The UK life sciences sector is one of the most significant contributors to the UK economy. It is high-tech, research-intensive, scientifically diverse, innovative and a key player in supporting the nation’s health. According to one analysis, it contributed £30.4 billion to the economy in 2015 and supported nearly half a million jobs.1 As the UK prepares to leave the European Union, the importance of this industry has been thrown into sharp focus, and it would be difficult to overstate how essential it will be that we continue to have a strong life sciences sector. To achieve that, it needs to be nurtured and empowered to compete in global markets, while playing a vital role in our national life.
The NHS, meanwhile, is too often seen simply as a consumer of public resources – in fact it too is a key component in the success of UK plc. It is the country’s largest employer and now forms 8 per cent of the economy. Of course, indirectly its impact is much greater than that. Its contribution to our health and wellbeing is both direct through the services it provides and also indirect through its purchasing power, as an employer and its vital role at the centre of communities.
The opportunity that now confronts us lies in the fact that these two huge sections of the economy are self-evidently mutually dependent. Indeed, they have been since the health service was founded more than 70 years ago. Yet the potential for co-operation has never been fully realised – relations between the two have not always been as productive as they might have been. There is now wide agreement that for a variety of reasons, the potential of a genuinely collaborative future is enormous and perhaps just as important. Failure to embrace this opportunity risks severe damage to both.
The case for change is overwhelming and can be seen in what is already being achieved.
The NHS can be at the cutting edge in helping to develop and evaluate new products. If the UK can be at the forefront of well-regulated and robust clinical trials and product tests, effective medicines and devices would become more quickly available here. More clinical trials also attract leading researchers and clinicians from around the world, and this in turn builds the base for more innovation and the chance to be at the forefront of clinical care.
As the life sciences industrial strategy points out, the NHS has ‘many potential assets that could be valuably applied in collaboration with industry to improve our understanding of how well therapies work in the real world, which patient populations are most likely to respond to therapeutic interventions and how innovations can be used to change whole pathways of care, ideally reducing cost and improving outcomes’. This represents a different form of relationship than has existed hitherto, one which tended to be more transactional and was often confined to the promotion of one product over another. If these very different benefits are to be realised we do need a different approach which recognises that the potential to both sides of longer-term relationships, risk sharing, and a mutual realisation that there can be wins all round.
The fact that the NHS across the UK provides universal coverage will be a huge advantage, provided we can capitalise upon it. It offers the prospect of access to defined patient populations with high quality information. It should allow us to embrace a digital revolution which is ushering in the age of data and is set to be one of the great drivers of improved performance and a key facilitator of innovation.
As such, having a National Health Service gives us a major advantage over many other jurisdictions. By using anonymised health data, it is possible to research innovations and technologies, develop new therapies and improve the way we deliver NHS care. Already we have seen what risk stratification can do in helping to devise new targeted interventions and improve care pathways.
We have seen too through the Getting It Right First Time (GIRFT) programme and other initiatives how powerful data can be in changing clinical behaviour – at every level in our healthcare system data can be used to drive improved performance and increasingly we will have access to real world data. If we can combine this evidence base with the expertise of industry there are enormous possibilities.
The UK already has major national data sources, including the UK BioBank with 500,000 participants and GeL, with more than 100,000 sequenced genomes. GeL was established in July 2013 by the Department of Health and Social Care in England to perform whole genome sequencing analysis on 100,000 participant samples. HDR UK has now formed the Health Data Research Alliance to develop tools to enable the use of health data for English research and innovation, which again should create trust and confidence, and speed up research and innovation. The Personalised Health and Care 2020 strategy for England sets out an ambition to create a digitised health and care system, including a collection of key datasets for research.
Another exciting innovation has been the creation and expansion of the Accelerated Access Collaborative, which brings together the key players from the NHS, research and industry to identify potential innovations and help to support the NHS in England to make best use of them. The new body is set to establish a single point of call for innovators, link up with the needs of clinicians and patients, establish a testing infrastructure, agree a joint funding strategy for health innovation and support the NHS to achieve faster adoption and spread. It will be vital that health organisations and systems feed into this work.
At the same time, it will be important that activity is not confined to the centre or indeed in the usual centres of excellence, vital though they are. The Industrial Strategy’s new ‘built on trust’ philosophy will only be achieved if there is active engagement and commitment from all parties and if it includes clinicians and leaders at a local level across the country.
One of the key catalysts for England will be the 15 Academic Health Science Networks, which have been charged with the task of helping to identify and spread health innovation at pace and scale across the health and care system. These regional networks can act as a bridge between academia, industry and the NHS, supporting researchers and innovators to deliver change and they will be critical in bringing the key players together. Active support and involvement by industry, NHS organisations and health and care systems should make sure they achieve their potential.
There is a tendency to over or underestimate the pace of change, and often the unexpected can happen. But most observers agree we are entering a period of rapid change. The nature of medicine and healthcare will change, and that technology will not only affect what is available but will change relationships and expectations among all the players, including patients and users of services.
The focus will have to be on how we invest in patient outcomes, adopt and spread innovation in all its forms and thereby increase the overall efficacy and efficiency of the health and care system.
The alternative, of course, is a system which looks unaffordable with uncontrolled rising demand and the whole exceeding our willingness to pay, at least from public funds.
But as this report shows, there are opportunities to create a different future; one in which we embrace new technologies which improve patient outcomes and, alongside that, deliver care in different ways that are more targeted and effective. The task must be not only to improve quality of life or extend life especially among the disadvantaged, but also to enable earlier intervention so that more of us can continue to live independently at or closer to home. We can only do that by working together.
1. ABPI, BIA, BIVDA, ABHI, PwC (2017), The Economic Contribution of the UK Life Sciences Industry.