A Digital Health Hub Welcome

Medical science and innovation is at the heart of modern least for joining the design and supply of technology with civilisation, and is the cornerstone of modern healthcare. the demands of transforming healthcare and delivering We find ourselves in an era of scientific convergence, better outcomes for patients and the clinicians who care Contents where different disciplines are coming together to shape for them, but also to underpin the system effectiveness the way that care is provided with increasing focus on and sustainability necessary to produce those improved The digital health opportunity 4 personalised and true precision . The digital and outcomes. “omic” revolutions which are advancing hand in hand have the potential to transform both public health, and the way The UK government is leading the way in this field with Why you need to be in the 6 we deliver healthcare and more effective disease digital health a strategic priority for the NHS. The “golden golden triangle treatment modalities in an holistic sense to individual triangle” encompassed by Cambridge, , and patients. Oxford provides a unique life sciences and technology ecosystem which promotes the growth and adoption of An ideal place to conduct clinical trials 8 Digital technologies are empowering people across the digital health technologies. breadth of society to track and manage their own health Snapshot of the ecosystem whilst also enabling the healthcare industry to efficiently Together we invite our colleagues from across the globe for digital health 10 manage, access and analyse all the available data. to collaborate with industry and academia within the region to help drive forward future health innovations and The National Health Service: Discoveries however are not made in isolation. They are translate those into the delivery of the patient outcomes a unique partnership opportunity 13 inevitably the product of collaborations, partnerships and we all aspire to. wider team-work, often crossing international borders. Such collaborations and partnerships are essential, not An easy place to do business 14

Innovation in the golden triangle 17 Keith McNeil, Chief Clinical Information Officer, NHS England

Support networks in the golden triangle 22 The digital health opportunity

How Cambridge, London and Oxford are leading the way

Digital health is transforming the future of healthcare. It is dramatically Furthermore, digital health enjoys significant political support at both changing and improving the way in which individual citizens can track, national and city level. The UK government is determined to lead the way Cambridge manage and improve their health. It is enabling the healthcare industry to in this field and is committed to creating an attractive investment environ- access patient data and open up new, faster, smarter pathways to ment for it. The Mayor of London has also identified health as a key personalised . It is also an enormous market opportunity. In economic driver for the city and the NHS has made digitisation a 2014, the global market for digital health was worth £23 billion. This is strategic priority in order to reduce healthcare costs and improve patient expected to nearly double to £43bn by 2018. The UK is at the heart of outcomes. the global digital healthcare revolution. Its domestic market - worth approximately £2bn today1 - makes it one of the most important. Already, many of the world’s most exciting advances in digital healthcare are happening in the golden triangle. Patient data is being combined with The golden triangle of Cambridge, London, Oxford and the greater south consumer apps, leading to personalised treatments as well as more effec- east region of England lies at a point of unique convergence, with all the tive health spending. New paradigms in patient data collection are ingredients to be the world’s capital of digital healthcare. It is a world-re- emerging. Revolutions in data analysis are taking place. nowned life sciences cluster, comprising of multiple award-winning research institutions, thousands of talented scientists, deep experience in The golden triangle is the land of digital healthcare opportunity - for London clinical trials, and a thriving global business and life sciences community. clinicians, researchers, entrepreneurs, managers, academics and inves- Similarly, London is the digital capital of Europe, ranked by the European tors. Whether you want to recruit new talent, move your research forward, Digital City index as the best city in Europe for digital entrepreneurs. It is raise finance for a new product, or prepare for an IPO, the region provides a hotbed of digital talent, with 195,900 digital technology employees the stage on which you can transform the future of healthcare. based in the city2.

Teamed with entrepreneurial dynamism, an open regulatory environment, political support, and a national single-payer healthcare system in the UK 1 Digital Health in the UK: An industry study for the Office of Life Sciences- Monitor Deloitte, Sept15 2 Oxford Economics, 2015 National Health Service (NHS), the region is an ideal location for digital healthcare to flourish.

Oxford

4 5 Why you need to be in the golden triangle A flourishing Nearly $900m of venture capital was UK ranks top in digital public services, invested into life sciences companies digital adoption, digital business and entrepreneurial ecosystem in Cambrige, London and Oxford in finance in Europe9. A rich research ecosystem 20155. The geographic points of the golden UK has the best depth of capital markets triangle are Cambridge, London and Approximately 400 commercially In 2015, London-based tech companies for entrepreneurs in Europe10. Oxford. The three key strengths of the 5 out of 8 of the UK’s Academic the UCL Institute of Digital Health, and successful spin-outs from university/ raised a record $2.28 billion, a 69% region are its research, digital, and Health Science Centres (AHSCs). the Academic Health Sciences Network industry partnerships in Cambridge, increase on 2014’s $1.3 billion in funding, UK digital adoption is the best out of 34 entrepreneurial ecosystems. (AHSN). London and Oxford. which itself was double the 2013 countries11. 8 of the UK’s top 10 universities for figures6. Within this triangle lies the digital and research excellence3 – University of 4 of the world’s top 10 universities – More than £1.56bn ($2.07bn) raised in DigitalHealth.London speeds up digital financial capital of Europe, leading Oxford, University of Cambridge, Imperial University of Oxford, University of life sciences IPOs and follow-on offerings $4.4 billion invested in London’s tech health adoption by bringing together universities and one of the world’s most College London, University College Cambridge, Imperial College London, on the London Stock Exchange in 2015. businesses by American VCs over the clinicians, healthcare providers, research powerful clusters of life sciences London, King’s College London, London University College London4. past five years - more money than institutes, entrepreneurs and industry to expertise. It is an outstanding ecosystem School of Economics (LSE), Institute of The UK has the largest pipeline of new anywhere else in Europe7. give companies a clearer route to market. - providing life science excellence, Cancer Research, and London School of New, world-class facilities are opened pharmaceutical product candidates in It also offers an accelerator programme technological know-how, financial Hygiene and Tropical Medicine. each year: the Europe, with over 460 in 2013. designed to support engagement within ingenuity and legal certainty. is the new centre of inter-disciplinary 5-7 CB Insights the NHS and healthcare sector. Leading medical research organisations translational medical research; the It is an ecosystem that is packed close based within the golden triangle include Alan Turing Institute is the new The Oxford AHSN region is well-positioned together. This dense cluster provides the Wellcome Trust, the Medical Research national centre for data science; A dynamic digital ecosystem to drive improvements in healthcare through multiple opportunities for the talented to Council and Cancer Research UK. UCL East is a major cross-disciplinary development of new technologies, finding interact. Innovators in different disciplines centre for entrepreneurship and better ways of applying existing technolo- and sometimes outside of the life London generates more research papers innovation; Imperial West houses London is the best city in Europe for gies and contributing to policy. sciences and digital sectors altogether, than any city in the world, after Boston. a huge new biomedical engineering digital entrepreneurs, Cambridge and are collaborating to apply their knowledge facility, home to the 100KGenome Oxford are ranked 11th and 13th The Eastern AHSN provides a doorway to create entirely new businesses in Key national networks that bring together Project and the Farr Institute. respectively8. into the NHS for businesses, with digital healthcare. The result: fresh researchers, health commissioners and navigation support, facilitated access to thinking and original ideas that are providers, patient groups, local authorities expertise and funding, and support for tackling some of the most difficult and businesses include the Cell and 3 as judged by REF 2014 individuals and collaborations. 4 QS World University Rankings problems in healthcare. Gene Therapy Catapult, the Precision Medicine Catapult, the Digital Catapult, 8 European Digital City Index 9-11Telefonica Index on Digital Health

6 7 An ideal place to conduct clinical trials

A clinical trial hotspot, the multicultural population of the golden triangle results in a significantly diverse genetic population available in one place with which to test medications and products. The region boasts a: A single payer system

• Highly diverse patient population of more than 16 million, including approximately three million born should be of great benefit outside the UK.

• Large single healthcare system that maintains to biomed, there is huge extensive patient records.

• Single point of contact for co-ordination, assessment potential in unlocking and patient recruitment support in the National Institute for Health Research (NIHR). NHS data. • Number of people taking part in clinical trials in England has trebled over the past five years.

• A receptive environment for trialing digital healthcare services. Jenny Barnett, , Chief Scientific Officer Cambridge Cognition In a recent survey carried out by McKinsey, the UK led the way in terms of digital interaction with patients across the whole healthcare system. More than 70% of all older patients in the UK want to use digital healthcare services, dispelling the myth that it is only attractive to younger generations.

8 9 Snapshot of the ecosystem Incubators and Science Parks Abingdon Science Park 5 Harwell Science and Innovation campus 6 Londoneast-UK Business and Technical Park 19 for digital health 13 14 Babraham Research Campus 18 Health Foundry 31 Microsoft Ventures 33 CAMBRIDGE Begbroke Science Park 2 Imperial Innovations Incubator 21 Queen Mary BioEnterprises Innovation Centre 36 BioPark 15 16 17 10 Imperial White City 20 St John’s Innovation Centre 14 18 Ipswich Cambridge Biomedical Campus 16 Janssen Health Innovation 8 Stevenage Bioscience Catalyst 9

Cherwell Innovation Centre 1 King's Innovations Marsh 32 Sussex Innovation Centre 12 Milton Keynes DigitalHealth.London 35 London Biosciences Innovation Centre 23 UCL Innovations and Enterprise 29 1 M1 M11 Colchester

2 9 Islington

Luton We OXFORD 10 Chelmsford Academic Health Science Network 3 4 King’s Cross Hackney Straord Eastern 17 M25 Victoria 23 Park Health Innovation Network (HIN) 34 5 Camden 8 Hoxton M40 Imperial College 6 Regent’s 24 30 Park 26 27 Kent, Surrey, Sussex 11 Reading 25 M4 28 29 Oxford 4 UCLPartners 28 LONDON Wormwood Scrubs Wessex 7 33 Canterbury City Guildford M25 M20 Paddington M3 Medcity 36 University/Research Institutes 20 32 Dover NoǞng Hill Alan Turing Institute 24 Hyde Park Centre for Cambridge Clinical Informatics 15 11 Hammersmith Kensington Gardens 30 Digital Catapult 25 34 35 Canary Wharf Green 31 Holland Park Park Farr Institute 26 7 London and Partners Waterloo Imperial Institute of Global Health Innovation 22 Westminster Hasǎngs 21 Kensington Southwark Oxford Institute for Digital Health 3 Brighton Park 12 22 Precision Medicine Catapult 13 Chelsea Portsmouth UCL Institute of Digital Health 27 Fulham Burgess Park

Baersea Southwark Park Greenwich 10 11 Park

Bishop’s’ PaPark The National Health Service: a unique partnership opportunity The digital health At a national level, the government is putting its collective weight behind the development of digital health. The NHS in England has committed to ecosystem is now rich with an informatics strategy to transform healthcare service delivery using technology at national and local levels. One of the key deliverables set out in this strategy is for all healthcare in the country to be paper free at the opportunities in London point of care by 2020. Already, all UK citizens have been given the option to access online, their most comprehensive health record, their primary for innovators who understand care or GP record12. The NHS is up-skilling its workforce and introducing the NHS digital academy to train information officers in informatics and clinical technology. the business/transactional It is willing to reward innovators and investors who can help it to achieve its Help is available for entrepreneurs to enable them to understand the goals by unlocking NHS talent and expertise. transactional flows in the NHS, funding, and fast track options for developing digital health. The NHS Innovation Accelerator (NIA) model of the NHS in London The UK government has made £4.2 billion available to support the supports the testing of innovations and drives the cultural change digitisation of NHS Trusts by 2023. The Global Digital Exemplar necessary for them to be adopted faster and more systematically. programme will see 12 acute trusts act as global reference sites. They It also enables entrepreneurs and the NHS to learn from each other. For will have the necessary infrastructure for personalised medicine, use example, when the participants identified the misalignment of incentives Dr Sami Ansari, Co-Clinical Director paperless eRecords and open up their APIs to digital SMEs who will be as a barrier to innovation, the NHS listened and then introduced an Brent CCG able to offer them tailored products and services. This will create an innovation tariff to ensure that good products are adopted and ecosystem for innovative pathways and partnerships with digital health businesses reimbursed. businesses to examine how data can be used to improve operational efficiency and drive clinical outcomes for patients. The Test Bed programme is designed to evaluate the real world impact of new technologies, combining different types of innovation together, in order to solve a problem. This approach is designed to ensure take-up for 12 source: https://www.gov.uk/government/publications/digital-health-work- ing-in-partnership/the-uk-pioneering-digital-health-solutions a device that has proven its utility.

12 13 An easy place to do business Access to funding

As a global financial capital, London provides access to finance for all digital The UK has one of the most business-friendly revenue greater than €100m and balance health enterprises - from early-stage regimes in the world, making it a fertile sheet assets greater than €86m - is currently seed finance through to IPO and a environment for digital health. It is ranked 8th 130%. deep, liquid stock market. There is also in the World Bank’s Ease of Doing Business a vibrant angel finance ecosystem Report 2015. Legal framework that protects IP throughout the golden triangle. The UK has strong and stable IP and legal Corporation taxes frameworks, based on freedom of contract The talent Corporation taxes are 20% and will fall to and world-class legal advisors. Companies 18% over the next two years - making them can invest in R&D here with the confidence The golden triangle has a rich among the lowest in Europe. This compares that the regulatory system will protect your IP, and diverse talent base, thanks to the with a US federal rate of 35% and a patents, and contracts. strength of its academic institutions European average of around 20%. and the range of research being Business advice undertaken in the sector. It is a brilliant Patent Box For an innovative, emerging sector such as place to find and hire great people The Patent Box enables companies to apply digital health, having a world-class quality - from specialist researchers to a lower rate of Corporation Tax to profits of business support infrastructure is vital. general managers – additionally, earned after 1 April 2013 from its patented All the major global accountancy firms have international talent is always keen inventions. multiple presences in the golden triangle. to move to the region.

R&D reliefs Time zone and language There is a generous environment for R&D The UK remains a gateway to Europe due tax relief. Under the SME scheme - for to its geographic position and the English The UK has companies of up to 500 full-time equivalent language. Office hours overlap with those staff, or with revenue less than €100m, countries that collectively account for 99% one of the most or balance sheet assets less than €86m of the world’s GDP. It is the perfect location - the rate of R&D tax relief can be as high from which to collaborate on global research business-friendly as 230%. Loss-making SMEs have the projects. regimes in the option to surrender some of their losses for a payable cash credit from HMRC. The rate world. for R&D tax relief for large companies - over 500 full-time equivalent staff, or with

14 Cambridge Cognition: Collaborating throughout Case studies the region Innovation in the golden triangle Cambridge Cognition translates gold Six months ago, Cambridge Cognition standard neuroscience research into tools entered into a joint venture with Lon- that are useable and practical for doctors, don-based design-led research company, researchers, and patients. These tools make Ctrl Group, to launch Cognition Kit. This new the drug development process more venture will take the partners’ science and efficient, through their development of tech expertise and apply it to consumer- software based on the new insights into grade wearable devices such as the Apple neuroscience that flow out of nearby Watch. Their approach is to use laborato- Cambridge University. The company retains ry-grade research to inform mass data close links with the university, which many consumer products, which then in turn staff members attended. As part of a cluster feedback large quantities of data for further of tech, biotech and pharma businesses in research into how people use things (e.g. Cambridge, finding partners to work with is drugs and medical devices) in the real world; straightforward; whether to collaborate on enabling both further product refinement research or when sourcing talent. and a better basis for research.

Like many medical device companies, In other words, Cambridge Cognition are Cambridge Cognition has found the UK to interested in not only helping to develop new The combination be a receptive environment. This is in part drugs but also in how mobile health can: of data and consumer thanks to Europe’s pragmatic regulatory help to make drugs more effective; or enable framework that makes it generally quicker patients to better manage their health; or apps will lead to more for innovative new products to reach the measure precisely how and when they use effective health spending market here than in the US. As well as their drugs. This information then positions having access to excellent clinical expertise them to make a digital health case for the and research, the company has also taken drug, beyond the simple assessment of its Jenny Barnett, Chief Scientific Officer, advantage of generous R&D tax credits and efficacy in a lab. Cambridge Cognition grants from Innovate UK to grow.

17 AliveCor: Delivering your Px HealthCare: Tracking cancer heartbeat at your fingertips patients wellbeing

In 2013, Px HealthCare launched its The NHS Innovation Accelerator has been We’ve had a very positive OWise breast cancer app in the a fantastic experience for Px HealthCare experience of participating Netherlands. The company had always and given OWise a launch pad for bringing in the NHS Innovation intended to grow its business abroad. it to patients in the UK. The company have Accelerator and we’ve found Having been selected for participation in been investigating how patients would like the AHSN network very the NHS Innovation Accelerator, and to use the app, working closely with NHS attracted by the appeal of the golden clinicians and IT architects. In February helpful. triangle, it decided to relocate its centre of 2016, Px launched a UK version of OWise business operations to the UK from July breast cancer and are now looking to 2015. develop OWise for all types of cancer. Francis White, VP Sales and Business Development, NHS Innovation Fellow The OWise app has functions for tracking Px are delighted with the help they have patients’ physiological and emotional received from UCLPartners (AHSN), who I like the vibe that we have wellbeing. Breast cancer has many options have helped open doors for them in the in terms of personalised medicine as there NHS, and have some fantastic ongoing in London, the environment, are more than 150 different combinations of work with UCL Hospital. the creativity that is around. treatments. Clear, graphical representations AliveCor is a Silicon Valley start-up based between symptoms and heart rhythm. understand how best to transform the cardiac It is a very small place, in a way, of this data can be shared with, and As a socially-motivated enterprise, it is around a break through idea, wearable medical- By assessing patients’ data remotely, the pathway to address, for example, the huge with lots of very talented people reviewed by clinicians. Clinicians can react looking for the right kind of investors and grade ECG devices you can stick onto the company reduces the 85% of patients who problem posed by undiagnosed atrial fibrillation. quickly to adjust drug dosages, for example, believes London is a good location due to together, with very diverse backs of smart phones, (Kardia Mobile) and present to hospitals with heart symptoms that or act to address pain or nausea, without its forward-thinking community. now integrated into a replacement strap for the can be severe but which are medically The company opened an office in the UK in talents, really smart legal necessarily having to see patients face-to-face. Apple Watch (Kardia Band). Cardiac rhythm unproblematic. They may also be hard to assess January 2013. In addition to their positive and financial brains rubbing disturbance, in particular atrial fibrillation, is a as palpitations may have subsided by the time experience of participating in the NHS together with really creative major risk factor in terms of strokes. patients present. So far they have recorded Innovation Accelerator, they have found tech and media people. about 1.5 million ECGs in the UK alone (10 ​working with​ AHSNs​ such as Imperial​ College When patients feel symptoms, such as million worldwide), building an anonymous Health Partners ​​which has serendipitously palpitations, they can capture ECG data and database with other data points that are shared introduced an AF taskforce, very helpful. At the Dr Anne Bruinvels, Founder, use voice to text to describe symptoms. with AliveCor. This will enable ECG studies to end of this financial year turnover is forecast to Px HealthCare Clinicians can the look at the correlation use large population data helping researchers be 3 times that of the previous year.

18 19 Seven Bridges: Commercialising the Isansys: The pursuit of more biomedical data analysis platform efficient patient monitoring

London is a great place within the life sciences sector. Isansys is creating a new class of All of this has been made possible with the It has some of the best data-driven biomarkers. Take the work support of the Oxford Academic Health scientists and a great global they are doing with hepatologists at the Science Network, which offers a live commmunity that people in London: the data testbed of 3.3 million people. This creates a from just one wireless wearable sensor strong pull of digital innovations through want to come and live and patch taken over a 20-minute period is into the health and social care system. work with. equivalent to the data and information content traditionally obtained from a “The AHSN recognised the power of what blood test which takes hours of lab time we’re doing and how it runs across a range Julia Fan Li, Senior Vice President and requires the patient to attend the of clinical sectors,” says Keith Errey, CEO of Seven Bridges hospital. This is a major shift towards Isansys Lifecare. “It was with their help and data-driven methods - it is, quite possibly, support that we received Phase 1 and the emergence of a new paradigm. Phase 2 funding from Innovate UK through the SBRI programme and were able to Isansys introduced the first generation transform our system from being ‘some- Seven Bridges UK is a biomedical data analysis The 100,000 Genome Project in particular has accurate view of the genetic makeup of both Patient Status Engine (PSE) in 2012 and thing interesting’ into a complete scaled We are now being company focused on connecting the world’s created a vibrant genomics environment in the individuals and the population as a whole. Seven launched the second generation PSE2 at system; bringing benefits to patients and biomedical data and make it useful. Seven Bridges UK. Last year they received a Small Business Bridges is also able to store and analyse vast the end of 2015. It is now available in a clinicians in the shortest possible timescale. recognised by people around provides a user-friendly platform for genomic Research Initiative (SBRI) grant from the quantities of data in the cloud. number of hospitals in the UK and the world. Over the last few analysis. As next-generation sequencing costs fall Department of Health and to overseas. The PSE2 is one of the few months we have shipped for human DNA, more and more data is being complete and launch an analysis tool for highly London & Partners helped the company to find viable technology solutions that is able to systems to Norway, Germany produced which needs to be analysed before it accurate variant calling using population office space in the city. The company has gone address the requirement for improved and and India. Demand has can be useful for clinical decision making. genome graphs. from 0 to 25 employees in 2 years. Seven more efficient patient monitoring, against a Bridges undertakes research as well as business, backdrop of increasing demands for surpassed our expectations. They opened their first overseas office in The graph-based tools are able to learn from R&D and commercial activities; commercialising healthcare services. London two and a half years ago, responding to data over time and provide a more accurate the pioneering biomedical data analysis platform political and policy announcements in the UK. reference paradigm. It helps create an ever more that helps drive therapeutic discovery. Keith Errey, CEO Isansys Lifecare.

20 21 Support networks in the golden triangle

Join us to shape the future of digital healthcare. You can access targeted support and expert advice from a number of organisations throughout the region, each one of which has the specific aim to help researchers, academics, entrepreneurs, corporates and investors locate, grow and thrive in the golden triangle ecosystem. We have an established track record in delivering MedCity Mayor’s International Business Academic Health Science Network Helps businesses to: Programme Supports industry/SMEs by: • understand the life sciences Supports high-growth SMEs to export their • fostering partnerships and collaboration evidence-based solutions, ecosystem products and grow their business: at all levels in NHS organisations, life • navigate the life sciences networks • through mentoring from experts and science companies and universities; • provide introductions to specialist entrepreneurs • speeding up adoption of innovation into combining science, healthcare corporate partners • taking them on trade missions practice to improve clinical outcomes • via workshops and event • co-creating, testing and evaluating new medcityhq.com products and services data, and technology within gotogrow.london ahsnnetwork.com London & Partners Department for International Trade the regulatory environments. Facilitates businesses to: Support businesses to: DigitalHealth.London • set up and scale up in London • expand and grow into global markets Eases businesses’ access to the • connect with London’s business • locate and grow in the UK NHS through: networks • facilitating matchmaking, Jenny Barnett, Chief Scientific Officer • access high quality professional gov.uk/dit collaborations and partnerships Cambridge Cognition legal and accountancy advice • supporting innovators to test and roll out products invest.london • providing market intelligence.

digitalhealth.london

22 23 Contact us

MedCity can help you navigate and access different parts of the academic, NHS and industrial life sciences and healthcare environment across the golden triangle of Cambridge, London, Oxford and the greater south east region of England. [email protected] medcityhq.com

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