdevelopment.


Ecosystem developmentDeveloping our health ecosystemOurambitionistocultivateastrongandsustainablehealthandsocialcaresystemwithinwhichallmemberorganisationscanthrive,andhealthcarebusinessescanbesupportedtobemoresuccessful.Theterm‘ecosystem’describesthediversearrayofparticipantsandresourceswhocontributetoavibrantlocalhealthandcaresector.

TheHealthInnovationNetworkaimstosupportanddevelopthelocalecosystemthroughworkingcollaborativelywithourmembership.

We work as a facilitator, broker and catalyst among our members and stakeholders.Weareachievingimpactbyworkingwithhundredsoforganisations,thousandsofindividuals,andthroughmultiplemediachannels–actingascatalysts,match-makers,co-ordinatorsandknowledge-sharers.Weprovideauniquesystemperspective,notrepresentinganyonestakeholdergroup.Ourseniorstaffandclinicalteamsaredrawnfromourmemberorganisations,andhaveestablishedrelationshipsthatenableustobrokerandfacilitateinter-organisationalproblemsolving.

Bringing together partners to create a world-leading Genomic Medicine CentreInsummer2014,NHSEnglandissuedaninvitationforbidstobecomenationalGenomicMedicineCentresaspartofthe‘100kGenomeProject’.OurChairman,RichardBarker,facilitatedthecreationofaconsortiumacrossSouthLondonandKent,SurreyandSussex(recognisingpatientflowsacrossourgeographies),whichwassuccessfullydesignatedasaGenomicMedicineCentreinDecember2014:ahugelyexcitingmilestonefortheregion.TheSouthLondonGenomicMedicineCentreservesapopulationofmorethan7millionpeopleandisapartnershipbetween:fourfoundationtrusts(Guy’sandStThomas’,King’sCollegeHospital,SouthLondonandMaudsley,andStGeorge’sHealthcare),twouniversities(King’sCollegeLondonandStGeorge’s,UniversityofLondon),twoAHSNs(HealthInnovationNetwork,andKent,SurreyandSussexAHSN),King’sHealthPartnersAcademicHealthScienceCentre(AHSC)andtwopatientorganisations(MacmillanCancerSupportandGeneticAllianceUK).

Apatientandpublicinvolvement(PPI)andcommunicationsforum,ledbytheHealthInnovationNetworkandsupportedbythirdsectorcolleagues,becameastrongelementofthebidandwasoneofSouthLondon’sdifferentiatingfeatures.Ourapproachhasgivenacriticalvoicetospecialistpatientorganisationsacrossournetworksandnationally,shapinghowthisworkisdelivered.

Reducing diabetic emergencies – minimising the impact of diabetes on people’s livesEarlydiscussionswithmembersandstakeholdersidentifiedthatsignificantnumbersofpatientswerecallingambulances,manybeingconveyedtohospital,duetopoormanagementoftheirdiabetesleadingtohyperorhypoglycaemia.Theseepisodescancauselong-termhealthconsequencesforpeoplewithdiabetes,andareoftenavoidablewithbetterdiabeticcontrol.OurDarziFellowwasinterestedtoseehowthesepatientswerebeingfollowedup,andwewerepleasedtoworkwithLondonAmbulanceService(LAS)inthisarea.Reviewingpatient-leveldataenabledadeeperunderstandingoftheissues,andtheteamthenbroughttogetherLAS,diabetesservices,GPsandcommissionerswithineachSouthLondonboroughtoreviewandimprovepatientpathwayslocally.

Significant numbers of patients were calling ambulances, many being conveyed to hospital, due to poor management of their diabetes leading to hyper or hypoglycaemia

AnnualReview2014-151110HealthInnovationNetwork

Interoperability – connecting members Bringing together best practice and evidence base to improve peer support in dementia

Improving outcomes for knee osteoarthritis with

Working together in patient safety

Created and launched in March 2015, our dementia

peer support resource pack downloaded

2,500+ times

WehavebeenworkingcollaborativelywithNHSEngland(London),inconjunctionwiththeOfficeforCCGsandourpartnerAHSNsinLondon,inordertodevelopacommonframeworkforinteroperabilityacrossLondon.Thisworkwillincreasetheabilityofourmemberstosharevitalhealthcareinformation,withthepotentialtosignificantlyimprovequalityandsafetyofcare.Joiningupdatasourcesinthiswayalsoprovideshugepotentialforresearchexploration.

Thisworkwillleadtothedesignofstandardsandconsentmodelstofacilitatewidercross-Londonsharingofpatientrecords.Buildingonthesuccessofeventsledbyourteam,avirtualinformationgovernancecommunityhasbeencreated,currentlywith70peopleincludingDameFionaCaldicottsignedupfromacrossourmembershipandfurtherafield.Theprovisionofaneasilyaccessiblecommunicationplatformenablesmemberstokeepuptodatewithdevelopmentsinthiskeyarea,includingcollaborationwithexpertsinthefield,andtoworktowardsdevelopinglocalsolutions.

AmappingexercisebyourdementiateamdiscoveredawidevariationinprovisionofpeersupportforpeoplewithdementiaacrossSouthLondon–withsomelimitedopportunities,particularlyforethnicminoritygroups,youngerpeoplewithdementia,andlesbianandgaypeople.TheHealthInnovationNetworkcommittedtoaddressthis,andhasworkedtogetherwithmanyexistingpeersupportgroups,peoplewithdementiaandprofessionalstodevelopapeersupportresourcepack.

Bringingtogetherexamplesofgoodpracticeandevidence-basedguidance,theresourcepackaimstohelpgroupsandorganisationstobettersupportpeoplewithdementiainSouthLondon.CreatedandlaunchedinMarch2015,ourdementiapeersupportresourcepackwasdownloaded1000timesinitsfirstmonthandhassincebeendownloadedafurther1500times,whichgivesthepotentialtodriveimprovementsinpeersupportoffered,inSouthLondonandnationally.

Wearealigningourprioritieswithpartnerorganisationstoachievegreaterimpact.

Throughdiscussionwithourmembersandstakeholdersweidentifiedthatpatientswhowerelivinginpainwithosteoarthritishadlimitedhelpinmanagingtheircondition.Practitionerswereoftennotconfidentintreatingthisgroupofpatients,andwerenotroutinelyfollowingNICErecommendations(toprovideeducationandexercisesupport).

Aninterventiontohelpthesepatients,‘ESCAPE-pain’(grouprehabilitationprogrammeforpatientswithkneeosteoarthritis),hadbeendevelopedinSouthLondon,byourClinicalDirectorProfessorMikeHurley,butwasnotbeingwidelyimplemented.Inthepastyearthemusculoskeletal(MSK)teamhavesuccessfullyspreadESCAPE-painacrosshealthcareprovidersinSouthLondonbenefittinghundredsofpatients,andarenowworkingwithleisurecentresandothernon-healthcaresettingstogettheprogrammeclosertopatients’communitiesandgivepeopletheopportunitytoself-refer.

InOctober2014,theHealthInnovationNetworklauncheditsPatientSafetyCollaborative(PSC)aspartofanationalprogrammeledbyAHSNs.TheSouthLondonCollaborativeisgrowingquickly,withpatientsandcarers,frontlinestaff,boardleadersandotherstakeholdersworkingtogetheracrossthewholehealthcaresystem,fromhospitalstopeople’sownhomes–withtheaimofco-designinginterventionsandinitiativestoreduceavoidableharm,savelivesandembedapatientsafetyculture.

RecognisingthattherearealreadyahugenumberofinitiativesinpatientsafetyfollowingtheFrancisandBerwickreports,andthatourmemberswillhavetheirownparticularlocalpriorities,wesetouttolinkourPSCcloselywithbothnationalandlocalinitiatives,includingSignuptoSafety,QualityAccounts,SafetyThermometer,andNHSChangeDay.Wehave,inparticular,madestronglinkswiththeKing’sHealthPartners’successfulSafetyConnectionsprogrammeandareshapingourprioritiesinlinewithworkalreadyinplaceacrossSouthLondon.WeareworkingwithfiveofourmembertruststodeliverearlyimpactsthroughtheNoCatheter,NoCAUTI(catheter-associatedurinarytractinfection)project,whichlooksathowsystemsandprocessescanbeimprovedtoreducecatheter-associatedinfectionsinpatientsinhospital.

Wealsosetaboutestablishing‘CommunitiesofPractice’inpatientsafety–acommunityinwhichmemberslearnfromandwithoneanother,andbuildthestrongrelationshipsacrossinstitutionsandprofessionsneededforpositive,systemicchangeinSouthLondon.

Of c.93,000 inpatients catheterised p/yr 7,000+ develop UTIs costing £14.6m in excess bed days

No Catheter, No CAUTI will improve care and cut costs

has spread to 10 sites benefitting 700+ patients – now breaking down barriers and being delivered in private health and leisure centres

Virtual information is key to updating our members


Patient and population benefits

Delivering patient and population benefits

ESCAPE-painhasspreadto10sitesbenefitting700+patients–nowbreakingdownbarriersandbeingdeliveredinprivatehealthandleisurecentres.

MeirKattanparticipatedinESCAPE-painatDulwichCommunityHospital:

“Iwashavingalotofkneepainandmymobilitywasn’tgood,soIwenttomyGPasIthoughtIneededakneereplacement.IwasreferredtotheESCAPE-painprogrammeandbegantheexerciseswhichIthoughtwerereallysimpleatfirst–infacttooeasy–butsoonrealisedtheywereworkingandbeingsimple,theyweresoeasytodo.

“Afterafewweeksontheprogramme,InoticedahugeimprovementandI’mnoteventhinkingaboutakneereplacementnow.I’mnotonlyfarlesstiredfromthepainbutcanwalksomuchbetter.Icando10,000stepsadaywithoutthinkingaboutit–mywifeevenboughtmea‘Fitbit’torecordmyactivitylevel!

“Thecoursehasworkedexceptionallywell–fromthetimingsoftheclasses,thepeersupportandimprovementinmykneeanddramaticdropinmypainlevel.Ireallycan’trecommendESCAPE-painhighlyenough.”

Feedbackfromusers,policyleads,academia,NHSEnglandandthethirdsectorhasalsobeenimpressive.

“It’sreallyimportantthatwepromotetheadoptionofthisprogrammeandmakesureitsdisseminationachievesthebestpossiblereach,”saidDrKarenRobb,RegionalRehabilitationLead,London,NHSEngland.

“Congratulations on the work the Health Innovation Network has done. This really captures the core NICE recommendations of sharing information and using exercise and turning it into practice – well done.”

Arthritis Research UK Professor of Musculoskeletal Therapies, Krysia Dziedzic, Keele University, and NICE Fellow

Net annual savings across health and social care of£10m p/yr can be achieved if delivered to just 5% of the South London knee osteoarthritis population

Case studies and outcomes

Meir Kattan

AnnualReview2014-151514HealthInnovationNetwork

Inthelastdecadetherehasbeenanastonishing75%increaseinpeoplediagnosedwithdiabetesbytheirGP.InSouthLondon,in2014,thediabetesprevalencemodelforlocalauthoritiesshowstherewere174,627peopleovertheageof16onGPdiabetesregistersandthisisexpectedtoriseto249,848by2030.

WerecognisedtheopportunitytobringmembersandpartnersacrossournetworktogethertocreateaDiabetesImprovementCollaborativetobreakdownbarriersandlookathowtocreatesystem-widesolutions,startingwithtechnologyinType1Diabetes.Over60consultants,specialistnurses,alliedhealthprofessionals,managers,commissionersandserviceusersfromacrossLondonhaveattendedeachofourDiabetesImprovementCollaborativeworkshops.

WorkingwithourpartnersatCLAHRCandHealthEducationSouthLondon(HESL),wehavedelivereddevelopmentopportunitiesforover100peopleworkingandlivinginSouthLondon,includinginteractiveworkshops,toconsiderhowbesttoinvolvepatientsinourworkandimprovepatientexperience.

HESLworkedwithustobidforandlaunchaSchwartzprogrammeforSouthLondonsupportingsixsitestodeliver‘compassionatehealthcaretraining’inhospiceandcarehomes,mentalhealthandcommunityservicesettings.

WorkingwithexperienceandengagementleadsacrosshealthandsocialcareinSouthLondon,patientgroupsandthevoluntarysector,wehavefurtherdevelopedtheSouthLondonPatientExperienceNetwork.ThisissupportedbyouronlineJivecommunitywith100followers,whichnowhostsawidelibraryofcontent,includingover50films,approximately60keydocumentssuchasreportsandframeworks,upcomingevents,andseveralguestblogposts.

Minimising the impact of diabetes on people’s lives

Valuing patient involvement and strengthening patient experience

Diabetes costs the NHS£10bn a year accounting for 10% of the NHS budget

10%

Supporting delivery of Schwartz Rounds (compassionate healthcare training) in partnership with HESL to six organisations across South London

By 2018 we will enable up to 15% of South London’s adult type 1 population to gain better control of their diabetes by using pump therapy

Our Diabetes Improvement Collaborative includes 10 clinical teams and over 60 multi-disciplinary healthcare professionals attended each workshop


SinceweestablishedourDiabetesImprovementCollaborativeinJune2014,therehasbeenanincreaseof16.4%inthenumberofpeopleusinginsulinpumptherapyfromSouthLondonproviders,thefastestrecordedincrease.Inrealtermsthismeansthatmorethan200additionalpeoplearenowreceivinginsulinpumptherapyandweareontracktoensurethatby2018,15%ofSouthLondon’sadulttype1populationwillhaveaccesstothistechnology.



WeareaddingvalueandworkingtoreducetheselevelsbyworkingacrossSouthLondontoaddressalcohol-relatedfrequentattenders(AFAs)whohavecomplexmultipleproblemsaswellasalcoholaddiction,andrepeatedlyvisithospitalemergencydepartments.

AlongsideplansforatrialinthisareabytheCLAHRC,ourteamarebringingtogetherpartnersfromanumberoflocalserviceswhoaretestingnewinitiativesandmodelsofcareforthisgroupofpatients,toshareexperiences,knowledgeandexpertise.

ByworkingwithoureducationpartnersinSouthLondonuniversities,weareofferingfilmstudentstheopportunitytoenteracompetitiontotackleunderlyingstigmathatsomeAFAsmayfaceamongNHSstaff.Thecompetition,whichwillbejudgedlaterin2015,willcreateaseriesofshortfilmsrelatingtostigmathatwillbeusedintrainingforNHSstafftowardstheendoftheyear.

Ouralcoholteam,ledbyProfessorColinDrummond,ourClinicalDirectorforAlcohol,areexploringwhytheinterventionIdentificationandBriefAdvice(IBA)foralcoholisnotwidelyadoptedinpractice.Despitestrongresearchevidence–largelyfromSouthLondonandMaudsleyNHSFoundationTrust’sInstituteofPsychiatry–demonstratingitsefficacyatreducingharmfulandhazardousdrinkinginpopulations,thisissuecontinuestochallengeoursystem.OneofourDarziFellowsconductedapilotprojectwithfourGPpracticesinSouthLondontounderstandthepracticalchallengestheyfaceindeliveringIBAeffectivelyinprimarycare,andsupportingthemindesigningstrategiesforimprovement.

Aswellasbeingarecognisedinternationalexpertinthefieldofalcohol,andleadingalcoholprogrammesacrossKing’sHealthPartnership,CLAHRCandtheHealthInnovationNetwork,ProfessorDrummondisleadingourteamtodevelopanonlinetooltosupportcommissioners,whichwillincludeguidanceonthecommissioningofIBAandassociatedtraining,andhelpmaketheeconomicandhealthimprovementcaseforIBA.Tocomplementthis,theCLAHRCteamisdevelopinganIBAapptotestapproachesthatdeliverIBAdirecttoendusers.

Identification and Brief Advice (IBA) – reducing harmful drinking

Joining up alcohol work in South London

In the past 8 years alcohol related hospital admissions doubled

Withtheaimofbringingtogetherevidenced-basedresourcestohelpcommunitygroupsandfunderssetupandrunpeersupportgroups,aswellasguidanceonhowtomakeolderpeoplegroupsmoredementiafriendly,ourteamwelcomedtheinvolvementofNadaSavitch,DirectorofInnovationsinDementia(acommunityinterestcompany).Herinsighthighlightedthepowerandimpactoffilminhelpingpeoplewithdementiaandtheircarerstoseethevalueofmeetingothersinasimilarsituation.

Nadaexplains:“Filmingpeoplewithdementiaallowstheirstorytobeheard,intheirownwords,andreallybringstolifetheessenceofpeersupport.Thereisamisconceptionthatpeersupportaddsnovaluetopeoplewithdementiaastheywillnotgetbetter.Thefilmsshowhowengagedpeopleareatthesegroupsandhowmuchenjoymentpeopleget.”

Aswellasfilms,thepackincludescasestudies,policyandresearchrelatedtothebenefitsofpeersupport,aswellasresourcesonfunding,stafftrainingandevaluationofgroups.Ithasbeendevelopedforthestatutory,community

andvoluntarysectorsthatareworkingwith,orcommissioning/fundingservicesfor,peoplewithdementiaandwewouldliketothankAgeUKandMentalHealthFoundationwhoalsocontributedresources.

Partnersandmembershavepraisedthepacksaying:

“WeareproudtohavesupportedtheHealthInnovationNetwork,withthedevelopmentoftheirresourcepack.Peersupport,suchastheDementiaCafesthatAlzheimer’sSocietyrun,canreallyhelpimprovepeople’squalityoflife.Theygivepeoplewiththeconditionandtheircarerstheopportunitytosocialisewithothersinsimilarsituationsandreceivevitalsupport.”Alzheimer’s Society

“Thisisgoingtobeatrulyusefulresource.Wearealwaystryingtoshareourexperienceasadementia-centredcommunityandtolearnfromothers’innovations.”Michael Edwards, Chair of Trustees, Lambeth Healthy Living Club

Bringing together peer support resources for people with dementia



WorkingacrossSouthLondon,agroupofpatientsafetypeers,ledbyourpatientsafetyteamareshapingasharingandlearningnetwork.

CommunitiesofPractice(CoPs)arenotnewintheNHSandhaveanestablishedplaceinimprovementworkandreducingfragmentationofpractice.MembershavehighlightedaninterestincreatingarangeofCoPsgoingforwardincluding:delirium;dutyofcandour;education,trainingandculture;medicationsafety;andSchwartzRounds,amongothers.

OurPatientSafetyCollaborativeisverymuchdrivenbyourmembers’needs.ItisledbyKateGrimes(ChiefExecutiveatKingstonHospitalNHSFoundationTrust),whoisSeniorResponsibleOfficerforourCollaborative.OurPatientSafetyClinicalDirectors–DrAdrianHopper(Guy’sandStThomas’NHSFoundationTrust)andChiefNurseJennieHall(StGeorge’sUniversityHospitalsNHSFoundationTrust)–workwiththeprogrammeteam.

What our members and partners say about our Communities of PracticeJanetConinx,HeadofPatientSafetyandRisk,CroydonHealthServices,andamemberoftheCoPDesignTeam,said:“Therehasbeenalotofenergy,sharingofgoodideas,successesinteamworkandwhathasstruckmeisthesimilarityonsubjects.”

ProfessorofImplementationScienceandPatientSafety,atKing’sCollegeLondon,NickSevdalis,said:“Peoplearealreadyasking‘isthisthebestwecanbedoing?’…thismakesusrealisewedon’tneedtoreinventthewheelasthereareguyswecanlearnfrom–it’saboutthespreadofgoodpractice.”

CatherineEde,SignuptoSafetyCampaignsaid:“Forme,meetingupwithallthetrustshasbeeninvaluable.It’sbeengoodtobeabletofindoutsuccessesaswellassomeoftheproblems.”

Patient Safety Collaborative, building ‘Communities of Practice’

Non-clinical internship schemeWearedevelopinginternshipopportunitiesinpartnershipwithKingstonUniversity,LondonSouthBankUniversityandGoldsmithsCollegetosourcetalentedcandidates.

WithbothgraduateandundergraduatenumbersgrowingacrossWesternEurope,includingtheUK,wehaveanimportantroletoplayinusingourextensivenetworkstosupportrecentgraduatesintojobs.

OurNon-ClinicalInternshipProgrammeaimstowidenaccesstonon-clinicalcareersinthehealthandsocialcareeconomyforgraduatesandundergraduatesinSouthLondon.

FocusedonharnessingtalentfromlocaluniversitiestobenefittheNHS,internshipscanbesetupwithanyHealthInnovationNetworkmemberorganisationinarangeofnon-clinicalareassuchasfinance,informatics,communication,marketingandprojectsupport.Allinternshipsaresalaried.

TukiyaMutupa,theHealthInnovationNetwork’sfirstinternasaprogrammeassistant,hasgoneontofindaroleinapharmaceuticalcompany.

Tukiyasaid:“Theinternshipallowedmetorealisemystrengthsinnewareasofworksuchasdataanalysisanddevelopnewskillsineventmanagementandwebsitemaintenance.Ihavereallydevelopedpersonallyandprofessionallyasaresultofmyinternship.”

Non-Clinical Internship

Programme – placed 12

interns in NHS

organisations

Tukiya Mutupa, the Health Innovation Network’s first intern, said:“The internship allowed me to realise my strengths in new areas of work such as data analysis and develop new skills in event management and website maintenance. I have really developed personally and professionally as a result of my internship.”


Value improvement and supporting economic growthImproving health outcomes is the primary driver of innovation. Innovations are sometimes thought to result in a cost pressure, and we are conscious of the financial pressures on the health and care system.

Therefore, the Health Innovation Network’s final objective is to ensure that we only support innovations that aim to improve value or encourage economic growth. Economic growth is a key focus as it will boost tax revenues, which fund the NHS. The Health Innovation Network’s projects support our members to improve the value of the services they provide or contribute to economic growth in different ways.

Focusing companies on solving health needsTheHealthInnovationNetwork’scollaborationwiththeSmallBusinessResearchInitiative(SBRI)forHealthcarehascontinuedtodevelop.SBRIawardssupportsmallbusinessestodevelophealthcareinnovations.Theybringtogetherbusiness,health,technologyandgovernmentpartnerstodeliveraseriesofcompetitionsforbusinessestoaddressmajorunmethealthneeds.Unlikemanyresearchanddevelopmentprojectsthatoffergrantormatchfunding,SBRIcontractsare100%fundedandtheinventorretainstheintellectualpropertyrights.Togetherwehaveshapedfundingcompetitionsforbusinessestohelpsolvesomeofthemostcomplexchallengesfacingolderpeoplewithmultiplemorbidities;thesewerelaunchedinJune2015.

Developing digital health opportunitiesTheHealthInnovationNetworkissupportingbusinessandthehealthsystembyexaminingthepotentialforutilisingtechnologyforonlineconsultationsandsupportforpatients.WeareworkingwithlocalGPsandbusinessestoevaluatethebenefitsofsystemsthatprovideconsultations,patientmanagementandsupportedself-care.ThesepartnershipsarehelpingustounderstandandarticulatethebenefitstomembersofinnovationinpracticeandwewillbemakingresultsofthisworkavailabletomembersinAutumn2015.

Promoting London as a centre for health industries ThethreeAHSNsinLondonhaveworkedtogetherwithLondon’sthreeAHSCsandtheMayor’sofficetoestablishandpromoteMedCity,whoseambitionistopositionGreaterLondonandSouth-EastEnglandasaworld-leading,interconnectedregionforlifescienceresearch,development,manufacturingandcommercialisation.MedCitybringsvaluableexpertise,particularlyaroundseedingactivities–bringinginvestors,industryandthefinancecommunitytogetherwithafocusonlifesciencesandbringstogetherpeoplebuildingonparallelinitiativessuchasTechCity.

WearealsoworkingwiththeotherLondonAHSNs,MedCityandtheGreaterLondonAuthoritytoimplementtherecommendationfromtheLondonHealthCommissiontodevelopaDigitalHealthInstituteandAccelerator.Aninitialstakeholdereventattractedmorethan100delegateswhoexploredthekeychallenges,opportunitiesandnextstepsfordevelopingthispioneeringpan-Londonprogramme.

Togethertheseinitiativeswillbuilduponworld-classclinicalandacademiccentrestohelpLondoncontinueitstrajectorytowardsbecomingaworld-leadingcentreforthelifescienceanddigitalhealthsector.


Building on expertise from industry TheHealthInnovationNetworkiskeentoworkwithindustrypartnerswhobringexpertisetosupportimprovementprojects.Ourindustrypartnershipsextendthroughoutourprogrammes,withpartnersinvolvedinmostofourclinicalthemes.Weareparticularlyproudofourdiabetesprogramme,whichhasdevelopedstrongjointworkingarrangementswithpharmaceuticalanddeviceindustrypartners.

TheDiabetesImprovementCollaborativeissupportedbythreecommercialpartners:RocheDiabetesCare,BoehringerIngelheimandJohnson&Johnson(JanssenandAnimas).Throughthisjointworking,theCollaborativeisabletoaccessconsiderableexpertisefromindustry,andworksalongsideourprogrammeteamandpartnersNHSElect,whichprovidesapositiveexperienceofcommercialjointworkingforthememberteamsparticipating.

Partnering with companies to develop required healthcare solutions with potentialThereisasignificantopportunitytobetterusetechnologytosupportthecareofpeoplewithdementia.Thedementiateampartneredwithalocalcompany,IXICO,tosuccessfullysecureSBRIfundingfordevelopmentofanonlinecaresupporttool,myMyBrainBook.Thetoolisintendedtogivepeoplewithdementiaandtheircarershelpwithcommunicationandco-ordinationofcare.OurteamhasworkedcloselytosupportIXICO’sproductdevelopmentby:

• providingtheinitialclinicalconceptforMyBrainBookandongoingclinicaladvice;

• bringinginthirdsectorpartners,suchasInnovationsinDementia,tohelpengagepeoplewithdementiainthedesignandcontentofthetool;

• brokeringaccesstolocalclinicalservicesfortestingandpilotingthetool.

Theprototypetoolhasbeenpositivelyreceivedbypeoplewithdementiaandtheirfamilies,aswellasthelocalserviceprovidersandvoluntaryorganisations(includingtheAlzheimer’sSociety)andcommissioners.TheMyBrainBookproductisnowbeingusedaspartofamajorstudybeingundertakenbythefourAHSNsandacademicsintheNorthofEngland.ThehopeisthatMyBrainBookwillbeasuccessfulproductforIXICOintheUKandpotentiallyinternationally.

Improving effectiveness through focus on staff health and wellbeing Wehaveprioritisedstaffhealthandwellbeingasanareathatfeaturesinrecentpolicydirection,particularlybytheLondonHealthCommission.Ithasthepotentialtosignificantlyimpactonthelocalhealtheconomyifweaddressbothabsenteeismandpresenteeism(staffbeingatworkbutunproductiveduetohealthandwellbeingproblems).AsthisisacommoninterestwithKing’sHealthPartners,weco-hosteda‘MindandBody’staffhealthconferenceinFebruary2015,attendedby200membersfromacrossourNetwork.Theinspiringdebatewasledbypresentationsfromacrossthepublicsector,industryandcharitiessharingexamplesofbestpractice,withDameCarolBlackandEarlHoweaddinganationalpolicyperspective.Buildingontheenergygenerated,wehaveestablishedanonlinegroupofapproaching100members,usingourJiveplatform,andareactivelyworkingwithindustrypartnerstoexploreopportunitiestocollaboratewithourmembersacrossSouthLondon.

Leadingbyexample,wehavesigneduptotheBritishHeartFoundation’sHealthatWorkmissionandareworkingtoachieveaccreditationfromtheGreaterLondonAuthority’sHealthyWorkplaceCharter.


Overthesummerof2014,weranoursecondInnovationGrantsandRecognitionAwards,apartnershipbetweentheHealthInnovationNetworkandHealthEducationSouthLondonthatcelebratesthetalentandgoodideasfromourmemberorganisations,particularlyinrelationtoinnovativeeducationandtraininginitiatives.

Wereceived64applicationsforfunding;awardedatotalof£500kingrantstoteamsand

organisationsincludingacuteandmentalhealthtrusts,communityproviders,clinicalcommissioninggroups(CCGs),universities,emergencyservices,charitiesandthirdsectorpartnersacrossSouthLondon;andrecognised10outstandingteamsandindividualsacrossourhealthandcaresystem.WeweredelightedthatBBC’sJustinWebbhelpedpresentwinnerswiththeirawards.Someexamplesoflastyear’swinnerscanbeseenbelow.

Health Innovation Network and Health Education South London Innovation Grants and Recognition Awards

Mealmats – Clare Fundell, Erin Probert, Amy Hewer and Rebekah Van Syke – Royal Hospital for Neuro-disability

MealmatsareaninnovativeresourcedevelopedattheRoyalHospitalforNeuro-disabilitytoimprovepatientsafetyatmealtimes.

Theyaresimplewipeableplacematscontainingmulti-disciplinaryguidelinesforeating,drinkingandswallowingfromSpeech&LanguageandOccupationalTherapy.Thismeansthattheguidelinesaboutwhatfoodanddrinktexture,equipment,positioningandlevelofassistanceeachpersonneedsisimmediatelyavailableatthepointofcare.TheuseoftheMealmatshasenhancedcompliancewithguidelinesandincreasedpatientsafetyandindependenceatmealtimes.

PatientSafetyAward

Developing the Whole Workforce

Award

Rising Star

AwardJeremy Corcoran – Guy’s and St Thomas’ NHS Foundation Trust

JeremyisahighlyspecialisedphysiotherapistworkingclinicallywithintherehabilitationphysiotherapyteamatGuy’sandStThomas’NHSFoundationTrust.Hisspecialistskillsandclinicalinterestarewithintheuniquevestibularclinicalsettingandpatientpopulations.

Alongsidehisclinicalwork,JeremyiscompletinghisPhDinthisclinicalspecialty.SomeofJeremy’sworkhasbeenpublishedinpeerreviewjournalsincludingTheOtorhinolaryngologistandTheJournalofLaryngology&Otology.Hehasalsoreceivedcharitablegrantstofundahighlyinnovativeprojectprovidinganefficientdiagnosticandevaluativedeviceforvestibularpatients.

Multi-agency response to domestic abuse – Dr Karen Cleaver (University of Greenwich) and DCI Andrew Furphy (Metropolitan Police Service)

Theprojectshouldhelpformthebasisforrecommendationsformulti-professional,multi-agencyworkingandworkforcedevelopmentacrossagenciesinSouthEastLondon.TheUniversityofGreenwichinpartnershipwiththeMetropolitanPoliceService(MPS)SouthAreaDeliveryTeamwillinvestigatehowtheMPScanworkwithotheragenciestodevelopcurrentpracticeinrespondingtodomesticabuseinSouth-EastLondon.Theprojectwillinvolveareviewoftheresearchliteratureandpreviousevaluationstoconfirmriskfactorsandestablishanevidencebaseforearlyinterventionsandmanagementfordomesticabuse,alongsideascopingexercisetoidentifyexistingprotocolsandguidelinescurrentlyemployedacrossagenciesinSouth-EastLondon.

RichardSumray,HESLChairman,withRoyalHospitalforNeuro-disabilitywinners

RichardSumray,HESLChairman,withJeremyCorcoran,PhysiotherapistatGuy’sand

StThomas’NHSFoundationTrust

JustinWebb,BBCjournalist,withDrKarenCleaverandDCIAndrewFurphy


Dr Adrian McLachlan, Chair, Lambeth Clinical Commissioning GroupRepresentingSouth-EastLondonCCGs

Dr Darren Tymens, GP, Medical Director, Local Medical Committee (Surrey and Sussex) RepresentingGPproviders

Peter Ellingworth, Chief Executive, Association of British Healthcare IndustriesRepresentingindustry

Cally Palmer CBE, Chief Executive, The Royal Marsden HospitalRepresentingspecialistandteachinghospitals

Professor Peter Kopelman, Principal, St George’s, University of LondonRepresentinghighereducationinstitutions

Catherine Pearson, Chief Executive, Healthwatch LambethRepresentingHealthwatch

Professor Peter Littlejohns, Deputy Director, South London CLAHRCRepresentingpartnerorganisation

John Goulston, Chief Executive, Croydon Health Services NHS Trust

RepresentingAcuteTrusts

Jonathan Lewis, Chief Executive, Bromley Healthcare

Representingnot-for-profitNHSproviders

Kate Heaps, Chief Executive, Greenwich and Bexley

Community Hospice Representingnot-for-profit

hospices

Miles Scott, Chief Executive, St George’s Healthcare NHS

Foundation Trust ViceChair,HealthInnovation

NetworkBoard

Dr David Goldsmith, Clinical Director, Research

Network South LondonRepresentingpartner

organisation

Professor Richard Barker OBE, Chairman

Dr Chris Elliott, Chief Executive, Sutton CCGRepresentingSouth-WestLondonCCGs

Professor Sir Robert Lechler, Executive Director, King’s Health PartnersRepresentingpartnerorganisation

Stephen Firn OBE, Chief Executive, Oxleas NHS Foundation TrustRepresentingmentalhealthtrusts

Will Tuckley, Chief Executive, Bexley Council

Representinglocalauthorities

Houda Al Sharifi, Director, London Borough of Wandsworth

Representingpublichealth

Peter Hewitt, Guy’s and St Thomas’ Charity

Representingpartnerorganisation

Aurea Jones, Director, Health Education South London

Representingpartnerorganisation,HESL

Tim McLachlan, Operations Director, Alzheimer’s Society

Representingthethirdsector

Board Members

Zoë Lelliott, Director of Strategy and Performance, Health Innovation Network

Chris Streather, Managing Director, Health Innovation Network

Dr Tony Newman-Sanders, Interim Medical Director, Health

Innovation Network and CCIO, Croydon Health Services NHS Trust

Anna King, Commercial Director, Health Innovation Network


Will Tuckley, Senior Responsible Officer (Alcohol) ChiefExecutive,LondonBoroughofBexley

Chrisha Alagaratnam, Senior Responsible Officer Interim (MSK)InterimChiefExecutive,EpsomandStHelierUniversityHospitalsNHSTrust

Professor Fiona Ross CBE, Senior Responsible Officer (Education and Training) DirectorofResearch,LeadershipFoundationforHigherEducationandProfessorofPrimaryCareNursing,FacultyofHealthSocialCare&EducationatKingstonUniversityandStGeorge’sUniversityofLondon

David Bradley, Senior Responsible Officer (Dementia) ChiefExecutiveSouthWestLondonandStGeorge’sMentalHealthNHSTrust

Andrew Eyres, Senior Responsible Officer (Diabetes) ChiefExecutive,LambethClinicalCommissioningGroup

Kate Grimes, Senior Responsible Officer (Patient Safety) ChiefExecutive,KingstonHospitalNHSFoundationTrust

Nicholas Hyde, Co-Clinical Director (Cancer) London Cancer AllianceConsultantmaxillofacial/headandnecksurgeon;andClinicalDirector(CancerServices)StGeorge’sHealthcareNHSFoundationTrust

Dr Hugo de Waal, Clinical Director (Dementia) ConsultantPsychiatrist,SouthLondonandMaudsleyNHSFoundationTrust

Adrian Hopper, Clinical Director (Patient Safety) DeputyMedicalDirectorforPatientSafetyatGuy’sandStThomas’NHSFoundationTrustandtheleadfortheMedicineClinicalAcademicGroupforKing’sHealthPartners

Professor Colin Drummond, Clinical Director (Alcohol) ProfessorofAddictionPsychiatryandConsultantPsychiatristattheNationalAddictionCentre,InstituteofPsychiatry,King’sCollegeLondonandSouthLondonandMaudsleyNHSFoundationTrust

Professor Mike Hurley, Clinical Director (MSK) Professor,SchoolofRehabilitationSciences,FacultyofHealth,SocialCareandEducation,StGeorges,UniversityofLondonandKingstonUniversity

Shelley Dolan, Co-Clinical Director (Cancer), London Cancer Alliance ChiefNurse,TheRoyalMarsdenNHSFoundationTrust

Aileen Jackson, Associate Clinical Director (Dementia)

JointCommissioningManager,RichmondClinicalCommissioningGroup

Dr Charles Gostling, Clinical Director (Diabetes) GeneralPractitionerwithaspecialinterestindiabetescareforLewishamandGreenwichHealthcareNHSTrust

Dr Natasha Patel, Clinical Director (Diabetes) Consultantindiabetesandacutemedicine,StGeorge’sHealthcareNHSFoundationTrust

Catherine Gamble, Associate Clinical Director (Dementia) HeadofNursing,SouthWestLondonandStGeorge’sMentalHealthNHSTrust

Jennie Hall, Clinical Director (Patient Safety) ChiefNurse,StGeorge’sUniversityHospitalsNHSFoundationTrust

Clinical DirectorsSenior Responsible Officers (SROs)Our SROs are drawn from across our South London membership.


HealthInnovationNetwork(SouthLondonAHSN)GroundFloorMinervaHouse5MontagueCloseLondonSE19BB

02071889805

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@HINSouthLondon

annual review 2014-15 · during 2014-15 the health innovation network has made great progress in...

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