Search

Scaling Inquiry: opportunities and frameworks

As part of the NHS Innovation and Life Sciences Commission, the Commissioners held a rich discussion on the need to establish opportunities and build frameworks to support adoption.

Chaired by Lord James O’Shaughnessy and Professor Mike Bewick, the fourth and final inquiry session of Curia‘s NHS Innovation and Life Sciences Commission focused on improving the scaling of health innovations, bringing together the recommendations of leaders in the NHS and life sciences industry.

The second half of the inquiry session focused on structural approaches the NHS and life sciences ecosystem must take to allow effective adoption.

  • Professor Ian Dodge – former National Director of Primary Care, Community Services and Strategy, NHS England
  • Professor Ben Bridgewater – CEO, Health Innovation Manchester
  • Daniel Ratchford – Senior Director, Healthcare, IQVIA
  • Andrew Davies – Digital Health Lead, ABHI

Collaborative approaches for NHS and industry

Professor Bewick opened the second session on the necessary approach for the NHS and industry to improve collaboration. Andrew Davies emphasised the importance of co-design, as collaboration works better with combined objectives and goals. However, he suggested there has been a breakdown in communication between the NHS and life sciences sector in achieving common goals. Davies argued that the correct framework for collaboration is vital and if the ecosystem installs a value-based approach, the adoption of innovations could be markedly improved.

Professor Ben Bridgewater noted the differences in background that exist between actors within the healthcare and life sciences industry. Therefore, aiming to improve collaboration between actors must be a high priority. He added the benefit of professionals gaining experience in different sectors of health and life sciences. He argued that these experiences enrich understanding and improve conversations between actors. Consequently, if the ecosystem can better understand each actor’s priorities, challenges and goals, then a more unified and successful approach to scaling innovations is possible.

Professor Bridgewater noted there is sentiment against the life sciences industry within some parts of the NHS, and this must be recognised and understood. Leaders within the NHS should therefore install a culture that ensures collaborations with industry are indeed partnerships to improve health outcomes for patients.

Professor Ian Dodge noted there are encouraging signs within NHS England, particularly the development of the Commercial Medicines Unit (CMU) that has opened conversations between the pharmaceutical industry and the National Institute for Health and Care Excellence (NICE). However, he noted these developments are still far from the level of collaboration needed between the NHS and industry.

Daniel Ratchford argued the NHS is slowly becoming less suspicious of the pharmaceutical industry, as conversations are starting to occur more regularly. Ratchford furthered Professor Bridgewater’s point about building understanding and communication between different actors to facilitate collaboration. On the collaborative deals, he argued transparency in terms of gains and risks is essential.

Contractual changes to NHS commissioning

As a response to commissioner Patel’s question about contractual changes to facilitate collaboration, Ratchford highlighted virtual wards as an exciting innovative practice that is showing different approaches from ICBs in its implementation. He noted that his experience of working with ICBs on virtual wards has given him confidence in the collaborations that are possible.

Professor Bridgewater noted the inherent difficulty of balancing the rigorous approach of academic researchers with the fast-paced innovation mindset of industry. He explained that his experience at Health Innovation Manchester pushed his inclination towards a faster approach to innovations, yet this dilemma has not been overcome. He concluded that before the NHS seeks to embark on contractual reform in the early stages, it needs to build relationships, ways of working and push for proof of value. Building on these steps will therefore improve the ability for innovations to be scaled more effectively.

On his experience working with the healthtech industry, Davies noted the difference in contractual arrangements between digital technologies and medical devices to diagnostics. He added to Professor Dodge’s point about CMU, noting the importance of structures to facilitate collaboration and innovation. However, within digital technologies and diagnostics, these structures are behind medicines and require time to evolve.

“The structures are still growing, and they are starting to take place with things like the MedTech directorate. However, outside that central area, you never know quite who you will be interacting with at a more local level. Further clarity in who does what would be a welcomed step forward” – Andrew Davies

Professor Dodge noted there was a promise in the NHS Long Term Plan for a clearer innovation pipeline, including allowing innovators to have greater conversations. He argued that this has not yet come far enough in achieving the “necessary fluidity” for innovation adoption. On Professor Bridgewater’s mention of purposeful design, he stressed the importance of context and clarity when presenting early discovery models as opposed to a proven standardised model. Professor Dodge concluded that collaboration between different national actors such as NICE and NHS England and the connection of national actors with local systems is paramount.

The AAC and government responsibility

On the role of the AAC and the responsibility of government to improve adoption, Professor Dodge explained the AAC, and other mechanisms highlighted the adoption issue the UK faces. Therefore, a more substantial effort is needed to achieve the levels of adoption needed. He added that ultimately the life sciences ecosystem must prioritise solutions to alleviate the burden on the NHS. In addition, it must focus on producing reproducible, standardised methods to allow adoption and scaling to improve.

“The AAC has shone a light on the need to be really clear about what the hypotheses are around expected benefit and the methods for driving it. And then there’s the question on how you get there through really effective engagement.” – Professor Ian Dodge

Professor Bridgewater noted collaboration is a “contact sport” that needs agencies to drive it, which must be fit for purpose and held accountable for being effective. He added the importance of the RACI matrix as a key ingredient to understanding who is responsible and accountable for the adoption of innovation.

Ratchford argued that the AAC and AHSNs have been successful to an extent. However, there is a much bigger picture of needed adoption which the UK is not currently delivering. He argued the NHS and government must encourage the needed conversations, starting at the local level and particularly within Integrated Care Partnership Boards (ICPBs).

Davies argued that responsibility for improving adoption must be shared between the public and private sectors. Currently the NHS is not sufficient in adoption, yet the UK economy is not investing enough in innovations, with many companies moving abroad to attain the required investment. For solutions, he added a rebalancing of the R&D tax credit from research to development is a simple fix, as well as further utilising pension funds.

Reimbursements for technologies and accountability for innovation in Integrated Care Systems

Lord O’Shaughnessy asked the final question on achieving reimbursements for health technologies and leadership responsibilities within ICBs to promote scaling. Professor Bridgewater noted the conversations in improving reimbursements and promoting innovation within ICBs are starting. He explained in the Greater Manchester ICB, they have agreed innovation priorities and criteria to measure success. The next steps are to agree priorities with all actors, at all levels.

Profesor Dodge added that “there has to be national accountability if you want national scale”, which therefore falls within NHS England, but must be assisted by national actors such as the Government including DHSC and NICE. He furthered Professor Bridgewater’s point on aligning local priorities between actors and added accountability and leadership for adoption must be centred in NHS England.

“The question on alignment is, to what extent it is informed by a co-production process? To what extent do you have all the AHSNs, ICBs etc. providing their inputs so that you have NHS England speaking on behalf of all its constituent parts rather than just inventing something that is disconnected” – Professor Ian Dodge

Professor Bewick and Lord O’Shaughnessy thanked panellists for their contributions and participants for attending the session.

Final thought

The second hour of the Commission’s final inquiry session provided key insights to the UK’s innovation adoption problem, focusing on incentivising adoption and the necessary framework. The panellists emphasised the UK has the tools to become a world-leader in adoption, improving population health and reducing burden on the NHS. To ensure progress, the UK must utilise mechanisms such as the AAC and AHSNs to create the needed reimbursement pathway.

Share

Related Topics

Latest

Video Features

How Can we Level Up the UK Sustainably?

Does Democracy Require Proportional Representation?

Marking LGBT+ History Month 2024

How Can Plugging the Skills Gap Support Decarbonisation?

Subscribe to our newsletter for your free digital copy of the journal!

Receive our latest insights, future journals as soon as they are published and get invited to our exclusive events and webinars.

Newsletter Signups
?
?

We respect your privacy and will not share your email address with any third party. Your personal data will be collected and handled in accordance with our Privacy Policy.

Never miss an issue by subcribing to our newsletter!

Receive our latest insights and all future journals as soon as they are published and get invited to our exclusive events and webinars.

Newsletter Signups
?
?

We respect your privacy and will not share your email address with any third party. Your personal data will be collected and handled in accordance with our Privacy Policy.

Never miss an issue by subcribing to our newsletter!

Receive our latest insights and all future journals as soon as they are published and get invited to our exclusive events and webinars.

Newsletter Signups
?
?

We respect your privacy and will not share your email address with any third party. Your personal data will be collected and handled in accordance with our Privacy Policy.

Newsletter Signup

Receive our latest insights as soon as they are published and get invited to our exclusive events and webinars.

Newsletter Signups
?
?

We respect your privacy and will not share your email address with any third party. Your personal data will be collected and handled in accordance with our Privacy Policy.