NHS and HE: Collaboration for the Future

NHS – HE Conference17 November 2011

Professor Sir John TookeUCL Vice Provost (Health)Head of School of Life and Medical Sciences

UCL SCHOOL OF LIFE AND MEDICAL SCIENCES

NHS-HE Collaboration for the future

• Track record and emerging threats

• How do we retain global competitiveness

• Key enablers

NHS-HE Collaboration for the future

• Track record and emerging threats

• How do we retain global competitiveness

• Key enablers

UK performance in terms of citation impact

• BIS citation analysis found UK “attracts more citations per pound spent in overall R&D than any other country.”

• Independent Thomson Reuters analysis found that UK scientific papers have greatest impact according to average number of citations.

• When raw data is adjusted to norms in each field and year of publication, the UK performance surpasses even that of the US, moving from second to first rank in 2007.

Source: E Marshall and J Travis, Science Vol. 334, 28 Oct 2011

Growing competition from ‘BIC’ countries

Annual growth in publications 1996-2008Annual growth in GDP spend on R&D 1996-2007

Source: Royal Society, ‘Knowledge, networks and nations’, March 2011

Investment in France

• French Initiative d'Excellence (Idex): €7.7 billion (£6.6 billion) invested in scheme to establish five to seven world class ‘academic clusters’.

• Proposed "Sorbonne League" will require universities, grandes écoles and France's independent research organisations, to work together.

• Universities of Bordeaux, Strasbourg and Paris Sciences et Lettres were selected earlier this year. The Second call for Idex members is under way.

Decline in Pharma

• UK share of clinical trials (6% in 2000 → 2% in 2006)

• Pfizer exit from UK

• Scaling down of GSK presence

Decline in Pharma

• Business model ‘broken’

• Regulatory burden

• Cost

• Limited industrially facing joint endeavours

Financial pressures on Higher Education Institutions and the NHS threaten our common purpose

NHS-HE Collaboration for the future

• Track record and emerging threats

• How do we retain global competitiveness

• Key enablers

How do we retain Global competitiveness in biomedical science?

• Harnessing the NHS as a ‘Population laboratory’

• Inter-institutional collaboration

Academic Health Science Centre: UCLPartners

QMUL

Barts & The London

Aims:

• Translation of biomedical research into population health gain;

• Service transformation - promotion of integrated health care across organisational divides;

• Development of leaders equipped to deliver change

UCL Partners – Achievements 2010-11

Highlights include:

• Development of a new cross-sector model of care for acute stroke that has reduced mortality to below 10% in North Central London, against a 22% national average.

• Creation of a globally relevant R&D programme in London to develop new treatments for brain cancer.

• Development of Whittington Health, a single integrated care organisation spanning primary, community and hospital care, organised around the needs of patients and the local population.

• “Open Eyes”. Extension of the application of a groundbreaking, clinically-driven electronic patient records which can be owned by the patient.

Neuroscience

Cardiovascular

Liver & digestive health

Infectious diseases

Eyes & vision

Child health

Women’s health

Cancer

Mental health & wellbeing

Immunology & transplantation

Ear, nose & throat (ENT)U

CLP

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Basic discoveriesProof of concept

(Experimental medicine)

Clinical Trials Evidence into Practice Health gain

Gap 1 Gap 2

Gap 1: attended to by BRCs- Funding renewed in 2011- £165m over 5 years- Pursuing greater academic

alignment

Gap 2: Translational agenda- Population Health- London Social Enterprise for

Health Improvement- Lead Provider PGMET

UCL Partners provides context and framework

Academic Health Science Systems as a National Resource

• Evidence into practice• ‘Learning organisations’• Service transformation and integration• PG Medical education and training

A variable concentration of biomedical science expertise

• Basic biomedical science with clear clinical motivation

• Collocation (basic in clinical setting)

• Collaboration (local and international)• Engagement with practitioners and patients

• Industry collaboration

Factors associated with high (academic and wider) impact cardiovascular and stroke research

Project Retrosight. RAND Europe 2011

London’s AHSCs

Global competitiveness: → Scale→ Collaboration / clustering

15 Hospitals

4 Academic partners

+ Extensive community networks

Partners Healthcare (Harvard)

8 Hospitals

2 Academic partners

+ 1 Rehabilitation network, 1 Home healthcare network, 1 Medical Management Service

London-wide inter-institutional collaboration

• The Francis Crick Institute

• Imanova

• Social Enterprise for Health Improvement

NHS-HE Collaboration for the future

• Track record and emerging threats

• How do we retain global competitiveness

• Key enablers

Key enablers

• Political will

• Culture and leadership

• Stream-lining governance

• Bioresources

• Informatics

Academy of Medical Sciences report

• Report sets out new regulatory and governance pathway to increase speed at which healthcare innovations become available to patients, whilst eliminating unnecessary bureaucracy.

• “A fertile research environment is vital for the health and wealth of the UK. The current system of regulation is making it increasingly difficult to initiate health research in the UK and is preventing patients from participating in studies. This is ultimately denying patients early access to new drugs and hindering improvements to public health for the wider society.”

Prof Sir Michael Rawlins FMedSci, Chair of the AMS Working Group

Informatics

• Electronic health records– Integrated care and research

• Bioresources

• Access to published knowledge– Clinical decision making– Commissioning– Policy– Research– CPD

The Peter Hill review

• Recommended continued collaboration between HE and NHS library services.

• Collaboration in London needs to continue to develop.

Potential areas for collaboration

• Consolidation of library holdings between NHS and HE

• Common open access policy

• Joint procurements (AHSS implications)

• Digital innovations

Digital innovations

Informatics:• personal access• coaching• remote sensing• data synthesis

“The future of cellular telephony is to make people’s lives better – the most important way, in my view, will be the opportunity to revolutionize healthcare”

Martin Cooper, inventor of the mobile phone

Conclusions

• NHS-HE collaboration is critical for our health service and economy

• Harnessing information is the key enabler