Health Hub 2020 Prioritised Patient Pathway Problems Summary
- Improving collaborative clinical care decision making for MS patients -
The Challenge - How can we optimise care for patients by improving, automating or streamlining collaborative clinical care decision making?
Clinicians often need to conduct peer to peer patient case reviews in order to initiate or change treatment plans. The reviews are usually conducted as part of a Multi Disciplinary Team (MDT) consisting of healthcare professionals (HCPs) from different clinical specialities. The MDT meetings are primarily face to face meetings, and often getting all of the relevant HCPs in a room with the correct data/clinical assessments in an accessible format is time consuming and resource intensive. Whilst some NHS trusts have embraced ‘virtual MDT’ meetings using platforms such as Skype, many others have not fully embraced this approach due to clunky technology, limited functionality for data sharing and the lack of interoperability with existing NHS systems.
Patient treatments (initiation/changes) are often delayed significantly as the current methods of MDT decision making are limited and thereby impact the time that it takes to make informed treatment decisions for patients. This leads to waiting times for patient reviews often being in months, not weeks. The current MDT approach to collaborative clinical treatment decision making is also inhibiting individual NHS trusts ability to effectively and efficiently optimise patient care, and reduce variation in care. Patient access to new innovative treatments is being delayed, limiting patient access to care which could significantly improve their health outcomes.
Desired Solution & Impact
A patient-centred scalable digital solution is needed that can improve, automate and streamline the current MDT method for collaborative clinical care decision making, that will:
• optimise patient care and improve access to the right treatment, at the right time and in the right setting
• reduce variation in patient care
• enable HCPs to make timely and informed decisions for patients
• support the NHS to accelerate new models of care – moving care out of hospital and into the community
• be interoperable to existing software and solutions used in the NHS and adhere to the NHS Open Standards for data and digital.
- Improving referral quality and treatment interventions for HF patients -
The Challenge - How can we support the referral decision making process for patients presenting with Heart Failure (HF) symptoms in primary care by identifying and resolving organisational barriers such as access to investigations and secondary care waiting times which may contribute to delay of diagnosis and treatment.
HF is a common, costly and treatable clinical syndrome.1 2 Over 920,000 people in England are living with the condition. From the healthcare system perspective the burden is large: 1-2% of the NHS budget is estimated to be spent on heart failure, with 60-70% related to the costs of hospitalisation.3Timely and accurate referral (to get diagnosis as well as treatment) is key to accessing appropriate, evidence-based treatment. This includes access to BNP testing, echocardiogram and specialist assessment.
Primary care has a vital role in HF diagnosis and referral decisions to allow timely initiation of evidence-based treatments which improve both patient outcomes and resource use in the healthcare system. Delays in referral of HF patients can result in hospitalisation or death, both of which can be avoided through timely and accurate appointments with specialist services. Inappropriate referrals and subsequent delays in diagnosis increase the likelihood of non-elective hospital admissions/readmissions. This can cause adverse effects on health system resource and capacity, and the lack of timely and appropriate referrals result in treatment delays and increase the amount of time taken to benefit from treatments.
Desired Solution & Impact
A solution is needed to transform the current pathway of care for HF patients who require specialist clinical interventions, that can:
• effectively improve patient care through appropriate, timely and accurate referrals between primary care and specialist services
• improve HF patient access to high quality care/diagnostics at the right time, in the right place.
What stage of company do you look for?
We focus on startups and would need you to have an MVP
What is the structure of Wayra’s Investment?
Wayra’s investment is composed of cash andservices investment via a convertible loan note (CLN) which will convert from loan notes (Conversion) into shares on a future date by two methods:
1. triggered future investment (Qualified Round) or
2. on a future date where no round of investment is taken in within 2 years (Maturity Date).
What rights will Wayra expect in any Wayra Agreement?
At a basic level, we will expect:
· Standard Shareholder consent rights which protect against actions which otherwise would unreasonably adversely affect Wayra,
· Pre-emptive rights,
· TagAlong rights,
· Aright to appoint a board observer (non-voting),
· Information Rights such cash in bank; MRR; monthly burn rate; FTE/headcount; whether the Company is currently raising and if so how much and at what valuation; documentation providing evidence of any funding raised; any relationship with Telefónica (e.g. pilot, trial etc.) and the relevant value; and any other significant information relating to the Company), and
· Aright to share basic executive and company information for the purposes of promoting your company and Wayra.
Are these right or the Wayra agreements negotiable?
Not really. Significant effort has been made to ensure that the terms are as competitive and reasonable as possible. Wayra manages a global portfolio of many hundreds of investments and it is essential that all documentation align with the general Wayra precedents as far as possible. That being said, if one or two practical “tweaks” are required due to your specific circumstances, then these can be discussed. In the interests of fairness and consistency between participant companies, wholesale or significant amendments aren’t possible.
Wayra charges around £34,000 for “Services”, what do these actually include?
There’s a high-level description of the Services at the end of this document. The Services may differ slightly from cohort to cohort and each participant won’t necessarily use the Services in exactly the same way but Wayra makes every effort to ensure that all participants benefit equally and in accordance with their individual needs. Rest assured, each participant costs Wayra far more than the Services amount in the contract and the £34,000 is a significantly subsidised figure. This £34,000 is part of the investment in your company and the value is recorded as such.
What is a Convertible Loan Note and what percentage will Wayra look for?
A CLN allows Wayra’s investment via a loan to be paid back to Wayra in shares but with a limit on how many shares. This limit is set out as a conversion floor (the “Floor”) or a conversion maximum shareholding (the “Max”). The idea of a Floor and Max is a standard feature of our CLN. Wayra also uses the most recent third party objective substantive investment’s value of your company with a discount, to calculate the Floor and Max (up to a maximum ever of 10%) in the CLN. If Wayra chooses to invest in your company then this Floor and Max gives everyone certainty around Wayra’s shareholding upon Conversion.
I’m already in advanced negotiations/haveagreed a commercial deal with a third party regarding my business’ products andservices. Will Wayra’s above set out expected rights affect this?
Wayra encounters this point relatively frequently and is happy to provide advanced consent to allow the pre-existing negotiations to continue. Wayra’s CLN willcontain “other business rights” (such as a right forTelefonica entities to be treated at least as favourable as those offered by your company to third parties in the same geographic market) are designed to help your company maximise its commercial potential and should notbe seen as a barrier to working with other people (something which Wayra supports and actively encourages). They are not exclusivity rights and are intended to provide Telefonica with competitive rates.
I’ve noticed that I need to get Wayra’s consent to do certain things, what does this involve?
Wayra adopts as “light touch” a position as possible and aims to restrict their consent rights to the big issues. Most of Wayra’s consents can’t be “unreasonably withheld or delayed” and are usually granted very quickly. It’s not in Wayra’s interests to stop or delay your company making important decisions. We want your business to be a success as much as you do!
Can I start in the Academy if my agreement isn’t signed yet?
No. Agreements must be signed prior to or on the day that you arrive in the Academy.
How long am I allowed to stay in the Academy?
According to the contract (and assuming all goes well and you hit your milestones), you will stay in the Academy for 8 months. Depending on circunstances, Wayra may choose to extend this period for up to 12 months in total if you so wish (although there’s no guarantee of this).