Problem clinics: AI, digital innovation, equity and pathways

We believe the best advances in health come from a true understanding of the challenges faced by patients, health professionals and the wider system at the point of need - or preferably before. This year we ran a 'Call for Problems' where anyone could submit the pain points, obstacles and complications they faced in our current healthcare system, and our experts have selected a number of scenarios to feature in this dynamic and interactive problem clinic.

Select the problem you are most interested in from the list below, join a table discussion with the submitter and an expert relevant to the field, and begin to co-create some potential solutions together! We know these problems will not be solved in a day, but hope to start interesting conversations that will continue beyond the event and in to real world practical outcomes in the future.

Here is a selection of the problems that you can participate in:

1. Tackling interoperability: Building more efficient digital architecture for clinicians.
   1. The NHS lacks a digital architecture for patient centred care.
      NHS digital architecture remains organised around provider organisations rather than cross-setting patient journeys, limiting clinicians' access to reliable information and coordinated workflows to deliver integrated care pathways across neighbourhoods.
      Community contributor: David Kwo, Ingenuity Services.
   2. Beyond AI assistants: The case for a clinical workflow companion.
      Healthcare has transformed access to information but not the clinician’s workflow, increasing cognitive load, administrative burden and missed opportunities to improve patient care and learning.
      Community contributor: Fadilla Refin, NHS / Umbil (Mastering Medicine Ltd).
2. Innovations in remote care: Improving outcomes for older adults with frailty.
   1. Waiting for the crisis: Why the health system only learns that an older adult is unwell once they need admitting.
      Older adults living with frailty are unobserved at home, at discharge and between contacts. Deterioration is invisible until it surfaces reactively through emergency calls, reattendance or a failed care package.
      Community contributor: Hazhee Rasoul, Vayla Health Ltd.
   2. The ageing well advice line: A whole-system approach to admission avoidance for older people living with frailty.
      Older adults with frailty experience fragmented urgent care, resulting in avoidable emergency department attendance and admission. Community clinicians need rapid specialist frailty advice and access to alternative care pathways.
      Community contributors: Dulce Silva and Liliana Chapas, West Suffolk Hospital - Bury Saint Edmunds.
3. Eliminating geographic variation and improving access for patients with complex needs.
   1. Closing the specialty infusion access gap: Bringing high-cost infusion therapy closer to patients.
      Patients requiring high cost specialty infusion therapies face fragmented care, geographic barriers and complex access pathways that can delay treatment and disproportionately affect patients living in rural communities.
      Community contributor: Abdel Bendamkila, ECU Health.
   2. More machines, fewer hands: The growing burden of complex HMV.
      The HMV service supports a growing population with complex ventilation needs, but workforce, infrastructure and support provision remain below BTS recommendations, creating significant capacity pressures and potential inequities in care.
      Community contributor: Sonal Abhijeet Jagtap, Leeds teaching hospitals NHS trust.
4. Improving efficiency and accountability in ICU discharge.
   1. Evaluating ambient voice technology for ICU discharge summaries: A paired, blinded non-inferiority study.
      Clinicians spend hours writing medical documentation instead of caring for patients. Ambient voice technology could return that time but only if the documentation it produces is demonstrably no worse.
      Community contributors: Molly Cupper and Raihaan Biju, Cardiff and the Vale University Health board.
   2. Hospitals can count the days but not the decisions behind them.
      Standards for a patient's first 72 hours on an acute medical unit require senior decisions that nothing records. Unowned decisions are worse ones, and an average cannot detect them.
      Community contributor: Geetha Girithari, Independent (Consultant Physician, Acute Medicine).
5. Digital equity and migrant populations.
   1. AI enabled HIV prevention must account for mobility and digital inequality.
      AI-enabled HIV prevention risks missing mobile young women when digital access, socioeconomic vulnerability, geographic context, and patient needs are disconnected; innovation must become equitable, evidence-led, safe, and context-aware.
      Community contributor: Shashwat Ravi
   2. Wellness washing in consumer health applications: Protecting migrant users from hidden clinical inferences and consent risks.
      Consumer health applications may often use wellness language to obscure clinically relevant risk inferences, weakening informed consent and creating disproportionate privacy risks for structurally vulnerable migrant users.
      Community contributor: Toan Quoc Nguyen, TU Dortmund University.
6. Digital streamlining to tackle fragmented care pathways.
   1. Why community pharmacy PrEP remains out of reach for those most in need.
      Despite national agreement on the value of community pharmacy PrEP, there is no agreed implementation pathway. Key barriers remain unresolved, limiting equitable access to HIV prevention.
      Community contributor: Alexander Clewlow, NHS England.
   2. Bridging the digital referral gap: A real-time referral system to reduce delays in emergency obstetric care in rural low-resource settings.
      Emergency obstetric referrals in rural low-resource settings are often delayed by fragmented communication, transport coordination, and limited information sharing, increasing the risk of preventable maternal and newborn complications.
      Community contributor: Abdul Ghani Khatir, Henan Normal University.
7. Shifting from reactive to preventative systems.
   1. The invisible demand crisis: Why healthcare systems measure overcrowding but fail to measure prevention.
      We measure the consequences of healthcare system failure- overcrowding and corridor care, but not successful prevention, creating incentives that prioritise treating demand rather than reducing it.
      Community contributor: Ivan Koay.
   2. Pre-visit preventive screening: Transforming primary care from reactive consultations to predictive population health.
      Primary care misses preventive screening because clinicians rely on opportunistic identification during short consultations. AI-enabled pre-visit screening can proactively identify eligible patients before appointments, improving prevention and outcomes.
      Community contributor: Sultan Alharthi, Prince Mansour Military Hospital.
8. Unlocking the value from patient wearables.
   1. Are we underutilising everyday technology in healthcare?
      Current monitoring of rare sleep movement disorders relies on infrequent, resource-intensive investigations and subjective reporting. This report highlights how a patient repurposed a consumer smartwatch to provide continuous, objective symptom monitoring at home.
      Community contributor: Richard Madeley, Leeds teaching hospitals NHS trust.
   2. PADUCA: AI- and biosensor-integrated smart footwear for real-time prevention of diabetic foot ulcers.
      Diabetic foot ulcers cause devastating, preventable harm in India, yet conventional footwear and single-parameter sensors offer no real-time, personalised warning before ulceration occurs, low-resource settings.
      Community contributor: Aarti Yadav, India.
9. Improving equity for children with neurodevelopment needs.
   1. Improving population health: Every child matters.
      NHS strategy rarely future-proofs for children. Neurodevelopmental waiting lists dominate metrics, crowding out other child health needs, while thin, narrative-free data makes system performance hard to benchmark or hold accountable.
      Community contributor: Joanne Beckmann, Central and North West London NHS Foundation Trust.
   2. Mandating equity: Standardising neuro-developmental FollowUp for HighRisk infants in the UK.
      Inconsistent implementation of developmental followup across the UK creates a postcode lottery, delaying identification and intervention for highrisk infants and contributing to avoidable inequalities in neurodevelopmental outcomes.
      Community contributor: Heidi Furr, Maidstone and Tunbridge Wells NHS Trust.
10. Overcoming structural barriers in women's health.
    1. Filling the gap: Community-led abortion accompaniment in abortion-restricted U.S. States.
       In abortion-restricted U.S. states, thousands lack access to legal abortion care. Community-led self-managed abortion (SMA) accompaniment groups can safely fill this gap.
       Community contributor: Ira Memaj, CUNY School of Public Health.
    2. Barriers to institutional delivery and child immunization during COVID19 lockdown: A mixed method study.
       Fear of contracting COVID-19 and financial burden, worsened by the healthcare system's collapse during the lockdown, pushed the community away from institutional delivery and child immunization, causing poor health consequences.
       Community contributor: Akansha Aggarwal, Maharaja Agrasen Kedar Nath Gupta Medical college.
11. Modernising vaccination strategies
    1. The existing vaccination programmes overlook human migration and mobility.
       The existing immunization programmes assume a static population despite increased human migration. This leads to high dropouts for multi-dose vaccines, fragmented vaccine histories, missed doses, and inequitable life course immunization across healthcare systems.
       Community contributor: Priyadharshini Prasanna Venkateswaran, KMCH Institute of Health Sciences and Research, Coimbatore, India.
    2. AI-generated vaccine misinformation has gone visual, and it's reaching the people least able to question it.
       AI-generated visual vaccine misinformation is spreading across platforms faster than health systems can detect or respond. Existing misinformation tools were built for text, leaving a critical surveillance and response gap.
       Community contributor: Sam Martin, Manchester Metropolitan University.
12. Data, privacy, and responsible AI in sexual and reproductive health.
    1. The hidden impact of NHS data Opt-Out on pregnancy outcome prediction.
       When women opt out of sharing NHS data, their pregnancy records are missing from research datasets, creating gaps affecting the accuracy and fairness of tools to improve maternity care.
       Community contributor: Zara Arain, Queen Mary University of London.
    2. Shaping responsible AI use in commissioning sexual and reproductive health services for London.
       AI could deliver personalised sexual healthcare focused on need to Londoners but needs careful, responsible system design with community involvement to ensure that existing inequalities and biases are not perpetuated.  
       Community contributor: Darren Cousins, London Sexual Health Programme.
13. Co-designing obesity management for populations at greatest risk.
    1. A community-based project that aims to co-design effective communication about the risks of obesity and endometrial cancer (EC).
       A community-based project that aims to co-design effective communication about the risks of obesity and endometrial cancer (EC) with the community to address the obesity epidemic and reduce EC risk.
       Community contributor: Aleksandra Gentry-Maharaj, University College London.
    2. Those at greatest risk of diet related ill health are often least supported to prevent it.
       Those at greatest risk of diet-related ill health are often least supported to prevent it. Digital nutrition education and behavioural health mechanisms could bridge the gap between knowledge and action.
       Community contributor: Bryan Tang, Think Through Nutrition / Oxford Brookes University.
14. Tackling missed appointments: Keeping continuity of care with vulnerable patients.
    1. Bringing specialist care closer to home: Community-based outpatient clinics to reduce missed appointments and tackle health inequalities.
       Hospital-centred specialist care excludes frail, disabled and deprived patients. Missed appointments cluster in these groups and predict disengagement across the whole pathway, driving delayed diagnosis, avoidable admissions and widening inequalities.
       Community contributor: Niloy Rahman, Glenfield Hospital.
    2. People in drug and alcohol treatment are left unsupported between appointments.
       People receiving drug and alcohol treatment are often left without timely, connected support between appointments, while key workers lack visibility of changing needs, risks and progress.
       Community contributor: Jorge Palacios, Bright Therapeutics.
15. Digital solutions to bridge the gap in lifestyle support for mental and physical health.
    1. Gaps in access to trusted nature-based self-support for adults with generalised anxiety disorder.
       Around 8% of working-age adults in England experience Generalised Anxiety Disorder, yet many, particularly those facing cultural, disability or access barriers, lack trusted nature-connected self-management support.
       Community contributor: Alex Boyd, Intercultural Roots for Public Health / EcoGPX Ltd.
    2. NHS exercise and lifestyle support is poorly supportive of people living with multiple long-term conditions (MLTC).
       People living with MLTC and polypharmacy have limited access to safe, personalised exercise support across NHS pathways, leading to inequitable long-term condition management and an increased burden of MLTC.
       Community contributor: Jacob Keast, VITOVA Limited / University Hospital of Wales.
16. Saving clinician time, improving patient care: Smarter approaches to everyday healthcare.
    1. Closing the gap: Improving smoking cessation support for patients admitted to the acute medical unit.
       Smokers admitted to our Acute Medical Unit are rarely offered NRT or referred for cessation support despite NICE guidance, and escorting them to smoke diverts nursing time and risks safety.
       Community contributor: Chidimma Linda Ahanonu, University Hospitals of Leicester NHS Trust. 
    2. Reducing backlogs for specialist care through AI using standardized protocols.
       Automating standardized diagnostic test orders before first outpatient appointments using NLP significantly increases same-day diagnosis and discharge rates, reducing low-value follow-up visits and non-attendance in specialist care.
       Community contributor: Jorge Short Apellaniz, Quironsalud.
17. Designing digital healthcare around patient need.
    1. Accident and emergency department overcrowding is a global problem. Virtual care can help.
       ED overcrowding compromises patient safety and care quality. Integrating an in-ED virtual care suite can safely streamline low-acuity throughput and significantly reduce emergency department length of stay.
       Community contributor: Jorge Short Apellaniz, Quironsalud.
    2. Beyond the numbers: The vital step before establishing digital endpoints.
       Digital health technologies for hepatic glycogen storage disease are often adopted without qualitative evidence of what patients define as meaningful, and thus risking burdensome, diabetes-derived technology that fails their management.
       Community contributor: Claude Chan, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.