Training is key in NHS technology challenge

Paul Vousden outlines the role of the UK Training Hub for Operative Technologies in Healthcare, the key tasks for improving training in the use of medical devices across the NHS and the focus areas for THOTH's activities. 18 July 2008

Iestyn Williams is right when he says technological innovation has long been central to improvements in healthcare. (MTB Europe, June 20 2008: How can technology adoption be speeded up in the NHS? [1])

The NHS recognises that it must build a bigger skills bank to deliver the exciting new medical technologies and innovations needed for an improved and more effective health service in the UK.

Too often, crucial skills lie with only a small minority of professionals and, until now, the UK has had a poor record of adopting new technology when compared with other European countries.

The need for change has been given fresh impetus by Health Minister, Lord Darzi, in his latest report on the future of the NHS [1]: "By setting clearer standards, recognising and rewarding innovation, we can keep pace with the latest advances in medical technology."

He added: "For new medical technologies, we will simplify the pathway by which they pass from development into wider use, and develop ways to benchmark and monitor uptake… training needs to change to enable staff to respond more effectively and flexibly to this dynamic environment …

“In this country we have a proud record of invention, but we lag behind in systematic uptake even of our own inventions.”

THOTH (Training Hub for Operative Technologies in Healthcare) was set up with funding from the NHS Innovation Centre and the Department for Innovation, Universities & Skills (DIUS) to help the NHS use emerging technologies better. The aims are to improve and increase technology take-up and create the evidence-based education tools to ensure the safe use of advanced medical devices.

THOTH’s clinical lead is Rajesh Aggarwal, a surgeon who is also part of Imperial College’s medical research group, and Dr Maire Smith, head of the NHS National Innovation Centre, is chair of the governing board. THOTH has a number of Trust-based clinicians and managers who work on secondment as project managers. It also has close links with academic, educational and information technology bodies, as well as IT and medical device companies.

This year we identified four key, strategic areas — patient safety, education and awareness, mobile technology and NHS re-configuration to target with our work. Several projects have already been completed and rolled out across the health service and new ones are in the pipeline. Project outcomes include guides, e-learning packages and DVDs.

The UK is known to have a poor track record of adopting new technology and there are inconsistencies in training. For example, with the use of laparoscopic surgery, Britain lags behind other European countries, such as Italy and France.

According to the Association of Laparoscopic Surgeons of Great Britain and Ireland, there were nine training courses being delivered by hospitals and institutes. There was, however, no standard curriculum for the course and no agreed framework for setting the course content. THOTH is working on addressing this, in conjunction with colleagues from Imperial College.

Part of the challenge is the scale of the NHS and its fragmented structure. THOTH is looking at ways to standardise training across the health service.

Key training tasks

Key tasks are to:

  • monitor training and skill gaps through interaction with the NHS and medical device industry;
  • take the lead on training in the use of advanced medical technology, through information exchange and collaboration with experts in healthcare, IT, engineering and education;
  • develop evidence-based curricula for clinicians to improve care standards and cost-effectiveness;
  • partner with the NHS supply chain to identify training gaps and disseminate solutions;
  • build and manage a multidisciplinary, cross-sector network of medical expertise;
  • maximise the flow of knowledge in the NHS and create new intellectual property; and
  • create global commercialisation of intellectual property.

But the training and education is not just for NHS professionals. Patients, too, have a role to play to ensure they benefit from good healthcare. They need to understand and support the move towards a more modern and technology-advanced NHS. They should be encouraged to be involved and ask questions about their care. This ensures they are more informed, while also serving as a check and balance for clinicians, making them more aware of patient safety.

This also chimes with the key recommendations of the Darzi Review, which aim to deliver the highest quality care for patients, with initiatives such as personalised care plans for people with long-term conditions and NHS Trusts eventually being required to produce an Annual Quality Report alongside it’s financial and operating report.

Membership of THOTH is increasing and includes NHS managers, healthcare professionals, academics and employees of government bodies, as well as trade bodies, manufacturers and service companies.

There is also a virtual network for healthcare professionals, designed to promote cutting-edge thinking in training to use medical devices.

Through our membership and stakeholder network, THOTH is exploring new innovations and reviewing how to encourage faster uptake of new technology within the NHS. Our network also helps stimulate and facilitate the flow of knowledge from industry into medical training.

One of the important ways we can do this is through greater use of e-learning, simulation and the use of web-based virtual worlds to help improve trainees’ understanding of areas such as: safety in operating theatre environments or how to operate and calibrate new models of medical devices such as infusion pumps.

Advances in medical technology play a pivotal role in the improvement and transformation of the NHS and the health economy of an ageing UK society.

For patients, better diagnostics, less invasive procedures and more effective treatments mean faster recovery and improved quality of life, reduced waiting times and greater access to the NHS.

While introducing new, more efficient medical technologies can involve increased short-term spending, lasting economic gains can be achieved by reduced treatment costs and a more rapid return to normal, productive life for patients. Improved patient outcomes also help the NHS achieve National Service Framework targets and other Department of Health guidelines.

Strategic focus

THOTH’s current strategic focus will be to concentrate on four areas:

Patient safety

Research shows that patients feel more confident and able to ask questions if they are kept informed and encouraged to become part of the team. A key NHS goal is to make healthcare more patient-focused and we will be exploring how we can encourage patients to become more involved in their care. The overall aim is to develop better communication with patients, ensure their safety and improve their health outcome.

NHS change and reconfiguration

NHS reconfiguration will see control move away from the centre and into local communities, with the focus firmly on clinicians and patients. As part of the Darzi Review England’s ten Strategic Health Authorities (SHAs) have published their visions for the future of the NHS in their regions. We will be reviewing these plans and talking to SHA representatives to explore the education and training implications of these bold new visions.

Mobile technology

Enormous changes have been taking place in mobile technology. As mobile devices become more sophisticated, more diagnosis and treatment can be carried out away from hospital. Our role, alongside colleagues from other parts of the DH and NHS, will be to examine the training needs arising from existing and future mobile technology developments.


The development of polyclinics, and other primary care initiatives, will see high-quality community facilities, equipped with leading-edge technology, providing a wide range of services. Our aim will be to identify the education needs for these new community-based centres and ensure that the training tools are in place for staff and patients.

Paul Vousden, managing director, Training Hub for Operative Technologies in Healthcare (THOTH)

More information on TOTH can be found at:


1. How can technology adoption be speeded up in the NHS? MTB Europe, 20 June 2008.

2. Department of Health. High Quality Care for All: NHS Next Stage Review Final Report. London, 30 June 2008.

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