The NHS ConfedExpo: A focus on taking healthcare into communities

The NHS ConfedExpo is a major event in the healthcare calendar and the 2023 edition at Manchester Central did not disappoint.          

The presence of the former Health Secretary, the Rt Hon Patricia Hewitt, provided the conference with a key focus around her review of Integrated Care Systems (ICSs) across the NHS in England, which are coming up to their first anniversary.      

The study, commissioned by the government, calls for a reset in national/local relationships and for a greater emphasis on preventing ill health. Or as Ms Hewitt put it: “The NHS is, in practice, more of a national illness service than a national health service.” 

Communication and community engagement was highlighted as critical, with the need to re-build trust in some communities a prerequisite to making progress in tackling health inequalities. Matthew Taylor, Chief Executive of the NHS Confederation, strongly backed the Hewitt recommendations and the level of cross-party support for ICSs. 

He said: “The agreement that we must reduce the number of overarching national targets imposed on ICSs will be music to the ears of ICS leaders, empowering them to concentrate on their localities. NHS leaders have been clear that a move to greater prevention will be imperative to reducing overall demand on the service and keeping people well for longer.”   

From an EMS Healthcare perspective, this is a critical subject area, given our ability to support community health programmes or deliver commercial clinical trials with much greater participant representation than in traditional settings. Our experience has shown that what people require is convenient access to encourage them to engage, and we know that mobile can deliver outstanding results.     

Spotlight on mobile clinics 

To the delight of the EMS Healthcare team attending ConfedExpo, we managed to turn a few heads on the exhibition floor with our Outreach vehicle on display – we were thrilled to be able to feature ThisVanCan, a fantastic example of how mobile units can bring health education and services closer to home.

We’re currently working alongside Greater Manchester Cancer Alliance on a community-focused prostate cancer campaign, which is already having a hugely positive impact. 

The mobile health clinic is touring multiple locations over the next six months throughout Greater Manchester. The “ThisVanCan” tour is specifically encouraging black men aged over 45 to come forward, as they are more at risk of developing prostate cancer than other men. 

It is particularly rewarding for us to demonstrate how effective mobile facilities can be in reaching traditionally underserved communities. What was notable about many of the panel discussions at Confed was that the absolute imperative of delivering better healthcare to diverse populations became a recurring theme.

Just look at the figures quoted in one of the sessions exploring the future of vaccination services. The case study highlighted was the Living Well buses, delivered by Cheshire and Wirral Partnership NHS Trust. The ambition with this project is to help address health inequalities in a region with significant areas of deprivation – and mobile was deemed to be the best solution, using supermarket and leisure centre car parks. 

Within eight months, a fleet of three Living Well buses delivered 17,000 vaccinations, more than 18,000 health screenings and 675 clinics.  Here’s the analysis of Jayne Wood, Director of Testing and Vaccine Operations for Cheshire and Merseyside: “Whether it’s through vaccinations, physical health checks or mental wellbeing support, Living Well demonstrates what can be achieved by bringing services to the heart of historically seldom-heard communities, combined with a meaningful engagement strategy that focuses on listening and learning.” 

The use of the bus struck a chord with Steve Russell, NHS England’s Head of Vaccinations, who acknowledged the role that mobile clinics can play: “Local leadership is critical in understanding the community, thinking about what works for them and then meeting that need in a different way, in settings that the NHS doesn’t serve well.”  

Testing time for clinical trials 

Another key area of discussion at Confed was the future of clinical trials and, specifically, how trials can be more inclusive and start to help address health inequalities. 

Amanda Pritchard singled out the NHS-Galleri cancer trial for praise: “This pioneering trial is the first step in testing a new way to identify cancers before symptoms appear. If provisional results prove successful, we will be rolling out the test to an extra one million people across the country from next summer, with the aim of diagnosing thousands more people with cancer, at an early stage.” 

This is a matter very close to EMS Healthcare hearts – we are extremely proud to be the operational partner which supplied the mobile units and the clinical staff that recruited 140,000 Galleri trial participants across the country in just 10 months. Volunteers gave blood samples at mobile testing clinics stationed in retail parks and other convenient community locations.  

What’s more, the approach of taking trials out of traditional healthcare settings achieved a participant satisfaction rate of 97%, which was critical to ensuring people came back a year later for their next test.  We are currently on target to reach an exceptionally high retention rate and the first Galleri trial results are due next April.   

The urgency of the situation was captured by Jameka Hill, Senior Director of Clinical Trial Health Equity at the pharmaceutical and biotechnology company, Moderna. She told the conference: “When clinical trials lack representation, the public loses confidence and this, in turn, impacts on health outcomes.” 

In the wake of last month’s O’Shaughnessy review of commercial clinical trials, the government has supported an ambitious recommendation to quadruple the number of UK trial participants over the next four years. There’s little doubt in my mind that mobile clinics will be a vital element in reaching anything like that figure.  

Dr Rebecca Clark is a GP in Blackpool, one of Britain’s most deprived areas. Dr Clark is also principal investigator at the UK’s leading primary care commercial research site, working to break down barriers of traditional clinical research delivery: “If we are to be successful, trust is a critical factor among hard-to-reach populations, and GPs are uniquely positioned to engage with communities in a way that no-one else can.” 

What was striking about the sessions at ConfedExpo was the breadth of ideas and innovative suggestions that came from both panellists and delegates – as is often the case, the questions and answers that followed the main presentations, produced the most evocative and challenging thoughts.   

We are delighted to have engaged with so many partners and delegates during a very busy two days at ConfedExpo. For EMS Healthcare, there are always learnings to be gleaned and we look forward to many rewarding follow-up conversations in the coming weeks and months.