Introduction

It is with great pride that we reflect on a transformative year for Health Innovation West Midlands (HIWM). As the organisation at the heart of health and care innovation in our region, we have made significant strides in accelerating the adoption of impactful solutions that improve patient outcomes and drive economic growth.

Over the summer, we welcomed several new appointments to our Management Board to help spearhead our mission to advance transformational health innovations across the region. This 15-member board brings together a wealth of expertise to support our continued commitment to delivering evidence-based innovations that enhance NHS productivity, reduce waiting times, and improve the West Midlands’ overall health and wealth.

This year, we were honoured to showcase our work at the Health Innovation Network parliamentary reception, sponsored by West Bromwich MP Sarah Coombes. The event highlighted how programmes across the 15 national Health Innovation Networks are saving over 100,000 hours of NHS staff time annually. Our partnerships with policymakers, clinicians, and innovators continue to ensure that the benefits of innovation are felt widely and equitably across the West Midlands.

The work of the Health Innovation Networks has gained significant national visibility this year, driven by a renewed focus on the innovation arm of the NHS and alignment with key government priorities. This heightened profile reflects the growing recognition of innovation as a critical enabler of a more sustainable, efficient, and patient-centred healthcare system.

We have strengthened our role as a connector—linking the NHS with academia and industry through initiatives like the Birmingham Health Innovation Campus and the Precision Health Technologies Accelerator. Our involvement in national conversations, such as the Innovation Ecosystem Programme, reinforces our commitment to building a sustainable, innovation-ready healthcare system.

In 2024, the West Midlands was recognised as one of the top three European regions for innovation at the European Capital of Innovation Awards. These awards celebrate cities that have embedded innovation into the daily fabric of urban life, advancing sustainable, inclusive, and resilient communities. This recognition reflects the strength of our regional ecosystem, where academia, industry, and the NHS work together to develop, test, and implement cutting-edge innovations.

We are also proud to share insights and expertise through our growing collection of thought leadership blogs, where we have explored topics such as point-of-care ultrasound scanning, wound care, and cardiovascular disease. These contributions help shape the national conversation on health innovation and share best practices across the system.

We are delighted to welcome Jonathan Pearson as our new Chair and extend heartfelt thanks to Professor Michael Sheppard for his exceptional leadership and service. As we look ahead, we remain committed to fostering a thriving innovation ecosystem that delivers real-world impact for our communities.

Together, we are shaping a healthier, more innovative future.

Our Overall Impact

Case Study Spotlight

Supporting cardiovascular health innovations

Health Innovation West Midlands (HIWM) supported University Hospitals Coventry and Warwickshire (UHCW) in securing funding from the British Heart Foundation (BHF) Innovation Fund during 2024/25.  

The BHF Innovation Fund is a bi-annual opportunity to apply for funding to support healthcare systems in testing and evaluating innovative approaches to enhance services for patients with cardiovascular disease (CVD). HIWM has been pivotal in bringing together innovators and health system leaders to develop bid submissions for this fund, fostering inward investment and potential income generation for the West Midlands. 

The approach involved publicising the innovation fund among regional stakeholders, convening discussions to explore bid options, and ensuring all eligibility criteria for the fund were met. Regular communication with BHF and collaboration between HIWM’s commercial and delivery teams ensured due diligence and robust bid submissions. 

HIWM supported the submission of 11 funding bids, engaging seven commercial innovators in the process. One of these bids has been successfully awarded funding. 

The successful bid will support UHCW in the development of an innovative software tool designed to assist clinicians in initiating and safely up-titrating medications for patients with heart failure. Up-titration refers to the gradual adjustment of medication dosage to achieve optimal therapeutic outcomes for individual patients. 

This project has secured £230,000 in funding to support the design, development, and testing of the software. A key focus will be ensuring the tool is practical and user-friendly for healthcare professionals, with the aim of improving patient outcomes, enhancing clinical decision-making, and increasing overall healthcare efficiency. The tool will undergo usability testing before any wider implementation across the healthcare system. 

Dr Michael Kuehl, cardiology consultant at UHCW, said: “Medication for heart failure has been shown to improve outcomes, increase life expectancy and make patients feel better. But the treatment is becoming more and more complex, with several types of tablets available. 

“We have developed an algorithm that records data from patients which can be used to suggest a medication treatment decision and dosage. This would give healthcare professionals, such as doctors, nurses, GPs, pharmacists and advanced care practitioners, more confidence in their use of the medication. 

“We will use the BHF funding to test the safety and accuracy of the algorithm and then translate it into the app. I hope we will be able to launch Apptitrator within two years and see how it does in the real world as part of a research trial.” 

The Midlands is set to lead the way in cardiovascular health innovation, thanks to the dedicated efforts of HIWM and its partners. With continued support and collaboration, the future looks promising for advancements in patient care and health system efficiency.

Leading implementation of Martha’s Rule in the Midlands (phase 1)

In 2021 13-year-old Martha Mills died from sepsis after her family’s concerns about her deteriorating condition were not acted upon. A 2023 coroner’s inquest concluded that earlier escalation to intensive care could have saved her life. In response, the Secretary of State for Health and Social Care and NHS England committed to implementing the Patient Safety Commissioner’s recommendation “Martha’s Rule” to ensure patients, families and staff are heard and their concerns acted upon. 

As part of the Managing Deterioration and Martha’s Rule National Patient Safety Programme, Health Innovation West Midlands (HIWM) and Health Innovation East Midlands (HIEM) were commissioned to lead the implementation of Martha’s Rule across the Midlands. We will support the implementation of Martha’s Rule 12 pilot sites across nine NHS Trusts in the West Midlands and eight pilot sites across five NHS Trusts in the East Midlands. 

  • Phase 1 will begin implementation and testing of the three core components of Martha’s Rule.  
  1. Patients will be asked, at least daily, about how they are feeling, and if they are getting better or worse, and this information will be acted on in a structured way.
  2.  All staff will be able, at any time, to ask for a review from a different team if they are concerned that a patient is deteriorating, and they are not being responded to.
  3. This escalation route will also always be available to patients themselves, their families and carers, and advertised across the hospital.
  • Establish a collaborative region-wide governance and support structure. 
  • Develop and disseminate practical tools and guidance to support implementation at provider level. 
  • Embed Martha’s Rule within the wider PIER (Prevention, Identification, Escalation and Response) framework. 

The Patient Safety Collaboratives (PSCs) at HIWM and HIEM adopted a multi-level implementation strategy (add graphic or visual to represent the below): 

  • Macro (Regional): Weekly leadership meetings with East and West Midlands Critical Care and Paediatrics Operational Delivery Networks (ODNs) to align strategy, share updates, and co-develop resources. Feedback and learning shared to NHS England – Midlands Regional Quality Group regarding progress of Martha’s Rule testing. Integration of Martha’s Rule into the Midlands Deterioration Network, chaired by HIWM/HIEM. 
  • Meso (ICB): Joint project meetings in areas with multiple pilot sites (e.g. Black Country) to ensure consistency and shared learning. Regular update meetings with ICBs to outline progress of phase 1 test sites. 
  • Micro (Provider): Monthly 1:1 virtual meeting with each pilot site to support development and initial modelling, monitor progress, address challenges, provide quality improvement and culture support, co-design and deliver education and training for Martha’s Rule and build trusted relationships with implementation teams. On-site support was also provided where requested to support the pathway design and practical application of Martha’s Rule.
  • A key output was the Martha’s Rule Implementation Guide, co-produced with regional partners including the West Midlands Adult Critical Care ODN, offering a clear roadmap and checklists for pilot sites. The PSCs also established a Patient Wellness Questionnaire Breakthrough Series, resulting in the development of a practical toolkit to support implementation. The resources have been shared nationally and have supported the development of national resources for Martha’s Rule. 

  • 20 pilot sites actively engaged in phase 1 implementation. 
  • Weekly regional leadership meetings established a consistent, collaborative approach. 
  • Implementation Guide and Toolkit developed and distributed to all sites.
  • Community of Practice and local teaching support embedded across the region. 
  • Positive feedback from pilot sites on the clarity, responsiveness, and support provided. 
  • Education and training courses co-developed and delivered with the ODN’s to phase 1 sites, including two regional sessions, one relating to culture and the other relating to PIER and identification of soft signs of deterioration. 
  • All 20 Midlands sites live with components 2 and 3 of Martha’s Rule and testing component 1 
  • 381 Martha’s Rule calls received between September 2024 – March 2025 (173 in the West Midlands and 208 in the East Midlands) 
  • Creation of a Midlands-wide Martha’s Rule dashboard (outlining number of calls, made by whom, number of reviews and themes of calls), which is the only one nationally. (we have screenshot images we can use here) 
  • Across the Midlands 37% of calls were reviewed with 24% resulting in a treatment change (including increased oxygen therapy, change in medication including antibiotics being prescribed) and 9% leading to a transfer to HDU/ICU (49% of calls were reviewed in West Midlands, with 30% of those reviewed resulting in a change in treatment and 11% leading to transfer to HDU/ITU) 

 “The collaboration between the Health Innovation Network and the Critical Care Network has been instrumental. This partnership has not only ensured the smooth implementation of the Martha’s Rule pilot in the Midlands but has also set a strong foundation for future innovations.” – Kirsty Datson, Lead Nurse, West Midlands Adult Critical Care Network.

  • Continued support for Phase 1 sites as they embed Martha’s Rule into routine practice and expand into testing in Emergency Departments, Maternity and Neonatal Care. 
  • Support an additional 15 Phase 2 acute sites (nine in West Midlands and six in East Midlands) to test the three components of Martha’s Rule. 
  • Expansion of the Midlands Martha’s Rule Community of Practice to include new adopters. 
  • Ongoing evaluation and refinement of tools and resources based on site feedback. 
  • Preparation for wider rollout across the Midlands and nationally. 
  • HIWM and HIEM to lead the testing of Martha’s Rule in community inpatient hospitals nationally, following a successful tendering process. 
  • HIWM to lead the PIER Framework programme nationally, following the successful development of deterioration strategies across West Midlands ICBs. 

Innovative digital tools transform musculoskeletal care in Black Country

In a ground-breaking move to address the rising demand for musculoskeletal (MSK) physiotherapy services, Health Innovation West Midlands (HIWM) has facilitated the use of two cutting-edge digital tools, Phio Access and Phio Engage, revolutionising the way MSK care is delivered in both primary and secondary care settings across the Black Country. 

Phio Access is an advanced MSK digital triage tool powered by artificial intelligence, capable of navigating over 3,000 decision-based scenarios. This tool adapts to local service pathways, ensuring patients receive the most appropriate treatment options, verified by clinical professionals. When self-management is deemed suitable, patients are referred to Phio Engage, a digital self-management platform offering tailored recovery programmes, outcome tracking, and direct communication with physiotherapists. 

The initiative was driven by the need to alleviate the pressure on MSK services post-COVID-19 pandemic, where demand significantly outstripped capacity, leading to increased waiting times and heightened clinical risks. The MSK service team at Sandwell and West Birmingham Hospitals NHS Trust (SWBH) identified Phio Access and Engage as the optimal solution to streamline patient care and enhance service efficiency. 

The implementation of Phio Access and Engage has yielded remarkable results. Each digitally managed patient saves on average one triage appointment and three follow-up appointments, contributing to a substantial reduction in waiting times. At SWBH, the mean wait time plummeted from 11.5 weeks in 2022 to just 3.7 weeks in 2023, significantly improving patient safety and service standards. 

The digital pathway has released clinical and administrative time, with the SWBH MSK service freeing up 1,240 hours for face-to-face triage and treatment over 12 months, and Walsall Healthcare NHS Trust (WHT) MSK service saving 230 hours in six months. The economic impact is equally impressive, with the digital pathway contributing to Net Zero by saving an average of 13.2kg CO2 per patient. 

High patient satisfaction scores underscore the success of Phio Access and Phio Engage, with most users rating the digital pathway as good or very good. The tools have demonstrated equitable access across diverse demographics, including gender, ethnicity, age, employment status, and deprivation levels.  

Figures show that 40.4% of Phio Access users are in full-time employment, while 14% are part-time. Similarly, 53.7% of Phio Engage users are in full-time employment, while 15.8% are part-time. This means that most users can self-refer to MSK services and manage their conditions at a time that suits them, rather than taking time off work for appointments. 

In addition, breaking down the patient demographics information further, 71.7% of Phio Access users and 69.8% of Phio Engage users are in the lowest Index of Multiple Deprivation (IMD) groups of 1-3. This highlights the tools’ effectiveness in reaching and serving patients in the most deprived areas. 

HIWM is committed to sustaining and scaling the use of Phio Access and Phio Engage across additional MSK services and primary care settings in the Black Country and beyond. This initiative not only aligns with the NHS Long Term Plan—by supporting the shift from hospital-based care to community settings and promoting the use of digital technologies—but also contributes to regional economic growth by helping people remain in work. 

“Our main challenge pre-Phio was that our self-referral service was a telephone process whereby patients called our admin team to be referred to physio. When the patients called, all self-referrals were triaged according to a very basic algorithm by non-clinical staff. As a result, all referrals had very little information attached, which would mean the referral may have been placed with an inexperienced clinician, or potentially needing referring onwards to the right place, which created an extra step that wasn’t needed. Now with Phio, our self-referrals are triaged appropriately. All clinicians are happy with those referrals that come in and is a lot safer, as referrals that need more urgent or emergency care are managed effectively.  

We also have the option of some referrals being managed remotely via the Phio Engage app which has helped take some patients off our waiting lists and gives them a quicker and better experience.”  – Jonathan Morris, MSK Physiotherapy Team Leader, Walsall Healthcare NHS Trust.

Two West Midlands ICBs lead the way in reducing opioid use to improve patient safety

Harm from opioid use for chronic non-cancer pain has been significantly reduced in two West Midlands Integrated Care Board’s (ICBs), Staffordshire & Stoke-on-Trent and Shropshire, Telford & Wrekin, supported by Health Innovation West Midlands (HIWM), using an innovative system wide approach as part of its national Medicines Safety Improvement Programme (MedSIP).  

The problem 

Over half a million people across England are prescribed opioids, for chronic pain, for longer than three months. Experts warn that long-term use can be dangerous and increases the risk of addiction, overdose and even death.  

The opioid prescribing rates of these two ICBs were among the highest in the country. Shropshire, Telford & Wrekin had the country’s highest prescribing rate for high-dose opioids (defined as a dose above > 120mg morphine equivalent) with 91.33 patients per 1,000 patients compared to a national ICB average of 61.95 per 1,000 patients. 

Five cross-cutting themes were identified for potential areas for improvement as outlined below: 

  • Prevent initiation of opioids for inappropriate indications 
  • De-escalate: Ensure opioids are not:
  • continued for longer than clinically appropriate 
  • used at a higher dose than clinically necessary 
  • Find chronic use: Identify patients taking opioids long term (>3 months) for non-cancer pain and review to identify potentially inappropriate use.  
  • Treat (Taper & Support): Support deprescribing of potentially inappropriate opioids with appropriate support for patients that includes non-pharmacological support). 
  • Sustain: Ensure changes to prescribing and the support available to patients are long-term. 

 Taking a whole-system approach, involving GPs, hospitals, community services and patients, the programme launched the following initiatives to address these: 

  • Training for healthcare professionals in safer pain management, supporting patients to manage their pain without relying on opioids. 
  • Clear policies were created for GP practices to prevent overprescribing.  
  • Worked with local hospital teams to improve opioid prescribing when discharging patients. This included better documentation, patient education and follow-up care.  
  • Launched a public awareness campaign to highlight the side effects of opioid use.
  • Reducing opioid use before surgery to improve recovery and reduce risks.  

The results have been impressive:  

  • 94% of local GP practices in Shropshire, Telford & Wrekin and 92% in Staffordshire & Stoke-on Trent engaged in the 24/25 Prescribing Incentive Schemes to improve opioid stewardship. 
  • Over 900 outdated prescriptions for opioids have been removed from patient records in Shropshire, Telford & Wrekin. 
  • 214 people have had their risk of opioid related death halved, due to safer prescribing in Staffordshire & Stoke-on-Trent. 
  • 245 people have had their risk of opioid related death halved, due to safer prescribing in Shropshire, Telford & Wrekin. 
  • 121 of 130 GP practices in Staffordshire & Stoke-on-Trent now have clear opioid prescribing policies. 
  • 39 healthcare professionals in Staffordshire & Stoke-on-Trent trained in the ‘Live Well with Pain’ programme. 

Opioid improvement work in Staffordshire & Stoke-on-Trent will continue, following evaluation of the East Staffordshire pilot, the ICB will look to refine and roll out the revised pathway across the ICB.  

Shropshire, Telford and Wrekin ICB plan to expand the GP prescribing scheme in 2025-26. 

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