UCLPartners academic health science partnership Professor the Lord Ajay Kakkar, Chair, UCLPartners Professor Sir David Fish, Managing Director, UCLPartners Dr Charlie Davie, Director of UCLPartners AHSN Clare Panniker, Chief Executive, Basildon and Thurrock University Hospitals NHS Foundation Trust What is UCLPartners? Six million population 23 healthcare organisations acute and 11 higher education institutes mental health trusts; community providers and research networks 20 Clinical Commissioning Groups (CCGs) Industry partnerships in research and 26 boroughs and local councils translation of innovation into health and wealth 2 Local Enterprise Partnership – key challenge • Working with the London Enterprise Panel, established by the Mayor of London • Professor Stephen Caddick, Vice Provost (Enterprise), UCL, is the only academic representative on the Panel • Key challenges of the panel: to compete with Boston and San Francisco; improve access to the NHS market to increase venture capital • How UCLPartners is contributing: working with industry to co-create technology and devices; creating long-term partnerships with industry and giving confidence to entrepreneurs, e.g. through new business models and procurement initiatives • Other areas of joint working: MedCity, Care City, London Health Commission, three London AHSNs and preparing to enable the success of the Francis Crick Institute 3 Defragmenting the pathway – an integrated journey to transform healthcare through innovation into practice Bringing together formal designations under one umbrella and working with partners to: Information • Discover new treatments and methods for Education improving health • Develop discoveries through clinical trials • Implement changes at scale and pace across the partnership Population • Evaluate how the system is working and what can be done next • Educate the workforce and develop capabilities • Use information to its best effect throughout the system 4 Example: Use of Natalizumab for multiple sclerosis DISCOVERY CLINICAL TRIALS IMPLEMENTATION EVALUATION CAPABILITY Surrogate “Real world” Treatment Educational markers and Phase 1-3 clinical evaluation received by publications and proof of concept trials clinical impact 112,000 patients clinical training studies and efficacy Relationships Patient pull Alignment Outcomes • Health improvement: 66% reduction in relapse, 50% reduction in relapse-related disability • Example of potential for economic gain: Natalizumab sales generated $1.6bn for Biogen in 2012 5 Business model Value add to population Value add to partner organisations UCLPartners turnover 6 Academic medical centre model for the AHSC INSTITUTE OF IMMUNITY & TRANSPLANTATION UCLH CANCER CENTRE BARTS UCL CANCER INSTITUTE CARDIOVASCULAR UCLPartners QUEEN SQUARE HOUSE MOORFIELDS / INSTITUTE OF OPHTHALMOLOGY CENTRE FOR CHILDREN’S RARE GOSHDISEASE & RESEARCHUCL Child Health 7 Population reach and impact through the AHSN AHSC PARTNERS nested in AHSN 8 Specialist cancer and cardiac services Benefits of improvements along whole pathway of care and to health economy: • 1,200 lives saved per year • Net present value gain of £94m • Globally competitive life sciences • International private practice Barts Heart Centre Cancer Centre at UCLH 9 Clinical trials Harmonisation North Thames Clinical Research Network Impact of harmonisation on approval times: ranks top nationally for recruitment median permission time (April to Aug 2014) 25,000 20,000 15,000 10,000 5,000 0 10 Quintiles Prime Site far exceeds the company recruitment target UCLPartners is the highest performer for Quintiles in Europe 11 Investing in genomics • UCLPartners, Cambridge and Newcastle Universities were the original partners in the Genomics England Rare Diseases Pilot • UCLPartners contributes 68% of the national sample DNA samples provided in Genomics Proposed governance structure of UCLPartners North England Rare Diseases Pilot (3 sites) West Genomic Medicine Centre 1400 NHS England / GEL 1200 1300 UCLPartners 1000 Executive Genomics Executive (Partnership Board) Board 800 then to UCLPartners Board 600 700 Genomics Operations Team 400 200 GOSH UCLH Moorfields NWLH RFH BH 0 Lead trust UCLPartners Cambridge and Newcastle Universities 12 Supporting people in London’s growth boroughs In Newham, UCLPartners is supporting: • Academic development of local people with £2m investment from Newham CCG and UCLPartners support to assist in the transformation of primary care • Establishment of an academic centre for health improvement science at the Sir Ludwig Guttmann Centre (the Olympic Medical Centre): potential scaling across London • Improvements in local health priorities through programmes on diabetes, cardiovascular disease, low birth weight babies and quality and capacity in primary care with a focus on health behaviours and inequalities • Children’s resilience through a mental health programme for young people, which has won £500k Big Lottery bid (with potential for £10m over five years) • University development in the Olympic park in potential collaboration with pharma 13 Supporting people in outer north east London • Supporting an innovative pilot primary care practice in Barking, Havering and Redbridge – delivering what matters most to 1,000 patients with most complex care needs • Care City – supporting local training and apprenticeships, informatics and industry • Life Study – largest ever cohort study of 80,000 children from birth to adulthood at Queen’s and King George hospitals, collaborating with CCG and other care providers 14 Mental health issues affect 1 in 4 people in England and have implications for employment Supporting workplace health and Improving wellbeing education & Getting employment people back outcomes in to work adolescents Better health and wealth Individual UK plc productivity Business productivity 15 New business model – shared risk, co-created, implemented Investment Value One-off seed funding of 25% for product maintenance UCLPartners £30,000 to and SME Concentra £10,000 profit 37.5% profit to UCLPartners (Concentra) Costs of 37.5% profit to Concentra £20,000 per More effective product and efficient care for patients £30,000 to £100,000 saving Recurring staff Client purchase (based on cost of cost savings of platform alternative platforms) £76k pa If this was rolled out across all local authorities total savings could be £15.2m plus recurrent annual savings of £11.5m 16 Innovation in informatics and data science Our approach to informatics • Connect the existing strengths the partnership has • Support partners to create a model of innovation that will save lives, transform services for patients and create value for organisations • Develop educational programmes for our clinical workforce • Expand industry partnerships Encouraging systemic innovation • UCLPartners is co-applicant and core partner of the only UK bid for the €600 million Knowledge Innovation Community in Healthy Living and Active Ageing – integrating Education, Research and Business • Aiming to create sustainable health systems across Europe, ready to tackle the challenges of our ageing population 17 Quality and safety • Value-based strategy based on Michael Porter’s work • Patient Safety Collaboratives • Sign up to Safety campaign • Partnership programmes are saving lives: • Collaboration across 15 trusts is reducing cardiac arrests in hospitals by up to 50% by identifying and responding to deteriorating patients 18 Atrial fibrillation – working together to save and improve lives Estimated Stage 2 bid for impact £500k to take UCLPartners to four more wide CCGs •>10% OACs •Clinical •Avoid 700 strokes pa Effectiveness •9% OACs •Avoid >50 strokes pa •Saves £8.4m pa NHS Group model •Saves >£600k pa NHS •Avoided 5 strokes pa costs = 10% OACs •Saves £60k pa NHS costs over 2 yrs. •Saves >£1m pa social •Saves £16m pa indirect costs social care costs Diffused to care costs Camden in 6 UCLPartners months diffuses across the partnership Atrial fibrillation community of interest Patient groups Local authority AHSNs CEG Providers SCNs Pharma Universities Med Tech NIC CCGs NICE 19 Stroke avoidance savings ref: Hunter et al 2013 Quality and value We must replace today’s fragmented system, in which every local provider offers a full range of services, with a system in which services for particular medical conditions are concentrated in health-delivery organizations and in the right locations to deliver high-value care. Prof Michael Porter, Harvard UCLPartners conference, City Hall, 2012 20.