2023: Our year, our progress
IGHI Annual Report 2023
A message from our Co-Directors at the Institute of Global Health Innovation.
Now in its 13th year, the Institute of Global Health Innovation (IGHI) continues to tackle the healthcare needs of the present and the future.
In 2023, through our convergence science approach that brings together, amongst others, clinicians, scientists, designers, engineers, policy makers, and public involvement specialists, we have been working collaboratively to address some of the biggest challenges facing healthcare systems worldwide.
From supporting global patient safety, reimagining healthcare design, educating future leaders, and optimising medical innovations, our work looks to champion high-quality healthcare for all.
Highlights from the past year include examining best practice public engagement in dementia research, cutting edge robotics, and supporting the delivery and restoration of health services in Ukraine.
But we are a global institute. In 2023, we turned our attention to two areas of increasing concern affecting people the world over. We established our Fleming Initiative, under the patronage of HRH the Prince of Wales, to keep populations worldwide safe for the next 100 years from the threat of antimicrobial resistance. We also catalysed the international research community across seven global development regions, working at the intersection of climate change and mental health, as part of our Connecting Climate Minds project. You can read more about these and our other activities in the report which follows.
To lead such a range of projects, engaging experts in our own team and around the world, is a pleasure. Through joint working we can continue to transform health for all through evidence-based innovation. It is the ethos of the IGHI.
Professor the Lord Ara Darzi
Professor Sir David Nabarro
Co-Directors, Institute of Global Health Innovation
Our 2023 highlights
Photo by Raimond Klavins on Unsplash
Photo by Raimond Klavins on Unsplash
The Fleming Initiative
Widespread misuse and overuse of antibiotics and other antimicrobials, from the food industry to the doctor’s surgery and the hospital bedside, has led to the global spread of drug-resistant microbes known as Antimicrobial Resistance (AMR).
If not mitigated in a meaningful and sustained fashion, drug-resistant infections have the potential to become a global humanitarian crisis, responsible for at least 10 million lives lost yearly by 2050. Already, there are almost 5 million deaths associated with bacterial resistance a year.
Without action we are heading for a post-antibiotic era, where a common infection or routine surgical procedure could become life threatening. The Fleming Initiative will drive a global movement to tackle antimicrobial resistance.
Climate Cares
In 2023, we launched the Climate Cares Centre, which builds on four years of research on the mental health impacts of climate change and focuses on mental health and wellbeing in the climate emergency.
It is the first Centre with a focus specifically on climate, mental health and wellbeing.
Climate Cares has led the global, Wellcome-funded project Connecting Climate Minds, to catalyse a global research community at the intersection of climate change and mental health.
The project is grounded in the needs of those with lived experience and brings together expertise from research, policy, design, and lived experiences from across the globe.
Photo by Tina Hartung on Unsplash
Photo by Tina Hartung on Unsplash
Ukraine Health Summit
The Institute of Global Health Innovation hosted a Ukraine Health Summit at Imperial College London, with support from the British Red Cross, to further efforts in supporting the delivery and restoration of health services in Ukraine, during and beyond the current armed conflict.
Bringing together speakers including the former Health Minister in Ukraine and the President of the Ukrainian Medical Students' Association, the event enabled contributions from various people with wide ranging expertise.
Through discussions on the day, participants identified how to support areas of transformation for health care.
Advancements in endoscopic robotics
ROBOGAST is a five-year EPSRC-funded programme (£5 million) within the Hamlyn Centre, that will create the next-generation, self-propelled soft robotic endoscopes designed for the diagnosis and minimally invasive treatment of GI tract conditions.
The research will support with achieving a 75% early cancer detection rate by 2028.
Patient and Public Involvement and Engagement
Helix leads the human centred design and Patient and Public Involvement and Engagement (PPIE) workstreams in the Care Research & Technology Centre at Imperial.
They developed a strategy for how to diversify the range of voices and increase the input of people affected by dementia.
Our 2023 impact in themes
IGHI works in the following themes:
Prevention and early detection
By tackling the risk factors of disease, diagnosing and intervening early, we can achieve a healthier world.
Healthcare delivery
We are world leaders in using technology, behavioural interventions and service redesign to improve care.
Health equity
We strive to overcome inequity in healthcare through understanding the needs of under-served populations, and implementing interventions and technology for everyone, globally.
Safety and quality
As a national and global centre of excellence for patient safety, we focus on improving quality and reducing healthcare-related harm.
Emerging global challenges
We anticipate and tackle arising global health issues such as antimicrobial resistance and the impact of climate change on mental health.
Prevention and early detection
Change Lab – Central London Healthcare Child Health Checks
The Change Lab team supported Central London Healthcare (CLH) to design an intervention to encourage parents of children aged 3–13 years living in Westminster to attend for a NHS Child Health Check and to invite them to the ELSA study – screening for Type 1 diabetes.
The Change Lab team led a co-design session with CLH and also consulted some parents at IGHI, to design the text message intervention(s), which NIHR Clinical Research Network North West London (NIHR CRN NWL) have announced as the most successful recruitment in Primary Care in the country. CLH have consented 433 children into this study and to date the majority of the recruitment for Primary Care is from CLH GP Practices. Current data shows only 97 recruits elsewhere nationally.
David Mummery, Primary Care Specialty Lead for CRN NWL announced this news and added:
This is a tremendous achievement... and this success has brought much attention from other CRNs nationally, with a view to how they can increase uptake in their respective areas. We would like to extend our gratitude to your ongoing contribution to research in NWL."
The team: Clare McCrudden, Kate Grailey, Sarah Huf
InSleep46 (with UK DRI Care Research & Technology)
The Helix team has supported the enrolment of a cohort from the Insight46 birth cohort (a group of people all born in 1946 and studied throughout their lives) into a NIHR Invention for Innovation (i4i) study using sleep sensors to identify risks for dementia in sleep patterns.
Helix created the process to allow 250 participants to self-install the sleep sensors, which will be in place for two years, and are working with researchers at Newcastle University on a public consultation to determine how this technology could fit into clinical practice.
The team: Matthew Harrison, Sophie Horrocks
Healthy Ageing
Helix kicked off a new multiple year project in partnership with a US healthcare innovation company, Optum Labs, looking at how we can use technology to support people to remain healthy as they age, and prevent or reverse frailty. The programme goal is to help older adults live welI and independently for longer through supporting them with healthy behaviours, save cost to healthcare systems, and potentially also to discover new “digital biomarkers” that can spot signs of frailty, for example using smartwatch data or home-based sensors that monitor daily routine.
In 2023, we completed our initial public involvement work with over 30 people, which has given us a view of which types of technology and sensors are acceptable to adults over the age of 65. We also assembled a Clinical Reference Group with specialists in primary care, geriatrics, digital health and behavioural science to make the most of the clinical networks we have access to at Imperial, and an Advisory Group of eight older adults to help steer the project. In 2024, we will be piloting the sensor kits in people’s homes and then co-designing, developing and iterating a personalised healthy ageing programme with pre-frail older adults aged 65 and above.
The team: Ara Darzi, Leila Shepherd, Alex Dallman-Porter, Matt Harrison, Gianpaolo Fusari, Brian Quan, Damion Lambert, Tricia Tay, Kate Grailey, Fiona O’Driscoll, Jonathan Gregory, Andrew Watt
Healthcare delivery
Future of Telemedicine
A report published on 17 January 2023 titled The COVID-19 Pandemic and the Future of Telemedicine, commissioned by the Health Committee of the Organisation for Economic Co-operation and Development (OECD), aims to assess the impact of the COVID-19 pandemic on the use of telemedicine in OECD countries. Researchers at IGHI captured high quality evidence in a literature review of the use of telemedicine in OECD countries for the report. They found that peer-reviewed articles on telemedicine were scarce prior to the COVID-19 pandemic.
Niki O’Brien joined a panel discussion with the Commonwealth Fund and the Organisation for Economic Co-operation and Development (OECD) to discuss the report's findings in the webinar “A New Era in Telemedicine: The Opportunities, Challenges and What Comes Next”.
The team: Niki O'Brien, Saira Ghafur
As telemedicine has boomed, it is crucial to understand the use and impact of telemedicine as a tool for the delivery of patient care. This mode of healthcare delivery will continue to expand and evolve in OECD countries and beyond, so it is critical that services are developed with quality, safety and equity in mind.”
Brazilian Delegation exchanges healthcare learning with IGHI
A delegation of Brazilians MPs and health regulators visited the Hamlyn Centre to learn about the work of the Institute of Global Health Innovation.
Professor Ferdinando Rodriguez y Baena, Co-Director of Hamlyn Centre, welcomed the delegation to the Hamlyn Centre and, along with Dr Ana Cruz Ruiz, Project Manager of the Hamlyn Centre, demonstrated a number of innovations in robotic surgery.
Representatives from other parts of the Institute of Global Health Innovation then shared their projects with the delegation. This included Dr Saira Ghafur’s work on the ECHO Framework for Cyber-security, which is included as a World Bank cybersecurity in health implementation brief, and Clare McCrudden showcased the OnTrack project for stroke rehabilitation.
The team: Ana Cruz Ruiz, Saira Ghafur, Peter Howitt, Clare McCrudden, Ferdinando Rodriguez y Baena
IGHI’s Behavioural Research in Health Group present at European Health Psychology Society Conference
IGHI’s Behavioural Research in Health Group presented at the European Health Psychology Society annual conference in Bremen, Germany in September.
They presented on a Randomised Control Trial of a video intervention to increase breast screening uptake, a systematic review of determinants of green behaviours in operating theatres, and a systematic review of financial incentive interventions for improving asthma management.
The team: Gaby Judah, Jasmine Hine, Aws Almukhtar
MedTechOne
MedTechONE is a framework designed to accelerate the translation of research technologies in musculoskeletal health and surgical innovation by providing comprehensive support to early career researchers. This support includes mentoring, targeted training, funding opportunities, and access to local and national clinical networks.
This year's activities comprised a launch event featuring the MedTechOne accelerator-funded projects, an overview of MedTech Fellowships/DT Prime Joint Calls, workshops aimed at assisting applicants in proof-of-concept calls, and networking opportunities for engineers and clinicians.
The team: Ana Cruz Ruiz, Ferdinando Rodriguez y Baena, Daniel Elson
OnTrack
OnTrack Rehab UPBEAT Trial begins recruiting patients
The aim of UPBEAT (UPper limB rEhabilitation After sTroke) trial is to undertake a randomised feasibility trial comparing the OnTrack Rehab intervention plus standard care to standard care alone within up to 5 NHS stroke rehabilitation services in hospital and community settings. A sample of 42 participants recruited from across all sites will be involved in the trial for up to 16 weeks.
The primary objective of the trial is to assess the feasibility to conduct a definitive trial of OnTrack as an adjunct to usual care for upper arm rehabilitation. Feasibility will be assessed in terms of:
- Trial Feasibility: including recruitment, retention and assessment of outcome measures
- Intervention Feasibility: including intervention fidelity, and acceptability to both patients and therapists
Secondary objectives:
- Gather preliminary evidence on the clinical effectiveness of OnTrack plus standard rehab care versus standard rehab care alone in patients with arm weakness post stroke.
- To estimate the cost and effects of OnTrack plus standard of care versus standard of care alone.
OnTrack‘s Trial Management group have been meeting to plan and coordinate the trial over the last 6 months in collaboration with the Clinical Trials Unit at Cardiff University. Most recently, the study sites have recruited the first trial patients and therapists have been trained in how to provide OnTrack Rehab to these patients.
OnTrack Rehab’s PPIE work leading to two promising features: Quality of Movement and Shared Motivation
Alongside the UPBEAT trial, OnTrack continues to work closely with its PPIE group (stroke survivors and carer) to co-design new features with the latest as focusing on Quality of Movement and Shared Motivation. At the Great Exhibition Road Festival, the Quality of Movement feature came to life as those over 16 were invited to participate in the GAMe (Gross Arm Motion Sensing) study. Participants’ arm, hand and finger movement was recorded through a smart watch, to improve an algorithm that will ultimately be used for arm rehabilitation for stroke survivors. With thanks to the hundreds of visitors who participated, we collected data that will tell us more about what movements the smart watch can and can’t collect.
For the Shared Motivation feature, the OnTrack Rehab team have hosted a series of workshops looking at the stroke survivors’ support network and how those within it can support with daily rehabilitation progress. The latest co-design workshop took place with co-facilitation support from Tori Simpson, a Global Innovation Design student at the Royal College of Art and Imperial College London who is also working in this area.
The next steps involve integrating these features into OnTrack’s rehabilitation platform.
The team: Brian Quan, Damion Lambert, Clare McCrudden, Ahmed Latif, Leila Shepherd, Gianpaolo Fusari, Shuang Wu, Tori Simpson
Hand hygiene
Change Lab collaborated with the Medical Director’s Office at ICHT to evaluate hand hygiene compliance at the Trust, prompted by an increase in hospital-acquired infections.
The team worked closely with Infection Control teams at ICHT to evaluate existing practice with a particular focus on two moments from the World Health Organisation's (WHO) five moments for hand hygiene – Moments 1 and 5. The team conducted 18 hours of observations on three target wards at the St Mary’s site, which demonstrated an average compliance of 42% with both moments.
Then, the team led a series of co-design workshops with behavioural insights experts, frontline staff and infection control staff. These were informed by data from the observations, a thorough literature review and background knowledge of ICHT staff and subject matter experts. These co-design workshops generated over 150 ideas of potential ways to improve hand hygiene compliance. These were refined to 11 shortlisted ideas by the Change Lab, and the final intervention was co-designed by the team. The team created and implemented three stickers that focused on nudging behaviour at three points where it was observed that Moment 1 failed during ward observations.
These three interventions were:
- A reminder at the edge of the patient’s bed to clean hands before care.
- A reminder on the glove boxes that glove use isn’t good for the environment, and that alternatives should be used where possible.
- A reminder on the computers on wheels to clean your hands each time you move back and forth between the computer and a patient.
Once implemented, the team conducted a second 18 hours of observation to evaluate our intervention's impact. It was found that a statistically significant increase of 11% (p=0.033), giving an overall compliance of 53% for the study period. Different increases were seen across the three wards, with improvements of 16.5% (p=0.06), 2% (p=0.698) and 9% (p=0.243). When analysed by moment, we saw an increase of 15% compliance with Moment 1 (p=0.005) and 11% for Moment 5 (p=0.07).
The research team is currently scaling the three nudges across more hospital sites and looking at ways to contribute to the NHS Trust’s Green Plan.
The team: Clare McCrudden, Kate Grailey, Sarah Huf, Fiona O’Driscoll, Alice Gregory
Hamlyn Symposium
The annual and much-anticipated Hamlyn Symposium on Medical Robotics took place 26–29 June 2023. A highlight of this year’s event was the Industry Forum, featuring a panel session by leading experts of medical robotics including Medtronic, Cambridge Consultants, and the CIO from Imperial College Health, to discuss the challenges and potential of digital surgery.
End of life user research and co-design
Helix worked with Imperial College Healthcare NHS Trust (ICHT) to improve the experience of people who spend their last days or hours of life in hospital, as well as the experience of those people important to them.
The project, funded by the Imperial Health Charity, sought to address the gap between the Trust’s desire for compassionate and personalised care and the inconsistent experiences encountered by people receiving end-of-life care in Imperial College hospitals. Helix supported ICHT on two phases of work. In the first phase, we interviewed 20 service users from a diverse range of backgrounds to understand needs and expectations of adult inpatients and the people important to them. This resulted in the identification of seven potential opportunity areas.
The second phase of work addressed the opportunity to ensure that people supporting the dying person have the information they need, and feel empowered to do everything they reasonably hope to do. This resulted in a new patient information booklet and improved online information which is easier to find. The content was co-designed by individuals with lived experience, incorporating information they wished had been available to them. In addition, we supported ICHT in designing a method to gather ongoing feedback on this sensitive topic. Several of the other opportunity areas identified by our project are also being taken forward by ICHT in other projects.
The team: Alex Dallman-Porter, Alice Gregory, Jodie Chan, Charley Pothecary (external Associate), Leila Shepherd, Ivor Williams
Delegation visits from Singapore
On 17 May, at the request of the NHS Consortium for Global Health, we hosted an educational session for a delegation from Singapore’s Ministry of Health. Presentations were held at the Digital Collaboration Space and included an overview of IGHI and the Helix Centre, a presentation on Imperial College Healthcare NHS Trusts’ Secure Data Environment, a discussion on national level infrastructure for AI, and a demonstration of a patient safety dashboard.
The team: Niki O’Brien, Peter Howitt, Erik Mayer, Leila Shepherd, Joe Zhang, Melanie Leis, Roberto Fernández Crespo
On 10 October, we hosted a visit for a delegation from the SingHealth Academic Department of Surgery, in collaboration with Imperial College Healthcare NHS Trust. Presentations included: Fleming Initiative; Patient Safety Research Collaboration; Helix Centre; Centre for Health Policy; and Digital and AI.
The team: Professor Bryony Dean Franklin, Melanie Leis, Peter Howitt, Leila Shepherd, Hutan Ashrafian, Eleni Daniels
Healthcare Delivery Research Highlights
Detecting how polarised light interacts with tissue
Research from the Hamlyn Centre and UCL's Wellcome/EPSRC Centre for Interventional and Surgical Sciences explores a new technique called surgical polaremic endoscopy that can detect how polarised light interacts with tissue, allowing for real-time detection of laryngeal lesions.
The research shows that lesions can be better detected by taking advantage of differences in the light-polarisation properties of cancer and healthy tissues.
National COVID-19 home blood oxygen monitoring programme delivered fairly
Evaluation of remote pulse oximetry monitoring programme shows that the patients who used the service were more likely to be non-white, overweight and from more deprived areas.
The research from Imperial College London shows that a national COVID-19 remote pulse oximetry monitoring programme, known as CO@h, was preferentially used by patients with a known increased clinical risk.
Barcode scanning for medication administration
New research explores barriers and benefits of using barcode scanning for medication administration.
The mixed methods study identifies barriers and facilitators to barcode medication administration (BCMA) use, from the view of patients and nursing staff, highlighting benefits for patient safety.
The research, published in BMC Nursing, explores barriers and facilitators of using barcode scanning for medication administration – which can help to ensure correct medications are administered.
Primary care practitioners' priorities for improving cancer diagnosis timelines
Diagnosing cancer early is crucial for improving survival rates.
Primary care practitioners' knowledge of their own patient populations and health systems could help improve the planning of more effective approaches to earlier cancer recognition and referral.
This research explores factors that can improve timeliness of cancer diagnosis in primary care across Europe.
Mapping the flow of healthcare data
For the first time, a comprehensive mapping of all electronic data flows, infrastructure and assets has been undertaken, and shows a complex landscape with tens of thousands of data transactions.
Mapping data flows has identified how data is shared between healthcare providers and users, and uncovers shortfalls in transparency, best practices for safe data access, and lack of value return to the NHS.
Patient perceptions of digital health services
We looked at patient perceptions of the benefits and risks of digital health services during COVID-19. The research paper was based on a survey of almost 10,000 patients in North West London – a first review of its kind. In addition to known risks such as data security and inequity in access, our findings illuminate some less studied concerns, including:
- Perceptions of compromised clinical safety
- Negative impacts on the patient-clinician relationship
- Difficulties in interpreting health information provided through electronic health records and mHealth apps
Primary to secondary care data-sharing
In the NHS, the ability to share primary care data with secondary care clinicians is a focus of continued digital investment. In this study, researchers report the evolution of interoperable technology... and test association of primary to secondary care data-sharing capabilities with clinical care quality indicators across all acute secondary care providers.
This is the first evaluation of clinical impacts resulting from a decade of shared care records development in the NHS.
Our research suggests that primary to secondary care data-sharing improves A&E pathway efficiency and patient experience of emergency care.
What drove preventative social behaviours during COVID-19 in the United Kingdom?
Researchers explored the relationship between preventative behaviours during the COVID-19 pandemic of people in the UK, and the reported number of COVID-19 deaths, the stringency of government’s policies, and the reported confidence in the handling of the pandemic by the public.
Overall, our analysis suggests that, out of these three metrics, the number of reported COVID-19 deaths is the one that made people adopt more preventative behaviours, with a higher number of deaths leading to more preventative behaviours, followed by the confidence in government handling of the COVID-19 pandemic, and finally the stringency of the policies.
Engaging the public in our work
Great Exhibition Road Festival
The 2023 Great Exhibition Road festival featured four of the Institute of Global Health Innovation's streams of work.
Our Helix Centre offered festival-goers the chance to try their hand at being a designer – reviewing real designs from healthcare or everyday life – and created a digital interactive experience where participants were able to engage in an arm and hand rehabilitation experience by creating beautiful digital graphics through their arm movements. Adult participants were also able to take part in a data collection study that yielded over 2,000 data points that will feed into the creation of new machine learning/artificial intelligence algorithms for upper-limb rehabilitation.
Our Hamlyn Centre gave people the chance to design a robot. Climate Cares displayed an exhibition of photos showing climate emotions to encourage visitors to think about how the climate crisis makes them feel, and we had screenings of the award-winning short film Nexus, about the mental health impacts of COVID-19 and the power of connection, based on our CCOPEY study.
Stemettes
Stemettes is an organisation created to inspire and support young girls, women and non-binary people who want to work in careers at the intersection of Science, Technology, Engineering, Arts and Maths. In 2023, Stemettes partnered with Imperial’s Global Challenge Institutes – including IGHI and its centres – to host a science festival on 26 July to celebrate turning 10 this year.
The Team: Sophie Horrocks, Emily Medcalf, Victoria Murphy, Madeline Tatum, Martina Trantalovska, Jack Cooper
Health equity
Friends of Care Research & Technology
Helix Centre leads the human centred design and Patient and Public Involvement and Engagement (PPIE) workstreams in the Care Research & Technology centre at Imperial. In 2023, they launched a new strategy to diversify the range of voices and increase the input of people affected by dementia into the work of the centre. They created a community of interested public members and professionals that can be drawn on for a wide range of involvement and engagement activities. The community was launched at an event on 11 October 2023 in White City, attended by 60 members of the public, that included community group stands, research presentations and facilitated discussions.
The team: Sophie Horrocks, Matthew Harrison
NHS Data: Maximising its impact for all
In 2023, we published a white paper recommending how our health data policy can create the most clinical, societal and financial value.
The white paper, ‘NHS Data: Maximising its impact for all’, launched on 20 April, identifies strategic and technical recommendations to move towards developing a health data policy ecosystem that is designed so that value, either clinical, societal or financial, is more readily extracted from patient data.
This new white paper adds to a previous report produced as a part of an ongoing project by the Institute of Global Health Innovation (IGHI), ‘NHS Data: Maximising its impact on the health and wealth of the UK’, providing a post-COVID update on the UK’s health policy data landscape, which highlighted how securely accessed datasets could rapidly translate to practical treatments that have helped millions of people worldwide.
The team: Saira Ghafur, Niki O'Brien, Peter Howitt, Annabelle Painter, James O'Shaughnessy, Ara Darzi
Improving equity in outpatients
Helix Centre has been working with Imperial College Healthcare NHS Trust (ICHT) on a project to address inequities in healthcare access. This is based on ICHT data showing that people from minority ethnic groups or living in deprived areas are up to 50% more likely to not attend their first outpatient appointment, a vital step in their care journey. Our project aims to support patient from these groups to attend their appointments, improving health outcomes in the future.
In 2023, we interviewed patients and staff to understand what the barriers to appointment attendance were. Following this, we conducted a series of co-design workshops with 23 local community members to come up with and develop ideas addressing these barriers.
We are running a clinical trial in 2024 to test several behavioural science informed messages and web pages developed with staff and community members. We want to understand whether these additional supports help people at risk of inequity based on their ethnicity or where they live to attend their appointment.
The team: Fiona O'Driscoll, Alice Gregory, Kate Grailey, Anna Lawrence-Jones, Leila Shepherd, Clare McCrudden, Roberto Fernandez Crespo, Sarah Huf
Ukraine Health Summit
On 25 April 2023, IGHI and the British Red Cross co-hosted a Ukraine Health Summit to further efforts in supporting the delivery and restoration of health services in Ukraine, during and beyond the current conflict.
The team: Ahmed Ezzat, Peter Howitt, Melanie Leis, Victoria Murphy, Niki O'Brien, Alexandra Shaw, Francis Ugwu
Digital health in Sub-Saharan Africa
A report by the Centre for Health Policy, “Digital health in primary health care: Current use and future opportunities in the Sub-Saharan African region” (pdf), explores where digital technologies are being widely used across Sub-Saharan Africa to deliver health services and address long-standing health system challenges. We launched the report with a webinar.
The report, produced in collaboration with Imperial's Global Digital Health Unit and the African Forum for Primary Health Care (AfroPHC), features key case examples from experts across the region to frame future opportunities, challenges and threats that must be addressed.
The team: Niki O'Brien, Saira Ghafur, Melanie Leis, Ana Luisa Neves, Ara Darzi
Networked Data Lab
The Networked Data Lab (NDL), funded by the Health Foundation, brings together analytical teams from across the country to use linked data captured at a local level to help decision makers better understand their communities’ needs.
IGHI is part of the North West London NDL, together with Imperial College Health Partners and the North West London Integrated Care System. As the North West London NDL, we use the Discover dataset to answer questions from the local community. This dataset contains deidentified data from over 2.7 million people in North West London, linking information from primary, secondary, mental health, community, and social care.
In 2022–23, we used the Discover dataset to answer key questions on two topics:
- Understanding unpaid carers and their access to support
- Utilisation and effectiveness of step-down and reablement care (ongoing)
Throughout this project, we have worked with public members with relevant lived experience to prioritise areas for research, come up with questions to ask of the data, make sense of the results, and share those results with local decision makers.
Our findings highlight the need to identify unpaid carers in GP and local authority data so that policymakers can understand need in their area and ensure carers receive the support they deserve.
These findings were also presented at the ADR UK Conference 2023 as part of their theme on Public engagement and involvement in population data research.
The team: Jodie Chan, Anna Lawrence-Jones, Roberto Fernandez-Crespo, Melanie Leis, Brittany Rae
Big Data and Analytical Unit
The Big Data and Analytical Unit (BDAU) collaborates with a large network of researchers from IGHI and beyond through its certified research environment known as the BDAU SE. In 2023, BDAU successfully completed the ISO 27001 recertification with no nonconformities. This resulted in its ISO 27001 certificate to be renewed for further three years until 2026, subject to successful delivery of annual surveillance audits.
In the last year, BDAU supported 66 users, including 13 researchers from IGHI and 53 researchers from other departments from across the College. A total of 135 research projects were facilitated within the BDAU SE. These projects utilised data from more than 25 different sources such as NHS England, Clinical Practice Research Datalink (CPRD), Imperial College Healthcare NHS Trust (ICHT), National Vascular Registry and surveys.
The team: Neil Clifford, Mahsa Mazidi, Davina Tijani
Safety and quality
Global State of Patient Safety 2023
Keeping patients safe from avoidable harm should be central to all health systems, and urgent action is needed. The new report, “Global State of Patient Safety 2023” provides valuable insight into the current state of patient safety around the world, through analysis of publicly available data from the last two decades.
Produced by IGHI and commissioned by the charity Patient Safety Watch, the Patient Safety Data Dashboard presents – for the first time – a consolidated view of 89 publicly available global patient safety indicators. A subset of these was used to create a novel patient safety ranking of OECD countries in which Norway comes at the top. The UK ranks 21st out of 38 countries, very close to the average.
At a launch at the House of Lords, attended by the Chancellor of the Exchequer and the Secretary of State for Health and Social Care, passionate campaigners, experts in healthcare and members of the global patient safety community came together to call for improved patient safety.
The report authors urge healthcare professionals, policymakers, and stakeholders to explore the full report and data dashboard for in-depth insights into global patient safety.
The team: Roberto Fernández Crespo, Gianluca Fontana, Peter Howitt, John Illingworth, Melanie Leis, Emily Medcalf, Victoria Murphy, Brittany Rae, Alexandra Shaw
Patient Safety Global Ministerial Summit
On 23 and 24 February 2023, 80 official delegations, 28 ministers, and leaders and experts on patient safety attended the 5th Global Ministerial Summit on Patient Safety in Montreux, Switzerland.
Imperial College London’s patient safety experts joined the event which called for a focus on strategies which enable the uptake of evidence-based practices, known as implementation science, to improve the safety of care.
Alexandra Shaw, Mike Durkin and Peter Howitt represented IGHI.
Their response to the discussions at the Summit, published as a Letter in The Lancet, draws attention to the opportunity to use learnings from the COVID-19 pandemic to enable health systems to move from plans to action for safer care.
HSJ congress
Our team attended the HSJ Patient Safety Congress in Manchester, where we spoke about our work in collaboration with Patient Safety Watch (PSW).
Alexandra Shaw (IGHI), John Illingworth (IGHI Consultant) and James Titcombe (PSW) spoke about our National State of Patient Safety Report 2022 and our ongoing global patient safety work, highlighting the importance of understanding the data and sharing international examples of best practice.
To enhance patient safety, we must first recognise that progress is impossible without measurement. Our Global State of Patient Safety report underscores the urgent need to establish a robust global framework for collecting comprehensive patient safety data, addressing existing data gaps, and implementing meaningful indicators."
WHO Global Patient Safety Conference
Melanie Leis and Alex Shaw represented IGHI at the WHO Global Conference "Engaging patients for patient safety" for World Patient Safety Day, where Melanie moderated a breakout session on the importance of family involvement for patient safety.
Patient Safety Roundtable
In November 2023, IGHI together with Patient Safety Watch and the Clinical Human Factors Group hosted the first National State of Patient Safety Roundtable to reflect on the progress made against the recommendations listed in our National State of Patient Safety 2022 report. With leaders from NHS England, the Parliamentary and Health Service Ombudsman, NHS Resolution, the office of the Patient Safety Commissioner, the General Medical Council, the Nursing and Midwifery Council, the Health Services Safety Investigations Body, Action Against Medical Accidents and Morgan Human Systems Ltd, six key themes emerged:
- Theme 1: A nuanced approach to data sharing is necessary to ensure that decision-makers have access to the right data at the right time.
- Theme 2: There has to be a cultural shift from focusing on patient safety incidents to understanding patient safety across the continuum of care.
- Theme 3: Change happens when organisations have aligned priorities.
- Theme 4: Determining those priorities is key – do we spend too much effort on issues with devastating outcomes that affect low numbers of people vis à vis issues of lower severity that affect a larger population?
- Theme 5: A long-term workforce plan for social care must be prioritised.
- Theme 6: The workforce matters for safety and safety matters for the workforce. A fundamental part of improving the safety of patients is addressing the safety and wellbeing of staff, including tackling racism.
The team: Melanie Leis, Peter Howitt
World Patient Safety Day
Our 2023 World Patients Safety Day event, on the theme of engaging patients for patient safety, was co-designed with patient representatives from our NIHR North West London Patient Safety Research Collaboration (PSRC) Research Partners Group & Imperial College Healthcare NHS Trust's Patient Safety Partners.
The event had more than 500 sign-ups. Expertly chaired by Professor Bryony Dean-Franklin, the event started with keynote speeches from Professor Darzi, Dr Henrietta Hughes (England’s Patient Safety Commissioner) and Rosie Bartel (US patient advocate) emphasising the importance of hearing patient’s voices. This was followed by a panel session on how clinicians, patients and carers can work together to support patients and their families to feel safe and engage with their care. The panel included Asmahan Al Nidawi, a community champion from North West London and Patient Safety Partner, who spoke about how communities from under-presented groups can be supported to have their voices heard.
The team: Eleni Daniels, Anna Lawrence-Jones, Emily Medcalf, Brittany Rae
WHO Global Patient Safety Collaborative
As the academic partners of the WHO Global Patient Safety Collaborative (GPSC), IGHI works closely with the WHO Patient Safety Flagship team to deliver research outputs, education and training materials, and capacity building activities for the four GPSC countries (India, Kenya, Mongolia and Pakistan) and the broader global patient safety community.
The team has supported the planning and launch of the Patient Safety Education and Training (PSET) Network, of which IGHI will be co-leads in its first iteration. Mike Durkin chaired two GPSC webinars on leadership for patient safety (September 2023) and systems thinking for patient safety (November 2023). Professor Bryony Dean Franklin travelled to India for a multi-site visit focused on medication safety (November–December 2023).
The team has worked on developing curriculum guides for Medication Safety and Patient Safety Essentials. The team also conducted global research on priorities for patient safety research, the findings of which have been translated into an academic paper and a WHO publication (all currently with WHO pending final approvals).
The team: Alexandra Shaw, Mike Durkin, Bryony Dean Franklin, Melanie Leis, John Illingworth, Ada Humphrey, Tetiana Lunova, Shahd Abdelaziz, Brittany Rae
Statins – NIHR Research for Patient Benefit
We were pleased to be awarded an NIHR Research for Patient Benefit grant for "Promoting STatin Adherence with a Tailored INtervention (STATIN): intervention design and feasibility testing".
The team will be working closely with a public steering group throughout the project, to shape the interviews to investigate determinants of adherence to statin medication and to plan co-design workshops. A diverse group of people who have been prescribed statins will attend the workshops and be involved in co-designing an SMS intervention to promote adherence, tailored to individual patient needs.
The team: Gaby Judah, Javiera Rosenberg, Anna Lawrence-Jones
Emerging global challenges
Climate Cares Centre launch
In 2023, we launched the Climate Cares Centre, which builds on four years of research at the nexus of climate change and mental health, and focuses on mental health and wellbeing in the climate emergency. Climate Cares is the sixth of IGHI's Centres of Excellence. It is the first Centre to exist globally with a focus specifically on climate, mental health and wellbeing.
Watch the short video introducing the new Climate Cares Centre:
The team: Emma Lawrance, Nienke Meinsma, Jessica Newberry Le Vay, Omnia el Omrani, Neil Jennings, Peter Howitt, Rhianna Thompson, Victoria Murphy, David Nabarro, Gianluca Fontana, Mala Rao, and global partners and affiliates
The Fleming Initiative
Widespread misuse and overuse of antibiotics and other antimicrobials, from the food industry to the doctor’s surgery and the hospital bedside, has led to the global spread of drug-resistant microbes known as Antimicrobial Resistance (AMR).
If not mitigated in a meaningful and sustained fashion, drug-resistant infections have the potential to become a global humanitarian crisis, responsible for at least 10 million lives lost yearly by 2050. Already, there are almost 5 million deaths associated with bacterial resistance a year.
Without action we are heading for a post-antibiotic era, where a common infection or routine surgical procedure could become life threatening. The Fleming Initiative will drive a global movement to tackle antimicrobial resistance.
Patronage announcement
In July 2023, HRH Prince William, Prince of Wales, was announced as the patron of the appeal to build the Fleming Centre.
The team: Ara Darzi, Rachel Davies, Eleanor Vale, Kate Grailey, Peter Howitt, Amish Acharya, Simon Dryden, Jack Cooper, Anna Lawrence-Jones
Connecting Climate Minds
Connecting Climate Minds is an ambitious Wellcome-funded global project launched publicly in April 2023. The team has worked with experts across disciplines, sectors, nations and lived experiences to better understand the mental health needs of communities around the world affected by climate change, and how aligned research and action on climate threats can support a safer climate future where no-one is held back by mental health challenges.
The results of over 20 in-person and virtual dialogues with hundreds of people from more than 80 countries, are summarised in Research and Action Agendas, Lived Experience stories, Case Studies and Toolkits on the Global Online Hub.
On 18 April 2023, Connecting Climate Minds launched with an online, interactive webinar attended by over 400 people.
Watch the webinar:
The team: Nienke Meinsma, Emma Lawrance, Jessica Newberry Le Vay, Omnia El Omrani, Mala Rao, Neil Jennings, Victoria Murphy, Peter Howitt, David Nabarro, Gianluca Fontana
COP28
This year’s UN Climate Change Conference of Parties (COP28), hosted by the United Arab Emirates to discuss progress on Climate Action, included the first ever health day at COP. At the dedicated Health Day, more than 140 countries made a historic commitment to the UAE Declaration on Climate and Health, and one billion USD in finance commitments were pledged for climate and health. Further, mental health and psychological wellbeing were integrated in the first section of the Climate and Health Declaration on common objectives.
Read more in our news piece: "Why mental health is front of mind at this year's COP"
Climate Mental Health Research
Rising temperatures linked to poorer mental health
Research from our Climate Cares team, published in the Lancet Planetary Health, suggests that increased ambient temperature, increased temperature variability (temperature relative to a comparison temperature) and heatwaves, all due to increase under climate change, may be associated with an increase in hospital attendance or admission for mental health disorders, poorer non-clinical mental health and wellbeing in the community, as well as an increase in suicides.
The team: Emma Lawrance, Rhiannon Thompson
Climate distress related to anxiety and action in young people
Our Climate Cares team, with colleagues at King's College London and the University of Queensland, carried out a study to understand the psycho-social impacts of climate crisis on young people in the UK. The study found that distress over climate change is related to many difficult emotions in young people – even in the absence of direct climate-related experience. It can, though, also motivate them to take positive climate actions.
The team: Emma Lawrance, Neil Jennings
Wellbeing support
Read the Climate Cares team's blog post on the importance of wellbeing support to sustain and support people who work in climate careers.
Tackling global health challenges
On 8 March, International Women's Day, we welcomed Imperial President Professor Hugh Brady to IGHI to hear about our programmes of work, pictured here with some of the women from IGHI who tackle global health challenges.
Educating future leaders
Our education and training programmes cut across our themes
Digital Maternity Leaders
The benefits of the Foundation and Postgraduate Certificate for Digital MWs is only now starting to be realised and hope these opportunities continue for Digital MWs across the country.
Since she has undertaken the Digital MWS Foundation course I have seen a complete transformation: she is a clear and confident voice, speaking as a subject matter expert and is now seeing the bigger strategic overview of digital transformation. We had a really sparking conversation, with her excited about ‘digital’, reflecting on projects, quoting service user engagement and showing real insight to her own personal journey as well as the digital programme of work. I am really excited to see her journey progress as a digital midwife and see the impact she can make to maternity services. I have encouraged her to now sign up for the PG Cert.”
After a 9-month journey, in June 2023 our first cohort of PG Cert in Digital Health Leadership successfully completed their programme. We hope our students will serve as digital changemakers in their NHS Trusts to make an impact on maternity services.
Funding for the Julia Anderson Training Programme
The Julia Anderson Training Programme received £2,000 from the Equality, Diversity and Inclusion (EDI) Seed Fund for a school outreach initiative. The Julia Anderson Training Programme (JATP) provides valuable paid opportunities for people with limited or no work experience, enabling them to support the delivery of activities at the Institute of Global Health Innovation at Imperial.
In 2023, we welcomed two cohorts of trainees, from 302 applicants:
- January cohort: Yiwen Wu, Patient Safety Trainee; Sarra Khadir, Patient Safety Trainee; Amelia Moores, Behavioural Science Trainee for cancer screening
- July cohort: Rao Fu, Operations Trainee; CJ Blair, Change Lab Trainee; Beatrice Sung, Helix Centre Trainee; Martina Trantalovska, Communications Trainee
The team: Sophie Pieters
Innovative Healthcare and Design MSc graduates
Our Healthcare and Design MSc students and alumni savored success in the 2023 WE Innovate Competition, to champion women-led teams with entrepreneurial ideas. The five finalists in 2023 included three graduates of our Healthcare and Design MSc.
- aiKNIT is founded by Healthcare and Design graduate Sophie Richter
- Aloe Health is founded by Healthcare and Design graduate Saw Nwe and Harry Fitzpatrick
- Matrix is founded by Healthcare and Design graduate Stiliyana Minkovska
Stiliyana Minkovska is an alumnus of our Healthcare and Design MSc programme, and is now a full-time founder of Matrix, a 21st century replacement for the speculum that is digitally enabled and designed for patient comfort and self-use in a clinical setting. In 2023, Matrix won the top prize in WE Innovate, Imperial’s competition for women-led startups.
“Matrix was born as part of my Master’s in Healthcare & Design with Imperial College London and the Royal College of Art (RCA). As part of the Master’s, I created a design methodology for applying systems and design thinking as a problem-solving lens in maternity. After a series of research and design exercises, I created Matrix. I received some micro grants then joined the WE Innovate programme in January 2023. WE Innovate was an incredible experience, which brought me closer to such phenomenal pool of expertise and knowledge. I couldn’t believe I went on to become becoming the First Prize winner!”
The Healthcare and Design team: Kate Grailey, Alice Gregory, Gaby Judah, James Kinross, Daniel Leff, Jessica Prestt, Ayana Sakey-Brimacombe, Leila Shepherd
Digital Health Leadership Programme
The Digital Health Leadership Programme students attended the Digital Health Leadership Forum in York in September 2023, to come together in person.
Among the keynotes, Andy Callow, Chief Digital Information Officer, Nottingham University Hospitals NHS Trust, spoke to students about how to be accountable and reflective in your practice.
In April, Cohort 4 of the NHS Digital Academy's flagship programme celebrated at the House of Lords.
The team: Jessica Prestt, Ara Darzi, Juliette van Wessem, Jennifer Bennet, Ivan Cheung, Tom O’Rourke, Toni Page, Christa Hansen, Aurelie Cnop, Louie Alvarado
Apolitical course on climate change and mental health
We are proud to have shared our Climate Cares expertise for a new online course on climate change & mental health, a collaboration between IGHI and the Grantham Institute for Climate Change and the Environment.
Working with Apolitical, we've developed a programme where people working in government can learn how to develop initiatives that support mental and environmental health.
Climate change and mental health are two of the biggest challenges facing governments globally, and they’re inextricably linked. Stronger social and emotional health means more climate action, and when people see and participate in climate action, their mental health improves.
In the first four months since its launch in September 2023, the course taught 136 participants: people working in both climate policy and in health policy. We really welcome this breadth of participants, which supports our aim to bring stronger collaboration across these currently disconnected policy spaces, and across national and local government.
Participants rated the course 8.6/10 for "Value for Time" compared to 8.4 average for other Apolitical courses and an 8.6/10 recommendation rating. Learners felt the content was applicable to their current role and felt confident to speak about it. One student said:
Connecting climate change mitigation and resilience initiatives to other topics such as mental health and wellbeing will make it much easier to get buy-in from stakeholders."
The team: Emma Lawrance, Jessica Newberry Le Vay, Jessica Prestt
Health Policy
The MSc Health Policy welcomed its 12th student cohort to the programme in September 2023, with over 50 students joining from the Department of Health and Social Care, NHS England Graduate Management Training Scheme alongside many others from a variety of professional backgrounds.
The students attended a comprehensive induction day with the programme team and including welcome talks from IGHI Co-Director Professor Sir David Nabarro and IGHI Course Directors Colin Bicknell and Erik Mayer.
The cohort have since attended their first three-day campus workshop. Among content delivered by the module leads, Ian Dodge (IGHI Adjunct Professor, Ex-NHS National Director) delivered a key note talk provided insights into the real challenges facing our future health policy leaders.
The team: Erik Mayer, Colin Bicknell, Jessica Prestt, Jason Murray, Melanie Perkins, Emmanuelle Dirix, Julien Le Jeune d'Allegeershecque, Jason Lawson, Joe Kerr
Looking ahead
From optimising our education offering, reaching students around the world through online programmes, to upgrading our BDAU Secure Environment, we are making improvements across our programmes of work to maximise impact.
Upcoming research includes preparing a Randomised Controlled Trial to boost breast cancer screening, and completing trials to share insights for improving patient care and scaling effective solutions. Through our Climate Cares Centre, we will launch an AXA-funded project dedicated to examining and addressing the mental health burden climate change is placing on young people in the Philippines and Australia. Our Helix team is developing their medical device technology, continuing their commitment to care research and technology. Our Patient and Public Involvement team are working with Mental Health Innovations to enhance the Shout Text Message service through a user-led group, whilst the Centre for Health Policy are analysing their data for insights. In December we will launch the next National State of Patient Safety 2024 report at the House of Lords. And our Hamlyn Centre will pursue cutting edge research, including through the much-anticipated Hamlyn Symposium 2024.
The new Fleming Initiative will take shape – you will hear of upcoming events, announcement of our Boards, and a film that exemplifies the Initiative’s approach to healthcare innovation.
We’re excited to pursue these endeavours, which reflect our collective vision to innovate, collaborate, and make a meaningful contribution to transform health for all through evidence-based innovation.
With thanks to all colleagues at IGHI
2023 saw IGHI colleagues who were nominated for the Faculty of Medicine's 25th Anniversary Staff Awards!
- Davina Tijani, Alex Shaw and Soh-Yon Park were nominated for "Outstanding Mentorship"
- Hutan Ashrafian was nominated for "Outstanding Achievement through Collaborative Research" and "Outstanding Contribution from Honorary Staff"
- Ruth Black was nominated for "Outstanding Education Support"
Our Co-Director, Professor Sir David Nabarro, was awarded an honorary doctorate from the University of Pretoria, in recognition of his exceptional contributions to society through his work in global health.
We celebrated together in the summer with a staff social, and saw colleagues recognised for their societal engagement (congratulations to Lindsay Dewa) and featured among Imperial people (read Sophie Pieter's blog post). IGHI women supported International Day of Women and Girls in Science (11 February) – thanks to Lindsay Dewa, Alice Gregory, and Scarlet Nazarian for their photos, and to Christa Hansen for her video featuring a very young scientist.
Throughout this report, we have identified the teams behind the projects, the individuals behind the innovation.
Thank you to the teams of people across IGHI and its Centres of Excellence: Centre for Health Policy, Climate Cares, Hamlyn, Helix, PSRC and ICCARE.
The programmes of work are supported by our Operations Team who with knowledge and grace are responsible for much of the delivery of our work in 2023:
Elenko Anastasov, Salzitsza Anastasova-Ivanova, Ines Baptista, Nikeysha Bell, Nazia Bharde, Eleni Daniels, Brandon Davies, Nicolette Davies, Rachel Davies, Simon Dryden, Gianluca Fontana, Laura-Maria Horga, Rachel Innes, Karen Jones, Marianne Knight, Hendy Maheswaran, Steve McAteer, Emily Medcalf, Robert Merrifield, Victoria Murphy, Kathryn Norman, Sophie Pieters, Alice Reddings, Karen Soltani, Sophie Sykes, Eleanor Vale.
And our JATP 2023 trainees: Sarra Khadir, Amelia Moores, Yiwen Wu, Calea-Jay Blair, Rao Fu, Beatrice Sung, Martina Trantalovska.