United Kingdom Report

£160 million Cancer Centre Opens at Guy's Hospital


A new £160 million (about US$200 million) Cancer Centre at Guy's Hospital, which has been designed by patients for patients, opened on 26 September.

The new Cancer Centre also brings together treatment and research in an Innovation Hub, which will transform King's College London's translational cancer research programme, enabling scientists to carry out more specialised research on different types of cancer.

Working alongside clinicians, King's researchers will analyse patients' conditions to better predict and monitor responses and assess resistance to treatment, enabling the centre to stratify patients, develop more personalised medicine and help design better therapies and drugs. The Hub will also introduce new treatments through research-led trials, enabling the hospital to increase the number of cancer patients registering for clinical trials and through their hubbased analytics improve the chances of successful implementation.

The hositals breast cancer biobank dates back to 1975 and the availability of tissue from this source has been invaluable for many national and international research studies. The volume and ethnic diversity of the patient population means they are uniquely placed to collect data about a range of cancers. The Hub will provide much-needed space and opportunity to consent patients and collect and store samples. Along with gathering more data on breast and prostate cancers, the hospital is expanding their biobank to include tissues from other tumour types where survival rates have remained static for decades: lung, upper-gastrointestinal, and head and neck cancers.

Tumour metastasis is the most common cause of death in cancer patients and there is a need to increase understanding of the genetic changes that program cancer cells to move from the primary tumour site, survive and grow as secondary tumours in distant organs and gain insight into how these changes induce a permissive environment in which the tumour can thrive. Embedding their research into the patient pathway will enable them to study molecular changes over longer periods of time, to help shape current and future treatments."

Professor Peter Parker, Head of the Division of Cancer Studies at King's College London, says: "Expanding our Experimental Medicine Programme will enable us to grow our capabilities in designing and conducting clinical trials for new treatments.

"Our vision is for the Innovation Hub to cross-fertilise ideas between researchers and clinicians so that potentially impactful discoveries can be advanced rapidly and successful approaches for one cancer type can be tested quickly in others."

Professor Sir Robert Lechler, Vice Principal (Health) of King's College London, and Executive Director of King's Health Partners Academic Health Sciences Centre adds: "Having clinicians and researchers working side by side will allow us to speed up the journey from discoveries in our laboratories and early clinical trials right through to innovative new treatments and therapies in our clinics. By doing this, we will continue to improve the physical and mental health outcomes and experience of cancer care for our patients."

Transforming cancer care

Dr Majid Kazmi, Clinical Director of Cancer Services at Guy's and St Thomas', says: "It is fantastic to welcome the first patients to our new Cancer Centre. [This] is the culmination of more than 10 years of planning and working in partnership with our patients to create a building to transform cancer care."

The new Cancer Centre at Guy's brings together most treatment under one roof - previously cancer care was provided in13 different locations in eight different buildings on the St Thomas' and Guy's sites.

It is the first cancer centre in Europe to provide radiotherapy treatment above ground level after patients said this would make a huge difference to them.

Largely funded by Guy's and St Thomas' NHS Foundation Trust, the Cancer Centre at Guy's was made possible by a grant of £25 million from Guy's and St Thomas' Charity and a £15 million grant awarded to King's College London from the UK Research Partnership Investment Fund (managed by the Higher Education Funding Council) for the Innovation Hub.

The charity Dimbleby Cancer Care will provide a range of information and support services for cancer patients and their families in the Cancer Centre's Welcome Village, including a drop-in information service, welfare benefits advice, psychological support, complementary therapies, and the provision of Dimbleby pillows for cancer patients and their families.

Speaking at the opening, Jonathan Dimbleby, Chair of Dimbleby Cancer Care, said: "Our charity has endowed more than £2 million to the new Cancer Centre at Guy's so this is a very exciting day for us. It is wonderful to see the last few years of everyone's hard work come to fruition.

Kieron Boyle, Chief Executive of Guy's and St Thomas' Charity, says: "The opening of the landmark Cancer Centre at Guy's represents a huge leap in the journey to transform cancer treatment, care and research here at Guy's and St Thomas'."

"Having cancer is something one in two of us will face at some point in our lifetime. Our support, and other generous donations, have enabled the Cancer Centre to be equipped with the very latest in technology and brought most cancer services under one roof.

Science begins at the Crick


The first scientists have moved into the new £650 million (about US$810 million) Francis Crick Institute building in London and are starting work in their purpose built labs. Next to St Pancras station and the British Library, the Crick will be the biggest biomedical research institute under one roof in Europe.

Research groups will continue moving in each week until the end of the year, as lab space is adapted for each research group. The start of 2017 will see the Francis Crick Institute up and running with all 1250 scientists and 250 other staff moved in and research projects ramping up.

Paul Nurse, Director of the Francis Crick Institute, said: "A remarkable state-ofthe- art new home for the Crick has been completed and the occupation by scientists has started. But this is only the beginning. As all our research groups move in over the rest of the year, it will be the discoveries we make here that will establish our place at the forefront of science in London, the UK and worldwide."

The Crick
Research at the Crick aims to discover how and why disease develops in order to find new ways to prevent, diagnose and treat conditions such as cancer, heart disease and stroke, infections and neurodegenerative conditions like motor neurone disease.

The Crick has been established through the collaboration of six founding partners: the Medical Research Council (MRC), Cancer Research UK, Wellcome, UCL (University College London), Imperial College London and King's College London.

The institute is bringing scientists together from across disciplines to tackle the pressing health concerns of the 21st century. By being open to collaboration, by training future science leaders and by seeking to improve people's health and wellbeing, the Crick aims to boost UK science and health and help drive the UK economy.

Professor Edward Byrne AC, President and Principal of King's College London, says: "As a founding academic partner King's is delighted to play a key role in this world-leading institute, bringing experts from a wide range of disciplines to work collaboratively under one roof. King's has an excellent track record in bringing scientists and clinicians together to translate research into innovative treatments as quickly as possible. Our expertise will strengthen further the institute's ability to bring basic and applied science together with clinical knowledge, to benefit patients across the UK as well as society as a whole."

The building
The Crick's building is one of the most complex buildings in London. It has been designed by architects HOK with PLP Architecture and constructed by Laing O'Rourke. Arup and AKT II were the engineers on the project, with Arup also the project manager. Turner & Townsend were cost consultants on the project and Cordless Consultants have provided IT and AV facilities.

The design, construction and commissioning of the 170m-long building with approaching 1 million square feet of floor space over 12 floors has been a technically challenging undertaking and an engineering project in itself. It required very high specifications to be met for the most sensitive and advanced research equipment to be used - such as high vibration resistance, close temperature control, minimisation of electromagnetic interference and high rates of air change. The building has also been designed to minimise impact on the environment, with solar panels on the roof and its own combined heat and power system.

The approach
On 1 April 2015 the Medical Research Council's National Institute for Medical Research and Cancer Research UK's London Research Institute merged to become the Francis Crick Institute. These research groups are being joined by scientists from the university partners (UCL, Imperial and King's), who bring with them specialist knowledge, skills and resources across a range of scientific disciplines. In particular, university researchers working in the Crick help add expertise in the physical and clinical sciences.

Collaboration and interdisciplinary working is designed in to the Crick. Research groups from different disciplines and from different original organisations have been given neighbouring lab space. Coupled with lots of open work space, breakout areas and shared core facilities, this means scientists can't help but bump into each other, have conversations and share ideas. It is all expected to lead to the generation of new insight, research directions and innovations.

The new building is equipped with state-of-the-art facilities for biomedical research. Genetics and genomic studies have access to advanced DNA sequencing, while the latest mass spectrometryequipment allows gene expression, proteins and metabolic pathways to be characterised. Bioinformatics support allows studies involving very large datasets. The robots in the highthroughput screening facility allow tens of thousands of drug candidates to be tested in cells. Electron microscopy, X-ray crystallography and nuclear magnetic resonance suites allow biological structures to be studied in fantastic detail.

Discovery science
The Crick specialises in discovery science: investigating the fundamental biological processes underlying human health and disease. But the increased understanding of these key processes can lead to opportunities to develop novel drugs and innovative new treatments. Translational research - the turning of biological discoveries in the lab into treatments for patients in the clinic - will be a focus for the Crick. For example, the institute has an ongoing partnership with GSK in which teams of scientists from both organisations work side by side in the lab and benefit from the sharing of ideas and approaches in investigating biological systems.

David Roblin, Chief Operating Officer and Director of Scientific Translation at the Francis Crick Institute, said: "It is tremendous to have reached the point when science is beginning in our glorious new building. It's been an achievement of many people to this point - in the design, the construction, the fitting out, and the project management of moving in people, equipment and experiments. To do this while also running active research programmes across multiple sites speaks to the skill and effort of our staff and supporters. It gives a sense of what we'll be able to achieve once we're all together in our new home."

New leadless pacemakers overcome lead-related complications


Royal Brompton & Harefield Hospitals Specialist Care provide pioneering diagnostics and treatment to international patients with heart and lung conditions. Many of our consultants are pioneers in their field and offer some of the most sophisticated treatment available anywhere in the world.

In December 2015, a patient at Royal Brompton Hospital was one of the first in the UK to be fitted with an innovative new pacemaker, the Nanostim, which works without leads. Consultant cardiologist and electrophysiologist Dr Tom Wong performed the procedure.

The Nanostim is less than 10% of the size of a conventional pacemaker. It is implanted directly into the heart via a catheter and does not require a pacing lead or a pulse generator pocket (nor scar or lump). The procedure takes less than one hour and is performed in a cath lab under local anaesthetic. Once inserted, the Nanostim securely nestles inside the heart, sending small pulses of electricity when needed to prompt the heart to beat at a normal rate.

After the procedure, patients without complications will normally be discharged the following day and can return to normal activity within one week.

The pacemaker battery life is at least equivalent to (if not longer lasting than) that of the conventional single chamber pacemakers - with 9 to 13 years of battery life. If the batteries do need to be changed the device can be retrieved and the battery replaced when using the Nanostim system.

Although the incidence of pacemaker complications is relatively low, when complications occur, they typically happen in the pocket where the pacemaker is implanted or with the leads. In up to 1% of patients, the pocket may become infected and in more than 1 in 100 patients, the leads may move out of place causing complications - these are some of the complications the leadless device overcomes. The Nanostim may provide further benefits in avoiding mobility issues in the shoulder that can be experienced in those that are fitted with a conventional pacemaker.

Dr Tom Wong can advise on patient suitability for leadless pacemakers at all RB&HH Specialist Care locations.


World�s largest brain imaging study produces exciting results

Data from the world's largest brain and body scanning study has been released. Kate Wighton of Imperial College, London reports.

Exciting early results from analysing the brain imaging data, alongside thousands of measures of lifestyle, physical fitness, cognitive health and physical measures such as body-mass-index (BMI) and bone density have been published in Nature Neuroscience.

The high quality of the imaging data and very large number of subjects allowed researchers to identify more than 30,000 significant associations between the many different brain imaging measures and the non-imaging measures. The findings have now been made available for use by researchers worldwide.

Results included:

  • Strong associations between people�s cognitive processing speed and markers of the integrity of the brain's "wiring" and the size of brain structures. These effects increased in strength as people aged.
  • A negative correlation between brain activity during a simple shape-matching task and intelligence, an effect that didn't relate to participants' age. This might be because the people who scored more highly on the cognitive tests needed to use less of their brain to carry out the task.
  • A pattern of strong associations between higher blood pressure, greater alcohol consumption, and several measures that could reflect injury to connections in the brain.
  • A separate pattern of correlations, linking intake of alcohol and tobacco and changes in red blood cells and cardiac fitness, to brain imaging signals associated with increased iron deposits in the brain.
  • Researchers also unearthed some more complicated patterns of correlation. For example, one pattern links brain imaging to intelligence, level of education, and a set of lifestyle factors that at first appear unrelated - including amount of time spent outdoors. It is plausible that, taken together, these factors create a profile of socio-economicstatus and its relation to the brain.
  • However, because UK Biobank is an "observational" study that characterizes a cross-section of individuals, it's not always straightforward to establish which factors cause which, but such results should help scientists to define much more precise questions to address in the future search for ways of preventing or treating brain disease.

UK Biobank will be the world's largest health imaging study. The imaging is funded by the Medical Research Council, Wellcome Trust, and the British Heart Foundation. It was launched in April 2016 after a number of years of planning and consultation with a large number of health and scanning experts. With the ambitious goal of imaging 100,000 existing UK Biobank participants, it is creating the biggest collection of scans of internal organs, to transform the way scientists study a wide range of diseases, including dementia, arthritis, cancer, heart attacks and stroke.

The paper describes the brain imaging part of UK Biobank, led by Professors Steve Smith and Karla Miller from the University of Oxford, and Professor Paul Matthews from Imperial College London.

Professor Miller said: "We are using cutting-edge MRI scans and Big Data analysis methods to get the most comprehensive window into the brain that current imaging technology allows.

"These results are just a first glimpse into this massive, rich dataset that will emerge in the coming years. It is an unparalleled resource that will transform our understanding of many common diseases."

Professor Matthews, Edmond and Lily Safra Chair and Head of Brain Sciences at Imperial, added: "These results are exciting, but merely provide a first hint of what can be discovered with the UK Biobank. This project also is a landmark because of the way it has been done: 500,000 volunteers across the UK are donating their time to be part of it and more than 125 scientists from across the world contributed to the design of the imaging enhancement alone. Imperial College scientists played a major role in its inception and leadership as part of a team recruited by the UK Biobank from a number of UK universities. This is a wonderful example of 'open science'."

First results
The paper reports the first results from this remarkable data resource, which includes six different kinds of brain imaging done in the 30 minutes that each volunteer is in the brain scanner.

Professor Smith explained: �We have 'structural imaging' - that tells us about brain anatomy - the shapes and sizes of the different parts of the brain. Another kind - 'functional MRI' - tells us about complex patterns of brain activity. Yet another kind - 'diffusion MRI' - tells us about the brain's wiring diagram. The rich and diverse information contained in these scans will reveal how the working of the brain can change with aging and disease; different diseases will best be understood through different combinations of information across these different images."

100,000 participants
UK Biobank has already scanned 10,000 participants, including images of the heart, body, bone and blood vessels in addition to brain scans. This will be by far the largest brain imaging study ever conducted; within another five years UK Biobank will have completed the scanning of 100,000 participants.

One reason for needing such large numbers of participants is to have enough subjects to allow discovery of early, possibly subtle, markers of future disease risk, both for a range of common diseases and for rare neurological disorders like motor neuron disease.

UK Pavilion set to showcase 'the very best of British innovation'


Each year, the Arab Heath congress and exhibition attracts a high level of UK clinicians, clinics and healthcare technology companies and Arab Health 2017 is no exception.

Over 100 leading healthcare businesses, renowned hospital groups and esteemed clinicians from world-leading clinics will be amongst the UK delegation travelling to the Middle East to showcase 'the very best' of British healthcare.

Organised by the Association of British Healthcare Industries (ABHI) - the industry association for the medical technology sector in the UK - the UK Pavilion will highlight how British developments are transforming the lives of patients and clinicians across the globe.

The centrepiece of the pavilion will be a state-of-the-art operating theatre, equipped with advanced UK technologies. This surgical 'stage' will celebrate collaborations between healthcare providers, clinicians and healthcare technology companies and allow visitors to watch Britain's best surgeons in action. Confirmed hospitals taking part in the demonstrations include BMI Healthcare, Royal Brompton Hospital and HCA International.

Exhibiting companies on the UK Pavilion will include Owen Mumford, a global manufacturer with over 60 years' expertise in the development of medical devices. The company prides itself on bringing together research, design expertise and engineering excellence to create products that improve lives and reduce healthcare costs.

Timesco Healthcare, who has been supporting medical professionals with pioneering products for over 50 years will also be exhibiting, along with Durbin, one of the world's leading specialist medical suppliers.

Pressure ulcer specialist, Rober will also be showcasing their pioneering mattress solutions that cater for a variety of needs including patients that are immobile, critically ill and bariatric. Their innovative range of mattresses and overlays has been developed in conjunction with clinicians and features clinically proven technology that prevents pressure injuries from developing. The technology also has therapeutic properties that promote the healing of established ulcers.

Edgbaston Medical Quarter
For the first time, the UK Pavilion will welcome the prestigious Edgbaston Medical Quarter (EMQ). Located within the heart of the UK and just one mile from Birmingham city centre, EMQ is a worldclass medical and life sciences destination. It boasts over 550 medical companies, a proliferation of over 180 medical organisations, 80 hospitals and specialist care centres, 44 GP clinics and routine care facilities and 23 training facilities. It is also home to 22 life sciences specialisms with active research programmes and is the 'go to' destination for more cost effective and rapid clinical trials.

London's renowned Harley Street Medical Area will be returning to the Middle East for its second year; this time with 20 worldleading clinics and hospital groups. This year's attendees include the prestigious King Edward VII Hospital, frequented by the British royal family and patronage by Her Majesty the Queen. Isokinetic, an international medical group specialising in the management and recovery of sports injuries and listed as one of the 45 FIFA Medical Centres of Excellence in the world will also be in attendance. As the world's largest private hospital group, HCA International is also joining the Harley Street Medical Area to showcase their clinical excellence and state-of-the-art facilities.

The UK is also proud to have a number of confi rmed speakers presenting at the Arab Health 2017 congress. One of these speakers is the international lead for FC Barcelona's Sports Science and Health Department and Isokinetic Medical Group, Dr Daniel Medina. Dr Medina will speak about the club's strategic vision for Innovation and Technology and its contributing role to both success on the fi eld of play and to the development of improved player health across the world.

Speaking about the UK Pavilion, Paul Benton, International Director of the ABHI, said: "We are extremely excited to be travelling to the Middle East, with what is our largest ever delegation of UK exhibitors."

"The UK is a key player in the drive to improve patient care around the world through the development and implementation of new technologies. We have a vibrant, diverse and highly innovative medical technology industry, which has cemented our reputation as a global leader."

  • The UK Pavilion will be located in Zabeel Hall 1 and Zabeel Hall 4. The ABHI stand will be located on Z1D30 in Zabeel 1.

Health reform - new models of care and accelerating technology adoption


Health and Social Care delivery systems globally are faced with common issues; spiralling costs due to increased demand caused by the ageing demographic, an epidemic in long term chronic disease e.g. obesity, diabetes, heart disease and rising patient / citizen expectations. Transforming these systems has become a priority and the direction of travel has generally been to redistribute resources away from the treatment of ill health, to early diagnosis (which avoids the need for more costly later stage intervention), self-management of disease and of course improved health and well-being.

The National Health Service (NHS) in England deals with nearly 1 million patients daily covering everything from antenatal screening, routine screening, treatments for long-term conditions, transplants, accident & emergency treatment, to end of life care. It has not wavered in its commitment to provide high quality care for all and through ongoing transformation, it is still regarded by many to be the most efficient in the world. However, it recognises the need to evolve to meet new challenges and to adapt to take advantage of the opportunities that science and technology offers.

The NHS England Five Year Forward View, published towards the end of 2014 and developed in partnership with major health institutions, patient groups and individual experts, created a collective view on how health and social care delivery needed to change over a five-year period. Central to this plan was:

i) to galvanise action around national public health issues such as obesity, smoking etc., ii) to enable patients/citizens to take greater control over their own health and

iii) to break down the barriers in how care is provided between family doctors and hospitals and between physical health and mental health.

New partnerships
Over the last year we have seen progress being made from major new partnerships formed to drive the development of new models of care. For example, 50 'Vanguard' sites have been working on new delivery systems across, 'acute care collaborations;' 'urgent and emergency care', 'integrated primary and secondary care' and 'multispecialty community providers e.g. moving specialist care out of hospitals into the community. Seven new 'Test Beds' funded by NHS England have been working on the simultaneous development of new innovative technology alongside service transformation.

Another recent programme set to transform healthcare delivery in England from the �bottom up�, thereby reflecting local needs and priorities, is the development of local Sustainability & Transformation Plans (STPs) aggregated into 44 regional footprints across England. The Health and Care organisations within these geographical footprints are working in partnership to secure immediate improvements in integrated delivery but more importantly to drive sustainable transformation in patient experience and health outcomes in the long term.

Perhaps the largest scale development in integration of health delivery in the UK has been with Health Devolution in Manchester. In line with the UK Government's strategy to transfer more powers and responsibilities from National Government to the regions, groundbreaking health devolution plans have given Greater Manchester and local NHS services much more control of the region's £6 billion health and social care budget. There willmajor focus on preventing ill health and promoting healthy lifestyles as part of this devolution deal.

NHS England continues to commit funding to both stimulating solutions to unmet clinical needs - its SBRI Healthcare programme awarded £17.5 million in grants last year, to small / medium sized companies that formed consortia to deliver solutions to unmet clinical need, and at the other end of the continuum, to speeding up the adoption of new innovative technology - in the first round of the new NHS Innovation Accelerator programme, 17 innovators received support to access 345 NHS providers and commissioners and raised £8.9 million in funding.

A new 'Innovation and Technology tariff' will remove the need for multiple local price negotiations, and instead guarantee automatic reimbursement when an approved innovation is used, while at the same time allowing NHS England to negotiate national 'bulk buy' price discounts on behalf of hospitals, General Practitioners / physicians and patients.

The Medical Research Council (MRC) and Innovate UK (the UK Innovation Agency) have committed significant funds to the Biomedical Catalyst programmer (£180 million over four years) supporting projects that seek to explore the potential of new innovative ideas or to test out such developments in a real world setting, in the areas of:

i) disease prevention and the proactive management of long term chronic disease
ii) the earlier or better detection and diagnosis of disease and
iii) tailored treatments to change the underlying nature of or provide cures for disease.

Catapult Centres
Innovate UK have also invested heavily in Catapult Centres, a series of physical centres where the very best of the UK's businesses, scientists and engineers work side by side on late-stage research and development - transforming high potential ideas into new products and services to generate economic growth. Health-related Catapults include the Cell & Gene Therapy Catapult; the Precision Medicine Catapult, the Medicines Discover Catapult and the High Value Manufacturing Catapult which also has health applications. The Catapults provide access to expert technical capabilities, equipment, and other resources required to take innovative ideas from concept to reality.

Perhaps the most attractive features of the UK Health ecosystem is its investment in world class research with the Research Councils having invested £3bn (US$4.6bn) per year on health research and Research Charities adding another £1b per year. The UK 100,000 Genomes Project, for example, will sequence 100,000 genomes from around 70,000 NHS patients with a rare disease, plus their families, and patients with cancer. The aim is to create a new genomic medicine service for the NHS - transforming the way people are cared for. Patients may be offered a diagnosis where there wasn't one before. In time, there is the potential of new and more effective treatments.

Technology Enabled Care
Another area that is beginning to transform healthcare delivery is developments in Digital/ Technology Enabled Care (TEC). With the costs of digital technology plummeting, the use of mobile technology (smartphones andtablets) advancing exponentially, and with an Increasing recognition that TEC can provide patients / citizens, carers, and healthcare professionals with data more easily, whilst improving health outcomes. TEC is considered to be key to any future integrated health and care system. The innovation infrastructure referred to earlier is nurturing a large number of digital solutions with the advantage of being tested in real world health situations in NHS England.

The UK Government has created a positive environment for life science investment in the UK, with the Patent Box initiative allowing companies to pay only 10% corporation tax on profits attributable to qualifying patents. Its R&D tax credit scheme provides small to medium sized companies with relief on qualifying R&D expenditure, and with its major investment in clinical trials, they are now easier to access and quicker to deliver.

NHS England have embarked on a journey to transform health and social care delivery through piloting 'at scale' new models of care which break down traditional barriers between care providers, provide the individual citizen with greater control of their own care, and tackle 'head on' public health issues such as obesity and smoking. Significant investment continues to be made in life science research and, with accelerating technology development and adoption in the NHS, developments in Technology Enabled Care and Genomic Medicine are set to transform future healthcare provision.


Medilink UK

Medilink UK, the largest representative body for the UK Life Science Industry (Med Tech, Biotech & Pharma), works closely with major UK Government agencies such as the Department of International Trade, NHS England and Innovate UK to drive innovation and international partnerships. It provides expert consultancy services to private and public organizations seeking support with fast tracking innovation and securing UK market access. www.medilinkuk.com


Date of upload: 15th Nov 2016

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