The Eyes have it…

How data and technology are re-focussing healthcare


When technology and science combine to secure vital diagnostic evidence from 13,000 retinal images in the blink of an eye, it would be hard to argue against a future dominated by AI.
The evidence is powerful.
An algorithm, trained on a huge data set, proved the far reaching capabilities of machine learning when it accurately predicted across a range of factors – including tagging blood pressure to within a millimetre of mercury – when put to the test on a new data set.
The research, by Poplin et al, is a clear illustration of a diagnostic future where diseases could be intercepted before they take hold and even register any symptoms.
How society deploys the power of AI across medicine was probed in the Future of Diagnostics – the second of four fascinating Future of Healthcare debates – held at the Blizard Institute at Queen Mary University of London.
Sir Harpal Kumar, head of Johnson & Johnson Innovation EMEA and former CEO of Cancer Research UK, told the audience that technology came with possibilities, challenges and questions.
“The importance of diagnostics cannot be overstated and it is going to be of ever greater importance in coming years,” he said.
“It is not inconceivable to imagine a world in the not too distant future where we will use diagnostics with the ability to diagnose the possibility of someone getting a condition and intervening before they do, so they never develop the disease.”
The event, organized by the Royal Institution, drew an audience from across medical technology, science and academia.
Professor Alastair Denniston, a consultant ophthalmologist at University Hospitals Birmingham who is leading research into the use of health data research and artificial intelligence, introduced Poplin’s data as example of a rich diagnostic potential.
The algorithm’s performance is way more than an impressive exercise in number-crunching as the data and its accuracy delivers extra information to help decode the intricacies of conditions that are difficult to spot early and treat adequately.
It also holds promise for scientists to define why more women than men suffer macular degeneration, according to Professor Denniston, who is based at the University of Birmingham and the NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital/UCL.
The implications of refining technology and delivering it in setting outsides clinics and hospitals, such as High Streets and rural areas, holds transformative potential around the world; around 31 million people – 300,000 in the UK – are blind or living with sight issues.
But society’s relationship with technology needs to be nuanced. “Increasingly, we will go to platforms of new technology,” added Professor Denniston. “Does this mean we will totally replace doctors and healthcare professionals? I would argue not.
“There will still be a role for human doctor and healthcare professional because diagnosis is not just a label. It is a fork in the road and when I get there I want someone to be there with me and I want them to be human. I want to know they know what it is like to be there to and that is where the perfect algorithm will not be enough.”
It is a textured view echoed by Professor Rebecca Fitzgerald, who is based at the Medical Research Council unit at the University of Cambridge, who celebrated future potential but emphasised the need not to over-diagnose and spread anxiety.
However, extra layers of diagnostic information from technology and genetics could identify people at risk of developing diseases and allow early interceptions. Around 55,000 people will survive five or years more if their cancer diagnoses are made at Stage 1 or 2, rather than at advanced stages, according to the UK government’s Long Term Plan for cancer survival.
Professor Fitzgerald also revealed the benefits of diagnostic technology that can be achieved with the Cytosponge process, an ingenious application to detect early oesophageal cancer. Patients, who would normally be put through a lengthy and uncomfortable endoscope procedure, need only swallow a pill attached to a string which expands into a textured sponge in the stomach and can then be drawn back through the oesophagus to collect cells that can be tested for cancer.
The Cytosponge test, which takes around ten minutes, is now in advanced clinical trials and Professor Fitzgerald’s team believes it will allow hundreds of patients to receive early, less invasive and toxic treatments to cure their conditions.
“Cancer can start developing ten years before it manifests itself, which means we have a great opportunity to detect these changes early and intercept them,” she said. “We might even be able to intercept them in a person who feels completely well before it causes them a problem that is symptomatic.”
Both speakers agreed that technology is leading towards having more diagnostic tests at GP surgeries and High Street pharmacies.
Technology and the strategic application of data and diagnostics are clearly potent weapons for healthcare to meet the mounting global healthcare challenges.

• The Future of Health series of events is sponsored by Medtronic.


Blizard Institute, Queen Mary University of London

The biggest question of a generation – what is the future of healthcare?

hero_image_history_ribuilding_1_0_005001ae5001ae.jpgThe Royal Institution is the crucible where scientific thinking has been tested and developed for more than for more than 200 years so it was a fitting venue to ask What is the future of healthcare?

It’s a big question.
With an ageing population living with multiple conditions, and resources – financial and structural – struggling to keep pace with demand, the issue is a collider for science, health, society and politics.

The points of view were wide-ranging and displayed the need for research, innovation and collaboration across all the disciplines involved in getting therapies to the people that need them most.

But the ingenuity and persistence that drives drug discovery and medical technology advances also needs to be harnessed with practical approaches that navigate education, awareness and regulation.

It will take a mosaic of responses to come prevent healthcare systems fracturing into oblivion.

The panel featured Dave Dawes, of the Future Care Capital think tank, Professor Beate Kampmann, director of the Vaccine Centre at the London School of Hygiene & Tropical Medicine, and Nick Crabb, programme director, scientific affairs at NICE, the government’s health agency that rules on what drugs and devices meet strict criteria for approval and funding.
Their perspectives varied but settled on common ground that societal changes were needed to create equitable healthcare, get technological advances into the public’s hands and promote individual responsibility to energise a movement in preventative health.

An audience of around 150, gathered at the Institution’s fabled lecture theatre, heard about the need to get the best from limited financial resources, how healthcare spending needed recalibrating to support preventative health and how advances in vaccination programmes had been shaken by the anti-vax movement, putting children, families and communities in peril.

Beate Kampmann illustrated the acute need to incorporate human behaviour and understanding into health policy by reporting that measles cases in the UK are rising because of vaccination refusal caused, largely, by ill-informed anti-vax campaigns.

Nick Crabb emphasised that health systems were facing an ‘affordability challenge’ and there was an imperative to make the best of technology so that people could retain their independence in the community rather than depend on hospitals and clinics. He added: “We end up in a bit of a moral dilemma because when people are in trouble, there is an expectation from themselves, their families and carers that the NHS is going to look after them.

“There has been an enormous amount of innovation in the life sciences industry that are allowing significant extensions to life and improvements to quality of life through innovative and expensive products and working through that is going to be a really big challenge for the next generation . I think financially sustainable care is crucial.”
Dave Dawes highlighted that 21% of the UK’s population would be over 60 by 2050 – the Office of National Statistics estimates that 20.4 million people will be aged 65 or over by 2066, a 26% increase on current figures. He added that, although achieving good health needed to address factors such as housing, wealth, taxation and family backgrounds, a key challenge was educating the public to be aware of their own health and how they can influence it.
Constructing healthcare systems  that can function for the next generation will take ingenuity, innovation and a steely determination to create more flexible and effective technologies, therapies and systems.
It was clear from the evening, and responses from the audience, that more discussion and debate are needed to build that future. Ignoring the tough questions and even tougher decisions is not an option.

  • The event was supported by Medtronic and was the first four debates on the Future of Healthcare.



Is digital nutrition the new Soul Food?


Listening to Kristen Scott Thomas could seriously enhance your mood


The mental health menu is full of apps designed to de-stress, de-compress and de-tangle cluttered lives. From the whale and aquatic mainstreamed by health spas to the spoken word, the digital mindfield is bathed in wellness.

Whatever works for you, works for you. But are we focussing too much on providing calming antidotes rather than building mental strength?

Being that May is Mental Health Awareness Month  in the US and Mental Health Awareness Week is in full swing in the UK,  new downloads, apps and digital initiatives are in full flow.

I’m no app reviewer, and this is not a product endorsement, but one approach intrigued and prompted the headline question. Moodrise styles itself as the world’s first on-demand digital drug delivery system for mobile devices with a sweet spot of supplying bite-size sounds, graphics words and images designed to upgrade our mental health through digital nutrition.

They are short snaps of uplifting or deflecting content – called pillcasts – with an innovative approach. Oscar-nominated actress Kristin Scott Thomas, who starred in The English Patient and Four Weddings and a Funeral, reads scathing restaurant reviews and proverbs. They also feature actress Daisy Lewis, star of ITV’s Downton Abbey.

And it is that idea of feeding yourself morsels of content to build a stronger self that needs more traction in the campaign for better mental health. Could a diet of strategically taken digital ‘drugs’ do the trick? Is this the new soul food?

Its founder, Michael Phillips Moskowitz, an entrepreneur and former chief global curator at eBay, believes the content can be particularly effective at breaking the often corrosive impact of social media and building a resilience through the pill casts. This, he claims, is founded on solid scientific evidence and brain chemistry principles and has the power counter the addictive and depressant elements of social media.

They are not, he insists,  an instant fix but can make it easier for people to balance their social media exposure, manage mental health issues and clear away some of the weeds on the path to happiness and fulfilment.

“We developed Moodrise to empower people to proactively manage their mental health. It helps users improve their digital literacy and progressively enhance our emotional resilience,.” he says.

Scott Thomas, a BAFTA award winner, is supportive, and says: “I worry that communication through social media doesn’t allow for tone. We miss the subtleties understood through expression, tension, warmth etc.

“There can be a tendency to exaggerate for effect so that subjects and ideas become very black and white. We’ve seen how extremely detrimental to self-esteem and for body image this can be.”

Not everyone has the time and finance to have regular spa days and the thought of carving out a free hour – when and where?! – to listen to relaxing sounds is a mission, but a daily hit of digital nutrition could be a powerful ally to mental health resilience. This idea of feeding our mental literacy is compelling. Mental health campaigning can be stuffed with negativity – the stats from the World Health Organisation are chilling – so it is good to try a different drumbeat.

How well Moonrise works is not the central point here; it is the notion of almost mirroring social media’s gameplay to promote positivity. Rather than the obsessive scroll through Instagram and twitter feeds, pop a pillcast and enjoy the diversion.

It is innovative, has scientific merit and listening to Kristin Scott Thomas is a joy.

Can we ever beat eating disorders?

dJmusAWBiMSbhcN-800x450-noPadIt’s British Pie Week and soon it will be National Cereal Day. Chances are that whenever you read this blog, there will be an awareness day, week or month in flow.

It is modern trait to colonise part of a calendar to push an interest or a cause but they make convenient marketing springboards into our consciences and the opportunity to trigger emotional responses.

Nothing wrong with that but the calendar has become pock-marked with prospectors’ stakes for commercial gain and the rush to claim a day has created the discordant dating that places pie and cereal celebrations immediately after Eating Disorders Week in the UK.

And that is a perfect example of the scale of issue facing valiant people fighting eating disorders and the campaigners and health workers striving to combat the complex personal issues involved and to promote wider understanding. Progress is followed by a slap in the face with a pie.

The advertising spend and marketing reach of big food companies is truly impressive or terrifying depending on who pays your wages. Spending on junk food advertising is 30 times greater than the government spend on promoting healthy eating, according to research by the Obesity Health Alliance. But that is only part of the story.

There are complex personal factors involved in eating disorders but it seems that few moments are free from the mental assault of seductive imagery because that spending power washes over the psychological touch points that influence how we feel about our personalities and appearance.

Try this experiment: how many pieces of advertising that seek to impact your appearance (i.e. your body shape and size) do you encounter during a routine day? Check out what the people look like; are they ‘slim’, ‘toned’, ‘attractive’ and ‘happy’? This is not just fashion and food, it is all the adverts that carry an undertone, or even blatant, message that there is a way to look. We probably don’t register this kaleidoscope of imagery that flashes across our peripheral vision but the brain clocks them, stores them and builds a bigger picture.

Just try it out; count the ads, the images and be surprised….and maybe a bit disturbed.

Add to this mix, the accelerant of social media; the photos and behaviours freighted with extra toxicity because they come from a supposed peer group, even if you’ve never met them or understand what personal challenges may simmer behind these perfectly staged images. Its a mega-pixel moment that disguises the truth.

The ads and social media are essentially telling us how to be better, happier and prettier, according to Camille Williams, writing for the Eating Disorder Hope charity in the US.  Her excellent work and advocacy, like that of many, seeks to promote freedom from the advertising sales tactics which can needle away at our self esteem.

But it is a tough job to resist the impulses about how we should look and behave that are drip-fed into our lives. Awareness and education are crucial along with government funding for schemes that can make a genuine difference which is why awareness days, weeks and months do have a legitimate place on the calendar.

Eating Disorders Week, organised by beat, the UK’s eating disorders charity, presented some profound research and inspiring testimony that has given hope to many. It put a range of conditions in the spotlight and helped dispel stereotypes, demonstrating clearly that disorders do not discriminate and that swift, focussed support can lead to transformative results.

Its aims were not just a commercial jack-up – like the intention of the pie and cereals worlds. They are part of strategy to have a genuine, positive impact on peoples’ lives. Its commitment continues across the other 51 weeks.

And it is needed. While advertising runs virtually unchecked, some clinics and hospitals in the UK are still turning people away because they are not ‘thin enough’, virtually incentivising anorexia.

Campaigner Hope Virgo’s (@HopeVirgo) drive to stop this iniquitous health issue is gathering pace with her effective DumpTheScales petition. Her bravery and relentless effort to help others exemplifies the massive changes needed to give everyone a fighting chance of combatting mental health conditions stoked by advertising and marketing billions.

Sign the petition here so these issues are debated fully and people are not turned away from treatment they desperately need.



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What is the most important element of a perfect heart health system?

Everyone wants things to be perfect, right? Or even near perfect;  maybe just better than a system that functions to its optimum. Updating and accelerating performance normally means a new piece of kit of a now cliched ‘paradigm-shift’ in healthcare delivery.

Surely technology will cleanse all the misfiring and sclerotic elements of healthcare? Well, better diagnostics and smart therapies all help but the one desire from clinicians, policy makers and everyone involved at the sharp end is that prevention becomes the dominant feature – not funding, not politics, not technology; just good education, guidance and the realisation that our health destiny is, largely, in our own hands.

In a recent article for a Raconteur feature in  The Times I asked senior figures what they would place first in a wish list to create a perfect cardiovascular (CVD) health system; Prevention was the word.

CVD kills 17.9 million people in the world annually according to figures from the World Health Organisation and Professor Sir Nilesh Samani, a distinguished cardiologist and now medical director of the British Heart Foundation (BHF), was swift to state that the ideal system would prevent disease in the first place. He was joined by Jan Kimpen, chief medical officer, of healthcare technology giants Philips who echoed the need to live and eat healthy. They have impressive devices and diagnostics – and lots of them – but getting the basics right is the crucial first step before we can get anywhere near perfection.

Public Health England has just stated that prioritising prevention in the NHS could make a drastic difference to the health of the nation and limit the financial burden on the economy from smoking, obesity and CVD. It estimates that 50 per cent to 80 per cent of CVD cases are preventable.

The NHS health check, a series of checks for people aged between 40 and 74, is one of the biggest prevention schemes in the world has benefitted around seven million people since its inception in 2013. But its uptake needs to be supercharged to meet the growing threat of an ageing population living with multiple conditions and the fast-advancing nightmare of generations embedded with obesity.

Technology and medical discovery will tackle the tsunami of ill-health head on but prevention – taken in combination with every ingenious health innovation possible – has to become society’s by-word for good health.





Prevention is better than cure

UnknownThe NHS just got a 70th birthday present of a funding boost to save the ailing institution which ‘celebrates’ its grand old age on July 5. The gift is welcome but remains wrapped because no-one in the government has said how much, when and for how long. It’s an exercise in pass-the-parcel with multi layers to be stripped off before we get to the prize.
And what will the present be? £5 billion, £50 billion, more? The PM and the Health Secretary are light on detail but in this case the principle is way more important than the small print.
Whatever they give will not be enough if it is a one-off payment. We need to change our relationship with public health funding as much as we need to change public health.
that £50 billion will build the healthcare walls a bit higher but it will do little to stop the rising tide of preventable diseases that will spill over the new heights of funding pretty soon. I’ve long argued for the funding of health to be prised away from polarised party politics – it is way too important to be an idealogical football….the Health and Social Care Act ‘reforms’ of 2012 cost £4 billion and, no matter how much that figure is debated, it did little to change the downward trajectory of the NHS. And the plans of other political parties are hardly visionary.
So, and it’s a big SO, we need to change we as a society address our health, individually and collectively. Change is rarely easy but this has to start from our first steps, first words, first lessons. Health should be as important as the Three Rs in childhood development.
I recently wrote a piece for The Future of Health supplement published in The Times which examined the pressure of an ageing population weighted down by chronic diseases that could be avoided.
The Danish think tank, Demos, argues that any solution to this demographic mudslide has to be co-ordinated across health provision, housing, town planning and technology. Its founder, Aleksi Neuvonen, commented: “It will be the biggest social change in history.”
It will be difficult but it is the only game in town if the NHS is to survive. It’s going to be a long road when you consider that hospitals have fast food outlets and junk food is the cheap, easy option.
The hope is in growing realisation that plodding along will not cut it. NICE, the government’s health watchdog, agrees and has set out a series of modelling tools that show the savings that can be made by interventions from alcohol to wellbeing.
We should celebrate the NHS’s 70th and all it stands for but also realise that we are at the difficult birth of a new healthcare challenge that should unite all across the political and societal spectrums.

A mental health story where cuts are a good thing!

How can mental health benefit from a cut, any cut, let alone lots of them?!

A group of barbers is providing a way by encouraging clients to talk about themselves and let out some of the stresses and strains that build up in life.

We’re all busy, or pretend to be, so we rarely have time to chat in a neutral setting where judgements aren’t handed out. The barbers – or hairdressers – is one of the few places where that can happen. Often derided for their ‘Going anywhere nice this summer’ depth of chat, barbers are in a rare position to be that escape valve.

And Torquay tonsorial (sorry!) Tom Chapman @HeresTommy is championing a scheme where barbers can spot signs of depression and mental health issues and maybe direct people to helpful organisations or just be comfortable talking about personal themes. It’s not turning them into inquisitors latching onto any comment and squeezing pscyho-analytical meaning from it but more being a listening post.



Tom, who runs Tom Chapman Hair Design,  founded the Lions Barber Collective, a charity dedicated to helping barbers provide that listening post as well as the sharp styling. ( I wrote about him in this week’s Sunday Express ( and printed below) and hope his cause gets nationwide appeal. Barbers will get training in how to talk to and engage with clients and to not to razor a furrow in someone’s beautiful hair with shock if they say ‘I’m a bit depressed at the moment mate’.

We all need space to accept that our lives are not Facebook and Instagram perfect and maybe doing it while looking in the barber’s mirror will provide perfect self-reflection. Tom has found that more clients are ‘opening up’ to him since they found out he was happy to talk. He has also found existing clients who said just chatting to him while they were going through difficult times provide a huge relief to their stress.

You could hardly find a more manly arena for mental health stigma shaking: Barbers are now a world of bulging forearms, tattoos and Viking bushy beards so it sets a fantastic example about the need for men to talk.

Tom has big plans to promote the scheme –  NHS England are listening and becoming involved – so that ‘listening’ barbers can declare themselves with an approved sticker in the window.

It deserves to be a big success and it will  help many people keep on an even keel and keep the demons at bay. You can still talk about what you did on your holidays and debate if Jose or Pep is the better football manager but you can talk about anything

The only downside I can see is that men may be having more haircuts than normal as they get used to visiting a barbers for a chat and a snip.




FROM THE SUNDAY EXPRESS – September 9, 2016

Barbers are being encouraged to act as trained listeners to help clients deal with depression and mental health issues.

The move comes as a study reveals that 53% of men are more comfortable talking to their barbers than their doctors about private issues.

They establish trust by visiting the same snipper over the years while they are forced to see different doctors when visiting their GP surgery, it added.

“Listening and talking is something we do naturally as barbers and hairdressers,” says Tom Chapman, an award-winning barber. “We don’t want to turn barbers into counsellers but we want to provide that safe place where guys can open up and talk.

“The family doctor relationship is slowly dying which means men are likely hiding from issues that they should be comfortably discussing with their doctors, such as depression, anxiety, and even PTSD.

“But they do build up huge levels of trust with a barber. It’s not often you get chance to sit down and chat one to one in this busy world so it is an ideal opportunity to talk.”

Tom, who runs a barbers in Torquay, Devon, got training in counselling techniques after a 27-year-old friend took his own life.

“It affected me and thought if only he could have talked to me or any of the 100s of people at his funeral maybe it would have helped,” adds Tom, who formed the Lions Barber Collective charity to provide mental health awareness courses for barbers.

“We see clients more regularly than they see their GPs and, with a bit of training, we will be able to teach guys to recognise the signs and direct them to where they can get more help. It’s not about questioning clients; it’s about making them feel free to talk as often just talking about something can make a difference.

“More people have been opening up to me since I started the campaign and some long-standing clients have revealed that just chatting to me during difficult times had helped them.”

Tom has joined forces with grooming brand Bluebeards Revenge ( which commissioned the survey to coincide with yesterday’s World Suicide Prevention Day, to raise awareness of men’s mental health.

It’s managing director David Hildrew, a former Royal Marine Commando, says: ““It’s very encouraging to see that barbers all over Britain are presenting a suitable pillar for men to lean on. As an ex-serviceman, I take male depression very seriously. It’s an illness that many military men suffer with in silence. The Lions Barber Collective charity is the perfect way to break down the barriers that men tend to build themselves and together we hope to help educate barbers around the world and encourage men to man up and talk about their problems.”