THE EASTERN

ACADEMIC
HEALTH SCIENCE
NETWORK
PROSPECTUS & BUSINESS PLAN 2012
Contact us

+44 (0)1480 364148

Email: eahsn@cuhp.org.uk
 THE EASTERN
ACADEMIC
HEALTH SCIENCE
NETWORK
PROSPECTUS &
BUSINESS PLAN 2012
Contents
1. EXECUTIVE SUMMARY 1
2. INTRODUCTION 2
3. EAHSN MODEL AND CORE PURPOSE 3
3.1 Vision and strategic goals 3
3.2 Structure of network model 3
3.3 Members, geographical footprint and population 5
3.3.1 EAHSN members 5
3.3.2 Geographical footprint and population covered 8
3.3.3 Health profile of the Eastern Region 8
3.3.4 R&D profile of the Eastern Region 9
3.3.5 Working with external partners, research networks and other AHSNs 10
3.4 Challenges and how we plan to address them 11
4. IDENTIFICATION, ADOPTION AND SPREAD OF BEST PRACTICE 12
4.1 Framework for translational research 12
4.1.1. Knowledge management  12
4.1.2 Translating research and learning into practice 15
4.1.3 Developing collaborative partnerships 17
4.1.4 Productive partnerships with industry/wealth creation 18
4.1.5 Driving service improvement 22
4.1.6 Vision and working with Eastern Local Education and Training Board (LETB) 23
4.1.7 Creating patient-centred information for health 23
4.2 Performance metrics 25
5. DELIVERING SPECIFIC FUNCTIONS IN RELATION TO RESEARCH 26
5.1 Key objectives in relation to research  26
5.2 Exemplars of research performance management 27
5.3 Promoting participation in research 28
5.3.1 More opportunities for patients to participate in clinical research 28
5.3.2 Increased recruitment of patients 29
5.3.3 Proactive support for life sciences industry research and development 29
5.3.4 Single sign-off for research governance 30
5.3.5 Timely payment of treatment costs 31
6. GOVERNANCE ARRANGEMENTS 31
6.1 Incorporation of partnership and nodes 31
6.2 Concordat between partner organisations  32
6.3 Shared values 33
6.4 Legal entity of the EAHSN  33
6.5 EAHSN Board of Directors 34
6.6 EAHSN Executive 34
6.7 EAHSN Node structure 34
6.8 EAHSN Reference Group 34
6.9 Leads for key priorities 34
6.10 Node responsibilities 34
6.11 AHSC nested within EAHSN 35
6.12 Impact assessment 35
7. EVIDENCE OF DEMONSTRABLE PROGRESS AND COLLABORATIVE WORKING 36
7.1 High impact innovations 36
7.2 NHS Midlands and East Ambitions 36
7.3 iTAPP push technologies - National Technology Adoption Centre (NTAC) 36
8. FIVE YEAR WORK PROGRAMME  36
8.1 Our clinical priorities 36
8.2 EAHSN education and training development five year programme 38
8.3 Collaborative procurement 38
AppendicesI
APPENDIX A: ANTICIPATED AND CONFIRMED EAHSN PARTNER AND AFFILIATED
ORGANISATIONSII
APPENDIX B: EAHSN ACTIVITY IN EDUCATION AND TRAINING  IV
APPENDIX C: EAHSN PROPOSED METRICS XVIII
APPENDIX D: FUTURE PRIORITIES FOR EDUCATION AND TRAINING XXIV
APPENDIX E: DRAFT OF FIVE YEAR BUSINESS PLAN XXVII
APPENDIX F: HEALTH ENTERPRISE EAST INDUSTRY ENGAGEMENT DRAFT
DOCUMENTL
Glossary LIII
1. EXECUTIVE SUMMARY
1. The Eastern Academic Health Science
Network (EAHSN) will bring together
universities, hospitals, mental health
services, primary care, clinical
commissioning groups, public health,
social care, the voluntary sector
and industry, translating world-class
research into improved patient care,
thus driving economic growth.
2. The EAHSN will be an energised,
proactive and non-hierarchical
organisation, working across four large,
established biomedical and clinical
communities, with a clear commitment
to drive sustainable improvements,
through partners with a track record
of excellence in research, teaching and
education, health services and industry.
3. Cambridge University Health Partners
(CUHP), as one of five designated
Academic Health Science Centres, will
be a member of the EAHSN and will
bring expertise, particularly in relation
to the first translational gap (linked
to the NIHR Biomedical Research
Centre), the application of genomics,
fundamental biomedical discoveries and
population health sciences.
4. The EAHSN will innovate and evaluate in
ways of healthcare delivery, which will
include more effective working between
primary care, secondary care and social
care to develop a new paradigm, with
focus on ambulatory, more integrated
care, personalised medicine, 7/7
working and improved quality with less
unwarranted variation.
5. EAHSN will initially work across three
areas of clinical priority: dementia,
long-term conditions (cardiovascular
disease, cancer, diabetes and chronic
respiratory diseases) and patient safety,
with clear deliverables for quality and ‘The EAHSN will
outcome in each, to make healthcare be an energised,
across the EAHSN more joined up for
patients, achieving better, safer, more
proactive and
cost effective services. non-hierarchical
6. The EAHSN will use strengths in public organisation,
health, research, innovation, education
working across
and service improvement to address
health inequalities and improve patient four large,
and population health outcomes. established
The EAHSN will bring academics and biomedical
providers together in order to develop
trusted, actionable information systems,
and clinical
linked to research databases, to drive communities,
a culture of quality improvement, to with a clear
promote and implement the most commitment to
clinically and cost-effective treatments.
7. The EAHSN will link research to health
drive sustainable
outcomes through improved delivery by improvements.’
working with partners, breaking down
barriers, bridging the gap between
research and implementation, thereby
achieving the goals of Innovation Health
and Wealth. In this, initial priorities
will be to streamline and simplify the
arrangements for research, to bring
innovation that benefits patients more
rapidly into practice, with proportionate
governance.
8. The EAHSN will establish broader and
deeper relationships with industry,
building on existing partnerships
with globally renowned research
departments and institutes, and leading
companies in growing markets. The
EAHSN will extend our established and
successful Small Business Research
Initiative (SBRI) and work with
Health Enterprise East, our leading
innovation hub, and technology transfer
enterprises to secure the region as
home to the largest and most successful
life science cluster outside the United
States and to sustain it for the future by
The Eastern Academic Health Science Network | 1
‘The EAHSN will deepening international business links
work through for the export of products and services.
9. The EAHSN will create a focused and
partners with accountable professional system with
a track record clinical and academic leadership at its
of excellence heart that will nurture innovation and
in research, drive excellence in health and care.
10. The EAHSN will be a flexible
teaching and organisation, seen as committed to
education, working in partnership to achieve
health services its goals and to form productive
links with other AHSNs, the National
and industry.’
Commissioning Board and the emerging
organisations in the NHS.
2. INTRODUCTION
The current configuration of the health
system does not allow for the rapid
translation of innovation into clinical
practice. This is a major disincentive
for industry to invest in research and
development. In response to this problem,
Innovation, Health and Wealth was
launched in December 2011 by the Prime
Minister, with the purpose of defining
the NHS’s contribution to the Plan for
Growth. Innovation, Health and Wealth
also set out a vision for creating a system
for delivery of innovation, through the
establishment of a number of Academic
Health Science Networks (AHSNs) across
the country, linking clinical research,
academic medicine, science and industry.
Innovation, Health and Wealth described
the important and unique benefits that
these networks could bring for patients,
populations and the economy.
AHSNs were identified by Innovation,
Health and Wealth as a vehicle by which
the NHS and universities would work
with industry, with the goal of improving
patient and population health outcomes
2 | The Eastern Academic Health Science Network
by translating research into practice, and
developing and implementing integrated
health systems. In this endeavour the
AHSN will effectively be a health system
that aligns education, clinical research,
informatics and healthcare delivery
across the region through a network of
collaborative partnerships. The Strategy
for UK Life Sciences was published in
tandem with Innovation, Health and
Wealth and sits alongside it in its vision
for a new focus of translational medicine,
the nurturing of innovation and the
provision of a route for the early adoption
and diffusion of innovation in the NHS.
The overarching aims of these two
important research strategies are to open
up universities and business to more
collaboration, and to open up the NHS to
new innovations. The Eastern Academic
Health Science Network (EAHSN) will be
the catalyst for creating a framework and
an environment to implement this across
the Eastern Region.
This prospectus sets out how the
EAHSN will serve its population of 4.6
million people, by inclusion of partners
from academia, NHS primary, secondary
and tertiary care, commissioning, public
health, social care and industry. The
number of network partners is ambitious,
but we believe that in order to achieve
cross-boundary working at multiple
levels, it is essential to establish strong
partnerships and shared values across
the region that are robust enough to
transcend boundaries.

3. EAHSN MODEL AND CORE PURPOSE
3.1 Vision and strategic goals
The EAHSN vision is to improve patient
and population health outcomes for
the population of the Eastern Region
by translating NHS and commercial
research into practice and developing
and implementing integrated healthcare
systems. We will do this in collaboration
with a network of local, national and
international partners by promoting
participation in research, translating
research and learning into practice,
collaborating on education and training,
driving service improvement, creating
patient centred information and enabling
productive partnerships with industry.
The EAHSN strategic goals are to:
• Create a regional framework for the
implementation of Innovation, Health
& Wealth and the Strategy for UK Life
Sciences that connects researchers in
our academic institutions with partners
in primary, secondary and tertiary care,
public health, social care, and industry.
• Work in partnership with industry,
and support both industry and NIHR
research, by providing easy access to
academic and clinical collaborators,
research infrastructure and research
subjects. To make the Eastern Region
the ‘go to’ place in Europe to set up
substantial new knowledge-based
healthcare businesses, building jobs,
increasing exports and creating wealth
for the region and the UK.
• Lead the effective identification of
innovation, best practice and evidence-
based approaches for improving health
that are cost-effective, and can be
rapidly adopted and implemented
across the Eastern Region. This
will include nationally designated ‘The EAHSN will
innovations and those arising from the include more
EAHSN programme of work.
• Address health inequalities by
effective working
identifying and addressing variations between primary
in health outcomes and in the delivery care, secondary
of healthcare in the Eastern Region care and social
through the analysis of robust data; and
to develop a trusted centre for data
care to develop
analysis and data sharing within the a new paradigm,
EAHSN, that will link primary, secondary with focus on
and tertiary care data, improving the
ambulatory,
quality and availability of information.
• Use proven improvement science more
methods and professional networks integrated care,
to deliver measurable improvement personalised
in outcomes for the major chronic
diseases that have the greatest scope
medicine,
for improvements. This will be achieved 7/7 working
both through better prevention of and improved
disease, better management of ill health
quality with less
and improved healthcare systems.
• Develop capacity and capability by unwarranted
creating a culture of learning within variation.’
the EAHSN workforce, educated to
be literate in research and research
translation, using an inter-disciplinary
approach to professional and clinical
leadership development.
3.2 Structure of network model
The EAHSN will cover a wide geographical
area which contains a number of
independent centres of excellence in
education, research and clinical delivery.
Although Cambridge University Hospital
Partners (CUHP) is an Academic Health
Science Centre (AHSC), an early decision
was made to pursue a non-hierarchical
approach in the network model, as we
wanted to achieve a broadly based,
horizontal organisational structure in order
to realise a sense of a shared vision. We
believe that this network model is better
placed to develop efficient knowledge
exchange networks that will support
research translation.
The Eastern Academic Health Science Network | 3
‘The EAHSN At the core of the network are a set
will initially of inter-relationships, the dynamic and
collaborative nature of which will transform
work across the quality of care in the Eastern Region. In
three areas of addition we will build upon the expertise
clinical priority: within the region in research, service
dementia, long- improvement, education and training, and
establish a common goal with industry to
term conditions create wealth.
(cardiovascular With these ideas in mind, we have
disease, cancer, developed an organisational network model
that is designed to achieve full integration
diabetes
across our regional health system (Figure
and chronic 3.1). For the model to work, it will
respiratory require effective and porous interfaces
diseases) and among academic departments, research
organisations and delivery systems. We
patient safety.’ have decided that this is best managed
by creating a structure with a centre and
four surrounding ‘nodes’. The centre is
the EAHSN which will be established as a
not-for-profit company (this is explained
in detail in Section 6 on Governance).
Each node will engage with partners from
local government, primary, secondary and
tertiary care, social care, public health and
industry who will become ‘members’ of
the node. In this way we hope to develop
a network of robust relationships across
the region encompassing all stages of the
patient pathway.
The nodes will be Cambridge, Colchester,
Norwich and Stevenage. Each node has a
large and established clinical community
and in addition there is a much larger
reference group of organisations across
each node, which will support the
EAHSN programme of work, through the
mechanism which is described in Section 6
(Governance arrangements).

Member Member

Member Node 1 Node 2

Member Member

Member Member Director Chair Member Member

Director Director
Department of Health Contract EAHS
£ Company
Director Director

Member Member Director Director Member Member

Member Node 3 Node 4

Member Member

Member Member

Figure 3.1 Model of node membership of the EAHSN

4 | The Eastern Academic Health Science Network

3.3 Members, geographical footprint
and population
3.3.1 EAHSN members
EAHSN membership is drawn from a wide
range of organisations from across the
region. We are concluding discussion with a
number of organisations, and our intention
is to encourage universal participation
within the defined geographical footprint.
The list of our members is therefore work
in progress and a full list of current and
potential members can be seen in Appendix
A. Current members are:
Higher Educational Institutions engaged in
healthcare education and research:
• University of Cambridge, University
of Essex, University of Hertfordshire,
University of Bedfordshire, University of
East Anglia.
Primary and community care:
• NHS Cambridgeshire and Peterborough
CCG, NHS East and North Hertfordshire
CCG, Cambridgeshire Community
Services, Hertfordshire Community
Services, Norfolk Community Health
and Care.
Secondary, Tertiary care and independent
and 3rd sector providers:
• Cambridge University Hospitals NHS
Foundation Trust, Hinchingbrooke
Healthcare NHS Trust, Papworth
Hospital NHS Foundation Trust,
Peterborough and Stamford Hospitals
NHS Foundation Trust, West Suffolk
Hospital NHS Foundation Trust,
Cambridgeshire and Peterborough
NHS Foundation Trust, East and North
Hertfordshire NHS Trust, Bedford
Hospital NHS Trust, Norfolk and Norwich
University Hospitals NHS Foundation
Trust, James Paget University Hospitals
NHS Foundation Trust, The Ipswich
Hospital NHS Trust, The Queen Elizabeth
Hospital King’s Lynn NHS Foundation ‘Working
Trust, Norfolk and Suffolk NHS together to make
Foundation Trust, Colchester Hospital
University NHS Foundation Trust.
healthcare across
the EAHSN
A designated Academic Health Sciences more joined
Centre: up for patients,
• Cambridge University Health Partners.
achieving better,
Public health: safer, more
• Eastern Region Public Health cost effective
Observatory (ERPHO), Cambridge
services.’
Institute of Public Health, Public Health
Genomics Foundation.
Local government:
• Cambridgeshire County Council, Norfolk
County Council, Suffolk County Council.
Node profiles
Cambridgeshire and Peterborough profile
With its centre in Cambridge, the
Cambridgeshire and Peterborough node is
a well-integrated health and care economy
serving a population of 1 million. Input to
the AHSN process has been led and co-
ordinated by Cambridge University Health
Partners. The co-terminosity of the major
providers with a single purchaser, single
mental health trust and single community
trust presents particular opportunities for
service development.
The area is characterised by the powerful
presence of international research
institutions such as those of the MRC, the
BBSRC (Babraham Institute), the Wellcome
Trust (Sanger Institute), Cancer Research UK
and the EMBL EBI (European Bioinformatics
Institute), the University of Cambridge and
industry clusters in bio-pharmaceutical,
wireless communications, electronics and
computing. The sub-region is particularly
well served with science parks and
technology consultancies.
North Essex Colchester profile
The North Essex node comprises those
parts of Essex most integrated with research
The Eastern Academic Health Science Network | 5
‘Working agencies in the Eastern Region. This node is
together to to based in Colchester where it is represented
by the University of Essex and its partner
address health the Colchester Hospital University NHS
inequalities and Foundation Trust. The node covers a
improve patient population of up to 720,000. The University
and population has particular strengths in nursing,
physiotherapy, speech and language and
health psychology and hosts the Regional Research
outcomes.’ Design Service (RDS), which represents a
wide range of organisations (five universities
and four trusts based in the EAHSN area)
working at the interface between higher
education and the NHS. The RDS East of
England fosters collaborations between
Universities, NIHR organisations; NHS trusts,
Clinical Trials Units (CTUs), third sector
organisations and lay representatives to
support health and social care researchers
develop high-quality research proposals
with potential to improve patient care.
The University houses the Institute for
Social and Economic Research and the UK
Data Archive. The hospital has a purpose-
built simulation centre and is a leading
centre for laparoscopic surgery. North
Essex has close links with the Association
of British Pharmaceutical Industries (ABPI),
Lilly, Novartis and MSD.
Hertfordshire and Bedfordshire profile
The Hertfordshire and Bedfordshire node,
centred on Stevenage, covers a population
of about 1.25 million and has links both
within the Eastern Region and also to major
medical and academic centres in London
and Oxford, relationships that will facilitate
working between the respective AHSNs.
Input to the AHSN process has been co-
ordinated by the University of Hertfordshire
and its principal NHS partners the East and
North Hertfordshire NHS Trust and the
Hertfordshire Partnership NHS Foundation
Trust which provides mental health and
community services.
The area is characterised by the presence
of major international pharmaceutical
companies such as GSK, MSD and Roche,
6 | The Eastern Academic Health Science Network
and clinical research strengths at East and
North Hertfordshire NHS Trust, the leading
research organisation within the Herts and
Essex CLRN, include cancer (especially at
the Mount Vernon Cancer Centre), renal
medicine and urology. The University
has particular strengths in pharmacy,
nursing, allied health professionals
and bio-engineering and was the THES
Entrepreneurial University of the year in
2010. Their £30 million Health Sciences
Building has world-class teaching and
conference facilities including the UK’s
largest purpose-built multi-professional
clinical simulation centre.
The University of Hertfordshire and
University of East Anglia (UEA) both have
active patient and public involvement
(PPI) in research strategies, and have a
joint project (RAPPORT, NIHR HSR) which
addresses the complex issues of PPI.
Norfolk and Suffolk profile
The Norfolk and Suffolk node has a
combined population of 1.6 million and
its node is in Norwich the home of UEA
Health Partners, a consortium of the
University of East Anglia and its principal
NHS partners. Mental health services are
provided by a single, recently-merged trust
covering Norfolk and Suffolk, the Norfolk
and Suffolk NHS Foundation Trust (NSFT)
which is among the top 10 Mental Health
Trusts in the country for portfolio studies
with a strong mental health research base.
It is host to the Mental Health Research
Network, and DeNDRON (Dementias and
Neurodegenerative Diseases Research
Network) for the region. UEA Health
Partners established a HIEC focused on
dementia (the Norfolk and Suffolk Dementia
Alliance) in 2010 which is leading teaching
and research in the field and which
supports the Trust’s Dementia Academy
initiative. NSFT has an innovative and
nationally recognised youth mental health
model developed from evidence from the
professional research unit and UEA.
 The Norwich Research Park (NRP) is home
to a major national centre for research
into crop science, food and microbiology
and combines the University of East
Anglia, Norfolk and Norwich Hospital and
the BBSRC-funded John Innes Institute
and the Institute for Food Research on a
single site. In the last year the NRP has
attracted (£26m) of government funding.
The research strategy of UEA’s Faculty of
Medicine and Health Sciences is aligned
with the potential of the NRP.
All these EAHSN partners already have
a history of working together to achieve
improvement in clinical outcomes. Towards
the Best, Together, a strategic partnership
for improvement in outcomes across
the Eastern Region, enabled significant
improvements, including establishment
of a regional trauma network; delivery
of 24/7 PPCI (Primary Percutaneous
Coronary Intervention) through working
collaboratively; and improvement in end-of-
life care. EAHSN is therefore starting from
an established base of cooperation and
collaboration: a warm as opposed to a cold
start.
Working with regional teams and national
partners:
• NHS Midlands and East: We have
shared our work with colleagues in
other AHSNs and worked in partnership
with NHS Midlands and East. The work
undertaken by NHS East of England in
Towards the Best, Together has provided
a valuable basis for the development of
this programme, and we acknowledge
the successful model that this has
provided for large-scale sustainable
change.
• National Commissioning Board (NCB):
We have discussed these proposals
with the NHS Regional Office of the
National Commissioning Board. We
will work closely with Local Area Teams
of the National Commissioning Board,
once they have been established, to
discuss our plans and proposed working ‘The EAHSN
arrangements. will drive a
• Public Health England (PHE): We
have involved colleagues in Public
culture of quality
Health extensively in the preparation improvement,
of this prospectus and in discussions to promote and
about the further development of implement the
data and information systems to drive
improvement. The regional office
most clinically
for Information for Health will be an and cost effective
important source of health intelligence treatments.’
expertise, and Eastern Region
Public Health Office (ERPHO) will be
transferred to PHE to take up this role.
It is our aim to establish an integrated
information system across the EAHSN
and we will work with PHE’s Information
for Health to achieve this. The regional
phe office for health improvement
and population health (still to be
appointed) will be responsible for the
PHE strategy for a 21st century health
and wellbeing service, and tackling
health inequalities. An invitation to join
as a network partner will be extended
as it is essential that we have strategic
public health input into our programme
of work particularly in terms of
implementation and evaluation.
• Health Education England (HEE):
We will work closely with the
Local Educational Training Board
(LETB), ensuring that work plans are
complementary and add value. See
Section 4.1.6 for details.
The Eastern Academic Health Science Network | 7
‘Initial priorities 3.3.2 Geographical footprint and
will be to population covered
streamline and The geographical area covered by EAHSN
simplify the will be the whole of the East of England
arrangements SHA area (except for the areas of South
Essex and West Hertfordshire which
for research, to
traditionally form part of the sphere
bring innovation
that benefits
patients more EAHSN regional profile at September 2012
rapidly into
practice.’
Figure 3.2 geographical footprint of EAHSN
3.3.3 Health profile of the Eastern
Region
The Regional Director of Public Health,
reporting on the health of the population
of the East of England in 20101,
highlighted that there has been progress
in health outcomes - particularly in death
rates from heart disease, stroke and
cancer which show steady declines. Other
areas in the report:
• The health of people in the East of
England is generally better than the
1.
Can be found at www. average for England, however, the
apho.org.Uk/resource/ region has a higher than average rate of
view.aspx?RID=95369 road injuries and deaths.
8 | The Eastern Academic Health Science Network
of influence of major London medical
institutions and will join an AHSN based
on University College London Partners,
but will be affiliated to EAHSN). In total
the geographical area of the EAHSN covers
a population 4.6 million across nine upper
tier local authorities.
• There are inequalities in health within
the region and these are closely related
to deprivation; the health of people in a
small number of local authorities in the
region, for example Peterborough and
Luton, is generally worse than average.
• Life expectancy in men is 79.6 years
compared to 78.6 years nationally;
within the AHSN however male life
expectancy varies from 77.5 years in
Peterborough to 80 in Cambridgeshire.
• Some parts of the area have significant
populations of older people - for
example 3% of the population of
Norfolk is over 85 (compared to 2.3%
across England) with consequent
 impacts on social care provision. Around
20% of the population still smokes -
rising to 25% in some places, and 23%
of adults are obese.
• GCSE attainment across the East of
England is higher than the average
for England. However, there are local
authorities in the region where the rate
of attainment is amongst the worst in
England.
• Death rates from all causes for men
and women have reduced substantially
in the region and remain lower than
England overall.
• The rate of alcohol related admissions
is lower than the England average but it
has continued to rise.
• The proportion of adults participating in
recommended levels of physical activity
has fallen in the region.
• While death rates from smoking in the
East of England remain lower than the
England average, preventing ill health
by addressing smoking continues to be
a priority for the region.
• We estimate that across the Eastern
Region, there are about 250,000
people with diabetes; 210,000 people
with heart disease; 110,000 people
with COPD; and nearly 100,000 stroke
survivors in the population. At least
22,000 people are known to suffer from
dementia, although this is likely to be a
considerable underestimate.
3.3.4 R&D profile of the Eastern Region
The Eastern Region has an excellent
record of collaboration between academia,
the NHS and industry which has led to
the establishment of an Academic Health
Science Centre (AHSC) in Cambridge -
Cambridge University Health Partners
(CUHP). There is a similar academic-NHS
grouping, the University of East Anglia
Health Partners in Norwich. Both of these
partnerships are associated with a Health
Innovation and Education Cluster (HIEC)
which draws in broader local collaboration ‘The EAHSN will
on improvement projects while being based establish broader
in a strong and well-defined industrial
cluster. The Hertfordshire and Essex nodes
and deeper
have similar but less formally constituted relationships
bi-lateral and multilateral collaborations with industry.’
between the Health service, HEIs and
industry.
In the research domain, the Eastern
region, as well as hosting one of the five
accredited AHSCs in the UK, also hosts
one of the five major NIHR Biomedical
Research Centres (the Cambridge BRC),
an NIHR Biomedical Research Centre
in dementia, an NIHR Collaboration for
Leadership in Applied Health Research and
Care (CLAHRC CP), a number of effective
and well-regarded topic specific clinical
and research networks (CRN), a leading
NHS Innovation Hub, and three successful
NIHR CLRNs (Comprehensive Local Research
Networks) with some notable successes
in clinical trial recruitment. The Research
networks are Anglia East Cancer Network
(Norwich), DeNDRON (Norwich), Primary
Care Research Network, Public Health
research in Cambridge and Norwich, Eastern
Region Diabetes Network (Cambridge), and
Research biobanks. There is a Clinical Trials
Unit based at Norwich Medical School and
run jointly with the Norfolk and Norwich
University Hospital, and the Clinical Trials
unit at CUH has just received accreditation.
Major investments by several research
councils, the Wellcome Trust and other
charities are described below.
The Eastern Region is home to a series
of exceptionally strong industry bases -
pharmaceuticals, biotech, informatics,
electronics, wireless sensing, materials
technology and food production, which
are, in many different ways, converging and
combining to provide innovation in health
and social care delivery. Traditionally strong
in basic scientific research and translational
medicine, the EAHSN is well placed to
address the later gaps in innovation in the
discovery-care continuum: this is largely a
The Eastern Academic Health Science Network | 9
‘The EAHSN will
secure the region
as home to the
largest and most
successful life
science cluster
outside the
United States.’
10 | The Eastern Academic Health Science Network
result of the ground-work undertaken by
these multiple-partner agencies in recent
years.
The region is an economic powerhouse
with an economy that is home to over
430,000 businesses and produces over
£110 billion of output per year - around
nine percent of the UK total. Companies
from across the globe chose to locate
here - including large multi-nationals like
Microsoft, GlaxoSmithKline, BIT, Ford, BAE,
Lotus and Johnson Matthey. Seven of the
UKs top 15 companies are based here.
The Eastern Region can claim to be the
centre of UK’s biomedical and bioscience
research and development - 25% of all UK
private sector investment in research and
development is spent in the region and 30
of the world’s leading research institutions
are based in the region. We are also
home to the largest and most successful
life sciences cluster outside the United
States and host to a globally-renowned
technology cluster in Cambridge. The region
can also boast considerable strength in
emerging sectors such as environmental
technologies and renewable energy.
However, our strength in research and
development is not yet matched by our
record on commercialisation. International
comparisons show that Eastern region
firms are less likely to introduce a new or
improved product to market, less likely
to introduce or allocate funds to training
or make capital investments to support
innovation.
3.3.5 Working with external partners,
research networks and other AHSNs
Academic Health Science Networks
In developing this prospectus we have
worked with other AHSNs through regular
meetings and sharing information. EAHSN
will work within the proposed network of
AHSNs to develop ideas, share learning
and, as appropriate, undertake projects
collaboratively or on behalf of other AHSNs.
Comprehensive Local Research Networks
and topic specific Clinical Research
Networks
The three Comprehensive Local Research
Networks (CLRNs) in the Eastern Region
(Figure 3.2) and the topic specific clinical
research networks (CRNs) have expressed
interest in working with the EAHSN. The
work of the CRNs will complement the work
done by the EAHSN in its clinical priority
areas and will offer CRNs an improved
platform for alignment as the networks will
be able to work with the EAHSN rather than
individual providers within the region.
Strategic Clinical Networks (SCNs) and
Clinical Senate
As with the CLRNs, the EAHSN will
complement the work of the Strategic
Clinical Networks (SCNs), and the Clinical
Senate. Our role will be to align our work
(cancer, cardiovascular disease, diabetes,
dementia and mental health) to support
the SCNs. The EAHSN could act as the
informatics, evidence base and innovation
arm to the SCNs. This proposal will need to
be explored as the SCNs and Clinical Senates
are developed. Well defined areas of shared
work and collaboration will be essential to
prevent duplication of effort e.g. in evidence
review, in public health intelligence and
implementation of best practice.
Association of British Pharmaceutical
Industry (ABPI)
We will ensure that the work of the
EAHSN will align with the newly created
structures being created between ABPI
and the NHS Commissioning Board. We
expect the larger national and international
members of ABPI to be working with all
AHSNs and we are already in discussions
with several of them to involve them in our
priority work-streams. Each of the nodes
will ensure the involvement of smaller, start-
up and local ABPI members.

Figure 3.3 Research structure in the EAHSN
Association of British Healthcare Industries
(ABHI)
We will ensure a more systematic
relationship with ABHI and its membership
on the adoption of medical technologies
and, in particular, of the emerging group of
home telehealth and telecare technologies,
especially at the level of evidence
assessment and input to policy.
One Nucleus/Medilink2
We will work with Medilink (for which
our Cambridge and Peterborough HIEC
member, One Nucleus is the regional
agent) especially in the area of collection of
statistics on industry sector development
and wealth creation.
3.4 Challenges and how we plan to
address them
Across the Eastern Region considerable
success has been achieved by working
through a clinical network model of delivery,
based on natural clinical communities
as opposed to a hierarchical model. The
EAHSN will build on this in the creation of
‘The EAHSN will
create a focused
and accountable
professional
system with
clinical and
academic
leadership at
its heart that
will nurture
innovation and
drive excellence
in health and
care.’
its distributive model of leadership. EAHSN
partners are working closely together
to explore and resolve the following
challenges, to maximise the benefits of the
network:
• Communicating the EAHSN’s vision to a
large number of network members who
are located over a wide geographical
area, in different organisations with
differing cultures, will present a
significant challenge, as will maintaining
a two-way dialogue. We believe that
the EAHSN nodal structure, with local
clinical champions and service users,
will help us considerably in addressing
this.
• Ensuring that the EAHSN leaders
meet regularly to strengthen their
relationship, share lessons learnt, make
decisions, share information, develop 2.
Medilink has corporate
policies and review strategy. The key to (medical, medical device
success will be excellent communication and health technology
and trust that transcends cultural companies), Associate
differences and ‘language’ barriers. (non medical companies)
We will explore the most flexible and and individual (in the
technologically able methods of sharing NHS, academia and
information, education and learning. industry) members.
The Eastern Academic Health Science Network | 11
‘The EAHSN will
use strengths in
public health,
research,
innovation,
education
and service
improvement to
address health
inequalities and
improve patient
and population
health
outcomes.’
3.
New Directions for
Knowledge Transfer and
Knowledge Brokerage in
Scotland. Office of Chief
Researcher Knowledge
Transfer Team Briefing
paper. Gill Clark and Liz
Kelly. Scottish Executive
Social Research 2005.
12 | The Eastern Academic Health Science Network
• Creating shared values across so a large
an organisation will present a challenge.
We need to celebrate and share inter-
professional, inter-disciplinary and
inter-nodal collaborative practices,
always exploring new ways to work in
integrative, innovative collaborative
models.
• Determining and agreeing the key
metrics by which to measure success of
the EAHSN will be a vital but challenging
task. If the bar is set too high so that
the metrics are linked to population
outcomes where cause and effect
cannot be established, then this will be
unhelpful and potentially de-motivating;
on the other hand, setting the bar too
low is not acceptable. Establishing key
performance metrics are essential as
the EAHSN will wish to demonstrate
clearly that it is adding value to the
health system.
• The economic outlook for the UK may
present challenges both to members
and to industry partners, who may be
challenged by recession with risks for
investment, sustainability of resources
and innovation.
• It will be essential for the EAHSN the
vision, strategy and Business Plan to be
revisited each year, and the strategic
plan updated if necessary and published
in the EAHSN Annual Report. Sharing
these experiences with other AHSNs will
also accelerate the learning.
It will be the task of the EAHSN Board to
do a risk assessment and to ensure that
everything is done to mitigate these risks,
using standard board level risk registers, and
this will help to achieve the sustainability of
the network.
4. IDENTIFICATION, ADOPTION AND
SPREAD OF BEST PRACTICE
4.1 Framework for translational
research
Our vision is to improve patient and
population health outcomes for the
population of the East of England by
translating research into practice and
developing and implementing integrated
healthcare systems. We will do this through
a number of mechanisms and levers
described below.
4.1.1. Knowledge management
Integral to our framework for translational
research is knowledge exchange. Our
strategy for knowledge management will
seek to adopt the most effective methods
of knowledge exchange (KE). The theory of
knowledge management and knowledge
transfer (also known as knowledge
exchange) are important concepts in
healthcare. The Canadian Health Services
Research Foundation was formed in 1997
to facilitate evidence informed decision-
making in Canada’s health sector, and built
the principle of ‘linkage and exchange’
into nearly all of its activities. At the
basis of these theories is the need for a
common language to create a collaborative
working environment. Cultural differences
between academic, policy and service
environments can lead to communication
misunderstandings, perpetuation of ‘silo’
working and the gulf between research,
policy and practice.
It is now recognised that there is a need
for knowledge brokers, who operate as go-
betweens linking academia, policy, public
sector practice and academia3. Work done
in Scotland’s Civil Service in 2005 identified
that the successful application of knowledge The EAHSN recognises that KE will play ‘The EAHSN will
brokerage resulted in increased research a crucial role in the translation of research establish broader
utilisation. Greenhalgh and colleagues into practice, and is the best use of the
used the term ‘knowledge purveyors’ in knowledge in an organisation; knowledge
and deeper
How To Spread Good Ideas, their important management creates new knowledge while relationships
research into diffusion, dissemination and it is in the process of being shared. Figure with industry,
sustainability in the NHS4. Other research 4.1 depicts a typical pathway of knowledge building
has found that electronic communication, translation into policy and practice. We
development of network, communities of will aim to build a deep understanding of
on existing
practice as well as knowledge brokers are this process so that it becomes part of the partnerships
the most effective methods of KE. organisational culture. with globally
renowned
Dissemination Implementation Diffusion
research
departments
New research Proof of clinical and and institutes,
Horizon scanning cost effective by
Clinical priorities work programme applying - health
Adopted Adopted Scaling up and leading
into local into local through Govt
Evaluation of current practice economics
Systematic reviews population perspective
policy practice policy companies
Innovation technical evidence in growing
markets.’
EVALUATION

Knowledge Knowledge Knowledge

exchange exchange exchange

Figure 4.1 Translation of research/innovation into policy and practice

4.
Greenhalgh, T. How
to spread good ideas.
A systematic review
of the literature on
diffusion, dissemination
and sustainability of
innovations in health
service delivery and
organisation. 2004.

The Eastern Academic Health Science Network | 13

‘The EAHSN Knowledge ‘harvesting’
vision is to The first step in the knowledge translation
process is the identification of new evidence
improve patient from a number of possible sources, for
and population example:
health • New evidence from the EAHSN clinical
priorities work programme.
outcomes for
• New research from within the EAHSN or
the population its network partners.
of the Eastern • A systematic process of horizon
Region by scanning (identifying emerging health
issues and advising on emerging
translating NHS technologies and innovation), this will
and commercial include ensuring that NICE technology
research into appraisals and guidance are rigorously
practice and and routinely adopted throughout the
network.
developing and • Identified by clinical variation in
implementing practice and outcomes (analysis and
integrated interpretation of health related data
sets including the determinants of
healthcare
health, monitoring of patterns of
systems.’ disease and mortality).
• An evaluation of an intervention or
clinical practice.
• Identified through a process of review
of current practice i.e. programme
review, patient pathway review or a
policy review, systematic reviews.
Developing and disseminating evidence of
effectiveness
Accelerating the dissemination of
research-based evidence into clinical
practice will need a mechanism that
ensures that the interventions enhance
the quality, accessibility and affordability
of healthcare services and improve patient
and population outcomes. Therefore new
evidence, or a new intervention, must be
assessed for clinical and cost effectiveness,
and have an impact assessment, before it is
recommended for adoption. At present the
function of assessment of new evidence or
evaluation of an intervention, is provided
in a number of locations usually by public
health experts e.g. the NHS Cambridgeshire
Evidence Adoption Centre, IFR (Exceptional
14 | The Eastern Academic Health Science Network
and individual funding requests) services
at the PCTs, specialist commissioning,
academic public health, NICE. These
services will be changing particularly as
some public health staff will be moving
to new working arrangements with local
authorities. One of the functions of the
EAHSN will be to identify the sources of
information and expertise in evaluation
and literature review, and where they
are located in the reorganised NHS/local
authority structure. We will seek to ensure
that these functions are effectively provided
to providers and commissioners without
either overlaps or gaps.
We expect that each node will set up their
own system of evidence review but it will
be important that there is no duplication
of work across nodes and across networks.
Therefore a system of sharing both positive
and negative findings will need to be set up
and evaluated.
Dissemination and uptake into policy
There are a number of methods that could
be used to disseminate into local policy
e.g. using boundary spanners, innovation
champions, research-service practitioners,
knowledge brokers, and creating ‘pull
through’ of knowledge by policy makers and
practitioners.
Adoption and implementation into practice
Methods for adoption and
implementation of innovation include
using ‘change agents’ to facilitate change
of clinical practice within primary,
secondary and tertiary care. By applying
methods of improvement science and the
principles of the NHS change model, we
will ensure that quality of service redesign
is consistent across the network. A major
part of the success of this implementation
strategy will be the engagement of clinical
commissioners and NHS service providers in
the process.
We believe that the knowledge translation
process from innovation to practice will:
• Deliver an effective identification and
diffusion of innovation and best practice
• Ensure and support the adoption
and spread of nationally designed
innovations.
• Identify innovations that the EAHSN
decides to prioritise for rapid diffusion.
• Provide for rapid evaluation and early
adoption of new innovations under tight
surveillance and monitoring.
4.1.2 Translating research and learning
into practice
The EAHSN will play a key role in the
identification of potentially high-impact
research from the many NIHR investments
and life sciences research groups in
regional universities and institutes. While
T3 and T4 translation into clinical practice
and policy, with a beneficial impact on
health outcomes, is the major focus, the
whole spectrum of translation from the
laboratory to the population is made more
efficient through the increased linkages
and communication between researchers
and the health system that will occur in
the nodes, the whole EAHSN and between
AHSNs at the national level. Here we
include some examples of current work
and opportunities for the network. The
existing work in all four nodes and the
centres of expertise in translation in each
University will enable the embedding of
approaches that facilitate translation into
routine practice in the health and social care
system.
For instance, the EAHSN encompasses
one of the nine NIHR collaborations for
leadership in applied health research and
care (CLAHRCs), as described above and
later in the section on collaborative work in
education. The EAHSN aims to incorporate
and build upon the implementation
science and methods to accelerate getting
research findings into practice that have
been established. Ideally, this will shape
the forthcoming application to NIHR for a
second round of CLAHRC funding. Such an ‘By applying
application will be designed to increase methods of
alignment with the footprint and aims of
the EAHSN within the resources available, to
improvement
work with other NIHR investments including science and the
the Evaluation and Implementation principles of
theme of the NIHR BRC and, if successful,
the NHS change
effectively to immortalise itself within the
EAHSN after a second, five year term. model, we will
The CLAHRC has increased the capacity ensure that
for applied health research and innovation quality of service
in the region through a programme of
CLAHRC Fellowships. Over a year, senior
redesign is
NHS and social care staff from around the consistent across
region are released a day a week to follow the network.’
a taught ‘innovation curriculum’ involving
the Judge Business School (JBS) and
Engineering Design Centre (EDC), work in an
apprentice model with health researchers
and take part in an action learning set.
This is described further in the section
on education (Appendix B) and links with
other initiatives involving the JBS such as
the Chief Residents Programme begun at
Addenbrooke’s Hospital and being rolled out
to other regional hospitals. The EAHSN will
expand and coordinate this approach within
and between the four nodes so as to create
capacity and capability for innovation.
The CLAHRC has increased the range of
decision tools to help decide which of many
potential innovations will lead to best value
for the NHS and social care; not everything
that is new is effective. Working with
systems engineers at the EDC, clinicians
and researchers have used maturity models
and, in particular, the Technology Readiness
Level (TRL) approach developed by NASA
to guide decisions on which of alternative
innovations, already supported by RCT
and cost-effectiveness evidence, may lead
to greatest value in a health system. This
TRL methodology will be scaled-up within
the EAHSN and form part of a systematic
appraisal of potentially innovative changes.
Engineers have also been closely involved in
the design approaches to improving patient
safety described, (Section 8, and the Draft
The Eastern Academic Health Science Network | 15
‘The EAHSN will Business Plan, Appendix E).
play a key role in Plans, described below (Section 4.1.7),
to make pseudononymised patient record
the identification data and information on health systems and
of potentially process, widely available within the EAHSN,
high-impact will greatly enhance ongoing research on
comparative effectiveness and systems
research from
analysis across the region. The considerable
the many NIHR strengths in health economics at UEA will
investments be linked with the health management
and life sciences interests of the JBS, where, for instance,
multi-level modelling of data on stroke
research groups demonstrates the complex relationship
in regional between staff workload, clinical outcomes
universities and and financial performance, is improving
institutes.’ the already effective stroke networks. This
approach to optimise care pathways and
workforce can be applied in other domains;
we propose an ‘exchange’ or economy
whereby partner organisations and nodes
can contribute information, work with
management scientists and economists to
define key questions of interest, increasing
their interest and eagerness for the results
resulting in rapid implementation of
innovation. The EAHSN and CLAHRC will
provide a forum for this exchange.
This model of ‘co-production’ and close
working between researchers and the full
gamut of research consumers (i.e. services,
commissioners, policy makers) has already
worked elsewhere at the regional level.
For example, psychometricians and health
economists in the CLAHRC using propensity
approaches for observational data worked
with the SHA and seven regional PCTs that
provided routine patient-rated outcome
data from the new IAPT psychotherapy
primary care services; more than 350
therapists have been appointed in the
region since 2007. IAPT services have led
to a massive increase in access to effective
cognitive behavioural therapies (CBT) for
those suffering mild to moderate depression
and anxiety. These are high prevalence
conditions with major personal and
economic impacts.
Data from 39,000 patients in seven
16 | The Eastern Academic Health Science Network
mature services in the Eastern Region
were used to assess the comparative
effectiveness of CBT delivered face-to-
face versus over the telephone, the latter
being cheaper, much more convenient for
services and patients and already supported
by small RCTs. For all but an infrequent,
identifiable clinical group, therapy over the
telephone was as effective (Hammond et
al., PLoS ONE in press). Monthly meetings
between researchers, commissioners,
managers and clinicians from across the
region during the research process meant
that all relevant groups defined the key
question, felt involved in the analysis and
could ‘pull through’ the findings into service
provision and share best practice. As a
result, there has been a net increase in the
region in the tele-healthcare approach;
the SHA initially devised a curriculum
to educate more tele-therapists, with
the charity, Relate, subsequently taking
this over to offer a national educational
programme. This co-production approach
has been success elsewhere (such as a joint
evaluation by CLAHRC and RAND Europe of
peer support workers in CPFT) and will be
used to push forward the main themes of
the EAHSN. Education is a key aspect of the
implementation and adoption of innovation
and our strategic approach is described
in the section on education below and in
Appendix D.
Another example of anonymous electronic
data sharing comes from mental health
services in Norfolk, Suffolk, Cambridgeshire
and Peterborough. These providers have
been pooling administrative incidence of
first episode psychotic illness in adults as
part of the Wellcome Trust SEPEA study
(www.sepea.org) into the population
determinants of these disorders in the
region. This has contributed to the
development of a population prediction tool
for the UK created as an open access, web-
based tool (www.PsyMaptic.org) designed to
support commissioning decisions and service
development (Kirkbride et al., BMJ Open in
press). The work has already contributed to
national commissioning guidance.
At the University of Hertfordshire,
research on the Expert Patient was used as
an example of an implementation process
during the national roll-out of the Expert
Patient Programme between 2002 and
2007 and the work was used to inform
the mainstreaming of London’s Expert
Patient Programme. A study evaluating
self-management skills in people with
Atypical Mole Syndrome has led to
changes in local dermatology practice.
Nationally, the research has been used
to inform DH regarding the development
of self-management for cancer survivors.
Internationally, the work on the expert
patient has supported recommendations for
a US sickle cell self-management programme
(http://sicklecellwarriors.com/?download=1)
and was widely disseminated via
BreastCareNet.com. In Europe the work
has led to a formal collaboration between
Hertfordshire and the University of Oslo,
Lund University Sweden, and Aarhus
University Denmark to establish a research
programme investigating and comparing
national approaches to self-management
facilitation in long-term conditions.
Research on dementia in many settings,
including care homes has been translated
into health impact in all four nodes. Work
in Hertfordshire and Cambridgeshire has
informed the National End-of-life care
programme and end-of-life care across the
East of England Strategic Health Authority
and links with translational work in the
CLAHRC and in the highly successful HIEC
in Norfolk (see below). Findings from the
end-of-life studies (EPOCH and Evidem)
have been used to develop strategy and
commissioning of educational interventions
for care homes, and the forthcoming Quality,
Innovation, Improvement, productivity and
Prevention (QUIPP) targets for end-of-life
care across the Eastern Region.
Research concerning benchmarking
quality in care homes and promoting
closer working between care homes and ‘The EAHSN
NHS services was published in a book will agree
on promoting quality in care homes and
a resource for care homes on the My
and develop
Home Life website (http://myhomelife. overarching
org.uk/) supported by Age UK and the priorities,
Joseph Rowntree Foundation. The British
policies and
Geriatrics Society (BGS) is revisiting its 10
year old report on care homes. Findings deliverables,
from the national APPROACH survey and to which all
systematic review of models of working node members
with care homes have informed the
guidelines supported by the Royal College of
subscribe, but
Physicians and the Royal College of General which may be
Practitioners for geriatrician and medical delivered in
involvement in care homes. different ways to
These are examples above of how
we translate research and learning into
suit local clinical
practice. We will take these approaches into communities.’
our networks for innovation in our priority
areas.
4.1.3 Developing collaborative
partnerships
Collaborative partnership working at
EAHSN level
The four nodes (as outlined in Section 3.3)
will agree a series of network functions:
• Setting regionally accepted priorities,
policies and encouraging shared
behaviours - The EAHSN will agree and
develop overarching priorities, policies
and deliverables, to which all node
members subscribe, but which may be
delivered in different ways to suit local
clinical communities.
• Analysis and dissemination of quality
data to support improvement work-
streams - The EAHSN will create a
system for the gathering, analysis and
dissemination of data on the quality of
healthcare delivery and the evidence
base for improvement. We will do
this by drawing on the expertise of
public health intelligence specialists
from the Public Health England (PHE)
local Knowledge and Intelligence
The Eastern Academic Health Science Network | 17
‘The AHSN will team (formerly Eastern Region Public
provide a forum Health Observatory). We expect
information systems, and in particular
for purchasers linkages between datasets to provide
and providers increasingly sophisticated data to assist
to think in the planning and evaluation of new
services and innovations.
strategically
• Network-wide collaboration to engage
about with industry and innovators - We
innovations that intend to provide a service to all our
could transform partners to support them in fulfilling
their obligations to adopt, diffuse and
the care for local spread innovation within their service
populations.’ configuration. We will do this by
building on the established strengths of
our successful innovation hub, Health
Enterprise East and using this to create
a new EAHSN Innovation Council.
Collaborative working at node level
Each node will champion and promote
their successes throughout the EAHSN
using knowledge exchange networks. They
will also take on programmes of activity as
determined by the agreed priorities at node
level. Functions will include:
• Educational activities managed by well-
established and independent Higher
Education Institutions working with
their communities of health and social
care institutions.
• Supporting and sustaining innovation
work which has already been
undertaken through HIECs, the
CLAHRC and similar organisations, and
disseminating the results, innovations
and practices developed to the rest of
the EAHSN.
• Workforce development and
recruitment issues, including 7/7 and
24/7 working.
• Collaborative procurement to
achieve economies of scale in specific
innovation areas.
• Working closely with public health,
local authorities and the third sector.
We will promote increased data sharing
between agencies in pursuit of service
18 | The Eastern Academic Health Science Network
improvement.
• Developing close strategic relationships
with commissioners. The AHSN will
provide a forum for purchasers and
providers to think strategically about
innovations that could transform the
care for local populations.
Collaborative working at membership level
As much as possible the EAHSN will
ensure that funding will reach the front line
of the innovative work being undertaken by
its members but without duplicating work
already funded at other levels. The principal
roles of the members will be:
• To undertake projects as per the agreed
network priorities.
• To identify clinical variations, unmet
clinical and administrative needs
and feed them into the knowledge
translation process as described above.
• To identify locally-led innovations
which can be adopted and diffused
throughout the region.
• To adopt innovations that have been
adopted and implemented through
the robust evidence review of the
knowledge translation process.
• To encourage and bring forward
talented and creative individuals who
can act as innovation champions.
4.1.4 Productive partnerships with
industry/wealth creation
The Innovation Health and Wealth report
emphasised the value of the NHS as a key
contributor to the UK economy. A key role
for AHSNs was identified to build knowledge
exchange networks with industry and
to build alliances and external networks
sharing best practice and growing economic
value for the UK economy. Following
extensive discussions both within the AHSN
designation process and with our own
local industry partners, the EAHSN will take
the following approach to relations with
industry:
Co-production of innovation
All four nodes of the EAHSN have well-
established links with industry and are
already collaborating in ways which have
prefigured the mission of the AHSNs. In
particular we have been active in creating
collaborative relationships between
our Universities and pharmaceutical
companies to co-produce work in the field
of drug discovery, early stage clinical trials
and translational development. These
relationships, such as that between the
University of Cambridge and GSK, involve a
high degree of mutual trust and the regular
exchange staff and expertise.
Through the Small Business Research
Initiative (SBRI) programme for industry
and the Regional Innovation competitions
for NHS innovators, we have been
instrumental in the successful co-production
of innovations from other industry sectors
which have been directed at defined needs
of the NHS.
The final report on the NHS Health
Innovation Alliance (PA Consulting,
September 2012) assessed over 100
technologies submitted by the six NHS
Innovation Hubs. Health Enterprise East
features strongly in the list of projects
scored highly for creating health and
wealth benefits - one third of the highest
ranked projects cited originated from
Health Enterprise East. Helping companies
to take products initiated and piloted
through SBRI into a later stage of product
development Health Enterprise East has a
record of bringing small and medium sized
enterprises into contact with a range of
clinicians/users as well as sources of venture
capital and angel funding.
Through this and the examples described
below we can demonstrate leadership and
active participation in co-production at all
points in the innovation pipeline.
Co-production of adoption, diffusion and
spread
The stage is now set for us to expand
those relationships into the later stages of ‘The EAHSN will
translation through the co-production of create a system
action plans for the adoption and spread of
validated innovation from each node into
for the gathering,
the regional market. The EAHSN will be the analysis and
mechanism which will enable co-production dissemination
of quantified, timed and actionable plans
of data on
which may be bought into by a large
number of organisations. The EAHSN will the quality
also be the mechanism by which we will of healthcare
be able to monitor and measure progress delivery and
against our joint objectives.
This process will also enable us to bring
the evidence
a greater involvement in the diffusion of base for
innovation from patients and from the improvement.’
front-line professionals who care for them.
Opinions from multiple ‘shop-floors’ in an
EAHSN region will serve to identify and
evaluate which barriers to adoption and
spread are of general significance and which
are of only local importance, enabling
innovators to adapt their products and
approaches where necessary.
Part of this broadening of relations
between the ‘post-research’ side of the
various industry sectors and the health and
care market will be facilitated by the very
extensive investments already made in the
science parks and biomedical campuses of
our region which are open for international
business.
The continuum of trust
The trust already established between
academics and scientists in the East of
England working in the pharmaceutical
industry and between engineers, developers
and clinicians in MedTech and other
industry sectors, will now be extended
to improve trust between the front-line
procurers, recommenders and users in NHS
and the manufacturers and suppliers in
industry essentially creating a continuum of
trust from invention to adoption.
The context - a powerful region for
innovation
The EAHSN has an enviable opportunity
The Eastern Academic Health Science Network | 19
‘EAHSN will - the Eastern Region is one of the fastest
seek to build growing regional economies in the UK. It
benefits from globally renowned research
on the work of departments and institutes, leading
our partners companies in growing markets, and a
- the regional strong relationship with the world’s leading
development financial centre in the City of London. In
health sciences, the region is home to the
agency, the local largest and most successful life science
government cluster outside the United States.
community and EAHSN will seek to build on the work of
our partners - the regional development
the emergent
agency, the local government community
local economic and the emergent local economic
partnerships partnerships to secure a network rich in
to secure a commercial understanding. The region
is host to a network of enterprise hubs
network rich -OrbisEnergy - developing multi-million
in commercial pound offshore renewable energy sector;
understanding.’ the Babraham Bioscience Technologies
Park in Cambridge; the Eastern Region
Production Innovation Centre (EPIC) in
Norfolk; and the GlaxoSmithKline Bioscience
Catalyst centre in Stevenage, Hertfordshire.
In conjunction with the UKTI team we have
begun to build an understanding of what
the EAHSN contribution can be to support a
unified case for inward investment.
Our work with industry will have three key
objectives:
1. To build the pipeline of innovation into
the NHS - supporting the development
of new businesses and ensuring the
NHS is at the forefront of exploiting new
products and services.
2. To build the case for commercialisation
of NHS products and services -
supporting the development of our
staff and growing commercial value and
expertise within the region.
3. To build an enduring dialogue with
industry where companies know they
can do business with us and the NHS
is alive to its contribution to wealth
creation.
Recent large-scale investment, especially
in the Norwich Research Park, Babraham
20 | The Eastern Academic Health Science Network
Research Park, Cambridge Biomedical
Campus and GSK Stevenage has increased
the capacity of our region to host world-
leading companies and to encourage
public-private sector collaboration. The
AHSN will, in association with the Local
Enterprise Partnerships and UKTI, create a
single unified case for inward investment
in the health and care sector in our region.
The EAHSN will create a regional initiative
to stimulate inward investment by attracting
companies to the centres of excellence
in our territory, but the work required
to ensure the availability of high-level
skilled staff, clinical trial capacity and other
technical facilities and to create excellent
working environments for incoming families
needs to take place at the node level and
match the needs of local authorities and
their Local Enterprise Partnerships. Our
overall Regional/Local approach is the ideal
way to stimulate this kind of investment
The EAHSN will become the principal
organisation based in the Eastern Region to
provide input to the health and social care
system on innovations, novel interventions
and new technologies and conversely to
provide input to industry on the unmet
needs of the health and social care
system which may be met through their
innovations. As we have identified in our
Expression of Interest document, we will do
this by creating:
• A shared system for the identification
of known innovation applicable to
our chosen service improvement
themes. This will be based on
combining expertise retained from
Health Enterprise East with that of the
equally successful technology transfer
operations of our member universities
and of local UKTI-funded agencies.
• A system to identify gaps which can be
filled by innovation. Our established
and successful Small Business Research
Initiative (SBRI) will provide the
basis for EAHSN to build and extend
targeted support to industry, thereby
 opening doors to the NHS for small and
medium sized enterprises. The EAHSN
proposes to continue to operate the
SBRI programme on behalf of the wider
area covered by NHS Midlands and East
and is also willing to take on a broader
national role in the running of the SBRI
programme in accordance with the
Technology Strategy Board’s emerging
plans in order to maintain continuity of
service and of input from innovators.
• Development of an EAHSN Innovation
Council. The Eastern Region Regional
NHS Innovation Council is already
in place and has a track record of
measurable achievement relative to
inclusive approaches to developing
a ‘New Compact with Industry’ and
support of allocation of regional
innovation funds such as the SBRI.
Membership of the Council includes
NHS providers and commissioners,
care organisations, third sector
representatives and industry
participants. Industrial members include
BT, Pfizer, GSK, Philips Medical, CISCO
Systems and MedTech SMEs. This will
be expanded as a network to include
the Innovation leads the new CCGs.
• Innovation Industry Exchange. The
EAHSN has developed a proposal
with GSK for the creation of a novel
collaboration between HEIs and the
pharmaceutical industry. This approach
will be evaluated with the intention to
build other similar opportunities with
other industry partners going forward.
Final year clinical medical students
studying within the geography of the
EAHSN could be offered the opportunity
of an ‘Innovation Fellowship’ within the
pharmaceutical industry as part of one
of their independent study modules
(typically four to six weeks in duration).
• Industry support services. Our
Innovation Hub, Health Enterprise East
currently provides three elements of
Industry support:
1. MedTech Consultancy Services - ‘The EAHSN
offering services to complement will be a key
the product development process
for those organisations without
organisation in
the time or resources to do so, providing input
specifically stakeholder research, and strategic
need translation, technology advice to the
scouting, concept creation focusing
around rapid engagement with the
wider health
right stakeholder. These services and social care
have proven methodologies systems, driving
and have been developed from
innovative
many years of delivering strategic
consulting assignments for global cross-boundary
healthcare companies. models of care
2. Clinical Expertise Database - and leading the
developed by Health Enterprise
East, with support from the
widespread
Cambridge HIEC and the UK introduction of
Intellectual Property Office, the effective new
database is a web-based tool to
technologies.’
facilitate the process of engagement
between key opinion leaders
and Medtech companies. The
database will enable interested
parties to more easily engage with
stakeholders within the NHS who
have registered their interest in
collaborating with industry. The
web-based portal is due to be
launched in September 2012.
3. Continuing our series of ‘Opening
Doors to the NHS’ events -
focused events on themes of
significance to the healthcare
agenda to enable delegates to
gain a better understanding of
specific NHS challenges and the
potential opportunities for new
associated products and services
to achieve better patient care.
Past events themes have been
Diabetes - Understanding Priorities
for Innovation; Diagnostics in the
Community and New Commercial
Perspectives for Industry.
We will align the work of Health
The Eastern Academic Health Science Network | 21
‘The EAHSN Enterprise East to our priorities and
will develop a workstreams and have begun to develop
this thinking in the engagement document
shared system in Appendix F.
for identification • Identification, adoption and
and diffusion diffusion of innovation. The EAHSN
will develop a shared system for
of known
identification and diffusion of known
innovation innovation applicable to EAHSN’s
applicable to chosen themes. Identification will
EAHSN’s chosen be based on combining expertise
retained from Health Enterprise East
themes.’ with that of the technology transfer
operations of member Universities.
Health Enterprise East’s annual
innovation competition, regional
and local bright idea competitions
enable the identification of over 150
innovation disclosures per year from
EAHSN members. Health Enterprise
East will offers specialist services
on IP management to the EAHSN,
development and commercialisation of
medical technology related innovations,
combined with working knowledge
of local NHS commissioning and
procurement processes.
Each of these programmes will
be measured and evaluated on the
contribution they make to delivering on
our (objectives/goals/ambitions - the
three) but they will also be measured on
the contribution we make to support the
economy. We will work with our partners
in industry to fully understand where we
need to do more to enable our member
institutions to grow the knowledge
exchange with industry.
4.1.5 Driving service improvement
We will seek to innovate both in the
development of new treatments and in
new ways of organising care. These will
include ways of delivering better integrated
care through more effective working
between primary care, secondary care and
22 | The Eastern Academic Health Science Network
social care. We will then enact solutions
into NHS practice. Sometimes this will
be in demonstration projects using the
resources of the network, at other times
as part of a formal evaluation of a new
treatment in a clinical trial, and at other
times disseminating examples of best
clinical practice or by promoting redesign of
existing services.
Our clinical priority areas for our five year
work programme (described in Section 8
below) are:
1) Dementia and mental health
2) Long-term conditions
a. Cardiovascular disease (including
stroke, our initial priority)
b. Diabetes
c. Cancer
d. Chronic respiratory disorders.
3) Patient safety
These work programmes will all link
world class research and innovation
to measurable improvement in health
outcomes, will answer research questions
and identify interventions that will lead to
improvements in quality and value and will
support local wealth creation.
We will establish EAHSN networks for
each programme, where a designated
node will lead the programme of work,
drawing on experts from across the wider
network. For example, the Essex node has
agreed to lead cardiovascular work; the
Cambridge and Peterborough node will
lead patient safety, and Norfolk and Suffolk
will lead diabetes. Leadership in the node
for each programme will involve clinicians
from all relevant disciplines, service users,
supported by senior management capacity.
The EAHSN network lead for each
programme will ensure that all partners in
the NHS, primary, secondary, tertiary and
social care are involved, as well as public
health and local government with the third
sector, such as Diabetes-UK, British Lung
Foundation being used to ensure patient
and service user participation. The networks
will work closely and will support the work
of the new Strategic Clinical Networks.
Key outcomes and deliverables for
each programme will be agreed by the
EAHSN Board. EAHSN nodes will be
responsible for delivery at a local level,
with an accountability understanding with
each node accompanying the devolution
of central funds. EAHSN nodes will be
expected to match funding in kind, with
a commitment of existing workforce and
other resources being provided to deliver
the programme.
We describe the programmes of work for
our clinical priority areas in Section 8; and
the Draft Business Plan, Appendix E.
4.1.6 Vision and working with Eastern
Local Education and Training Board
(LETB)
East of England has a strong track record,
based around the four EAHSN nodes, each
with an HEI with significant experience in
healthcare education. There is a high level of
innovation in health education ranging across
a wide range of disciplines at undergraduate
and postgraduate levels and in CPD. We will
build on the experience and strengths of our
two established HIECs, which will provide
the EAHSN with models of education and
training to deliver more ambulatory care,
provided closer to home, better integrated
and enabled by a workforce suited to this
changing paradigm of healthcare delivery.
Our vision for the EAHSN involvement in
education is:
• Innovation in health education to
enhance quality.
• Use education as a means to deliver
improvements in healthcare through
specific programmes.
• Use education to improve the quality of
the healthcare workforce.
• Use education and training to establish a
workforce in the wider health sector that
is academically trained for their posts
and able to lead or facilitate change.
Our strong base will allow the education ‘Key outcomes
and training domain of our AHSN to work and deliverables
collaboratively with the East of England
LETB. Our proposed working model of
for each
interaction with the LETB will be based programme will
on a clear understanding of roles of each be agreed by the
body as well as cross-representation of
EAHSN Board.
board membership between the two. The
LETB has statutory roles through Health EAHSN nodes will
Education England (HEE). The AHSN views be responsible
its role as being to complement these as for delivery at a
well as facilitate other strategic missions
of the LETB. This may be undertaken
local level, with
through being commissioned by the LETB an accountability
to undertake specific aspects of LETB understanding
delivery. A particular example that plays to with each node
this synergy of working is the dual issue of
quality assurance and quality enhancement
accompanying
of education. The LETB will be required to the devolution of
quality assure its programmes but quality central funds.’
enhancement - an aspect of Innovation
in education, which has its roots in HEI
processes - will be a major part of the
EAHSN work in Education. In addition,
the EAHSN will work with the four local
workforce partnership groups, in a similar
manner either informing the work of the
partnership group or being commissioned
by it.
A detailed description of the
achievements of all four nodes in education
and training can be found in Appendix B.
4.1.7 Creating patient-centred
information for health
Analysis and dissemination of quality data
for service improvement
Data on health and healthcare has the
power to drive innovation, improve health,
improve patient safety and improve quality
of care. Data from local clinical systems
in both primary and secondary care,
combined with national routine datasets,
will be at the heart of developing linked
system-wide anonymised data as a strategic
goal for the AHSN. By this we mean data
linked at patient level between and within
The Eastern Academic Health Science Network | 23
‘Traditionally service sectors - secondary:secondary
strong in basic care, primary:secondary care and so on.
Such data are essential for tracking patient
scientific outcomes, improving health, improving
research and healthcare efficiency and productivity,
translational understanding patient pathways,
adding value to research data and for
medicine, the
commissioning health and social care. The
EAHSN is well AHSN recognises that there are significant
placed to address information security and confidentiality
the later gaps in concerns in this kind of data sharing and
will work with partners to put in place
innovation in the robust and appropriate information
discovery-care governance and assurance arrangements.
continuum.’ We will work with the Cancer Registry (to
be part of Public Health England) who have
considerable local expertise on extracting
data from clinical systems including the
governance requirements to link data across
clinical pathways.
A key focus of the AHSN will be to put
in place systems to exploit these data to
meet its strategic objectives and align
services, researchers, the public health
system, commissioners and the public, in
shared efforts to improve health, quality
and reduce inequalities. To this end, we
will take advantage of the re-provision and
development of clinical systems in both
secondary and primary care where possible
to put in place mechanisms for data sharing.
The EAHSN will take on a role in providing
to its members accurate, comprehensive
and actionable data about the quality
of care in our region, not only in terms
of the quantitative data from GPs and
hospitals (which will shortly be made
publicly available and which gives a two-
dimensional view of activity) but we will
add the third dimension of intelligence
which comes from many long-term studies,
led by clinical academics in the EAHSN’s
research-intensive hubs, providing essential
information about the health of our
EAHSN’s population, for example, the work
of the Cambridge Institute of Public Health.
We will build on the work of the Quality
Observatories in tracking outcomes like
24 | The Eastern Academic Health Science Network
hospital mortality, patient safety and
pressure ulcer frequency and the work of
public health observatories in monitoring
population health and clinical variations and
health inequalities.
We will do this through:
• A small in-house capacity to develop
information strategy and engagement
with data providers to commission
informatics and analytical services on
behalf of the network.
• Supporting the systematic publication
of local data on clinical variations
in outcomes, care processes and
healthcare inputs, and key health issues
data derived from primary care and
other sources e.g. from PHE Knowledge
and Intelligence Teams (KITs).
• Working with the Public Health England
local KITs covering the Eastern Region
to provide expert advice, needs
assessment, quality surveillance and
expert advice as appropriate [through a
funded SLA].
• Working with the Cambridge Institute
of Public Health on evidence translation
and synthesis, links between care and
public health outcomes, and evaluation
methods.
• Working with Clinical Commissioning
Groups (CCGs) and local Commissioning
Support Services (CSSs) to define ways
of harnessing primary care data; and
with Local Authorities to harness social
care data.
• Working with Quality Surveillance
Groups in Local Area Teams of the
Commissioning Board to support key
decision makers with timely data on
quality outcomes and patient safety.
• Working with industry and researchers
with expertise in data management
and informatics, data security and data
exploitation to make best use of data.
• Working with the BRC to support
the development of an informatics
and information pilot programme
- Data4Health Cambridgeshire - to
 develop system-wide data linkage and
disease registers.
• Developing Data4action and
Data4outcomes programmes to provide
the system with ‘actionable’ data
through interactive, accessible tools.
Facing the challenges of sharing personal
data
In addition to the sharing of population-
based data for local service planning and
improvement, the EAHSN will also tackle
the challenge of sharing personal data
between agencies data for more immediate
service delivery.
The landscape for data sharing and
collaboration has become fragmented
in most localities. Each of the nodes can
point to particular local instances of data
sharing projects and the EAHSN believes
that in order to facilitate knowledge sharing
and common best practices it is important
that the nodes share learning from such
initiatives and adopt and spread the best
examples to the rest of the region.
There is a traditional divide, enshrined in
law, regulation and the Caldicott Principles,
between personal, confidential data which
is shared by individuals directly involved in a
patient’s care on a ‘need to know’ basis and
anonymised, aggregated data which may be
shared by individuals and organisations for
secondary uses such as research, population
health planning and epidemiology. However,
advances in computer networks, software,
mobile systems and search technologies
have created new opportunities for
‘mining’ healthcare information and
potentially extracting valuable knowledge
and understanding from unstructured data
held in diverse locations in incompatible
formats. The challenge for all providers
and commissioners will be to achieve
the potential of such systems without
compromising the confidential relationship
between patient and doctor.
The needs of commissioners for
budgetary control across a local system or
of researchers for 100% capture of data ‘In addition to
on a given population tend to require the sharing of
linkage of hitherto unlinked data sets,
which, if disclosure of data from one
population-
set to another is not properly governed, based data for
including implementation of proper consent local service
mechanisms, can leave clinicians exposed to
planning and
legal liability and loss of trust. Government
policy and the law are in a state of flux on improvement,
some of these issues. the EAHSN will
In Cambridge we have considerable also tackle the
expertise in all aspects of data and network
security, information governance, ethics
challenge of
and government regulation as well as data sharing personal
integrity, analysis and interpretation. We data between
therefore intend to pioneer the creation of agencies,
a trusted centre for data analysis and data
sharing which will combine the expertise
data for more
of several units under the umbrella immediate
organisation of the Cambridge Institute service delivery.’
of Public Health with partners across the
EAHSN region to provide advice and support
to members.
4.2 Performance metrics
The EAHSN will monitor its performance
against a set of metrics outlined in Appendix
C. It will also monitor a second set of
metrics which it is not solely responsible
for delivering, but which are indicators of
the success of improving health, wealth
and innovation of the population within the
geographical area of the EAHSN.
The metrics relating to the clinical priority
work streams will need to be discussed
and agreed by the EAHSN members once
organisational structures are in place, and
work plans have been approved.
We will build in an internal evaluation
process, led by UEA.
The Eastern Academic Health Science Network | 25
‘One of the
EAHSN strategic
goals is to make
the Eastern 5. DELIVERING SPECIFIC FUNCTIONS IN
Region the ‘go RELATION TO RESEARCH
to’ place in
There are considerable NIHR investments
Europe to set and a wide range of CRN coverage within
up substantial the geographical footprint of the EAHSN
new knowledge- (Figure 3.3). The Primary Care Research
Network (PCRN) and all the topic specific
based healthcare research networks are well-established in
businesses.’ the Eastern Region with strong recruitment
from most of the relevant provider trusts
that are partners to our application. Their
alignment within the EAHSN will not be new
and their success is reflected in recruitment
to portfolio studies.
Within this context, there is already
a healthy interaction between research
and innovation in many of our regional
universities, health providers and
companies. This benefits clinicians,
innovators, academics and entrepreneurs
but these relationships can be improved
and made more systematic so as to realise
value and exploit more opportunities arising
from research.
One of the EAHSN strategic goals (Section
3.1) is to make the Eastern Region the ‘go
to’ place in Europe to set up substantial new
knowledge-based healthcare businesses.
We include commercial and non-
commercial health research within that goal
which means that optimising recruitment to
studies is a key objective. Here, we outline
our overall strategy for the core functions
and levers for recruitment, followed by a
more detailed consideration of the specific
headings required in the guidance.
In essence, the EAHSN will harmonise and
5.
Cambridgeshire and share research governance systems; work
Peterborough NHS towards reducing the number of research
Foundation Trust offices in the EAHSN, work with existing
6.
Cambridge University NIHR bodies and infrastructure, share
Hospitals NHS high-quality information on process and
Foundation Trust recruitment for performance management
26 | The Eastern Academic Health Science Network
and improvement. These approaches will
allow us to design a system within which
‘single sign-off’ may be feasible.
5.1 Key objectives in relation to
research
The EAHSN will work closely with existing
NIHR organisations, incorporating them
into the network if required by national
guidance. We have collaborated with our
three CLRNs in designing this section of the
prospectus and consider the following our
key objectives:
• We will establish an EAHSN-wide system
to manage research participation and
performance effectively and efficiently,
through a sub-committee reporting
to the EAHSN Board, consistent with
national systems and approaches. Our
approach will deliver a step-change
improvement in the initiation and
delivery of clinical research on time and
on target by constituent NHS providers.
• The EAHSN will reduce the number of
Research Management and Governance
(RM&G) offices in provider (recruiting)
organisations by coalescing and merging
them within nodes. This process has
already started (e.g. CPFT5 merging
with CUHT6 R&D office, and a single
R&D function serving Hertfordshire
Acute and Mental Health Trusts) and
allows the combined offices to have
more senior RM&G management with
economies of scale throughout the
organisation. NHS Trust CEOs and other
organisations (e.g. local authorities)
enjoy mutual assurance through
harmonised procedures and quality
control. The CLRNs need to liaise with
fewer offices working with similar
systems.
• Information on recruitment can
be shared within the relevant
organisations and within the EAHSN
for benchmarking, performance
management and quality improvement.
• The process may ultimately produce a
single provider R&D office per node;
theoretically, this could be a single
EAHSN office with local outposts in
nodes. Data management across the
EAHSN is fundamental to this approach.
• We recognise that changing the delivery
of care by changing healthcare systems
is a key part of improving the health of
our population. The AHSN recognises
and will promote the important of
health systems research designed to
ensure that we make the most effective
and efficient use of the resources
available to the region.
This streamlined system of fewer, larger
research offices, alignment with NIHR
structures and networks, and the routine
and systematic analysis of recruitment data
will greatly facilitate recruitment within
the EAHSN. Our three CLRNs and others
involved the EAHSN believe this approach
will also help integrate the CLRNs and other
CRN structures within the EAHSN if such a
model is policy is adopted by NIHR. All three
CLRNs have detailed work programmes to
increase participation in research, simplify
RM&G and work with industry. We consider
that providing them with a simplified
system within which to work is the optimum
approach.
Our experience also means that NIHR
bodies, research networks, provider trusts
and universities involved in the EAHSN
all understand how participation and
performance management fails and how
it can be improved. This experience will
be shared within the wider EAHSN system,
particularly by adopting examples of good
practice and harmonisation of procedures.
5.2 Exemplars of research performance
management
Our analysis suggests that exemplars of
performance management share a small
number of characteristics. These include:
• The availability of recruitment data ‘The EAHSN will
as near to real-time as possible, harmonise and
with relevant parties using the same
information from a single data entry
share research
point, avoiding duplication of effort governance
by the research team, topic network, systems; work
R&D office and possibly CLRN. Current
towards reducing
systems may involve several data
entry points (research coordinator and the number
network clinical studies officers at the of research
study level) and read-off mechanisms offices in the
ranging from NIHR portfolio to more
derivative information in the research
EAHSN, work
networks, trust R&D departments and with existing
the CLRN; these may differ, whereas all NIHR bodies and
parties need the same information. infrastructure.’
• Regular (e.g. monthly) review of these
real-time recruitment data, comparison
with target and appropriate adjustment
of activity and resources being
understood by all parties. This requires
transparency, commitment and time
from the topic networks, CLRN, R&D
departments and study coordinators.
Such reviews already occur in two of
our CLRNs for industry and portfolio
studies.
• Clarity of leadership for performance
management on a project-by-project
basis including, or with authority from,
study chief investigators who need to
understand the systems and why this is
important; some do not.
• Streamlining and clarity of responsibility
between different local resources such
as the Clinical Trials Units in Cambridge
and Norwich and their local research
networks.
• Working closely with NIHR and the
CLRNs and following any realignment in
network architecture that may involve
geography or amalgamation of some
topic-specific networks. However,
focus within and between nodes, with
benchmarking, exchange of information
and practice will lead to rapid levelling-
up and improvement. Current thinking
is that the three CLRNs and topic
The Eastern Academic Health Science Network | 27
‘The EAHSN is networks would lead this for portfolio
discussing with studies on a topic-by-topic basis.
• Simplifying information flow is also
all its constituent helped by reducing the number of
CCGs how the intersections to which all organisations
larger network contribute. We have had success in
reducing the number of trust R&D
can support CCG
offices through coalescence and
responsibilities shared staff. In partnership with the
for research and relevant CLRN, this has occurred in
include them as CUHT and CPFT in Cambridge, in East
and North Herts and Hertfordshire
partners in the Partnership, and in the Norfolk and
strategy outlined Suffolk NHS FT; in all these examples
here.’ where the approach has succeeded,
closer working relationships between
the research offices and the Research
Ethics Committees (RECs) have yielded
additional benefits and streamlining.
The EAHSN is discussing with all its
constituent CCGs how the larger network
can support CCG responsibilities for
research and include them as partners
in the strategy outlined here. The EAHSN
model of fewer, larger offices leads to
efficiencies that include shared information
systems, processes, communication and
the ability to improve leadership with more
senior managers and smaller joint teams
that reduce duplication; we consider these
will help CCGs and await further national
guidance on this.
The EAHSN partners are committed in
the post-April 2013 landscape to radically
reducing the number of R&D offices through
these mechanisms, coalescing on the four
nodes with close alignment of purpose
between CCGs, the CLRNs, EAHSN and
research offices within the nodes and across
the wider network.
5.3 Promoting participation in research
This overarching approach allows the
EAHSN to promote participation in research
in the following ways:
28 | The Eastern Academic Health Science Network
5.3.1 More opportunities for patients
to participate in clinical research
The EAHSN will build on local NIHR
systems, RECs and networks in order to
simplify local provider systems and align the
purpose of AHSN and research networks,
as described above. The EAHSN will provide
a coordinated provider platform on which
the CLRNs can exploit opportunities for
recruitment in primary and secondary
care, mental health and social care to both
non-commercial and commercially-funded
clinical research. We will develop an EAHSN-
wide Research sub-committee of the EAHSN
Board, to oversee working with research
networks, establishing research priorities
and overcoming barriers to research.
The EAHSN undertakes, where possible, to
put the patient at the heart of recruitment,
initially through advanced consent when
people first enter the healthcare system,
whether in primary or secondary care,
subsequently to be contacted about
relevant studies. The development of
disease registers based on primary and
secondary care data, as described in Section
4.1.7, will form a highly streamlined and
automated basis of trial recruitment.
Partner organisations within and
between EAHSN nodes including local
disease specific and primary care research
networks will adopt the same recruitment
performance indicators at board level and
which can be made available within the
network. Strategies for Patient and Public
Involvement (PPI) will be aligned and
shared within R&D departments, nodes and
across topic networks such that patients in
any node (that will often be involved with
more than one provider) have a consistent
message about research, albeit that some
recruitment practices are specific to
particular disease areas and situations.
Systematic involvement of primary
care in the EAHSN and working with the
Primary Care Research Network (PCRN), will
improve opportunities for many patients
with long-term conditions to take part in
research given the shift away from hospital
care for these people. The network will also
analyse on a node-by-node basis points on
care pathways, from community, primary,
secondary and tertiary care, where patients
can be informed about opportunities to
take part in research and to be recruited.
Such an approach for long-term conditions
with complex care pathways underlines the
need to involve social care and the third
sector within this system and to extend the
culture of research to this sector. We have
examples of successful working with social
care in large scale health research that has
achieved health gain (e.g. study of mental
health disorders in looked-after children by
the CLAHRC).
In terms of rare diseases, the EAHSN is
well placed to exploit a population-wide
and systematic approach to ascertainment
of patients. This can be used to exploit the
power of biomedical infrastructure with the
region such as within the NIHR Cambridge
BRC that has been invited to establish and
lead the NIHR’s new Translational Research
Collaboration in Rare Diseases.
One way to increase opportunities for
participation is simply to increase the
numbers of high-quality, non-commercial
portfolio research projects running within
the EAHSN. This involves a combination of
improving the quality of proposals through
collaboration with academic and clinical
resources in the network, involvement
of the Eastern Region Research Design
Service (RDS) in early stages of protocol
development, using a common approach
to PPI, and coordinating the resources and
procedures for peer review.
Collaboration by the entire EAHSN
will lead to more high-quality proposals
from within the region. In addition to
biomedicine, the EAHSN has a number of
key strengths such as the health economics
expertise in UEA and that emerging in
Cambridge; the strong nursing, allied health
professional and social sciences research in
Hertfordshire and Essex; and UEA who have ‘The EAHSN
key strengths in nursing science. Applied will provide a
health research expertise exists in all
centres including the existing NIHR CLAHRC
coordinated
and the BRC where health evaluation and provider
implementation is a new theme. platform on
which the CLRNs
5.3.2 Increased recruitment of patients
can exploit
Our strategy of reducing the number opportunities
of R&D offices and harmonising their for recruitment
processes will mean the EAHSN will
have a single platform for approval of
in primary and
and recruitment to non-commercial secondary care,
and commercially-funded research with mental health
commitment from the NHS (and other) and social care
providers. The resources within the EAHSN
and partner organisations such as the
to both non-
research networks can then be focused, commercial and
as appropriate. However, this also means commercially-
that the whole system needs a process
to prioritise resources between portfolio
funded clinical
and non-portfolio, commercial and non- research.’
commercial research. Such priorities do
not necessarily determine whether a study
can go ahead or not (although could do),
but may involve questions as to where
in the EAHSN has capacity for maximum
recruitment for a particular study. These
resources and capacity may involve
potential patients or other resources such
as clinical trials units or pharmacies. Our
current thinking is that there will need to be
a sub-committee of the EAHSN board with
representation from nodes and CCGs to
review such matters; discussion is ongoing.
5.3.3 Proactive support for life sciences
industry research and development
Proactive support includes clear plans
between University and NHS partners to
support recruitment to all phases of clinical
research as part of the national effort. Much
can be done to support the life sciences
industry, with many opportunities within
the EAHSN and work already underway by
our three CLRNs. There are a number of
The Eastern Academic Health Science Network | 29
‘In terms of strategic alliances between individual large
rare diseases, companies and particular universities and
NHS Trusts; these include GSK with the
the EAHSN is University of Cambridge and CUHFT. There
well placed are concentrations of med-tech and biotech
to exploit a around Stevenage, Norwich, Colchester
population-wide and Cambridge as already described, with
opportunities for further development in all
and systematic these sites. The rich University landscape
approach to within the EAHSN also means the network
ascertainment can be available to a wide range of scientific
and other disciplines including the physical
of patients.
sciences, management and engineering.
This can be Early phase interaction between industry,
used to exploit the NHS and universities can be enhanced
the power of within the EAHSN through a number of
mechanisms. For example:
biomedical • Fellowships and exchanges of staff from
infrastructure the three sectors to increase knowledge
with the region.’ and awareness;
• Discussion between clinicians and
industry at early phases of research to
explore practical application of novel
products and interventions, including
informing the practicalities of trial
design;
• Joint technological and methodological
development, such as adaptive trial
design and analysis which is a focus of
the MRC biostatistics unit in Cambridge
and many Pharma companies;
• Co-production of research foci,
especially for med-tech industries to
explore how developments can become
innovations in practice;
• Shared buildings and capital
developments as is possible at science
parks and other sites around Norwich,
Stevenage, Colchester and Cambridge;
• Joint appointments between industry
and universities such as with University
of Cambridge and GSK;
• Joint education ventures such as the
Wellcome Trust-GSK Translational
Medicines and Therapeutics (TMAT)
programmes for masters-level and PhD
study;
• Clarity of access to centres of excellence
30 | The Eastern Academic Health Science Network
and precisely designed care pathways
with clear points for assessment, access
by researchers and recruitment. This
includes community settings as well as
technology-heavy front-door studies
in specialist centres outside working
hours.
5.3.4 Single sign-off for research
governance
The EAHSN will have as one of its
prime objectives to move all its members
towards effective, harmonised systems
for research governance. We recognise
that the concept of single sign-off for
multi-site studies represents an ideal. In
moving towards this objective several
sites within the EAHSN area have already
created joint research offices between
more than one NHS provider and HEIs.
Simplification within and between EAHSN
clusters with harmonisation of process does
not achieve ‘single-sign-off’ by individual
Trusts. However, few or even a single
R&D office sharing Standard Operating
Procedures (SOPs) and having delegated
authority from cluster organisations for pre-
processing of governance matters means
work covering several trusts is undertaken
contemporaneously, not sequentially, and
provides trusts with mutual assurance.
It reduces delay for larger, multi-centre
studies crossing EAHSN nodes or multiple
AHSNs, and paves the way for further
economies (which would ultimately be
one or a very few offices for the EAHSN)
and, when legally feasible, single sign-off
for large studies including recruitment in
both primary and secondary care. Partners
consider that working initially with four
nodes is a more realistic approach than
attempting a single change for the whole
EAHSN, particularly as the coverage is so
large in terms of geography and health
systems.
Harmonisation and reduction in
complexity will facilitate the NIHR
implementation plan for ‘Proportionate
Systems of Research Governance’ and
a common approach, via streamlining
within nodes to meeting the contractual
requirement to meet the benchmark of 70
days or less from receipt of a valid research
application to the time when that provider
recruits the first patient for that study.
Examples of streamlining could include a
central system for peer review, perhaps
with specialism within nodes and common
reports to trust boards and other relevant
organisations, including the EAHSN board.
Within this node structure for
performance management of research
governance, provider trusts and primary
care providers can be provided with, and
exchange information on, appropriate
incentives to staff, clinical pathways and
teams for recruitment. Different approaches
to financial incentives for recruitment,
including the allocation of research capacity
funding (RCF), can be compared. Education
is also important in improving recruitment.
Many clinicians are unfamiliar with asking
patients to take part in trials and can be
shown how best to do this. Performance
data and approaches to behaviour change
can, themselves, be exchanges and subject
to formal multi-level quantitative analysis.
5.3.5 Timely payment of treatment
costs
These are for patients who are taking part
in research funded by Government, NIHR
and research charity partner organisations
through the NHS commissioning system.
The EAHSN has begun discussions with all
our CCGs regarding how best to support
their statutory responsibilities for promoting
research and ensuring that the NHS
meets the treatment costs for patients
who are taking part in research funded by
Government and research charity partner
organisations. These discussions are at an
early stage and vary between CCGs given
their different locations and sizes. However,
we believe that it is only through working ‘Partners will
as part of the EAHSN and being part of an be required to
increasingly streamlined and efficient system
that these responsibilities can be met by
commit to a
CCGs. The increasing inclusion of health shared vision,
economic evaluations within effectiveness values and
and efficacy studies means that CCGs will behaviours
be able to monitor the overall value of their
participation in research, also supporting
in return for
CCGs in pulling-through interventions shown access to EAHSN
to be cost-effective into their commissioning resources,
decisions. The National Commissioning
expertise and
Board, working with NIHR, may provide
further guidance on the payment of leadership.’
treatment costs in which case the EAHSN
would adopt the recommended approach in
its working with CCGs.
6. GOVERNANCE ARRANGEMENTS
6.1 Incorporation of partnership and
nodes
The EAHSN will be incorporated as a
voluntary membership organisation open to
all service providers and commissioners in
the region, related healthcare organisations,
CCGs and to universities with health-related
activity. Partners will be required to commit
to a shared vision, values and behaviours
in return for access to EAHSN resources,
expertise and leadership. At the time of
writing, we have individual commitments to
membership of our AHSN from Cambridge
University Health Partners, five universities,
all 12 major hospital trusts in the area, three
community trusts, three mental health
trusts, the regional ambulance service, the
Eastern Region Public Health Observatory
(ERPHO), Health Enterprise East, the PHG
Foundation and the Cambridge Institute of
Public Health. These map to four natural
clinical, referral and research and innovation
The Eastern Academic Health Science Network | 31
‘There are communities (Figure 3.3, page 11) referred the EAHSN (it may not be appropriate for
considerable to as the four ‘nodes’ of the AHSN (‘the smaller CCGs) they will be fully involved
Nodes’) (Figure 6.1, page 32). Where locally, for example through membership of
opportunities for commissioners are not full members of executive committees of nodes.
EAHSNs to work
to add value to, Funding
and partner with, Shared aspirations, principles, behaviour, best practice
new and existing Local
organisations Cambridge & Trusts
Peterborough
across the NHS Node
and
Partners
landscape.’
Local

Leadership for innovation

Peer support and review

Norfolk & Suffolk Trusts
Funding Regional AHSN Node and
Partners
DH
Local
Accountability Hertfordshire & Trusts
Bedfordshire Node and
Partners
Local
Colchester
Trusts
University of Essex
and
Node
Partners

Delivery
Understanding needs, local innovation, new ideas

Figure 6.1 Relationships of EAHSN and nodes

6.2 Concordat between partner • An agreement of complementary work-

organisations
There are considerable opportunities
for EAHSNs to work to add value to, and
partner with, new and existing organisations
across the NHS landscape, including Clinical
Senates; Strategic Clinical Networks (SCNs),
LETBs, CLAHRCs, the local presence of the
new NHS Improvement Body, Health and
Wellbeing Boards and others. The EAHSN
will work with key partner organisations,
to establish a concordat of understanding,
ensuring that organisations have:
• Clarity of their respective roles,
functions and priorities, including
governance arrangements;
plans, to avoid duplication, or gaps in
delivery;
• A commitment to add value to each
other’s work;
• Agreed the extent of and arrangements
for sharing resources;
• Agreed arrangements for sharing
intelligence, and communication.
The EAHSN will lead facilitation of the
concordat across partner organisations
including AHSN level agreements between
commissioners and providers and the
National Commissioning Board, through the
new local area teams and regional office.

32 | The Eastern Academic Health Science Network

6.3 Shared values
Partners will be required to commit to:
• Priorities outlined in the NHS Outcomes
Framework with a particular focus on
enhancing the quality of services for
people with long-term conditions.
• Evidence-based quality improvement
to reduce unwarranted variation in
practice and patient outcomes, using
peer support and peer challenge.
• Promotion and adoption of innovations
already identified in Innovation, Health
and Wealth and/or identified through
the Spreading Innovation in the NHS
initiative.
• Openness and transparency in data
analysis and reporting.
6.4 Legal entity of the EAHSN
Following advice given after consultation
with Eversheds solicitors, the EAHSN
intends to adopt the following model of
incorporation:
• The EAHSN will be established as a new
legal entity, as a not-for-profit company,
limited by guarantee. Its members will
be the Nodes and other organisations
may be co-opted to become members if
required.
• The EAHSN will have an independent
chair and other non-representative
directors who, in accordance with the
AHSN Guidance, will be required to
have extensive experience of working
with industry although they cannot be
representatives of individual companies.
• The Accountable Officer will be an
individual agreed by the Board of EAHSN,
being an additional director to those
otherwise nominated or appointed.
• The four Nodes will be given rights,
either under the constitution of the
EAHSN or under a members’ agreement,
to each appoint two directors to the
board of the EAHSN on a representative
basis.
• The EAHSN will plan from the outset ‘The EAHSN will
to have the ability to grow organically be established
and/or subsume other activities or
organisations e.g. from the SHAs.
as a new legal
• As a legal entity the EAHSN can own and entity, as a
exploit IP as required and contract in its not-for-profit
own name. company, limited
• Each of the Nodes may choose to be
created by their members either as
by guarantee.
unincorporated or incorporated entities. Its members
will be the
The Nodes will be allowed to have their
Nodes and other
own governance models e.g. they could
have a ‘doughnut model’ of inner and outer organisations
core members. The EAHSN will not be may be co-opted
prescriptive about the legal form of nodes to become
although the EAHSN will want the members
of nodes to commit to basic principles.
members if
• The Nodes will select their required.’
representatives on the EAHSN Board (it
is anticipated that these will usually be
one NHS Chief Executive and one senior
academic from the Node’s HEI).
• The Nodes will be encouraged to
involve the local NIHR clinical research
infrastructure the CLAHRC and its
linkages with Local Education and
Training Boards.
• The Nodes would also be given other
member rights such as veto rights
over certain matters e.g. admission or
expulsion of other Nodes as members,
change in business focus of EAHSN,
giving of charges or guarantees by the
EAHSN.
• CUHP, as an AHSC will ‘nest’ within
EAHSN as a member of the Cambridge
and Peterborough node. It will continue
to provide infrastructure, personnel and
administrative support to the EAHSN,
using expertise it has developed in
running research networks (particularly
in relation to the NIHR Biomedical
Research Centre), clinical networks,
academic public health and the
translation of genomic medicine into
patient benefit.
• The EAHSN will hold contracts with the
The Eastern Academic Health Science Network | 33
‘The key to Nodes for funding and the delivery of
success will the EAHSN’s agreed plans.
• The Nodes may also agree local
be excellent subscription arrangements over and
communication above the EAHSN funding to deliver
and trust that locally agreed objectives.
transcends
6.5 EAHSN Board of Directors
cultural
differences The EAHSN Board of Directors will have
and ‘language’ the following structure:
• Independent Chair
barriers.’
• Accountable Officer
• Two directors from each of the four
nodes (one HEI one NHS)
• NHS improvement lead and clinical
network director
• Clinical senate board member
• LETB board member
• Two directors from industry/wealth
creation
• Company Secretary
• This gives an EAHSN Board of 15 Directors
including the Chair. The EAHSN Board
will meet 10 times a year. A Shadow
Accountable Officer has already been
appointed, Dr Robert Winter, Director of
the Academic Health Science System for
CUHP, to oversee the EAHSN Prospectus
and Application, and will be responsible
for formally establishing the EAHSN. All
EAHSN appointments will be made in
open competition after designation.
6.6 EAHSN Executive
An EAHSN Executive will be formed by:
• Accountable Officer EAHSN
• Accountable Officer for each of the four
nodes
• EAHSN Research Lead
• EAHSN Informatics lead
• EAHSN Information/Public Health lead
• EAHSN Industry Lead
• EAHSN Education and Training Lead
• Director of Innovation and Clinical
Networks
• EAHSN Communications lead
34 | The Eastern Academic Health Science Network
This gives an EAHSN Executive of 12
people. The EAHSN leads for Research,
Informatics, Industry, Education, Clinical
Networks will each be expected to lead a
multidisciplinary steering group composed
of relevant colleagues from each EAHSN
Node. The Executive Team will meet on a
weekly basis. The Executive Team will be
responsible of the delivery of the Business
Plan and agreed work programmes, on
behalf of the Board.
6.7 EAHSN Node structure
Each of the four EAHSN Nodes will have
its own Accountable Officer and may choose
to formally establish a legal entity. The
membership of each EAHSN Node will be
determined locally to allow engagement
and delivery of the EAHSN goals: however
EAHSN will require Nodes to ensure and
demonstrate that they are actively involving
CCGs, commissioners, all providers of NHS
funded services, HEIs involved in health
and care, other providers and partners in
industry. The Node Accountable Officer and
one other representative (either NHS of HEI)
will represent the node on the EAHSN Board.
6.8 EAHSN Reference Group
The EAHSN Reference Group will consist of
Board level representatives of all members of
the network. It will meet three times a year.
6.9 Leads for key priorities
The EAHSN will appoint leads for the key
priorities. Leads will be responsible and
accountable to the Executive for delivery
and providing a quarterly report for the
Board.
6.10 Node responsibilities
Nodes will be responsible for delivery
at a local level, with an accountability
understanding with each node
accompanying the devolution of central
funds. Nodes may be expected to
commit matched funding in kind, with
a commitment of existing workforce
and other resources being committed
to deliver the programme; and will also
be expected to seek additional external
sources of funding to support delivery. The
areas addressed by each node may differ,
depending on local patterns of ill health,
for example using existing strategic needs
assessment reports. The nodes and EAHSN
as a whole will ensure that all aspects of
Equality and Diversity are considered in
their work.
The nodes will also be responsible
for engaging as widely as possible with
industry in their areas, in order to maximise
competition from commercial entities to
deliver the EAHSN programme. In doing
so, we recognise the need to address the
potential for conflict of interest.
6.11 AHSC nested within EAHSN
The EAHSN will have one of the five
designated Academic Health Science
Centres (Cambridge University Health
Partners) nested within it. CUHP has been
funded exclusively by the four partner
organisations (Cambridge University
Hospitals NHS Foundation Trust, Cambridge
and Peterborough NHS Foundation Trust,
Papworth Hospital NHS Foundation Trust,
and the University of Cambridge). CUHP has
an agreed portfolio of work for which it is
accountable to the partnership.
In addition to the delivery of this existing
portfolio of work, CUHP will become a lead
organisation for facilitating delivery in the
Cambridge and Peterborough node, aligning
it with all health partners in the local health
system. Alignment with the health partners
in the Cambridge and Peterborough node
will enable CUHP to realise its ambition
to work as an Academic Health Science
System (AHSS), to deliver cross cutting work
(e.g. integration of care, informatics) which
is not achievable as a partnership-based ‘EAHSN will
exclusively on providers in secondary and work within
tertiary care.
In summary, CUHP will thus have two
the proposed
portfolios of work, to: network
1. Deliver its role as an Academic Health of AHSNs
Science Centre, in accordance with to develop
its designated role. For this it remains
funded by the CUHP partners.
ideas, share
2. Extend and develop its role to become learning and,
a key organisation responsible for as appropriate,
driving progress in the Cambridge and
undertake
Peterborough node and to contribute
to the wider EAHSN. For this CUHP projects
would have a contractual arrangement collaboratively
for delivery with the EAHSN. or on behalf of
This model delivers the following benefits:
other AHSNs.’
• Avoiding dominance of the EAHSN by
CUHP if it were central to the delivery of
the EAHSNs delivery; enabling greater
ownership by its full range of members.
• Preventing duplication of activity across
Cambridge and Peterborough partners,
with CUHP working to deliver a portfolio
of AHSS work.
• Delivering organisational efficiency and
productivity gains in infrastructure costs
• Drawing on, to the benefit of the
whole EAHSN, and learning from
CUHP’s experience of working across
health system in research, education
and training and network-based
improvement programmes.
6.12 Impact assessment
The Public Sector Equality Duty is set
out in the Equality Act 2010. The AHSNs
have a commitment to promote equality
and address inequalities, and to ensure
that the policy development of the Eastern
Academic Health Science Network will
not have an adverse impact or a potential
adverse impact on those people who share
a protected characteristic and those who
do not, the users of our services or our
staff. In keeping with this obligation, we will
The Eastern Academic Health Science Network | 35
‘The non- undertake an Equality Impact Analysis which
communicable will enable us to consider the impact of
each current and proposed service, policy,
disease (NCD) procedure or function in relation to all
priorities are the protected groups. We will give ‘due regard’
highest causes to equality in relation to the services that
of preventable we commission and, where appropriate,
deliver and the manner in which we recruit,
and avoidable train and develop our staff. We will identify
mortality and any gaps or areas of concern that may
morbidity in the adversely impact on one or more groups.
NHS.’
7. EVIDENCE OF DEMONSTRABLE
PROGRESS AND COLLABORATIVE
WORKING
7.1 High impact innovations
The EAHSN is committed to supporting
delivery of nationally identified High
Impact Innovations. We will drive delivery
of High Impact Innovations determined
both nationally and locally. The four nodes
will each deliver against these; some
concurrently and others through early
adopter status, followed by EAHSN roll out
to the other three nodes.
We will work with CCG Innovation Leads as
primary partners in planning delivery of these
innovations. We will support them with clarity
of best practice, including health economic
analysis, and with access to improvement
science expertise, from the partnership
agreement we propose to establish with the
new NHS Improvement Body.
Evidence of progress made on nationally
identified high impact innovations are
detailed in Section 4 of our Draft Business
Plan in Appendix E.
7.2 NHS Midlands and East Ambitions
The EAHSN will also progress the Midlands
36 | The Eastern Academic Health Science Network
and East Ambitions, continuing to address the
reduction in grade 2, 3 and 4 pressure ulcers;
improving patient experience and outcomes;
and working to ensure that Every Contact
Counts. See Appendix E for more detail.
7.3 iTAPP push technologies - National
Technology Adoption Centre (NTAC)
The iTAPP technologies, now an integral
part of NTAC, will be used as a key set
of tools to maximise the adoption and
spread of innovation. An early priority in
2012/13 will be the inter-operative fluid
management technologies (IOFMT) which
EAHSN partners will deliver through the
nodes, by bringing together clinical and
other experts to agree a plan of work
to support and apply the innovation,
supported by the IOMFT Implementation
Toolkit.
Partners will be agreeing a further
programme of implementation once the
EAHSN has approval to proceed, and will
identify an initiative a year, selected once
analysis is complete of the areas with
greatest scope for improvement.
8. FIVE YEAR WORK PROGRAMME
8.1 Our clinical priorities
The non-communicable disease (NCD)
priorities are the highest causes of
preventable and avoidable mortality and
morbidity in the NHS. Taken together,
they account for more than 70% of the £7
billion health spend in the area subtended
by EAHSN. The doubling of the region’s
population over the age of 85 in the next
20 years warrants EAHSN priority, as 70%
of those over 75 years have one or more
long-term conditions, compared to 20%
of the 16-44 year old age group. The areas
addressed by each node will depend on
local patterns of ill health, for example
using local joint strategic needs assessment
reports.
Informed by the burden of disease, risk of
harm, and the potential for improvement,
EAHSN partners have identified three
priorities for the next five years:
1. Dementia and mental health
2. Long-term conditions
a) Cardiovascular disease
b) Cancer
c) Diabetes
d) Chronic respiratory diseases
3. Patient safety
The EAHSN will design a work programme
over five years to answer research
questions for our clinical priority areas
to identify interventions that will lead to
the improvement in the management of
these long-term conditions. This work will
focus on the scope for preventing up to
80% of heart disease, stroke and type 2
diabetes and over a third of cancers being
preventable with lifestyle changes.
For each clinical priority area, there will
be an EAHSN’s Network for Innovation
for which a designated node will lead
the programme of work and draw upon
experts from across the wider network.
For example, in early discussion the Essex
node has agreed to lead Cardiovascular
work; the Cambridge and Peterborough
node has agreed to lead patient safety, and
Norfolk and Suffolk will lead mental health
(dementia). Leadership of the node will
involve identifying clinical and non-clinical
opinion leaders in the areas concerned,
supported by senior management capacity
to lead the programme. These innovation
networks will ensure that all partners
in the NHS, primary, secondary, tertiary
and social care are involved, patients
and carers, as well as public health and
local government and the 3rd sector, and
they will work closely with the emerging
Strategic Clinical Networks, essentially a ‘Key outcomes
‘Network of Networks’, to provide a co- and deliverables
ordinated approach to co-production with
an emphasis on innovation. The advantage
for each priority
of this is that they can map onto established will be set by
clinical communities. The performance the EAHSN
metrics will be linked to deliverables as has
Board. Some will
been done in the DH Cancer, Cardiac and
stroke network which have been driven by reflect uptake
NHS Improvement. and spread of
Each Innovation Network will have access innovation, and
to EAHSN wide or local intelligence to
inform its work:
others will be
• Informatics, including identifying aligned with the
variation in practice and outcomes, NHS Outcomes
baselines, information to monitor its Framework,
progress against agreed metrics.
• Industry, including through Health
which reflects
Education England. the desired
• Education and training, including clinical outcome
through the LETB.
of innovative
• Innovation intelligence.
• Research intelligence. practice.’
• Health economics intelligence.
• Improvement Science intelligence,
including though the local arm of the
New NHS Improvement Body.
Key outcomes and deliverables for each
priority will be set by the EAHSN Board.
Some will reflect uptake and spread of
innovation, and others will be aligned with
the NHS Outcomes Framework, which
reflects the desired clinical outcome of
innovative practice.
The Innovation Networks (i.e. one
per EAHSN priority area) will have a
responsibility in identifying, understanding
and responding to unwarranted variation
in practice and outcomes; the role of both
primary and secondary care in improving
outcomes; the adoption and spread of
effective innovations in treatments and
in the organisation of care; and driving
change through improvement science
methodologies, including working through
the Eastern auspices of the new NHS
Improvement Body.
The Eastern Academic Health Science Network | 37
‘The EAHSN will The examples of delivery for each work
build on the priority have been developed in discussion
with partners, but will need to be affirmed
excellent training by the EAHSN Board once in place.
record of all The detailed plans for our clinical
partners through priorities are set out in Appendix E, our
Draft Business Plan.
facilitation of
node-based 8.2 EAHSN education and training
programmes as development five year programme
well as AHSN-
The EAHSN will build on the excellent
wide education training record of all partners (see
development Appendix B) through facilitation of
programmes.’ node-based programmes as well as
AHSN-wide education development
programmes. Education and training will
be operationalised at node level through
existing established, HEI-based structures.
The aims of the education and training
section of the EAHSN will be to:
1. Drive forward innovations in healthcare
through education and training.
2. Use our track record to use innovative
ways to deliver education.
3. Support the delivery of the EAHSN
clinical priorities and associated
networks for innovation.
The AHSN through its education and
training group will share practice to
develop node-based programmes and
avoid duplication. Methodologies that solve
problems of delivery (e.g. e-learning and
virtual learning environments) and course
assessment (marking systems, quality
assurance of programmes) will be shared.
In this way we will use the membership
of the EAHSN to standardise the quality
of programmes and the assessment of
registered students across the networks.
Specific areas of work will include:
• E- learning/distance learning: for
masters courses, mandatory training,
staff induction.
• Simulation: co-ordination of simulation
suites mapped onto local training
needs.
38 | The Eastern Academic Health Science Network
• Surgical skills training.
• Educational and assessment
methodology.
Our model is to establish developmental
work within nodes and then role these
out across the wider EAHSN. The use of
education to innovate healthcare delivery
will be based upon the work of the HIECs.
Node-developed programmes of education
in training, in specific disease areas (e.g.
dementia and the Norfolk and Suffolk HIEC)
will be rolled out through the network first
through the EAHSN education and training
group and where the health area maps to
an EAHSN strategic priority then rolled out
as an established part of workforce training.
More details on our future priorities for
education and training are in Appendix
D. However, in summary, the education
themes will include:
• Dementia care education and training
across health and social care providers
• Basic psychological therapies skills for
physical health services staff.
• Education programmes in support
of the NHS Midlands and East stroke
services review, and training support
for development of stroke practitioner
roles.
• Diabetes education for primary and
community providers as well as
secondary care, and lay trainers
• Education in support of COPD,
including patient self management, and
supported self management.
• Service improvement science, including
research literacy and innovation/change
management methodologies.
• Patient safety training programmes.
8.3 Collaborative procurement
The Eastern AHSN already benefits from
the Eastern Region Procurement Hub and
its activities both within and outside of the
region and with other collaborative and
hubs. The majority of the Eastern AHSN
members are also already members of the
hub, but the EAHSN would aim to increase
this collaboration to maximise procurement
opportunities as a lever to increase quality
and value for money. For example one of
the nodes is already looking to adopt a
collaborative and consistent approach to
assessment against the recently published
National Standards of Procurement as a
means to achieving individual and collective
improvements.
EAHSN will use procurement as a key
lever to stimulate innovation across health
provision, stimulate industry engagement
and involvement and align its strategic
priorities to deliver the activities set out in
this prospectus.
Hertfordshire Partnership Trust
Innovative Technology Adoption
Procurement Programme: helping the NHS
to adopt innovative medical technology.
The Trust actively pursues collaborative
procurement. This is mainly through the
provision of its procurement services which
are all collaborative in nature. The Trust
mainly receives its procurement service
through:
• Hertfordshire Supply Management
Confederation (HSMC).
• Eastern Region NHS Collaborative
Procurement Hub (EoECPH).
HSMC is the Trust’s procurement service.
It is a shared service which provides
procurement to the five trusts across
Hertfordshire. It is structured to take
advantage of scale across Hertfordshire and
as a default looks to collaborate when going
to market for individual trusts. A recent
survey of contracts demonstrated that 30%
had been collaborated across Hertfordshire.
EoECPH is the regional procurement hub.
Their primary focus is to aggregate spend
across the Eastern Region. They have a
category management approach which
means they focus (specialise) in specific
areas of spend such as Medical Surgical
Consumables and IT Hardware. This means ‘The Eastern
they have a deep understanding of the Region can
category and strong relationships with
the suppliers. From aggregating volume
claim to be the
across the region they go to the market centre of UK’s
and establish framework agreements from biomedical
a range of suppliers for specific products/
and bioscience
categories. This means the Trust can buy
their products through pre-collaborated research and
Hub framework agreements. To give a sense development
of scale as to how prevalent this is at EN - 25% of all UK
Hertfordshire; 40% of the spend on clinical
consumables (£20m of non pay annual
private sector
spend) was through EoECPH frameworks. investment in
In addition, there are two other research and
procurement vehicles that HSMC buy through development
which assure collaboration. One is NHS
Supply Chain which is the national supplier
is spent in the
to the NHS. They are effectively a wholesaler region and 30
and provide an end to service supply chain of the world’s
service - from procuring and ordering the
leading research
goods to their dispatch and delivery. NHS
Supply Chain are ideally positioned to institutions are
aggregate spend nationally. Again to give based in the
a sense of scale the Trust spends £7.5m region.’
annually with NHS Supply Chain.
Secondly is the Government Procurement
Service which is the route to source
product which has been competed on a
national basis; typical categories are energy,
software and consultancy services.
One of the corporate measures being
discussed by the Department of Health
to demonstrate good procurement is the
percentage of non-pay spend through
collaborative agreements. This is a metric
HSMC and EoECPH fully support and one
which we are ideally placed to impact
positively. In order that we continue the
strong position the Trust currently enjoys
HSMC and EoECPH are working even more
closely together to ensure that when a
new contract is required we assess if this
could be more effectively procured through
a collaborative arrangement. In turn both
organisations develop a joint procurement
work plan for the trust based on the best
value procurement route.
The Eastern Academic Health Science Network | 39
40 | The Eastern Academic Health Science Network
Appendices

APPENDIX A: ANTICIPATED AND CONFIRMED EAHSN PARTNER AND AFFILIATED ORGANISATIONS

APPENDIX B: EAHSN ACTIVITY IN EDUCATION AND TRAINING
APPENDIX C: EAHSN PROPOSED METRICS
APPENDIX D: FUTURE PRIORITIES FOR EDUCATION AND TRAINING
APPENDIX E: DRAFT OF FIVE YEAR BUSINESS PLAN
APPENDIX F: HEALTH ENTERPRISE EAST INDUSTRY ENGAGEMENT DRAFT DOCUMENT

The Eastern Academic Health Science Network | I

 APPENDIX A: ANTICIPATED AND CONFIRMED EAHSN PARTNER AND AFFILIATED ORGANISATIONS

Cambridgeshire & Peterborough Node Colchester/University of Essex N

AHSC CUHP x  
University University of Cambridge* x University of Essex
      Anglia Ruskin University
CCG NHS Cambridgeshire & Peterborough CCG x NHS North Essex CCG
      NHS North East Essex CCG
      NHS Mid Essex CCG
      NHS West Essex CCG
NHS Basildon and Brentwood
     
CCG
NHS Castle Point, Rayleigh &
     
Rochford CCG
      NHS Southend CCG
NHS Thurrock Managed Care
     
CCG
Colchester Hospital University
Acute Trusts Cambridge University Hospitals NHS Foundation Trust* x
NHS Foundation Trust
Mid Essex Hospital Services
  Hinchingbrooke Healthcare NHS Trust x
NHS Trust
Southend University Hospital
  Papworth Hospital NHS Foundation Trust* x
NHS FT
Peterborough & Stamford Hospitals NHS Foundation
  x  
Trust
  West Suffolk Hospital NHS Trust x  
Mental Health Cambridgeshire & Peterborough NHS Foundation Trust* x North Essex Partnership Trust
      South Essex Partnership NHS FT
Anglian Community Enterprise
Community Cambridgeshire Community Services  
(ACE)
West Essex Community
     
Services
South West Essex Community
     
Services
Tier 1 LA Cambridgeshire County Council x Essex County Council
  Peterborough City Council    
       
       

Other Eastern Region PHO x

Health Enterprise East x

Cambridge Institute of Public Health x
PHG Foundation x

II | The Eastern Academic Health Science Network

Node Hertfordshire & Bedfordshire Node
x University of Hertfordshire
x University of Bedfordshire
  NHS East & North Hertfordshire CCG
  NHS Herts Valleys CCG
   
  Bedfordshire CCG
  Luton CCG
   
   
x East & North Hertfordshire NHS Trust
The Princess Alexandra Hospital NHS
 
Trust
  West Herts Hospitals NHS Trust
  Bedford Hospital NHS Trust
  Luton & Dunstable Hospital NHS FT
  Hertfordshire NHS Foundation Trust
  Bedfordshire & Luton PT
  Hertfordshire Community Services
   
  Hertfordshire County Council
  Bedford Borough Council
  Central Bedfordshire Council
  Luton Borough Council
Norfolk & Suffolk Node
x University of East Anglia x
x    
x NHS Great Yarmouth & Waveney CCG x
  NHS North Norfolk CCG   x
  NHS Norwich CCG   x
  NHS South Norfolk CCG  x
  NHS West Norfolk CCG   x
  NHS East Suffolk & Ipswich CCG  
  NHS West Suffolk CCG  x
Norfolk & Norwich University Hospitals
x x
NHS Foundation Trust
James Paget University Hospitals NHS
  x
Foundation Trust
  The Ipswich Hospital NHS Trust x
The Queen Elizabeth Hospital King's Lynn
x x
NHS Foundation Trust
     
x Norfolk & Suffolk NHS Foundation Trust x
     
x Norfolk Community Health & Care x
  SERCO (for Suffolk)  
  Norfolk County Council x
  Suffolk County Council x
     
     
The East of England Ambulance Service
NHS Trust
KEY
Anticipated member of EAHSN x
Anticipated affiliate: likely to be a member of another AHSN x
Cambridge University Health Partners (CUHP) *
The Eastern Academic Health Science Network | III
 APPENDIX B: EAHSN ACTIVITY IN
EDUCATION AND TRAINING
CAMBRIDGESHIRE AND PETERBOROUGH
NODE
The Cambridge University Health Partners
(CUHP) Academic Health Sciences Centre
has an established programme of excellence
in education and training. This network aims
to support and improve the diffusion and
adoption of innovations and of evidence-
based clinical practice, underpinned by
an integrated approach to education and
training. CUHP has worked across the health
system through the Cambridgeshire and
Peterborough HIEC, and through the Chief
Executives group.
Some of the strengths and achievements
in relation to education of the
Cambridgeshire and Peterborough cluster
include the following:
CUHP Education and CUHP Endorsement
CUHP partners have local and national
reputations for excellence in education
and have brought educational capacity
and leadership. It has coordinated the
HIEC projects, and developed a range of
educational innovations. CUHP has framed
this as ‘education by the bedside’.
Over the last 12 months, CUHP has
developed a system of course endorsement
which has enabled partners to use the
CUHP brand. For example, colleagues
in Cambridge University Hospitals NHS
Foundation Trust (CUHFT) have recently
provided an endorsed programme on
advanced neuro-critical care which has been
of regional and national interest.
Cambridgeshire and Peterborough HIEC
Projects
The focus on patients with long-term
conditions has been a strength of the
Cambridgeshire and Peterborough HIEC.
IV | The Eastern Academic Health Science Network
There has been good engagement of
stakeholders in these projects and they
have been positively evaluated. The projects
have included strong ‘cross-over’ between
physical health and mental health, and a
focus on self-management and supported
self-management for people with long-
term conditions. CUHP has coordinated and
managed the HIEC. Projects have been led
by partner Trusts, but have had an impact
across the health system.
Stroke Services Review - education,
training and workforce development
CUHP has been commissioned by NHS
Midlands and East to lead on the stroke
services review. The purpose of the review
is to achieve a step change improvement
in the quality of stroke services and stroke
outcomes. The outcome of the work will
be the production of a clear vision for
the most effective and sustainable way of
achieving this; providing high-quality, safe
services 24/7 across the region. As part
of this review, CUHP is also leading on a
review of education, training and workforce
development and producing a toolkit for
providers and commissioners in support of
the new best practice service specification
for stroke services.
CLAHRC CP Fellowship Programme
The CLAHRC CP Fellowship programme is
aimed at clinicians, health and social care
practitioners and managers, who would
like to work at the interface of research
and practice, develop an understanding
of the research environment and, through
a taught component, develop skills in
research methodology, service redesign and
change management. The focus within the
Fellowship programme is on local applied
research and evaluation, building local
capacity for evidence-informed practice,
and facilitating networking across health
and social care.
 Thirteen fellowships were awarded
for 2011, twelve for 2011/12 and eight
in 2012/13. These fellows have come
from a wide range of backgrounds
- NHS consultants, NHS managers,
clinical psychologists, consultant clinical
neuropsychologists, GPs, registered
nurses, pharmacists, commissioners and a
road safety officer. They have come from
organisations across the East of England
(Bedfordshire, Cambridgeshire, Norfolk and
Great Yarmouth).
The fellows carry out a project during
their fellowship year under the supervision
of one of Cambridge University’s senior
researchers. This can be a specific project
chosen by the fellow or they can contribute
to a project within one of our CLAHRC
themes. In addition to the research project,
there is a programme of monthly half day
teaching workshops and half day action
learning sets (ALS). The research time,
workshop and ALS sessions are protected
time for the fellow. The key aim of the
Fellowship is to make the programme
valuable to the individual fellow and their
employing organisation.
The Cambridgeshire Festival of Leadership
Cambridge and Peterborough NHS
Foundation Trust (CPFT) in partnership
with the Cambridgeshire County Workforce
group has coordinated two successful
leadership festivals. These festivals have
provided a wide cross-section of the health
and social care leadership community with
leadership development opportunities. A
particular strength of these festivals has
been the trans-organisational nature of the
leadership activities.
The Chief Resident Leadership and
Management Programme
This successful clinical leadership
programme has been run by CUHFT and
supported by the Deanery. This programme
is designed to give senior medical trainees
an insight into the language and tools
of the core disciplines of management
within the context and challenges of the
UK healthcare system. Modules are based
on the core management disciplines of an
MBA and embedded in individual service
improvement projects: From September
2012, it is planned to be delivered by CUHP
to senior medical trainees from around the
region.
The Cambridge Simulation Centre
CUHFT has developed a well-regarded
clinical simulation centre, which supports
multi-professional and inter-disciplinary
learning using electronic mannequins
that simulate a wide variety of realistic
patient care scenarios. Training scenarios
are programmed and designed specifically
to meet the needs of each group of
practitioners depending on the level of
experience. This enables participants to
rehearse relevant simple and complex
procedures, and have exposure to rare
clinical events. For a full list of courses,
see www.addenbrookes-pgmc.org.uk/
courses.asp. As well as using simulation
to deliver education, the centre aims to
improve patient safety through teaching
and training, with research methods being
developed to reduce clinical error.
The Cambridge Surgical Training and
Research Centre
CUHP is taking forward a development
with PA Consulting to establish a new
Cambridge Surgical Training and Research
Centre. The centre will provide advanced
cadaveric training across all surgical
specialties through a cadaveric laboratory.
Surgeons will have an opportunity to
develop their skills and gain experience in
basic and complex surgical techniques with
expert guidance. In addition opportunities
for research into new surgical techniques,
The Eastern Academic Health Science Network | V
 surgical anatomy, new implants and
equipment will be supported.
E-learning
All partner trusts have developed some
e-learning, particularly for mandatory
training. Work is underway to take
e-learning to a new level. CUHP and CUHFT
Post Graduate Medical Centre (PGMC)
are working in partnership to develop a
shared virtual learning environment (VLE).
Funding has been secured to develop
e-learning capacity for the health system,
and for establishing, and further developing
e-learning programmes for the relevant
HIEC projects on Moodle (i.e. dementia,
Chronic Obstructive Pulmonary Disease
(COPD)/spirometry, long-term conditions/
mental health, supported self-management,
diabetes and end-of-life care) for CUHP
educational programmes. The PGMC
have developed a number of e-learning
programmes including an education
supervisors course.
Post-graduate certificate in medical
education
The Cambridge University School
of Clinical Medicine, in partnership
with University of Cambridge Institute
for Continuing Education (ICE), has
developed a one year part-time Masters-
level programme for doctors and other
professions allied to medicine who have a
teaching role, and/or a role in training and
appraising healthcare professionals. The
first programme runs in September 2012.
Further information about the full
range of undergraduate and postgraduate
education is available on partner HEI
websites, and on NHS Trust websites.
UEA HEALTHCARE PARTNERS NODE
The hospital trusts of the UEA Healthcare
Partners are a major contributor to health
VI | The Eastern Academic Health Science Network
education in the UK working with HEI
health-based programmes (primarily
with UEA but also with the University of
Cambridge) and in postgraduate workforce
training with the deanery.
UEA Health Partners already prepare each
year at graduate level over 350 nurses in
various fields (including adult, children’s,
mental health and learning disability),
over 140 allied health professionals
(physiotherapists, clinical psychologists,
occupational therapists and speech and
language therapists) and almost 170
doctors. In this we draw on placement
opportunities provided by many NHS and
social care organisations, including the
private sector and extending in some cases
far beyond the East of England. We operate
through a well-established network of
practice education facilitators (pefs) who
liaise with UEA’s director of placements. Our
performance is scrutinised and regulated by
the multiprofessional deanery and UEA has
established itself as an educational provider
with high entry standards and low attrition,
for which we have received bonus quality-
related payments.
In addition we provide post registration
education and learning to the value of over
£1.6 million annually across a wide range of
skill areas. It is a strategic aim to expand this
provision. We have appointed earlier this
year a chair in workforce futures who heads
up a CPD business development unit, which
includes expertise in developing distance
and electronic learning.
Some of the strengths and achievements
in relation to education of the UEA cluster
include the following:
UEA has a major interest in healthcare
training. The faculty of medicine and health
sciences has three schools: the norwich
medical school; the school of allied health
professions and the school of nursing
sciences. In addition, within the faculty
of science there is a school of pharmacy.
Between these there are currently 2938
registered students at undergraduate
and postgraduate levels. Specifically, at
undergraduate levels there are:
Medicine, 782; physiotherapy,
occupational therapy, speech and language
therapy, 276; adult and children’s nursing,
mental health and learning disabilities
nursing, midwifery and operating
department practice, 931; pharmacy 476.
There are a wide range of postgraduate
studies relevant to the ahsn and these
include the diploma in clinical psychology
(with collaboration with Cambridgeshire
and Peterborough NHS Foundation Trust),
54 students; physiotherapy, occupational
therapy, speech and language therapy 117;
adult and children’s nursing, mental health
and learning disabilities nursing, midwifery
and operating department practice, 232;
and pharmacy 43.
UEA is a high-quality provider of
education and research in health and social
care.
School of Allied Health Professions, UEA
The School of Allied Health Professions is
home to education and research in speech
and language therapy, physiotherapy and
occupational therapy. The school is housed
in an award-winning building with state
of the art clinical skills facilities which
underwent a major update in 2012 in
order to accommodate new innovations in
educational and clinical practices.
The school is very active and successful
in supporting the NIHR clinical academic
initiative, offering fully funded Research
Masters places as well as successfully
supporting NIHR applications for doctoral,
career development and senior research
fellowships.
The research in the school supports
people to regain function following illness or
disability and to participate more fully. Our
research focuses on:
Older people - investigating ways to
support people with dementia and their
carers, in care homes or while living at
home in the community. Importantly this
increasingly includes demonstrating how
organisations can ensure such care is
respectful.
Communications - addressing issues
for enhancing communication for people
with various intellectual, cognitive and
motor disabilities, including stammering.
Such research is supported by a language
laboratory equipped with specialist software
for speech analysis and video editing.
Education - patient, public and
professional education to address health
and life challenges. Here collaborative
research has been used to develop
educational resources to prepare people
to live and work with long-term medical
conditions, rare or life-threatening illnesses
and life changing circumstances.
Assistive technologies - enabling people
and carers to live independently, while
also building appropriate partnerships
with agencies and commercial companies
developing such technologies.
Restorative neurology - to improve
current therapeutic interventions so that
many more people can resume the activities
they did before they had a stroke. To do
this we combine clinical, neurophysiological
and biomechanical investigation of the
production and control of movement.
Musculoskeletal - researching therapies
to aid restoration of function to the
musculoskeletal system. Research activity
includes investigation into patellofemoral
dislocation, carpal tunnel decompression
and post operative splinting and the impact
of biologic therapies on functional gain, and
other common musculoskeletal disorders.
Cardovascular and Respiratory
group - increasing understanding of
how interventions can impact on the
cardiovascular and respiratory systems.
Our researchers have developed working
partnerships with a variety of health and
social care and voluntary organisations
including Age UK, the Alzheimer’s Society,
Arthritis Research UK, Action for ME, UK
The Eastern Academic Health Science Network | VII
 OT Research Foundation and charities that
support research into cancer.
Norwich Medical School at UEA
The School has established a reputation
for exciting and innovative approaches
to education supported by a strong and
rapidly developing research programme. As
part of the Faculty of Medicine and Health
Sciences it has a growing emphasis on inter-
professional co-operation in teaching and
research.
The presence of four BBSRC research
institutes on the Norwich Research Park
(Institute of Food Research (IFR), John Innes
Centre (JIC), The Genome Analysis Centre
(TGAC) together with a business science
park provides unique opportunities not
available to other comparable medical
schools.
Our focus is on developing translational
research themes which answer important
health questions from an understanding of
the basic science and genetics of disease
through to clinical trials and from there
to adoption into clinical guidelines and
assessment within the broad healthcare
community. We also wish to understand the
epidemiology and health economic impact
of the diseases we are studying.
Our research themes are, nutrition and
health, gastroenterology and gut biology,
microbiology, bone and joint disease,
diabetes and endocrinology, vascular
disease, cancer, clinical trials - including
statistics and health economics, health
policy and practice evaluation - including
epidemiology, psychological sciences, and
MR imaging.
School of Nursing Sciences, UEA
The School of Nursing Sciences (NSC)
is located in its own building on the
Norwich Research Park within the main
University Campus and close to the Norfolk
and Norwich University Hospitals NHS
VIII | The Eastern Academic Health Science Network
Foundation Trust.
The strategic aim of UEA School of
Nursing Sciences (NSC) is to improve the
quality of healthcare through world class
research and education. The School intends
to develop outstanding practitioners and
leaders of healthcare and to become a
leading academic force in the field of
nursing sciences internationally. The School
provides undergraduate pre-registration
programmes in all fields of nursing (adult,
child, mental health, learning disability),
midwifery and operating department
practice). Approximately 750 undergraduate
students and 1,100 post registration
and postgraduate students are currently
taking a variety of modules and courses,
including MSc programmes in Health
Sciences, Mental Health and Advanced
Practice. With the School of Allied Health
Professions, the School of Nursing Sciences
has secured Department of Health funding
for masters-level clinical academic career
pathway development within the region
and has made new research professorial
appointments in public health nursing and
elder care.
The School has 30 doctoral students and
funded research programmes in three areas.
These are: urgent care systems and access
to care (clinical and cost effectiveness of
triage systems, evaluation of new models
of care, improving access to care, end-
of-life care); wellbeing in older age (adult
protection, quality of care, dementia care)
and in mental health (adult mental health,
including psychosis, anxiety and depression,
admission prevention and inpatient care;
vulnerable groups including those with
acquired brain injury, learning disabilities
and cognitive problems including dementia;
physical comorbidity in severe mental illness
and depression as a comorbidity of long-
term conditions; adherence to treatment
and protected engagement time. The
School has methodological expertise is in
systematic reviews, randomised controlled
trials and mixed methods research including
qualitative approaches which explore
service user perspectives
Within the faculty, the Norwich Research
Park and the wider University, the School
is supporting UEA Health Partners by
developing and delivering dementia care
programmes with the HIEC; contributing to
the success of SHA successor organisations
(LETBs) and developing a new link academic
role with a focus on service improvement.
Current School priorities include the
integration of research with teaching and
learning so that high-quality research
informs student learning and drives
curriculum innovation. Aspirations for
research include a strong return to REF 2014
for nursing sciences; growth in research
income as a proportion of total income
for the school and from research councils
to support the school’s major research
themes; growth in the number of research
active academic staff through development,
clinical academic fellowships and external
appointment of leading academic staff from
the field of health sciences and growth in
the number and quality of postgraduate
research students. The School has a
valuable resource of over five thousand
alumni, many in practice within the region.
Education and Training Innovation
UEA Healthcare Partners have been
focused on training professionals in new
innovations and in pulling research through
into the clinical sphere, recent exemplars
include:
QuIPP Alive - a conference on service
improvement and production of a service
improvement teaching model - SWIFT
funded (first place award in the NHS
Improvement Faculty Conference).
Preoperative education for patients facing
the following procedures- hip replacement,
total knee replacement, colorectal surgery,
and the educational needs of patients with
primary systemic vasculitis.
Norfolk and Suffolk HIEC
UEA were commissioned to develop and
run an innovative Postgraduate Certificate
in Leadership in Person Dementia Care.
This programme was designed as a
multi-agency initiative, supported by the
Norfolk and Suffolk Health Innovation and
Education Cluster (HIEC) and the Norfolk
CWG together with a comprehensive range
of stakeholders including patients, carers,
voluntary organisations, health and social
care providers and practitioners from many
disciplines. In 2012/13 commissions of up to
68 places have been placed.
Locally, the Norfolk and Suffolk HIEC has
undertaken significant work in developing a
robust competency framework, identifying
learning needs across a number of
professions and individual practitioners and
in mapping good practice in education as
is undertaking a full audit including web-
based training resources.
This PGCert is aimed at senior levels
of practitioner, those who make clinical/
practice decisions and aspiring clinical
leaders across health, social care and the
private/voluntary sectors with two cohorts
now underway.
The course is characterised by being
flexible, face-to-face contact will be
enhanced by Action Learning/Enquiry
Sets and a truly multi-agency and multi-
professional approach, recognising that
inter-professional communication is as
valuable as content. The programme
will require students to learn from
experience and in practice, to demonstrate
achievement of the Norfolk and Suffolk
Dementia Alliance Competencies and to
cascade learning through their teams and
organisations. Senior leaders at Director
of Nursing or equivalent level have been
targeted to identify key practitioners to
be nominated for these first two cohorts
and to support the initiative at Executive
Board level. Thus the programme intends
to support leadership to promote a culture
The Eastern Academic Health Science Network | IX
 in which excellent care is recognised and
promoted from Board to patient and vice
versa to stop care being task-orientated
and enable person-orientated/centred
care. It will also be concerned with setting
expectations and holding to clinical leaders
and practitioners to account and is delivered
collaboratively drawing on respected clinical
experts and academics, researchers active in
the field of dementia care and practice and
service users and carers.
The HIEC offers a competitive travel
scholarship which is open to students on
this programme with the aim of facilitating
dialogue and practice development
informed by national and international
ideas. Amongst the scholarships funded are
visits to dementia centres in Holland.
The programme comprises three modules:
1. Foundations of Person-centered
Dementia Care
2. Advanced Practice in Dementia Care
3. Leadership for Dementia Champions
Workforce Development
UEA has developed a broad portfolio of
profession-specific and inter-professional
continuing professional development
and postgraduate training for registered
healthcare professionals. The training offer
spans UEA’s integrated Faculty of Medicine
and Health Sciences allowing healthcare
professionals to form multi-professional
communities of lifelong learning during
their training.
The portfolio is targeted to respond to
key learning frameworks including the
NHS Education Outcomes Framework and
the NHS Knowledge and Skills Framework.
The portfolio is delivered using a range of
contemporary work-relevant pedagogies
and is supported by a growing online
learning support resource. UEA has adopted
a philosophy of striving to ensure that its
training programmes can be delivered in,
or close to, the workplace to minimise the
time professionals spend away from their
X | The Eastern Academic Health Science Network
place of work.
UEA’s approach enables learners and
their employers to decide whether to
undertake accredited modules as part of,
or out with, a formal degree programme.
Bespoke modules and short courses are
frequently designed in close partnership
with employers to ensure that the training
offer rapidly responds to specific targets to
improve patient outcomes and experience.
UEA is able to support employers to
measure the outcomes of their training
and hence maximise the return on their
investment on training.
E-learning
Norwich Medical School, in partnership
with the James Paget University Hospitals
NHS Foundation Trust has established
a series of distance learning masters
programmes for qualified clinicians. To
date Masters programmes in oncoplastic
breast surgery, coloproctology and regional
anaesthesia have been established with
orthopaedic knee surgery being developed.
NHS Pharmacy Practice Unit (PPU) - based
at UEA
The educational work of the PPU covers
the north part of the East of England,
taking in the counties of Cambridgeshire,
Norfolk and Suffolk. There are two essential
strands to its work: pre-registration training
of graduates and a range of educational
training and development services for
registered pharmacists and pharmacy
technicians.
Pre-registration training forms the
bridge between the MPharm degree (or
equivalent) and becoming a practicing
pharmacist registered with the General
Pharmaceutical Council. Trainees are
placed in NHS organisations (mainly acute
hospitals) across the three counties on a 52
week supervised programme, with training
and assessment supervised by a small team
within the PPU. The Specialist Education
Training and Development Service offers a
range of programmes and network activities
for Registered Pharmacists funded by the
East of England Deanery aimed at driving up
quality.
COLCHESTER AND UNIVERSITY OF ESSEX
NODE
Health-associated education at the
University of Essex (UE) is delivered by the
School of Health and Human Sciences, the
Centre for Psychoanalytic Studies and the
School of Biological Sciences. Activity in this
area includes:
• The delivery of pre-registration
programme for adult nursing (80 BSc &
20 MSc) mental health nursing (24 BSc
& 20 MSc), physiotherapy (10 BSc & 30
MSc), occupational therapy (15 BSc &
28 MSc), speech and language therapy
(30 MSc), dental hygienists (15 FdD) and
clinical psychology (10 doctorate);
• Foundation degrees for assistant
practitioners in adult care and mental
healthcare (up to 20 on each);
• Graduate and post graduate
certificates for psychological well-being
practitioners (up to 24 per cohort);
• A variety of continuing professional
development opportunities including
professional doctorates, post graduate
and undergraduate degrees, modules
and non-credit bearing workshops.
Some of the strengths and achievements
in relation to education of the Colchester
and University of Essex cluster include the
following:
• The Arts and Humanities Research
Council (AHRC) Autonomy Summer
School offered by the School of
Philosophy and Art History, a three-
day training course aimed at frontline
professionals and researchers who
face issues surrounding autonomy and
mental capacity in the fields of medicine
and psychiatry, social care, policing and
law. The aim of the Summer School is to
equip practitioners and researchers with
an understanding of the philosophical
ideal of individual autonomy and to
provide a forum for the discussion of
the dilemmas surrounding its practical
application.
• The Foundation Degree in Oral Health
Science where dental hygienists in
training undertake their practice
learning in community dental practices
rather traditional dental training clinics.
The first course in the UK to place
students in general dental practice for
work-based learning and assessment
thus preparing them for the real world
of dental practice. Whilst educating
our student hygienists in the primary
care environment, there is a significant
contribution to service provision in
terms of assisting the SHA to meet
its pledges to provide NHS dental
care. In particular a large number of
patients seen are individuals who have
previously not seen a dental hygienist
before, often because of the costs
associated with seeing a hygienist
privately, including NHS and NHS-
exempt patients, children and special
needs patients. This service provision
is therefore helping to reduce health
inequality. Research shows strong links
between low socio-economic status
and periodontal disease as well as
links between periodontal disease and
general health.
• The School of Health and Human
Sciences offers two musculoskeletal
pathways providing multiple pathways
for experienced clinicians to expand
their knowledge and skills. They
will enable clinicians to assess and
manage patients with a range of
musculoskeletal conditions beyond
their normal scope of practice. Optional
modules allow students to expand their
musculoskeletal practice with a focus on
The Eastern Academic Health Science Network | XI
 imaging, including ultrasonography, or a
focus on patient management including
injection therapy.
• Changes in health trends, policies and
technologies create the necessity for
health professionals to continuously
re-define and improve their skills. The
breadth and depth of expertise required
by different individuals means that the
traditional educational programme with
a ‘set menu’ approach no longer reflects
the complex needs of the students.
Healthcare Practice pathways meet this
need by providing a range of options
consisting of short courses within
a credit accumulation and transfer
framework. Pathways are available in:
long-term conditions; respiratory care;
end-of-life care; and mental health.
• Colchester General Hospital has
a purpose-built simulation centre
containing fully equipped clinical areas,
patient simulators, laparoscopic surgery
simulations and advanced audio-visual
links into clinical areas of the hospital.
• The MSc in Cardiac Rehabilitation is
an interdisciplinary MSc within the
School of Biological Sciences offering
an academic qualification in cardiac
rehabilitation. The course aims to
enable suitably qualified physical
activity and healthcare specialist to
be able to administrate, organise,
and deliver cardiac rehabilitation
programmes primarily at Phases III
and IV. The objective of the course is
to improve the prognosis of cardiac
patients by adding to the knowledge
of these experts in the delivery of their
services to the clients.
HERTFORDSHIRE NODE
University of Hertfordshire
The University of Hertfordshire (UH), the
UK’s leading business-facing University,
is one of the four members of the
XII | The Eastern Academic Health Science Network
Hertfordshire EAHSN node. In line with its
vision and strategic drivers, the University
has significantly developed education and
research strengths in pharmacy, nursing,
allied health professions, postgraduate
medicine and other health-related
areas. It has embraced the concept of
interdisciplinary education and research
and is working with NHS organisations, local
government, industry and charities, through
various formal and informal structures, to
build the evidence base for better patient
care delivered by a wide variety of health
professionals.
Innovation, creativity and an enterprising
mindset are the defining characteristics
of the University of Hertfordshire, which
provides flexible and transformational
learning and commits to adding value
and delivering positive and productive
engagements with business, industry and
the professions.
The variety of education and training
provided at UH from undergraduate
preparation for registration with registrant
bodies to postgraduate Continuing
Professional Development, with its
advancing scope of practice courses, means
the student body represents the diverse
range of health professionals seen in UK
health services.
Students have the opportunity to work
in multi-professional groups to improve
their understanding across professional
boundaries and encourage collaborative
learning and working that will bring benefit
to service users. Students bring specialist
in-depth knowledge of their profession and
professional codes of conduct to the group
so that health and social care pathways
can be critically reviewed in the context of
professional practice.
UH continues to plays a central role in the
local and regional economy, contributing
positively to its social and economic
development, for example through the
University-owned UNO Bus intra- and inter-
regional transport service, which provides
an amenity for the broader community
while seeking to reduce the environmental
impact of travel.
UH has a highly innovative approach
to health education. Example include;
inter-professional learning, StudyNet/
blended learning, use of Clinical Simulation
Centre, Virtual Simulation Centre (Virtual
Environment Radiotherapy Training), Public/
service user involvement/OSCE, Doctorate
in Health Research (DHRes) Masters Clinical
Research (MClinREs), MSc in Mental
Health Recovery and Social Inclusion, MSc
Paramedic Science, Flexible Framework for
MSc for AHPs.
Some of the strengths and achievements
in relation to education of the University of
Hertfordshire cluster include the following:
The Learning and Teaching Institute
This is a five-year HEFCE funded project,
was established at UH in 2005 and received
public recognition as a Centre for Excellence
in Teaching and Learning. At the end of
the project, the unit was incorporated into
the University’s Learning and Teaching
Institute to sustain and extend the excellent
reputation and good practices it had
established. Blended and flexible learning
enhances established ways of learning
and teaching and maximises the use of
technology to improve students’ learning
and increase the flexibility of how, when
and where they study. Nine members of
staff from UH have won National Teaching
Fellowship awards, including one specifically
for innovative work in the development and
implementation of high-fidelity simulation
within healthcare education.
Clinical Simulation at UH
The University of Hertfordshire is leading
the way in scenario-based simulation
training in healthcare education in the
UK. The University houses the Clinical
Simulation Centre (CSC), which is the
largest purpose-built multi-professional UK
simulation centre. It features multiple, fully
equipped, simulated clinical environments
including intensive care and ward areas,
pharmacies, a GP surgery, counselling
and observation rooms, a versatile audio/
visual system, and a variety of adult and
paediatric advanced patient simulators. The
CSC is used for single and multi-professional
training and education at pre-registration
and post-registration levels across a
range of healthcare professions including
medicine, pharmacy, nursing, midwifery,
paramedic, physiotherapy, radiography and
radiotherapy.
The recent arrival at UH of the Virtual
Environments for Radiotherapy Training
(VERT) will help to address the urgent
need to train more radiotherapists to fill
the shortfall of practitioners in the NHS.
VERT is one of the most sophisticated
radiotherapy training systems in the world
using immersive visualisation technology
will allow students studying for the
BSc in Radiotherapy to view a virtual
patient’s anatomy and to run real-life
CT scans combining physical and virtual
environments to simulate real life.
The relevance and importance of
simulation to improve patient safety is
recognised within the government’s agenda
and is supported by the Chief Medical
Officer who has identified that simulation
training in all its forms would be a vital part
of building a safer healthcare system.
The University has not only invested
heavily in the physical simulation
environment, but it has also developed
a team of staff who are now experts in
facilitation of high-fidelity simulation
sessions who are as essential to the success
of simulation within education as the
technology itself.
Public Involvement in Teaching and
Learning
The University supports the involvement
The Eastern Academic Health Science Network | XIII
 of the public, not only in research activities
but also in elements of healthcare
professionals’ education and preparation
for registration with registrant bodies.
From development of curricula through
to selection of suitable students and
subsequent assessment of these students’
progress, the public and patients are an
important part of the team. For example,
service-user focus groups were held at
key stages during the recent successful
revalidation of the allied health professions’
new curricula including dietetics, paramedic
science, physiotherapy, radiography, and
radiotherapy.
Innovation in post-graduate studies for
health professionals
Many of the University’s cutting-edge
programmes and courses are leading the
way in the UK, such as the Pre-registration
Paramedic Degree programmes developed
in conjunction with Ambulance Trusts and
also the professional body the College of
Paramedics.
The Centre for Research in Primary
and Community Care (CRIPACC) has
led the development of a unique part-
time professional doctorate for health
researchers, the Doctorate in Health
Research (DHRes). Run as a cohort-
based, residential programme, the DHRes
programme enables clinical and service-
based researchers to develop and provide
applied research that meets the needs of
the users of health and social care ranging
from clinicians to managers.
In 2009, UH was awarded an NIHR/Chief-
Nursing-Officer-funded Masters in Clinical
Research (MClinRes) contract which has so
far enabled award grants to 39 NHS-based
masters students. The University is one of
seven universities in England who received
almost £2 million in funding to support the
programme.
In addition, CRIPACC and the School of
Health and Social work also lead on the
XIV | The Eastern Academic Health Science Network
NIHR/CNO funded mentorship programme
to support academic clinical career fellows
in nursing, midwifery and AHPs. This is the
first funded mentorship scheme of this kind
for non medical NIHR fellows in which UH
plays a leading role based on its expertise
in coaching and mentoring and the use of
Studynet as the learning platform.
Research in mental health recovery
at the School of Health and Social Work
has led directly to the first European
on line MSc in Mental Health Recovery
and Social Inclusion. The project, which
began in January 2012, is funded by the
Erasmus LifeLong Learning Curriculum
Development stream. Its target groups are
team leaders and professionals who aspire
to leadership in mental health services in
the multidisciplinary range of mental health
professions in Asti (Italy), Hertfordshire
(UK), Lisbon (Portugal), Turin (Italy) and
Warsaw (Poland). In each country the
project has a national advisory group of
service users, carers, and professionals.
UH has developed a postgraduate
programme for paramedics in Advanced
Paramedic Practice (Critical Care) and was
also successful in the validation of the first
national MSc in Paramedic Science in the
UK, which began in September 2009.
UH provides NHS London with the
Doctorate in Clinical Psychology (DClinPsy).
This fully funded programme attracts far
more psychology applicants each year
than places and has gained a significant
reputation for its research based training,
resulting in highly prepared Clinical
Psychologists who go on to provide services
across the NHS.
Pharmacy
UH has a School of Pharmacy. Its
education and research programmes
stem from a strong science base of inter-
professional learning with nursing and allied
health professions.
UH offers world-class teaching and
learning facilities for pharmacy, including
the Clinical Simulation Centre - which
features a pharmacy which has the first UK
University robotic dispensary, intensive care
units, ward environments, and a GP surgery,
as well as the latest audio visual technology.
In an environment that imitates real life,
students can quickly gain confidence in key
areas of practice.
The University is one of the first in the
UK to have a fully functioning campus
pharmacy run by its own School of
Pharmacy. The pharmacy aims to enhance
clinical training of the University’s pharmacy
and healthcare students by providing a
full range of over-the-counter pharmacy
services, public health consultations and a
limited prescription service.
The School has more than 250 full-time
undergraduates, runs a postgraduate course
that can be studied either full-time or as
individual modules, as well as part-time
courses for practitioners, covering areas
such as supplementary prescribing and
non-medical prescribing. The emphasis is
on developing professional attitudes and
patient orientation, together with a broad
appreciation of different healthcare roles.
UH has embraced the concept of inter-
professional learning for many years and
this includes the Patient Assessment
and Management Level 6 Module on the
MPharm, which is delivered predominantly
by paramedic and nursing staff and
paramedic students to ensure pharmacy
students have an opportunity to experience
alternative ways of working and gain an
understanding of how their role interfaces
with primary and emergency healthcare.
Nursing, Midwifery and Social work
education
UH is a major UK providers of nursing,
midwifery and social work education,
offering a wide choice of pre and post-
qualification education and training, backed
by world-class facilities, which attract
top-class students and academic staff.
This education provision lies across three
departments within the School of Health
and Social Work.
More than 3,500 undergraduates and
postgraduates are currently studying on
DipHE, Enhanced Diploma, BSc, PgD, PgC
and MSc programmes in nursing, midwifery
and social work. Our portfolio also includes
more than 200 accredited stand-alone
modules and non-accredited short courses
to help qualified nurses and midwives
update their skills and practice.
The well-equipped teaching and learning
environment includes Europe’s largest and
most advanced medical simulation centre.
Here the University provides training and
education for the UK’s two largest Strategic
Health Authorities - East of England and
London. Flexible programmes and a leading-
edge curriculum including clinical nursing
training for the new NHS role of Community
Matron.
As well as many part-time and visiting
staff, the School has more than 110 full-
time teaching staff members who are
experienced practitioners and active
researchers in their fields. Their first-hand
clinical expertise and enthusiasm for
their subject add a valuable dimension to
programmes, and are behind the School’s
national and international reputation for
innovation and high teaching standards.
UH has a new £30 million Health Sciences
building offers an exceptional inter-
professional environment for education and
training in this fast-changing sector. The
Clinical Simulation Centre, where students
have the opportunity to practise advanced
clinical skills in hospital and community
settings that imitate real life, enables
them to quickly become competent and
confident in new methods of working and
gives qualified practitioners the opportunity
for further continuing professional
development.
The school has developed an award-
winning work-based (distance learning)
The Eastern Academic Health Science Network | XV
 pre-registration midwifery (shortened)
programme to appeal outside its traditional
catchment area through the use of
e-learning and flexible learning approaches.
This work-based learning package has
reinvigorated the midwifery programme,
maintained the interest of commissioners,
using modern technologies and best
learning and assessment practices to
improve the support for students in the
clinical areas.
From September 2012, the School has
been validated to introduce a Master of
Midwifery study level and the ‘Physiological
Examination of the Newborn’ module into
the pre-registration programme.
As part of the DH policy for increasing
the number of health visitors nationally
to 4,500 by 2015, the School has a large
contract with the East of England SHA and
NHS London to educate over 50 new health
visitors per year. This will be supported
through an innovative virtual Community of
Practice for health visitors in collaboration
with the Open University and the newly
founded Institute of Health Visiting.
With commissions from two SHAs,
supporting three NHS Trusts, recruitment
is buoyant. Trust feedback is positive
and student evaluation is very good. Link
lecturers enjoy student engagement that is
enthusiastic and motivating, with students
effectively utilising and valuing contact time.
The Centre for Learning Disability Studies
This centre, launched in 2012, has as its
mission:
“To prepare, support and sustain the
development of the health and social care
workforce to enable health and social care
staff where ever possible to work with
people with learning disabilities drawing
on evidence based practice to support
them to lead valued life styles. We will
achieve this by offering world class evidence
based educational opportunities, as well
as undertaking research and engaging in
XVI | The Eastern Academic Health Science Network
consultancy services.”
This will be achieved by a unique
collaboration with all our practice partners
in the NHS, Local Authorities, the third
sector, and supported by people with
learning disabilities and their families. This
exemplar collaboration will contribute
to the development of a highly educated
and competent workforce, whose practice
will be grounded within human rights
framework using a value based, Person
Centred Approach.
In partnership with HPFT the centre is
also taking over the St George’s learning
disability information web pages - these are
internationally renowned for high-quality
eminent knowledge source. It has secured
a number of honorary fellows for HPFT,
we are intending to host in partnership
with HPFT an international conference on
Intellectual Disability Nursing next year, also
another in partnership on Forensic Nursing,
we have an ambitious new portfolio of LD
courses on offer many offering innovative
ways of learning this will bring about a
significant increase in CPD income to
80/100K.
A joint bid for a research project with
psychology and HPFT to NIHR is underway.
Allied Health Professions
Innovation has made the Department of
Allied Health Professions and Midwifery one
of the UK’s most in-demand providers of
education and training for healthcare and
related emergency services¹ professionals.
Inter- professional learning using medical
simulation technology in realistic workplace
settings is a key feature of our programmes.
Its dynamism made the University of
Hertfordshire the place of choice for piloting
training courses for new and emerging
NHS roles, such as assistant practitioner,
emergency care practitioner and physician’s
assistant.
The UH Clinical Simulation Centre offers
a state-of-the-art environment for and
training in this fast-changing sector. Here,
in hospital and community settings that
imitate real life, students can practise
advanced clinical skills, quickly becoming
competent and confident in new methods
of working. The recent arrival of the Virtual
Environments for Radiotherapy Training
(VERT), one of the most sophisticated
radiotherapy training systems in the world,
at UH will allow students studying for the
BSc in Radiotherapy to view the inside of
a patient’s anatomy and to run real-life CT
scans. VERT uses immersive visualisation
technology to allow radiotherapy students
to enter a virtual radiotherapy suite and
set up a virtual patient for treatment. It
addresses the urgent need to train more
radiotherapists to fill the shortfall of
practitioners in the NHS.
The Department has been instrumental
in developing the role of the critical care
paramedic with its MSc in Paramedic
Science and postgraduate programme for
paramedics in Advanced Paramedic Practice
(Critical Care).
Hertfordshire Partnership Foundation NHS
Trust
HPFT’s primary academic relationship
is with University of Hertfordshire.
The Hertfordshire Partnership NHS
Foundation Trust has recently been
validated as a University Trust from 2013
and is in discussion with the University
of Hertfordshire regarding areas where
they can work together for the mutual
benefit of service users and students. As
part of this close working relationship, a
Lead Nurse at HPFT, has been awarded the
title of Honorary Fellow of the University
of Hertfordshire and will have input into
the undergraduate nurse training at the
University, using her expertise to bridge
the gap between classroom theory and
practical experience. The Professorial
Lead for Learning Disabilities at the UH
Centre for Learning Disability Studies has
been working with the Trust, bringing a
wealth of knowledge, skills and contacts.
Strengthening links with partners is
strategically important to UH and this is
particularly so in the area of Health and
Social Care.
The University status reflects already well-
established relations between HPFT and UH
in many areas including:
• Undergraduate and post graduate
nursing studies
• Postgraduate teaching in training in
clinical psychology, including the D. Clin
Psych program
• Undergraduate and post-qualification
social work studies
• Developing (jointly UH + HPFT) a
higher professional training scheme
(MRCPsych) for psychiatrists in training
• Development of the an MSc in
psychiatric studies
• New developments seem likely in area
of Learning Disabilities under the co-
appointment of Professor Bob Gates
• A particularly strong program is Short
Courses in Psychiatry - providing
accredited continuing teaching in
psychiatry and mental health and
attracting 500 participants per year.
HPFT also has research links with
Cambridge University, in the area of
neuroscience research, particularly in the
field of OCD. This is a highly productive
collaboration leading to many research
outputs and joint supervision of PhD study
programs (approx two per year).
The Eastern Academic Health Science Network | XVII
 APPENDIX C: EAHSN PROPOSED METRICS
The EAHSN will monitor its performance against a set of metrics outlined below; and will also contribute to and monitor a second set of health system metrics
which by their nature, the EAHSN cannot be solely responsible for delivering, but which are essential indicators of the overall success of improving health, wealth
and innovation. The metrics relating to the priority work streams will need to be discussed and agreed by the EAHSN members once structures are in place, and
work plans have been approved.

EAHSN metrics Population metrics Key partners to population

metrics will include

1. Corporate • Establishment of the EAHSN Cambridge University Health

• Establishment of an EAHSN office and supporting infrastructure Partners (CUHP)
• Establishment of the Board
• Recruitment of a chief executive, and executive team
2. Dementia and • Network for Innovation in Dementia and MH established Metrics may include: Providers

XVIII | The Eastern Academic Health Science Network

Mental Health • Work plan and metrics agreed and signed off i) Identifying unmet need and addressing inequalities: CCGs
NHS Outcomes • Measures identified and implemented to speed up adoption and • % gap between expected and diagnosed prevalence Higher Education Institutions
Framework: spread of dementia and MH innovation • % of diagnoses made on emergency admission LETB
Domain 1 • Work plan implemented ii) Uptake of NICE guidance and technological appraisals Strategic Clinical Networks
Domain 2 (2.6) • Evidence of active patient and public involvement iii) Adoption and spread of evidence-based interventions: Health and Wellbeing Boards
• Evaluation of effectiveness of the Year 1 work programme; and • % reduction from baseline of inappropriate use of anti- Industry Partners
subsequent modification to programme as required to Year 2 and psychotic medication Cambridge University Health
beyond • Programme of education and training provided for providers Partners (CUHP)
• Evidence shared to support adoption and spread (informatics re of care
case for change; evidence base and assessment of ROI at local • Number of organisations receiving services from the Norfolk
level; and support materials for implementation) and Suffolk Dementia Alliance
 3. Long-term • Network for Innovation in LTC established Metrics may include: Providers
conditions: • Work plan and metrics agreed and signed off i) Identifying unmet need and addressing inequalities: CCGs
a)Cardiovascular • Measures identified and implemented to speed up adoption and • % gap between expected and diagnosed prevalence Higher Education Institutions
b) Cancer spread of LTC innovation • % of diagnoses made on emergency admission Letb
c) Diabetes • Work plan implemented ii) Uptake of NICE guidance and technological appraisals Strategic Clinical Networks
d) COPD • Evidence of active patient and public involvement • % EAHSN local health system uptake of NICE guidance CG68 Health and Wellbeing Boards
• Evaluation of effectiveness of the Year 1 work programme; and stroke, and Quality Standard Q2 Industry Partners
NHS Outcomes subsequent modification to programme as required to Year 2 and • % EAHSN local health system compliance with NICE Quality Cambridge University Health
Framework: beyond Standard Q59 heart failure Partners (CUHP)
• Evidence shared to support adoption and spread (informatics re • % EAHSN local health systems following NICE technical
Domain 1 (1a,1b, case for change; evidence base and assessment of ROI at local guidance TA 249 dabigatran etexilate
1.2,.1.3,1.4) level; and support materials for implementation) • % EAHSN local health systems following NICE Technical
guidance TA 256 rivaroxaban
Domain 2 (2.31) • % CCG uptake of NICE guidance for the provision of cancer
post discharge survivorship support
Domain 3 (3a and 3b) iii) Adoption and spread of evidence-based interventions
• % EAHSN local health systems delivering 7/7 working for
Domain 4 (4.4,4.6) stroke and TIA
• % EAHSN local systems uptake of other evidence based
Domain 5 (5.3) interventions e.g. home based renal dialysis
• Evaluation of the HIEC End-of-life Care Register; and
depending on outcome, uptake in other nodes
• e- Hospital module developed to facilitate information
sharing for cancer across sectors
• % EAHSN health systems uptake of the cyto sponge for early
detection of oesophageal cancer
• Completion of a pilot for lay trainers in diabetes prevention
• Evidence base established for uptake of exercise programmes
(CEDAR)
• % EAHSN local systems adopting the evidence base for
reduction is foot ulceration
• Evaluation of evidence relating to integration of diabetes care
• Establishment of an EAHSN training programme, using e
learning, based on Diabetes UK approved modules
• Reduction in unexplained variation in diabetes related
admissions band bed occupancy
• % EAHSN health system adoption of diabetes patient advisors
• % EAHSN health systems providing an out of hours admission
avoidance helpline for diabetes
• % EAHSN health systems provision of community diabetes
facilitators
• Evidence base established for earlier diagnosis in COPD
• % EAHSN local health systems providing 7/7 community
diabetes care
• % of systems adopting evidence base for supported self-care
for COPD

The Eastern Academic Health Science Network | XIX

 4. Patient safety • Network for Innovation in Patient Safety established • Number of ‘never events’ e.g. wrong site surgery, misplaced Providers
NHS Outcomes • Work plan and metrics agreed and signed off naso-gastro tubes CCGs
Framework: • Measures identified and implemented to speed up adoption and • % reduction in litigation bill to EAHSN partners, attributed to Higher Education Institutions
spread of patient safety innovation patient safety errors LETB
Domain 5 (5a, 5b, 5.4) • Work plan implemented Strategic Clinical Networks
• Evidence of active patient and public involvement Health and Wellbeing Boards
• Evaluation of effectiveness of the Year 1 work programme; and Industry Partners
subsequent modification to programme as required to Year 2 and Cambridge University Health
beyond Partners (CUHP)
• Evidence shared to support adoption and spread (informatics re
case for change; evidence base and assessment of ROI at local
level; and support materials for implementation)
• Establishment of EAHSN wide arrangements for reducing incidents
associated with high risk medications across a variety of settings
• EAHSN Safety Management System and Protective Hazard Analysis

XX | The Eastern Academic Health Science Network

developed to respond proactively to risks
• Programme of clinical leadership, education and training on safety
management developed
• Risk Toolkit produced to facilitate working between partner
organisations
• Analysis undertaken of how Human factor (HF) design can be used
to improve safety
• Analysis undertaken of the health economics of patient safety
• EAHSN Care Pathway process developed for dementia/frail elderly,
taking a cross boundary approach to safe pathway design
 5. High Impact • Work plan and metrics agreed and signed off • % EAHSN health systems uptake of high impact innovation: Providers
Innovations • Measures identified and implemented to speed up adoption and fluid management CCGs
(including iTAPP), and spread of HII and SHA Ambitions • % reduction from baseline of grade 2,3 and 4 pressure ulcers Higher Education Institutions
SHA Ambitions • Work plan implemented • Dependent on evaluation of the current acute /mental health LETB
• Evaluation of effectiveness of the Year 1 work programme; and usage of the Net Promoter initiative, adoption and spread for Strategic Clinical Networks
NHS Outcomes subsequent modification to programme as required to Year 2 and use in other settings Health and Wellbeing Boards
Framework: beyond • % EAHSN health systems using evidence base for lifestyle Industry Partners
• Evidence shared to support adoption and spread (informatics re interventions, to support Every Contact Counts Cambridge University Health
High Impact case for change; evidence base and assessment of ROI at local Partners (CUHP)
innovations: level; and support materials for implementation)
• Plans developed for adoption and spread of agreed telehealth/
Domain 1 (1a, 1b) telecare initiatives, and implementation underway
• Local application of evidence base established, to inform EAHSN’s
Domain 2 adoption and spread of telehealth/telecare to support 3 Million
(2.1,2.2,2.3,2.4) Lives Campaign
• Evaluation undertaken of net promoter initiative, to inform roll out
Domain 4 (4.4) to other NHS providers

Ambitions:

Domain 1 (1a, 1b, 1.1,

1.2, 1.3, 1.4)

Domain 2 (2.31)

Domain 3 (3.3,3.6)

Domain 4 (4.1, 4.2,

4.3, 4.7)

Domain 5 (5.3)

The Eastern Academic Health Science Network | XXI

 6. Research and Processes simplified for uptake of trials • Increase in the overall number of trials CRNs
translation of • Reduction in time from trial approval to recruitment of first patient • Increase in the number of people in trials NIHR CLAHRC
research • Feedback from all EAHSN partners on level of involvement in the Cambridge NIHRC Biomedical
NHS Outcomes research translation process Research Centre
Framework: • Evidence of active patient and public involvement NIHR CLRNs
the work will impact • Demonstration of organisation-level support for research to NHS Innovation Hub
on all domains and practice and adoption of innovation activities e.g. Providers
build activity to • adoption of guidelines and or best practice at organisational level CCGs
address Domain 1 (1a, • use of clinical pathways and best practice guidelines Higher Education Institutions
1b specifically) • Evidence of integrated information systems and data repositories (inc. Clinical Trial Unit at
• Evidence of capacity to support research and research translation Norwich Medical School)
into practice e.g. LETB
• knowledge translation initiatives, knowledge brokers Strategic Clinical Networks
• number of clinicians involved in research and service redesign Health and Wellbeing Boards
projects Industry Partners

XXII | The Eastern Academic Health Science Network

• Evidence of use of EAHSN research outputs and innovation in local Cambridge University Health
and national policy (T3 and T4 gap) : Partners (CUHP)
• research cited in policy, briefing documents and guidelines
• direct measures or modelling of estimated cost savings
• evidence of implementation activity across the EAHSN as a result of
research translation e.g. Case studies, pilot projects and redesign
projects
• Surveys with key stakeholders
• Quality of research:
• Number of studies conducted, completed and published in peer
reviewed publications.
• Number and the increase of patients recruited into patient-oriented
research
• Evidence of research and innovation agenda that involves needs of
all stakeholders
• No of research grants awarded
• Number of national and international awards for EAHSN research
and innovation
• Evidence of education and training that supports strategic goal
to develop capacity and capability of ‘research-educated’ EAHSN
workforce
 7.Collaboration with • Plan developed and implemented for addressing the hurdles to • Number of industry partners involved in joint programmes or CRNs
industry collaboration in research and development projects NIHR CLAHRC
NHS Outcomes • Survey undertaken to establish feedback from industry partners • Innovation Fellowships developed Cambridge NIHRC Biomedical
Framework: the work on level of involvement in innovation from design to evaluation; Research Centre
will impact on all improvement against baseline NIHR CLRNs
domains and build • Systematic national SBRI programme rolled out, which supports Providers
activity to address other AHSNs to undertake SBRI competitors CCGs
Domain 1 (1a, 1b • Number of companies supported to develop innovation in the Higher Education Institutions
specifically) healthcare market (led by Health Enterprise East) LETB
• Innovation scouts in place in NHS providers supporting Strategic Clinical Networks
identification, development, adoption and spread of innovation Health and Wellbeing Boards
• Innovation council reconfigured to respond to EAHSN priorities, to Industry Partners
provide a forum for vibrant and productive discussion Cambridge University Health
• Innovation council sets a series of meaningful measures to address Partners (CUHP)
industry engagement Local Economic Partnerships
• Number of licences (through Health Enterprise East) (LEPs)
One Nucleus/Medilink
Industry representative bodies
(IoD, CBI, Chambers, EoE
Business Group, ABPI, ABHI)
NHS Innovation Hub
8. Wealth Creation • Private and public sector investment leveraged through SBRI • Employment in the region (number of jobs and % change) Providers
NHS Outcomes programme • % long-term unemployed CCGs
Framework: • Jobs created and jobs safeguarded through SBRI programme • Number of NEET (not in employment, education or training) Higher Education Institutions
the work will impact • Businesses created through commercialisation of NHS products, • Number of Disability Living Allowance (DLA) LETB
on all domains and number and investment value (through Health Enterprise East) • Jobs created through EAHSN sponsored innovation activity Strategic Clinical Networks
build activity to • Agree a suite of appropriate economic indicators to adequately • Number of healthcare businesses established in the Eastern Health and Wellbeing Boards
address Domain 1 (1a, address wealth creation and jobs sustained within the regional Region Industry Partners
1b specifically) economy, to be developed in conjunction with Insight East • Number of medical innovations evaluated and adopted Cambridge University Health
(economic analysis), One Nucleus, LEPs, and County Council • Number of new products licensed Partners (CUHP)
Business Development Teams • Number of patents filed Local Economic Partnerships
• Regional GDP and GVA (LEPs)
Industry representative bodies
(IoD, CBI, Chambers, EoE
Business Group)

The Eastern Academic Health Science Network | XXIII

 APPENDIX D: FUTURE PRIORITIES FOR
EDUCATION AND TRAINING
Cambridgeshire and Peterborough cluster -
future priorities
Our future priorities include two broad
work streams:
• Education for innovative clinical practice
• Innovations in education and education
research
Education for innovative clinical practice
• The aim of this work stream is to
develop and equip our staff to be skilful
safe and innovative clinical practitioners
who can exercise leadership for quality
improvement and who can work
collaboratively and confidently with
patients, carers and a wide range of
health and social care agencies.
• Healthcare Leadership and
Management Programme
It is proposed to establish a Healthcare
Leadership and Management course
as part of an overall programme.
It is envisaged that these will be
a mix of multi-professional and
uniprofessional, led by CUHP and
provided in collaboration with the Judge
Business School, Institute of Continuing
Education (ICE) and other education
partners. This programme will provide
a range of opportunities for the health
system supporting effective leadership
and management through exposure to
national and international leadership
exemplars, and to service improvement
science.
• Innovation and Evidence-based
Practice Programme
It is proposed that CUHP will work in
partnership with the LETB, the CLAHRC
CP, Health Enterprise East and the IPH
to establish a programme for innovation
and evidence-based practice. The
programme will include:
XXIV | The Eastern Academic Health Science Network
• Formal education courses at
certificate, diploma and masters
level
• Innovation Fellowship programme
through the CLARHC CP and other
partners. The programme will
focus on research-based evidence
methodology and skills, change
management, and systems theory
applied to healthcare.
• Innovation Scouts through Health
Enterprise East
The programme will equip senior clinical
staff and managerial staff with knowledge
and skills in epidemiology, research skills,
accessing, understanding and using the
evidence base, change management and
service improvement approaches. It will also
make a contribution to the adoption and
spread of innovation within organisations.
• Long-term Conditions (LTC) programme
Improving the care of patients with
long-term conditions is a key local
health system priority. It is proposed
to build on the work taken forward by
the Cambridgeshire and Peterborough
HIEC projects to establish an integrated
approach to Long-term Conditions
(LTC) education and to develop a
whole workforce LTC competency
framework. A key component will be
the development of a post-graduate
certificate in long-term conditions,
aimed at developing advanced
practitioners. The competency
framework would include coverage
of leadership, service improvement,
innovations, personal health planning,
self-management (and supported
self-management), mental and
physical health issues, user and carer
partnership and specialist components.
• Trauma Education Programme
CUHP will work with the CUHFT
major trauma centre and the trauma
network to develop and provide inter-
professional education for evidence-
 based trauma care across the East of
England. The education programme
will contribute to optimised clinical
care and outcomes for patients and
equip staff in best practice emergency
care. The programme will make use of
telemedicine, the Cambridge Simulation
Centre, and e-learning as well as face-
to-face training.
Innovations in education and education
research
The aim of this work stream is to ensure
that education is delivered in innovative,
high-quality, cost effective and accessible
ways, backed up by research and
development into healthcare education
processes.
• Education research
Educational Research in CUHP follows a
number of key themes. The Cambridge
University Clinical School’s Medical
Education Research Group (MERG)
undertakes research aimed at informing
curriculum development in the light of
changes affecting both medical practice
and medical education. MERG draws
its members from the Clinical School ,
the General Practice and Primary Care
Research Unit and the East of England
Deanery. MERG also undertakes a
training role, providing support and
guidance for doctors in training wishing
to combine medical education research
with clinical work. Members are also
involved in the design and delivery
of the new PG Certificate in Medical
Education, aimed at raising the overall
level of medical education skills in the
school, including research skills. The
projects within the programme of
research activity can be grouped under
three broad areas:
• Curriculum content and its impact
• Teaching and learning methods
• Assessment
Research into optimisation of skills
training is undertaken within the Clinical
School Skills Unit and in CUHFT. Significant
work has been undertaken to evaluate and
determine the efficacy of simulation-based
training in the Simulation Centre at CUHFT
including the evaluation of simulation
training
The Addenbrooke’s Simulation Centre
supports further research into education
for patient safety, with publications in high
impact Journals in the area of drug labelling
and preparation. Recruitment into the
educational research projects listed above
could be widened by collaboration with
the other nodes, particularly in the field of
simulation research.
• Simulation centre(s)
The cluster will support the continuing
development of a range of multi-
professional simulation centre
programmes, promote access to the
simulation centre and provide support
across the EAHSN for the development
of simulation education approaches.
The cluster will support and contribute
to the development of an AHSN
simulation centre network.
• The Cambridge Surgical Skills Training
and Research Centre
CUHP will support the establishment
and promotion of the Cambridge
surgical skills and research training
centre as a resource for the cluster and
for the EAHSN.
• E-learning
The cluster will ensure the continuing
development of a multi-partner
virtual learning environment with an
extending range of clinical education
and clinical skill learning products
and tools, including up to Masters
level. There will be an initial focus on
long-term conditions, trauma care,
mental health and clinical leadership.
This development will also support
virtual communities of practice and
e-portfolios as well as formal learning
programmes.
The Eastern Academic Health Science Network | XXV
 • Collaborative provider led education
The aim of this work stream is to
develop a new provider-led approach
to continuing professional education in
partnership with HEI partners, so that
education curricula and programmes
reflect modern clinical practice and
are optimally accessible to clinical
staff. Historically, CPD has tended to
be developed by NHS organisations
in isolation from each other and
commonly ‘menu driven’ by HEIs. There
have also been widespread concerns
about the acquisition of clinical
skills and competence following CPD
programmes.

CUHP has adopted the concept of a

collaborative education programmes which
could deliver high-quality and good value
post-registration education programmes for
the partners. Benefits of this collaborative
approach include the potential for more
locally accessible, work-based delivery
of education, a more rapid mechanism
for curriculum development reflecting
evidence-based clinical practice and
reduced costs of academic accreditation.
CUHP will work with NHS and education
partners on developing and evaluating this
new approach.

HIECs

The EAHSN will take on the responsibility

for the sustaining of activities initiated by
its Health Innovation and Education clusters
in so far as they have been successful
and for promoting the adoption of any
proven innovations emerging from them
throughout the cluster.

XXVI | The Eastern Academic Health Science Network

APPENDIX E: DRAFT OF FIVE YEAR BUSINESS PLAN

CONTENTS

1. INTRODUCTION
2. GOVERNANCE ARRANGEMENTS
3. VISION AND STRATEGIC GOALS
4. EAHSN FIVE YEAR WORK PROGRAMME
5. KEY MILESTONES
6. SUCCESS FACTORS
7. FINANCIAL SUMMARY
8. KEY FINANCIAL RISKS AND MITIGATION
Glossary

The Eastern Academic Health Science Network | XXVII

 1. INTRODUCTION
1.1 DH guidance
The guidance published by the DH regarding
the establishment of Academic Health
Science Networks on 20th June 2012, set
out their core purpose as:
‘An Academic Health Science Network
provides a systematic delivery mechanism
for the local NHS, universities, public health
and social care to work with industry to
transform the identification, adoption and
spread of proven innovations and best
practice.’
1.2 The process for establishing AHSNs
The process for establishing AHSNs was
through the submission of an Expression of
Interest in July and Prospectus and Business
Plan at the end of September 2012. It
is anticipated that AHSN applications
approved in November will establish
arrangements to become operational by 1st
April 2013 and by May 2013, full coverage
across England will be achieved.
1.3 Business Plan
This Business Plan (‘the plan’), produced
as an integral part of Prospectus sets out
the intentions and priorities of the Eastern
Academic Health Science Network (EAHSN)
over the next five years and the governance
and infrastructure necessary for the EAHSN
to achieve its aspirations. The plan has
been developed with the involvement
of its key stakeholders and is focused to
deliver improved quality of patient care
through research and innovation and to
deliver the Innovation, Health and Wealth
agenda as locally as possible. The plan
includes indicative information on the
key milestones, success factors and more
particularly the financial allocations which
will require formal agreement by the EAHSN
Board in due course.
XXVIII | The Eastern Academic Health Science Network
2. GOVERNANCE ARRANGEMENTS
2.1 Incorporation of partnership and nodes
The EAHSN will be incorporated as a
voluntary membership organisation open to
all service providers and commissioners in
the region, related healthcare organisations,
clinical commissioning groups (CCGs) and
to universities with health-related activity.
Partners will be required to commit to
a shared vision, values and behaviours
in return for access to EAHSN resources,
expertise and leadership. At the time of
writing, we have individual commitments to
membership of our AHSN from Cambridge
University Health Partners, five universities,
all seventeen major hospital trusts in the
area, seven community trusts, six mental
health trusts, the regional ambulance
service, the Eastern Region Public Health
Observatory (ERPHO), Health Enterprise
East and the PHG Foundation. These map
to four natural clinical, referral and research
and innovation communities referred to as
the four ‘nodes’ of the AHSN (‘the Nodes’)
(Figure 2.1). Where commissioners are not
full members of the EAHSN (it may not be
appropriate for smaller CCGs) they will be
fully involved locally, for example through
membership of executive committees of
nodes.
2.2 Concordat between partner
organisations
There are considerable opportunities for
EAHSNs to work to add value to and partner
with new and existing organisations across
the NHS landscape, including Clinical
Senates; Strategic Clinical Networks (SCNs);
LETBs, CLAHRCs; the local presence of the
new NHS Improvement Body; Health and
Wellbeing Boards and others. The EAHSN
will work with key partner organisations,
to establish a concordat of understanding,
ensuring that organisations have:
• Clarity of their respective roles,
 Funding
Shared aspirations, principles, behaviour, best practice

Local
Cambridge & Trusts
Peterborough
and
Node
Partners
Local

Leadership for innovation

Peer support and review

Norfolk & Suffolk Trusts
Regional AHSN

Funding Node and

Partners
DH
Local
Accountability Hertfordshire & Trusts
Bedfordshire Node and
Partners
Local
Colchester
Trusts
University of Essex
and
Node
Partners

Delivery
Understanding needs, local innovation, new ideas

Figure 2.1 Relationships of EAHSN and Nodes

functions and priorities, including • Priorities outlined in the NHS Outcomes

governance arrangements; Framework with a particular focus on
• An agreement of complementary work- enhancing the quality of services for
plans, to avoid duplication, or gaps in people with long-term conditions.
delivery; • Evidence-based quality improvement
• A commitment to add value to each to reduce unwarranted variation in
other’s work; practice and patient outcomes, using
• Agreed the extent and arrangements for peer support and peer challenge.
sharing resources; • Promotion and adoption of innovations
• Agreed arrangements for sharing already identified in Innovation, Health
intelligence, and communication. and Wealth and/or identified through
the Spreading Innovation in the NHS
The EAHSN will lead facilitation of the initiative.
concordat across partner organisations • Openness and transparency in data
including AHSN level agreements between analysis and reporting.
commissioners and providers and the
National Commissioning Board, through the 2.4 Legal entity of the EAHSN
new Local Area Teams and Regional Office.
Following advice given after consultation
2.3 Shared values with Eversheds solicitors, the EAHSN
intends to adopt the following model of
Partners will be required to commit to: incorporation:

The Eastern Academic Health Science Network | XXIX

 • The EAHSN will be established as a new
legal entity, as a not-for-profit company,
limited by guarantee. Its members will
be the Nodes and other organisations
may be co-opted to become members if
required.
• The EAHSN will have an independent
chair and other non-representative
directors who, in accordance with the
AHSN Guidance, will be required to
have extensive experience of working
with industry although they cannot be
representatives of individual companies.
• The Accountable Officer will be an
individual agreed by the Board of
EAHSN, being an additional director
to those otherwise nominated or
appointed.
• The four Nodes will be given rights,
either under the constitution of
the EAHSN or under a members’
agreement, to each appoint two
directors to the board of the EAHSN on
a representative basis.
• The EAHSN will plan from the outset
to have the ability to grow organically
and/or subsume other activities or
organisations e.g. from the SHAs.
• As a legal entity the EAHSN can own and
exploit IP as required and contract in its
own name.
• Each of the Nodes may choose to be
created by their members either as
unincorporated or incorporated entities.
The Nodes will be allowed to have their
own governance models e.g. they could
have a ‘doughnut model’ of inner and outer
core members. The EAHSN will not be
prescriptive about the legal form of nodes
although the EAHSN will want the members
of nodes to commit to basic principles.
• The Nodes will select their
representatives on the EAHSN Board (it
is anticipated that these will usually be
one NHS Chief Executive and one senior
academic from the Node’s HEI).
• The Nodes will be encouraged to
XXX | The Eastern Academic Health Science Network
involve the local NIHR clinical research
infrastructure the CLAHRC and its
linkages with Local Education and
Training Boards.
• The Nodes would also be given other
member rights such as veto rights
over certain matters e.g. admission or
expulsion of other Nodes as members,
change in business focus of EAHSN,
giving of charges or guarantees by the
EAHSN.
• CUHP, as an AHSC will ‘nest’ within
EAHSN as a member of the Cambridge
and Peterborough node. It will continue
to provide infrastructure, personnel and
administrative support to the EAHSN,
using expertise it has developed in
running research networks (particularly
in relation to the NIHR Biomedical
Research Centre), clinical networks,
academic public health and the
translation of genomic medicine into
patient benefit.
• The EAHSN will hold contracts with the
Nodes for funding and the delivery of
the AHSN’s agreed plans.
• The Nodes may also agree local
subscription arrangements over and
above the EAHSN funding to deliver
locally agreed objectives.
2.5 EAHSN Board of Directors
The EAHSN Board of Directors will have the
following structure:
• Independent Chair
• Accountable Officer
• Two directors from each of the four
nodes (one HEI one NHS)
• NHS improvement lead and clinical
network director
• Clinical senate board member
• LETB board member
• Two directors from industry/wealth
creation
• Company Secretary
This gives an EAHSN Board of 15 directors
including the Chair. The EAHSN Board
will meet 10 times a year. A Shadow
Accountable Officer has already been
appointed, Dr Robert Winter, Director of
the Academic Health Science System for
CUHP, to oversee the EAHSN Prospectus
and Application, and he will be responsible
for formally establishing the EAHSN. All
EAHSN appointments will be made in open
competition after designation.
2.6 EAHSN Executive
An EAHSN Executive will be formed by:
• Accountable Officer EAHSN
• Accountable Officer for each of the four
nodes
• EAHSN Research Lead
• EAHSN Informatics lead
• EAHSN Information/Public Health lead
• EAHSN Industry Lead
• EAHSN Education and Training Lead
• Director of Innovation and Clinical
Networks
• EAHSN Communications lead
This gives an EAHSN Executive of 12 people.
The EAHSN leads for research, informatics,
Industry, Education, Clinical Networks will
each be expected to lead a multidisciplinary
steering group composed of relevant
colleagues from each EAHSN Node. The
Executive Team will meet on a weekly basis.
The Executive Team will be responsible of
the delivery of the Business Plan and agreed
work programmes, on behalf of the Board.
2.7 EAHSN node structure
Each of the four EAHSN Nodes will have its
own Accountable Officer and may choose
to formally establish a legal entity. The
membership of each EAHSN Node will be
determined locally to allow engagement
and delivery of the EAHSN goals, however
EAHSN will require Nodes to ensure and
demonstrate that they are actively involving
CCGs, commissioners, all providers of NHS
funded services, HEIs involved in health
and care, other providers and partners in
industry. The Node Accountable Officer and
one other representative (either NHS of
HEI) will represent the node on the EAHSN
Board.
2.8 EAHSN Reference group
The EAHSN Reference group will consist of
Board level representatives of all members of
the network. It will meet three times a year.
2.9 Leads for key priorities
The EAHSN will appoint leads for the key
priorities. Leads will be responsible and
accountable to the Executive for delivery
and providing a quarterly report for the
Board.
2.10 Node responsibilities
Nodes will be responsible for delivery
at a local level, with an accountability
understanding with each node
accompanying the devolution of central
funds. Nodes may be expected to commit
matched funding in kind, with existing
workforce and other resources being
committed to deliver the programme; and
will also be expected to seek additional
external sources of funding to support
delivery. The areas addressed by each node
may differ, depending on local patterns
of ill health, for example using existing
strategic needs assessment reports. The
nodes and EAHSN as a whole will ensure
that all aspects of Equality and Diversity are
considered in their work.
The nodes will also be responsible for
engaging as widely as possible with
industry in their areas, in order to maximise
competition from commercial entities to
deliver the EAHSN programme. In doing
so, we recognise the need to address the
potential for conflict of interest.
The Eastern Academic Health Science Network | XXXI
 2.11 AHSC nested within EAHSN
The EAHSN will have one of the five
designated Academic Health Science
Centres (Cambridge University Health
Partners) nested within it. CUHP has been
funded exclusively by the four partner
organisations (Cambridge University
Hospitals , Cambridge and Peterborough
FT Partnership, Papworth Hospital, and
the University of Cambridge). CUHP has
an agreed portfolio of work for which it is
accountable to the partnership.
In addition to the delivery of this existing
portfolio of work, CUHP will become a lead
organisation for facilitating delivery in the
Cambridge and Peterborough node, aligning
it with all health partners in the local health
system. Alignment with the health partners
in the Cambridge and Peterborough node
will enable CUHP to realise its ambition to
work as an Academic Health Science System
(AHSS), to deliver cross cutting work; e.g.
integration of care, informatics) which
is not achievable as a partnership based
exclusively on providers in secondary and
tertiary care.
In summary, CUHP will thus have two
portfolios of work, to:
i) Deliver its role as an Academic Health
Science Centre, in accordance with
its designated role. For this it remains
funded by the CUHP partners.
ii) Extend and develop its role to
become a key organisation responsible
for driving progress in the Cambridge
and Peterborough node and to
contribute to the wider EAHSN. For
this CUHP would have a contractual
arrangement for delivery with the
EAHSN.
This model delivers the following benefits:
• Avoiding dominance of the EAHSN by
CUHP if it were central to the delivery of
the EAHSNs delivery; enabling greater
ownership by its full range of members.
• Preventing duplication of activity across
XXXII | The Eastern Academic Health Science Network
Cambridge and Peterborough partners,
with CUHP working to deliver a portfolio
of AHSS work.
• Delivering organisational efficiency and
productivity gains in infrastructure costs
• Drawing on, to the benefit of the
whole EAHSN, learning from CUHP’s
experience of working across health
system in research, education
and training and network based
improvement programmes.
2.12 Impact assessment
The Public Sector Equality Duty is set out
in the Equality Act 2010. The AHSNs have
a commitment to promote equality and
address inequalities, and to ensure that
the policy development of the Eastern
Academic Health Science Network will
not have an adverse impact, or a potential
adverse impact on, those people who share
a protected characteristic and those who
do not, the users of our services or our
staff. In keeping with this obligation, we
will undertake an Equality Impact Analysis
which to enable us to consider the impact
of each current and proposed service,
policy, procedure or function in relation
to all protected groups. We will ensure
‘due regard’ to equality in relation to the
services that we commission and, where
appropriate, deliver and report the manner
in which we recruit, train and develop our
staff. We will identify any gaps or areas of
concern that may adversely impact on one
or more groups.  
3. VISION AND STRATEGIC GOALS
3.1 Vision and strategic goals
The EAHSN vision is to improve patient
and population health outcomes for
the population of the Eastern Region
by translating NHS and commercial
research into practice and developing
and implementing integrated healthcare
systems. We will do this in collaboration
with a network of local, national and
international partners by promoting
participation in research, translating
research and learning into practice,
collaborating on education and training,
driving service improvement, creating
patient centred information and enabling
productive partnerships with industry.
The EAHSN strategic goals are to:
• Create a regional framework for the
implementation of Innovation, Health
& Wealth and the Strategy for UK Life
Sciences that connects researchers in
our academic institutions with partners
in primary, secondary and tertiary care,
public health, social care, and industry.
• Work in partnership with industry.
and support both industry and NIHR
research, by providing easy access to
academic and clinical collaborators,
research infrastructure and research
subjects. To make the Eastern Region
the ‘go to’ place in Europe to set up
substantial new knowledge-based
healthcare businesses, building jobs,
increasing exports and creating wealth
for the region and the UK.
• Lead the effective identification of
innovation, best practice and evidence-
based approaches for improving health
that are cost-effective, and can be
rapidly adopted and implemented
across the Eastern Region. This
will include nationally designated
innovations and those arising from the
EAHSN programme of work.
• Address health inequalities by
identifying and addressing variations
in health outcomes and in the delivery
of healthcare in the Eastern Region
through the analysis of robust data; and
to develop a trusted centre for data
analysis and data sharing within the
EAHSN, that will link primary, secondary
and tertiary care data, improving the
quality and availability of information.
• Use proven improvement science
methods and professional networks
to deliver measurable improvement
in outcomes for the major chronic
diseases that have the greatest scope
for improvements. This will be achieved
both through better prevention of
disease, better management of ill health
and improved healthcare systems.
• Develop capacity and capability by
creating a culture of learning within
the EAHSN workforce, educated to
be literate in research and research
translation, using an inter-disciplinary
approach to professional and clinical
leadership development.
4. EAHSN FIVE YEAR WORK PROGRAMME
4.1 EAHSN priorities
Informed by the burden of disease, risk of
harm, and the potential for improvement,
EAHSN partners have identified three
priorities for the next five years:
i) Mental Health, focusing on dementia
in the first year
ii) Non communicable disease:
• Cardiovascular disease, focusing on
stroke in the first year
• Cancer
• Diabetes
• Chronic respiratory diseases
iii) Patient safety
The EAHSN will design a work programme
over five years to answer research questions
for each non communicable disease to
identify interventions that will lead to the
improvement in the management of these
long-term conditions.
For each priority area, there will be EAHSN
Centre for Translational Research. A
designated node will lead the programme
of work and draw upon experts from across
the wider network.
Key outcomes and deliverables for each
The Eastern Academic Health Science Network | XXXIII
 priority will be set by the EAHSN Board.
Some will reflect uptake and spread of
innovation, and others will be aligned with
the NHS Outcomes Framework, which
reflects the desired clinical outcome of
innovative practice.
Whilst the EAHSN Board will own and
oversee achievement of both the strategic
goals through the work programme,
delivery will take place at a local level within
and across the four nodes.
For each clinical priority area, there will
be an EAHSNs Network for Innovation
for which a designated node will lead the
programme of work and draw upon experts
from across the wider network.
For example, in early discussion the Essex
node has agreed to lead cardiovascular
work; the Cambridge and Peterborough
node has agreed to lead patient safety, and
Norfolk and Suffolk will lead mental health
(dementia). Leadership of the node will
involve identifying clinical and non-clinical
opinion leaders in the areas concerned,
supported by senior management capacity
to lead the programme.
These innovation networks will ensure
that all partners in the NHS, primary,
secondary, tertiary and social care are
involved, patients and carers, as well as
public health and local government and the
3rd sector, and they will work closely with
the emerging Strategic Clinical Networks,
essentially a ‘Network of Networks’, to
provide a co-ordinated approach to co-
production with an emphasis on innovation.
The advantage of this is that they can map
onto established clinical communities.
The performance metrics will be linked to
deliverables as has been done in the DH
Cancer, Cardiac and Stroke Network which
have been driven by NHS Improvement.
Each Innovation Network will have access to
XXXIV | The Eastern Academic Health Science Network
EAHSN-wide or local intelligence to inform
its work:
• Informatics, including identifying
variation in practice and outcomes,
baselines, information to monitor its
progress against agreed metrics.
• Industry, including through Health
Education England.
• Education and training, including
through the LETB.
• Innovation intelligence.
• Research intelligence.
• Health economics intelligence.
• Improvement science intelligence,
including though the local arm of the
New NHS Improvement Body.
The Innovation Networks (i.e. one
per EAHSN priority area) will have a
responsibility in identifying, understanding
and responding to unwarranted variation
in outcomes; the role of both primary and
secondary care in improving practice and
outcomes; the adoption and spread of
effective innovations in treatments and
in the organisation of care; and driving
change through improvement science
methodologies, including working through
the Eastern auspices of the new NHS
Improvement Body.
The examples of delivery for each work
priority have been developed in discussion
with partners, but will need to be affirmed
by the EAHSN Board once in place.
4.2 EAHSN network for innovation in
dementia and mental health
The EAHSN will work with mental health
service partners and other EAHSN partners,
the emergent Eastern mental health clinical
network and the CLARHC CP to ensure the
adoption and diffusion of evidence-based
mental health service developments and
improvement.
The Eastern Mental Health Clinical Network
has been formed by the East of England
SHA, the mental health NHS FTs and the
Royal College of Psychiatrists. The key
work streams of the mental health clinical
network include:
• Dementia (commencing first year)
• Child and adolescent mental health
(commencing year 2)
• Quality and safety
• All age IAPT services (Improving Access
to Psychological Services)
• Integrated physical and mental health
The NIHR CLAHRC for Cambridgeshire and
Peterborough (CLAHRC CP) represents
collaboration between the Cambridgeshire
and Peterborough NHS Foundation
Trust and the University of Cambridge
in partnership with a wide range of
Cambridgeshire and East Anglian health
and social care providers to take forward
translational research. The research themes
include child and adolescent mental
health, adults with learning disabilities
and acquired brain injury, older people
with mental health problems and end-of-
life care. In an application to NIHR for a
further five years of funding the CLAHRC
will further align its programmes of applied
health research with the EAHSN. The EAHSN
will particularly focus on the following key
deliverables.
a) Dementia
There are now new Dementia Intensive
Support teams across Norfolk and Suffolk,
and a Dementia Academy has been
established to train formal and informal
carers who are working with Dementia
Sufferers linked with the Alliance. The
Norfolk and Suffolk NHS Foundation
Trust (NSFT) and UEA are expanding their
established academic research in dementia,
which currently includes DeNDRON as well
as academic posts. NSFT is also about to
be nominated as lead for the new National
Dementia Network in East of England. The
UEA Health and Social Care Partnership
will therefore lead on Dementia science
development and innovation for East Anglia.
A programme of work will include:
• A range of initiatives in line with the
PM’s Challenge on dementia to support
evidence-based care of people with
dementia:
o Support for nodes and CCGs to
work across health and social care to
introduce measures that speed up
early intervention and diagnosis.
o Improvements in quality of care in
acute hospital.
o A programme to reduce
inappropriate use of anti-psychotic
medication.
o Care provider education
and training.
• Rolling out the innovative work of the
Norfolk and Suffolk Dementia Alliance
to the other three nodes.
• Deliverables will include performance
against the awaited dementia metric in
the NHS Outcomes Framework.
b) Child and adolescent mental health
The AHSN will prioritise the adoption and
diffusion of evidence-based child and
adolescent mental health services in line
with the Graham Allen review of early
intervention services, the national CAMH
review and CLAHRC findings. This will
include:
• Young people’s IAPT services.
• Multisystemic therapy services for
adolescents on the edge of care (at risk
of becoming ‘looked after’ or at risk
of custody) and those with complex
physical health problems and poor
compliance.
• Services that support the transition
from childrens’ services to adult
services.
• Enhanced detection and early
intervention in children and young
people with autistic spectrum disorders,
including closer integration with child
development services provided by
community and acute trusts.
The Eastern Academic Health Science Network | XXXV

c) Integrated physical and mental
healthcare - liaison psychiatry service
model; appropriate management of
medically unexplained symptoms and long-
term conditions; improving the physical
health of people with serious mental
health disorders.
Recent health economic analysis from
an innovative 24/7 liaison psychiatry
service in Birmingham (RAID; www.
centreformentalhealth.org.uk/pdfs/
economic_evaluation.pdf) focusing on the
elderly suggests that investment in this
approach can improve patient outcomes
with reductions in bed-days and costs in
the acute sector. There is a well-established
liaison psychiatry service at Cambridge
University Hospitals NHS FT provided by
Cambridgeshire and Peterborough NHS FT.
This service has successfully demonstrated
good outcomes in relation to patients
with mental health problems and patients
with physical and mental health problems.
The service has developed an expertise
in relation to patients with long-term
conditions and patients with medically
unexplained symptoms. A service model has
been developed which enables the liaison
psychiatry service to be scaled up to work
across the county and across a network of
acute hospital providers. In the community,
IAPT psychotherapy services (see 4.1.2 in
main text, page 15) are being developed
with NHS Midlands and East to link with
the acute sector and provide appropriate
interventions for medically unexplained
symptoms and psychological aspects of
long-term conditions We will use this
model to explore more innovative ways of
organising mental health services to provide
continuity and consistency of management
both within the specialist services and
between primary and secondary care.
Finally, the EAHSN will focus on integrating
mental and physical healthcare in primary
and secondary care settings so as to
XXXVI | The Eastern Academic Health Science Network
reduce inequalities in physical health and
mortality suffered by those with serious
mental illness. We expect these areas to be
included as targets for new applied health
research in the application for a second
round of CLAHRC funding within the EAHSN
(see 4.1.2 in main text).
4.3 EAHSN Network for innovation in
cardiovascular disease
Network partners have identified stroke as
the first order priority work steam within
cardiovascular disease and plan to deliver
the following:
a) Supporting collaboration in prevention
and early intervention
Addressing adoption of best practice
in primary prevention, in particular AF
management, with an increase GRASP AF
in GP practices to improve anticoagulation;
and the use of innovative approaches
to delivery e.g. AF assessment at flu jab,
which will target high risk cohorts. Industry
partners, including pharma, will be engaged
to support adoption and spread of best
practice, with appropriate arrangements
to avoid conflict of interests. Full roll
out is estimated to save lives, and save
approximately £3m across the EAHSN.
b) Operationalising agreed best practice
Supporting CCGs in implementing the
deliverables and outcome of the Midlands
and East best practice Stroke Review,
focusing on sharing best practice. This
will include the delivery of education
and training, working across local health
and education providers to collaborate
and respond to the need for new ways
of working e.g. the development of new
roles of stroke practitioners; and that
programmes utilise proven innovation and
technology in how education is delivered.
The latter will benefit from collaboration
with industry, to ensure that the NHS adopts
effective techniques and technologies in
its delivery. It will also include support for
the adoption and spread of early supported
discharge (ESD) which has a saving of
thousands of pounds per patient, and
reduces social care use by up to 200 hours
a week.
c) Championing innovation in delivery
Piloting stroke as the early implementer
of 7/7 working; this work will include both
stroke and high risk TIA, and will be linked
with implementation of the Stroke Review
conclusions, which will be known in early
2013/14.
d) Support in adoption and spread of NICE
guidelines, quality standards and technical
appraisals
We will support implementation of
Clinical Guidance CG68; Quality Standard
Q2 for Stroke; Technological Appraisals
for dabigatran etexilate TA 249, and
Rivaroxaban TA 256. This work will support
local assessment of the health economics of
delivery, and adopt and spread innovative
practice in delivery.
e) Managing heart failure
We will support implementation of the
NICE chronic heart failure quality standard
(Q59), including using the European Society
of Cardiology’s evidence based guidelines
on diagnosis and treatment of acute and
chronic heart failure.
f) Adoption and spread of existing good
practice: renal home dialysis
Driving the adoption and spread of home
based renal dialysis, already in place in the
Cambridge and Peterborough and Essex
nodes; enabling patients to benefit from
greater freedom and independence; making
better use of acute hospital resources; and
reducing time lost from the workplace,
contributing to local wealth creation.
4.4 EAHSN network for innovation in
cancer
Key deliverables may include evidence
of adoption and spread on selected
innovations; evidence of wealth creation;
evidence of the improved outcomes.
a) Implementing national best practice
Driving adoption into practice where this
has been slow to be implemented e.g.
NICE guidance for the provision of post
discharge survivorship support including
support for self management, and access to
psychological services. EAHSN Innovation
Network will support CCGs with assessment
of the return on investment; and where
there are health economic benefits, pilot
community based psychological support,
to reduce avoidable follow up in hospital or
primary and community settings.
b) Rolling out local evidence based HIEC
initiatives
Evaluating and as appropriate, depending
on findings, roll out the outcome of the
HIEC project for an end-of-life care register
beyond the Cambridge and Peterborough
node to the other three EAHSN nodes
c) Information sharing for fully integrated
care
Facilitating development of an e-hospital
module to share key patient information
across acute, primary and community
care. EAHSN would look to pilot this in the
Cambridge and Peterborough node, as part
of the second wave of the Addenbrooke’s
e-hospital programme, 2014/15. In the light
of evaluation, learning will be shared with
other nodes.
d) Adoption and spread of innovation
Developing the award winning cyto-sponge,
an innovation cited in Innovation Health and
Wealth, December 2011, for early detection
of oesophageal cancer, from prototype and
test stage, to widespread access and uptake
across the EAHSN and nationally.
e) Simplifying processes; improving uptake
The Eastern Academic Health Science Network | XXXVII
 in trials; and making the region a better
place for industry to engage
Providing an EAHSN set of research and
development (R&D) processes, to support
collaboration with industry and the uptake
of clinical trials in area of rare cancers
f) Facilitating communication and
addressing emerging hurdles to
collaboration in research and development
Facilitating periodic cancer symposia to
enable discussion between industry and
NHS R&D team partners to:
• Discuss strategic direction and
emergent thinking.
• Enable the blockages to effective and
timely collaboration to be identified and
addressed at an early stage, with EAHSN
as the facilitator for addressing these.
4.4 EAHSN network for innovation in
diabetes
Deliverables may include the evidence
of adoption and spread on selected
innovations; evidence of wealth creation;
evidence of the improved outcomes
a) Diabetes prevention:
Using lay trainers with diabetes in the
provision of diabetes prevention services
and in provision of diabetes care, building
on two NIHR funded pilot projects in
Norwich have piloted the use of lay trainers
with diabetes in one of the largest diabetes
prevention studies ever conducted in the
UK (Sampson PI £2.8M; Murray et al 2011).
The EAHSN will pilot the use of lay trainers
in providing lifestyle education for those
at risk of developing diabetes, and those
with screen-detected type 2 diabetes. We
will work in collaboration with healthcare
professionals and behavioural psychologists
across the region, using interventions
and existing training programmes already
developed in the Norfolk diabetes
prevention study.
XXXVIII | The Eastern Academic Health Science Network
b) Prevention through weight management
and exercise
Establishing the evidence base emerging
from the Centre for Diet and Activity
Research (CEDAR), which is studying the
factors which influence dietary and activity
related behaviours, and developing and
evaluating public health interventions.
c) Improving integration of care
Promoting innovative models of working
between primary and secondary care
to provide a more integrated service.
The integrated primary, secondary and
community care model in Essex, which
is now also exploring a private-public
partnership model of delivery, is an
exemplar of best practice; the evaluation
of which will inform the other nodes’
development of integrated diabetes care.
d) Improving care for diabetic foot disease
Diabetic foot disease currently accounts for
20% of the total cost of managing diabetes
(A Boulton; Lancet 2006); results in 100
amputations each week in the UK; 85% of
all major foot amputations in people with
diabetes are preceded by foot ulceration
(Pecorara et al 1990). Time to heal: 65%
by 12 months (Jeffcoate et al 2006). This
evidence based intervention supports the
NHS Midlands and East Ambition to reduce
pressure ulcers. Based on evidence from
Ipswich, with a population 335,000, this
innovation resulted in a 75% reduction in
amputations, and bed day savings of £386k
per year; extrapolated to a saving of c £5
million per year across the EAHSN.
e) An EAHSN wide training programme for
care of people with diabetes
Developing a training programme
developed from a Cambridge and
Peterborough HIEC initiative for seven
groups of staff from healthcare assistant
to nurse consultant; using Diabetes-UK
approved integrated care training modules;
and developed using eLearning packages.
f) Patient diabetes care
Addressing variability in diabetes related
admissions and bed occupancy. Up to 15%
of all acute beds in the UK are occupied by
inpatients with diabetes (NADIA). There is
also substantial variability between acute
trusts in admission rates, bed occupancy,
and length of stay (NADIA, NDIS), with
an excess length of stay associated with
diabetes leading to an estimated £600m
excess cost in England and Wales (Kerr et
al 2012). Models proven to reduce this as
well as reduce admission rates for diabetes-
specific conditions have now been well
established (Sampson et al 2006, 2007;
Evans et al 2012). The EAHSN will use these
models in combination with QOF and other
high-quality data now available through
industry partnerships which reveal age and
population adjusted admission rates and
bed occupancy for individual GP practice,
CCG and provider unit, to describe and
reduce this variability and excess cost. The
Joint British Diabetes Society in Patient
Care Group Chair Mike Sampson, as well as
the Diabetes Inpatient Specialist Nurse UK
Group Chair Esther Walden are both based
in Norwich and will be able to lead this work
across the EAHSN.
g) Diabetes patient advisors
Providing ‘out of hours’ lay mentorship and
healthcare emergency advice. The Norwich
Patient Advisers programme was first
established in 2006 and uses people with
diabetes who have been trained to provide
lay mentorship for others with diabetes
through an out of hours advice line. This
model provides immediate support based
on the common experience of having
diabetes, to reduce the psychological
burden of the disease. The EAHSN will
enable this highly successful and popular
programme to be rolled out across East
Anglia, using an already established training
programme for lay advisors.
h) Admission avoidance helpline
Providing an out of hours regional diabetes
specialist advice line for diabetes patients
at immediate risk of admission. The Norfolk
node already has a highly successful
telephone advice provided by diabetes
specialist staff for patients with diabetes
operating between 9-4 Monday to Friday. In
a recent study, up to 400 of the 7000 calls
taken in one year were felt to have directly
prevented admission: for patients needing
emergency advice on dealing with a severe
hypoglycaemic episode or how to deal with
intercurrent illness and the presence of
ketonuria (Evans et al 2012). The EAHSN
would enable a regional roll-out of this to
include an out of hours service specifically
for patients at immediate risk of DKA
who would otherwise attend hospital and
frequently require admission.
i) Peer support initiative
Rolling out the learning form the RAPSID
trial of peer support in Type 2 diabetes.
This cluster Randomised Controlled
Trial has recruited 1,360 people living in
Cambridgeshire, North Essex and North
East Hertfordshire. Around 150 of the
participants have been trained to provide
non-directive peer support to others in
the intervention localities, either on a 1:1
group, or combined group and 1:1 basis,
with people in control localities receiving
normal care. The trial is underway and
outputs will include a toolkit for others to
use in developing and implementing peer
support interventions. When the findings
are available, the EAHSN will facilitate
discussions with commissioners and others
about the best way to implement the
learning from this study.
j) Community diabetes facilitators
Node-wide community-based diabetes
specialist nurses to improve diabetes in
primary care and reduce insulin associated
prescribing costs Community based
diabetes specialist nurses are currently in
Norfolk to support patients in primary care.
The Eastern Academic Health Science Network | XXXIX
 These highly experienced facilitators are
supported clinically by the specialist team.
The team has dramatically reduced the
requirement for secondary care referrals,
despite the year on year increase in the
incidence of diabetes. This innovation has
allowed secondary care to focus on the
smaller proportion of patients with complex
disease; and improve insulin prescribing
in line with NICE guidance; and deliver
2010-2011 targets to ensure that 70% of
all new insulin starts are with low cost
human insulins. The EAHSN will allow this
innovative and successful programme to roll
out across the region.
4.5 EAHSN Network for Innovation in
Chronic Respiratory Disorders
Key deliverables may include the adoption
and spread on selected innovations;
evidence of wealth creation; evidence of
the improved outcomes.
a) Driving innovation in earlier diagnosis in
COPD
Building on the existing local HIEC work and
work of the DH Respiratory Programme and
its regional network and leads, establishing
systemic evidence based arrangements for
the early diagnosis of people with poor lung
function and at risk of developing severe
respiratory problems. This will include
education and training, for service users and
professional, and encompass an integrated
approach across hospital, primary care and
community services. The development of risk
stratification will involve industry partners.
b) Innovation in delivery, with 7/7 access
Establishing systematic evidence based
arrangements for admission avoidance
and early supported discharge, to reduce
avoidable bed-days, and support. This will
include the development of 7/7 community
response services; and 24/7 specialist
nursing support.
XL | The Eastern Academic Health Science Network
c) Adoption and spread of supported self
care
Developing the existing successful
Cambridge based Centre for Self
Management Support (CSMS) to the benefit
of the whole EAHSN. Support for local
systems includes:
• Innovative material and tools, for local
regional and national adoption e.g.
patient led personal health plans.
• A practical resource to support patients,
carers and clinicians.
• Self management skills training
and support for patients carers and
clinicians.
• A promotional hub for SMS.
• Support to CCGs to understand the role
of self management as part of their
productivity agenda.
The Centre is funded through a range of
grant funding, consultancy, fund raising,
and through commercial opportunities.
Matched funding is being sought from the
Health Foundation, to extend the scheme,
which would become an integral part of
the EAHSN. The outcome of an application
for funding of £1.3m to NIHR is currently
awaited, which will evaluate the benefit
of enhanced pulmonary rehabilitation
incorporating self management skills
training.
4.6 EAHSN network for innovation in
patient safety
We will deliver a network of innovation for
Patient Safety building on the success of
the Eastern Region Patient Safety Clinical
Programme Board which was a cross-cutting
work stream of the Towards the Best,
Together initiative. Measurement will be key
to the successful delivery of network wide
improvements; particularly with respect
to variation in safety and quality. We will
establish a ‘safety thermometer’ to monitor
harm free care, with data for the Patient
Safety Network coming from the Eastern
Quality Observatory which has led work
nationally on the development and use of
data on hospital mortality.
Driven by reports showing that one in ten
people admitted to NHS hospitals suffers
avoidable harm, this work will to accelerate
learning from national reports including
DH, CQC and the imminent Francis 2 report.
We will collaborate with industry and other
partners to innovate safety improvements
through technology, better clinical pathway
work, and by harnessing biomedical
research, bringing clear patient benefits
and demonstrating an early impact of the
EAHSN across the Eastern Region.
The Patient Safety Network will develop
pre-emptive approaches to patient safety
with clinical risk management, prospective
hazard analysis, and design for safety,
working closely with the Department of
Engineering at the University of Cambridge.
The Patient Safety Network will provide
support structures for the implementation
of reports and enquiries during a period
of considerable organisational upheaval,
and work to increase awareness of patient
safety issues. We propose that the EAHSN
initially focuses on:
• Reducing ‘never events’, e.g. wrong
site surgery, and misplaced naso-gastro
tubes; and
• High risk medications e.g. insulin,
oxygen, warfarin, opioids, methotrexate
across a variety of healthcare settings.
Emphasis will be given to:
• Improving safety through the reduction
of unexplained variation;
• Developing shared processes wherever
possible;
• Exploring the impact of new eHospital
programmes, where electronic decision
support software will have an increasing
role.
Designing and implementing safer systems
The EAHSN Patient Safety Network will be
supported by a theme of Designing and
Implementing Safer Systems, for which
external further funding will be sought,
including through the NIHR research
programmes. This will comprise both
research-related and applied work, with
each informing the other. We will develop
and utilise a range of tools to help design
out system problems, and design in better
quality care, making it easier for staff to do
the right thing even when under pressure,
and helping the system to ‘fail-safe’.
Pre-emptive approach to patient safety
We will collaborate with a variety of
industry partners, where there are low error
rates, to identify, develop, adapt and apply
external safety principles. The Patient Safety
Network will develop a more proactive,
anticipatory and balanced approach to
managing risk rather than relying on the
current NHS practice of incident reporting
and accident investigation. Key features will
include:
• Developing the concept of a Safety
Management System and the use of
Prospective Hazard Analysis to identify
and respond to risks up-front before
large-scale changes such as service
reconfiguration are introduced.
• Clinical leadership, education and
training on safety management.
• Focusing on the theory and language of
risk management.
• Providing a Risk Toolkit and facilitation
assistance, working closely with
commissioners and providers across the
region.
• Exploring how Human Factors (HF)
design can be used to improve safety;
focusing not only on products, but tasks,
work, environments, organisations and
systems, e.g. the implications of 7/7
working; the design of the eHospital
initiative and addressing unexplained
variation, using Inclusive Design,
The Eastern Academic Health Science Network | XLI
 enabling systems to exclude people
from involvement when demands
outweigh their capabilities. We will
apply these principles to the care of our
older service users and for those with
disabilities.
• Working to establish the health
economics of patient safety.
• Developing an EHSN care pathway
process; working through the nodes
to deliver sustainable system-level
changes, which take a cross-boundary
approach in safe pathway design
for complex conditions and multiple
morbidities, such as the frail elderly and
patients with dementia.
The EAHSN Patient Safety programme will
encourage the identification and adoption
of a range of innovations which address
safety issues identified through the risk
assessments and work with stakeholders.
These will range from medical devices to
new therapies, and new ways of delivering
services to the delivery of improvement
science ideas. Innovations will require
timely evaluation, and we will work with
Health Enterprise East to complement their
evaluation service for independent review
of innovations, utilising methods such as
computer-based simulation to prototype
new service designs, before they are
implemented, and to evaluate such services
in near-to- and actual-use conditions, for
example utilising the cadaveric centre.
Levers for improvement will be to support
the work that identifies variation, support
for assimilating evidence base, access to
intelligence which will all enable a positive
mechanism to engage commissioners
at CCGs, together with costing element
provided by health economics, as well as
peer challenge and support and CQUINs.
XLII | The Eastern Academic Health Science Network
4.7 High impact changes and SHA
ambitions
In addition to the EAHSN priorities
described above the five year work
programme will also include the delivery of
the High Impact Changes and three of the
SHA Ambitions.
a) High impact changes
Fluid management. We will build on the
progress already made in Hertfordshire,
where fluid management individualised
goal-directed fluid therapy is available
in every main theatre at the Lister and
QEII Hospitals; and LIDCO intervention is
available on both sites and share evaluation
of the outcomes , alongside that of the
three national case studies for IOMF
(http://iofm.innovation.nhs.uk/pg/cv_blog/
content/view/5255/network?cview=4932),
to achieve target comparable reductions
in operative mortality (23%); length of
stay (three days mean, four days post op);
central venous catheter insertion (23%),
decrease in re-admission rate (29%),
decrease in re-operation rate 30%, and
reduction in length of stay within critical
care (Level 3) (5 days).
The NHS Technology Adoption Centre
(NTAC) evidence base and dissemination
toolkit will be used to support effective
adoption. EAHSN partners will agree
targets as part of their commitment
to a comprehensive work plan, which
will proceed immediately after AHSN
designation. Delivery will be led by the
Innovation Network for Patient Safety.
The NHS Technology Adoption Centre
(NTAC) evidence base and dissemination
toolkit will be used to support effective
adoption.
Three million lives. The EAHSN will build on
existing telehealth and telecare initiatives
already underway across the Eastern
Region, linking health and social care. We
will do this through collaboration with
leading companies based in the region,
including BT in Suffolk, Philips in Cambridge
and Docobo in Essex and many small and
medium sized enterprises in the wireless
healthcare sector which are represented
on our Innovation Council. Our region
lags other parts of the country in the
deployment of these technologies, despite
being a technical leader in such areas as
interoperability and standards. This is in
part attributed to lack of clarity in the
evidence base, and caution about the scale
of the benefits of telehealth expressed by
respected authorities including the King’s
Fund. We will support CCGs in identifying
the evidence base, and the areas in the
EAHSN and each node where there is
scope for benefit. Our ambition is to catch
up and make a contribution pro-rata to
its population in the three million lives
campaign, working in area where there is
clear evidence of benefit to both patient
outcomes and productivity. An early priority
will be developing Telehealth and Telecare
to support CODP self-management.
We will work through our Innovation
Network for COPD , linking with our Centre
for Self Management Support (CSMS) to
identify and deliver a programme of work
to support adoption and spread, and
innovation in the nodes. We will build on
external experience of national exemplars
including Newham, Milton Keynes and
Gloucester; and on the Essex telemedicine
pilot currently in planning stages. Local
evaluation of outcomes will be undertaken
by the CSMS, and will be used to inform
roll out to other areas with high unplanned
admission rates e.g. UTI.
The role that these changes will have, is
in gaining an understanding among staff
and leaders in organisations in the Eastern
Region around reducing variability and the
role of industry to help deliver changes and
demonstrates that we will use the delivery
of these to achieve a wider ambition on
health and wealth.
b) NHS Midlands and East ambitions
The EAHSN will also progress the NHS
Midlands and East Ambitions, which have
been set as local requirements for the
EAHSN for 2013/14. Partners across the
EAHSN have identified the greatest scope
for gain in the following areas:
Reduction in grade 2, 3 and 4 pressure
ulcers. All systems across NHS Midlands
and East are committed to the reduction of
pressure ulcers. Performance has improved
but working through the AHSN, partners
will be supported with a shared evidence
base to achieve clinical and cost effective
best practice, and establish the return on
investment of the ‘invest to save’ initiatives
needed to take performance to a target
of zero avoidable pressure ulcers in all
providers in EAHSN in 2013. We will use
the NHS Change Model to drive delivery:
Transparent measurement (including
variation in outcomes); systems drivers;
engagement to mobilise, leadership for
change; spread of innovation, improvement
methodology, and rigorous delivery. This
will include evidence based diabetic foot
management. For example, we will build
on work in Hertfordshire, Colchester
and Cambridge who have all made
demonstrable progress to eliminate Grade
2,3 and 4 pressure ulcers by December
2012. The EAHSN will lead the adoption
and spread of good practice across the
region and beyond, providing toolkits, and
guidance to achieve its own target of zero
avoidable pressure ulcers by December
2012. Delivery will be led by the EAHSN
Network for Innovation in Patient Safety.
Patient outcome and experience. All
The Eastern Academic Health Science Network | XLIII
 acute and mental health providers across
the EAHSN, including its private sector
partner Circle, which runs Hinchingbrooke
Hospital, have already implemented the
net promoter innovation, which raises
the profile, and subsequently the quality,
of patient outcome and experience.
This involves asking a single question as
part of evaluating service user and carer
experience, publishing results, and using
improvement methodologies to address
necessary improvement. This innovation
supports cultural change in the partnership
between service user and carers, and
professionals. We will look to evaluate the
use of this innovation, and its impact locally,
and in the light of this support the rolling
out to other providers e.g. community and
primary care.
Each node already has a range of
approaches to monitoring and improving
patient outcome and experience. EAHSN will
establish the most effective methodologies,
and where appropriate collaborate on their
delivery: training, focus groups, carers’
surveys, exemplar arrangements for timely
feedback; but the main vehicle for deliver
will be the nodes. Delivery will be led by the
EAHSN Network for Innovation in Patient
Safety and Experience.
Every contact counts. All systems have
introduced measures to ensure that every
contact counts in reduction in alcohol
consumption, weight management,
and smoking cessation; and referral
to subsequent lifestyle behaviours
interventions. We will implement the SHA
MECC toolkit which builds on national and
local evidence. We will also build on existing
analysis of the cost benefit of lifestyle
interventions in the Hertfordshire node to
support CCGs in maximising the outcome
of this initiative, including linking effectively
with the NHS Health Checks programme;
and support delivery of our diabetes
programme of work, working delivering
XLIV | The Eastern Academic Health Science Network
through the EAHSN Network for Innovation
in Diabetes.
5. KEY MILESTONES
The work to establish an EAHSN
commenced in earnest in April 2012 and
through the summer, engagement and
involvement of members has been the focus
of attention.
The following sets out at a very high level
the key milestones for the EAHSN for the
coming months to April 2013:
SEPT 12
• Meeting of EAHSN Working Party
• Meeting of EAHSN Reference Group
• Submission of EAHSN Prospectus and
Business Plan
Oct 12
• Identify key leads in each node including
CCG Innovation Leads
• Arrange a joint meeting with Health
Enterprise East/SBRI
• Draft and agree shadow network and
node arrangements
• Collect evidence in support of HIIs
NOV 12
• National Panel Review Prospectus
• Develop informatics and public health
support
• Agree theme and other leads
• Establish baseline information for six
key priorities
DEC - MAR 13
• Establish Shadow arrangements and
commence recruitment
• Establish and formalise node and
network arrangements
• Continue stakeholder engagement
• Develop and agree performance
measurement metrics
• Develop and agree Year 1 programme
plan
APR 13 • Greater involvement of patients and
• Complete recruitment and formalise users in chosen priority areas aligned
structures and arrangements to local clinical research and industry
• EAHSN Board meeting leaders.

6. SUCCESS FACTORS Alignment

In keeping with the defined core purpose
of AHSN’s and in support of the agreed
priorities and work programmes, the
success factors of the EAHSN are set out
below and will be refined during the coming
months:
• Contract agreed and in place with the
NCB.
• Concordat in place with agreed key
deliverables with the newly established
Clinical Managed Networks, Clinical
Senates and LETB.

Research
• Consistently high than average rates of
recruitment to clinical trials across the
EAHSN.
• High levels of patients participating in
clinical research.
• Increased recruitment of patients to
non-commercial and commercially-
funded clinical research by the
constituent NHS providers.
• Increased support for life sciences
industry research and development.
• Harmonised, simplified and
proportionate research governance.

Service improvement
• Safety Faculty established that delivers
reduced avoidable harm.
• Reduced unwarranted variance.
• Collation and provision of actionable
data to drive improvements in patient
outcomes.
• Increased adoption and spread of NICE
guidelines and technologies to benefit
more patients.
• Increased adoption of High Impact
Innovations across the network.

Industry engagement and wealth creation

• Established EAHSN Innovation Council.
• Innovation fellowships agreed and in
place.
• Developing and expanding HEE and
SBRI.

The Eastern Academic Health Science Network | XLV

 7. Financial summary 7.2 Infrastructure costs

7.1 Income The EAHSN is committed to keeping central

An indicative budget in the region of £9.2m
has been identified for the EAHSN, based
on the population formula proposed by the
DH. Further income opportunities have also
been included such as SBRI along with the
potential for the EAHSN to be commissioned
independently for other work in future.
The EAHSN considered and decided not
to pursue members’ subscriptions at this
stage. This may be considered further at
some point in the future and also local
agreements within individual nodes to
adopt this approach would be left to local
agreement.
infrastructure costs to a minimum whilst
balancing the need to ensure effective
arrangements are in place. Specific funding
has been identified for nodes to enable
them to establish adequate local support
and the remainder allocated to the work
programmes. A central Innovation/
Transformation fund is also proposed
to support nodes to develop and test
innovation approaches. Pay and non-pay
costs have been identified in line with the
arrangements set out in the governance
section. It has been assumed that the
majority of staff will be seconded into the
AHSN from partner organisations. The
table below provides an estimated wte
breakdown.

Role wte
Chair 1.00
Accountable Officer 1.00
Improvement/Network lead 0.40
NED contingency 2.00
Company secretary 0.40
Research lead 0.50
Industry lead 0.50
SBRI/industry lead 1.00
Education and training lead 0.50
Informatics/Public Health lead 0.40
Informations project lead 1.00
Informatics - Data analyst 2.00
Communications 0.80
Programme clinical champions 0.60
AHSN office manager 1.00
Innovation services (HEE) 3.90
Total network and board infrastructure 17.00

Accountable officer (0.4 Node) 1.60

HEI lead (0.1 Node) 0.40
Node acountable officer support and project lead (0.7 Node) 2.80
Node clinical champions (0.1 Node) 0.40
Total nodes 5.20
Estimated whole time equivalents 22.20

XLVI | The Eastern Academic Health Science Network

In addition to the staffing structure set out
above, it is assumed that the following
roles will be provided in kind by network
members or form part of substantive
positions elsewhere:
• Node informatics leads
• Node project leads
• Clinical senate leads
• LETB Director
An admin allowance of £50,000 has been
included for each of the four nodes.
7.3 Programmes of work
The majority of the funding will be allocated
to the programmes of work. This will be
determined by the priorities identified by
the nodes and agreed at the EAHSN Board.

An allowance has been made within the As programmes will be at differing stages of
staffing costs for backfill monies to support development, the resource requirements
CCG leads to attend innovation council will vary over time. An indicative year one
meetings. allocation is given below:

£
Dementia and mental health 1,000,000
Cardiovascular (including stroke) 1,000,000
Cancer 500,000
Diabetes 500,000
Chronic respiratory diseases 500,000
Patient safety 500,000
HII and SHA ambitions 500,000
Transformation fund 1,000,000
Innovation fund 500,000

Indicative total 6,000,000

Where the AHSN is commissioned to deliver
on a particular workstream, this will be
allocated in a way which is complementary
to the main programmes of work. The year
one plan includes an anticipated income
stream and expenditure programme
associated with COPD by way of example.
The plan assumes that the AHSN will
host the SBRI programme currently
commissioned by the NHSCB and that this
will consist of programmes to the value of
£10m per annum after the first year. Future
expansion of this element is possible, but
has not been included at this stage.

7.4 SBRI Income and expenditure for the SBRI

The plan has been constructed following
the working assumption that the SBRI
programme will transfer from Midlands and
East SHA to the Eastern AHSN.
programmes have been matched in each
financial year to ensure that the impact
can be clearly distinguished from the other
activities of the AHSN. In reality, it is likely
that the timing of the payment of the

The Eastern Academic Health Science Network | XLVII

 awards will lag behind the receipt of the
income and will therefore require a more
accurate payment profile to be constructed.
The doubling of the SBRI income in the plan
is associated with plans to achieve European
matched funding (Euro Horizon 2020
programme). Due to the lengthy application
and approval process this has been built in
from year three.
• There are also risks associated with
reductions in the funding available, e.g.
SBRI, should national priorities change.
The Business plan will be kept under
regular review and has the advantage
that a number of commitments can be
reviewed on an annual basis to ensure
that the AHSN can live within its means.

8. KEY FINANCIAL RISKS AND MITIGATION

• The main financial risk relates to

uncertainties regarding the timescales
for delivery. Depending on the final
governance structure, the main
mitigation for this will be flexibility
across financial years to ensure that
the programme delivery is not overly
dominated by the need to fit in with
reporting periods.
• As the financial plan includes a number
of estimated figures, there remains a
risk of unforeseen costs being incurred
or transferred to the AHSN. To mitigate
this, a 5% risk contingency has been
built into the plan (excluding SBRI,
which has its own risk management
mechanisms). Furthermore, it is
anticipated that the funds available for
allocation across the programmes can
be flexed each year in line with resource
availability. Should the programmes
underspend, or the risk contingency
not be required, this will be taken into
account in the allocation of funding for
future years.
• The plan has been constructed
at constant prices. There is a risk
associated with inflation, for example
if income is inflated at a rate lower
than expenditure. The risk contingency
would be used in the first instance to
manage this risk, although the AHSN
Board would need to take this into
account in setting the allocation for
work programmes future years.

XLVIII | The Eastern Academic Health Science Network

 Summary Financial Plan, EAHSN

Year 1 Year 2 Year 3 Year 4 Year 5

Income
AHSN Central funding 9,200,000 9,200,000 9,200,000 9,200,000 9,200,000
Commercial events 5,000 5,000 5,000 5,000 5,000
SBRI 11,500,000 10,000,000 20,000,000 20,000,000 20,000,000
Leading regional/national work 150,000
Total income 20,855,000 19,205,000 29,205,000 29,205,000 29,205,000

Expenditure
Infrastructure
Pay and backfill Central network 1,132,519 1,132,519 1,132,519 1,132,519 1,132,519
Nodes 614,969 614,969 614,969 614,969 614,969
Non pay Central network 214,767 219,767 219,767 219,767 219,767
Nodes 240,000 240,000 240,000 240,000 240,000
Innovation services Commissioned 383,395 383,395 383,395 383,395 383,395
SBRI support costs Commissioned 500,000 500,000 700,000 700,000 700,000
Health economics Commissioned 150,000 150,000 150,000 150,000 150,000
Set-up costs 105,000
Infrastructure costs 3,340,650 3,240,650 3,440,650 3,440,650 3,440,650

Programmes
Streams of work } 6,000,000 6,100,000 6,100,000 6,100,000 6,100,000
Transformation fund }
Innovation fund }
COPD initiatives 150,000
SBRI awards 10,904,350 9,404,350 19,204,350 19,204,350 19,204,350
Programme costs 17,054,350 15,504,350 25,304,350 25,304,350 25,304,350
Risk contingency 460,000 460,000 460,000 460,000 460,000
Total expenditure 20,855,000 19,205,000 29,205,000 29,205,000 29,205,000

The Eastern Academic Health Science Network | XLIX

 APPENDIX F: HEALTH ENTERPRISE
EAST INDUSTRY ENGAGEMENT DRAFT
DOCUMENT
The EAHSN Industry services will focus
around providing a pro-active hub between
the NHS and Industry. The activities will be
based around the structured framework
Figure 1 Industry engagement framework
1. Priority review of areas of focus
At the outset an initial prioritisation phase
is required to provide the areas to feed into
the detailed care pathway analysis. For each
area of the EAHSN channels stakeholder
interviews will be carried out across the
nodes to understand the priorities of the
primary, secondary and community care.
The information will be analysed, mapped
and prioritised on the basis of an agreed
set of criteria taking into account the goals
of the AHSN, DH, NHS and WHO. This will
L | The Eastern Academic Health Science Network
illustrated in figure 1 to achieve the goal
of increasing innovation, adoption and
diffusion. The services will ensure a high
level of engagement for all involved across
the EAHSN region from the outset and will
deliver tangible output at each stage in the
process.
provide a prioritised list of areas for focus
as well as providing initial valuable insights
into how care provision can be improved.
2. Care pathway analysis to understand
within the key areas of unmet need or
improvement requirement
For each of the areas of focus from the
priority review an established process
of care pathway analysis will be used to
formally review prevention, screening,
diagnosis, monitoring and treatment/
management of conditions to identify areas
of significant need within.
This process will again engage with
stakeholders across the EAHSN nodes in
primary, secondary and community care
to build up a representative care pathway
to provide clear resolution of the disease
or condition from the perspective of the
people involved, products used and the
places care is delivered.
This proven methodology has developed
to identify triggers for change where there
are unmet needs from either a technology,
service or process perspective or where
no solution currently exists. Care pathways
also readily provide a mechanism to
determine what impact changes could
have on the provision of care and where
the focus should be. Again, the process of
prioritisation will continue to progress areas
for further investigation using a criteria-
based scoring approach.
3. Systematically investigate focus areas
through clinical stakeholder and industry
workshops
With each of the prioritised areas
workshops will be held involving clinical,
patient and industry attendees. These
workshops will serve to investigate the
unmet needs in each opportunity area
in more detail by drilling down into the
functional requirements, hurdles that must
be overcome and barriers to adoption. This
will provide a platform for dissemination
and a spring board for innovation.
4. Provide technology showcase events to
introduce technology innovations to key
stakeholders within the NHS to increase
awareness of solutions in the areas of
unmet need
In addition to stimulating innovation and
new product development it is important to
ensure existing solutions are not overlooked
for the areas of need. The process of raising
awareness and creating demand for new
technology by the NHS is difficult for most
companies to achieve without employing
a large and dedicated sales force. Whilst
showcasing at industry events is a common
method used to demonstrate products and
services these rarely attended by those on
the NHS frontline. To facilitate this process
showcase events will be held across the
region to bring technology to the user.
This approach will facilitate the process of
product information diffusion and will seek
to promote adoption.
5. Equip industry with a better
understanding of technology adoption
and procurement within the NHS through
‘opening doors’ events
In addition to the activities focused around
the specific areas of unmet need, three
events will be held per year to bring
together Industry and NHS stakeholders
to share information on specific issues
and provide a platform for Industry to
understand the subtleties of the NHS.
These events will be held under the already
established brand of ‘opening doors to
the NHS’. Past events have covered the
following themes
• Diabetes - understanding priorities for
Iinnovation.
• Diagnostics in the community.
• New commercial perspectives for
industry.
In the first year the focus will be on
understanding the process of technology
adoption by the NHS and the procurement
processes as these areas are known to be
key areas of uncertainty for industry.
Going forward new themes will be
introduced and common themes may
rotate, adapted to reflect policy changes,
new processes and different Industry
perspectives/challenges to give deeper
insight.
The Eastern Academic Health Science Network | LI
 6. SBRI competition areas Additional Services Health Enterprise East
will offer to Industry outside of the EAHSN
A further beneficial outcome of the care umbrella
pathway reviews and workshops will be the HEE will continue to offer a range of
identification of validated themes for future specialist MedTech consultancy services
SBRI programmes. to complement the product development
process for those organisations without
Supporting resources the time or resources to do so, specifically
In addition to proven methodologies for stakeholder research, need translation,
care pathway analysis, workshop facilitation technology scouting and concept creation
and deep technical insight, Health focusing around rapid engagement with
Enterprise East has developed resources the right stakeholder. These services have
to facilitate the process of industry proven methodologies and have been
engagement with clinical and patient developed from many years of delivering
stakeholders across the region. HEE also has strategic consulting assignments for global
established links with local, national and healthcare companies. These services will
international Medtech and Pharma industry. build upon those provided under the EAHSN
• Clinical Expertise Database with support on a case-by-case basis.
from the Cambridge HIEC and the
UK Intellectual Property Office, the
database will enable interested parties
to more easily engage with stakeholders
within the NHS who have registered
their interest in collaborating with
industry. To date we have over 350
clinicians signed up with an on-going
campaign to increase numbers further.
The web-based portal is due to be
launched in September 2012 - www.
clinical-insight.com.
• Patient Insights Database - currently
being developed by Health Enterprise
East to facilitate the process of device
developers recruiting patients for
inclusion in focus groups, interviews
and validation studies. The aim is to
develop a comprehensive database of
patients and carers who are managing
long-term conditions such as diabetes,
Asthma, COPD, MS and RA willing to
engage with device developers respond
to the increasing requirement for device
developers to engage with patients.
www.patient-insights.com.

LII | The Eastern Academic Health Science Network

Glossary

ABHI Association of British Healthcare Industries

ABPI Association of British Pharmaceutical Industries
AF Atrial Fibrillation
AHP Allied Health Professional
AHRC Arts and Humanities Research Council
AHSC Academic Health Science Centre
AHSN Academic Health Science Network
AHSS Academic Health Science System
ALS Action Learning Set
APPROACH Analysis and Perspectives of integrated working in Primary care Organisations
and Care Homes (Study)
BAE British Aerospace
BBSRC Biological and Biomedical Research Council
BGS British Geriatric Society
BRC Biomedical Research Centre
BSc Batchelor of Science
CAMH Childhood and Adolescent Mental Health
CBI Confederation of British Industry
CBT Cognitive Behavioural Therapy
CCG Clinical Commissioning Group
CEDAR Centre for Diet and Activity Research
CLAHRC Collaborations for Leadership in Applied Health Research and Care (Initiative)
CLAHRC CP Collaboration for Leadership in Applied Health Research and Care,
Cambridgeshire and Peterborough
CLRN Comprehensive Local Research Network
CNO Chief Nursing Officer (of the NIHR in context)
COPD Chronic Obstructive Pulmonary Disease
CPD Continuing Professional Development
CPFT Cambridgeshire and Peterborough NHS Foundation Trust
CQC Care Quality Commission
CQUIN Commissioning for Quality and Innovation
CRIPACC Centre for Research in Primary and Community Care
CRN Clinical Research Network
CSC Clinical Simulation Centre
CSMS Centre for Self Management Support
CSS Commissioning Support Service
CT Computed Tomography (Scan)
CTU Clinical Trial Unit
CUHFT Cambridge University Hospitals NHS Foundation Trust
CUHP Cambridge University Health Partners
CWG County Workforce Group
DClinPsy Doctorate in Clinical Psychology
DeNDRON Dementias and Neurodegenerative Diseases Research Network
DH Department of Health
DHRes Doctorate in Health Research
DipHE Diploma of Higher Education

The Eastern Academic Health Science Network | LIII

 DKA Diabetic Ketoacidosis
EAHSN Eastern Academic Health Science Network
EBI European Bioinformatics Institute (of EMBL)
EDC Engineering Design Centre
EMBL European Molecular Biology Laboratory
EoE East of England
EoECPH Eastern Region Collaborative Procurement Hub
EPIC Eastern Region Production Innovation Centre
EPOCH Evaluating Processes of Care and the Outcomes of Children in Hospital (Study)
ERPHO Eastern Region Public Health Observatory
ESD Early Supported Discharge
EVIDEM Evidence based Interventions in Dementia (Study)
FdD Dental Hygienist Diploma
GCSE General Certificate of School Education
GP General Practitioner
GRASP AF Guidance on Risk Assessment and Stroke Prevention for Atrial Fibrillation
GSK Glaxo SmithKlein
HEE Health Education England
HEE Health Enterprise East
HEFCE Higher Education Funding Council
HEI Higher Education Institution
HF Human Factors
HIEC Health Innovation and Education Cluster
HII High Impact Innovations (Initiative)
HPFT Hertfordshire Partnership NHS Foundation Trust
HSMC Hertfordshire Supply Management Confederation
IAPT Improving Access to Psychological Therapies (Initiative)
ICE Institute for Continuing Education
IFR Individual Funding Request
IFR Institute for Food Research (Norwich)
IoD Institute of Directors
IOFM Inter-Operative Fluid Management
IPH Institute of Public Health
iTAPP Innovation Technology Adoption Procurement Programme
JBS Judge Business School (Cambridge)
JIC John Innes Centre (Norwich)
KE Knowledge Exchange
KIT Knowledge and Intelligence Team
LEP Local Enterprise Partnership
LETB Local Educational Training Board
LTC Long Term Condition
MBA Masters of Business Administration
MClinRes Masters in Clinical Research
ME Myalgic Encephalopathy
MECC Making Every Contact Count (Initiative)
MERG Medical Education Research Group (Cambridge)
Mpharm Master of Pharmacy
MRC Medical Research Council

LIV | The Eastern Academic Health Science Network

MRCPsych Member of the Royal Society of Psychiatrists
MRI Magnetic Resonance Imaging
MSc Master of Science
MSD Former Merck Sharpe and Dohme Company
NADIA National Diabetes Inpatient Audit
NASA National Aeronautical and Space Adminstration
NCB National Commissioning Board
NCD Non-communicable Disease (defined by WHO)
NDIS National Diabetes Information Service
NED Non Executive Director
NHS National Health Service
NICE National Institute for Clinical Excellence
NIHR National Institute for Health Research
NRP Norwich Research Park
NSC School of Nursing Sciences
NSFT Norfolk and Suffolk NHS Foundation Trust
NTAC National Technology Adoption Centre
OCD Obsessive Compulsive Disorder
OSCE Objective Structured Clinical Evaluation
OT Occupational Therapy
PCRN Primary Care Research Network
PCT Primary Care Trust
PEF Practice Education Facilitator
PgC Post Graduate Certificate
PGCert Post Graduate Certificate
PgD Post Graduate Diploma
PGMC Post Graduate Medical Centre
PhD Doctor of Philosophy
PHE Public Health England
PHG Public Health Genomics Foundation
PPCI Primary Percutaneous Coronary Intervention
PPI Public and Patient Involvement
PPU Pharmacy Practice Unit
QOF Quality and Outcomes Framework
QUIPP Quality Innovation Productivity and Prevention
R&D Research and Development
RAID Rapid Assessment Investigation and Discharge
RAPPORT HSR Research with Patient and Public Involvement: a realist evaluation
(Study)
RAPSID Diabetes Peer Support Study
RCP Research Capacity Funding
RDS Research Design Service
REC Research Ethics Committee
RM&G Research Management and Governance
ROI Return on Investment
SBRI Small Business Research Initiative
SCN Strategic Clinical Network
SEPEA Social Epidemiology of Psychoses in East Anglia (Study)

The Eastern Academic Health Science Network | LV

 SHA Strategic Health Authority
SLA Service Level Agreement
SMS Self Management Support
SOP Standard Operating Procedure
T3 Translational Gap 3 - Translation to Practice
T4 Translational Gap 4 - Translation to Scale
TGAC The Genome Analysis Centre (Norwich)
THES Times Higher Education Supplement
TIA Transient Ischaemic Attack
TMAT Translational Medicines and Therapeutics
TRL Technology Readiness Level
UEA University of East Anglia
UH University of Hertfordshire
UKTI UK Trade and Industry
UNO University Bus for Everyone
UE University of Essex
UTI Urinary Tract Infection
VERT Virtual Environments for Radiotherapy Training
WHO World Health Organisation

LVI | The Eastern Academic Health Science Network

The Eastern Academic Health Science Network
 Contact us

+44 (0)1480 364148

Email: eahsn@cuhp.org.uk
LVIII | The Eastern Academic Health Science Network