Challenging the NHS to innovate
George Freeman, Minister for Life Sciences, explains how the NHS will make the most of research and innovation.
The challenges
Our health system is facing enormous challenges:
- an ageing population
- health inequalities
- the need for rigorous discipline in public finances
- a medicines bill of over £13 billion in 2014 to 2015 with spending in this year expected to rise
- the ever increasing public expectations of what healthcare can deliver
We are also facing a number of public health challenges in obesity, diabetes and dementia with dementia alone costing the UK £26 billion per year.
All of this means that the NHS faces complex and difficult decisions in every area of its work.
Research and innovation in the NHS are critical for addressing these challenges. We need to harness the best of our clinical, research, academic and industry expertise to meet and address these challenges.
At the same time there is a gap between our ability to innovate within the UK and turn these innovations into health benefits for the population and to grow and generate the wealth from our £56 billion life science industry we need to pay for our rising healthcare costs.
As the UK’s first Minister for Life Sciences - jointly at the Department of Health and the Department for Business, Innovation and Skills - I want to see the NHS embrace innovation and become a true early adopter of new technology to help tackle the urgent productivity challenge of delivering better health outcomes for every pound.
The Prime Minister has charged me with accelerating the uptake of transformational technologies in 21st century medicine - principally informatics and genomics.
And, to do that in a way that attracts inward investment to the UK in research and innovation, creates new companies, drives growth and prosperity and raises revenues that pay for the healthcare we are going to need more of as an advanced society.
The opportunities
With our world leading science base and the world’s only fully integrated health system, we have the opportunity to be at the forefront of a new age of 21st century healthcare.
We have a strong platform from which to do this. I’m amazed by the sheer breadth of our dominance in global health - antibiotics, DNA structure, cloning.
Health will be the booming industry of the 21st century. The emergence of advanced digital technologies and the widespread use of smartphones opens up unprecedented opportunities for treatment and prevention.
In addition to the wide array of wearable technologies, there are no less than 100,000 health apps easily available to download allowing people to take more control of their own health and wellbeing.
Despite almost 60% of adults in the UK owning a smartphone we know only 2% of the population has had some kind of digitally-enabled interaction with NHS.
The range and sophistication of technologies offers us the potential to provide a more tailored and patient-centred approach to care.
Simple use of SMS messages can remind patients about appointments, medication and self-testing as well as allowing them to instantly update their records on key vital signs such as blood pressure or glucose levels.
There is opportunity here for productivity and growth. The UK’s digital health industry is set to grow by nearly £1 billion in the next 3 years.
The UK has particular potential in health apps, spurred on by initiatives such as Tech City in London and in health analytics.
We are investing further to cement this advantage through initiatives such as Health North’s Connected Health Cities.
I am delighted to announce today that the Department of Health and NHS England have committed £650,000 to a new innovation prize to accelerate the development and scaling of high-quality, evidence-based and safe digital tools that improve mental health outcomes.
Mental health disorders are the single largest cause of disability in the UK, affecting 1 in 4 people with an estimated cost to the economy of £105 billion per year. Digital technology could transform mental health service delivery by making effective interventions available to more people.
I am really proud that the global demand for UK know-how continues to gather pace; Healthcare UK has supported six international delegations to visit this Expo in Manchester to learn from the Best of British Innovation. I hope you will join me in wishing them all a warm welcome.
I will also showcasing the UK’s excellence and capabilities in the healthcare and life sciences sector on a global stage at the ‘The Future of Health’ at Milan Expo at the end of September.
This will be a great opportunity for the UK and overseas healthcare and life sciences leaders, innovators and opinion formers to discuss the serious challenges facing healthcare and the life sciences sector and to develop partnerships that can address these challenges.
How we will deliver
NHS England’s Five Year Forward View is a vision for the transformation of the NHS that all of us can get behind. It sets out how NHS England and its partners will commit to driving improvements in health through developing, testing and spreading innovation across the health system.
I want to tell you about some of the key programmes that I hope will deliver this ambition.
1. Data and Digital Health
First, unleashing the power of data in the NHS to improve individual care, system monitoring and performance and research.
We’ve got to keep people out of hospital, get better at preventing disease, diagnose earlier, reward healthy lifestyles, and have fewer people with long term chronic conditions filling up the most expensive place on earth - advanced western hospitals. Data and digital health are key. We have set up the National Information Board to drive the digital transformation of the health system.
We are determined to use digital and data interoperability to continue to drive the integration of our health and care system.
Something we are working on, is an integrated patient record which can be updated in real time and shared by all health and care professionals involved in your care, as well as seen and updated by you.
I think this would really transform the quality of care in the NHS. That’s why I championed the Health and Social Care (Safety and Quality) Act last Parliament which, from the 1st October will mandate the use of the NHS number as a single patient identifier across all services as well as introduce a legal duty to share information, so that people’s care can be coordinated across the system.
We heard at this morning’s National Information Board Leadership Summit about the hugely successful first year of operation of the new Spine - the technological backbone of the NHS.
It provides improved, functionality and flexibility and has already delivered £21 million of savings over the old system and meant that the NHS is saving 750 hours every single day.
This is a compelling example of how technology can save the NHS resources in terms of both money and staff time thus freeing up staff to deliver better patient care.
2. Genomics
Second, I am proud that we are leading the world by using cutting edge technology in the form of whole genome sequencing to transform healthcare and health research. NHS England is a key delivery partner for the 100,000 Genomes Project alongside Genomics England, Health Education England and Public Health England.
This ambitious initiative is shining the spotlight on science and technology in its broadest sense across healthcare - not just genomic and clinical genetic services.
It is driving advances in informatics and data standards and integration, in molecular pathology and other clinical laboratory sciences and across the diagnostic services that are vital to the overall characterisation of disease and assessment of its severity.
The reason the NHS is able to make this huge jump forward, more than anywhere else in the world, is the unique ability to combine genomic sequence data with the lifetime of phenotypic data in an individual’s NHS medical records.
It is the insight and learning from the analysis of genotype and phenotype side-by-side that will really drive the discoveries and advances from genomic medicine.
All of this work is moving the NHS to a new model of diagnosis and treatment based on an understanding of the underlying causes and drivers of disease rather than deduction from symptoms and individual tests.
The move to personalised medicine should identify certain groups within the population that respond well to particular treatments - opening the door for new pharmaceuticals or treatments.
Alternatively this may allow industry to revisit pharmaceuticals or treatments that weren’t sufficiently effective across all of society, but might be particularly good when targeted to individual groups.
In establishing a unique collaboration between NHS Genomic Medicine Centres, industry and academia for analysis of the genomic dataset, this project is also contributing to economic growth and establishing the UK as a leader in this sector. The aim is to grow the industry from £0.8 billion in 2015 to at least £1.2 billion in 2018.
There is a 100,000 Genomes Project stand here at Expo which is being run by colleagues from across the health service and delivery partners and Illumina and I would encourage you to go and find out more.
3. Test beds
Third, we need to understand better how these novel technologies and approaches work in the ‘real-world’.
The NHS presents an exciting opportunity to innovators that until now has been greatly untapped.
The test bed programme is a big opportunity to unlock the potential of the world’s only fully integrated health system, using it as the ultimate platform for assessing the real value of innovations.
Test beds will partner global innovators with NHS organisations to trial digital technologies, including Internet of Things technologies, at scale and in a real clinical setting. Our global call to innovators generated a huge response with 376 expressions of interest submitted.
Over the summer global innovators & health leaders have been joining forces at matchmaking events to form partnerships and identify solutions to local health challenges.
I am excited at the prospect of the needs of healthcare and the creative energy of industry coming together to speed the implementation of digital technologies for patient benefit and to promote economic growth.
4. Academic Health Science Networks
Fourth, NHS England has established the Academic Health Science Networks (AHSNs) which connect academics, NHS, researchers and industry to accelerate the adoption and diffusion of innovation helping to catalyse economic growth at the same time as driving improvements in the quality and efficiency of care.
AHSNs are working with partners locally and nationally to develop innovation eco-systems right across the NHS, so that innovation is championed by all - from patients to CEOs.
Nationally, they are core to the delivery of the Small Business Research Initiative (SBRI), National Innovation Accelerator programme and test beds - 3 fundamental national delivery platforms for innovation.
And there are also many good examples of where AHSNs have led the diffusion of innovation in their geographical areas, to meet local clinical needs.
Greater Manchester AHSN’s Innovation Nexus connects small to medium sized companies with the NHS to help strengthen their technologies and make them relevant to NHS needs. In 6 months, the Nexus has leveraged £1 million additional funding to support company growth and supported 60 companies: 12 are now receiving further intensive support; 5 have set up offices in the region; 2 have secured their first NHS contracts.
AHSNs also working all round the country to create the local infrastructure to allow innovations to thrive from supporting a remote monitoring system for women with gestational diabetes in Oxford to a light therapy mask for the prevention and treatment of diabetic retinopathy in the South West.
5. Accelerated Access Review
And last but not least, I have launched the Accelerated Access Review, independently chaired by Sir Hugh Taylor. The review will look at the journey innovative products take, from clinical trials or proof-of-concept, right through to wide-spread adoption in the NHS.
The pathway to adoption in the NHS is long and incredibly complex. It’s difficult for innovative things to get to patients.
And for some products, especially med tech and digital, the pathway is not just complex but there isn’t really a pathway at all.
This review will explore how we can speed up patient access to innovative medicines and medical technologies by capitalising on innovations in digital, genomics and personalised medicine; taking time and cost out of the development pathways for new products; and, making best use of existing NHS assets to create the best system in the world in which to design and develop innovative medical products.
Closing remarks
Meeting the challenges to our health and care system through these exciting initiatives needs a team effort.
We need your help to create a culture across the health and care service that values and promotes innovation.
One of the ways you can do this is by engaging with the Accelerated Access Review. I encourage you to visit the online portal and provide your comments by 11 September. By listening to patients, service users and professionals, the review is able to gather an in-depth knowledge of how this could be achieved and to find out what’s working well and what needs to be improved.
The ultimate challenge is one of changing culture so we need to help one another look at new things from a different perspective. If we are to unlock the full potential of our health services, we need to nurture professional communities that prize innovation together.
I take a great amount of reassurance from the fantastic work you are showcasing at this Expo that we are heading in the right direction.
Working with new transformative technologies towards a more innovative NHS that delivers better value. That’s what we should all be working for.