United Kingdom Report

UK healthcare consolidates after major structural reform

UK Healthcare has been through a period of consolidation over the last 12 months after undergoing a number of major structural changes in 2013. Many of the changes over the last 12 months have been driven by radical government policies which placed innovation and early technology adoption at the heart of healthcare delivery in the UK.

These changes, designed to foster healthcare innovation, have developed in parallel with a major transformation in the organisation of the NHS, with the commissioning of services moving to the new GP-led Clinical Commissioning Groups (CCGs) supported by Commissioning Support Units. The drivers for change have been borne out of challenges felt across the globe – the ageing demographic, growth in long term chronic disease, enhanced patient expectations, and of course, the need to contain costs at a time when economies continue to face huge pressures.

And whilst these challenges remain, the NHS has further enhanced its standing as the world’s leading healthcare system in a major international survey – matched by a well-supported Life Sciences sector which is thriving in a challenging global market.

Primary care

Arguably the biggest change in UK healthcare service delivery in recent times – the shift in responsibility of primary care in England from Strategic Health Authorities and Primary Care Trusts – is now one year in to its reign.

This change came about from the UK Government’s White Paper, ‘Equity and Excellence: Liberating the NHS’ which outlined radical reform to the way healthcare is delivered in the UK; one of the central principles being that community based General Practitioners (GPs) take responsibility for budgets and commissioning through CCGs.

Transforming innovative ideas and goodwill into operational realities that deliver the outcomes patients and populations need will be critical for CCGs in their second year in order to meet the longer term challenges. The direction of travel is pointing towards a more patient-centred approach – with a very clear focus on moving from a treatment-based culture, to an agenda of prevention and patient self-management.

NHS leading the way

The NHS has been declared the best healthcare system by an international panel of experts who rated its care superior to countries which spend far more on health. The report has been produced by the Commonwealth Fund, a Washingtonbased foundation which is respected around the world for its analysis of the performance of different countries’ health systems.

It examined evidence about performance in 11 countries, including detailed data from patients, doctors and the World Health Organisation. The fund’s researchers concluded that the United Kingdom ranks first overall, scoring highest on quality, access and efficiency.

In the Commonwealth Fund study the UK came first out of the 11 countries in eight of the 11 measures of care. It was awarded top place on measures including providing effective care, safe care, co-ordinated care and patient-centred care.

UK Life Sciences

George Freeman, a Conservative MP and former healthcare entrepreneur, was appointed in July as the UK’s first Life Sciences minister, an endorsement of the government’s desire to promote this thriving sector.

The appointment of George Freeman MP was followed later in the year by the announcement that Britain’s life sciences industry is on course to raise its most financing in 2014 for at least seven years, in a sign that government efforts to promote investment in the sector are beginning to pay off. UK companies raised £734m of capital in the first half of this year, surpassing the £483m raised in the whole of 2013, making it the top European destination for life science fundraising.

The UK Government’s 2013 annual Strengths and Opportunities report – which collates information on the medical technology, medical biotechnology industrial biotechnology and pharmaceutical sectors in the UK – provides very encouraging reading. Based on information in the report, the life sciences sector in the UK consists of 4,980 companies.

In total the sector employs 176,000 people in high technology companies across the UK and the industry sells into a global industry with current total market values of £612bn for pharmaceutical and biologics, £223bn for medical technology and £32bn for the rapidly growing industrial biotechnology market. These markets have historical strong growth rates and forecast rates are 8-10% per annum.

Life science companies based and operating in the UK generate £52bn in turnover from sales into the UK and overseas and this represents approximately 6% of the world market sales. These figures provide positive reading against the Government’s Strategy for UK Life Sciences.

The Government has continued to invest in research in the Life Sciences sector, with the Innovate UK (formally Technology Strategy Board) and Medical Research Councils Biomedical Catalyst Fund, and NHS England SBRI awards supporting new collaborations to deliver solutions to priority unmet clinical needs.

Working in partnership

Government strategies adopted in 2013 have continued to emphasise the importance of partnership working with the private sector. Major initiatives arising from the UK Government’s ‘Innovation Health and Wealth’ policy include the creation of Academic Health Science Networks (AHSNs) and the launch of a new funding mechanism for health technology innovation – the Biomedical Catalyst Fund.

AHSNs are charged with bringing together the NHS, academia, industry and other major stakeholders to improve the identification, uptake and spread of innovation in the NHS, whilst also improving international linkages. The networks represent a cultural shift in the NHS, with a recognition that service delivery can only be transformed through the rapid adoption of new technologies and that this requires the strategic participation of the UK Life Sciences business community – the focus being on improving the UK’s health and wealth.

The Biomedical Catalyst Fund, an Innovate UK and Medical Research Council programme, provides significant funding for the seamless translation of ideas to commercialisation (up to £2.4m for early stage and up to £2.4m for late stage) to derisk new product propositions making them more attractive to investors. Another major initiative launched last year and now making real strides is Healthcare UK – a joint initiative between UK Trade & Investment and the Department of Health – to help NHS organisations to do business overseas.

This is being achieved through strategic promotion of the UK healthcare sector to overseas markets and supporting healthcare partnerships between the UK and overseas healthcare providers. The AHSN network has provided a seamless interface between individual NHS trusts and their skills and capabilities, relevant to specific international markets. The year ahead – Life Sciences taking centre stage The UK is now arguably better placed to confront the challenges which affect global healthcare systems, addressing the rising costs of healthcare delivery whilst meeting the increased expectations of patients.

The UK General Election in 2015 will see healthcare come into sharp focus – with all of the major political parties recognising this as a key manifesto item. The future NHS will be characterised as a system and workforce that is focused on outcomes, and a public that takes more responsibility for its own healthcare, no matter who has the political mandate. With UK political and public will pointing firmly to the issue of improved healthcare delivery, the NHS, alongside its ambitious Life Sciences sector, is well placed to improve the innovation health and wealth of the nation. l For further information visit: www.medilinkuk.com www.medilink.co.uk

Single keyhole surgery for lung cancer

Consultants at Royal Brompton and Harefield Hospitals are using a new form of keyhole surgery for lung cancer, using just one small incision – instead of three or more separate incisions. Our surgical team believes that this may result in less pain, less scarring, reduced recovery time and increased mobility post operation.

Conventional surgery for lung cancer is performed through a fairly large cut in the back of the chest and involves spreading the ribs to remove the diseased section of lung. The introduction of multiple hole keyhole surgery is already thought to allow for a more rapid recovery and return to normal life in those patients suitable for this technique.

Traditionally this type of surgery has involved making three or four small cuts to the chest, through which a telescopic camera and surgical tools are inserted to examine the lungs and remove the affected areas. An improved technique pioneered by Consultant Thoracic Surgeons, Mr Eric Lim and Mr Simon Jordan at Royal Brompton Hospital, allows surgeons to perform keyhole surgery through just one incision less than three finger breadths. The entire operation is performed through this access alone.

Apart from standard lobectomy procedures, more complex operations have also been done with this single port keyhole surgery including segmentectomy, lung resection with chest wall resection, revision surgery and sleeve resection (removing part of the airway and reconstructing the two ends back together to restore airway to minimise loss of lung function). Although keyhole surgery is gradually gaining in popularity in the UK, it still remains relatively uncommon, accounting for less than 14% of lung cancer operations performed in 2010.

In contrast, consultants at Royal Brompton and Harefield Hospitals performed over 133 keyhole procedures between 2010 and 2013 and are minimally invasive surgeons at the Royal Brompton Hospital are able to perform over 60% of conventional lung cancer resections using this new technique, through a single keyhole. Next year, Mr Eric Lim will be leading a UK-wide clinical trial that compares keyhole surgery with conventional open chest surgery to further define the relative benefits and answer important questions on outcomes.

 Date of upload: 14th Nov 2014


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