SBRI Healthcare Competition: Urgent & Emergency Care
In 2019, an average of 70,231 people attended emergency departments (EDs) each day in England. This is 4.8% higher than in 2018. At ‘Type 1’ EDs – i.e. major hospital Emergency Departments offering a 24-hour service – the increase was similar, at 4.9%. Over the last five years, attendances at Type 1 EDs have risen 10.6%, which amounts to over 4,000 extra people attending each day. When Type 3 facilities such as minor injury units and urgent care centres are included, the increase is almost 9,000 extra attendances per day across England. A systematic review in the British Journal of General Practice3 showed that inappropriate attendances may account for between 24% and 40% of presentations at EDs. The latter review has been well cited and similar issues identified around the world.
What can be done to release pressure on the system and improve quality of health and care?
Under the overall theme of ‘Urgent and Emergency Care’, two categories have been identified via consultation with clinicians and other stakeholders working in provision of care across the spectrum. Applicants are expected to respond to one of the two categories and, in both Categories, should consider if their solution is specific to, or can be tailored to, one of the sub-categories, whilst being mindful of the broader impact on the urgent and emergency care system.
Category 1: Reducing demand
There are significant increases in ED demand1-7 with evidence to suggest that significant proportions of patients present to the ED with less urgent needs. These patients are often younger adults and are more likely to present out of hours3. Patients that present with less urgent needs could be treated by other services such as primary care, pharmacies or through self-care. By definition, in order to reduce the number of people arriving at the front door, innovations are required that intervene at the incident, in the community, at home, through primary care or NHS 111.
Category 2: Reducing the length of stay in the Emergency Department
When urgent or emergency care is required there are often delays within the pathway; these may be in Primary Care (see Category 1), assessment areas, inpatient wards or prior to discharge. Innovations that give enhanced confidence to patients and carers in home, primary and community care management and in early intervention could enable early discharge and a reduction in admissions to hospital from the ED. This may be particularly true in both children and in elderly patients with complex conditions.
Given the higher numbers of unnecessary ED attendances for children, there are likely to be some specific approaches to address this issue that may not be generalisable to adults. So these two groups may be considered as sub-categories and solutions developed for adults should not be assumed to work equally well for children and vice-versa. Any evaluation of a solution to this challenge should be designed to take into account the differences and studies powered accordingly.
Funding available and how to apply
The SBRI competition is open to single companies or organisations from the private, public and third sectors, including charities. The competition runs in two phases (subject to availability of budget in 2021):
• Phase 1 is intended to show the technical feasibility of the proposed concept. The development contracts placed will be for a maximum of 6 months and up to £100,000 (inc. VAT) per project
• Phase 2 contracts are intended to develop and evaluate prototypes or demonstration units from the more promising technologies in Phase 1. Only those projects that have completed Phase 1 successfully will be eligible for Phase 2.
Developments will be 100% funded and suppliers for each project will be selected by an open competition process and retain the intellectual property rights (IPR) generated from the project, with certain rights of use retained by the NHS. The competition opens on 15 July 2020. The deadline for applications is 1pm 27 August 2020.