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BUSINESS QUARTER West Midlands: March 2016

SPECIAL REPORT

HEALTHCARE AND LIFE SCIENCES

Unlocking the genome The West Midlands is at the centre of an ambitious initiative

The frontierman The man who is fighting to beat leukaemia

Live Debate

Getting to grips with life sciences

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THE WEST MIDLANDS ACADEMIC HEALTH SCIENCE NETWORK

EDITOR’S VIEW CONTENTS 04 07

Giving a competitive edge to life sciences in the West Midlands We have an important role in supporting healthcare to increase its contribution to the West Midlands’ economy. We are driven by two imperatives: improving population health and generating wealth in our region. As a membership organisation bringing together the life sciences industry, health and care providers and commissioners, academia and citizens, we are uniquely placed to support healthcare in increasing its contribution to the economy.

We lead, catalyse and drive co-operation, collaboration and productivity between partners, and accelerate the adoption of proven innovations at scale and pace regionally, nationally and internationally. This is achieved in a collaborative environment in which the technology-rich West Midlands’ life sciences community and other members are mutually supportive and collectively attracting additional investment.

BUSINESS UPDATE News round up of what’s happening in West Midlands’ healthcare and life sciences

INCUBATING INNOVATION Dr David Hardman on an £8m initiative

GIFT OF FREEDOM

LIVE DEBATE

Clive Bawden on a new approach to addiction

A Government minister and a panel of experts wrestle with life science questions

INTEGRATING FOR HEALTH BQ2 looks at progress in partnership with the sector

The improved generation and adoption of innovation benefits the local economy by boosting productivity and gives the region’s life sciences industry and academic institutions a competitive edge.

HEALTHCARE AND LIFE SCIENCES Partnership and collaboration have become the strategic cornerstones for Greater Birmingham’s health economy in all its forms; from pharma to biotech, from Big Data to life sciences, and from world-class academic research to advanced clinical trials. The initial healthcare cluster, in the heart of the city, evolved almost unnoticed outside the area, but now its achievements and its innovations are attracting international acclaim. We chose Professor Charlie Craddock for our cover picture for his creation of a new business model, which delivers life-saving drugs to patients at no cost to the NHS, his relentless determination to deliver ever-better outcomes for patients, and his infectious enthusiasm. However, many others deserve their spell in the spotlight, so we also tell the stories of other individuals and organisations, bringing hope and life to many thousands of people who would otherwise have neither. The region’s healthcare economy isn’t just about identifying new ways to tackle illness and disease though, it’s about creating wealth and employment for the benefit of everyone. The West Midlands earned its place in history as the birthplace of the Industrial Revolution, but in years to come, it might also be known as the region where data and digital technology were the catalyst for a renaissance in healthcare. Ian Halstead, Editor In partnership with

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SILK AND SERENDIPIT Y How chance led Graham Silk to co-found Cure Leukaemia

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Don’t ignore IP protection

BUSINESS UPDATE Chambers backing for charity Cure Leukaemia has been chosen as the official charity of the Greater Birmingham Chambers of Commerce for a second successive year. Chamber president Greg Lowson selected the city-based organisation in 2015, and it ultimately received almost £10,000, thanks to quizzes, a summer barbeque, Christmas lunch and other fund-raising events. Lowson, who heads the Birmingham office of lawyers Pinsent Masons, has now decided that the Chamber should support the same cause throughout 2016. “As a trustee of Care Leukaemia, I have seen first-hand the tremendous work being done by Professor Charlie Craddock and his team at the Centre for Clinical Haematology and across the Midlands, to deliver world-class treatments to patients battling blood cancer.” The decision was welcomed by the Chamber CEO, Paul Faulker, who is also a trustee at the Jewellery Quarter-based charity. “I saw at close quarters the amazing work which Cure Leukaemia supports, when I was chief executive at Aston Villa, and the club’s captain Stiliyan Petrov was diagnosed with

blood cancer in 2012. We are proud to support a charity which not only does so much for patients, but also boosts the reputation, and the economy, of this great city.”

Birmingham health needs a brand Steve Hollis, the deputy chairman of Greater Birmingham & Solihull Local Enterprise Partnership (LEP), believes Birmingham’s health economy must now develop a global brand, to win the overseas investment which can underpin its future growth. As the former regional chairman of KPMG, who also held high-profile positions within its international operations, he is convinced that the world of high finance is attracted to big brands.“It’s wonderful that the Institute of Translational Medicine (ITM) is now a reality, and the Life Sciences Campus is progressing as planned, because the LEP has been right behind those projects from the initial concept. “The ITM also gives the healthcare economy a tangible presence and focus, where senior policy advisers from Whitehall, ministers, politicians and other visitors can see how different organisations in the city have come together for everyone’s benefit. “The Regional

(l-r) Greg Lowson and Paul Faulkner

Growth Fund, the LEP, the city council and the University Hospitals Birmingham (UHB) NHS Foundation Trust all showed real bravery, to commit capital and revenue to deliver the ITM. “The Silk Report has also reinforced our belief in the importance of the health economy to Greater Birmingham, and we are now engaging at a strategic level with senior politicians, who are visibly impressed by what has been achieved here, and the potential to achieve much more. “However, what happens next? For me, we need to up our game on the global stage. We need to position ourselves alongside such established international healthcare locations as Boston and Singapore to attract global capital, and to do so we need a global brand. ”Yes, we’ve been able to access public money so far in our journey, but the LEP’s job is now done, in a financial sense, and this isn’t a time to be asking for money from government. “We need more private sector capital to come in, and we also need a leadership group from here to take us to the next stage, because there is a great deal of hard work and commitment ahead.”

Health UTC opens The UK’s first specialist health training college has opened in the heart of the Black Country, after a £10m investment programme. The formal ceremony at the Health Futures University Technical College (UTC), in West Bromwich, attracted an array of sponsors, educational partners and other guests, but the VIP was Lord Baker. The veteran Tory grandee chairs the Baker Dearing Trust, which he founded with Lord Dearing to promote the concept of UTCs. Some 20 employers and educational bodies came together to deliver the college, including NHS Foundation Trusts from Birmingham and the Black Country, and its sponsors include the University of Wolverhampton, West Midlands Ambulance Service and the MidCounties Co-operative Pharmacy. The UTC’s aim, reflects the vision of Lords Baker and Dearing, that youngsters will be able to receive a blend of practical, scientific and technical education, and study more traditional subjects at GCSE and A-level. Robert Fell, the UTC’s principal headteacher, said the college was aiming its syllabus at youngsters aged between 14 and 19, who were considering careers in the NHS, health sciences or the pharmaceutical industries. “I am very privileged to be leading the first specialist UTC in the country, and am sure the students, staff and partners will all contribute to our success.” The college includes science labs, specialist simulation and skills units, a mock hospital ward, a visualisation centre, IT suites and a roof-top games area. Students will also be able to take part in employer-led technical challenges, alongside real-life scenarios, whilst also benefiting from the latest interactive study techniques and the use of simulation technologies.

A medical specialist at the Birmingham office of patent attorneys Marks & Clerk has counselled that healthcare entrepreneurs should seek legal protection for their ideas, especially if they look to lucrative overseas markets. Florian Bazant-Hegemark is Austrian, and gained his first academic qualifications when qualifying as an engineer in Vienna, but also holds a PhD from Cranfield University, where he studied medical diagnostics. He has since assisted Marks & Clerk clients operating in such sectors as medical devices, biotech, pharma and nanotechnology. Having worked with a start-up venture which became a leading manufacturer of skin imaging devices for medical uses, he understands the commercial realities facing such fledgling companies. “There are many potential hurdles when you look at export markets for the first time, not least the challenges of language and the regulatory environment. However, entrepreneurs also need to consider if they have IP protection for their products or processes, and if their rights could be enforced in the particular country, or countries, they are looking at. “I know from first-hand experience that probably the biggest problem facing startups is resources. They clearly have tough decisions to take, and they must also take those decisions fairly early on when they consider overseas markets. “They could perhaps defer paying the fees for their IP protection for 18 months, but they still need to take specialist advice before making any decision. “My impression is that there is an increased awareness of IP issues, among start-ups and SMEs in Greater Birmingham, but equally, I fear there are still some companies trying to go it alone.”

“There are many potential hurdles when you look at export markets for the first time, not least the challenges of language and the regulatory environment“

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One-stop disease centre The Centre for Rare Diseases, which opened at Birmingham’s Queen Elizabeth Hospital last autumn, has already welcomed 1,100 patients through its doors. Located in the Heritage Building (the former QE hospital), it forms part of the National Institute for Health Research’s clinical research unit, within the Institute of Translational Medicine. Dr Graham Lipkin, who leads the centre and is a consultant specialising in kidney diseases, said 34 specialist clinics were available, which integrated expert multispeciality care with clinical research. “Many patients with rare conditions have to travel considerable distances to access clinical services, and the nature of these diseases means travel is often complicated by the need for special transport. Our concept is to provide one-stop care; so patients, supported by their carers, can undergo diagnostic tests and see all the relevant specialists for their condition, and the multidisciplinary team in a single visit. Many people in the UK are living with rare diseases, which can have a major impact on the quality of their lives, and those of their close relatives. We estimate there are around 7,000 rare diseases, and most are inherited. Our centre works with patients, staff and partners to co-ordinate input from the large number of medical, nursing and therapy specialists which are usually required to provide the best level of care for people living with these conditions.”

“Our concept is to provide onestop care; so patients, supported by their carers, can undergo diagnostic tests and see all the relevant specialists for their condition”

A meeting of minds Birmingham’s first digital health incubator opens in March inside the iCentrum building developed by Innovation Birmingham, whose CEO Dr David Hardman explains more about the project Teal of success A Birmingham-based family business has enjoyed record turnover and record profits - by helping the NHS tackle outbreaks of infection in its hospitals. TEAL Patents has previously underlined the city’s long-time reputation for manufacturing innovation by becoming the world’s largest maker of portable hand-wash units, which provide hot water, but require no access to either mains water or drainage. Managing director Manty Stanley says the business has served the health, education, catering and commercial vehicle sectors for years, but its breakthrough with the NHS came during 2015, when it introduced a new service. “We’ve been working closely with infection control departments for something like 15 years, focusing on ways to reduce the risk of infections spreading due to poor hand hygiene. “People need to be able to wash their hands in hot water wherever they are, and whenever they need to. Last year, we came up with the idea of offering a new service, which we called the Teal Task Force. We offered next-day deliveries of these portable units, which could be hired when there were medical emergencies or plumbing outages, and they were extremely popular. We guaranteed the 24-hour delivery because we understand the need for speed when trying to contain the spread of infection. We’ve always enjoyed significant commercial success overseas, and our units are popular from the Iberian peninsula through to the Middle East and on to Australasia, but the record numbers from 2015 were down to the TTF concept.”

New director at CBRE The fast-developing links between Birmingham’s professional services community and the city’s health economy have been reflected in CBRE’s decision to strengthen its healthcare team. Jon Hodgkins joins as an associate director, after ten years at Savills, where he headed its healthcare division for the Midlands, the South West and Wales. His role there included advising on care homes, medical centres, retirement villages, hospitals

and day nurseries. Hodgkins also acted as an independent expert for contentious valuations and planning applications. He comes to CBRE with more than 20 year’s experience of providing property-related services to the healthcare sector, joining the agency’s three current members of the specialist markets team. The arrival of Hodgkins follows the recent Core Cities report from CBRE, indicating that

investment in specialist markets in Birmingham reached just over £1bn during the last decade, against only £541m in industrial property, which has long been considered a particular strength of the city’s economy. Rob Robinson, who heads the specialist markets team, says healthcare (along with student housing) is no longer a niche target for investors, but is increasingly seen as part of a balanced portfolio.

Our concept was to drive forward the Smart City, so we developed and funded this £8m scheme speculatively as an incubator for the next generation of entrepreneurs, who have grown up in a world where social media, 3D printing and cloud-based business solutions are second nature. We secured a £7.5m commercial loan through the city council to cover the main construction and fit-out costs, and also won support from the Greater Birmingham and Solihull LEP to create additional work space inside the building. The iCentrum will have just over 42,000 sq ft of space, and thanks to the support of the West Midlands Academic Health Sciences Network (WMAHSN) we will have the city’s first incubator dedicated to early-stage tech companies working in the health sector and developing digital solutions. Our research demonstrated very clearly that there was a market need for such space. Digital health will be one of this centre’s four specialisms, along with finance, intelligent mobility and the Internet of Things (IoT). Having all four of these high-growth sectors here will allow people from each company to interact with the others, which we believe will act as a catalyst for even more ideas. We’re also asking every prospective tenant how they propose to overcome challenges in their sector

“We are setting ourselves and the people who come here very big challenges, but my belief is that if it works, it will be unique, and that is not a word which I would ever use lightly” to better understand their focus. Everything we are trying to achieve here is about innovation, and about solutions which are not sector-specific or boundary-specific. We believe, for example, that because so many creative minds are working in proximity that iCentrum will become a breeding ground for radical and disruptive innovations. We also hope that solutions devised for one sector will be applied in different ways to the needs of another sector. We are setting ourselves and the people who come here very big challenges, but my belief is that if it works, it will be unique, and that is not a word which I would ever use lightly. Our wider operational model at Innovation Birmingham is to devise and deliver a nextgen science park, and it’s been clear from the interest which our concept has attracted even before construction work got underway, that it is a vision which many others are finding as compelling as we do. Obviously, the hard work starts now, because we have to prove our concept, just as the

individuals coming here with bright ideas have to test and prove their concepts. We’re working very closely with Tony Davis, the commercial director at the WMAHSN, on the challenges which will be put to early-stage companies working in digital health. We are looking to work with at least 10 businesses in each of our four sectors, and we’ll shortly be recruiting a specialist business development manager to drive our strategy. The first tenants have already arrived, and we’re starting to see a community developing inside iCentum, which bodes well for future collaborations. We’ll also be formally encouraging people to interact with each other because sometimes creative minds need a little nudge in the right direction. Our agenda for the science park is based on the ‘Without Walls’ concept and it’s working there, so I am confident it will work in our new building. It is very exciting, and it will be even more so to see what progress has been made in a few months, as more new tenants arrive and everyone settles in. n

PROFILE

Calthorpe Estates

Calthrope Estates

Calthorpe Estates takes the EMQ message to global audiences Calthorpe Estates has created the fast-growing healthcare and life sciences community, Edgbaston Medical Quarter (EMQ), within its 1,600-acre estate “Successful development is never simply about providing quality space - it’s about place making and creating an environment where people want to live, work and relax.”

Mark Lee, Chief Executive of Calthorpe Estates It would have seemed fanciful, even just a few short years ago, to have imagined that a dynamic healthcare community and life sciences cluster of international significance could be created in Edgbaston, just a mile from Birmingham’s city centre. Now though, with EMQ it has become a reality, and on such an imposing scale that it is home to threequarters of the city’s healthcare economy. More than 180 medical organisations, 80 hospitals and specialist care centres, almost 50 GP clinics and routine care facilities and 23 training centres are there, within walking distance of each other. A powerful cluster of advanced research centres, healthcare institutions and academic centres of excellence has also evolved nearby; including the Queen Elizabeth Hospital, the Institute of Translational Medicine, the BioHub, the Trials Acceleration Programme and the Centre for Defence Medicine. The presence of so much knowledge and a well-connected community within a small area has also enabled the various bodies to easily unite on numerous collaborations, notably the relationship between the University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham on the ‘100,000 Genomes Project’.

Now it has become clear that the message about the merits of the EMQ, as the premier location within Birmingham’s healthcare and life sciences economy, is understood both throughout the UK and to a growing international audience. Calthorpe Estates’ CEO, Mark Lee, attended the Middle East’s largest exhibition and congress for the medical industry (Arab Health) in Dubai earlier this year, and was pleased to note the enthusiasm with which the EMQ story was heard. “We met a lot of the top-quality medical operators, and they were - without exception - keen to hear about Birmingham’s collective expertise in healthcare and life sciences. The location is very attractive given its access to a large, stable and diverse population for the benefit of accelerated clinical trials, the evolution of EMQ, progress on our 27-acre Pebble Mill site and the availability of accommodation from incubator space and buildings for consulting rooms, to clinics and hospitals, through to land and new build development opportunities. “You could see people were impressed by the scale of the opportunities and recent projects; the £50 million Dental Hospital and School of Dentistry which opens in the spring, and Circle Health’s plans

for its 160,000 sq ft private hospital. They’ll be on site in the next few months, which is great news. “It wasn’t just the size though, it was because everything is so close at hand and we have the space to grow. When we explained that Pebble Mill was in Edgbaston, close to the University of Birmingham, and just down the road from the Life Sciences Campus, it was evident to everyone that there is a genuine destination for life sciences and healthcare within Edgbaston and Birmingham. “We’ve just got a one-acre plot left now at Pebble Mill, and we’re very optimistic that we can develop it into over 54,000 sq ft of space for medical use. ”We plan to spec-build some of the space, and prelet the rest. I don’t think a signing from either the private or the public sector, or both, is far away as we’ve had so much interest. When that deal is done, it would be one of the last pieces of the Pebble Mill jigsaw going into place.” Lee says overseas audiences, whether at Arab Health, MIPIM, or other events attracting potential investors or tenants, were also impressed that Calthorpe Estates had committed significant amounts of its own money into creating the EMQ. “Putting in the infrastructure just for Pebble Mill has cost £3.5 m, we’ve also invested heavily in upgrading our existing office space and other buildings, and enhancing the our offering with the creation of Edgbaston Village, a premier mixed-use retail and leisure destination, whilst promoting the arts, leisure and sports facilities across the Estate through Edgbaston First,” he says. “Over the decades, Calthorpe has sustainably developed the Estate, whilst maintaining the leafy character and period charm of the area, and our long-term commitment to creating communities is

Plot 4, the last remaining plot at Pebble Mill, with outline planning for 53,800 sq ft healthcare facility really paying off. Successful development is never simply about providing quality space - it’s about place making and creating an environment where people want to live, work and relax.” It’s a philosophy which continues to attract individuals, companies and organisations to both the EMQ, and to the wider Edgbaston estate, and Lee cites the recent arrival of two tenants with a medical focus. “Optima Hair have rapidly grown and taken larger premises on Highfield Road in the heart of EMQ and Edgbaston village. They specialise in replacing hair for men and women, and a lot of their work is for teenage victims of cancer who need to build their confidence after chemotherapy.” he says. “We’ve also just welcomed a doctor from Harley Street. He’d never been to Edgbaston before, but he couldn’t wait to set up a clinic here after he’d visited. Like all newcomers, who have only heard vaguely of the area, he was quite taken aback when he saw the quality homes, excellent educational establishments, the array of restaurants, and renowned sporting and leisure facilities, in addition to the green space and its close proximity to national

and global markets. “Ease of access is set to be enhanced with the arrival of HS2, the future extension of Birmingham airport and other infrastructure and transport projects currently in hand such as the rapid transport system and Metro, whilst not forgetting access to high speed broadband. As Lee explained, “We often say to people, if they know London well, that they will find Edgbaston to be like Marylebone Village in many senses, although to be honest, I think we have more to offer. “One long-awaited element of the wider Birmingham offer is, of course, the new-look New Street Station complex, complete with its eye-catching Grand Central retail element. It is a plus-point for us, and for everyone trying to attract investors or visitors to Birmingham. There has been so much progress in the city in recent years, the revamped Mailbox is very impressive, and there’s been a lot spent by other retail landlords to keep up. “I expect 2016 to be a year of transition for the city, as everything which was achieved last year beds into place, but explaining just what has been happening here will be a key element of our message, particularly when we’re

talking to international audiences. “I think there are exciting times ahead for Birmingham, with the new city council leader, innovative ideas on leveraging assets to drive growth and their commitment to driving the Life Sciences sector forward. “We’ve already got a great relationship with the council, with Marketing Birmingham, and with the Greater Birmingham & Solihull Local Enterprise Partnership, and these partnerships will certainly be crucial as we look to build on the foundations of what we have already achieved here in Edgbaston.”

Calthorpe Estates, 76 Hagley Road, Edgbaston, Birmingham B16 8LU +44 (0)121 248 7676 www.calthorpe.co.uk

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Robin Vickers

Those who are making better health their business Robin Vickers is the founder and managing director of Birmingham-based Digital Life Sciences, set up to transform healthcare through patient-centred digital solutions. “We were created through the merger of three companies, because we all wanted to change the interactions between patients and healthcare professionals, and were convinced that healthcare was lagging behind other strategic sectors in its adoption of digital,” he says. “If you look at banking, insurance, travel, retail and many other areas of business activity, they have transformed how they engage with customers over the last decade, through their effective use of technology. “However, you look at healthcare in Britain, the

Members of the region’s healthcare and life sciences community update BQ on their activities and their plans for the rest of 2016 penetration of digital as a disruptive vehicle for change is still tiny, although the case for its use is very powerful, judged by either the best and most effective use of NHS resources, or the best outcomes for patients. “For us, there are two key issues. How easily can individuals access doctors or nurses for advice, diagnosis and treatment, and how can they be best supported to self-manage their condition, and their long-term care issues remotely, and in settings which are most convenient and

comfortable for them. “I think individuals should be able to access Skype-style services from their home, their place of work, or even as they travel, and access other healthcare services remotely, without needing to go to their GP, an A&E unit or hospital, all of which are under enormous and ever-increasing pressure.” Vickers cites multiple research studies indicating that some two-thirds of people would like to access their healthcare requirements remotely.

As evidence of a funding crisis within the NHS continues to surface, he also considers the logic for the provision of new digital solutions is overwhelming. “If you study the patient data for those with long-term conditions, such as diabetes and asthma, their treatment accounts for between 70-80% of the public cost of the health service, so ways of reducing that figure need to be urgently considered,” argues Vickers. “The biggest challenge though is the complexity of the NHS’s procurement networks. At the moment, we sell products and services directly to healthcare providers, and to commissioning bodies, but the fragmentation of the structure is so great that it remains very difficult for new entrants to the purchasing market. “We find ourselves not only providing products and services, but also having to create new pathways to deliver them to the people and organisations who require them, and ultimately, it’s the patients who suffer.” Binding Site CEO Charles de Rohan is impressed at how the region’s professional services community is interacting with the healthcare and life science sectors. “Every aspect of the health economy is complex and sometimes confusing for those new to it, so it’s very positive to see firms looking to understand more about how we operate, and what we need,” he says. “In terms of promoting these sectors, and attracting tenants, suppliers and investors, Marketing Birmingham continues to impress, as does its willingness to explore opportunities. “There are always going to be major challenges when companies and organisations are growing at such a pace; real estate is an obvious one, as is the need to attract and retain talent, so the support of the city council and the LEP is particularly appreciated. “I am intrigued to hear the council leader, Coun. John Clancy, talk about his concept of ‘Brummie Bonds’ as a possible source of investment for our industry, and to hear his suggestion that the regional local authority pension fund might also provide finance.” De Rohan is equally pleased by the commitment of the area’s higher education providers to the West Midland’s healthcare, biotech, pharma and life sciences community. “The links to education are very important too,” he says. “The cluster which has evolved

Theo Arvanitis

“If you study the patient data for those with long-term conditions, such as diabetes and asthma, their treatment accounts for between 70-80% of the public cost of the health service, so ways of reducing that figure need to be urgently considered” Charles de Rohan

Tim Francis

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in this area wouldn’t have developed so powerfully or so swiftly without the presence, support, research capabilities and talent of such universities as Birmingham, Aston, Birmingham City, Coventry and Warwick. “Binding Site is also establishing formal links with local schools, to help give teenagers a deeper insight into what we do as a company, and what amazing career opportunities lie within the healthcare and life science sectors. “We have already set up a partnership with Joseph Chamberlain College, and are about to establish a second one, so we can help broaden the horizons of their pupils, by bringing them here to learn about us and the world of healthcare.

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“We want to attract the next generation of school-leavers to our industry, and the first step is to create a structure which enables them to discover more about us and other members of our community.” A major research project gets underway in April, aimed at tackling the long-term issue of miscarriages. Around 250,000 occur every year, and roughly a third of women suffer more than one of these traumatic events. The National Tommy’s Centre for Early Miscarriage Care and Research (NEMC) is the first in the UK and the largest in Europe and the University of Warwick has been chosen as a partner, together with the University of Birmingham and Imperial College London.

Breakthrough technique for trials Leveraging genuine commercial value from healthcare innovations is crucial, as City financiers always need to know they can generate a decent return for their investors. However, a spin-out venture from Coventry University (InoCardia), spawned from research by Professor Helen Maddock, is proving particularly appealing, as her colleague, Dr Tim Francis, an Intellectual Property (IP) Commercialisation Executive, explains. “When new drugs are developed, it can be several years before unexpected side-effects on humans are discovered. For example, they may affect the contractions of a patient’s heart. Even if only relatively few people were affected the drug would have to be withdrawn,” he says. “Patients who weren’t affected would lose out, as would the pharma company concerned. It’s often said that it will cost £1bn to bring a new drug to market, so if you’ve spent a year or two researching a new product, that’s a great deal of time and money lost, including potential future revenue. “However, Professor Maddock has developed a new technique for monitoring how a drug will impact on a heart at a much earlier stage than previously possible. Her test, which uses human heart cells, is understandably of great interest to pharma companies and investors. InoCardia has already received grant aid and investment funding worth £1.5m, and is beefing up its executive board as it prepares for growth. A pharma company’s research team would start with thousands of potential compounds when it begins to develop a new drug or treatment,” says Dr Francis. “The InoCardia test can be applied so that number is reduced down to the most promising compounds - well before clinical trials could start. “Discovering at that stage that there would be problems with some patients’ hearts would enable the research project to either shut down, or change direction. Either would be of huge benefit to the pharma company involved.” Dr Francis also believes InoCardia’s success will enhance Coventry’s reputation as a centre for advanced research in the field of healthcare and life sciences. “We’ve risen dramatically up the university rankings in recent years, essentially for the quality of our teaching. The university is now coupling that drive forward in teaching with significant investment in our research to ensure its quality matches our ambitions to be world-leading,” he says. “We’ve got a new five-storey Science and Health building due on stream in 2017, hundreds of new staff members up to professor level are being recruited, and there’ll be a significant increase in the number of our PhD students too. “Pure research is invaluable, of course, but high quality research with strong commercial applications is also very attractive to potential investors, staff and students alike.”

Researchers from Warwick Medical School (led by Professors Siobhan Quenby and Jan Brosens) and the university’s Institute of Digital Healthcare will be involved. The latter’s Professor Theo Arvanitis is leading the team which will develop a clinical database to support the NEMC and evolve a sophisticated predictive model to reduce the number of miscarriages, “Tommy’s, the baby and pregnancy charity, funded the project and we’ve assembled a very powerful consortium across the three centres,” he says. “We’ll have a large group of academics in our work team, and will be using modules from our existing Comprehensive Unified Research (CURe) Framework, which was a key reason that our tender was accepted. We’ll also be creating a national database, initially by taking information from all three centres. “Once we’ve brought together all the existing online clinical data, we can add new data so it will effectively act as a registry for information on miscarriages. We’ll then be able to harness the power of this data to identify the major influences on this condition.” Prof Arvanitis expects assembling the initial tranche of data to take less than two years. At the same time, other consortium members in life sciences and healthcare will be exploring potential new techniques to reduce the incidence of miscarriages.“It’s a lengthy programme of study, including controlled trials. We hope to start a pilot after two years, and by year four to be building the database at a national level,” he says. “There has already been much research into miscarriages, so we can gradually create a fusion of data and clinical trials to discover the best outcomes. The 250,000 figure is between 10% and 15% of all births, so a surprisingly large percentage. Age, general health, previous history, environment and lifestyle are all major factors, and smoking remains a significant influence. However, until now there hasn’t been the resources to create a predictive model which allows data-driven conclusions to be reached.” n

“Around 250,000 occur every year, and roughly a third of women suffer more than one of these traumatic events”

A platform for freedom Birmingham-based digital healthcare provider Breaking Free Group is a national finalist in the Government’s ‘Great Faces of British Business’ competition. Commercial director Clive Bawden explains its innovative model The group was founded by Dr Jon Ward, who had previously established an educational psychology business (CPA). By 2009-2010, he saw the potential to create a new form of consultancy, which would use technology as a route to care, so he set up Breaking Free. His aim was to address the underlying psychological and lifestyle influences which drive addictive behaviour, by developing a powerful and flexible digital health platform. Previously, if someone wanted to tackle their addictions, they had three options: try by themselves, check in to a private clinic, which was very expensive, or join one of various organisations, such as Alcoholics Anonymous. However, but those models haven’t really changed in years. Jon’s innovation was not simply to see how programmes for alcohol and drug dependency could be delivered remotely by digital technology, but to realise that interventions had to be evidence-based. Everything Breaking Free does is underpinned by data and research, and we have now had 14 papers published on our work. Several of these have been by academics at King’s College London, and we’ve just done one with Harvard. All these papers were written by people who have no connection with Breaking Free, they were all peer-reviewed and have passed the quality threshold. Such input and analysis also helps us test, fine-tune and enhance our programmes. Breaking Free Online is a treatment and recovery programme which has been commissioned by more than 60 local authorities and NHS Trusts, and adopted by several national charities which provide treatments for substance abuse. We’re working with Turning Point, for

“Breaking Free Online is a treatment and recovery programme, which has been commissioned by more than 60 local authorities and NHS Trusts, and adopted by several national charities” example, and also with CRI, which is a £100m organisation tackling severe cases of alcohol and drug abuse. In the past, many of these people would be turned away by charities or casework teams because of the severity of their condition and their behavioural issues. Providing a remote online service works better for individuals who are attempting self-help, and

we have also developed Staying Free, a toolkit designed to prevent relapses, available as an app on Android or IOS platforms. Then the Ministry of Justice approached us because it wanted to address the issue of drug addiction within prisons. We were asked if we could use our methodology to create new pathways of care, and so we did a two-year study at ten prisons, which was the world’s first online health monitoring initiative for offenders. NHS England commissioned the programme through its ‘Gateways’ project, which looks to provide better continuity of care between prisons and communities, and is a major element of the Government’s efforts to reduce reoffending rates. Our staff were installed in each prison, working alongside the educational interventions to monitor the success of our programmes. All the feedback has been positive, and we’d certainly hope to be commissioned for further studies. Now we’re seeing significant interest in our work throughout the UK and overseas. Our products are in a specialised market niche, as we grow we may ultimately enter different markets, but there’s a long way we can go with our existing products. We see ourselves as an innovative element within the wider digital healthcare economy, but we are certainly not claiming to offer miracle cures. However, our programmes are now proven to work for people who wish to tackle their addictions, and wish to do so via digital platforms. Looking ahead, we’d be disappointed if we weren’t operating in at least one overseas geography, but there are lots of ‘What Ifs’ ahead, and we’re only a small business at the moment. n

INSIGHT

bqlive.co.uk

On a silk road The Silk Report is the strategic stepping-stone for Birmingham’s healthcare and life sciences sector of the future. Ian Halstead chatted to its author Until the heart-stopping moment when Graham Silk was told that death was only a matter of time, his world revolved around his wife, their youngsters and his beloved Baggies. However, since that chilling day in 2001-after he simply popped in to ask his GP about a niggling knee injury-he’s also been a passionate believer in the power of healthcare innovation. Silk understands better than anyone the compelling logic for scientific advances to be translated ever-more quickly into new drugs, devices, diagnostics and biomarkers-signposts which offer clues to potential diseases and conditions which might impact an individual. “I was diagnosed with chronic myeloid leukaemia (CML), but couldn’t have a transplant because my brother wasn’t a close enough match, and was also told that no drug was available through the NHS which could offer any hope,” he recalls. “I began searching the internet to learn about potential new drugs and discover which people were pre-eminent in the field of blood cancer. I

“I was like a drowning man clutching at straws. I was told he’d moved, and my heart sank. He could have gone anywhere”

discovered there was a supposed ‘wonder drug’ called Glivec, but it was very new and even the clinical trials were all taking place in the United States. I kept on searching, and discovered that someone called Charlie Craddock worked at Hammersmith Hospital in London. He had a great reputation, so I rang them to talk to him. I was like a drowning man clutching at straws. “I was told he’d moved, and my heart sank. He could have gone anywhere in the world, of course, and I could see from his CV that he’d previously been based in Seattle. Then I was told he’d moved to take up a new post in Birmingham, and here was I was sitting in Halesowen.” Serendipity at its absolute finest … and his discovery soon led him to meet Craddock, just settling into his new job at Hospitals Birmingham NHS Foundation Trust. “He was raising money to fund the recruitment of a research nurse, and six months after I’d been diagnosed, he told me that he’d got three places on a clinical trial for this new drug. Two had been taken, but I could have the last one,” recalls Silk. ”Around 40 people in the UK, out of 130,000 who had blood cancer, eventually received this revolutionary new treatment, which is now one of the most commonly-used drugs for CML. Then it was dubbed the ‘golden bullet’ drug, and became the first example of what we now know as personalised medicine.” Three years on, and having been told his illness was in remission, Silk co-founded Cure Leukaemia with Craddock, and remains a passionate advocate both for its work, and the research nurses who are funded by the charity and now operate in hospitals across the West Midlands. “At the very earliest stage, after the research behind a potential new drug has been peer-reviewed, the work of these nurses is absolutely crucial. A drug development programme which used to take seven years now takes only three, so this new approach was very popular with the pharma companies,” says Silk. Allied to his background in finance and investment, his experiences made him the ideal choice when Greater Birmingham and Solihull LEP needed someone to chair its Life Sciences Commission in 2015, to create a ‘road map’ for how the area’s life sciences sector could develop to benefit patients, the wider community and the economy. The idea was to research and make a case which

“He was raising money to fund the recruitment of a research nurse, and six months after I’d been diagnosed, he told me that he’d got three places on a clinical trial for this new drug” The Greater Birmingham Life

Sciences Commission

The Silk Report

could be put with credibility to the city council, the LEP’s partners, government, big pharma and also potential providers of finance from the venture capital and private equity communities. “The LEP’s board wanted to see how private sector investment could be maximised, on current projects - such as the Institute of Translational Medicine (ITM) on the Queen Elizabeth hospital site, and the Life Sciences Campus which is being developed on derelict industrial land nor far away in Selly Oak-and for the future,” says Silk. “At the same time, it was also important to make a compelling argument to the government about opportunities for us to transform the pace at which patients benefit from healthcare advances.” Life Sciences Minister George Freeman had known Silk since before his front-bench appointment, and referred to him (anonymously) in his maiden Commons speech. He was clearly impressed by the depth of research and analysis which underpinned the tightly-argued 44-page report, providing a supportive foreword, and adding “I look forward to working with you on the next steps ...”. The Silk Report concluded by highlighting what its author considered the biggest threat to the region’s ability to establish a world-class life sciences sector-the potential failure to immediately identify the required funding. It was timely therefore that, as the analysis was being digested by the LEP, the council and many others, a new council leader was elected in Birmingham, and one eager to consider new economic solutions. “I met John Clancy recently, and was very impressed by his ideas for novel funding streams,” admits Silk. “The idea of ‘Brummie July 2015

Bonds’ as a vehicle to drive investment, and that regional local authority pension funds might also be used, are both very interesting. “I know George Freeman believes the politics should be taken out of health, and it was noticeable at the BQ Live Debate that he paid tribute to the work done by Andy Burnham, so I think Clancy’s approach will chime with him. “Greater Birmingham has a diverse and established population of 5.6m, and that’s going to be another tremendous asset as we look to strengthen the scale of the health economy in this area. “It’s not just about research and data driving medical advances, and creating benefits which accrue to patients though, it’s also about creating wealth and employment. There are many different strands to the regional economy, but there is no doubt that this sector can be a real driving force. “Charlie [Craddock] has said that Birmingham can become a test-bed for the world, for drugs, diagnostics and devices, and I am sure that is right. The NHS is already learning from what is happening here, but there’s still a lot more it can learn. “Charlie and his team, and the model they have evolved, have so far leveraged an incredible £200m of drugs for free, and now the ITM is up and running, it will be able to leverage much more into other health sectors. “The use of digital technology is at the heart of everything which is happening, and we can create an amazing economic boom, not just in the West Midlands, but for the UK, and we can do so using models which are affordable and sustainable. “George Freeman rates Birmingham as one of the four leading global centres for translational medicine, and now we have to take these opportunities and magnify them for the benefit of patients, and for everyone in the wider West Midlands economy.” n

PROFILE

The Binding Site

Black Swan project adds new chapter to Binding Site story Binding Site researches, develops and manufactures innovative medical solutions, to improve the diagnosis and treatment of blood cancers and immune system disorders There’s a great deal to admire about Binding Site; not least its sleek and imposing HQ in the Edgbaston Medical Quarter, a remarkable long-term track record of innovation, and impressive year-on-year growth in both employment numbers and revenue. The company’s specialised diagnostic products help doctors, clinicians and laboratory researchers across the globe identify and tackle immune system disorders and blood cancers, with a particular focus on myeloma. It’s an especially brutal cancer, which attacks the white blood (plasma) cells in our bone marrow, degrading their ability to produce antibodies to fight infection and disease. “The survival rate for myeloma-or Multiple Myeloma as it is often known, because it usually invades several areas of a patient’s body-has increased remarkably over the last decade,” says Charles de Rohan, Binding Site’s gregarious and globe-trotting CEO. “Even just a few years ago, someone diagnosed with this disease would have a typical life expectancy of between two to three years, but now we hear reports of patients living for ten and even fifteen years. “We are in a niche part of the clinical diagnostic

“Being so close to the QE Hospital is a tremendous positive, because in terms of reputation it has become the John Lewis of medicine.”

field, but one which is constantly expanding because of demographic influences here and in other developed countries. Populations are ageing, so more instances of Multiple Myeloma are being seen and more people are living longer with it. Equally, our tests are enabling clinicians to diagnose and monitor more accurately, and the new therapies are both better tolerated and more effective. Binding Site’s commercial success means that its workforce has grown steadily, in Edgbaston, but also in its overseas subsidiaries. “We employ 700 people worldwide, and are coming up to 500 full-time jobs in the UK,” says de Rohan. “Being so close to the QE Hospital is a tremendous positive, because in terms of reputation, it has become the John Lewis of medicine. Our success helps us attract top-quality staff, and so does our location. ”We are now shipping around 250k ‘kits’ every year from here, and in 2015, 92% of our products went overseas. It’s been great as an organisation to receive two Queen’s Awards for Export (and one for innovation) but everything is about improved patient care and better diagnostic techniques, not accolades. ”Over the last five years,we’ve doubled our size and I’d expect that level of expansion to be achieved in the next five. It’s been particularly pleasing as it’s all been via organic growth too.” The Calthorpe Road organisation has become an established and respected international brand, in a fast-changing and ultra-competitive sector, and is now represented in more than 100 countries. “We find ourselves being regarded more as a partner than a supplier, by the people and the organisations

Binding Site HQ in Edgbaston Birmingham we work with,” says de Rohan. “All our products are developed and manufactured in the UK, which is very energising and satisfying for everyone concerned. ”Roughly half our overseas sales are in North America, and most of the rest are in Europe, so there’s still a lot of room for global growth. We see South America, India and China as markets with the largest potential, and we’re going through the regulatory approval process in China at the moment. “Clinical trials are starting now, and it’s likely to be another two years before our products go on sale there, but that’s not an unusual timetable. We always have to be measured in our approach to new overseas territories.” The latest project in which Binding Site has become involved underlines the regard with which de Rohan and his colleagues are held.

Three years ago, the International Myeloma Foundation launched its Black Swan Research Initiative (BSRI) to develop the first definitive cure for Multiple Myeloma. The California-based organisation has since assembled a global consortium of researchers, analysts and data experts to help achieve its goal, and has just chosen Binding Site to spearhead its biggest-ever research project-in Iceland. “We’ll be screening everyone in Iceland over the age of 40, to try to identify the origins of myeloma by using our diagnostic tools” says de Rohan. “The ultimate goal is to devise treatments which will prevent people from contracting this awful disease or to treat them before the clinical symptoms appear, and it’s incredibly exciting to be involved in such a project. It’s the first time such a study has been carried out across a whole population, and it will last three years, but the funding is already in place from the BRSI. “Even at this early stage, the USA’s Food and Drug Administration is taking a keen interest in the project, because the findings will be of huge benefit in every country. It’s also great to fly the flag, not just for ourselves, but for the whole healthcare and life sciences community here in Birmingham.” However, even though Binding Site is a hot-house of medical innovation and advanced research, it also faces the same challenges as any other large business, to continually improve efficiency, productivity and accuracy. “We are always trying to improve our products in

terms of consistency and quality,” says de Rohan. “We already have an excellent structure in place, but we produce biological material which, by its nature, can not always be 100% consistent. “We invested significantly in a new Enterprise Resource Planning (ERP) system during 2015, which was an extremely important decision for us. We’re a global business, and we needed to ensure that our core systems and processes meet the latest ‘best practice’ standards. “We went through a lengthy period of research to identify the right provider, and eventually chose a Swedish company, IFS (Industrial and Financial Systems). We were very impressed by the intuitive nature of their system, the training was excellent, and they engaged fully with us throughout the process.” Binding Site’s back-office functions went live in February 2015, the UK arm and its manufacturing operations followed last November, and over the coming months the system will be gradually rolled out to the group’s overseas divisions. “It required a very large amount of work just to populate the system, and of course everything had to be compliant from a regulatory perspective,” says de Rohan. “We’ve now moved from paper-driven systems to using bar-codes and touch-screens. “I’d expect the system to be fully live across the entire group by late 2016 or early 2017. The initial benefits were impressive, and we expect to see more efficiencies as everyone becomes accustomed to the new structure and procedures.”

Binding Site has also spent some £1.5m on a sophisticated new automated production line, dubbed the ‘Filling Station’ at its Edgbaston HQ, to replace its previous set-up. “It’s made a dramatic difference,” admits de Rohan. “The overall throughput is significantly faster, there’s a much faster change-over when we need to use different bottles, and the labelling process is easier and quicker. “Yes, it was a lot of money, but we have managed to fund both projects internally. The world, and the markets which we serve, continue to change and to change at speed. “As a business and an organisation, we must continually evolve to meet the requirements of our customers and the wider market. You always have to respect the competition, but equally, we are always eager to remain three steps ahead.”

0121 456 9500 charles.derohan@bindingsite.co.uk 8 Calthorpe Road, Birmingham, B15 1QT www.bindingsite.com

LIVE DEBATE bqlive.co.uk

TAKING PART

LIVE DEBATE

THE VOICE FOR BUSINESS DEBATE

Birmingham’s ICC was the venue when BQ held its Live Debate on the city’s fast-growing healthcare and life sciences economy. Ian Halstead covered the event Deliberation and debate are the ways to stir the soul of a democracy, according to the veteran American civil rights campaigner, Jesse Jackson. Not that he’s known for discussion, more for powerful flights of fanciful rhetoric, but there’s absolutely no doubt he would have enjoyed a tour-de-force by the Life Sciences Minister, George Freeman. After a long day criss-crossing Birmingham meeting a small army of people, and visiting an array of healthcare locations-the Mid-Norfolk MP would have been forgiven for dropping down a gear … or two. Instead, Freeman demonstrated not just an impressive mastery of his complex brief, from digital health to big data, and from genomics to pharma and beyond, but also presented his thoughts with such passion and purpose that the other panel members were visibly entranced. Even one-time Labour Chief Whip, Jacqui Smith, could be seen nodding in accord, whilst others scribbled notes as future aide-memoires. “There’s no doubt that a genuine healthcare

cluster has evolved in Birmingham, with tremendous examples of best practice,” began Freeman. “I’m always keen to see conversations develop between the NHS, pharma, the public sector, academics, hospital trusts and clinical researchers, and it was clear that they are happening here. It’s very much the ‘big picture’ approach which is needed.” It was clear that his affection for life sciences was deep and personal. “I worked in the life sciences industry in the late-90s, including four years as a venture capitalist, though I was very much a generalist surrounded by professors,” said Freeman. “I then worked in a start-up doing digital health, became very interested in stratified medicine and in how big data could take the sector forward. I’m an outspoken advocate of translational patient-centric medicine, involving scientists and universities, so was very pleased to see examples of this approach today. “You see something incredibly powerful, when

you have academics and healthcare specialists, with massive amounts of clinical data. You can create new pathways and drive innovation linked to advanced research.” Freeman even paid tribute to the work of former Labour Health Secretary, Andy Burnham, although conceding that the political cycle didn’t dovetail easily with the needs of healthcare, because of the latter’s requirement for long-term investment. “Our challenge is to build on previous achievements, although now against a very different landscape,” he added. “The 20th century model of bio-pharma was deep science, with a lot of luck involved in terms of access to finance, and maybe 15 years and $1 billion required to bring a drug forward. “That approach was based on the ‘blockbuster’ concept which appealed to the City, even though the record of discovery with regard to New Chemical Entities (NCEs) over the last 20 years was very poor. “Now though pharma can’t afford to spend

millions and wait 15 or 20 years for new drugs to come forward, and the NHS can’t afford to pay the costs which would be required at the end of that pipeline, or put up with a lower level of outcomes whilst it waits for those drugs. “I recently went to Cambridge (Massachusetts) to see a £500m R&D centre right in the middle of a campus, and that is very much the model for the future, as can be seen here in Birmingham,” he said. “Now the sector is coming right back to patients, data and genomics, which is where it was in the golden age of pharma. There has been remarkable progress: 98% of women now survive breast cancer, for example, but the challenges of an ageing society require different approaches and different models. “We should commit ourselves to this new landscape, and the NHS must better engage with the outside world. We are trying to unleash the power of our health system to take a lead in the new patient-centred model of health and life sciences research, in which devices, diagnostic, and digital must all converge. “A very challenging technological landscape which will transform the way in which we regulate. Let’s leverage the power of our research, particularly in infomatics and genomics. It’s equally vital to have access to diverse and large population data, of which the West Midlands is an excellent example.” Freeman paused to sip a glass of water, but his

enthusiasm for the subject clearly wasn’t diluted. “We need big investment in genomics, so let’s be ambitious and be bold. Others are chasing us, but we have the momentum,” he said. “Unfortunately though, we are failing on the data and the infomatics. We’ve nearly got the infrastructure, but the interoperability is poor. We have created a railway line, but no-one has crossed it. “Genomics and data are the technologies which will create the new landscape, but although I don’t see a funding gap, I do see an innovation barrier. “The Academic Health Science Networks (AHSN) are a great concept, but lack procurement leaders and have funding problems. They are basically marriage brokers, but they need more tools. ”I’d like to see more, and bigger, partnerships in healthcare in our biggest cities, such as Birmingham, because you never know which pathways work, which might and which never will.” Freeman had a healthy scepticism about what any government could achieve, seeing a future health economy driven by incentive-led and place-based integration. “Looking at Norfolk, £1.2 billion is spent on healthcare, but it all goes into different ‘silos’ and much isn’t best used,” he admitted. “I’d like to hear a compelling Heseltine-type plan for devolved healthcare, from council leaders,

George Freeman, Life Sciences Minister Mike Carr, programme delivery director for the Greater Birmingham & Solihull LEP Jacqui Smith, chair of the UHB NHS Foundation Trust and the Heart of England NHS Foundation Trust Graham Silk, chair of Hampson Holdings Richard Devereaux Phillips, director of healthcare policy for the Association of British Healthcare Industries Peter Dines, investment director and head of life sciences for Mercia Technologies Tony Davis, commercial director for the West Midlands AHSN Simon Phillips, planning, development and regeneration director with Bilfinger GVA Dr Christopher Parker, Managing Director, West Midlands Academic Health Science Network Tony Soteriou, Deputy Director for NHS Research Infrastructure and Growth, Department of Health In the Chair: Caroline Theobald BQ Taking notes: Ian Halstead BQ Venue: ICC Birmingham BQ is highly regarded as a leading independent commentator on business issues, many of which have a bearing on the current and future success of the region’s business economy. BQ Live is a series of informative debates designed to further contribute to the success and prosperity of our regional economy through the debate, discussion and feedback of a range of key business topics and issues.

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academics, the business community and others. “Birmingham is poised in a very exciting place, and although there are rival clusters, in Scotland and the North, not just along the traditional London-Cambridge-Oxford axis, the closeness of integration is creating something very powerful, and the Birmingham story must be told; again and again and again. “The new Institute of Translational Medicine is the poster-child for what I am talking about, with regards to access. It is quite extraordinary what it can achieve in terms of delivering drugs, attracting philanthropy and securing investment. “If I am right about the future landscape, then nowhere is doing it better than here, not even Belfast because they haven’t quite got the clarity of leadership on translational medicine. You will be right in the sweet-spot. “I also like the regional links between telematics, healthcare and manufacturing. The idea of making devices here in a connected city is powerful, and I think an investment prospectus would work, as being able to track, trace, and then cost diseases will be critical.” By now, Freeman wasn’t so much warming to his theme, as almost melting, so he gave way to allow the panel members to respond. Graham Silk, who chairs the investment vehicle Hampson Holdings, agreed that greater focus was needed on creating infrastructure, and suggested the appeal of the city’s healthcare economy could see a return to Birmingham’s great Victorian era of philanthropy. “We do need to drive our reputation globally, but at the same time, there must be focus on our changing demographics,” he added. Mike Carr, programme delivery director for the Greater Birmingham and Solihull LEP, said his experience from the medical devices sector suggested that the timing of a new and integrated health strategy was critical, and he hoped to see more effective and more

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centralised local leadership. The quality and strength of leadership in the NHS was the issue for Richard Devereaux Phillips, the director of healthcare policy for the Association of British Healthcare Industries. “I like the idea of using big data to standardise systems and deliver better outcomes, but we mustn’t forget that although the pharma sector varies enormously in scale its players require the same essentials,” he added. “Switzerland, for example, isn’t an immediately obvious location for big pharma because of cost, but it makes entrants very welcome, not least through very efficient processes.” Peter Dines, the investment director and head of life sciences for Mercia Technologies, suggested that the NHS needed to develop better procurement structures and systems, and although a morsel of food prevented Freeman from replying, his nod sufficed. Continuing the welcome mood of accord, Tony Davis - commercial director for the West Midlands AHSN agreed that the network needed more tools, especially for procurement and incentives, and that different organisational structures should indeed be considered.

Jacqui Smith, who chairs Birmingham’s two major NHS Foundation Trusts, accepted that the central challenge was for the city to become more effective at telling its own story. “It’s also crucial to focus on how the NHS accumulates and collates patient data. I do wonder if the correct incentives are in place,” she added - a point which also gained Freeman’s approval. “Equally, although collaboration at all levels is fine, at some point decisions have to be taken. At the moment, there are several parallel agendas on the future of Birmingham’s healthcare economy, and they need to be unified.”

“It would need someone inspiring, bold and visionary to chair this body. That individual might be the new Metro Mayor, or might not, but must be someone with real drive and commitment”

“The closeness of integration is creating something very powerful, and the Birmingham story must be told; again and again and again”

There was another cautionary note from Simon Phillips, the planning, development and regeneration director with Bilfinger GVA, who is working with the city council and the NHS on the new Life Sciences Campus. “There’s been a great deal of talking in recent years, but now the city needs to move into a genuine delivery phase,” he said. “The right land and the right kind-of space has

to be available, particularly grow-on space, or potential occupiers will look elsewhere. The sector also does need to raise its profile to make wider audiences aware of what is happening here.” However, the debate was very much Freeman’s show, and his positive mindset was again seen when he summed up what he believes Birmingham should do next.

“I like Graham’s idea of philanthropic investment in healthcare, particularly the idea of using locally-backed Birmingham Bonds to attract new revenue streams to the sector, which reminds me of the great era of civic achievement which this city enjoyed under Joseph Chamberlain,” he said. “Investment into healthcare from companies, organisations and individuals would really develop a shared sense of community spirit. “I’d also like to see Birmingham create a new form of partnership, getting people to commit to a signed contract. It would need someone inspiring, bold and visionary to chair this body. That individual might be the new Metro Mayor, or might not, but must be someone with real drive and commitment. “To me, there also should be a civic goal. Not rewriting existing strategies, but aiming, say, to make Birmingham the healthiest city in the country and tackling inequality and lack of provision. Health and wealth together would be a very powerful force.” And then he was gone, whisked away at speed to ensure that the London train didn’t leave without him. Leaving just one observer to add the perfect footnote ...”He just didn’t seem like a politician.” n

PROFILE

Coventry University

What the West Midlands is doing to attract and develop the best talent in life sciences and healthcare

Fundamental movement skills (FMS), physical activity and obesity in British children, Professor Mike Duncan, Dr Samantha Birch, Dr Sam Oxford, Dr Emma Eyre, Elizabeth Bryant (Physical Activity, Exercise and Obesity). As fundamental movement skills underpin all forms of physical activity it is important that children master these as early as possible. We have been tracking 600 children from Coventry over a four year period, measuring mobility, levels of physical activity and body fatness. Our work has highlighted some important issues related to children’s current and future health and is suggestive that efforts to reduce child obesity levels in Britain may be unsustainable if they simply focus on asking children to exercise more. Our research has also demonstrated that putting effort into ensuring children develop the key fundamental movement skills early on will result in children being more physically active and less likely to be overweight or obese as they get older. These findings have clear and important implications for Education policy relating to PE as well as being relevant to other areas related to child health and development. Full findings from this research are due for publication in the Journal of Sport Sciences.

Investing in opportunities for research stars for the future – locally and nationally Coventry University’s Faculty of Health and Life Sciences is widely recognised for its research and for the quality of its education provision. Professor Guy Daly, Faculty Executive Dean: “We have dedicated, knowledgeable and hardworking staff; first class teaching facilities; and strong partnerships with employers from a range of sectors, which combine to create an excellent learning environment for those wishing to pursue a career in the health sector. As a result; when canvassed for opinion our students consistently confirm their high levels of satisfaction with their courses and our staff”

An artist’s impression of the University’s new Health and Life Sciences (HLS) building

Associate Dean of Research, Professor Jane Coad: “We have a strong focus on increasing and spreading knowledge within our field and to that end we have established three new Faculty Research Centres spearheaded by expert scholars.”

• Violence and interpersonal aggression • Identity and resilience in communities and organisations • Brain, belief and behaviour • Atypical development

THE CENTRE FOR RESEARCH IN APPLIED BIOLOGICAL AND EXERCISE SCIENCES (CABES) Executive Director, Professor Alfonso Jimenez: “CABES furthers our understanding of fundamental biological pathways and processes, applying biological sciences to advance diagnosis and prevention of disease. “Our aim is to enhance Coventry University’s reputation for scientific research of excellent quality covering three key themes: Cellular and Molecular Biosciences; Biological Systems, Health and Disease; and Physical Activity, Exercise and Obesity.”

THE CENTRE FOR TECHNOLOGY ENABLED HEALTH RESEARCH (CTEHR) Head of CTHER, Professor Beth Grunfeld: “Bringing together interdisciplinary teams of 31 academics and over 30 doctoral researchers to create four themes which focus on different aspects of health and technology research, the centre has internationally recognised strengths in health behaviours and interventions, children and families, innovative technology and health economics. “CTEHR works closely with users, service providers, commissioners and industry and conducts theoretically driven research that benefits the health and wellbeing of our nation through the advancement of fundamental knowledge, promotion of behaviour change, development of services and contribution to policy.”

THE CENTRE FOR RESEARCH IN PSYCHOLOGY, BEHAVIOUR AND ACHIEVEMENT (PBA) PBA focuses on the development and evaluation of theoretically-rooted, evidence-based psychological interventions across many areas. The centre delivers on five themes: • Children’s literacy and developmental disorders

In addition to the new Faculty Research Centres, in 2015 Coventry University joined forces with twelve

other University Alliance universities to launch the Doctoral Training Alliance (DTA) programme in response to industry needs and to promote the UK’s economic growth and productivity. The DTA programme aims will utilise highlyemployable researchers with the expertise and skills in strategically-important research areas. Researchers from the CABES and the CTEHR are part of the first cohort. This is the largest single community of researchers working in the applied biosciences for health and a truly exciting time in the world of research at Coventry University. SPOTLIGHT ON OUR RESEARCH PROJECTS Inocardia The work being carried out by Inocardia, a Coventry University spinout company led by Professor Helen Maddock in CABES, is an example of research that explores current practices to develop safer and more economical interventions. When drugs are developed to treat a particular disease or for human use they sometimes have side effects that cause heart damage. This is a significant risk to human health and is costly to the pharmaceutical industry when a dangerous product is withdrawn from market. Current drug testing relies on the use of

animals that often do not do well in predicting the effect on humans. Professor Maddock and her team have developed a pioneering new way – using real human heart tissue – to test the effect of drugs on the heart without using human or animal trials. This simulated cardiovascular system – known as a work-loop assay – provides the most realistic model of heart muscle dynamics in the world to date, and opens up unprecedented possibilities for identifying negative effects of drugs early and inexpensively – potentially saving lives and speeding up the development of successful drug treatments. Children and Families research The Children and Families Research (CFR) group led by Professor Jane Coad within CTEHR evaluated the effectiveness of nursing and support for cancer services for 16 to 24 year olds across the North West of England. This pilot model, supported by the Teenage Cancer Trust, saw improved provision and

quality of care as a result of the work carried out by Jane’s team and the project won the prestigious Nursing Times HRH Prince of Wales Award for Integration of Care in 2015. The project is now being rolled out nationally. Autism With PBA, Dr Sarah Cassidy leads a research project around sensory and motor difficulties in autism spectrum conditions, and whether these are related to the severity of social and emotional difficulties associated with these conditions. IMPACT OF OUR RESEARCH There are many stories of impact, as part of our intervention work, and results can be seen quickly or emerge more slowly over time. The impact of policy, the end user experience, future research ideas and funder collaborations, and partnerships are what make research at the Faculty of Health and Life Sciences an exciting place to work.

Creative approaches to service design: development of a new assistive technology service, Dr Gillian Ward, Nikki Holliday, Darren Awang (IDTU). We are pioneering a new assistive technology service that enables people with complex health issues to live more independent lives, helping them to live at home and better equipping friends and family to support them. The service was piloted over three months with 39 users and carers. The results were overwhelmingly positive, with all participants wishing to keep the service. Success was due, partly, to the application of established design principles to make the service useful, usable, efficient and desirable.

For more information call 024 7615 8258 or email knowledgetransfer@coventry.ac.uk

INTERVIEW

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Partners pushing medicine’s frontiers Geoff Thomas

The world of social media can be a dark and dangerous place for the unwary but it’s also a remarkable storehouse of knowledge. Peeking at the individuals and organisations someone chooses to ‘follow’, for example, offers an intriguing insight into their perceptions and pastimes. Charlie Craddock’s Twitter flock includes the Berlin Philharmonic, the RSPB, the Poetry Archive, the AGA cook-shop and a weekly radio programme on ‘early music’ broadcast from Indiana, suggesting an eclectic mind … and someone who’d be grand company on a long train journey. However, his multitude of professional ‘follows’ indicates this is also someone who lives and breathes their chosen profession. Which is immensely fortunate for Geoff, and many other victims of blood cancer, who would long since have breathed their last, but for the innovative treatments and drugs developed by Craddock, with his researchers and nurses at Cure Leukaemia and Birmingham’s Centre for Clinical Haematology (CCH). Thomas was a combative midfielder who blossomed at Crewe, before moving on to captain Crystal Palace in an FA Cup final, and notching up time with Forest and Wolves. Nine caps for England were a reward for tenacity and dedication, both qualities needed in abundance not long after his football career ended. “I was only 37, in 2003, when I was diagnosed with a rare form of blood cancer, chronic myeloid leukaemia, and told it was incurable

Ian Halstead met up with Professor Charlie Craddock, the co-founder of Cure Leukaemia, and its best-known fund-raiser, the ex-England international Geoff Thomas without a stem cell transport. “I’d had spells when I was exhausted, and had been losing weight, but put it down to starting full-time work. Fortunately my wife, Julie, persuaded me to visit my GP, and six hours after he did his tests, he rang with the news. “I’d always been very fit, which seemed to give me some chance, and had suffered injuries late in my career, which had built up mental toughness. Saying that, my white blood cell was over 200, and should have been between seven and 11. “My doctor referred me to the QE hospital, and I met Charlie. At first, they thought I might only live three months, but Charlie got my white cell count down, and they thought I might live for three years. “Coincidentally though, Charlie and Graham Silk had just founded Cure Leukaemia, to allow patients with blood cancer access to the latest drugs.Luckily too, my sister Kay was a perfect match for the transplant, but there were still months of treatment, and at one point, I was in isolation for five weeks, because my immune system wasn’t functioning. “I was very lucky, as I still remind myself. Julie and Charlie were brilliant, the new drugs worked and after 18 very tough months, I was in remission.” The deep bond he developed with Craddock is evident, but it’s the relationships Thomas built with cancer victims who were less fortunate which still cast a shadow.

“Every time you met someone, you knew some wouldn’t survive, and the memories of those who lost their battles is still with me,” he says. Much of his time is now spent raising funds for Cure Leukaemia and the blood cancer charity, Bloodwise and speaking to a wide array of audiences on cancer issues. In 2005, Thomas raised £250,000 by cycling 2,200 miles to Paris, two days ahead of the Tour de France, and ten years on decided to repeat the feat by leading a team of amateur cyclists along all 21 stages of the route to the French capital. “Charlie had already proved that his new model worked. Better research and better use of data was giving pharma firms the certainty they needed to invest in new drugs, and in return they freely gave their drugs back to the QE to treat more patients,” says Thomas-and his passion is almost overwhelming. “It was a business model which saved lives, but we still needed more research nurses to release the wealth of knowledge and data from inside the NHS. We wanted to take luck out of the equation, so blood cancers could be tackled with precision through innovative drugs and treatments. ”Raising £1m would enable patients at the QE to ultimately benefit from £10m of the latest drugs, but which would cost the NHS nothing. “On 19 May, we’re off again on the same route, but to coincide with Euro 2016. Yes, we hope to raise a significant amount of money again, but we’re also aiming to tell everyone that

Charlie Craddock

“Now the Institute for Translational Medicine (ITM) is open, we are on track to replicate what we have done for blood cancer, for other diseases” Birmingham is a world-class centre for blood cancer, and that Charlie and his fabulous team are doing amazing life-saving work.” As Thomas then strode away with purposeful gait, Craddock took up the story of how Birmingham became a global centre for the diagnosis and treatment of blood cancers. He arrived with an international reputation; studying medicine at Oxford University, completing post-grad research in haematology at London’s Hammersmith Hospital, then returning to Oxford’s Institute of Molecular Medicine, before working at a cancer research centre at the University of Washington, in Seattle. In 1999, he was appointed director of the QE’s blood and marrow transplant unit, and five years later was appointed to the newly-created Chair of Haematology at the University of Birmingham. “I came here because I saw a great opportunity to make a difference,” says Craddock. “Now we understand the biology of cancer so much

better, have better clinical trials and better access to data, we are having better outcomes for patients. We have built up the expertise and reputation of our bone marrow unit, until we are one of the top two in the UK, and can now give patients access to drugs and treatments which are not readily available via the NHS. “As we developed our model, we realised that it was scalable, so we could do it for diseases which affected the kidney, the heart and other parts of the body. The trials and the tests which are happening at the QE have genuinely become a test-bed for the world. ”We have evolved a great infrastructure, working not just with pharma, but with colleges here and overseas to drive new treatments, and are leading several Europe-wide trials. Now the Institute for Translational Medicine (ITM) is open, we are on track to replicate what we have done for blood cancer, for other diseases. “Already, we have more than halved the time

it takes to set up and run a clinical trial, which is very appealing to the venture capitalists, the private equity houses and other investors who are needed to back the research.” Craddock is though typically self-effacing about his own role. “Many people have been involved. Steve Hollis (deputy chair of the Greater Birmingham and Solihull LEP) is a great facilitator with the ability to pull people together, David Eastwood (vice-chancellor of the University of Birmingham) and Julie Moore (chief executive of University Hospitals Birmingham NHS Foundation Trust) provide great leadership. The support we have received from our institutions and their staff has also been tremendous, but the real heroes are the patients, and our incredibly generous supporters who contribute to Cure Leukaemia. “We are at a new frontier for medicine, but everything we do is based on a partnership model. It’s never just about the efforts of one or two individuals.” n

INSIGHT

PROFILE

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The Institute of Digital Healthcare

Export help on hand Ajay Desai is head of international trade at Coventry and Warwickshire Chamber of Commerce, and the regional lead for UK Trade and Investment (UKTI) on healthcare. He explains his role to BQ

Hopefully, most people have heard of us, but if not, UKTI was set up to assist UK-based companies gain access to international markets. We have country experts and sector experts in our London headquarters and in our regional offices. In the West Midlands, UKTI staff are based in the region’s Chambers of Commerce, and I’m based at the Coventry and Warwickshire Chamber. My speciality is advising companies in the healthcare and life sciences sectors, which could be anything from medical devices to pharmaceuticals. Typically, my first point of contact with such companies will be at a UKTI event, another networking event or through a direct approach from the business. The first thing I do is meet the management team, learn more about their products and their strategy for export markets. We’ll then discuss the other elements of their operational strategy, and how that will need fine-tuning if they are to successfully target overseas sales. Language is an obvious issue, but logistics and payment processes are almost as important. Typically, they’ll require help from myself in the wider UKTI network, to identify potential customers, useful contacts and sometimes even their competitors in these new markets. We

also have a very strong international network through our High Commissions and embassies. They’ll have sector specialists, commercial attache’s and analysts who can provide the latest data and market trends, so the company is able to build its new overseas strategy on firm foundations. I’ll also have information on trade shows, exhibitions or conferences in their sector. Arab Health, for example, which is held every January in Dubai, is a major event in global healthcare, and a growing number of firms from the West Midlands now travel there, take space and meet other delegates, and it’s a great place to do business. At the moment, I am working with Premier Health Products, which is a family-owned business based in Coventry specialising in vitamins, minerals, nutrition and other forms of food supplements. Typically, they supply independent pharmacies and small to medium-sized chains, but they are also very successful in overseas markets. When I began advising them, they sold to six or seven countries, but now they are selling to 25, so they’ve been a real success story for how UKTI can help companies. Now, the managing director Simon Petros is looking to expand into new territories, and also to set up a digital platform, so he asked if we were able to assist him again.

He needed to know how to get some new products tested, but that’s not my area of expertise, so I asked my colleagues based in Hereford and Worcester Chamber, and they’re helping him to identify contact companies who will be able to help him. It’s a good example of how we like to work. If the first UKTI officer or international trade adviser doesn’t know the answer to a company’s problem, another one will. Team-work is absolutely critical. In life sciences, for example, companies always need to ensure their products reach the quality standards required in a particular country or region. In the UK, they would deal with the National Institute for Health and Care Excellence (NICE). However, when they look to enter new overseas markets, they will not be familiar with the structure or organisation which operates there to assess health care products, so I’ll liaise with the local UKTI sector specialist to identify what the company needs to do and put them in touch with the relevant people. Winning export sales can be very demanding, especially if a business and its management team are new to overseas markets, but it’s very satisfying when it works, because it’s all about helping to create wealth and employment for UK companies. n

“Typically, they supply independent pharmacies and small to mediumsized chains, but they are also very successful in overseas markets. When I began advising them, they sold to six or seven countries, but now they are selling to 25, so they’ve been a real success story for how UKTI can help companies”

Transforming the Healthcare System through Digital Technology Professor Theo Arvanitis, of the Institute of Digital Healthcare, looks to the future A future where the medical practitioner has portable diagnostic tools and limitless knowledge at their fingertips was envisioned by science fiction writers years ago. Although the details and timescales are unclear, this will be the future of healthcare. To deliver this vision effectively, we need to develop digital technology solutions that will improve the quality, safety, accessibility, and productivity of our healthcare. WMG, at the University of Warwick, has partnered with the NHS and Warwick Medical School to establish the Institute of Digital Healthcare (IDH) to address these challenges. HEALTH INFORMATICS AND BIOMEDICAL IMAGING We are increasingly using imaging to understand the physical nature of disease effects. Professor Theo Arvanitis is working on new methods to diagnose complex diseases in the brain: “The brain is the most complex organ, and we still do not fully understand how it can go wrong and cannot easily access it. But applying several diagnostic tools in parallel, for example combining medical imaging such as MRI scans, with complex computer software to spot disease characteristics and predict patterns, can give amazing insights and save lives”. EFFICIENCY AND SAFETY OF HEALTH SYSTEMS The increased pressure on our health services means that we need to improve the efficiency of the medical system at many different levels. WMG has been at the forefront of applying these approaches to manufacturing for decades, and the IDH is translating this to the health sector. Dr George Despotou, Assistant Professor of Health Informatics and Patient Safety, highlights that “digital technology offers profound capabilities here, enabling improvements in patient safety, service efficiency, and patient empowerment, whilst alleviating resource challenges; but they need to be

“Health and wellbeing will be transformed in the future through a different digital health revolution”

Professor Theo Arvanitis, Head of Research at the IDH introduced systematically and carefully to ensure their dependable operation”. REHABILITATIVE AND ASSISTIVE TECHNOLOGIES Physiotherapy and rehabilitation is highly effective at restoring physical function following neurological or musculoskeletal injury. However, limited resources means there is limited scope for patients to receive guidance and monitoring during the period when they must perform these exercises. Dr Mark Elliott, Assistant Professor of Healthcare Technology at the IDH comments: “There is an opportunity to exploit low cost motion tracking sensor technologies, combined virtual and augmented reality devices, to provide continuous guidance and feedback to patients during physiotherapy. This subsequently improves adherence to the exercises and the likelihood of normal movement being restored”. SELF-MONITORING AND SELF-MANAGEMENT A growing number of us are using a range of self-monitoring devices related to our health and fitness. Professor Caroline Meyer, Professor of Digital Healthcare, points out that, in the context of healthcare self-monitoring, “coordinating the activities and knowledge of several fields could lead to a massive change in how we avoid as well as treat

conditions, such as obesity”. It is important that these four key areas should not be viewed separately. Understanding patients, connections, and the pathways through health services is vital to ensure the system is optimised for the real world and not an ‘average’ patient. At the IDH, we believe the health system could be made more effective at preventing us from falling ill in the first place, and treating us more quickly if we are ill. The issue is that we have existing systems that have legacy structures and technologies for collecting and communicating patient data; systems that cannot cope with the scale and complexity of the new challenges and approaches needed. We need to radically change the way we look at healthcare provision, and digital technology can be a significant part of the proposition for change. ‘Leading that transformation through our high impact research activities is what we here at the IDH are all about’ concludes Professor Arvanitis.

For more information on the work of the Institute of Digital Healthcare, visit www.warwick.ac.uk/IDH

CASE STUDY

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A world leader in unlocking the genome The West Midlands is at the centre of an ambitious initiative using pioneering science to transform diagnosis and treatment for patients with cancer and rare diseases As part of the 100,000 Genomes Project, the region is helping to decode complete sets of people’s genes to accelerate the delivery of personalised healthcare. It is anticipated that around 75,000 people will be involved between 2015 and 2017. A genome is a person’s set of genetic instructions. Each one contains all the information needed to build that organism, and to allow it to grow and develop. Our bodies are made up of trillions of cells, each with their own genome and made from DNA. The West Midlands Genomics Medicine Centre (WMGMC) is one of 13 centres across England and started recruiting patients in February 2015. It brings together 18 local NHS health trusts, led by University Hospitals Birmingham (UHB) NHS Foundation Trust, which bridge an internationally-recognised, clinical and academic community, and is expected to deliver 13,500 of the 100,000 samples. The scale and diversity of the region’s unique patient population gives access to one of the largest and most interesting patient cohorts in Europe. Professor Dion Morton, a leading surgeon and director of the WMGMC, said: “The project provides an unprecedented opportunity for improved diagnosis and management of certain conditions, as well as enhancing opportunities for research and the development of treatments. “Our GMC gives us the opportunity to be a world leader in the use of genomics and genetic technologies for participant benefit within the

NHS,” he said. “Integral to this, and the adoption of the complete functional genomics pathway-from genome sequencing and DNA, through to products such as metabolites and biomarkerswill be the development of new capability and capacity for genomic medicine within the NHS and the transformation of care delivery. “It is now 16 years since the Human Genomes Project breakthrough, which led to the hope that doctors would eventually identify faulty genes responsible for specific diseases and ultimately, develop medicines to treat them. “We are instrumental in building on what has been achieved since then and moving it forward, putting Birmingham at the forefront of sciencenot just in the UK but on a global scale.” The regional initiative is underpinned by the work of the West Midlands Academic Health Science Network (WMAHSN). Dr Christopher Parker, managing director of the WMAHSN, said: “The genomics project is a prime example of how life sciences and academia can work with healthcare providers to help deliver improvements in the region’s health and wealth. “Not only will patients gain from the

transformation in diagnosis and treatment for cancer and rare diseases, but many people will also benefit from more effective prevention. “This partnership will help us to shape our workforce to operate in a transformed and growing health environment. It will benefit the population as a whole, as well as promoting the better sharing of data for research and other purposes and ultimately creating jobs for the local economy.” The West Midlands was selected for the first wave of GMCs because collectively, the partners have a track-record of providing excellence in genomic services and have been evaluated by NHS England to ensure they meet the requirements to deliver the project. After samples are collected, they are sent securely to Illumina, who have been procured by Genomics England to sequence the whole genome and to analyse it. Results are then sent back to the NHS for validation and clinical action. Some participating patients will benefit during the lifetime of the project because a conclusive diagnosis can be reached for a rare and inherited disease more quickly, or because a treatment for cancer can be targeted at the

“We are instrumental in building on what has been achieved since then and moving it forward, putting Birmingham at the forefront of science not just in the UK but on a global scale”

particular genetic change that is present in the cancer. But for the majority of patients taking part, the benefit will be in the improvement in knowledge of the influence of genetics on disease and how it is expressed in an individual; how other people with similar diseases can be helped in the future; and how different types of tests can be developed to detect changes beyond the genome. Central to the WMGMC is the newly-opened Institute of Translational Medicine (ITM), a bespoke research facility that embodies the ethos of the 100,000 Genomes Project. It is based on the QE hospital complex, which is also home to the WMAHSN. The ITM hosts five key thematic areas, including cancer and rare diseases. In September 2015, a new Centre for Rare Diseases opened there, offering a prospective cohort of patients who may wish to participate in the 100,000 Genomes Project, along with their family members. Collaboratively, the ITM and WMGMC are

“This partnership will help us to shape our workforce to operate in a transformed and growing health environment. It will benefit the population as a whole, as well as promoting the better sharing of data for research and other purposes and ultimately creating jobs for the local economy.” underpinned by state-of-the-art clinical informatics which will support knowledgesharing among the local delivery partner trusts to ensure a legacy that will benefit patients for generations to come. UHB has an international reputation for its IT and informatics systems which have been developed in-house with the involvement of clinicians. The trust, in collaboration with its academic partner, the University of Birmingham, is leading a workstream for the 100,000 Genomes Project to develop the use of digital systems and devices to support both patient and staff communications. Industry support for the 100,000 Genomes

Project comes in the form of a number of companies nationally who have come together to create the Genomics Expert Network for Enterprises (GENE) Consortium. The consortium will oversee a year-long industry trial involving a selection of whole genome sequences across cancer and rare diseases. Genomics England will also collaborate with companies which specialise in data analysis, so that the project can benefit from cutting edge advances in handling big data. The trial aims to identify the most effective and secure way of bringing industry expertise into the 100,000 Genomes Project in order to realise the potential benefits for patients. n

To personalise treatment and surveillance we can use genomic information... from a person

from a person’s cancer

from an infective organism .... to develop new treatments based on the effect of genomic changes

PROFILE

The BioHub Birmingham

Incubator collaboration aims to start-up the Midlands Engine A new partnership will bring together the best of two locations to nurture high-tech enterprise

BizzInn incubator space An exciting new collaboration between Birmingham’s two leading science parks will change the face of business support for start-ups and SMEs in the city. The Business Incubation Project proposes a partnership involving the city centre Innovation Birmingham Campus and Birmingham Research Park, in the heart of the Edgbaston medical cluster, which will extend and enhance the region’s support for innovative hi-tech SMEs in the Life Sciences and digital sector. There has always been a great spirit of co-operation between the two sites and this new partnership will combine their resources and expertise for the greater benefit of current and future entrepreneurs. Working in partnership with The University of Birmingham, and its technology transfer company, Alta Innovations, and with financial assistance from the European Structural and Investment Funds (ESIF), an holistic and structured programme of support is being created that nurtures enterprise and builds a distinguished “place” for high-tech

businesses to develop and grow. It will deliver unique access to digital and biological-laboratory facilities, sector expertise, face-to-face support from business development experts, and a wide network of professional associates. Members will benefit from a vibrant ecosystem of support: with secure incubation space; help with access-to-finance; professional advice and mentoring; training; networking and development opportunities through expert workshops, seminars and thought-provoking keynote addresses. The Business Incubation Project will provide increased exposure for fledgling businesses in the region and beyond, and provide access to an enviable network of contacts. A supportive environment makes a world of difference to the future prospects of start-up businesses. UK Business Incubation (UKBI) data has shown that such locations have proven to increase the survival rate of new companies from 50% to 80%. The Business Incubation Project will

further Birmingham’s reputation as the UK’s most entrepreneurial region and start-up ‘hotspot’. The University of Birmingham has been a pioneer in supporting new Life Sciences enterprises in the city. For start-ups with a need for a laboratory space, there’s nowhere better to get established than The BioHub at Birmingham Research Park. “The name says it all,” says CEO of Birmingham Research Park/Alta Innovations, Dr James Wilkie. “It’s a hub for bringing life and research to Birmingham; a place for biomedical start-ups to grow into something brilliant. This is the first purpose-built facility of its kind in the UK and confirms the West Midlands’ ambition to be at the forefront of life science innovation.” The BioHub has an impressive 4,500 sq.ft of biomedical laboratory space which is shared by tenants, and further individual laboratory units are planned for completion in 2017. Businesses based at the site have access to shared equipment at affordable, all-inclusive rates, and this is proving a popular finance model for life science start-ups. Probably more important for any nascent business is the proximity of The BioHub, and its sister incubation space BizzInn, to The University of Birmingham. Businesses benefit from an extensive network to business, science and technology and on-site teams offer invaluable advice and access to research expertise. Alta Innovations provides advice on investment, IP protection and business strategy – the kind of real help which can give a new business that all-important leg-up on the ladder to success. Alta Innovations has itself been involved in the commercialisation of many technologies, and there are well over 30 active spinout companies from The University of Birmingham, collectively valued at over £160m. Since opening in April 2015, new tenants have come from point of care, food technology and molecular diagnostics spheres. One such company is Linear Diagnostics Ltd, a medical diagnostics spinout company of the University of Birmingham,

The BioHub; The University of Birmingham

Lab Station includes basic equipment

“The University of Birmingham has been a pioneer in supporting new Life Sciences enterprises in the city.” founded in 2011. They are developing a bioassay platform that can detect and quantify a wide range of analytes, such as bacterial pathogens, viruses, proteins, DNA and small molecules using a combination of a novel bio-nanoparticle and an optical detector. Proximity has also been a key to the success of Innovation Birmingham in the digital environment. Their strategy is focused on a service offering for founders of new technology ventures, as well as more established tech businesses. The campus facilities include the Entrepreneurs for the Future (e4f) multi-occupancy centre, hot-desking facilities and a wide range of flexible office units (115-10,000 sq.ft). However, the campus is far from just bricks and mortar; the team actively nurtures an interactive and supportive community. They encourage people to visit and engage with the businesses based there. By creating a wide range of valuable

Old Joe tower at Birmingham University opportunities, the missing aspects of a successful business puzzle can be solved, helping innovators and tech entrepreneurs to succeed. One exciting tenant operating at the interface of digital and healthcare is the Conigital Group, a pioneering City Infrastructure technology firm. They are smart tech and systems/platform integrator whose primary goal is to create inclusive smart cities that address the needs of the visually impaired and ageing population through the use of innovative IoT (Internet-ofThings) sensors and application software. A 2,500 sq.ft Digital Health incubator will be featured within Innovation Birmingham’s Serendip® Smart City Incubator in the new £8m iCentrum® building. The NHS-funded West Midlands Academic Health Science Network (WMAHSN) has signed up as the partner to deliver the new challenge-led facility, enabling tech start-ups to access the region’s network of NHS trusts and Clinical Commissioning Groups. The ground-breaking incubation centre will seek to accelerate the growth of early stage businesses with a tech product or service offering that addresses innovative solutions to those with long term conditions, promotes wellness and the

prevention of illness, provides advanced diagnostics, genomics and precision medicine, or helps with the management of mental health. Dr David Hardman MBE, CEO of Innovation Birmingham, said: “Sitting at the heart of the new building will be Serendip®; an incubation centre purpose-designed to nurture relationships between corporate executives and entrepreneurs. Having the WMAHSN on board to deliver a Digital Health incubator is very exciting for the region. Early stage innovative companies in the healthcare sector will be able to access invaluable support by being based in this new facility.”

For further information contact The BioHub Birmingham® 0121 415 8543 thebiohub@contacts.bham.ac.uk www.thebiohub.co.uk

INTERVIEW

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Taboo subjects are increasingly rare in society, where the most intimate topics can now be exposed and examined at whirlwind pace via social media. However, outside its practitioners and their patients, mental health still largely remains a subject cloaked in secrecy, as it has been for centuries. Progress is rarely made in any sector without the spotlight of public debate, so it’s pleasing and refreshing to hear about the remarkable achievements of Birmingham and Solihull Mental Health NHS Foundation Trust and West Midlands Police. Together, they have evolved a new way of dealing with individuals whose mental health issues bring them into contact with the frontline of our emergency services. Detective Chief Inspector Sean Russell, who leads Birmingham and Solihull’s mental health work for the regional force, explains the origins of the Street Triage project. “For many years, when people suffered a mental health crisis on the street, they were typically detained by the police, and taken to what the 1983 Mental Health Act calls a ‘place of safety’. The relevant legislation is Section 136, so you will still hear of a Section 136 referral,” he says. “These unfortunate individuals were often taken to police cells, not because they had committed crimes, but simply because there wasn’t a system in place for them to be taken anywhere else. Police officers didn’t have the appropriate skills to deal with them, so it was frustrating for all concerned. “It was clear that a new approach was needed, and one of the significant drivers for change was the tragic death in 2011 of a young black man, Kingsley Burrell. He was detained in Birmingham under the Mental Health Act, and died following a prolonged period of restraint by officers and health service staff.

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Together they tackle a taboo An innovative mental health project devised in the West Midlands is gaining national attention. Ian Halstead finds out why “We began using specialist hospital units as ‘places of safety’, but it wasn’t always possible to find space in those units, and we were still seeing between 25 and 50 individuals detained in police cells every year, often because they were in a public area, and their behaviour was seen as violent.”

“We began using specialist hospital units as ‘places of safety’, but it wasn’t always possible to find space in those units, and we were still seeing between 25 and 50 individuals detained in police cells every year”

DCI Russell’s ‘day job’ is heading the unit which tackles violent crime in Birmingham and Solihull, but before joining the force 20 years ago he worked in the health service. “I wanted a more thoughtful approach and a multi-agency approach,” he says. “I’d been a medic, and had a wide range of experience on the streets with the police, so it seemed logical to bring the police and the NHS together, to provide a more sophisticated and effective response. “Birmingham and Solihull Mental Health NHS Foundation Trust really embraced the idea, and we evolved the concept of ‘Street

Triage’ response teams, where police officers, paramedics and mental health nurses were sent to incidents in teams of three. “The individuals, often young men, could be assessed and treated on the spot, then taken to places of safety. As a result, there was a dramatic fall in the number being detained under section 135, from 650 when we introduced the new approach to 333 in the 2014-2015 financial year. “The resultant savings in police time meant officers could spend more time preventing crime, and serving their communities. The presence of paramedics at each incident meant 650 fewer people were taken to A&E units, a significant benefit to the NHS, particularly at a time when its services are under so much pressure.” The new model was first extended in the Black Country, and then to Coventry, and further afield as recognition of its success became more widely known. “Our strategy is constantly evolving, and as community engagement deepens, and police officers and paramedics learn more about how mental health issues can manifest themselves, I am sure we will see the number of individuals detained continue to fall,” says DCI Russell. “It’s also very pleasing to hear that other towns and cities, and other NHS trusts, are learning from our experiences, and looking to adopt similar mental health strategies, for the benefit of everyone.” John Short, the CEO of Birmingham and Solihull Mental Health NHS Foundation Trust, says the triage approach continues to win approval from forces and NHS trusts across the country, and reports that it has recently been adopted in Dorset. “They have called it ‘Street Triage’, even though it’s a largely rural area, but because it would really stretch their resources, the nurse stays in the control-room when the teams attend incidents,” he says. “In major urban areas, these teams might receive three, four or five calls every day, but in less populated areas, the demands are much less. The number of people detained in Birmingham and Solihull continues to fall, and so far in the 2015-2016 year, no-one has

“Now, just in this one area, hundreds of people who would previously have ended up in police custody are being treated in a compassionate and effective manner”

ended up in police custody via s136, which is very gratifying.” The success of the Street Triage concept has even reached Downing Street, and Short met both David Cameron, and the chief executive of NHS England, Simon Stevens, to discuss how other innovations might be adopted within the mental health community. “I think they were surprised to hear that the old system could involve a van full of police officers being dispatched to look after an incident involving just a single person,” admits Short. “However, it is still vital to have an officer there; to provide an element of safety for the public, and to help divert these unfortunate individuals away from the criminal justice system. It’s a far more efficient use of resources, and the head of the ambulance service in the West Midlands is a great believer in this approach. “Now, just in this one area, hundreds of people who would previously have ended up in police custody are being treated in a compassionate and effective manner, and all the agencies concerned have a much sharper focus on issues around vulnerability. “In the past, it was always considered that the agency which was best at recognising vulnerability was the fire brigade, not least because no-one ever turns away a fire officer who knocks at their door. “Now we’re seeing the West Midlands Fire Service doing excellent work with housing associations, to make sure that as many people as possible understand the issues involved. The Street Triage teams are the most visible sign of the new strategy, but there’s a great deal of work going on out of public sight. “The next step, which we’re already working on, will be to engage with people more via their

Sean Russell

John Short smart phones. If individuals suddenly experience a mental health crisis, it would be a massive boon if they had a number to ring, which had someone with a medical background there who understood their personal issues. “We’ve received funding for a project to look at developing a more tailored response, and we’re the only mental health trust in the country to have that funding, which is a great compliment to the work we’ve all been doing here.” n

INSIGHT

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Jacqui Smith chairs two NHS Foundation Trusts: University Hospitals Birmingham (UHB) and Heart of England. She tells Ian Halstead about the challenges and opportunities ahead

Smith sees ‘attitude’ as the secret of UHB’s success

Jacqui Smith cemented her place in political history as Britain’s first female Home Secretary; but in the early stages of her Parliamentary career, she also served as minister for health. In late 2013, the former Redditch MP returned to that sector when asked to chair the UHB Trust, and since December 2015 has also chaired the crisis-torn Heart of England Trust, which runs Heartlands, Good Hope and Solihull Hospitals. For good measure, Smith also chairs Birmingham Health Partnership (BHP), which coordinates the research relationship with the University of Birmingham, leveraging crucial revenue streams from its innovative projects. She, and her chief executive Dame Julie Moore, were parachuted in to lead a rescue of Heart of

England after health watchdog Monitor revealed that the Trust had racked up a deficit of £30m in just the first five months of its financial year. Before turning to the woes of her ‘sickly neighbour’ though, it’s intriguing to hear Smith’s insight into the workings of the very successful UHB Trust, and its world-renowned Queen Elizabeth Hospital. “Returning to the sector, it was very interesting to see the many ways in which big data was being used, and also the tremendous strength here in research,” she says. “The QE’s reputation means it can attract doctors, surgeons and consultants who are world leaders in their field, and the quality of their work is remarkable. There are still some people who consider research a distraction, but my time here has shown the opposite is true.” Smith studied politics, philosophy and economics at Oxford University’s Hertford College and her grounding in economics was certainly a bonus when joining the UHB Trust. “We employ around 8,000 people here, and the annual turnover is roughly £800m, so it’s a major player in the city’s economy. On my first visit, I was surprised by the sheer scale,” admits Smith. “However, right since the trust was established, it has been managed and operated very tightly. I knew Julie was well regarded before I came, but working alongside her I realised just why she is so highly thought of, and we also have a very strong board of executives and non-executives. “Big data is increasingly important in all aspects of healthcare, and the trust has a very strong focus on using information to drive quality into its systems and processes. You can’t let issues develop until you are fire-fighting, so we are determined to ‘organise out’ concerns as soon as possible. “Our prescribing system, for example, was designed by clinicians, and is so effective that it enhances the professionalism of our doctors.” Smith is such a compelling advocate for the QE and the UHB Trust that it feels as if she never left her brief at the Department of Health. She does though identify what many believe is the greatest failing of NHS England: that it is too slow to intervene when hospitals or trusts run into difficulties. “News of the Heart of England’s crisis was initially difficult to comprehend, because it couldn’t have built up such a deficit in just a few

months,” says Smith. “We all thought it was the job of the NHS to solve the problems of the NHS, but that doesn’t happen. “We took our decision to help because we consider ourselves to be both pragmatic and altruistic, but the crisis revealed that the NHS system simply doesn’t have enough leaders. “The average tenure of an NHS chief executive is just two years, and it’s just not possible for any government to drive good leadership qualities into the NHS. Inspections and regulations can never be a substitute for leadership skills and experience. Monitor does set each trust targets, but there is no Plan B. There aren’t enough good hospitals which can cope with the challenges of an ageing population and tighter finances. When I was Minister of Health, the NHS was accused of not treating people over a certain age. Such discrimination doesn’t exist nowadays, but inevitably that has created additional pressures. There are also new pressures from the bottom up, as local GPs and health centres can’t cope with the rising demand.

for what, and who was accountable, so the leadership and management teams do need to be strengthened.” A formal action plan has now been presented by Moore and Smith to Monitor, with proposals for financial recovery, a new organisational structure and a strategic focus on performance. “Restoring its finances will take some time,” admits Smith. “All trusts hope to access some funding from central sources, but it isn’t healthy for any organisation to run a deficit and hope to be bailed out at the year-end.” Her medium-term hope is that Heart of England can evolve a similar culture to the UHB Trust, which Smith believes underpins its success. “Clearly, the healthcare here is excellent, but what really impressed me from the start was the attitude of everyone, the way people treat each other and how patient care really is at the centre of everything,” she says. “We’re also making great use of technology. For example, we have the ability to get real-time feedback from patients, whereas nationally, the

“We took our decision to help because we consider ourselves to be both pragmatic and altruistic, but the crisis revealed that the NHS system simply doesn’t have enough leaders” ”Some of the old certainties about peak demand are gone too. More people are living longer, and demand is just as intense in the summer as in the winter.“ As to how the Heart of England Trust might be brought out of intensive care, Smith is cautiously upbeat. “They had problems managing their A&E department, serious governance issues, and of course, they were in serious financial distress,” she says. “They had suffered from a high turnover of senior executives which inevitably impacted on how the trust was being run. “We are now stabilising its finances, and trying to import elements of best practice which work so successfully here. We’re also attempting to get our IT system, which is very good, into their systems. “It’s a complex trust in terms of its structure, so we need to bring in both financial expertise and operational expertise. Unfortunately, people there had lost track of who was responsible

NHS takes six months for the same process. “Our patients can raise issues about their ward, their treatment, their food, anything which impacts on them, and those comments will be assessed whilst they’re still with us, and if changes need to be made, they will be. “We developed BHP to maximise our revenue, and brought forward the Institute of Translational Medicine on this site, particularly for SMEs who need to test their bright ideas and gain proof of concept. It’s proved so popular that it’s already full, which demonstrates what demand there was for such facilities.” Smith also sees the onset of devolution as a major opportunity for even deeper integration at strategic and operational level between the NHS Trusts, the city council and the local LEP. “Birmingham has everything here to become a global leader in healthcare and life sciences. We have demonstrable clinical excellence alongside academic expertise and if we can gain greater control over central funding via devo, then it can not come soon enough for me.” n

PROFILE

Digital Life Sciences

Delivering healthcare in a digital world Robin Vickers, founder and managing director of Birmingham-based Digital Life Sciences, explains how its innovative services are helping implement sustainable change in the healthcare sector WHAT DOES DLS DO? Digital Life Sciences is a multi-award winning digital healthcare services and products business based in central Birmingham. The company is the only whole lifecycle digital business within the health sector (Healthcare Strategy, Business Transformation, Product Development and Localisation, Run and Manage). We are unique in the sector as a digital health company that is part consultancy, part systems integrator and part technology provider. Our customers like this uniqueness, because it means that we are able to work with healthcare business leaders, clinicians and managers to create solutions for both strategic and tactical business issues – implementing sustainable change enabled through digital technology. As a healthcare digital transformation company we find ourselves at the forefront of helping providers and commissioners to manage the population in new ways – that drive efficiency in individual provider organisations but also across pathways of care within local communities. We’re clear that there’s a new model of delivering clinically effective, high quality and safe care – that helps provider organisations to become more efficient, as well as delivering a sustainable return on investment to the wider NHS system (through improved patient management and a reduction in both A&E and ambulatory care sensitive admissions to hospital). Digital Life Sciences has recently merged with Spring Active. As an emerging provider of remote, digital and physical back pain management services this represents our first clinical pathway vertical. Our plan is to add others organically or via partnership agreements and/or future acquisitions. WHAT ARE OUR CORE SERVICES? Digital Life Sciences provides health and care organisations with a whole lifecycle approach to managing the development of new care models. Our business services include:

1. Business Strategy and Business Case Development - working with commissioners, GP federations, Health Trusts, Primary and Community Providers to develop the health and care business models that will scale in the future – and putting in place the local business cases and plans for their adoption; 2. Care Model/Pathway Design and Development – using data driven and user centred design principles to work with health and care organisations to design specific care models and pathways for their patients, care coordinators, managers and clinicians; 3. Business Transformation Roadmap and Technology Roadmap Development – helping healthcare organisations move from strategy and vision towards deployment by developing multi-stage business transformation and technology improvement roadmaps....effectively creating local transformation

“As a healthcare digital transformation company we find ourselves at the forefront of helping providers and commissioners to manage the population in new ways – that drive efficiency” and technology programme plans; 4. Business Transformation Programme Management – managing the delivery and implementation of localised new models of care, operating models, technology deployment and workforce changes – taking the organisations from start to finish through the business change process; 5. Benefits Realisation and Sustainable Commissioning – extracting and analysing population impact data across the whole provider landscape, helping local organisations to prove the value of new models of care and move them towards being commissioned on a sustainable basis;

6. Technology Hosting, Support and Management – managing all your enabling technologies under one roof, offering a one-stop-shop approach to technology – freeing up health and care organisations to stay focussed on patients whilst we look after the enablers! WHAT ARE OUR CORE PRODUCTS? At the heart of the business there are currently two core digital products: 1. DLS Access – a scalable platform, built in symphony, that enables patients to request access and receive remote healthcare consultations with NHS clinicians from anywhere on the planet; 2. DLS Care Planning – a long term care and supported self-management platform that enables patients to track and share their data – as well as connect with clinicians. DLS Access is commercially available in the market and is our most mature offer. DLS Care Planning is a pre commercial product and has been developed through publically funded R&D trials. DLS Care Planning is currently being rebuilt on to the same code base as DLS Access and being made ready for commercial use. Our intention being to ultimately offer both on a single platform SaaS basis. Spring Active is an early stage remote clinical digital-physical provider of back pain management services with back pain being the largest cause of disability in the western world. The offer is currently being market tested, with two core products: 1. HealthyBack Coach – providing a remote, early intervention, physiotherapy led video coaching service for people with back pain; 2. Premier Programme – an intensive residential, psychologist led functional restoration programme for the treatment of back pain. The back pain products are currently being market tested and refined with private sector clients with a view to ultimately offering these services on both a private pay and commissioned service model to public NHS commissioners.

Robin Vickers and Peter Dines, Digital Life Sciences Group

Who are the key people in Digital Life Sciences? Peter Dines, Chairman. Peter has significant experience in the healthcare industry with a proven track record of developing and growing successful companies. Previously, he founded Surgi C, the UK’s leading independent spinal implant supplier and Newtech Ortho, leading a successful exit of both companies. He subsequently refinanced Diagnostic World and led a successful trade exit in 2014. He is a Founder Director at Spring Active which has now merged with Digital Life Sciences as a group company. Robin Vickers, Chief Executive and Co-Founder. Former Big 4 strategy and transformation consultant, 15 years in the healthcare sector, successfully exited a niche strategy consultancy in 2008, subsequently led strategic development for a FTSE 250 services firm. Launched own business portfolio in 2009 which led to the formation of Digital Life Sciences. Deep routed sector experience and relationships in healthcare, leading the delivery of awards for care pathway development, Guardian Public Services, Medilink and HSJ. Chair of the West Midlands AHSN Industry Group and Technology Advisor to the Government’s 7-day Access Board. Keith Nurcombe, Commercial and Delivery Director – Digital Products - over 25 years experience in healthcare markets including the UK, Europe, USA and South America. Experience in pharmaceuticals, medical hardware, consumer OTC medicines and healthcare technology. Eight years at GSK including UK Marketing Director for the OTC and Oral Care markets. Led one of the largest national venture capital funded medical staffing businesses in the UK (£40m) taking the business from significant loss into profit as well as starting a healthcare technology business, O2 Health, which exceeded £25m of sales within 2.5 years of creation. Significant contacts in the NHS and UK private healthcare business as well as in European and global healthcare markets. Also a Non Executive Director for a chain of care homes in the Midlands specialising in dementia as well as a provider of GP Out of Hours services and national 111 provision across four counties.

WHAT PROBLEMS DO THESE PRODUCTS SOLVE? There are two significant problems in UK healthcare that cause very significant efficiency challenges for NHS commissioners: 1. People having an ability to access and receive a clinical consultation at times that are convenient to them (and on the same day). This lack of access to appropriate clinical advice and support on demand causes significant cost increases in the NHS due to patients going to other settings (typically A&E, Walk-In Centres, Hospitals). DLS Access resolves this problem by opening up access and shortening consultation times....thereby helping to stop people going to other, more expensive, parts of the system. 2. The growing prevalence of Ambulatory Care Sensitive (Long-Term) conditions in the UK (Diabetes, COPD, Heart Disease, Asthma, Obesity, Chronic Pain etc...) account for over 70% of the costs of the NHS system. The vast majority of these conditions can be managed outside of hospital (at lower costs), however there are currently no mechanisms for patients to be supported to selfmanage at home. This is the problem that DLS Care Planning is trying to resolve. Essentially we are trying to drive efficiency in the NHS through two solutions – giving people better access to primary care services to stop them going to more expensive services, giving people genuine support (in mobile and at home settings) to reduce ambulatory care sensitive admissions and attendances at hospital. The latter being an area where we can not only provide the digital platforms, but also the clinical support (e.g. for back pain).

For more information please contact Robin Vickers Digital Life Sciences Waterloo House 20 Waterloo Street Birmingham B2 5TB t. 0121 663 0300 m. 07834800417 robin.vickers@digitallifesciences.co.uk www.digitallifesciences.co.uk

OVERVIEW

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Feeling the pulse Integration between Birmingham’s professional services industry and its health economy is considered critical for future growth, so BQ looks at the progress being made Grant Thornton director James Cook once worked on the front-line of the NHS in Birmingham, and he’s retained his passion for the health economy. His firm’s healthcare practice spans both public and private sector, and is the largest provider of external audit services to the NHS, and the police, fire and ambulance services. “There’s been much debate in recent months about the future strategic direction of the new West Midlands Combined Authority (WMCA), but one area where it is leading the way is on mental health,” says Cook. “It has already established a Mental Healthcare Commission (MHC), chaired by the former LibDem Minister, Norman Lamb, who has a deep knowledge of mental healthcare, and a working group headed by Detective Chief Inspector Sean Russell, who has done such tremendous work on the Street Triage initiative. “Sean came to our recent Round Table on this subject, with John Short (chief executive of the Birmingham and Solihull Mental Health NHS Foundation Trust) and it was very interesting to hear about how the emergency services are working with the trust on a partnership basis. ”There is a significant cohort of people who use the police, fire and ambulance services, and in the past there were concerns that each of these bodies responded individually on mental health issues, so vulnerable people were not receiving the full range of services they required. “Now though, it’s evident that partnership working is being adopted. Sean was very passionate about the subject, and I think people are now realising that mental health issues do not simply affect the individual. “The economy is impacted by the cost of providing benefits, companies are impacted when people have time off sick and there is a significant impact on society too. It makes sense,

“It makes sense, from every perspective, if mental healthcare is regarded as a major strategic concern within the wider economy” from every perspective, if mental healthcare is regarded as a major strategic concern within the wider economy. ”It’s also crucial, as Sean and John made very clear, that individuals who are suffering are identified and treated before they reach crisispoint.” Also present at the Grant Thornton event was Steve Appleton, managing director of Oxfordshire-based Contact Consulting, a specialist research and consultancy practice, with particular expertise in mental healthcare and social work. “Our work tends to focus on vulnerable groups and their treatment within society, so we were pleased to see that the WMCA was making mental healthcare a major issue,” he says. “We’ll be working with all seven of the Metropolitan Borough Councils across the authority’s area, to see what service provision there is now, and how we might enhance and develop those services. “The work of the MHC is due to run through to July 2016, and we’ll be researching and identifying best practice in five core areas of activity; employment, housing, primary care, intervention and criminal justice. “We’ll then be factoring in what is happening in these areas from a national and international perspective, taking evidence and then making a series of recommendations about future services.

“A key focus will be issues around access to accommodation, we’ll be seeing what lessons can be learned from the Street Triage initiative, and also holding events to test public opinion in Birmingham, Coventry and Wolverhampton. “We’ll then report back to the WMCA and NHS England, and feed back ideas and suggestions to the MHC’s working group which Sean is chairing.” For EY’s Pete Shanahan, an executive director in its healthcare team, another major challenge for the health economy is how SMEs can more easily access the NHS. “The NHS has a massive challenge in trying to achieve the £22bn in ‘efficiency savings’ which the Government is demanding, especially as its budget is being reduced in real terms at the same time,” he admits. “There are also major demographic issues; the population is growing year-on-year, the percentage of people over 65 is also increasing and people are living for longer. As a result, the NHS really has to do things differently, such as making it easier for SMEs to win work with it. “Some procurement networks are quite flexible, but much more needs to be done to increase access for local firms, who could potentially provide products and services more efficiently. SMEs still have difficulty accessing the tender platforms, and there’s no reason why they aren’t allowed to approach health organisations directly.” Shanahan identifies the provision of remote digital healthcare as one area where the NHS lags behind changes in society’s use of technology. “My daughter came home at Christmas and had tonsilitis. She just couldn’t understand why we couldn’t simply take a picture of her tonsils on a phone and send it to the doctor. I’ve seen research showing that around 70% of people

have smart phones, but only 2% interact with the NHS using digital technology,” he says. “Much of our technology is developed by small-scale providers too, so like most SMEs, they struggle to engage with the NHS. I am sure many of their innovations could help make our health service more efficient and increase the level of patient satisfaction, particularly among the younger generation.” DLA Piper partner Jim Lavery sees real momentum in the evolving relationships between Birmingham’s professional services firms, the various elements of its health economy and the city council. “There’s rightly been a lot of talk about Edgbaston Medical Quarter and the Institute of Translational Medicine, but you’ve also got the Biohub, the new Dental Hospital and the private hospital which Circle Health is developing,” he says. “When you also consider what’s happening in biotech and medical devices, and the tremendous partnerships between academics and clinicians at the QE and elsewhere, there’s a real economic powerhouse being created here. “When you look at Binding Site, which has grown from a university spin-out to a high profile global business and with a wonderful reputation for innovation, you really do think that the West Midlands should be shouting out more loudly about just what it has achieved, especially in such a fiercely competitive sector. “We’re making remarkable progress with clinical trials too, and one of the biggest influences is the presence of our stable and ethnically diverse population, which was an unknown asset for so long. “The venture capital houses and the private equity players are really taking notice of our health economy now, which can only be of benefit to the organisations and companies operating in this sector. “Private enterprise is creating productive partnerships with the public sector, and Birmingham, the regional economy and the people who live here will be the winners. As will the patients who are being treated better and faster than ever before.” n

“Birmingham should be shouting out more loudly about just what it has achieved, especially in such a fiercely competitive sector”

James Cook

Jim Lavery

Steve Apppleton

Pete Shanahan

PROFILE

Birmingham Health Partners

Birmingham Health Partners’ vision is to connect people, places and pioneers to accelerate advances in healthcare A strategic alliance between University Hospitals Birmingham NHS Foundation Trust, the University of Birmingham, Birmingham Children’s Hospital NHS Foundation Trust and Birmingham Women’s Hospital (BWH), Birmingham Health Partners brings together clinical, scientific and academic excellence across an integrated medical and life sciences campus BIRMINGHAM HEALTH PARTNERS: ACCELERATING ACCESS TO DRUGS, DEVICES AND DIAGNOSTICS Birmingham Health Partners (BHP) is a strategic alliance between the University of Birmingham (UoB) and three major teaching hospitals: the Shelford Group member University Hospitals Birmingham NHS Foundation Trust (UHB), Birmingham Children’s Hospital NHS Foundation Trust (BCH) and Birmingham Women’s Hospital NHS Foundation Trust (BWH). BHP’s mission is to harness research strengths in the University and NHS to deliver better treatments and care to our patients. Accelerating patient access to new innovative medicines and technologies is at the heart of what we do in Birmingham. We improve patient care and well-being by facilitating discoveries made in the laboratory and translating them into clinical practice as quickly as possible. Birmingham can do this at a pace, scale and efficiency which is unrivalled in the UK. Globally, we are one of the few cities equipped to deliver the full circle of translational medicine and BHP is the driving force behind the Birmingham life sciences engine.

INTEGRATED HEALTHCARE RESEARCH INFRASTRUCTURE Birmingham has a superb campus that encompasses, within a 10-minute walk, major hospitals, world-class research facilities at a leading Russell Group University, major clinical trials units and clinical research facilities, the Institute of Translational Medicine (ITM) and the Biohub, which provides incubator space for startup companies. BHP has: • An Advanced Therapies Facility and Human Biorepository • The NIHR Clinical Research Facility (incorporating both paediatric and adult studies) • The UK’s largest regional genetics diagnostic service and the West Midlands Genomics Medicine Centre • World-leading clinical digital systems within UHB which are integrated with the UoB’s Centre for Computational Biology (CCB) for granular level informatics and stratified patient data. With one of the largest clinical trial portfolios in Europe, delivered through three UK Clinical Research Collaboration-registered Clinical Trials Units, state-of-the-art facilities for experimental medicine and world-class academic expertise, Birmingham is the go-to place to ensure accelerated execution and adoption of clinical trials in a real life setting. Birmingham has an integrated research and innovation platform that covers the full circle of translational medicine: from discovery, development and validation through to implementation and ultimately evaluation in

Institute of Translational Medicine reception

“The ITM allows clinicians, academics, methodologists, patient groups and industry partners to maximise their interaction” clinical practice. We are the largest national centre for the 100,000 Genomes Project, which aims to improve the prediction and prevention of disease and the personalisation of therapy through the use of more precise diagnostic tests. Our ability to deliver in this area is facilitated by our access to large patient cohorts allied to extensive bio-banking capacity, underpinned by innovative pathology services and world-leading expertise in diagnostic testing methodology. UNIQUE POPULATION Patients are our greatest resource and asset. Birmingham and the West Midlands has a socially and ethnically diverse, non-transient population of over five million. It is the youngest population of any UK city. This has allowed us to collect large and well phenotyped cohorts of patients and controls which include both common conditions and an extensive portfolio of rare diseases. In addition, Birmingham is renowned for its expertise in using informatics to improve patient care. Our systems can be integrated with national and international databases providing us with access to large and complex datasets through which we address fundamental issues around patient characteristics, treatments and clinical outcomes.

THE PARTNERS The £545m Queen Elizabeth Hospital Birmingham (QEHB), run by University Hospitals Birmingham NHS Foundation Trust (UHB), was opened in 2010 and hosts a range of leading-edge local, regional and national services, including the largest solid organ transplantation programme in Europe; the largest renal transplant programme in the UK; a specialist centre for liver, heart and lung transplants and cancer studies; and the Royal Centre for Defence Medicine. UHB houses state-of-the-art clinical informatics, with one of the most advanced electronic data systems in the world. Clinical, prescribing and outcome data are all captured on an integrated database, permitting advanced analysis of patient outcome and rapid identification of suitable patients for clinical trials. BHP is the home of the ITM, a single point of entry for individuals, organisations and businesses seeking to maximise biomedical research translation for the benefit of industry, the economy and, ultimately, patients. As a central meeting point and working hub, the ITM allows clinicians, academics, methodologists, patient groups and industry partners to maximise their interaction and develop productive collaborative networks.

For more than a century, research from the University of Birmingham (UoB) has created a major impact on the city, the region and the world. UoB brings people from across the world to the city, including researchers and teachers and more than 4,000 international students from over 150 countries. Home to nearly 30,000 students and with more than 7,500 postgraduate students from across the globe, UoB plays an integral role in the economic, social and cultural growth of local and regional communities, working closely with businesses, employing 6,000 staff and providing 10,000 graduates annually. UoB is in the midst of one of the most exciting and transformational campus redevelopments since the first phase of building on our Edgbaston campus was completed in 1909 under the auspices of Sir Aston Webb. The development, worth close to £400 million over the next five years, will create outstanding new facilities which will benefit students, staff, visitors and the local community, while drawing on Aston Webb’s original campus masterplan, as well as subsequent plans, and laying a sound basis for the future. Birmingham Children’s Hospital NHS Foundation Trust (BCH) provides a comprehensive range of paediatric and child and adolescent mental health services to patients from Birmingham, the West Midlands and beyond. BCH is the largest specialist UK centre for paediatric diabetes, childhood cancer, intestinal transplantation and inherited metabolic diseases, and has recently been selected as one of only three UK NSCAG Lysosomal Storage Disease treatment

centres. BCH is second only to Great Ormond Street with regard to the range and number of patients with rare diseases that are treated and together with King’s College London, has the largest paediatric liver transplantation programme which is closely integrated with the adult programme at University Hospitals Birmingham NHS Foundation Trust. It is a key hub for the NIHR Medicines for Children Network. BCH CRF caters for children with cancer, obesitydiabetes, liver disease and inherited metabolic diseases in accordance with our scientific research strategy. Several specialty-based research clinics have been established in the facility, which enable patient screening and recruitment to research studies to be undertaken in tandem with routine outpatient appointments. Birmingham Women’s Hospital NHS Foundation Trust (BWH) is one of only two ‘stand alone’ maternity hospitals in the UK and is a centre of clinical and research excellence. All four clinical specialties within the hospital (maternity, gynaecology/fertility, genetics and neonatology) contribute significantly to deliver research of the highest quality which has national and international impact. BWH brings strength to BHP to ensure the collaboration covers all major aspects of medical care. Human development is predicated upon the transition from ‘gametes to new-born’ and then tracks through childhood, being influenced by the environment. Many adult morbidities such as cardiovascular and metabolic diseases have their origins in peri-conceptual and prenatal life; BWH builds on the links with the University of Birmingham, Birmingham Children’s Hospital and University Hospitals Birmingham to enable closer collaboration between researchers in women’s health, genetics, paediatric and adult medicine and the development of a partnership which encompasses aspects of healthcare from conception to late adulthood.

Mike Smith, Commercial and Intellectual Property Manager +44 (0) 121 371 4222 Michael.Smith3@uhb.nhs.uk http://www.uhb.nhs.uk

INTERVIEW

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Clancy speaks his (open) mind Birmingham City Council leader counillor John Clancy sat down with Ian Halstead to discuss the city’s healthcare and life sciences economy - and much more

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It’s been barely four months since John Clancy finally toppled Sir Albert Bore as leader of the council’s controlling Labour group, so he’s still discovering the myriad challenges of running Western Europe’s largest local authority. These include the Whitehall-imposed requirement to slash £800m from the city’s budget by 20192020, maintaining its array of services, addressing its major housing shortfall and implementing radical changes to address the damning Kerslake Report into the council’s operations. Whilst also driving forward Birmingham’s physical renaissance, and ensuring that its economy and its manufacturing base can continue to prosper. Not forgetting of course, the impact on the city of the Government’s devolution agenda and the creation of the fledgling West Midlands Combined Authority. It’s an accumulation of tasks which would surely cause Hercules to blanch, but already Clancy has made two decisions of major significance, which in the years to come could well define his leadership. The first was to appoint Waheed Nazir, the council’s wellrespected director of planning and regeneration, to lead on economic strategy, giving him a seat within the corporate leadership team. He’s already demonstrated an imaginative approach to regeneration, and proved capable of handling a prodigious workload, earning respect on both counts from the region’s property and development community. “We need people who can be creative in how they think and how they address challenges,” says Clancy. “Some issues are going to be gamechangers for the city’s economy, which resonate with investors and occupiers; HS2 is certainly one, so is modern manufacturing, and healthcare and life sciences is another.” Secondly, Clancy has demonstrated a welcome willingness to embrace the views of others, and his inner circle of advisers includes Aston University’s Professor David Bailey, Birmingham Airport’s CEO, Paul Kehoe, and Marketing Birmingham’s chief executive, Neil Rami. It’s not yet evolved to become a Ministry of All the Talents, but is a refreshing contrast to previous city council leaders. “We need to be innovative in how we address our challenges, how we devise our future pathways, and how we come up with solutions which are effective and pragmatic,” says Clancy. “There has to be a nexus in which ideas from different sectors can be considered and discussed.

“There’s no single route to economic success at any level, although we do have an advantage because Birmingham is famous for manufacturing innovation, in both products and processes. “For decades, we’ve been known as the heartland of Britain’s automotive industry, and thanks to the success of JLR and others, we’ve been able to maintain that reputation, but new manufacturing models are increasingly important – the use of 3D printing across an array of business sectors, for example. “The healthcare, life sciences, pharma and biotech sectors are becoming hugely important to Birmingham, particularly in the Edgbaston Medical Quarter (EMQ), and it’s very pleasing to see many examples of partnership working between our universities, the public sector and the private sector. “It’s crucial to have a vision, but it’s also critical that the vision is shared. Take the Life Sciences Campus project, for example. We are the lead partner on a £180m project to transform a derelict and contaminated industrial site into

“It’s an accumulation of tasks which would surely cause Hercules to blanch, but already Clancy has made two decisions of major significance” a science park with 400,000 sq ft of space for offices, laboratories and research. “The Greater Birmingham and Solihull Local Enterprise Partnership (GBSLEP) shared our commitment, and was able to access £5m of funding from the Local Growth Fund. The campus is close to the QE site and the University of Birmingham, so it’s a very attractive location for local, national and international occupiers. “I am confident that we will see ground-breaking medical innovations there, and we are also working with the LEP to develop links between the campus and the city’s professional services community. The outcomes for our economy will be tremendous, and something like 2,200 jobs will be created directly. The success of the EMQ, and the potential of the Life Sciences Campus, are also tremendous stories to tell within the UK.” As cuts continue to savage local authority budgets though, innovations in funding are required, not merely in new partnership models

at the operational level. Clancy, a lawyer by training and economist by inclination, is much taken by the concept of ‘Brummie Bonds’, where the council-and the regional local government pension fund-could use their underutilised assets to guarantee new investment products, to attract new revenue streams from banks and institutions. Remarkably, at least to non-economists, the city council has more than £6bn of assets, and the West Midlands Local Government Pension Fund has accumulated not far off £11bn. Clancy would like to see the new funding used for multiple uses, notably housing, but also for infrastructure projects and for the city’s new economies, such as the fast-growing healthcare and life sciences sector. He’s been banging on about Brummie Bonds for years, long before the Government’s austerity agenda was conceived, but now it seems it’s an idea whose time has finally come. The idea has certainly gained traction with the Government’s Life Sciences Minister George Freeman, who spoke with enthusiasm on the subject whilst attending BQ2’s Live Debate at Birmingham’s ICC. It’s no surprise therefore to learn that a private meeting has been arranged between Clancy and Freeman, when the concept of Brummie Bonds can be discussed in detail. “I’ve always liked the idea of issuing bonds, or having a local Municipal Bank, or a Regional Investment Bank, or even a sovereign wealth fund for the West Midlands,” admits Clancy. “It’ll be interesting to test the water with George, to see what the feeling inside the Government might be about Brummie Bonds. I’m a great believer in economic self-determination. You don’t want to go cap-in-hand to the City for money, but being able to offer a viable investment opportunity is something different. “We as a council need to be open to new ideas, just as Birmingham needs to be open to them. We’re already seeing engagement between ourselves, the universities and the city’s financial and professional services sector with regard to the EMQ, the Life Sciences Campus and The Biohub. Looking forward, I’d like to see that really evolve into genuine and long-term partnerships, where we can engage with the great thinkers along Colmore Row for everyone’s benefit. If it works for the healthcare and life science sectors, it can work for other business sectors, and our city and its people will be the winners.” n

PROFILE

NIHR CLAHRC West Midlands

Creating lasting and effective partnerships across health and social care organisations and universities The Collaboration for Leadership in Applied Health Research and Care West Midlands (CLAHRC WM) is a five-year initiative funded by the National Institute for Health Research (NIHR) and by matched funds from local health and social care partner organisations. The NIHR income supports the service evaluation programmes and the matched funding supports the

service developments and their implementation, through the mobilisation of Leadership and Diffusion Fellows embedded in the services. The initiative’s mission is to create lasting and effective partnerships across health and social care organisations and universities to improve services for patient benefit. In addition, we have an overarching goal to combine the Patient and Public Involvement

(PPI) that informs service development and delivery, with the PPI that informs the research and evaluation thereof. Given the scale of problems faced by health and social services, the CLAHRC WM is oriented around ‘big ticket’ topics – services where decisions have major consequences for human health. Based on extensive discussions with stakeholders, four ‘service’ themes have been established:

Maternity and child health led by Professor Christine MacArthur, University of Birmingham www.clahrc-wm.nihr.ac.uk/research/theme1maternity-child-health

Prevention and early intervention in youth mental health led by Professor Max Birchwood, Warwick Medical School www.clahrc-wm.nihr.ac.uk/research/theme2prevention-early-intervention-youth-mental-health

Prevention and detection of diseases led by Professor Aileen Clarke, Warwick Medical School www.clahrc-wm.nihr.ac.uk/research/theme3prevention-detection-diseases

Chronic disease (integrated and holistic care) led by Professor Jon Glasby, University of Birmingham www.clahrc-wm.nihr.ac.uk/research/theme4integrated-holistic-care-chronic-disease

Case study 1: Ground-breaking early intervention service in Birmingham offers mental health services for young people aged 0-25 Clinical evidence suggests that half of all lifetime mental health illnesses begin by the age of 14 and three quarters by age 25 (excluding dementia). This is reflected by increased referral rates to Child and Adolescent Mental Health Services (CAMHS) in recent years. However, research by CLAHRC WM Theme 2 (Youth Mental Health) revealed that many young people with first-episode psychosis face long and damaging treatment delays in their care pathways. While such delays can be due to poor helpseeking behaviour, CLAHRC WM research highlighted how bottlenecks in specialist mental health services were of most serious concern. Problematic transitions to adult services were also highlighted, with the previous cut-off in traditional CAMHS at age 16 leaving many young people ‘in limbo’, right at the point when they are clinically most vulnerable. As a result of this research, CAMHS in Birmingham will now be offered for young people aged 0-25.

Dr Diane Reeves, Chief Accountable Officer of Birmingham South Central Clinical Commissioning Group (CCG), described Theme 2’s work as the “key plank of local, high-quality research which influenced the development and re-commissioning of youth mental health services in Birmingham.” The new service will be provided by Forward Thinking Birmingham (www.forwardthinkingbirmingham. org.uk) led by Birmingham Children’s Hospital NHS Foundation Trust and the evaluation will be led by our own Theme 2 at the Universities of Warwick and Birmingham, assessing its mobilisation and impact including outcome indicators in the NHS Outcomes Framework. The 0-25 ‘Birmingham’ model is also being exported to other parts of the country, including Norwich, Oxford and Mersey Care NHS Trust. For further information on this project, please visit: www.clahrc-wm.nihr.ac.uk/research/theme2prevention-early-intervention-youth-mental-health

Case study 2: Managing and treating back pain appropriately reduces the burden on health services and benefits the wider economy

In addition to the four clinical topics, we have two cross-cutting themes, which provide collaborative support to the service themes, and conduct research on the basis of learning across themes:

Theme 5 – Implementation and organisational studies led by Professor Graeme Currie, Warwick Business School www.clahrc-wm.nihr.ac.uk/research/theme5implementation-organisational-studies/

The CLAHRC WM initiative undertakes a number of collaborative projects linked to the Themes listed above. Please visit www.clahrc-wm.nihr.ac.uk for a full list of projects. CLAHRC WM also has an active role in developing capacity for service delivery research in

academia, the health service and among patients and the public. We are also contributing to the ‘wealth’ of the region though our engagement with industrial partners and commercial enterprises. We highlight a number of case studies to demonstrate our impact

Theme 6 – Research methods led by Professor Richard Lilford, Warwick Medical School www.clahrc-wm.nihr.ac.uk/research/theme6research-methods

on health service provision in the West Midlands and beyond. We are working with other NIHR initiatives and CLAHRCs to contribute to the NIHR at 10 media campaign to show we are improving the health and wealth of the nation through research.

Back pain is the most common reason middle-aged people visit their GP and the second-most-common reason for sickness absence from work. To assist the management of lower back pain, CLAHRC WM has developed a brief screening tool for use in clinical practice: STarT Back. STarT Back is an example of stratified care for low back pain, whereby patients are screened for the type and likely duration of back pain and are matched to appropriate care pathways. STarT Back has been shown to be both clinically and financially effective, by reducing over-treatment of low-risk groups, and ensuring the management of this group remains in primary care, with more effective

and efficient matched and targeted treatment for medium- and high-risk groups provided by physiotherapists in community and secondary care settings. A linked study demonstrated that applying the STarT Back approach provided a 40% reduction in the referral of low-risk groups, while medium- and high-risk groups gained earlier access to therapy, improved outcomes and a significant reduction in wait times. In early 2014, the West Midlands Academic Health Science Network (WMAHSN) supported a funding application to extend the STarT Back approach to care management across the West Midlands, to support GPs in using the tool and train

physiotherapists in treatment approaches. Telford & Wrekin CCG and Shropshire Community Trust reduced physio wait times from ten to four weeks. To date, 14 of 22 West Midlands CCGs have implemented the toolkit. The project developed industry partnerships with EMIS (Egton Medical Information Systems) and www. patient.co.uk. These partnerships have allowed the tool to be integrated into the GP clinical system, enabling automated completion and access to high-quality patient information and auto-referral to appropriate matched treatments. The approach has been adopted by CLAHRCs/AHSNs in North West Coast and North East Coast. For further information on this project, please visit: http://www.keele.ac.uk/sbst/

CLAHRC West Midlands For further information www.clahrc-wm.nihr.ac.uk @CLAHRC_WM Join our News Blog http://clahrcwmblog.wordpress.com/

INSIGHT

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Big data means big opportunities Tim Jones, the executive director of delivery at University Hospitals Birmingham (UHB) NHS Foundation Trust, crunches numbers with Ian Halstead Big Data is Big News … and Big Business too. With the NHS under ever-increasing financial and demographic pressures, each NHS Trust and every hospital is desperate to drive greater efficiency into its operating model. For those that succeed, the rewards will be significant, especially if they can create their own digital platforms which are commercially attractive to others, and then use anonymised patient data to create revenue streams from pharma companies and elsewhere. However, the same pressures which are the catalyst for change also mean immense workloads for those individuals tasked with delivering more from less. Fortunately for patients in Greater Birmingham, UHB has long been a national pioneer of big data and innovative strategic IT solutions.

Leading the trust on all things digital-and on just about every other aspect of its operations, including education, HR, organisational development, performance, research and strategy-is its executive director of delivery, Tim Jones. It’s a rather vague title, especially for someone who is anything but, as Jones makes clear with a precise and considered assessment of how the world of the NHS meets the new technological universe. “Healthcare has been one of the slowest adopters of digital and big data, which is puzzling given the number of statistics and the

amount of information it generates,” he admits. “The biggest challenge was developing the right data platform, but we were very aware of what needed to be done, and developed our own system for prescribing drugs which gave us a huge advantage. ”Saying that, however much data you accumulate it’s not an end in itself, of course. The key is how you translate the data into meaningful actions and better outcomes for patients.” The original platform was created at UHBthrough collaboration between clinicians and

“The same pressures which are the catalyst for change also mean immense workloads for those individuals tasked with delivering more from less”

academics-some 15 years ago-but Jones says the trust has been able to maintain its lead in the healthcare IT sector through constant innovation, and the willingness to commit significant human and financial resources. “I suspect that most people outside the NHS aren’t aware of how much happens at major hospitals, just in terms of patient numbers and prescriptions,” says Jones. “We have a phenomenal amount of data passing through our systems day-in and day-out. We issue something like 20,000 prescriptions every week, and deal with around 2,000 out-patients every day at the QE site. “The vast majority of hospitals still use lots of different pieces of paper, with pens of different colour, and I really don’t know how they manage to cope. “Since we rolled out our system across all areas of the hospital, it has become the bedrock of our clinical support system, and we’re always fine-tuning it to ensure that greater levels of efficiency are delivered.” The QE only opened in 2010, meaning it had years of existing patient data from the previous QE which needed to be integrated into the IT system. “We looked at different ways of efficiently accessing the old paper-based information. Back-scanning was considered, but the quality wouldn’t have been great and it would have cost between £1m and £2m,” says Jones. “The best solution was to develop a clinical portal, which could store previous records, and also provide real-time access to current patient data.” The new portal has subsequently generated huge benefits within the complex and lengthy training programme for junior doctors, although that wasn’t a catalyst for its development. “There’s an enormous amount of detail about the way we work, about patients, about the hospital’s operational structure, and information about our systems and processes for them to acquire in their first twelve weeks,” says Jones. “Our clinical portal monitors every patient, every drug and every dose, and we calculate that it prevents around 20,000 errors by junior doctors in prescribing every year. Mostly, they’re very

“Our clinical portal monitors every patient, every drug and every dose, and we calculate that it prevents around 20,000 errors by junior doctors in prescribing every year” small errors, but it’s reassuring to know that the portal is there as a back-up. “We have built-in a system of ‘nudges’ and checks for patient protection, to ensure the correct drug is always given in the correct amount for the right condition or illness. If someone tried, for example, to prescribe too much of a certain drug, or to the wrong patient, the system would simply refuse to accept the instruction.” The clinical portal and its prescription system have also created remarkable improvements in the speed at which tests and processes can be carried out. “We looked at the data for infection control, when checks were being made for the possible presence of the MRSA bug, before ‘decolonisation’ could be carried out, and it was taking 48 hours for the results to get back from the lab to the ward,” admits Jones. “We were able to automate the process, and

now the delay is just five seconds. Nurses can carry out the tests, and then administer the drugs (if required) immediately. We’ve also been able to sharply reduce the amount of drugs being prescribed-but then not used in full. “The typical figure for any NHS hospital is around 20%, but by more precise monitoring and checks, we’ve got that down to around 10% and 11%. “There’s always going to be an element of wastage when prescriptions are being issued, because it’s impossible to predict exactly how much of each drug will be needed, but I think we can get the figure down to between 5% and 6%, which would be a massive cost benefit for us. ”By crunching all the data, we can also now take real-time action about the level of drugs which are available. If, for one example, one ward is running low, then the system will inform the staff. “It’s not just about being more efficient, delivering better outcomes for the patients, and reducing our drugs’ bill though, we also see this process as an integral element of the training process, as it does make the junior doctors more aware.” However, Jones is concerned that many manufacturers of medical devices have not yet tweaked their business models, to take full advantage of their technological innovations. “The use of ‘wearables’ hasn’t taken off as expected, largely because the industry has failed to realise that the value is in the data, not the device itself,” he says. “It would be useful to have all this automated data, but staff still need to visit patients and talk to them. We have around a million patients a year, so the cost per unit is prohibitive. If hospitals have to pay £50 per unit for each patient, no-one can afford it. “The traditional model, of recouping R&D costs in the first year or two, just doesn’t work. Manufacturers need to engage more with clinicians and much earlier. Perhaps they could also look at partnership models with hospitals, because the current strategy by the device makers isn’t helping them, the NHS or the patients.” n

SUMMIT REPORT

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Setting out on the pathway to investment Clinicians, academics and business leaders learn of new collaborative opportunities and funding at the second Health and Wealth Economic Summit in Birmingham Last year’s launch of a seven point growth plan saw the West Midlands Academic Health Science Network (WMAHSN) set out how it will be making the West Midlands an internationally attractive arena in which to do business and discover tomorrow’s innovations, as well as making UK healthcare a sought after product overseas. At the second Health and Wealth Economic Summit at the Botanical Gardens, the WMAHSN shared the progress that’s being made and introduced the new services that will support innovations, opportunities and collaboration between healthcare, academic and industry stakeholders in the West Midlands. Professor Michael Sheppard, chair of WMAHSN

explained: “We have two objectives. To improve the health of people in the West Midlands and to generate economic growth. We ask, how can we further these objectives?” WMAHSN’s commercial director Tony Davis began by setting the scene: “We face the creation of a combined authority and devolution. The local enterprise partnership (LEP) is an important part of the landscape. Before we can look at the opportunities, we need to ask what challenges these will bring and what steps do we need to take in order to be ready? “We’re introducing secondments, actively looking at supporting the Greater Birmingham and Solihull LEP. We’re also investing in partnerships. A great example of this is the

Institute of Translational Medicine, a hub that enables closer working. We won’t stop there: we will continue to work with and interact with partners. “We have EU programmes including the European Institute of Innovation and Technology Health Knowledge and Innovation Community (EIT Health KIC), a consortium of European businesses, research centres and universities. Three programmes have been funded, plus more testbed activity. Working with the LEP’s Employment and Skills Board, we’ll identify skills shortages and needs, because if we truly change healthcare delivery, we will need a skilled workforce. This must be a key consideration as our productivity gap needs to be addressed.”

Tony Davis introduced the new secondees to WMAHSN. Taking up the mantle as medicine’s optimisation lead was Geoff Quinn, regional senior key account manager for the Midlands and East at Pfizer. Geoff appealed for clinicians to get in touch: “What we’re doing must fit with what everyone else is trying to achieve, so please shout and engage.” A second secondee, Richard Devereaux Phillips from the Association of British Healthcare Industries, took to the stage. As WMAHSN’s new Greater Birmingham and Solihull Local Enterprise Partnership Life Sciences strategist, he is still developing the new role. Setting out his priorities, he said: “There is work to do. We must define and scale the opportunity for the West Midlands, addressing finance, the integration of data systems and looking at attracting people in. Birmingham has a great offer and we need to raise awareness of it. With the life science campus coming next to the largest hospital, this is a most exciting time. We’ll be judged on what this looks like in ten, 15 and 20 years’ time.” Taking this point, Michael Sheppard addressed Tony Davis: “We’ve been talking about this for some time, but what’s the difference? Is it just marketing?” Tony replied: “The region has the capacity and

capability, but we’re not there yet. We have a lot to be confident about and we should stop being so modest and shout more about what we do. In comparison to the strength of our region, the devolution case for Manchester is just smoke and mirrors.” Articulating these strengths, WMAHSN’s business manager Lucy Chatwin introduced delegates to the Meridian online health innovation exchange, describing its role as ‘innovation push and pull’. “What is working elsewhere, can come here and we support the adoption of that. For example, we’ll ask the question, ‘How can we empower mental health carers?’ Then it’s over to clinicians, academics and businesses to submit their answers. We want to find proven innovations where we can immediately recognise the value to the healthcare organisation and reduce the timescale for adoption and scalability. Our success in this, and that of Meridian, will be based on the principle of a ‘return on involvement’.” Meridian will sit alongside the services provided by MidTECH on intellectual property management for healthcare and an app, which enables busy clinicians to capture innovative ideas that strike them during practice, avoiding the possibility that they will be lost. MidTECH’s

“In comparison to the strength of our region, the devolution case for Manchester is just smoke and mirrors.” senior innovation manager James Turner explained: “Our main goal is to capture ideas and help get money back into the NHS. Using the app, clinicians can quickly jot an idea down and fire it over. We then work with them to find a partner who can make a product fit for purpose.” Providing further access to potential industry collaborators, Medilink West Midlands will manage the new Industry Gateway Service, contracted by WMAHSN to be an access point for industry. Delegates were given the opportunity to table questions to an innovation and adoption panel, which included MidTECH’s James Turner, commercial development manager for University Hospitals of North Midlands NHS Trust Tammy Holmes, NHS England programme manager Rob Chesters, founder of Digital Life Sciences Robin Vickers and David Farmer, the deputy clinical director of South Worcestershire Clinical Commissioning Group (CCG).

SUMMIT REPORT bqlive.co.uk

Asked what strengths could the West Midlands exploit, Robin began: “We have great people and influencers. A great community of products and ideas. What we need is a clear handle on money, as everything requires investment and people ready to pay. At the moment innovation is made in Birmingham and scaled elsewhere.” This led to the enquiry: “How would you encourage a small business to work with the NHS?” James responded: “Start a simple conversation with MidTECH. We can stop people going down a long and costly road. We can identify where you can get the best advice so you need to come to us early. Commissioning can be glacial, but if you’re providing solutions, it’s faster. We can ensure you’re genuinely answering commissioners’ and patients’ needs.” The afternoon session of the summit focused on funding and the best approach to take to accessing investment. Lucy Chatwin announced the launch of the SME Innovation Fund, which will provide loans for early stage technologies addressing long term conditions, mental health, genomics or wellness. Bethan Bishop, who manages innovation and industry engagement for the Heart of England

“When we collaborate, we solve problems. We have so many challenges in healthcare, we can’t do it ourselves. We must work much more collaboratively.” Foundation Trust, followed with news of the Interactive Healthcare Fund, which will focus on collaboration: “We’re articulating real challenges that we face every day and taking those challenges to SMEs. When we collaborate, we solve problems. We have so many challenges in healthcare, we can’t do it ourselves. We must work much more collaboratively.” The summit concluded with another opportunity to question a panel of experts, this time focusing on funding and finance for innovation. Peter Dines, investment director at Mercia Technologies, senior European policy manager for the NHS European Office Michael Wood, head of regeneration at University Hospitals Birmingham NHS Foundation Trust, David Taylor, WMAHSN’s Paddie Murphy and Bethan Bishop faced the floor. Reminding delegates of the funding

opportunities opening up from the Horizon 2020 programme, Michael Wood offered advice to organisations looking to get involved. He explained: “What does the West Midlands do well? Don’t just chase money – rather focus on your core skills. Think about what you can offer in the areas covered by the EIT Health KIC. Thanks to Paddie Murphy’s work, this region will get calls. Your phone will ring from Europe. Who will we get involved? What’s the business plan for the West Midlands? You must match your strengths with our EU knowledge.” Questions concentrated on investment and funding pitfalls. David Taylor warned: “You need to collect data properly from day one. You will be audited, and it will be severe. Set aside, as part of the bid, an admin charge to cover good management.” Summing up her perception of the pitfalls, Paddie Murphy said: “I’ve seen so many solutions in search of a problem.” Closing the summit, Professor Michael Sheppard reflected on the remarkable progress made in the last year. He concluded: “We must sweat the economies of scale, identify strengths and clearly state our assets. We’re all focused on the best outcome, whether it’s a health outcome, or a wealth outcome.” n

DO YOU HAVE A HEALTHCARE INNOVATION OR CHALLENGE? THEN WHY ARENâ&#x20AC;&#x2122;T YOU USING MERIDIAN? Meridian is the pioneering online innovation exchange for the healthcare community from the West Midlands Academic Health Science Network.

Anyone - including from the NHS, academia, industry, public and the third sector can share their innovations and ideas, swap success stories, build networks and contact others whose innovations could revolutionise healthcare in the West Midlands.

Users can also upload their healthcare challenges and needs via campaigns, inviting solutions through new or existing innovations, speeding up the adoption and spread of good practice across the region.

Join the Meridian community for free now at meridian.wmahsn.org meridian@wmahsn.org | @wmahsn | 0121 371 8061