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Research and Innovation at the Heart of the NHS

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Research and Innovation at the Heart of the NHS Research and innovation at the heart of the NHS Sir Malcolm Grant, Chair, NHSE NHS Health and Care Innovation Expo 6 September 2018 What this session is about • The economic case • The opportunity: research and innovation in the NHS’ Long Term Plan • The foundations on which to build • Areas for future development: • Partnerships with industry designed into the way we work in the NHS • Developing an innovation pipeline with parity between medicines, diagnostics, devices and digital products • Developing an expectation of universal responsibility for adoption of proven innovation • Investing in mechanisms that spread innovation 2 The clinical and economic case: innovation for the long-term health of the NHS For patients • Hospitals that are research active have lower mortality rates than those that are not. This effect is not limited to research participants1 • 83% of people believe that health research is very important and 48% believe they receive better care in hospitals that are undertaking research2 1. Ozdemir, B.A; Karthikesalingham, A; Singha, S; Poloniecki, J.D; Hinchliffe, R.J and Thompson, M.M, et al (2015) ‘Research Activity and the Association with Mortality’ PLoS ONE 10(2) 2. Hunn A, Survey of the general public: attitudes towards health research 2017. Health Research Aurthority. 2017 3. Health Economics Research Group, Office of Health Economics & RAND Europe (2008; 2014) Medical Research: What’s it worth?: Estimating the economic benefits from medical research in the UK 3 4. King’s Policy Institute (2016) Public medical research drives private R&D investment The clinical and economic case: innovation for the long-term health of the NHS For patients For the service • Hospitals that are research active have • In the UK, for every £1 spent on research lower mortality rates than those that are the combined health and economic return not. This effect is not limited to research is 24-27p p.a. in perpetuity3. participants1 • Internationally, a £1 increase in government • 83% of people believe that health research spending on medical research is associated is very important and 48% believe they with between £0.83 and £1.07 increase in receive better care in hospitals that are private research spending4 undertaking research2 1. Ozdemir, B.A; Karthikesalingham, A; Singha, S; Poloniecki, J.D; Hinchliffe, R.J and Thompson, M.M, et al (2015) ‘Research Activity and the Association with Mortality’ PLoS ONE 10(2) 2. Hunn A, Survey of the general public: attitudes towards health research 2017. Health Research Aurthority. 2017 3. Health Economics Research Group, Office of Health Economics & RAND Europe (2008; 2014) Medical Research: What’s it worth?: Estimating the economic benefits from medical research in the UK 4 4. King’s Policy Institute (2016) Public medical research drives private R&D investment The foundations constructed in 2018: Life Sciences Industrial Strategy and the NHSE 12 actions Life Sciences Industrial Strategy 12 actions to support research in the NHS Includes: • Simplify NHS research processes • Articulate the NHS’s own research priorities better: • Enhance our data infrastructure: Life Sciences Industrial • Support advanced research into leading edge Strategy technologies: – A report to the Government from the life sciences sector • Improve and simplify our adoption ecosystem • Accelerated Access Collaborative • Back AHSNs to become the main local NHS • AI in radiology and pathology delivery vehicle for spreading innovations • Digital Innovation Hubs • Review and simplify the number of different national innovation projects and programmes www.england.nhs.uk 5 6 Research and innovation in the Long Term Plan Long Term Plan workstreams High level health and clinical outcomes assessment (relative performance and gap closing opportunity) Enablers Enablers Digital and Workforce, training Life course “lens” Clinical priorities “lens” technology and leadership (incl. HEE budget) Prevention of ill-health, personal responsibility and health inequalities (including PHE/local authority prevention Cancer budgets) Cardiovascular and respiratory Efficiency and Primary care productivity Healthy childhood and maternal health Mental health Integrated and personalised care for people Learning disability and autism with long term conditions, including Local and national Research and dementia, and older people with frailty system architecture innovation Clinical review of standards OFFICIAL – SENSITIVE 6 What we’ve heard is required to support innovation in the NHS Build a richer pipeline of proven innovations Improving uptake and spread of these A which meet the needs of patients and the B proven innovations NHS 1. Integrated 2. Expanded 3. Single signal 4. Building 5. 6. Building service for real-world of readiness for awareness and Understanding capacity and innovators testing commissioning demand at uptake and capability in point of care providing adoption and incentives spread So – potential areas of future development • Partnerships with industry aligned to the needs of the NHS • Providing parity between medicines, diagnostics, devices and digital products in terms of evaluation and commissioning • Developing a culture where adoption of proven innovation is everyone’s responsibility • Investing in mechanisms that spread innovation 8 1 New partnerships with industry: rolling the pitch Salford Lung Study The paradigm of enlightened self interest: Industry has to come up with strategies to prevent all that is World’s first pragmatic, digitally- enhanced preventable if health systems are to randomised controlled trial of a pre-licensed medication in COPD delivered by NHS, have budget capacity for higher cost university and other local organisations in personalised medicines. partnership with GSK: • 4,200 consenting patients Need to demonstrate that new • 80 GP practices products provide value for money for the NHS • 130 pharmacies www.england.nhs.uk 9 1 New partnerships with industry: rolling the pitch Salford Lung Study 100,000 Genomes Project World’s first pragmatic, digitally- enhanced First programme globally to sequence patients randomised controlled trial of a pre-licensed recruited from routine channels & treated through medication in COPD delivered by NHS, routine care university and other local organisations in Partnership between NHSE and Genomics partnership with GSK: England; Illumina & 6 Interpretation partners • 70,000 patients – 100,000 Genomes • 4,200 consenting patients • 85 acute trusts • 13 NHS Genomic Medical Centres • 80 GP practices • >200 rare diseases & 15 cancer classes • 130 pharmacies • >260 cancer pathways The next phase: into the clinic www.england.nhs.uk 10 Combining the information: The Human Panorome • The Whole Genome as starting point: the functional genomic pathway • Bringing together the multiple maps of the various stages of the functional genomic pathway in an individual, together with related environmental and social information, provides a panoromic ‘Google Earth’ type map of an individual “With personal technology, doctors can see a full, continuously updated picture of each patient and treat each individually” From Topol. 2014. Cell 1 Partnerships with industry: local diversity/national framework? Sensyne Health, University of Oxford and Oxford University Hospitals NHS Foundation Trust Aim: Development of new digital health products. Commercial approach: Royalty fee + equity share + investment in local R&D www.england.nhs.uk 12 1 Partnerships with industry: local diversity/national framework? Sensyne Health, University of Oxford and Oxford Royal Free London NHS Foundation Trust and University Hospitals NHS Foundation Trust DeepMind Health Aim: Development of a new app (Streams) for patients Aim: Development of new digital health products. with acute kidney injury, to expedite access to care Commercial approach: Royalty fee + equity share + Commercial approach: Access to product free of charge investment in local R&D www.england.nhs.uk 13 1 Partnerships with industry: local diversity/national framework? Sensyne Health, University of Oxford and Oxford Royal Free London NHS Foundation Trust and University Hospitals NHS Foundation Trust DeepMind Health Aim: Development of a new app (Streams) for patients Aim: Development of new digital health products. with acute kidney injury, to expedite access to care Commercial approach: Royalty fee + equity share + Commercial approach: Access to product free of charge investment in local R&D UKBiobank Polygenic risk study (Nature Genetics, Aim: TBC August 2018) Commercial approach: open access resource; • Rare monogenic mutations researchers and companies required to return findings • Coronary artery disease – 8.5% and resources back into BioBank; “the world’s best minds and technologies working on understanding human population at greater than 3x health”; “moving from an era of genomic medicine to increased risk genomic prevention”. Polygenic risk study • More than 5m Britons have triple the normal risk of heart disease www.england.nhs.uk 14 1 Partnerships with industry: local diversity/national framework? Sensyne Health, University of Oxford and Oxford Royal Free London NHS Foundation Trust and University Hospitals NHS Foundation Trust DeepMind Health Aim: Development of a new app (Streams) for patients Aim: Development of new digital health products. with acute kidney injury, to expedite access to care Commercial approach: Royalty fee + equity share + Commercial approach: Access to product free of charge investment in local R&D UKBiobank Moorfields
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