NHS AI To Speed Up Cancer And Heart Care

NHS patients will be among the first in the world to benefit from new artificial intelligence (AI) technologies thanks to a £50m boost announced today.

A range of AI-powered innovations which can rapidly and accurately analyse breast cancer screening scans and assess emergency stroke patients will be tested and scaled, helping clinicians deliver the right treatment faster.

Take-home technology could also see patients given devices and software that can turn their smartphone into a clinical grade medical device for monitoring kidney disease, or a wearable patch to detect irregular heartbeats, one of the leading causes of strokes and heart attacks.

The NHS has been at the forefront of the AI revolution with the creation of the NHS AI Lab, with these tools and products part of the £140m AI in Health and Care Award programme, each receiving a share of over £50m. The award is managed by the Accelerated Access Collaborative in partnership with NHSX and the National Institute for Health Research.

The package also includes funding to support the research, development and testing of promising ideas which could be used in the NHS in future to help speed up diagnosis or improve care for a range of conditions including sepsis, cancer and Parkinson’s.

The NHS is committed to becoming a world leader in the use of AI and machine learning, aiming to reap the benefits that range from faster and more personalised diagnosis to greater efficiency in screening services.

Sir Simon Stevens, NHS Chief Executive, said: “The NHS has and always will rely first and foremost on the clinical expertise of our staff, but the innovations we’re funding today have the potential to save lives by improving screening, cancer treatment and stroke care for NHS patients across the country.”

"We're still in the early stages of AI, but when the latest chapter in the history of medicine comes to be written, AI in health care will doubtless rank alongside earlier advances such as the stethoscope, the X ray and the blood test."

Health Secretary Matt Hancock said: “The NHS has always spearheaded world-leading technologies that can transform and save lives, so it is vital we continue to harness the full potential of modern digital advances to help patients living with life-limiting illness and support our hardworking NHS staff.

“During the pandemic we have all seen the positive impact new technology can have – from our next generation rapid testing, to our machine-learning tools helping the NHS predict where beds and oxygen are needed - and I’m determined we continue down this path.

“Today’s funding will ensure the NHS can continue to fast-track pioneering artificial intelligence to the frontline, freeing up clinicians’ time and saving lives.”

Today’s announcement supports a range of technologies at different stages of development, from initial concepts to real-world tests.

AI products will be trialled in several NHS organisations before potentially being adopted across the health service.

Each product will undergo robust testing and independent evaluation to ensure they are effective, accurate, safe and value for money.

The AI in Health and Care Award forms part of the NHS AI Lab and is managed by the Accelerated Access Collaborative in partnership with NHSX and the National Institute for Health Research.

Matthew Gould, chief executive of NHSX, said: “Throughout the pandemic, the NHS has shown how digital technology can transform the service it provides, quickly and safely, but we have a long way to go.

“The NHS AI Lab was set up to drive the adoption of data-driven technologies, with the goal of enhancing the care our staff can give their patients, and these awards should give that effort a serious boost.”

Lord Darzi, chair of the Accelerated Access Collaborative, said: “The AAC and the AI in Health and Care Award are helping to cement the UK’s international reputation as the perfect location to trial and test new technologies.

“Today we have backed a range of innovators from academia, industry and the NHS to develop and deliver AI tools and products that can transform our health system and ensure we continue to be a world leader in medical science and research.”

Subject to contracting, successful products to be spread include:

• Healthy IO - will spread their AI powered app that turns a smartphone into a clinical grade medical device capable of detecting albuminuria, an early warning sign of Chronic Kidney Disease which could help patients with diabetes.

• Irhythm Technologies - will spread their wearable ECG monitoring patch and service that utilises AI-led processing and analysis to help diagnose atrial fibrillation

• Brainomix will share their digital tools, used to assess emergency stroke patients, to a number of NHS sites following recent successful deployment at Royal Berkshire NHS Trust.

The NHS will also support the first real-world tests of technologies including a system that can detect prostate cancer in biopsy tissue slides, and a device which uses an algorithm to immediately diagnose heart failure.

The NHS AI Lab, announced by the prime minister last year, is a key part of the efforts to increase the use of innovative new technologies in the health service.

As well as testing and scaling AI products, the NHS AI Lab has also published updated guidance to help local health and care organisations ensure they ask the right questions when looking to buy AI products.

The new AI Buyers Guide will help local NHS bodies walk the line between the exciting possibilities presented by these technologies with the need to ensure that any products our organisations buy meet the highest standards of safety and effectiveness.

The AI in Health and Care Award will distribute £140m over three years, with the next round of applications set to open in the autumn.

• Over 530 applications were received across the four phases which were reviewed through a series of stages including long-listing, due diligence checks, clinical and peer reviews, and interviews.
• As part of the selection process each applicant had to commit to complying with the laws and regulations that protect health and care data as well as the NHS’s Code of Conduct for data-driven technologies.
• The NHS is supporting the first real-world tests of technologies including:
  • Kheiron Medical Technologies - will test their breast cancer scan machine reading algorithm in NHS screening services.
  • Ibex Medical Analytics -AI system - which detects cancer and other clinically important features in prostate biopsy slides. It will be tested using information from 600 men across 6 NHS hospitals, and compared with assessment from trained pathologists.
  • Eko DUO device - a ‘smart’ stethoscope that records an ECG as well as heart sounds, and is used like a standard stethoscope which can provide an immediate diagnosis of heart failure using an AI algorithm. It will be evaluated in 500 patients in GPs and secondary care, comparing results to current NHS heart failure care pathways.
  • Oxford Heartbeat - will test their PreSize Neurovascular medical software that can help doctors plan for high-risk brain surgeries by choosing the best stent for each patient. It will be tested across 5 hospitals to evaluate how it works and whether it can help save money.
• Earlier stage projects have also been funded, intending to test new concepts for use in the NHS, including:
  • Odin Vision’s AI technology, which assists doctors to detect and characterise cancerous and pre-cancerous polyps during colonoscopy procedures.
  • A project at Imperial College London that will test a method to automatically and continuously recommend to clinicians the correct dose of medications for treating sepsis in individual patients, personalising treatment and potentially improving survival.
  • University College London’s SamurAI system, which uses AI to learn when to stop or change the use of antibiotics to ensure they are only used when really necessary.
  • Lifelight software from Xim Limited that contactlessly measures blood pressure, heart rate, respiratory rate and oxygen levels in the blood using the camera on any smartphone. This project will collect data to allow Lifelight to measure blood pressure more accurately so it can diagnose high blood pressure more effectively.
  • A small table-top device, developed by Albus Health, that can automatically monitor a range of symptoms and metrics without patients having to do or wear anything, helping to predict preventable asthma attacks in children will be tested within existing NHS infrastructure to generate real world evidence of clinical benefit and economic value.

Four categories of AI products are being supported:
Phase 1 - to support the demonstration of the technical and clinical feasibility of the proposed concept, product or service.
Phase 2 - to support the development and evaluation of prototypes and generate early clinical safety/efficacy data.
Phase 3 - to support the first real-world tests in health and social care settings of AI products or tools to develop evidence of efficacy and preliminary proof of effectiveness, including evidence for routes to implementation to enable rapid adoption.
Phase 4 - to support the spread of AI products or tools that have market authorisation but insufficient evidence to merit large-scale commissioning or deployment. Successful products will be adopted in a number of NHS sites to stress test and evaluate the AI technology within routine clinical or operational pathways to determine efficacy or accuracy, and clinical and economic impact.

The winning technologies for each phase are as follows:

Phase 1 projects

Stewardship of Antimicrobials using Real-Time Artificial Intelligence (SamurAI)
University College London
The SamurAI system will use AI to combine historical data for patients prescribed with antibiotics with the findings of specialists in infection as they review prescriptions. The system will learn when to stop or change the use of antibiotics to ensure they are only used when really necessary.

Deep learning for effective triaging of skin disease in the NHS
University of Dundee
This project is developing an AI (deep learning) system to distinguish common benign skin lesions from common skin cancers with state-of-the-art accuracy. This research will develop the system with representative image data from NHS clinics.

A fully automated ultrasound tool to screen for fetal growth restriction (FGR) in the first trimester
University of Oxford
This project will further develop fully automated ultrasound tools (the OxNNet toolkit) that can provide reliable measurements of placental size and shape in the first trimester, as well as estimating the blood flow within it. This can form the basis of a population-based screening test for fetal growth restriction (FGR). By identifying women at high risk of FGR early, we can increase monitoring and deliver the baby before it is stillborn and, in the future, test new treatments that could help prevent FGR from developing.

Personalised Preoperative (Neoadjuvant) Chemotherapy (NACT) to optimize curative treatment in breast cancer
University of Nottingham
This project will identify features from MRI scans in breast cancer patients, in combination with routine clinical data and advanced computational modelling, to predict the response to NACT. This will help clinicians to make better decisions for each individual patient and minimise unnecessary treatment.

OCTAHEDRON : Optical Coherence Tomography Automated Heuristics for Early Diagnosis via Retina in Ophthalmology and Neurology
Newcastle University
The OCTAHEDRON project aims to use machine learning to detect early signs of neurodegenerative disease - such as Parkinson’s - in OCT scans of the retina. NHS doctors’ input and analysis of thousands of OCT scans will teach the computer system how to recognise changes in the retina that could help to detect neurological disorders sooner when treatment can be most effective.

Improving diagnostic yields of the Faecal Immunochemical Test using artificial intelligence and machine learning
Advanced Expert Systems Limited
This project will develop a computer model to identify potential cases of bowel cancer or polyps using results from FIT and other patient data, to enhance the NHS bowel cancer screening programme. The aim is for this system to help identify high-risk patients who can be prioritised for colonoscopy, reducing unnecessary, costly procedures.

Development of AI techniques to predict eye cancer using big longitudinal data
University of Liverpool
This project will further develop a novel, fully-automatic AI-powered diagnostic tool to support the accurate diagnosis and monitoring of choroidal naevi (patches of pigment at the back of the eye) and to predict the risk of ocular melanoma, the major form of eye cancer. The aim is to help to streamline the management of patients and reduce cost for the NHS by assessing and monitoring in the community for low-risk lesions, and follow up conditions with high risk factors in secondary care.

An artificial intelligence macular disease treatment decision tool for patients with wet age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion
Macusoft Ltd
This project will complete development of computer software that will be able to tell whether the patient’s eye is stable or not without them needing to see eye doctors for regular check-ups. The software will allow more patients to be seen and treated, by creating efficiency and capacity for busy eye clinics

Project Rhapsody: Investigating the clinical feasibility of using AI-based deep audio and language processing techniques to diagnose neurological and psychiatric diseases
Novoic Ltd
This AI technology offers a novel way to analyse complex speech/language patterns from free speech to detect common neurological and psychiatric diseases. A key differentiator is the use of proprietary speech representation methods to build generalisability and robustness into the tool–this research will help establish the clinical feasibility of this first-of-its-kind modality.

AI-enabled point-of-care technology for radiotherapy planning peer review
Mirada Medical Ltd
This project will determine the clinical and technical feasibility of using AI for review of RT treatment plans for cancer patients. This will be tested using anonymised clinical images to evaluate how effective the approach is, with the ultimate aim of conducting effective, faster checks to improve treatment.

Prognosis of epilepsy using at-home EEG monitoring
Neuronostics Limited
This project will develop a smartphone-based app that can receive and segment EEG recordings from wireless headsets to assist with assessing how well epilepsy treatment is working. The project will deliver a prototype device and a roadmap for product development.

Autonomous cardiac MR acquisition
Barts Health NHS Trust
This project aims to use AI to fully automate cardiac MRI scans. Autoscanning and autoanalysis will add precision and help to predict clinical outcomes better than current care, as well as speeding up scanning, reducing waiting times, saving money and freeing up scarce resources.

Senti: Wearable technology to enable remote precision and predictive medicine for respiratory patients
Senti Tech Limited
This project is developing a device which enables remote chest examination for respiratory patients through sensors embedded into a jacket. The research will use AI to develop ways to predict deterioration in patients with long-term respiratory conditions, personalise treatment and enable patients to make more informed healthcare choices.

An artificial intelligence algorithm for diagnosing attention deficit hyperactivity disorder (ADHD) in adults
University of Huddersfield
This project will develop a first-of-its-kind AI solution for diagnosing ADHD in adults. This will shorten the time people will need to wait for a diagnosis because a broader range of health professionals will be able to complete the diagnostic assessments quicker. The AI will use clinical data to guide health professionals about who requires extra assessment and who doesn't.

Woubot: An AI predictive system to produce personalised care recommendations for chronic lower limb wounds
Nine Health Global Ltd
This project will create a suite of automated software tools for community and wound clinics, with a user-friendly mobile application designed by doctors and nurses for their own use within the NHS. The app will generate a personalised care pathway for each patient, and use image and other automated software to monitor progress and outcomes.

Phase 2 projects

FORE AI
Odin Vision Limited
Doctors miss up to 25% of cancerous/pre-cancerous polyps during colonoscopy procedures. Odin Vision’s award winning AI technology assists doctors to detect and characterise polyps. Better early detection and instant diagnosis have the potential to improve patient outcomes, reduce costs and improve the patient experience. The FORE-AI project will evaluate this AI technology across multiple hospitals to analyse the benefits for patients and the potential cost savings.

Clinical validation of the AI Clinician decision support system for sepsis treatment
Imperial College London
This project will test a method to automatically and continuously recommend to clinicians the correct dose of medications for treating sepsis in individual patients, personalising treatment and potentially improving survival.

Developing Lifelight: A contactless vital signs monitor for CVD screening
Xim Limited
Lifelight is software technology that completely contactlessly measures blood pressure, heart rate, respiratory rate and oxygen levels in the blood using the camera on any smartphone. This project will collect data to allow Lifelight to measure blood pressure more accurately so it can diagnose high blood pressure more effectively.

Digitally adapted, hyper-local real-time bed forecasting to manage flow for NHS wards
University College London
This project aims to improve a model that predicts future demand for hospital beds, allowing local teams to adjust staffing levels or reschedule operations in line with future demand. The model will be tested with clinical and operational teams to make sure it is reliable, easy to use and safe.

Interactively trained ‘human-in-the-loop’ deep learning approach to improve cardiac CT and MRI assessment for accurate therapy response and mortality prediction
University of Sheffield
This project will develop an interactive deep learning method to measure heart health in large groups of patients, using MRI/CT scans. Existing detection algorithms will be used on these scans and the data will then be edited by experienced consultants to improve the measurements. Ultimately this could provide better predictions of responses to treatment and survival in patients with heart disease.

Artificial Intelligence to improve cardiometabolic risk evaluation using CT (ACRE-CT)
Caristo Diagnostics Limited
Caristo Diagnostics’ FatHealth technology is using standard CT scans combined with AI techniques to detect fat tissue inflammation, which can indicate a higher risk of developing diabetes or dying from heart disease. The project will analyse 20,000 CT scans to train the AI algorithm and help develop accurate risk predictions.

Dem Dx triage support platform for ophthalmology referrals
Dem Dx Limited
This project will develop and test a new technology to gather and process information about patients’ eye symptoms, to help healthcare staff make accurate and safe triage decisions and deal with the most common eye problems. This could help free up specialist time for urgent and complicated cases that need faster treatment.

BioEP: From prototype to clinical evaluation
Neuronostics Limited
BioEP is a computer biomarker of epilepsy that is designed to augment electroencephalograms (EEGs) to address delays in diagnosis of the condition. The project will further develop a prototype of a diagnostic decision support tool that can provide a risk score showing how easy it is for seizures to occur.

SMARTT critical care pathways - (Safe, Machine Assisted, Real Time Transfer):
An artificial intelligence based decision support tool to enable safer and more timely critical care transfer
University Hospitals Bristol and Weston NHS Foundation Trust
This research is developing an AI tool that will help to decide which patients are well enough to leave intensive care, helping to free up bed spaces and provide better care. The tool uses data from monitors, ventilators and blood tests and will help clinicians make more accurate and timely decisions. It will be tested in a real intensive care unit as part of this project.

Prediction and prevention of asthma attacks in children
BreatheOx Limited
Albus Health have developed a small table-top device that can automatically monitor a range of symptoms and metrics without patients having to do or wear anything, helping to predict preventable asthma attacks in children. Alongside Birmingham Children's Hospital, Imperial College London, Asthma UK and Oxford AHSN, this project will test the system within existing NHS infrastructure to generate real world evidence of clinical benefit and economic value.

Autonomous telemedicine - cataract surgery follow-up at two NHS trusts
Ufonia Limited
The project is using Ufonia's natural-language AI assistant delivered via a normal telephone call, to follow up with patients after cataract surgery at two large NHS hospitals. This study will evaluate Ufonia's clinical decisions with those of expert clinicians and assess how acceptable the system is for patients and clinicians.

Natural language processing for real-time data capture in electronic health records to improve clinical care and operational efficiency
University College London Hospitals NHS Foundation Trust
This project is developing a natural language processing system to support the conversion of clinician’s text in electronic health care records into a structured format that can be processed by computers to help support clinical decision making, planning and research. The system works at the point of care, during data entry, and clinicians are given the opportunity to validate the suggestions before they are added to the patient record. The system will be tested in a simulation environment and then tested at University College London Hospitals and Great Ormond Street Hospital.

Phase 3 projects

A study to assess the clinical and cost-effectiveness of the Ibex Medical Analytics - AI System: Histology system in diagnosing clinically important prostate cancer in prostate biopsy tissue
Imperial College London
Investigating the accuracy of a new AI tool (Ibex Medical Analytics - AI system) in detecting cancer and other clinically important features in prostate biopsy slides from 600 men across 6 NHS hospitals, and comparing with assessment from trained pathologists.

Real world testing of PreSize Neurovascular: medical device software to optimise stenting surgeries to reduce complications
Oxford Heartbeat Ltd
Testing medical device software that can help doctors plan for high-risk brain surgeries by choosing the best stent for each patient - finding out how the software works across five hospitals, with the aim of improving the standard of care while minimising cost to the healthcare system.

EchoGo Pro: NHS impact of automating coronary artery disease risk prediction in stress echocardiogram clinics
Ultromics Ltd
EchoGo Pro uses AI to analyse stress echocardiograms to help more accurately diagnose heart problems such as blood vessel blockages. This project will assess how the device will benefit the NHS and patients in 12 hospitals and compares results with patients assessed normally by doctors, as well as seeing if the device can save money.

Point-of-care heart failure diagnosis for GP use: Implementation and evaluation of a simple AI-tool into the folio of care pathways serviced by Imperial’s Connected Care national GP network

Testing an AI tool to help GPs diagnose heart failure - the Eko DUO device is a ‘smart’ stethoscope that records an ELECTROcardiogram as well as heart sounds, and is used like a standard stethoscope. It can provide an immediate diagnosis of heart failure using an AI algorithm. This will be evaluated in 500 patients in GPs and secondary care, comparing results to current NHS heart failure care pathways.

Evaluation of the DEONTICS AI platform for personalised, evidence-based treatment planning in multidisciplinary cancer care: Increasing compliance with national standards of care and streamlining MDTs in prostate cancer
Guy’s and St Thomas’ NHS Foundation Trust
The DEONTICS AI platform is designed to increase the efficiency and effectiveness of multidisciplinary team meetings that make decisions on cancer care for individual patients. This study will evaluate how the platform works to triage less complex patients straight to the treating clinicians, whilst also supporting decisions on care for prostate cancer patients with more complex needs.

Phase 4 projects

e-Stroke Suite
Brainomix Ltd
A set of tools that uses AI methods to interpret acute stroke brain scans, and helps doctors make the right choices about treatment and the need for specialist transfer of patients with confidence. It also provides a platform for doctors to share information between hospitals in real-time avoiding the delays that can occur.

Smartphone albuminuria self-testing
Healthy.io (UK) Ltd
Using a home test kit and mobile app, Healthy.io’s solution empowers patients to self-test at home with clinical grade results. Fully integrated to the Electronic Medical Record (EMR), real-time results are available for clinician review and follow-up. Shifting testing to the home increases uptake while reducing workload in primary care.

DLCExpert
Mirada Medical Ltd
DLCExpert uses artificial intelligence software to automate the time-consuming and skill-intensive task of outlining (or “contouring”) healthy organs on medical images for radiotherapy planning so that they are not irradiated during treatment.

EchoGo Pro: Automating coronary artery disease risk prediction in stress echocardiogram clinics
Ultromics Limited
A fully automated and scalable application for quantification and interpretation of stress echocardiograms that autonomously processes “real world” echocardiographic image studies to predict prognostically significant cardiac disease.

Automated diabetic retinal image analysis software
Optos Public Limited Company
OptosAI uses a machine-learning algorithm to analyse images of the back of the eye for the presence/severity of any diabetic retinopathy, and then advises if referral to an eye care specialist is needed (based on the local clinical pathway).

Mia Mammography Intelligent Assessment
Kheiron Medical Technologies
Deep learning software that has been developed to solve critical challenges in the NHS Breast Screening Programme (NHSBSP), including reducing missed cancers, tackling the escalating shortage of radiologists and improving delays that put women's lives at risk.

Maximising Hospital Resource
ICNH Ltd (DrDoctor)
DrDoctor uses AI to get the greatest use from every scheduled appointment within a hospital. It ensures attendance is as high as possible by using past appointment attendance and demographic data to predict those less likely to attend in the future.

RITA: Referral Intelligence and Triage Automation
Deloitte
An AI solution to automate the triage of GP referrals – assessing the urgency and next step for the referral and sending through directly to the next step in the process. In addition the solution includes a virtual assistant that supports clinicians in writing letters back to GPs, significantly speeding up this process.

Veye
Aidence
An AI platform to optimise oncology pathways, which can be integrated into existing software systems. Veye Chest, the first clinical application, is unique in its ability to currently automate early lung cancer detection, and soon also support treatment response assessment.

Zio Service
iRhythm Technologies Ltd
A complete and clinically proven ambulatory ECG monitoring service, utilising powerful AI-led processing and analysis to support clinical workflows and improve the diagnostic yield and timeliness of cardiac monitoring.

About the NHS AI Lab

The NHS AI Lab is a focal point to accelerate the safe adoption of AI into the front line of health and care. It brings together government, the NHS, academics and technology companies to help tackle some of the toughest challenges in health and care.
The NHS AI Lab believes in creating a sustainable health and care system which achieves better outcomes, equality and fairness for all. We want to support AI technologies that have potential to improve the quality of health and care services while building a robust ethical and regulatory framework to ensure patient and citizen safety. https://www.nhsx.nhs.uk/ai-lab/

About the Accelerated Access Collaborative

The Accelerated Access Collaborative brings together industry, government, regulators, patients and the NHS to remove barriers and accelerate the introduction of ground-breaking new treatments and diagnostics which can transform care. The AAC supports all types of innovations: medicines, diagnostics, devices, digital products, pathway changes and new workforce models. www.england.nhs.uk/aac/

About NIHR

The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

Funds, supports and delivers high quality research that benefits the NHS, public health and social care
Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
Partners with other public funders, charities and industry to maximise the value of research to patients and the economy

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.