The frequently asked questions below have been devised in response to queries from applicants to the second wave of the Test Beds programme at previous briefing webinars and events.

• General
  • Diabetes Test Bed
  • Programme funding
• Wave 2 competition eligibility and process
  • Health and care challenges
  • Partnerships
  • Collaboration events
  • Full competition
• Next steps for successful Test Beds
  • Evaluation

General

What is an NHS Test Bed?

A Test Bed is a partnership between businesses and NHS organisations; it can also include academia, local government and the third sector. This partnership will come together to test combinations of innovations (digital products and services) in a real clinical settings; improving patient care at the same or less cost. These partnerships also offer businesses an opportunity to gain insight from working with the NHS.

Why launch a second wave of Test Beds?

The first wave of the Test Beds programme signals promising outcomes and a revolutionary way of supporting the testing of innovation in the NHS; in turn transforming the delivery of services. It is the only national programme focussed on care pathway redesign to maximise the value of new technology / innovation, as recently noted in an article by the King’s Fund. Building on the programme’s early successes, the expansion of the programme shows the Government’s and NHS England’s commitment to improving access to innovation and making sure, through real-world testing, that these are relevant to users’ needs.

What type of innovations are we looking for?

Businesses must have a market-ready regulated digital health product; CE marking (where relevant). We are looking for products that address a clearly defined health and care challenge, for example those given by NHS England in its Five Year Forward View and recent Next Steps publication. In working through your application as a partnership, we expect businesses to work with the NHS to articulate what the hypothesis for their project is and describe how the product(s) will work to address this.  If your final partnership application is successful, any apps may be required to go through the NHS digital assessment process if they have not already done so.

Are digital solutions which are already being used or tested in the NHS eligible for the programme?

Yes, we welcome digital health products already in use in the NHS, provided that the final proposal submitted to us is for an innovation that brings together a new combination of products and / or processes.

What do you mean by ‘combinatorial’?

‘Combinatorial’ means new combinations of products – or processes (that is, care pathway redesign). We would expect the digital products to work in combination with other products in the partnership, as well as innovations in service delivery; producing better outcomes for patients at the same or lower cost.  To note: it is not necessary to combine products if this does not make sense to your proposed innovation.

What role do the Heath Innovation Networks play in the Test Beds programme?

During the matchmaking phase, our Heath Innovation Network partners will bring together potential NHS-business partnerships; pairing NHS organisations facing particular health and care challenges with businesses that can provide digital products to tackle these challenges at Collaboration Events.

Once these partnerships are formed and the full competition opens on 16 April, the Heath Innovation Networks will work with support the NHS-business partnership to develop a high-quality final application for submission to the national Test Bed team.

When will a final evaluation be published for Wave 1?

Test Beds from the first wave (seven in total), will each submit a report to the National Test Bed team on 27 July 2018. The seven evaluation reports will be reviewed by our national evaluation partners and used to produce an overall final programme report. This will be made available in autumn 2018.

What are the funding streams for the second wave of the Test Beds programme?

The second wave of the programme is divided into two separate funding streams:

• Test Bed(s) tackling learning and self-management for people with type 2 diabetes, as outlined under Diabetes Test Bed.
• Test Beds addressing health and care challenges.

Diabetes Test Bed

Why is there separate funding for a diabetes Test Bed?

Supporting people with type 2 diabetes to manage their own condition is a key aim of NHS England’s National Diabetes Programme, which has a workstream to explore self-management through the use of digital enablers. NHS England is dedicating £1.5m for Test Bed(s) that address learning and self-management support for people with type 2 diabetes. The learning from these Test Bed(s) will inform the wider digital diabetes workstream. More information about the wider work to establish how digital innovation can support diabetes care can be found here.

How will diabetes Test Bed(s) differ from other NHS Test Beds?

Test Bed(s) funded as part of the diabetes specific stream must focus on digital approaches to learning and self-management support for people with type 2 diabetes and will work closely with the National Diabetes Programme. This will ensure that the learning produced by diabetes Test Bed(s) is linked into national learning and best practice around digital innovations to support diabetes outcomes. The funding and administration of this Test Bed will be carried out through Innovate UK in line with the other NHS Test Beds.

What will the evaluation requirement for a diabetes Test Bed(s) be? Will this differ from the other prospective NHS Test Beds?

There will be the same evaluation process for all Test Beds. The evaluation will be focused on digital element for the diabetes Test Bed(s). Further information is available in the evaluation section.

Programme Funding

How much funding is available for the programme and how will it be awarded?

Up to £6 million will be available for the second wave of the NHS Test Beds programme. Project costs can range from £500,000 to £1.5 million. Projects outside this range will be considered but would require further justification from applicants.

What funding is available for SMEs?

Micro and small businesses can receive up to 70% of their eligible project costs, and medium-sized businesses can receive up to 60%. We encourage large businesses to apply and benefit from participating in the national programme, but unfortunately will be unable to contribute to their project costs.

For SMEs who are eligible to have a percentage of their costs funded, are there any defined project costs?

A full list of project costs eligible for remuneration will be available from Innovate UK when the main competition opens on 16 April.

What funding is available for international businesses?

We will be accepting applications from international businesses; however, international businesses without a UK base or who do not meet the criteria of an SME are not eligible for funding.

Are you open to bids requesting part funding?

Yes – if there is an exciting proposal we will be happy to consider scaled down or part funding.

What investment are businesses expected to provide?

Micro and small businesses will receive up to 70% of their eligible project costs, and medium-sized businesses will receive up to 60%. We would require the additional costs to be invested by the businesses. Unfortunately, we will be unable to contribute to the project costs of large businesses.

For further information on these categories, please see  Innovate UK guidance.

What are the benefits for businesses, given the investment expected of them?

Businesses will have access to funding if they are an SME. All businesses will have access to subject matter experts, support from the national Test Beds team that will focus on unblocking barriers to progress that arise during implementation; and will benefit from being part of a well-known national programme.

Access to subject matter experts throughout the programme will include:

• support from the national Test Beds programme team and specialist expertise on information governance, procurement, and evaluation
• events and webinars on specific topics to problem solve and share learning with other Test Beds
• access to wave 1 legacy documents: ‘how to’ guides on evaluating complex interventions and information governance requirements
• access to template documents used by the first wave of Test Beds to assist in setting up and maintaining NHS-industry collaborations

The overall programme benefits include:

• an opportunity to improve patient care by testing new approaches and gathering real-world evidence about what works and what does not work
• test and evaluate products at scale in real-world settings; giving businesses the opportunity to receive insights from clinicians and patients on their products
• partner with organisations that bring different skills
• national exposure from involvement in the programme

Wave 2 competition eligibility and process

Health and care challenges

What themes have emerged from the Expression of Interest phase of the competition?

The following themes for have emerged from the Expression of Interest (EOI) phase:

• Secondary Care – this theme comprises challenges relating to cancer, maternity, surgical pathways, outpatients, imaging/ diagnostics, cardiovascular conditions and discharging patients from hospital
• Diabetes – this includes learning and self-management support, prevention, lifestyle / behaviour change, and post-diagnosis symptom management
• Mental Health – this includes prevention, self-care prevention and symptom management for chronic and severe conditions
• Integrated Care – this theme refers to challenges relating to primary care settings, management of long term conditions, early detection of conditions and healthy ageing
• Operational Infrastructure – this theme refers to managing patient flow, urgent and emergency care, workforce challenges, integrated care records, medication optimisation, infrastructure and asset management

Do you have a list of health and care challenges to focus on?

Test Bed partnerships must jointly propose tackling a health and care challenge currently facing the NHS in England, such as those outlined in the Five Year Forward View and Next Steps publications. Challenges were defined by NHS organisations when submitting their expressions of interest (as above). At the application stage, we expect these themes to be further refined into focused hypotheses.

Digital health products are then matched to these challenges, based on their expressions of interest, and invited to Collaboration Events to discuss creating partnerships. Information about the challenges will be sent prior to these workshops; and if you are no longer interested or it is no longer relevant to you; you can drop out of the process. The collaboration events are also an opportunity to further refine the question your projects will be focusing on.

When final partnership applications are submitted, assessors will want to see how the partnership’s proposal contributes to tackling a well-defined health and care challenge hypothesis with an estimation of the impact the intervention will have. The competition may take a portfolio approach to ensure a range of projects tackling different challenges are supported, but there is no defined list of priority areas that applications must address.

Is there a preference for health and care challenges different to those tackled by the first wave of Test Beds?

We welcome any health and care challenge, even if it is similar to those selected in the first wave of Test Beds. These challenges could relate to particular clinical pathways or broader system challenges that the NHS faces. The reason for having the EOI phase is to find out what innovations are available, and what health and care challenges sites most want to tackle across the NHS; therefore, we would encourage all to submit.

The national Test Beds team is most interested in applications which have a focused hypothesis as to how a particular technology can address a particular health or care challenge.

Are challenges relating to social care in scope?

Yes – we are interested in submissions that relate to both health and care challenges. Applications can integrate partners from outside the NHS; however, an NHS organisation will still have to lead the Test Bed.

Partnerships

What kind of organisations can join a proposed Test Bed partnership?

Alongside NHS organisations and businesses, proposed partnerships could include academic partners, local authorities, registered charities, third sector organisations or social enterprises.

Our Test Bed proposal relates to both health and social care – must the lead organisation be a NHS organisation?

Yes. We welcome challenges and partnerships relating to both health and social care, but the partnership would need to be led by an NHS organisation. This could be either a hospital, primary care network or a integrated care system.

Can GP practices or organisations lead a Test Bed?

GP practices may lead a Test Bed in their capacity as NHS organisations, but would need to clearly demonstrate how they can achieve sufficient engagement and scale across their local health economy to appropriately evaluate their project.

GP practices cannot lead a Test Bed if they are a business (a limited company); practices or organisations that are limited companies can only participate as partners in a Test Bed and will be subject to the funding rules for SME businesses, not public sector organisations.

Is there a suggested number of partners who should be in a Test Bed?

There is no limit, or prescription, around the number of partners in each Test Bed; however we would advise that in selecting your partners each one should add value and we would ask you to be mindful how the different partners related to the overall cost of the intervention; ensuring that what you are testing could be taken up by the NHS, if successful (please consider potential costs, impact on patient outcomes and value for money). The focus should be on what kind of partnerships will actually be able to come together and deliver in the short eighteen month timeframe of programme.

We have already formed a partnership between businesses and NHS organisations – are we still eligible to submit as a partnership?

We welcome partnerships which have already been formed or are in the process of being formed; or which are formed at the collaboration events, or indeed bring new partners into the proposed Test Beds after the collaboration events.

If you have already formed a partnership, then there is no requirement for all partners to submit an EOI or attend collaboration events.  However we would encourage organisations and businesses to attend relevant events as it will give an opportunity to meet with other potential partners who may add value to your Test Bed, or make other valuable links.

How important is it for commissioners to be involved in prospective Test Beds?

It depends on the project, the health and care challenge it seeks to tackle, and the scale. As commissioners and Commissioning Support Units (CSUs) have access to the data about the local population, it is helpful to involve them in the partnership to enable robust evaluation. However if the innovation is staff-facing and focused on driving operational efficiency, commissioner engagement may not be as vital.

We encourage applicants to consider how their project links to their local Sustainability and Transformation Partnership (STP) and Integrated Care System (ICS) where relevant.

Can a business with a solution relevant for more than one Test Bed participate in more than one partnership?

Yes – provided that they can meet the commitments / expectations of the different Test Beds.

How should businesses work with each other given that digital innovations are commercially sensitive?

We expect businesses which apply to be ready and willing to work with other businesses as part of a Test Bed. This means that they will need to share data within the Test Bed, but this need not be commercially sensitive. During the preparatory phase, Test Bed partnerships should work through collaboration agreements and data sharing agreements without breaching commercial sensitivity, as well as agreements around intellectual property should an innovation prove beneficial.

The national support partners will be able to assist with setting up these agreements.

Collaboration events

What are the next steps after the EOI phase?

If your EOI is selected, you will be invited to attend a Collaboration Event in April 2018, at which you can meet potential partners for a Test Bed proposal. These events are not compulsory.

What are collaboration events and what do they involve?

The primary purpose of the collaboration events is to bring together businesses and NHS organisations along with other potential collaborators to explore how they could build partnerships that address specific health and care challenges.

Events will focus on one or more health and care challenge, bringing together businesses with products that match the challenges faced by NHS organisations. Other organisations which can add value to a Test Bed partnership, such as third sector or charitable organisations, may also be invited to attend by our Heath Innovation Network partners.

As well as an opportunity to meet potential partners for a Test Bed application, the collaboration events will allow businesses and NHS sites to network and make broader relevant connections.

Businesses and NHS organisations who have submitted EOIs can invite other potential partner organisations who they would like to participate in their Test Bed proposal.

When are the collaboration events being held, and what challenges will they focus on?

The collaboration events schedule and their challenges are as follows:

Due to a high volume of EOIs relating to this challenge, there will be two Integrated Care collaboration events on 20 April in Bristol; one in the morning and one in the afternoon.

What support will be provided during the collaboration events to ensure that links are made between the innovators with solutions which match the health and care challenges of NHS organisations?

AHSNs will be facilitating these events and support the matching of businesses with products relevant to health and care challenges of NHS organisations. Each event will have an innovator zone where companies will be able to showcase their products and potential sites will be able to get an overview of some of the innovations on the market.

As it may not be practical to attend all five of the collaboration events, how can we ensure that we do not miss out on opportunities to form partnerships with relevant organisations at other collaboration events?

All organisations are welcome to attend as many collaborations events as desired, particularly if you think you have a product relevant to more than one theme. However, we acknowledge that this may not be feasible for all organisations, especially small and medium size enterprises.  To enable connections to be made between organisations and businesses who attend different collaboration events, we will share contact details as well as descriptions of the health and care challenges / products after the collaboration events.

Full competition

When does the competition open and close?

The competition opens on 16 April 2018. There will be a briefing webinar held on 26 April 2018 and this will then be uploaded to the Innovate UK website.

The closing date is 12 noon on 20 June 2018. Please note that no late submissions to the programme can be accepted and therefore please ensure you submit your application in plenty of time.

What questions will the application form ask?

The application form will ask ten questions and each answer can be up to 500 words.  There is also limited opportunity to upload support documents.

The ten questions are:

1. Need or challenge: what is the health or social care challenge that this project addresses?
2. Approach and innovation: how could the intervention you propose be scaled?
3. Evaluation: how will your Test Bed project be evaluated? We expect this to include impact, process and economic evaluation
4. Project Impact: what benefits is your Test Bed project expected to deliver and over what timescale?
5. Project Management: what implementation approach will be adopted and how will the project be managed?
6. Wider impacts: what is distinctive about your proposed Test Bed?
7. Risks: what are the risks to the Test Bed project’s success? How will these be mitigated?
8. Project Team: does the Test Bed project team have the right skills, experience and access to facilities to deliver the identified benefits?
9. Costs and value for money: what is the total financial commitment required for the Test Bed project?
10. Additionality: how will financial support from the Test Bed programme add value?

The application form includes suggestions on areas to cover within your answers.

What is the process for assessing Test Bed applications?

All applications will be reviewed by up to five assessors and marked against a pre-defined scoring scheme. The highest scoring applications will then be invited to an interview between 13 – 17 August 2018.

The interview panel will review all applications following the panel interviews and reserve the right to take a portfolio approach to ensure variety and geographical spread of successful projects. Successful Test Beds will be informed following the interview process.

Does my application need to have more than one business involved to be ‘combinatorial’?

A combinatorial project can involve new combinations of products and / or processes. The majority of proposals will therefore involve more than one business. If your final application only includes one product or business, you will need to be clear about what health and care processes are being proposed or changed as part of the programme, and why this makes your proposal combinatorial.

Will the specialist guides on evaluation, partnerships and information governance deriving from the experiences of the first wave of Test Beds be available ahead of submission deadline for final applications?

They will be published in summer; however, these may be made available to partnerships applying to the competition in draft form ahead of the submission deadline on request.

Who can I contact for support during the competition phase?

Different support partners will be best placed to answer your queries during the competition phase:

• For support in developing your Test Bed application, please contact your local Heath Innovation Network. You can find your local network by visiting the Heath Innovation Network homepage
• For queries about the competition process, including overall eligibility, please contact the Innovate UK support desk: support@innovate.gov.uk
• For other queries about the Test Bed programme, please contact the national programme team: england.testbeds@nhs.net

Next steps for successful Test Beds

What are the next steps once a Test Bed proposal has been selected?

Once successful Test Bed proposals have been selected, they will be supported to set up their projects during a ‘preparatory phase’ (28 August – 28 September 2018), which will include:

• evaluation support from a national evaluation partner to design a robust evaluation which meets the needs of the programme
• information governance support to complete collaboration agreements and other necessary documentation
• partnership building support from the AHSNs to ensure effective collaboration among Test Bed partners

Projects will begin on 1 October 2018.

How long will successful bidders be given to demonstrate their solutions?

Once successful Test Beds have been selected, projects must start on 1 October and last no longer than 18 months, finishing their testing and evaluation no later than 31 March 2020.

Evaluation

What does a Test Bed evaluation entail?

Test Bed evaluations will extract rich learning about the impact of these innovations on clinicians, patients and the wider health system, as well as what causes these effects; so that others, across the country, can benefit from the experience of the sites.

Each site will be required to produce an interim and final evaluation report which shares learning; outlining findings relating to process evaluation, economic impact and patient level outcomes. Evaluators will be asked to answer the following kinds of questions:

Impact / economic evaluation

• How effective are the combinatorial innovations in reducing unscheduled admissions to hospital, length of stay and other productivity outcomes compared to care pre-implementation?
• What is the typical patient journey seen for each innovation?
• Do patients experience a change in overarching quality of life or health-related quality of life?
• How does service use at the individual patient-level change following implementation of the innovations?
• Do patients report they are better able to self-manage their long-term-condition(s) following implementation of the innovations?
• Do patients perceive the innovation as feasible and acceptable?
• Have the innovations been effective in preventing further ill-health for patients (e.g., through mitigating further long-term conditions or preventing falls)?
• What impacts did the intervention have on patients’ clinical outcomes?
• How do quality of care outcomes (e.g., co-production, dignity, respect, timeliness, accessibility) at individual patient-level, change during exposure to the combinatorial innovations?
• What are the changes in net financial costs of the intervention for the health system?
• Were patient outcomes improved at lower cost to the NHS? To what extent did the Test Bed intervention offer value for money (offering benefits greater than costs)?
• Under what conditions and for whom were improvements in health outcomes most significant (and least significant)?
• Have any unintended consequences been observed?

Process evaluation

• What process did you go through to design your programme/ testing?
• Were the interventions delivered in line with the proposed plans? What changed and why?
• Were the governance arrangements for the intervention effective and why?
• Did the partnership of the NHS with innovator firms work as intended and why? Has this partnership/ different engagement with the NHS resulted in improved technology pull-through?
• Did the NHS get better products or processes as a result of collaboration/testing/learning?
• What have the benefits to innovation partners been of engaging with the NHS as part of the Test Bed programme?
• What were the barriers to effective delivery (and uptake of technology/services) and how were they overcome?
• What were the facilitators of effective delivery (and uptake of technology/services) and how were they ensured?
• Were there any unintended consequences that needed to be managed and how was this done?

How do Test Beds work with the national evaluation partners?

Each site is required to work collaboratively and openly with national Test Bed evaluation partners; ensuring consistent evaluation design, implementation and ongoing evaluation takes place throughout the project that can contribute to an overall evaluation of the second wave of Test Beds programme in 2020. The national Test Bed evaluation partners will assist successful Test Beds during their preparatory phase in order to ensure their evaluation is fit for purpose.

Each site will be expected to sign a Memorandum of Understanding (MoU) which outlines clear ways of working with the national programme and which includes a commitment to sharing data. Sites will be required to take an ‘open book’ approach and ensure that mechanisms are in place from the outset of the project to make sure that data and relevant information is made available to the national programme with maximum transparency.

Will a local evaluation partner be needed?

We know from the first wave of Test Beds that there is value in having local evaluation expertise around the table for programme set-up. Therefore, as well as a national evaluation partner who will be procured centrally in time for the preparatory phase, Test Beds will also need a local evaluation partner.

During the one month preparatory phase, evaluation partners should help you think about the design of the Test Bed evaluation, data collection, process as well as impact evaluation. The national evaluation partner will provide support to local evaluation teams.

Given the short timeframe to test the new Test Bed innovations, what support will be provided to obtain ethical approval from e.g. the Health Research Authority (HRA) if it is required?

The programme has strong links with the HRA, and partnerships that are successfully selected to be Test Beds should let us know if they need support in applying for HRA approval early on and we can provide support. We also have strong links with the Care Quality Commission (CQC) and therefore can ensure that innovations being tested are meeting their future regulatory needs.  If the hypothesis / proposal of the Test Bed partnership is clearly defined, then there should not be too many delays in obtaining ethical approval.