Vox sector special: 6 companies powering the NHS efficiency transformation
In some senses the surge in healthcare demand is a consequence of the triumphs of modern medicine, which have extended people's lifespans but also resulted in a higher prevalence of co-morbidities, further augmented by the lasting repercussions of the Covid-19 pandemic.
Streamlined, efficient processes have always been a crucial ingredient to any thriving healthcare system, but an increased focus on where efficiency-driven reforms can be made in the NHS has come about in recent light of tightened government budgets across the board and the strains of the pandemic.
With budgets squeezed, the Efficiency and Savings Review was launched as part of the Autumn Statement last year, with aims to bolster vital frontline services as the UK’s economic situation deteriorated. For the NHS, the Efficiency and Savings Review included the efficiency savings the NHS is making to achieve their efficiency target of 2.2%, double the 1.1% agreed as part of the NHS Long Term Plan in 2019.
There have been no changes to NHS funding since the most recent Spring budget, meaning that the emphasis remains on reforms driven by efficiency rather than increased funding. As a result, there is a growing demand for external service providers to help alleviate the burden on the NHS, with providers ensuring that all resources are utilised effectively and achieve the best possible healthcare outcomes for patients.
NHS efficiency can encompass a wide range of areas, from reducing waiting times and improving access to care, to improving the speed and accuracy of diagnoses and treatment plans. To achieve optimum efficiency, the NHS also needs high-performing, reliable technology supporting it to speed up every-day processes.
One company that has proven instrumental in achieving this is (,) a healthcare software company that provides ICT solutions such as bespoke websites for healthcare professionals and other public and private sector organisations.
EMIS has pioneered groundbreaking efforts to enhance the efficiency of the NHS. In 2014, the company was the first clinical system provider to enable patients to book GP appointments online and order repeat prescriptions, as well as enabling patients to access their own records online. This structural shift has led to greater patient satisfaction rates as well as improved healthcare outcomes across the board.
Its main product, EMIS Web, serves as a comprehensive tool for healthcare professionals, assisting them in patient management, appointment booking, clinical documentation, decision-making and prescription management. It aims to enhance efficiency, improve patient safety, and support the delivery of high-quality healthcare services.
EMIS is well known, but there are other UK-listed companies that are emerging to help improve NHS efficiency by ensuring that processes are smoother, faster and safer, even in the face of increasing demand and limited resources.
Defining efficiency
When we think of efficiency, we might think of ‘technical’ efficiency which looks at the optimal combination of resources in any one activity to produce maximum output at minimum cost. Or in other words, doing the right things in the right way and avoiding waste.
However, in healthcare, efficiency does not solely rely on achieving maximum outputs while minimising costs. It is crucial to also consider the quality of care provided. Overloading doctors with an excessive number of patients in an attempt to lower costs per patient may initially appear appealing, but it can compromise the standard of healthcare provided and contribute to medical professional burnout.
For this reason, the concept of ‘allocative’ efficiency is often applied to a healthcare context. This relates to prioritising some activities over others in relation to how they will meet set objectives, or considering if available resources are being directed towards the right outputs.
An example of this could be the allocation of resources towards preventive care and early interventions for chronic diseases, which can lead to better health outcomes and cost savings in the long term. For example, by prescribing hypertension medication at an early stage, patients have the potential to mitigate the risks associated with more severe conditions like cardiovascular disease.
It’s also important to consider the time frame. Investment in new technologies, training, or system reorganisation can have upfront costs but may result in longer-term efficiency gains.
6 companies accelerating NHS efficiency
With NHS efficiency being a more imperative focus than ever, here are six companies following in EMIS’s footsteps and helping to make the NHS more efficient.
Totally
With the NHS experiencing a surge in 111 calls during the colder months, the most recent Christmas season proved a huge challenge for the service. In December 2022, NHS 111 received 700,000 calls within a single week, a 60% rise compared to the previous week driven by an increase in strep A concerns. Except for the first two weeks of the Covid pandemic, this was the highest number of 111 calls ever recorded, according to NHS England.
With this in mind, () is in a strong position to address the growing demands on healthcare services, including 111 calls, and enhance the overall efficiency of the NHS. By providing quality urgent care services like NHS 111 and urgent treatment centers, as well as elective care services such as community dermatology clinics and first contact practitioners, Totally is making sure that patients have speedy access to the most suitable care within the NHS.
Totally also delivers additional clinical capacity through insourcing and outsourcing arrangements to trusts and hospitals tackling growing waiting lists. The company’s help with this is particularly crucial, given that in the wake of the pandemic, the pressure of caring for large numbers of patients seriously unwell with Covid-19 has led to the waiting list for elective care reaching the highest level since current records began. Totally is helping to narrow the gap of open patient pathways, helping NHS England reduce waiting lists by approximately 40,000 in the last year alone.
The company has recently picked up multiple contracts, a testament to its crucial role in improving the efficiency of the NHS. Last month, Totally announced a framework agreement with NHS Wales for insourcing services to address 735,000 open patient pathways by December 2022. They also secured a £1.5m contract for urology services in Ireland to help reduce waiting lists for diagnostic colonoscopy and gastroscopy procedures from May 2023 to December 2023
Overall, Totally’s services address growing healthcare demands, reduce waiting lists, and ensure timely access to appropriate care, all enhancing NHS efficiency.
Crimson Tide
() is a software company that provides mpro5, a software platform that delivers mobile workforce solutions for businesses. It helps businesses manage tasks and workflows, track assets and equipment, ensure compliance with regulations, and provide real-time reporting and analytics. The platform also enables better communication and collaboration between team members.
Crimson has recently been picking up pace in helping healthcare facilities become more efficient. The software company recently announced it had won a contract with an NHS trust in the South East of England for c.£250k, swiftly followed by a further contract win with the NHS in May. Crimson’s implementation of mpro5 into NHS facilities will drive efficiencies and savings across NHS Trust estates.
Crimson collaborated with Coventry and Warwickshire Partnership Trust (CWPT) to integrate mpro5 with its subcontractors, enabling efficient management of over 90 sites with a small estates team. By utilising mpro5, CWPT successfully replaced numerous functions of their overwhelmed help desk. Acting as the linchpin, mpro5 facilitated seamless communication and coordination between CWPT's facility management system and the 125 external companies responsible for inspections, maintenance, and repairs, streamlining operations across all involved parties.
As a result, CWPT's maintenance helpdesk has been reduced from nine people to just two, freeing up department time to focus on more complex tasks such as assessing completed work.
On the financial front, Crimson’s ‘land and expand’ strategy - in essence, upselling to existing customers - saw annualised recurring revenues increase by 51% in 2022 to £5.75m.
DXS International
() is supporting NHS efficiency by providing up-to-date guidelines, integrating decision support into workflows, facilitating evidence-based decision-making and promoting cost-effective healthcare delivery, all of which contribute to the NHS's efficiency savings targets.
It’s flagship product, Best Pathway, is designed to help GP’s tackle referral inefficiencies. DXS smart referrals make referrals forms shorter, so they’re easier and faster to complete, in turn significantly reduces referral rejection rates.
Its second product, ExpertCare, is a hypertension-prescribing tool that frees up NHS clinicians time by allowing nurses and pharmacists to conduct the majority of hypertension consultations with minimal GP input, in turn, maximising time to see other patients.
ExpertCare can reduce GP time spent on hypertension consultations by 328 hours per year, which equates to an annual saving of £24,000. Moreover, by contributing to a significant reduction in heart attacks and strokes, ExpertCare has the potential to save the NHS an average of £14,000 per practice per year.
From a financial perspective, DXS said it aims to rapidly scale annual revenue to £4.7m by April 2024, up from £3.3m in April 2023. Plans to achieve this will come from increasing NHS revenue by 27% to £2.3m, with approximately 16% (representing 60% of the increase) of the NHS revenue increase currently under discussion.
Overall, DXS International's provision of up-to-date guidelines, integrated decision support, and cost-effective healthcare solutions support NHS efficiency and contribute to its savings targets.
Kooth
() is a UK company that offers mental health and wellbeing support to people across the country through its online digital platform. Its goal is to build inclusive communities and services for people of all ages, including adults, young people, employers, and students. It’s digital mental well-being platform adopts a proactive approach to mental health support, emphasising preventive care and early interventions as key components of its product.
Its mental health and wellbeing support services can contribute to improving NHS efficiency by reducing the demand for NHS mental health services. In 2021, Kooth was contracted by more than 90% of NHS England Clinical Commissioning Groups to support the mental health needs of children and young people. This was particularly vital at the time given the rise in mental health issues in the wake of Covid, with government stats finding that during school closures from March to June 2020, depression and post-traumatic stress disorder symptoms significantly rose in children and young people aged 7.5 to 12 years compared to pre-pandemic levels.
Kooth's services also help to support the mental health and wellbeing of NHS staff themselves. This can indirectly contribute to improving NHS efficiency by reducing staff absenteeism, improving staff retention rates, and enhancing the overall functioning and performance of the NHS workforce.
For example, Kooth presents the case study of an NHS worker who was placed on a waiting list for NHS IAPT services by his GP. However, after receiving counseling interventions on Kooth, the NHS worker experienced significant enhancements in his mental health and subsequently opted to remove himself from the IAPT waiting list.
Overall, Kooth can help to alleviate some of the pressures on NHS mental health services by contributing to a more sustainable, preventative, and inclusive mental health support system.
Intelligent Ultrasound
() is improving NHS efficiency through smoother, faster, and safer imaging department processes. Originating from Cardiff University, this company develops user-friendly software applications that enhance the ease and efficiency of ultrasound imaging, employing a ‘Classroom to Clinic’ approach to accelerate scanning by providing training support and clinical support tools for medical professionals.
Two products have been developed by Intelligent Ultrasound so far, one for one for obstetrics, the other on regional anesthesia. For the former, Intelligent Ultrasound has developed ScanNav assist, software that is embedded in ultrasound scanners that provides real-time guidance to clinicians and is used to act like a scanning assistant comparing images to standard criteria, in turn reducing operator variability and subsequently improving patient outcomes.
For local anesthesia, ScanNav Anatomy Peripheral Nerve Block is a tool that helps doctors perform ultrasound-guided nerve blocks more accurately. When using an ultrasound machine, doctors can use ScanNav™ to see a color overlay on the ultrasound image that highlights important anatomical structures.
It’s AI-led technology allows for faster throughput, more accurate diagnosis, and reduces operators’ burnout. It’s equipment is already in use at a number of UK NHS hospitals, including John Radcliffe in Oxford, Hull Royal Infirmary, Stoke Mandeville in Buckinghamshire and University College London.
Genedrive
() is striving to improve NHS efficiency by developing and commercialising molecular diagnostics for infectious diseases, human genotyping and pathogen identification. They specialise in developing rapid, affordable, and easy-to-use diagnostic tests that can be deployed in various healthcare settings, including resource-limited and remote areas.
Genedrive’s MT-RNR1 ID Kit is currently available in NHS trusts across the country, and is used to accurately identify babies with the primary genetic variant who may be at risk of hearing loss, yielding results in less than 30 minutes.
1 in every 13 babies in the UK is born prematurely, which is accompanied by an increased risk of infection following an underdeveloped immune system. Aminoglycoside antibiotics are used to treat severe bacterial infections, but in an estimated 1 in 500 cases, their use can result in permanent hearing loss.
The Genedrive® MT-RNR1 ID Kit can be used to identify if a baby has a genetic variant that make them not respond well to aminoglycoside antibiotics. The kit is simple to use, with healthcare professionals needing minimal training, alongside being easily adopted into existing neonatal admissions processes.
Another of Genedrive’s products - the CYP2C19 ID kit - currently in development, has the potential to prevent stroke-related deaths and improve NHS efficiencies. Each year in the UK, over 100,000 strokes occur, leading 38,000 deaths and leaving two-thirds of survivors with long-term disabilities.
From strokes, the financial impact on the NHS alone exceeds £3 billion annually. However, when considering broader factors such as the societal cost encompassing loss of productivity among stroke survivors of working age and the hours dedicated by unpaid caregivers, the overall economic burden reaches a staggering £26 billion per year.
Genedrive’s CYP2C19 ID kit is designed identify people carrying the loss-of-function mutation conferring inadequate metabolisation of a common drug given to heart attack patients to stop them from having another one - known as clopidogrel.
Overall, Genedrive’s products offer quick results and ease of use, contributing to improved efficiency in healthcare delivery.
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