Academic Health Science Network (AHSN) - Expression of Interest

Our AHSN will translate cutting edge research and innovation into measurable health gain for a local population of 4.3 million, and enhanced adoption nationally and internationally

We will continue to develop our culture of collaboration and partnership working by building upon our currently stated UCLPartners (UCLP) values (http://www.uclpartners.com/):

• Patient-led, organising care around patients' needs and preferences • Population-focused, taking a system-wide view to drive improved health outcomes at speed and scale • Drawing on academic expertise across disciplines in biomedicine and beyond • Working across boundaries, spanning primary, secondary and tertiary health care, social care, and public health

Our principal strategic goals will be to:

• Support and facilitate measurable improvements in health, health care and wellbeing of our population, recognising the importance of reducing health inequalities • Enhance economic gain for the population through better health, innovation and its implementation into practice

These goals will direct UCLPs’ health improvement, education and research Programmes. The early priorities will be aligned with the immediate needs of the system and the population:

• Early diagnosis and prevention of the causes of premature death in our population, most notably cancer and cardiovascular disease which together contribute to two-thirds of premature deaths • Long-term conditions which account for such a high proportion of health care spend

Our AHSN works with patients, carers, providers and commissioners to deliver improvement through a range of enablers including informatics, leadership development and a readily accessible space for collaboration (virtual and physical). We will support the development, alignment and delivery of effective and meaningful incentives within the whole system, going beyond the nationally identified high impact innovations, to maximise the value of the social and health system across the AHSN.

Partnership working is already underway to deliver better health, better developed leaders and to contribute to wealth creation

With more than 70 active projects UCLP already has ongoing and completed work that aligns with the functions and levers of an AHSN. For example:

• Promoting participation in research: We are improving access for patients and commercial agencies to clinical trial sites by creating an AHSN platform across the partnership, including harmonised NHS permissions and contract negotiation (‘”single sign-off”) for clinical studies. This will be in place across North East (NEL) and North Central London (NCL) in 2012, and offered across the new AHSN. • Translating research and learning into practice: The delivery of Hyper-Acute Stroke Centres and Units across our geography was enabled and evaluated by UCLP, then extended along the whole pathway to monitor and deliver improvements from prevention through to rehabilitation. Supported by commissioners we have started an assessment, and the development of a peer learning set to support partner delivery of the IHW designated 2012 “high impact innovations”. • Collaborating on education and training: The UCLP Staff College fosters transformational leaders and the delivery of multi-professional training. As “Lead Provider” for more than 1200 medical and dental posts across NEL and NCL UCLP is developing a values-based Masters programme shared with a new postgraduate nursing career programme (“UCLP Excel Programme”). We continue to establish international links (e.g. Boston Partners, Yale University), and now have delegated authority from the GMC to sponsor overseas trainees across UCLP. • Driving service improvement: Our novel Integrated Cancer System which serves > 3m people includes a continuous whole system audit that will extend to all of the 3000 patients presenting to A&E with cancer to iteratively drive earlier diagnosis. We are working in new ways to empower patients to drive service improvement. For instance, 500 people with COPD have been given personalised scorecards so they can demand the right services for them, where their treatment falls short of NICE standards. • Ensuring information is at the core of the work of the AHSN: Technology-enabled innovations to empower patients with long-term conditions are being introduced (Apps, patient e-access relationship management system, Skype clinics, telemedicine) and we are progressing a range of projects for data sharing across the partnership. • Wealth creation: We are fostering a culture of more productive relationships with Industry through staff exchanges (recruitment, secondment, fellowships, joint projects and leadership development), and enhancing access, development, testing and delivery of new drugs, devices, diagnostics, and software to become the “go to” place for Industry. 1

Academic Health Science Network (AHSN) - Expression of Interest

Operations & Governance

The AHSN will have nested within it the AHSC functions (“early phase research/first in man”). The designated AHSN and AHSC functions will be overseen and delivered through one legal entity (UCLP), with a single Board, Executive and enabling organisation. This will allow more rapid translation into practice. • An Advisory Council will represent the views of the full range of stakeholders and members of the AHSN • A UK PLC Group will help drive the Wealth Creation agenda • Executive groups will lead delivery on education, research and our portfolio of programmes. As a programme reaches critical mass (as achieved for integrated cancer) focused, skill based programme Boards will be formed • The Executive will define and approve strategy, provide leadership, allocate resources and ensure the AHSN and AHSC defined strategic goals are delivered • The Board will oversee strategic delivery, ensure good governance, and act as the custodian of the UCLP culture and values

UCLP serves as a social enterprise and is an incorporated body limited by guarantee with three years of unqualified accounts. The partnership carries a small surplus each year allocated for reinvestment and maintains a strong cash balance (more than 4 months operating costs) to ensure financial stability. It will serve the function of both an AHSC and an AHSN.

The LETB for NEL and NCL will share a common Advisory Council with our AHSN. We have sought affiliation with the East of England LETB (for S&W Hertfordshire and South Bedfordshire) to ensure we maintain alignment. We continue to develop strong relationships with the Clinical Research Networks (CRNs) in London (NEL, NCL) and Essex and Hertfordshire, and our 3 BRCs and 2 BRUs represented on the research Board. We will model partnership behaviour working with AHSNs in London (and with Improvement Science London), and nationally. The operational and governance structures, metrics and deliverables will continue to evolve as UCLP adapts to deliver the agreed goals for its licence.

Footprint & Membership supporting this Expression of Interest

We will serve a direct population of 4.3 million people across NCL and NEL, South and West Hertfordshire and South Bedfordshire (mapping to 14 CCGs). Essex Partners, if approved as an AHSN, will be an affiliated member to enhance the benefit of scale and partnership working for patients and populations. This AHSN bid will service a contiguous population and includes support from:

Clinical Commissioning Groups in Barking & Dagenham, Barnet, Camden, City & Hackney, Enfield, Havering, Haringey, Islington, Luton & Dunstable, Newham, Redbridge, Tower Hamlets, Waltham Forest. And we are in constructive discussion with Hertfordshire Valleys CCG Acute, Community and Mental Healthcare Providers: Barking, Havering and Redbridge University Hospitals NHS Trust: Barnet and Chase Farm Hospital NHS Trust : Barnet, Enfield Haringey Mental Health NHS Trust : Barts Health NHS Trust: Camden and Islington NHS Foundation Trust : East London NHS Mental Health Foundation Trust : Great Ormond Street Hospital for Children NHS Foundation Trust : Hertfordshire Community NHS Trust : Homerton University Hospital NHS Foundation Trust : Luton and Dunstable Hospital NHS Foundation Trust : NHS Foundation Trust : North East London NHS Foundation Trust : North Middlesex University Hospital NHS Trust : Royal Free London NHS Foundation Trust : Royal National Orthopaedic Hospital NHS Trust : Tavistock and Portman NHS Foundation Trust : University College London Hospitals NHS Foundation Trust : Whittington Health : West Hertfordshire Hospitals NHS Trust Higher Education Institutes & Research Networks: City University : CLRN for Essex and Hertfordshire : Central and East London CLRN : Institute of Education, : London School of Hygiene and Tropical : London South Bank University : Middlesex University : University College London : University of East London : Queen Mary, University of London.

We will actively extend our existing partnerships with our Primary Care Providers, Local Authorities, and The Third Sector. We have already engaged major industry and other commercial partners to interact with our proposed AHSN platform and support the UK PLC group (eg GlaxoSmithKline and Novartis UK). 2