SBRI Healthcare: Urgent and Emergency Care

Overview

A new national Small Business Research Initiative (SBRI) Healthcare competition is being launched by NHS England and NHS Improvement in partnership with the Academic Health Science Networks (AHSNs) to identify innovative new products and services for Urgent and Emergency Care.

Eligibility & Funding Costs

The competition is open to single companies or organisations from the private, public and third sectors, including charities.

The SBRI scheme is particularly suited to small and medium-sized businesses, as the contracts are of relatively small value and operate on short timescales for Government departments.

The competition runs in two phases (subject to availability of budget in 2021):

• Phase 1 is intended to show the technical feasibility of the proposed concept. The development contracts placed will be for a maximum of 6 months and up to £100,000 (inc. VAT) per project
• Phase 2 contracts are intended to develop and evaluate prototypes or demonstration units from the more promising technologies in Phase 1.

Only those projects that have completed Phase 1 successfully will be eligible for Phase 2.

Developments will be 100% funded and suppliers for each project will be selected by an open competition process and retain the intellectual property rights (IPR) generated from the project, with certain rights of use retained by the NHS.

Exclusions

There are a number of technologies or types of solution which are already available, sometimes from multiple suppliers, these are listed below.

Any technologies that negatively impact staff workloads will also be excluded.

• Bed capacity monitoring systems
• New social networking, messaging or imaging apps
• New tele-health systems (incorporation of existing tools as part of a solution is acceptable)
• Patient tracking systems
• Task lists
• Development of new wearables

Additional Resources

You can find the full competition briefing document on the SBRI Healthcare website.

 
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Scope

Under the overall theme of ‘Urgent and Emergency Care’, two categories have been identified.

Applicants are expected to respond to one of the two categories and, in both Categories, should consider if their solution is specific to, or can be tailored to, one of the sub-categories, whilst being mindful of the broader impact on the urgent and emergency care system.

Category 1: Reduce Demand

There are significant increases in ED demand with evidence to suggest that significant proportions of patients present to the ED with less urgent needs. These patients are often younger adults and are more likely to present out of hours. Patients that present with less urgent needs could be treated by other services such as primary care, pharmacies or through self-care. By definition, in order to reduce the number of people arriving at the front door, innovations are required that intervene at the incident, in the community, at home, through primary care or NHS 111.

Potential solutions to this challenge should be able to work across metropolitan, urban and rural settings, be scalable and, if necessary, configurable to the range of local services. Solutions may be related to pathway redesign and management, self-care, monitoring or diagnosis and intervention. Potential solutions to this challenge include strategies that support:

1. Redesign of care pathways to provide urgent and emergency care outside of the ED setting

2. Reducing delays in assessment (triage) in out-of-hospital settings to ensure that early intervention out-of-hospital is more often an option

3. Improved confidence and capacity in emergency care outside the ED

• By better education of care home staff and primary care clinicians (especially with assessment of children)
• Better triage and assessment in the community (primary care, home, care home etc)
• New tools to deliver care at the point of need
• Tools to increase confidence in safe diagnosis and provision of treatment/watchful waiting

4. Early identification of deterioration of at risk patients with long term conditions (LTCs), to allow early interventions prior to ED, who otherwise are highly likely to arrive at the ED

• In particular, a focus on reducing the number of attendees with exacerbations of respiratory LTCs, who make up a steeply increasing percentage of ED admissions – note adult and paediatric differences may be important
• Enabling confident self-care for patients with long term conditions
• Tools for home and self-care for adults and children with LTCs that that provide confidence and are configured for available local urgent and emergency services

5. Reduce overnight 999 overnight calls from community hospitals and care homes while still providing correct patient care

6. Specific interventions applicable to children and their carers

• Educational tools for parents and carers
• Tools that support GPs and other community clinicians to more confidently triage children
• Out of hospital monitoring solutions

7. Specific interventions related to young people

8. Proofs of concept that have been developed as part of the response to the COVID-19 pandemic that need further development and supporting evidence to enable wider rollout

• Non-invasive wearable devices could support acquisition of real-world data. By monitoring patients remotely and continuously, exacerbations could be predicted and data could be used to determine the progress of disease in a timely manner
• Alternative and creative solutions to deliver pulmonary rehabilitation, allowing professionals to remotely monitor and advise patients while they perform these exercises. Coupled with remote monitoring, this could allow early discharge or avoid hospital admittance

Category 2: Reducing the length of stay in the Emergency Department

When urgent or emergency care is required there are often delays within the pathway, these may be in Primary Care, assessment areas, inpatient wards or prior to discharge.

Delays in accessing timely care and treatment often mean an extended stay in the ED and possibly in hospital. Their journey through the ED may be delayed by slow assessment and treatment and/or by slow discharge either home or to other health and care settings, such as hospital wards or care homes.

Innovations that give enhanced confidence to patients and carers in home, primary and community care management and in early intervention could enable early discharge and a reduction in admissions to hospital from the ED. This may be particularly true in both children and in elderly patients with complex conditions.

Additionally, effective triage and streaming to identify those non-essential attendees at the ED, so they can be directed to more appropriate care, will free up resources to deliver care to those patients who need to be in the ED. Challenges Potential solutions to this challenge include system and technological innovations (digital, diagnostic and device) that:

1. Enhance the quality and safety of care by reducing delays to diagnosis

• Rapid turnaround of laboratory diagnostic tests
• More point-of-care tests

2. Address access issues to other, non-ED services to enable prompt care and assessment; right time, right place, right staff

3. Reduce pressure on a stretched workforce, while ensuring care is

• Better for patients
• Easier for staff to deliver

4. Enabling safe and efficient discharge from the ED

• Providing confidence in home or community management
• Integrating all the appropriate patient and resource information to allow more rapid decisions to discharge

5. Enabling self care as early in the pathway as possible