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? )
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 : "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
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
Part of the challenge is the scale of the NHS and its fragmented
structure. THOTH is looking at ways to standardise training across the
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
- build and manage a multidisciplinary, cross-sector network of
- 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
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
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
THOTH’s current strategic focus will be to concentrate on four areas:
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.
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.