The health and care system in the UK looks after an ageing population with increasingly complex care needs, but money is tight. This means the NHS needs to:
- develop new ways of providing care and,
- when a new approach works well, understand and share learning about that success with other parts of the health and care system quickly.
To meet this challenge, the Rapid Service Evaluation Team (‘RSET’), comprising health service researchers, health economists and other colleagues from University College London and the Nuffield Trust, have come together to rapidly evaluate new ways of providing and organising care.
We have been funded by the National Institute for Health Research (NIHR) Health Service and Delivery Research (HS&DR) programme for five years, starting on April 1st 2018. The NIHR HS&DR programme have also funded a second team, the Birmingham, RAND and Cambridge Evaluation (‘BRACE’) Centre, which is a collaboration between the University of Birmingham, RAND Europe, the University of Cambridge and National Voices. The two teams will coordinate their evaluation programmes to maximise benefits from our work.
What are we doing?
We are studying the latest changes in health and care services, and provide meaningful lessons about these changes in a timely manner.
We are looking at changes in terms of:
- the impact of services on how well patients do (e.g. their quality of life, how likely patients are to recover)
- whether services give people the right care at the right time
- whether these services are good value for money
- how changes are put into practice, and what patients, carers, and staff think about how the changes happened and whether they think the changes made a difference
- what lessons there are for the rest of the NHS and care.
What are we evaluating?
We are evaluating service innovations – those driven both by national policy, and local needs – from innovative organisational hospital forms such as hospital groups and innovations in the management of services to new ways of delivering services to patients, and quality improvement initiatives.
We are working with our Stakeholder Advisory Board (a specially selected group of national experts, including patient and public representatives from a wide range of settings) and others to identify health and care innovations to evaluate.
How are we evaluating?
Different service innovations will require different approaches to their evaluation. We are using a range of quantitative and qualitative approaches as appropriate to each evaluation, including, analyses of administrative and other datasets, economic analysis, stakeholder interviews and focus groups, surveys and discrete choice experiments.
How are we sharing results?
We want the findings from our research to have a timely impact. We believe that sharing findings as they emerge will increase their impact and benefit for patients, the public, and the health and care systems. Therefore we share our findings rapidly with the people who are making changes.
For each project, we are working with our partners to agree how best to share lessons from our work effectively. We are experts in doing this, and have excellent links with health and care services across the country.
We are also making use of user-friendly summaries, blogs and webpages, workshops, present at conferences, and publish research articles that can be read freely by the public.
Who do we work with?
We involve patients, and the public, clinicians, and those running health and care services at every stage of our research, both within projects and across the programme as a whole.
We work closely with the NIHR, and be guided by our Stakeholder Advisory Board, which looks at
- whether we are doing what we set out to do
- keep us up to date on the latest service changes, and
- tell us what they think about our new plans for research.
If you have an idea for a service innovation we might evaluate, or want to get in touch, please contact us at RSET@nuffieldtrust.org.uk
Evaluations in progress
- Evaluation of remote home monitoring (COVID Oximetry @ home) models during the COVID-19 pandemic in the UK: overview and Phase 2
- Investigating innovations in outpatient services
- An evaluation of the implementation, effectiveness and cost effectiveness of a youth violence intervention programme for vulnerable young people attending Emergency Departments in London
- Centralisation of specialist health care services: a mixed-methods programme
- Pre-hospital specialist triage of potential stroke patients using digital technology: a rapid service evaluation to capture learning and impact of innovations prompted by the COVID19 pandemic
- Peer supported social care in prisons
- Identification and prioritisation of innovations in adult social care and social work
Previous evaluations from Nuffield Trust and UCL
- Evaluating new models of health care, Spotlight
- Learning from stroke
- RESPECT-21: Reorganising specialist cancer surgery for the 21st century’
Evaluations in progress
Evaluation of remote home monitoring (COVID Oximetry @ home) models during the COVID-19 pandemic in the UK: overview and Phase 2
Status: In progress
When COVID-19 patients come to hospital with an advanced course of the disease, they often arrive in acute care emergency departments with very low oxygen saturations, often without accompanying breathlessness (‘silent hypoxia’). As a result, many patients have experienced extended hospital stays, invasive treatment, potential admission to Intensive Care Units (ICU) and death.
Remote home monitoring models (sometimes referred to as ‘virtual wards’) allow patients most at risk of deteriorating to monitor their vital signs at home and report readings to hospital or primary care staff. This helps avoid unnecessary hospital admissions (appropriate care at the appropriate place), and escalates cases of deterioration at an earlier stage to avoid invasive ventilation and ICU admission. Remote home monitoring models have been implemented in the US, Australia, Greece, Canada, and the UK, with some variation in the frequency of patient monitoring, technology used (telephone or video calls and use of applications or online portals), patient criteria and use of pulse oximetry.
Despite previous research on the use of remote home monitoring models for other conditions, there is a lack of research on the implementation of these models during the COVID-19 pandemic. This evaluation of remote home monitoring models in the UK seeks to address this gap in two phases: (i) by capturing the lessons learned during the implementation of these models in first wave of the pandemic and (ii) evaluating the use of these models during winter 2020-2021.
Phase 2 of the study, currently in progress, will evaluate the models implemented during wave 2 of the pandemic using a mixed-methods study design.
Titled COVID Oximetry @ home (CO@h), the project will address: clinical and cost-effectiveness; implementation; and patient and staff experiences of managing people with COVID or suspected COVID symptoms. The project will look at how oximeters have been used in the community to allow earlier discharge, as well as preventing hospitalisation. Patients can keep track of their own oxygen levels at home and only come into hospital if their reading drops below a determined number.
The study will comprise 4 workstreams: Clinical effectiveness, Cost effectiveness, Patient experience/behaviour change and Workforce experience/behaviour change in order to answer the following 4 questions:
1. How is CO@h associated with mortality and use of hospital services?
2. What are the costs of CO@h and is it good value for money?
3. What are the experiences and behaviours (i.e. engagement with CO@h, use of other services) of patients in CO@h? Do these vary by type of model or patient characteristics?
4. What are the experiences of staff delivering CO@h? What are the factors influencing delivery of CO@h? Do these vary by type of model, geography etc.?
Investigating innovations in outpatient services
Status: In progress
The NHS Long Term Plan set an ambitious aim of reducing the number of face-to-face outpatient attendances by 30 million over the next ten years. In part, this is a reaction to the huge growth in appointments and attendances over the last decade and in part to encourage better ways of delivering care, reducing inefficiencies and improving patient experience and outcomes.
The objectives of this work are to:
- Review the evidence on the effectiveness of innovations to improve outpatient services and understand the factors that influence how innovations are implemented.
- Describe how outpatient activity has changed in England since 2008, including outlining how services have responded to the 2020 Covid-19 pandemic.
- Use time series data analysis methods to identify trusts and specialties whose outpatient activity appears to have changed in practically significant, and positive ways. For example, this might be a growth of non-face-to-face appointments, or a reduction in cancellations and did-not-attends.
- Use contextual data to identify whether any changes identified might be explained by, for example, changes in population characteristics.
- Carry out interviews with a small number of trusts to investigate whether specific trends identified might be attributable to particular innovations in outpatient services.
A second phase of the work will aim to robustly evaluate, with mixed methods approaches, a limited number of innovations. These would be selected from a shortlist of services identified during the initial phase, or from other innovations identified by RSET.
An evaluation of the implementation, effectiveness and cost effectiveness of a youth violence intervention programme for vulnerable young people attending Emergency Departments in London
Status: In progress
There are rising levels of knife crime and other serious violent injuries among young people in London and within metropolitan areas across the UK. Health services are increasingly viewed as having an important role to play in helping to prevent community violence given the rising cases presenting in NHS emergency departments. To help address the risks to young people caught up in cycles of violence, the charity Redthread places a team of experienced youth workers in hospital emergency departments to work alongside staff and support young people. If hospital staff are concerned about a vulnerable young person, they refer directly to the Redthread team who will reach out to the individual – in what is known a ‘teachable moment’ – and begin to work with the young person on a one-to-one basis, accessing other support services or agencies as required.
NIHR RSET researchers will evaluate this intervention at University College London Hospital (UCLH) by using a phased, mixed-methods approach. Phase 1 will involve a scoping review of the literature, analysis of previous Redthread evaluations and their findings, and qualitative research to understand the Redthread programme theory and service adaptations introduced due to the Covid-19 pandemic. The team will also undertake a feasibility review for quantitative and cost-effectiveness analyses.
Phase 2 will involve an in-depth process case study at UCLH, including interviews with key stakeholders and observations of meetings and Redthread training; a full economic evaluation to determine the cost-effectiveness of the intervention; and a quantitative analysis evaluating the effectiveness of the intervention in terms of readmissions or reattendances to hospital services in London.
The evaluation will integrate this evidence to identify lessons for Redthread and similar charity initiatives based in NHS hospitals. The findings will lead to the development of an evaluation framework which will be co-designed with stakeholders during an end of study workshop. Finally, the project will contribute to the published research literature and evidence base about hospital interventions that aim to help young people at risk of violent injury and vulnerable to other types of harm.
Centralisation of specialist health care services: a mixed-methods programme
Status: In progress
There have been significant changes in the provision of specialist clinical care in the NHS in recent years, with plans to centralise specialist services into fewer centres. Specialist services are not available in every hospital because specialist teams of health care professionals with the required knowledge, skills and experience usually deliver them. There have been longstanding recommendations for centralisation of specialist services. The aims of this study are to use quantitative and qualitative research methods to investigate (a) how the centralisation of specialist health care services in the UK can be characterised, (b) how different approaches/models to centralisation might work better in different settings, and (c) whether and how patients, the general population, health care professionals, hospital managers and commissioners would prefer specialist health care services to be centralised.
The objectives are:
O1. To undertake a novel scoping review to identify what “centralisation” as a service innovation means in the context of specialist health care services, and what the dimensions of centralisation are.
O2. To use the scoping review to develop a taxonomy to map the different models of centralisation.
O3. To identify in conjunction with the funder and NHSE&I specific conditions of interest for centralisation of specialist health care services in England and conduct original discrete choice experiments (DCEs) to analyse the preferences of patients, the general population, health care professionals, hospital managers and commissioners.
The associated research questions are:
RQ1: What are the general features and dimensions of ‘centralisation’ of specialist health care services as a service innovation?
RQ2: How might centralisations of specialist health care services be classified?
RQ3: What are the preferences of patients, the general population, health care professionals, hospital managers and commissioners for centralised specialist health care services?
For RQ1 we will undertake a scoping review to identify the key components of centralisation for specialist health care services in the context of service innovation. This scoping review will map the diverse body of published and grey literature that exists around the main features of centralisation for specialised services. For RQ2 we will use the scoping review to develop a taxonomy of different models of centralisation. Using the findings of the scoping review plus other most specific reviews, for RQ3 we will conduct discrete choice experiments to elicit preferences for centralisation of selected specialist health care services of key stakeholder groups.
Note that this study is the core of a wider proposed programme of research, which will include one or more empirical studies to evaluate the impact of centralising specialist health care services in specific clinical domains. These evaluations will overlap the current study and could include evidence reviews of the effectiveness and cost-effectiveness of centralisation, impact evaluations on patient outcomes, processes of care, and costs and cost-effectiveness, evaluations of stakeholder preferences, and implementation studies.
The proposed research will be developed in partnership with research users, to maximise its usefulness and impact. It will provide new data for research users on what patients, the general population, health care professionals, hospital managers and commissioners think about the centralisation of specialist services, which issues matter to them the most when considering this, how strongly they feel about these issues, and their preferences with regard to the centralisation of specialised services. We will discuss the key components of centralisation of specialist health care services by developing a taxonomy that could be used by other research teams exploring centralisation in other healthcare contexts/specialties. Results of this research will inform policy makers and other research users on how the centralisation of specialist services might be best organised around the needs and preferences of main stakeholders.
Pre-hospital specialist triage of potential stroke patients using digital technology: a rapid service evaluation to capture learning and impact of innovations prompted by the COVID-19 pandemic
Status: In progress
Clinical leaders in North Central London and East Kent have asked NIHR RSET to evaluate new digital systems which allow stroke specialists to examine and prioritise (‘triage’) potential stroke patients before they reach hospital. These new systems are being piloted by stroke specialists and ambulance services in response to the COVID-19 pandemic.
Working with local stroke and ambulance services, NIHR RSET will conduct a rapid mixed method service evaluation. The evaluation will include a rapid scoping review of available evidence on remote pre-hospital triage for potential stroke patients using digital technologies, with a particular focus on implementation factors and how technology may assist real-time clinical decision making. It will also include analyses of remote triage systems that are being piloted in two areas: North Central London and East Kent. We will use qualitative data (documents, interviews, and meeting observations) and quantitative data (locally collected measures and national audit data) to analyse the perceived usability, acceptability, and safety of the new triage systems, and their impact on care delivery.
The lessons generated through this evaluation will be of use to service planners and stroke and ambulance services. Locally, lessons will inform decisions about potential further implementation of remote triage systems for stroke across London and the South East Coast. Nationally, they may influence the pre-hospital workstream for delivery of the NHS Long Term Plan. Finally, this work will potentially lead to development of a larger research proposal.
Peer supported social care in prisons
Status: In progress
Many adults in prison require support with social care needs. In 2014, two Care Acts were introduced to ensure that those who needed social care within prisons were able to receive social care. However, these needs are often unmet and delivery of social care varies across the UK.
In recent years, the provision of social care has been supplemented with peer support initiatives to provide a package of social care support. Peer support workers support social care providers to provide non-personal care to other prisoners. Previous research has highlighted benefits to prisoners and prisons.
To better understand the landscape of social care in prisons, the team will perform documentary analysis of Her Majesty’s inspectorate of Prisons (HMIP) reports to answer the following questions:
1. What social care is currently provided in UK adult prisons?
2. Who delivers social care in UK adult prisons?
3. What peer support initiatives are used for social care in UK adult prisons?
4. What social care indicators are relevant?
Additional work on the project is currently on hold due to the coronavirus pandemic.
This project was identified as part of the work from the ‘Identification and prioritisation of innovations in adult social care and social work’ project undertaken in 2019.
Evaluation of remote home monitoring (COVID Oximetry @ home) models during the COVID-19 pandemic in the UK: Phase 1
Researchers from the NIHR-funded BRACE Rapid Evaluation Centre have worked with RSET, Public Health England and NHS England & NHS Improvement to conduct a rapid evaluation of the national NHS remote home monitoring model for COVID-19 patients.
Phase 1 of this study explored staff experience of using models like pulse oximetry at home during the COVID-19 pandemic, looked at the use of data for monitoring progress, and documented how staffing and resource allocation can affect the success of these models.
This involved a study of eight NHS sites which implemented a range of COVID Oximetry @ home models set up during the first wave of the pandemic.
Here are some of the key findings:
- Staff described high levels of patient engagement.
- Staff felt the remote monitoring of patients reduced their risk of contracting Covid-19.
- The mortality rates appeared to be low compared to other Covid-19 patients, but as there was no control group, it is difficult to compare effectiveness.
- Patient/ carer training is key to making these tools a success. There was some indication that models based on telephone calls, rather than apps were more inclusive as they include patients without internet access or technological literacy.
- Coordination between primary and secondary care facilitated implementation.
- Some concerns were raised about how sustainable these services are: they were set up quickly with discretionary input but need dedicated funds and management support.
- There also needs to be better integration with NHS Test and Trace to streamline the referral process.
The study drew out the lessons learned for development and implementation of this model of care across the country for winter 2020-21 and were disseminated widely across the country. Findings were used in the decision by the National Incident Response Board to support the national roll out of this model in December 2020: COVID Oximetry@home (CO@h).
Special measures for quality improvement and challenged providers: evaluating the impact of improvement interventions in NHS trusts
The Special Measures for Quality regime (SMQ) provides NHS trusts with increased support and oversight from NHS Improvement (NHSI) following a Care Quality Commission (CQC) inspection that has rated as inadequate the leadership and one other domain. There is also a ‘watch list’ of challenged NHS providers at risk of going into SMQ that receive support (this list is not in the public domain). According to NHSI, trusts in SMQ and those on the ‘challenged providers’ list can receive a combination of three main interventions to tackle quality problems: 1) Improvement Director, 2) buddying, and 3) access to central funding. These might be delivered in conjunction with other interventions and are often within a context of leadership changes at board level.
There is currently limited knowledge about whether, and how, targeted interventions from NHSI drive improvements in quality, how much they cost, and whether the current improvement regime strikes the right balance between support and scrutiny. There is also interest in understanding why some trusts become sufficiently resilient and avoid re-entering special measures or exit the regime sooner than others.
Therefore, this study will evaluate the responses of NHS providers to the SMQ and challenged providers’ regimes. The aim is to determine how trusts respond to the various SMQ interventions and how they may impact on organisations' capacity to achieve and sustain quality improvements over time.
Following a scoping exercise which included the types and characteristics of trusts subject to the special measures regime since 2013, as well as a survey of the literature to identify key themes and concepts relevant to this evaluation, a set of research questions and design methods have been developed.
Potential outputs from this evaluation will include:
- Lessons for trusts on responding to interventions in SMQ/challenged providers regimes, such as what to prioritise and the organisational capabilities found to support quality improvement
- Lessons for the Department of Health and Social Care and NHSI on how to support challenged providers and those in the SMQ regime in light of the varied internal and external contexts of health care organisations facing performance difficulties
- Recommendations on the use of routine, quantitative data to track quality improvements, including at system level, and the potential costs and benefits of interventions of the SMQ regime
- A conceptual framework to help evaluate the SMQ regime and challenged providers programme in future.
Project lead: Professor Naomi Fulop
Identification and prioritisation of innovations in adult social care and social work
As the needs and demands of social care and social work increase, there is a growing number of innovative models and approaches trying to tackle the challenge. The aim of this project is to identify and shortlist innovations in adult social care and social work in the UK for evaluation.
The project is being led by two national rapid service evaluation teams (RSET and BRACE), and is being funded by the National Institute for Health Research (NIHR). The research will support the ongoing development of the NIHR’s programme of research on social care and social work, including informing future funding calls.
The first phase of the work will identify as many social care and social work innovations as possible. To do this, we will contact a wide range of people with knowledge of these sectors – including people who use social care services and carers, frontline professionals, service providers and commissioners, national organisations, think thanks and researchers. The innovations identified will then be brought to a workshop, where participants will discuss and prioritise the innovations for potential evaluation. In the second phase of the work, the two rapid evaluation teams will evaluate one or more of the top priority innovations.
- Final study report: Report of horizon scanning and prioritisation process of innovations in adult social care.
- Fulop N, et. al. (2019) Special Measures for Quality Improvement and Challenged Providers: Study Protocol for Evaluating the Impact of Improvement Interventions in NHS Trusts. International Journal of Health Policy and Management. doi: 10.15171/ijhpm.2019.100 (Link)
- Vindrola-Padros C, et al. The implementation of improvement interventions for ‘low performing’ and ‘high performing’ organisations in health, education and local government: a phased literature review. International Journal of Health Policy and Management. doi: 10.34172/ijhpm.2020.197 (Link)
- Vindrola-Padros C, et al. Remote home monitoring (virtual wards) during the COVID-19 pandemic: a systematic review. [pre-print] (Link)
- Vindrola-Padros C, et al. The implementation of remote home monitoring models during the COVID-19 pandemic in England. [pre-print] (Link)
- Vindrola-Padros C, et al. The implementation of remote home monitoring models during the COVID-19 pandemic in England. EClinicalMedicine, doi: 10.1016/j.eclinm.2021.100799. (Link)
- Greenhalgh T, et al. Remote Management of covid-19 using home pulse oximetry and virtual ward support. BMJ, doi: 10.1136/bmj.n677 (Link)
- Cowan K et al. Rapid prioritisation of topics for rapid evaluation: the case of innovations in adult social care and social work. Health Research Policy and Systems, doi: 10.1186/s12961-021-00693-2 (Link)
- Fulop N, et. al. (2020) Rapid Evaluation of the Special Measures for Quality and Challenged Provider Regimes: A Mixed-Methods Study, Health Services and Delivery Research. doi: 10.3310/hsdr-tr-129663 (Link)
- Fulop N, et. al. (2020) Rapid Evaluation of the Special Measures for Quality and Challenged Provider Regimes: A Mixed-Methods Study – Executive Summary (Link)
- Walton H, et al. (2019) Innovations in Adult Social Care and Social Work Report. (Link)
- Special Measures for Quality
- Naomi Fulop and Chris Sherlaw-Johnson presented emerging findings to the Acute Care and Provider Team, Department of Health and Social Care on the 9th December 2019.
- Naomi Fulop and Chris Sherlaw-Johnson presented emerging findings to the Joint Strategic Oversight Group (JSOG) meeting chaired by Ted Baker (Chief Inspector of Hospitals, CQC) and Steve Powis (National Medical Director, NHS England) on the 29th January 2020. Attendees included over 30 senior representatives from NHS Improvement, NHS England, CQC, HEE and GMC.
- Naomi Fulop and Chris Sherlaw-Johnson gave a presentation on findings at the NHSE/I Intensive Support conference, a national conference organised by the NHSE/I Intensive Support teams on the 5th February 2020. Attendees included over 120 senior staff from Trusts receiving intensive support, senior representatives from NHS Improvement, NHS England and CQC.
- Naomi Fulop (Chair), Jean Ledger and Chris Sherlaw-Johnson recorded a remote interactive workshop (online) drawing on findings for the Health Services Research UK (HSRUK) conference, June 2020. Workshop title: Addressing failure and turnaround in health care organisations: a review of current approaches and experiences across NHS providers. (Link to watch the session)
- Naomi Fulop and Chris Sherlaw-Johnson presented findings to the NHS Improvement Directors’ meeting, 13th July 2020. Attendees included over 20 improvement directors.
- Naomi Fulop and Chris Sherlaw-Johnson pre-recorded a presentation on the findings for the BMJ Leaders in Healthcare Conference in Nov 2020. Workshop title: Improving organisations and the role of medical directors.
- Naomi Fulop and Chris Sherlaw-Johnson gave an online presentation on the findings to Department of Health and Social Care on the 24th August 2020. Attendees included Helen Beazer (Interim Deputy Director, DHSC) and staff in CQC sponsorship, Quality, Patient Safety and Investigations and Strategic Finance.
- Evaluation of remote home monitoring models during the COVID-19 pandemic in the UK
- Naomi Fulop and Steve Morris presented emerging findings from phase 1 rapid literature review and empirical study of remote home monitoring models to the PHE, NHSE, NHS Digital and NIHR on 17th September 2020.
- Naomi Fulop presented to The Patient Safety Collaborative Learning Network (90+attendees) on 29th September 2020.
- The team have contributed findings from phase 1 study in a presentation to the National Incident Response Board (NIRB) on the 30th September in relation to potential national roll-out of these models.
- Naomi Fulop presented to the Covid-19 Community of Practice for pulse oximetry: Evaluation meeting (30+ attendees) on 30th September 2020.
- Naomi Fulop presented to the North West Coast Managing Deterioration Patient Safety Network (200+ attendees) on 1st Oct 2020.
- Identification and prioritisation of research topics in adult social care and social work
- Holly Walton presented a virtual session on methodological insights for rapid prioritisation of adult social care innovations at the HSRUK meeting in July 2020. (watch the session)
- Fulop N, Sherlaw-Johnson C, & Ledger J. (2020, February). Special Measures for Quality and Challenged Providers: Evaluation of the Impact of Improvement Interventions in NHS Trusts. Poster session presented at the NHSI/E Intensive Support Conference, London, UK.
- What is rapid research and why is it relevant for health care?, by Cecilia Vindrola-Padros
- Evaluating, fast and slow: reflections from the Rapid Evaluation Conference, by Jean Ledger and Chris Sherlaw-Johnson
- Virtual wards: caring for COVID-19 patients at home could save lives, by Cecilia Vindrola, Naomi Fulop, and Trish Greenhalgh
- An introduction to rapid qualitative evaluation, by Cecilia Vindrola-Padros
- Rapid ethnographies in a changing world, by Cecilia Vindrola-Padros
- Rethinking evaluation: the rigour of rapidity, by Arne Wolters
Addressing failure and turnaround in health care organisations: a review of current approaches and experiences across NHS providers.
Rapid prioritisation of adult social care innovations for evaluation: Reflections and considerations.
The RSET Stakeholder Advisory Board (SAB) provides RSET with advice and representation from experts across the health and social care sectors from around the UK. The SAB provides overall programme oversight and ongoing advice and support for the programme.
- Rob Webster (Chair): Chief Executive, South West Yorkshire NHS Foundation Trust
- Charlie Davie: Managing Director, UCLPartners
- Alisha Davies: Head of Research and Development, Public Health Wales
- Hannah-Rose Douglas: Senior Analytical Manager, Research Lead for Analytical Services, NHS England
- Daniel Farag: Director, NESTA Health Lab
- Steve Feast: Managing Director, Eastern AHSN
- Dominic King: Clinical Lead, Deepmind
- Tara Lamont: Deputy Director, NIHR Dissemination Centre
- Kirsten Major: Chief Executive, Sheffield Teaching Hospital
- Martin Marshall: Chair of Royal College of General Practitioners Council
- Liz Mear: Managing Director, Leeds Academic Health Partnership
- Raj Mehta: Patient and Public Involvement Advisor
- Jen Shand: Executive Director, Care City
- Allison Smith: Interim Head of Insight, Helpforce
- Adam Steventon: Director of Data Analytics, The Health Foundation
- Fola Tayo: Patient and Public Involvement Advisor
- Denise Tyrell: Director, Leadership and Engagement, North East London Commissioning Support Unit
- Arne Wolters: Head of the Improvement Analytics Unit, The Health Foundation