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Andy Burnham, Lord O’Shaughnessy and leaders in life sciences examine the impact of levelling up and local partnerships on health outcomes

From right to left: Angela McFarlane, Senior Vice President, IQVIA (Chair), Lord James O’Shaughnessy, former Minister for Innovation, Dr Ruth Bromley, Chair, Manchester Health & Care Commissioning, Richard Kemp the Deputy Chair of the Community Wellbeing Board, Liverpool City Council, Kate Bratt-Farrar, CEO of Heart Research UK and the Rt Hon. Andy Burnham, Mayor of Greater Manchester.

From right to left: Angela McFarlane, Senior Vice President, IQVIA (Chair), Lord James O’Shaughnessy, former Minister for Innovation, Dr Ruth Bromley, Chair, Manchester Health & Care Commissioning, Richard Kemp the Deputy Chair of the Community Wellbeing Board, Liverpool City Council, Kate Bratt-Farrar, CEO of Heart Research UK and the Rt Hon. Andy Burnham, Mayor of Greater Manchester.

The Mayor of Greater Manchester, Andy Burnham joins a distinguished panel of health and life science experts at a question and answer panel discussion in Liverpool.

Bringing the conversation to communities across the country:

This exciting ‘Levelling Up the Conversation’ event brought together an expert panel of leaders in healthcare and the life science sector in Liverpool to discuss innovation as a means to drive down health inequalities and improve health outcomes across the country. With the clear strides made in the North West but difficulties to replicate success nationally, the distinguished panel were able to reflect the voices of the region, patients, the NHS, local authorities and industry for the discussion. Acknowledging the issues facing health and life sciences in the UK as well as the real possibilities for success, Vice President of Strategic Planning for Northern Europe at IQVIA, Angela McFarlane opened proceedings  – noting how important it is to take this discussion to communities across the UK.

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Barriers to levelling up in healthcare:

Dr Ruth Bromley, Chair of Manchester Care & Commissioning and Richard Kemp, Liverpool City Councillor, detailed the impacts of wider inequality and poverty as a major barrier to levelling up in healthcare. Dr Bromley stated that there “shouldn’t be any barriers at all to levelling up” and that the question we need to ask ourselves as a country is “are we ready to concede privilege and move resources to those who need it most?”. She further detailed her own experience of seeing the impacts of poverty and the coronavirus pandemic in reducing the life expectancy of men by three years in Manchester.

Mr Kemp agreed on these points, explaining that there is a 12-year gap in life expectancy between the richest and poorest areas of his city, Liverpool. The social determinants of housing, employment opportunities, diet and education are all key contributing factors to these inequalities, as Mr Kemp declared “I don’t think we are going to get this right by the end of the century. We are talking about inbuilt prejudices, inbuilt problems, but we’ve got to make a start on them.”

Mayor of Greater Manchester, Andy Burnham provided an example of progress – detailing the findings of a report which showed devolution in healthcare had narrowed health inequalities in Manchester. He said: “It’s not as bleak as the audience might think – there is evidence that if you devolve properly you can start to make a difference by bringing the different services together”. However, we need to confront the reality that “there is a mountain in front of the NHS now”.

Measuring success:

In addressing Angela McFarlane’s practical question of how success is actually measured in levelling up, the Mayor reemphasised the importance of life expectancy as a tool to draw comparisons across the country and between different sections of society. Adding further, he said the wider importance of social determinants must be measured, particularly education and the “levels of school readiness” of primary school children. In his view, if you improve these social determinants of health, you will achieve true levelling up in health outcomes.

Mr Kemp took a different angle in measuring success, placing more importance on quality of life than just life expectancy. He detailed the subsequent impact of child obesity on a lifetime of health issues. On obesity he explained: “we know that three percent of our 11-year-olds are clinically obese. We know that is going to lead them to at least two major health interventions by the time they are 65 and they won’t live much longer than that. We know that a lot of their life is going to be miserable as they will have mental health problems”. He added, “of course we have to work on the macro level, but we have to work on the micro level at the same time.”

Clinical research supporting the levelling up agenda:

To the Chair, Angela McFarlane’s question on how the levelling up agenda can be supported by clinical research, Kate Brat-Farrar, CEO of Heart Research UK suggested that questions must be asked of ‘how’ research can contribute and ‘who’ is doing that research so that we can effectively support early research across the country.

She asked the question as to why some groups and communities are not accessing the treatment and care that is available, leaving sections of society disadvantaged in areas of health. She explained: “it’s about getting into communities and researching with people about what is impacting their lives and I believe that is what will make the difference.”

Angela McFarlane added several important points on the need for the outlook on primary care research to change. She explained that clinicians across the health service could integrate research further into their treatment of patients – suggesting patients take part in research where relevant that could aid their diagnosis journey.

Former Minister for Innovation, Lord James O’Shaughnessy joined the discussion from an economics standpoint. He explained that boosting clinical research is a wealth generating opportunity, improving local economies that are in need of levelling up. He added: “don’t think of clinical research as something that happens in universities or just with clinical academics. This is a wealth generating opportunity and of course if you generate wealth, you generate economic activity – you get the better jobs that Richard was talking about and probably nothing does more for better health than high standards of employment and high good quality skilled jobs.”

On achieving this, he explained: “it’s to some degree about reframing how we think of clinical research, not as something that is added on to treating a problem but actually is a wealth generator.”

Final thought:

Chamber UK and IQVIA’s ‘Levelling Up the Conversation’ panel discussion in Liverpool provided an open and honest appraisal of the UK health and life science sector. The distinguished panel with an audience of leading experts in life sciences allowed the levelling up agenda to be examined from several relevant angles. In this first part of the discussion, some key conclusions and insights were reached.

The experiences from Ruth Bromley and Richard Kemp in Manchester and Liverpool respectively, proved the UK has a long way to truly achieve levelling up of health outcomes and reducing health inequalities between regions. The evidence provided of recent reductions in life expectancy in the North West are truly shocking and deserve the attention of the whole nation. The passion shown from both panellists deserves huge praise, as working to improve health outcomes in their region is a clear driver of their work and career.

The emergence of Integrated Care Systems and opportunities for advancement in clinical research was identified as an opportunity to progress in achieving levelling up in health with Manchester leading the way. However, until this is adopted we will have to wait and see whether that progress can be replicated everywhere.

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