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BUSINESS QUARTER WEST MIDLANDS: Special Report - Life Sciences and Healthcare

FAR SIGHTED Catching up with two innovative healthcare start-ups which are looking to the future

TAKING ON THE TABOO Ambitious proposals to improve mental health in the West Midlands

BENCH TO BEDSIDE Interview with the Institute of Translational Medicine’s new director Professor Subrata Ghosh

Health and Wealth

How the West Midlands’ life sciences and healthcare sectors are tackling the challenges of tomorrow

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WELCOME

LIFE SCIENCES AND HEALTHCARE

CONTENTS 08. LOOKING TO THE FUTURE Profile of two healthcare start-ups 12. ON THE GLOBAL STAGE Calthorpe Estates’ Mark Lee on Edgbaston Medical Quarter 16. TRIALS THAT BENEFIT US ALL Looking at the importance of clinical trials 18. TACKLE THE TABOO Talking to two men driving mental health improvements 22. BATTERY CHARGED A look at a new £171m Life Sciences Park

The national news agenda has been awash with gloomy stories about the NHS for months, so it’s very satisfying to report that there are many positive stories to be discovered in Greater Birmingham’s healthcare and life sciences sectors. The arrival of Professor Subrata Ghosh has given the Institute of Translational Medicine a charismatic leader with a world-class reputation and an entrepreneurial mindset perfectly suited to these challenging times. The ambitious £171m scheme to deliver 400,000 sq ft of new space at Birmingham Life Sciences Park and the expansion plans at the Innovation Birmingham Campus, testify to strategic vision on a grand and global scale. The Edgbaston Medical Quarter and Pebble Mill are also attracting attention on the international stage, and the government has awarded ‘centre of digital excellence’ status to the University Hospitals Birmingham NHS Foundation Trust. Meanwhile, innovative start-ups such as Give Vision, Kaido and Linear Diagnostics are pioneers of the next generation of healthcare businesses. Many challenges lie ahead, to be sure, but there’s a great deal to admire - and much of which to be proud. Ian Halstead, Editor

24. FACING THE CYBER THREAT Cyber-security issues facing the healthcare and life sciences sectors 28. ONE AT PEBBLE MILL Talking to Calthorpe Estates’ Ralph Minott 32. BENCH TO BEDSIDE Interview with Professor Subrata Ghosh 38. UNDER THE MICROSCOPE Three opinions on the challenges ahead for the region’s healthcare sector 46. OUR WAY FORWARD Report on leading summit to look at challenges and opportunities

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Magnolia House inspires pride Scheme up for award

Birmingham Children’s Hospital NHS Foundation Trust (BCH) has invested £1m on a new bereavement support centre, so hundreds of parents and young people can have life-changing conversations each year in a ‘home-fromhome’ sanctuary. The first of its kind in the UK, and funded entirely by charitable donations, Magnolia House sets the benchmark for palliative and bereavement care across the country, ensuring that devastating news is no longer delivered in offices, empty cubicles or even playrooms. Every element has been designed together with bereaved families; from the pastel-coloured interior and the comfortable furniture, to the floor-toceiling windows that allow for lots of natural light, as Nicki Fitzmaurice, BCH’s Palliative Care Lead explains. “The families we care for have wanted a space like Magnolia House for such a long time and thanks to hundreds of charitable donations, we can now offer an environment that gives parents a chance to process life-changing news, ensuring they are able to focus on being emotionally available to their child. “Feedback from families was clear, it needed to be unlike any other area in the hospital, not smell or sound like a busy ward and have lots of natural light, so they didn’t feel like they were enclosed. We’re proud to have created a setting that honours them.” Magnolia House is located centrally on the BCH site, and named because of the trees found in its surrounding garden. It has two private counselling rooms, a calming lounge area, kitchen and dining space, a play area for siblings, and a peaceful and private garden where families can sit and reflect. It also has a large and private family room complete with its own bathroom, kitchen and garden. Fundraising was spearheaded by the hospital’s near-neighbour Wesleyan. The financial mutual successfully raised £750,000 of the required £1m, thanks to more than 200 fundraising activities, and the final £250,000 was raised through public donations.

The new £50m Birmingham Dental Hospital and School of Dentistry has been shortlisted for a hat-trick of awards at this year’s Royal Institute of Chartered Surveyors (RICS) West Midlands Awards. The first development to be built on Calthorpe Estates’ Pebble Mill scheme will offer cutting-edge treatment to a patient population of around 1.5m, while also securing the future of dental training in the region for years to come. The project was developed by BaS LIFT, has been shortlisted in the infrastructure, community benefit and design through innovation categories, and will be competing against other schemes in the West Midlands. Ewan Forsyth, development director at BaS LIFT, said: “We couldn’t be prouder of what we have achieved with the development, however a RICS award would definitely be the icing on the cake”. Ralph Minott, Calthorpe’s director of development, added: “The Dental Hospital is the first project at Pebble Mill to complete and we are delighted that the exceptional standard of the facility has been recognised. “Our vision is to create an outstanding centre for medical, healthcare and life sciences here, and the schemes that are just coming forward promise to be equally exceptional.” The RICS awards highlight the most inspirational regional initiatives and developments, in land, property and construction, to celebrate the achievements of those working in both the built and natural environment. The ceremony at which the winners will be announced is on 18 May, at Edgbaston Cricket Club.

Breakthroughs on show Life-changing research will be in the spotlight in May at Queen Elizabeth Hospital Birmingham’s annual research showcase, where teams from across University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham will exhibit the work that is changing lives and transforming the NHS. From looking at our genetic make-up and its influence in rare diseases and cancer, to advances in trauma care and reconstructive surgery, as well as novel ways to manage infections, the medical campus hosts a vast array of research delivering remarkable breakthroughs in patient care. The event is part of the National Institute for Health Research’s ‘OK to Ask’ campaign, which marks International Clinical Trials Day, and aims to encourage patients and the public to ask about the opportunities for them to make a difference and take part in clinical research. The showcase, which will have more than 20 intriguing and interactive exhibits, is open to the public, patients and staff, and will be held on 19 May, in the main entrance at QEB.

For more information, please email showcase@uhb.nhs.uk

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Surgical contract win Centre gets grant University Hospitals Birmingham NHS Foundation Trust has been awarded £3.5m from the European Regional Development Fund, to establish a medical devices testing and evaluation centre in partnership with the University of Birmingham (UoB) and Aston University. The grant will be match-funded, including £2.5m from UoB, and the £7m will be invested in accelerating the translation of novel innovations in the laboratory through to the clinic, and to commercial exploitation. The new centre will support the development of existing markets, and stimulate new ones, for SMEs in the life sciences sector; enabling them to bring products to market quickly, at less cost and with reduced risk. To be based inside the Institute of Translational Medicine, on the main Queen Elizabeth Hospital site, it will begin operations once refurbishment work has completed, which is expected to be August 2017. It is predicted that the centre will be able to assist around 130 SMEs in the first three years of its operational life.

US Partnership Birmingham’s The Binding Site has launched its latest collaboration with a US clinic, to develop new clinical tests for testing, diagnosing and monitoring patients with multiple myeloma and related diseases. The Edgbaston-based group has been working with Mayo Clinic for more than 20 years, and this latest project will see it establish an R&D lab in Minnesota, where its American partner is headquartered. “Our roots are founded in clinically relevant science, and one of our key attributes is the ability to develop and produce anti-bodies, and corresponding diagnostics tests, for diseases which are difficult to identify or measure accurately,” said The Binding Site’s CEO, Charles de Rohan. “This agreement further demonstrates our commitment to improving patient care, by providing laboratories across the world with new and improved diagnostic techniques. Mayo Clinic and ourselves share a philosophy of always keeping the patient at the centre of our work.”

A Birmingham stamping and presswork specialist is targeting growth in the medical sector after landing a new £100,000 contract. Brandauer, which employs 55 people at its state-of-the-art factory in Newtown, is supplying components for a surgical tool, used during operations, to crimp implants used in female sterilisation procedures. The order was won against global competition, with the firm impressing its customer with its lead times, the quality of finished products, and its ability to provide prototyping services in the development stage. Rowan Crozier, Brandauer CEO, said: “Medical accounts for only about 5% of our £7m turnover, but it is an area that lends itself to our precision manufacturing capabilities, and the launch of our new Special Product Division. “This contract win builds on other long-standing relationships with that sector, to supply nose bridge clips for medical face masks and stainless steel scissor blanks for use in suture blades. “In order to corner more market share, we have developed our own sub-branding for this sector (Brandauer Medical), created specialist marketing material and have also tried to attend more international events. It’s an approach that is starting to pay off.”

Catapult enables waterhole Investment by the government’s Medicines Discovery Catapult (MDC) has allowed the University of Warwick to open a new £1m research lab at its school of life sciences. The sophisticated equipment will support the early discovery of new medicines, and be available to both the academic community and SME biotech companies across the UK. Three machines have been acquired thanks to the support, and Professor Chris Dowson says it’s the first time such kit has been available in this country. “This Catapult lab has an extraordinary amount of capability in a small space, which will enable us to make great advances in microbiology, chemistry and structural biology. “This equipment will support advanced screening and target validation, to identify future therapies for complex diseases, and the initial focus will be on tackling the increasing threat of anti-microbial resistance.” The MDC supports and promotes innovative, fast-to-patient drug discovery in the UK, and is the latest of 11 catapults established to transform the UK’s capability for innovation and help drive future economic growth. Its CEO, Chris Molloy, described the new facilities as a ‘waterhole’ - which could serve the UK’s healthcare community in two ways. “Firstly, it provides capability to which many drug discovery companies have previously not had access, and secondly, it enables us to foster and facilitate collaboration between companies and academics, to help move great ideas into realistic commercial opportunities, for the benefit of the health and wealth of the UK. “Collaboration is the key to future drug discovery, as the landscape is changing rapidly, and the old way of doing things is no longer fit for purpose.”

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Playing to

our strengths

ealthcare and life sciences is one of our five priority sectors, so it is very important for us, for the city, for the regional economy, and above all, for everyone who lives and works here. “It is a centre of excellence, with excellent infrastructure, strategic relationships between the teaching hospitals and the universities, a proven ability to carry out accelerated clinical trials, and the presence of the Institute of Translational Medicine (ITM) is, of course, critical. “When we are making the case for Birmingham’s healthcare and life sciences sectors, at overseas events and conference, you can see that the strength and breadth of the cluster is very appealing. “Greater Birmingham is already home to more than 550 medical technology companies, more than any other area in the UK, and it’s now of a scale which attracts international attention. “We carefully fine-tune our offer, according to the audience we are looking to reach. When we were at MIPIM 2017, for example, Calthorpe Estates and the Edgbaston Medical Quarter were strong brands, and news of the £171m Birmingham Life Sciences Park also interested potential investors and tenants. “When we were at Arab Health, and other sector-specific events, we would talk more in depth about the cluster,

the R&D, the availability of lab space and the focus on accelerated trials. “In general terms, we also make the point that whilst Brexit has created uncertainties, the devaluation of sterling has made investment in the UK more attractive. “People visit us in increasing numbers, and when they do come to see how our network operates in practice, we always involve our local

Nicola Hewitt is Business Birmingham’s commercial director, and leads on its inward investment activities. She gives her take on the city’s health economy. stakeholders; it might be Birmingham Health Partners, or the University of Birmingham (UoB), or one of the teaching hospitals, so visitors can get a tangible sense of partnership. “The number of potential FDI (foreign direct investment) inquiries has risen steadily over the last three years, and one asset which is often mentioned is our population, which is large, established, diverse and stable, and therefore a tremendously attractive asset to clinicians, researchers and drug companies. “It’s also very evident that our healthcare and life sciences cluster appeals equally to Big Pharma, to entrepreneurs, to established businesses looking for somewhere to grow, and to start-ups. “Greater Birmingham also has an established base of companies working in medical devices and diagnostics, which has been a springboard for our expertise in medi-tech. “It’s also very pleasing to discover that the scale and potential of our healthcare and life sciences cluster resonates with so many different audiences. A delegation from the Qatar-UK Business and Investment Forum visited the UoB recently, because our societies share so many healthcare challenges. “We also found that our offer was equally well received in California and the Sillicon Valley, especially our focus on accelerated clinical trials, and so one of our key areas of activity in Q2 of 2017 will be looking to turn those conversations into solid expressions of interest.” n

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Looking to the future

Ian Halstead catches up with the founders of two innovative healthcare start-ups, Kaido Group and Give Vision, based in the heart of Birmingham.

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reating the next generation of techsavvy companies, in tune with the digital era and capable of providing genuinely radical products and services, is a global challenge, but it’s being tackled with impressive success on the Innovation Birmingham Campus. It’s an ambitious initiative to bring together the public and private sector; creating connections between people with ideas, technologies, expertise, experience… and money, to stimulate collaboration and promote innovation. Some 150 technology businesses are already based on the 104,000 sq ft campus, and in February 2017, the CEO of Innovation Birmingham, Dr David Hardman, unveiled plans to deliver another 90,000 sq ft of new space by Q1 2020, which would make it the UK’s largest dedicated technology location. “We know the demand is there, because the two state-of-the-art buildings we have opened in the last year (iCentrum and the Universities Centre) are already almost fully occupied,” he says. “Our ambition and vision for Innovation Birmingham reflects the scale of opportunity this city presents. We have already become a hub for innovative digital businesses, from start-ups to scale-ups and beyond. “Now we are continuing to develop out our masterplan; to satisfy the demand from existing tenants, to provide space for those who wish to relocate here, and to be able to accommodate the new digital businesses of the future.” To fund the new space, Innovation Birmingham has appointed a team from KPMG’s Corporate Finance practice in the Midlands to seek investment, in exchange for equity stakes in the campus. That’s for the future, of course, but for now, the flagship scheme on the site is very much iCentrum; an imposing 42,000 sq ft structure which catches the eye from the outside, but whose internal design cleverly creates the

sense of being inside a towering skyscraper. Walking inside is like entering a new digital universe and the sense of energy is tangible. The open-plan design, break-out space and large restaurant area have been designed to encourage connectivity between tenants, and it clearly works. Hardman’s research suggests that growth rates on the Innovation Campus consistently run ahead of those achieved at similar techbased schemes elsewhere in the country. One of the many pioneering digital start-ups at iCentrum is Kaido Group, whose Insights platform, created with its partners at Microsoft, aims to take advantage of the huge opportunities provided by Big Data and technology to revolutionise healthcare. Put simply, it aims to combine the use of ‘actual’ intelligence, Artificial Intelligence (AI) and data to deliver healthcare models which will have a profound impact on how services are delivered, across healthcare systems and the life sciences sector. Especially appealing of course to a health service desperate to cut costs, improve patient care and also eager to empower patients to better manage their health, away from underpressure hospitals and GP surgeries. March 2017 saw the launch of Kaido Wellbeing, targeted at the corporate healthcare sector, which it believes is the only health platform combining professional health expertise with AI to deliver personalised wellbeing guidance to employees. The venture was only established in November 2015, but has already attracted significant investment from the business community, and equal amount of positive attention from the region’s healthcare sector, as founder and CEO Rich Westman explains. “I was the academy strength and conditioning coach at Worcester Warriors, and before that had been at Leicester Tigers. Several of us from the Warriors had different skills, sports psychology, nutrition, fitness, and

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so on, but we all had a vision about sharing our combined knowledge to benefit others. “To be honest, I was also fed up with the day-to-day activity. It may have been at elite sport level, but it was very repetitive and often mundane. I’d done business studies and sports science at Loughborough, but I wasn’t really using the business side. “Our initial plan was to create an app so people could access high-quality information and guidance to give them insights about their healthcare decisions. As it happens, because digital technology evolves so swiftly, we now use a cloud-based AI platform, Insights, which can be integrated into any other platform. “The concept of Kaido was well received, we had a break or two along the way, in terms of investment and personnel, and then looked for

“

somewhere to be based. None of us fancied London, but we had no strong preferences about location, until we met David Hardman. “He ‘sold’ us his vision for Innovation Birmingham, and the iCentrum as a place to be at our very first meeting, and we came here in April 2016. The West Midlands Academic Health Science Network backed us, and we were impressed by its commercial director, Tony Davis. “From that point, we really started to understand the opportunities offered by Big Data. We realised we could take data from anywhere, combine it with ‘real’ intelligence, and then use AI to create what we call ‘actionable insights’ so individuals could take charge of their own healthcare decisions.” An intriguing idea, of course - not least for

“Now, our ambition is to use digital technology to transform how healthcare is delivered.”

the NHS, employers and individuals keen to make changes to their lifestyle and behaviour - but one which needed to be thoroughly evaluated and validated. Westman and his colleagues then won a place on an intensive 12-week incubator programme, at Microsoft’s UK headquarters on the Thames Valley Campus, near, Reading. “They analysed absolutely everything, loved our concept… but hated the idea of an app, so that’s when we decided to migrate to a cloudbased platform. Everyone we then met in the healthcare community also embraced our vision of delivering preventative and predictive models of healthcare. ”Now, our ambition is to use digital technology to transform how healthcare is delivered. We want to prove how sharing data and knowledge creates huge benefits.” It’s a mindset which dovetails perfectly with the innovative Trials Acceleration Programme conceived in Birmingham by Charlie Craddock, as Westman accepts. “Absolutely. He had the original idea of using real-world evidence and data to deliver personalised healthcare, which could slash the cost and time of clinical trials, and it’s a model which we fully embrace.” Just yards away from Kaido’s open-plan office is Give Vision. The former’s use of digital technology is intriguing and innovative, but the latter’s is revolutionary. Founder Stan Karpenko and his talented team have created an electronic headset, SightPlus, which gives people with visual impairments the gift of sight. It’s a light, hands-free and portable device, allowing people to read, watch TV, see people around them, and to conduct a life which would previously have been impossible. It may sound like something from the future digital universe of Westworld, and you’d likely need multiple PhDs to understand how it works, but it does. Karpenko offers glasses to recreate the sense of minimal vision, then places his headset atop them. A whirling environment of blue appears, but as the controlling joystick is manipulated, blurred images appear, and then it’s possible to read headlines and see pictures.

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“

“By 2025, I believe anyone who is considered blind will be able to see, read, go shopping, and lead an independent and fulfilling life.”

Awesome is one of the contemporary world’s most over-used words, but it’s difficult to find another. Intriguingly, the catalyst for the SightPlus concept - now at its third prototype stage, and already in use in the West Midlands - was the experiences of blind code programmers, who contacted Stan whilst working on another project. “In 2014, I was working on a hobby project with Peter, who then worked for Google Glass, but is now with us at Give Vision,” recalls Karpenko. “We did the work on Open Source, and a number of blind code programmers contacted us. People are surprised that programmers can be blind, but code needs to be short and elegant, and the very best programmers can create solutions in their head. “Their comments inspired us, they were like superheroes to achieve what they did without

sight, and we started thinking how we could do something for them, and for anyone who suffers from impaired vision. “For example, we looked at how Birmingham City Council communicated with blind people, and those living with sight loss. Essentially, they were offered a plastic magnifying glass, and when we met the council leader, John Clancy, last year, we discussed what more could be done. “It was pretty much the same at the Royal National Institute of Blind People, they were supplying reading aids, not addressing the issues faced by blind people. We looked at wearable technologies, the use of virtual reality, and computer ‘vision’ and gradually had an evolution of ideas. “We realised this was a good problem to solve, for millions of people, and finally we created software which worked with a standard

Stan Karpenko, Give Vision

smartphone and goggles. Even four or five years ago, it wasn’t possible, because the technology wasn’t there, or was too large or too heavy, but now it is. “The first prototype worked, but was too heavy, the second was better, and the third is very light and easy to use. At this moment, we can restore sight for two in three people, but by 2025, I believe anyone who is considered blind will be able to see, read, go shopping, and lead an independent and fulfilling life.” It’s a remarkable statement, made more so by the matter-of-fact way in which Karpenko speaks, and he clearly thinks it’s an achievable ambition. ”The quest for our team is to solve sight loss for people who cannot be cured, and our strategic view is shared by our partners, our investors, and everyone here,” he says. “We have an amazing team, some come from Poland, Germany and French-Polynesia, and I grew up in a Russian city inside Lithuania, but we’re all extremely happy to be based in the UK, and to be living and working in Birmingham.” n

Rich Westman, Kaido Group

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For me – seeing was believing In 1993, Lee Bennett went blind in just six weeks, but now he can see again, thanks to Give Vision’s remarkable ‘electronic goggles’. He tells Ian Halstead his story.

’ve been going to the Sight Village UK exhibition in Birmingham every year, for ages. It’s interesting just to hear about the latest technology, but I’d never found anything which could help me. I can only see blurred images and smudges, but I’m always optimistic. “Last time, I met one of the Give Vision people, and agreed to try their headset on. I put it on, moved the control joystick, and it was unreal. For the first time in 24 years, I could see an eye-chart and actually read it all right down to the bottom line. “I went home, and all I could think about was what a surreal experience I’d just had. About six weeks later, Give Vision rang and invited me to trial their latest headset. It was amazing. “For years, I’d been using unreliable PC-based technology to let me see some things, or using other stuff, which was just really magnifying glasses. “The headset was hands-free, so I could actually read things I was holding. I went back home, and I could watch my TV from across the room, instead of having to sit inches away from the screen. I could even use a normal PC. “Up to the age of 23, I’d taken sight for

granted, but then a rare condition destroyed my central vision in one eye, and six weeks later, the other one went. With the glasses I went to Waterstones, explained what I was doing to the assistant, took a book off the shelf, put it down and I could read it. It was so amazing I was overwhelmed. “Maria from Give Vision took me around, and I saw the outside of the Bullring for the first time, then went back home to West Brom, and couldn’t believe how much had changed. “We used to live near the old Oak House, and I hadn’t been there for 20-odd years. I went to see the building, but could also see people’s faces. “I’m a civilian support officer with West Midlands Police, but when I went into work, talking about reading eye-charts and seeing stuff from across the room, they must have thought I’d gone crazy. “The best things are the small stuff. My parents are both dead, and although I’ve got a picture of them on my fireplace, I haven’t been able to see them properly. With this headset, and especially the newest prototype, I can see

them as I remember them, and I can look at pictures of my old German Shepherd too. “It makes you well up inside, and when you see twigs and leaves on trees, and can see the grain on wood, it feels like a miracle. I can see my sisters properly too, and now we can all look at old photos together, and all my memories just feel so real now. “My mates are really pleased for me, of course, and I think they also appreciate not having to read the menus out loud, every time we go for a meal. I’m also looking forward to going to snooker tournaments and seeing the players and their shots, not just listening to the commentary on an ear-piece. “Going away on holidays, and seeing what other people see, is something I’m really going to enjoy, but one of the greatest pleasures is simply being able to write freehand. To have thoughts, and to be able to express them, without having to switch on a special PC and boot the software, is a really special moment.” n

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Providing

extras

Justine Davy, head of fundraising for the Queen Elizabeth Hospital Birmingham (QEHB) charity explains her role.

am immensely proud to work for the QEHB charity which, even during my time, has raised millions of pounds for incredible causes. “We aim to provide the ‘added extras’ which the NHS cannot. These could take the form of research and specialised and expensive equipment, to pizza nights for teenagers with cancer, and even Fisher House, a ‘home away from home’ for military patients and their families. “We support and fund world-class research, and the money we raise pays for cutting-edge technology and equipment which changes lives every day here at the QE. “As one example, the charity raised £6.5m so the QEHB could become the first hospital in the UK to have both the CyberKnife and TomoTherapy cancer treatment machines. “The former can treat small well-defined tumours located in traditionally difficult-toreach parts of the body, which if damaged would have devastating effects. It is commonly used to treat selected brain tumours and increasingly used to treat other tumours around the body. “The latter allows incredibly accurate scans to be taken of patients to ensure that they are positioned correctly before they receive intensity modulated radiotherapy. “The TomoTherapy system also reduces the dose of radiation to healthy tissues and critical structures, making radiotherapy treatments more effective and less harmful. “This is particularly important when we treat children, as children are more sensitive to the effects of radiation than adults, and we don’t want to treat the cancer they have now, only

to store up problems further on in life. “Many people are unaware that the QEHB is one of the country’s leading paediatric radiotherapy centres, with hundreds of children coming from across the region for treatment. It is incredibly awe-inspiring to see the bravery of these children and their families. “Our charity also funds world-leading research, such as the accelerated drugs programme, which tests existing drugs to see if they could have new applications in cancer treatments that were not previously known. “Head and neck cancers, in particular, are very tricky to treat due to the invasive nature of surgery required to remove the tumours. That fact that the trials we have funded may

help to reduce the size of these tumours is immensely exciting. “Similarly, we support the Cancer Immunology and Immunotherapy Centre (CIIC), bringing together a team of scientists from the University of Birmingham and doctors from the QEHB to harness the power of the immune system in fighting cancer. “CIIC is directed by Ben Willcox, Professor of Molecular Immunology at the School of Cancer Sciences. The work our charity does means that amazing scientists such as Professor Willcox can undertake research that would not have otherwise been possible. “However, we can only carry out our work thanks to all the donors and fundraisers, who have helped to raise nearly £4m in the 2016-2017 year alone. “We offer the chance for people to take part in sporting challenges, such as Velo Birmingham, the region’s first 100-mile closed road bike race, and events such as the Great Birmingham Run and this year, the first Birmingham International Marathon. “There are countless ways in which you could become involved in supporting QEHB and helping us to carry on this charity’s amazing legacy. “Please visit our website at qehb.org for information on our campaigns, how to get involved, and how you, or your company, can support the QEHB Charity. If you want to take part in our sporting events, please also visit bikeforbrum.org or runforbrum.org.” n

Promotion

Edgbaston Medical Quarter takes its place on the global stage Birmingham’s Edgbaston Medical Quarter is winning international acclaim as a destination where healthcare professionals can live, work and enjoy life. Ian Halstead finds out more from Calthorpe Estates chief executive Mark Lee.

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

Demographics have made health and life sciences one of the most buoyant business sectors in the developed world; as people live longer and look to science to cure their ailments and illnesses. A rare combination of world-class medical researchers, leading healthcare academics, innovative biotech companies and the renowned Queen Elizabeth Hospital Birmingham has created the fast-growing Edgbaston Medical Quarter (EMQ). The location has swiftly acquired an international reputation, for the scale, scope and quality of its healthcare practitioners and researchers, and is seen as a major long-term driving force for the economies of Birmingham and the wider West Midlands. EMQ was conceived and delivered by Calthorpe Estates; a property investment and development company which has been family-owned for 300 years. Calthorpe manages its prestigious 1,600-acre estate, just a mile from the city centre, and has earned a reputation as one of the UK’s most forwardthinking and progressive property investment and development companies. Its chief executive, Mark Lee, is rightly proud that the company has been place-making, and creating thriving communities, throughout its long history. “Right from the time Sir Richard Gough acquired the original estate in Edgbaston, he was determined to retain its rural nature, and thanks to his foresight, it has retained the feel of a village community to this day, despite its urban location. “When doctors, clinicians and other potential tenants (or residents) come here for the first time, the first things they remark on are the strong cluster of medical and healthcare excellence, alongside how green and leafy it is. ”They’re also impressed by the leisure, cultural and educational options here, but above all, it’s the community ambience which makes them feel they want to be here, and to work here.” Home to two-thirds of the city’s healthcare

economy, EMQ now boasts more than 180 medical organisations, 23 training facilities allied to medicine, 44 GP clinics and routine care facilities and 80 hospitals and specialist care centres. The area has fast developed an international reputation for medical excellence, and attracted leading practitioners and researchers from many of the UK’s most important medical institutions. EMQ also incorporates one of the UK’s largest urban conservation areas, and is considered an ideal location for SMEs needing to establish a base for product development, clinical trials or procurement routes.

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“EMQ is seen as a major long-term driving force for the economies of Birmingham and the wider West Midlands”

Lee says focusing on a long term vision has underpinned its EMQ strategy from the concept stage. “We were absolutely determined to ensure that this location wasn’t just about grand workplaces and R&D centres for major companies and organisations, it’s just as important that we have the small private clinics, the specialist consultants and the consulting rooms here. “As the quarter evolved from a cluster of related businesses into an international destination for healthcare, life sciences and medicine, we brought ‘back office’ functions here, and George Road has proved very popular for dentists, doctors and other individual practices. “The most pleasing aspect for me though hasn’t been about helping to bring all these people and companies here, but to see how they are beginning to collaborate.

Promotion

“I am told there is nowhere in the UK where such a mix of researchers, academics, clinicians, specialist teams and R&D laboratories can be found within walking distance of one another, and it’s very exciting to think what progress they will make on current and future healthcare issues as their relationships really start to blossom.” The area’s healthcare and life sciences community is also evolving quickly thanks to innovative and productive partnerships between its academic institutions and the NHS Hospital Trusts, notably through the presence of Birmingham Health Partners. “We’re committed to an ongoing programme of investment, expansion and refurbishment across EMQ, and our wider estate here, but equally, we have been impressed by the willingness and ability of the public sector to help deliver major projects and initiatives,” admits Lee. “The Institute of Translational Medicine (ITM), for example, will transform the pace at which new drugs and treatments move through the development and trial phases and into production. ITM came on stream last summer and was a pivotal moment for the sector’s future, it’s often described as the jewel in the crown of Greater Birmingham’s life sciences cluster, and I would echo that. “It’s also very pleasing to see Birmingham City University (BCU) invest so much in its Edgbaston campus. I suspect many people outside the health sector aren’t aware that BCU is one of the country’s largest providers of nursing and healthcare education. “It is investing £20m in new facilities, and the biggest single project is its new School of Life Sciences, offering a range of courses in health, nutrition and biomedicine.” At the same time, Calthorpe’s long-term strategy of investing in its own estate has led to its ambitious New Garden Square mixeduse scheme, in an outdated commercial zone bordered by Hagley Road and Beaufort Road. “The buildings here need serious modernisation and are largely unoccupied, so we’re planning to deliver 500,000 sq ft of Grade A office space, with around 400 units of ‘build to rent’ housing,” says Lee. “The area is almost 11 acres, so it’s a major project for the city, not just ourselves. Our vision is to extend the traditional city core out

Artist impression of 30 Highfield Road, new medical hub

Leafy Edgbaston with green open spaces, within the mixed-use Calthorpe Estate

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“We have been impressed by the willingness and ability of the public sector to help deliver major projects and initiatives”

towards Edgbaston, in line with the aims of the Big City Plan and Birmingham City Council. “We’re agnostic about what tenants we’d like to see come here, as the New Garden Square comes forward, but I must admit, I think it’d be ideal for a good-sized life sciences operation.” Certainly, as an inspiration to healthcare start-ups, or established companies looking for grow-on space, there’s nowhere more impressive in Birmingham than one of Calthorpe’s tenants, The Binding Site, which began life as a research spin-out from the University of Birmingham in 1983, and has become a global success.” The company provides specialist diagnostic products to clinicians and laboratory professionals worldwide; devising,

manufacturing and delivering innovative medical solutions which improve the diagnosis and management of blood cancers and immune system disorders, with a particular focus on myeloma. The Binding Site now employs some 700 people worldwide, with 500 in the UK, and its products are sold in more than 100 countries. It has also won four Queen’s Awards; two for Export, another for Innovation, and the most recent for Enterprise in the international trade category. It’s testament to the strength and international profile of Greater Birmingham’s life sciences cluster that The Binding Site’s CEO, Charles de Rohan, has kept the group’s corporate headquarters within EMQ. n

Cutting-edge healthcare in Edgbaston

Edgbaston Medical Quarter is at the centre of the healthcare and life sciences revolution that is taking place in Birmingham, on the Calthorpe Estate. With its rapidly growing healthcare and life sciences community, supported by internationally renowned training and educational facilities, which sit alongside a vibrant commercial, leisure and lifestyle destination, it is easy to see why it is becoming the â&#x20AC;&#x2DC;go toâ&#x20AC;&#x2122; centre for clinical trials, medical and healthcare excellence. For 300 years, Calthorpe Estates has been place-making and creating thriving communities within its 1,600 acre estate in Edgbaston, in the heart of the United Kingdom.

To find out more about this world-class medical and life sciences destination visit www.calthorpe.co.uk/EMQBQ Offices / Residential / Retail / Medical / Leisure / Education

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t its simplest, WMAHSN is a catalyst for the spread of proven innovation at pace and scale - improving health, generating wealth and employment and delivering changes throughout the health and social care economies. We’re often described as brokers: connecting people, patients and populations, and creating the right environment for new and productive partnerships between the NHS, academics and industry. There are three elements to the service: comprehensive IP support (provided by MidTECH), an industry gateway delivered by Medilink West Midlands and an online health innovation exchange, also called Meridian, where people can share, network and inform our work. The Meridian exchange offers virtual access to the service and the opportunity to connect

Innovation brokers Tammy Holmes, Innovation and Adoption Programme Manager for the West Midlands Academic Health Science Network (WMAHSN), looks back on the first year of its Meridian Innovation and Adoption Service. with the wider healthcare community, and share and adopt good practice with more than 600 active users and counting. When we began to develop the health innovation exchange, we weren’t entirely sure what our future members might need, but we did know that it needed to be simple to register and easy to navigate. At an operational level, the Meridian health innovation exchange has three main features, so members can share and promote, ‘push’ opportunities for wealth and health improvements and ‘pull’ ready-made solutions for their specific challenges, or areas they have identified for improvement. We have also built in what we call an ‘Innovation Warehouse’, which is essentially a stockpile of stories about companies, entrepreneurs and innovators, highlighting how they identified and tackled their challenges, about products, skills, finance, or any of the multitude of issues which growing and ambitious businesses face. In this area, members can contact each other directly, if they like the work of others, if they would like to discover more, or if they believe they can offer potential solutions to challenges. Elsewhere, there is a wide range of discussions, sometimes about specific issues, but often on topics with much broader appeal, such as proof of concept, and we also have links to both other AHSNs and to national initiatives. The Meridian exchange is very much focused on all the needs of the West Midlands’ healthcare

community, so we also have regionally led campaigns where users can provide details of their innovations; at the moment, we have 170 such innovations available for all users to view. We pride ourselves on being very proactive, so if we realise that someone has posted too much information, in their enthusiasm, we contact them, and remind them of issues around IP. I have worked across the NHS, academia and the private sector to acquire and enhance the key skills I require to broker new relationships and develop collaborative projects, so I am often able to help members. Equally, there are occasions when members create their own innovative solutions to challenges, and are happy to share their discoveries with myself and others. I must admit, the first year in which the service has been operating has been even more successful than we hoped, and it was very pleasing to see we had attracted interest from overseas, with members coming from as near as Germany and as far away as the US. As we move into our next year, we are looking for new ways to add value to the Meridian Innovation and Adoption Service, as we want the community which is being created to grow organically. We even held a physical event in February 2017, Meridian Live, which was tremendously successful, so we’ll certainly be holding a second one. We’re also hoping to launch an Innovation Fellowship programme, which would help to build connections between innovators and decision-makers. People new to the NHS usually think it’s a single organisation, like a giant whale, and they’re surprised when I say it’s more like a very large shoal of fish… swimming in roughly the same direction. n

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Trialblazers

Ian Halstead talks to Pauline Boyle, acting chief operating officer of the National Institute for Health Research in the West Midlands, and hears the stories of two of its patients; Dr Andrew Thompson and Dietmar Bruck.

n this era of personalised medicine, where treatments are increasingly novel and specific, rather than traditional and generic, it’s vital that the NHS creates ever-more efficient pathways for patients to access innovative drugs as early as possible in their development. The National Institute for Health Research (NIHR) operates through a 15-strong network of regional clinical research networks (CRN), giving patients the opportunity to take part in clinical studies; in the primary care system, at GP surgeries, dentists or pharmacies, or at hospitals and NHS Trusts.

Dietmar’s Story

Such research offers individuals early access to new treatments, interventions and medicines, allowing the NIHR to assess which options can then be rolled out nationwide, ultimately delivering better and more costeffective patient care through the NHS. Pauline Boyle is acting chief operating officer of the Stafford-based West Midlands arm of the NIHR, and is rightly proud of the contribution which this region makes to the national network. “Our primary aim is to increase the health and wealth of the nation through clinical

“I’d never heard about clinical trials, but the advantages of taking part were pointed out to me by my doctor when I visited him for my constant coughing for over three weeks. “My cough came on suddenly, I thought I was going to get a cold so wasn’t too concerned, although it did get progressively worse and then I happened to see a newspaper article advising anyone not to ignore a persistent cough that had lasted more than three weeks. “As an ex-professional footballer for Coventry City, I am accustomed to having very regular medical attention and check-ups, so the thought of seeing my GP held no fears. “I would advise people of all ages not to be afraid. Go and get checked out, because thinking it will be all right and will go away could be fatal. “Sadly, three people very close to me thought their problem would go away, and I lost them all, including my wife, Maureen who was only 51. She was constantly tired and lacking energy, but thought it was because she was working hard, and that it would be OK soon. “I insisted she seek help and took her to see her GP. She received excellent attention from the NHS, but blood

research, and we offer patients the opportunity to participate in our trials, across a range of conditions,” she says. “For the 2016-2017 year, the West Midlands NIHR is the largest recruiter of people on to commercial clinical trials of all the regions, more than 3,000 patients, and we also have something like 850 ‘live’ research studies underway here. “In March 2017, national NIHR data showed that one million patients had now taken part in research via their local CRNs, and it was very pleasing to see that at least 175,000 of those patients came from this region.

tests and x-rays confirmed she had leukaemia, and she passed away three months later. “From my experience, there were no downsides to participation in research. As anticipated, I was tested, x-rayed and generally well looked-after; I also had the advantage that I found out more about my body and learned more about my condition. “Fortunately, my outcome was good. I would most certainly recommend it, and it made me feel good to know and understand. “I would certainly be prepared to take part in another study: the more you know about yourself the better, and such knowledge could be very important. “Participation in research is something I would wholeheartedly recommend. My own health is important to me, and I always try to make sure I keep myself fit by doing exercises, swimming, healthy eating and keeping my weight down. “Now health research means so much to me, it shows how much the NHS is trying to help by making us aware of the importance of keeping healthy and fit - and by giving us good advice.”

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“More than 40% of our local GP practices take part in the primary care studies, and all our 28 NHS Trusts across the West Midlands participate in clinical research, which is of benefit to all patients in this region, regardless of whether they choose to join the research studies. “It’s always been known anecdotally, that if you were treated somewhere which specialised in interventional studies that you had a much greater chance of survival than if you went somewhere else. “However, there was also a recent two-year study of colorectal survival rates throughout England which generated ample evidence to show that patients did receive higher quality of care, at hospitals which carried out clinical research, and therefore had a greater chance of survival.” Boyle also highlights a report commissioned by NIHR from KPMG’s economics team, published last November, demonstrating that clinical research created significant wealth and employment, in addition to delivering improved patient outcomes. “Put simply, if a patient enters a clinical trial they benefit from access to novel treatments, and the NHS benefits because it isn’t paying for the drugs which are being trialled. “All the CRNs look to engage with pharma companies of all sizes, but in the West Midlands we have a specific focus on SMEs, because there are so many of them in this region. We consider our SMEs to be a rich resource, and have established a dedicated industry team to which they can pitch ideas. “At the moment, we are having a big push on what are known as ‘biosimilar’ drugs, which are drugs almost identical to an existing drug which has come to the end of its licence. Once copyright on the original drug expires, other manufacturers naturally try to produce something which has the same benefit for patients. “We are very keen to promote clinical trials using biosimilar drugs, because the potential savings for the NHS will be enormous, as once the drug comes off licence, the price will tumble sharply, so we’re always looking to engage with innovative SMEs, who are capable of manufacturing such drugs. “Patients receive the same quality of care as before, but the NHS can save its limited resources, and then switch those resources into other areas of healthcare. At first I was uncomfortable talking to patients about health, wealth and finance in the context of clinical research, but now it makes perfect sense. “We’re also looking at how new research can guide us to the effectiveness of treatments. It might be, for example, that 10 sessions of chemotherapy using the latest equipment are as effective for patients as 20 sessions used to be. “Obviously, the original figure was based on earlier clinical trials, but as technology improves, and as we understand more about particular conditions, then the numbers change. It’s always about delivering better outcomes for patients, but we also have to do more with less.” n

Andrew’s Story Dr Andrew Thompson was a successful GP working with the homeless when a stroke changed his life, but taking part in clinical research gave him back his sense of purpose. After his stroke, which happened at home in May 2016, he got involved in several clinical trials almost immediately, having been approached whilst he was in Sandwell General Hospital. He says: “It gave me something to focus on and was a positive in a negative situation. As a GP, and as an Honorary Senior Lecturer at the University of Wolverhampton, I had been involved in carrying out research in the past, so I was aware of the benefits it can bring to patients and the wider NHS. “The experience has been positive and I have always got in mind that in being treated for my stroke, I am the recipient of the accumulated knowledge of colleagues. “It’s the same response as when you are asked if you will be examined by a medical student - why not? If people don’t sign up to participate, then medicine wouldn’t be able to move forward.” The studies he took part in included a drug trial, a speech and language trial and a cognitive capacity trial. He joined the first just a month after his stroke, whilst on the rehabilitation ward. “I had no previous history of stroke, but was working a 90-hour week with substance misusers, as well as carrying out my duties as Assistant Coroner for the Black Country, and I am sure that fatigue and stress contributed to my condition,” says Thompson. “Taking part in research gives positive meaning to the experience of illness and I am now living independently again and am getting more involved in community life. I have always been active in the trade union movement and am still able to play my part. “I would encourage others to ask about taking part in relevant research - it was part of my treatment anyway and some parts are really fun and interesting, which stops you from dwelling on your condition. “The researchers were exceptionally helpful and flexible and if you are fortunate, the study can make a big difference to your recovery. “Sometimes it can be hard to stay positive after such a lifechanging event, but knowing you are helping to improve treatments for future patients gives you a whole new perspective.”

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Tackle the taboo

for all our sakes The West Midlands Combined Authority has made mental health one of its strategic priorities. Ian Halstead discovers more from the two driving forces behind its ambitious proposals; Supt Sean Russell and former LibDem Health Minister, Norman Lamb

ental health remains the final taboo for Western civilisation; despite an array of programmes and initiatives aimed at tackling both the stigma, and the impact, of mental disorder over the decades. Well-intentioned all, of course, but it’s hard to say that they’ve resulted in more than minimal progress to the health and well-being of the millions of individuals affected. However, the West Midlands Combined Authority (WMCA) is determined that actions rather than words will be the outcome of its Thrive West Midlands action plan, launched in January 2017, after months of diligent research by its Mental Health Commission (MHC). An impressive line-up of researchers, academics, analysts, people with mental health issues, and members of the wider public contributed to the plan. Now, the individuals tasked with ensuring the MHC delivers on its targets are Supt Russell, seconded from West Midlands Police for two years as implementation director, and Lamb. Both are high-profile campaigners for those impacted by mental health issues, and it’s easy

to see why they’ve formed such an effective partnership, as their passion for improving the lives, the health and the wealth of those who suffer the blight of mental illness shines through their every word. Russell - like Lamb - is very much one of the new breed of evidence-based observers, and has an array of statistics at hand to underline the case for putting mental health atop the WMCA’s agenda. The most eye-opening figure is that the failure to tackle mental health in all its forms costs the West Midlands £12.5bn each year. “Roughly 70,000 people across the region are economically inactive, because of mental health challenges, which costs £2.2bn a year, and in terms of crime, mental health adds £1bn a year to the costs of the criminal justice system,” says Russell. “Almost a quarter of adults will have a mental health problem at some point in their lives, and we lose 4.1 million working days a year because of such problems. If you look at the statistics for suicide, each one is a terrible tragedy for the individual, and their family and

friends, but there’s also a significant financial cost. “For the last full year in which data is available, 474 people took their own lives in the West Midlands, and the average cost for all the services involved in the aftermath of each death is £1.6m. If we could prevent just 60 of those deaths happening, we’d stop 60 personal tragedies - and save almost £100m.” In an era of public sector austerity, where funding pressures grow ever-greater upon the NHS and the wider economy, Russell believes the MHC strategy also makes sound sense at the financial level. “There is a fiscal gap of £3.9bn in the West Midlands, because of cuts in central government funding, and addressing issues relating to mental health can make a very significant contribution towards narrowing that gap, by reducing the benefits bill, getting people back to work and increasing productivity,” he says. “We want to raise issues of mental health well-being across the community, and to make people aware of how widespread mental health issues are. We can all suffer from ‘initiative overload’ on occasions, but this is a precise and targeted strategy, and we also have a mechanism in place to make sure things happen. ”Firstly, we must give people more support and guidance to get back into work, then help them during their transition back into employment, and that aspect is very important. “Secondly, we must do more to reduce the number of rough sleepers, and the numbers in hostels, or who are ‘sofa-surfing’, because they often have mental health issues, and we must get them into decent housing, so they have safe and stable places to live. “Thirdly, we need to find ways of keeping people with mental ill-health out of the criminal justice system, to screen people right from the start so that they receive the treatment and understanding they need, and also to prevent such individuals from reoffending. “There’s been an innovative project in Milton Keynes about ways to reduce the rate of re-offending, and we’re learning from their experiences to see what more can be done here.

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Norman Lamb

Supt Sean Russell

“There’s been such a stigma about mental health for so long, that people still don’t like to talk about it.”

”Fourthly, we have to develop and deliver new models of care, and to understand what modern mental health care looks like, for primary and secondary healthcare providers, and finally, we have to get the wider community involved. “There’s been such a stigma about mental health for so long, that people still don’t like to talk about it, but we have to raise awareness about what mental well-being means, not solely for the individuals who suffer, but for everyone in the community, so it is regarded in the same way as any other illness or condition.” Lamb makes an equally passionate advocate for tackling the scourge of mental health, and thinks the imminent election of the first WMCA Mayor will be a critical moment, if the MHC’s action plan is to be delivered swiftly and effectively. “I’m hoping the arrival of the Mayor will invigorate, and then turbo-charge this process, although it must of course depend on their personal motivation,” he says. “However, I am pleased that the Conservative candidate (Andy Street) has picked up on the idea of the ‘well-being premium’, which is a fiscal initiative for public and private sector employers, so they receive a discount on their business rates if they demonstrate commitment to the mental well-being of their employees. “We’re talking to the government, and hoping to get support for a twoyear trial, involving 100 companies of all sizes, across the West Midlands, so we can collect evidence to see if incentivising employers works. “We have initial funding for a pilot, and I’d hope that if the Mayor puts their authority behind it, that we could get started during 2017. We are partnering with the Health Foundation on this project, and if it works, it could be rolled out nationally.” Lamb is equally enthused by the concept of Individual Placement and Support (IPS) provision, which allows individuals with significant mental health issues to gain - and to stay in - employment. “We’ve got almost £10m to carry out a full-scale trial of IPS. The idea is to help people ready themselves for work, help them identify suitable work, support them during the interview process, and then assist them when they’re in work. “I visited Vancouver last year, and they have a well-established and proven IPS system. It gets people off benefits, gives them a better life, and everyone wins. Despite the evidence, we don’t yet do it here, because government operates from silos, and the DWP doesn’t work with the Department of Health as it should. “However, if our trial delivers the data we are confident it will, I would hope government finally recognises that it needs to adopt a more joined-up approach to mental health issues, and again, there is no reason why IPS could then not be rolled out nationally. “Sean and myself are absolutely committed to the Thrive West Midlands action plan, as is the WMCA, and I’m very optimistic that a year from now, significant progress will have been achieved.” n

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Battery set to C

POWER growth

reating the right kind of space for new and growing healthcare companies, and their supply chains, is a major strategic challenge, so it’s good to see the city council, the Greater Birmingham and Solihull Local Enterprise Partnership (GBSLEP) and the University of Birmingham (UoB) taking their time over the crucial development phase. Removing decades of industrial contamination took almost two years, but now the site, once home to Yuasa Batteries, is fully remediated, and plans are being fine-tuned to deliver 400,000 sq ft of science park space: for R&D uses, SMEs, their suppliers and start-up ventures. The massive project was initially driven by the city council, in partnership with GBSLEP, but almost 10 acres of the site was recently acquired by UoB. Driving the debate now is Birmingham Health Partners (BHP) a strategic relationship between the UoB and the city’s two NHS Foundation

Trusts; University Hospitals Birmingham, and Birmingham Women’s and Children’s. Dr John Williams, BHP’s managing director, is currently preparing a strategic ‘refresh’, which will soon be going to the board, and the Birmingham Life Sciences Park (LSP) will be high on the agenda. Naturally, he is unable to be specific about the new approach, but was willing to discuss the rationale which will underpin his recommendations. “The LSP is still at the concept stage, but is also moving forward quite rapidly. We are currently gathering all the market intelligence and data which decisions will require, and I’d expect to see a public announcement in between three and six months,” said Williams. “You could say that we now have all the pieces available, and now we have to assemble the jigsaw. However, we realise we need to deploy unprecedented levels of technology to support healthcare innovation and are looking

Birmingham’s giant Life Sciences Park is a £171m project, with the potential to create 2,200 jobs. BQ2 asked the three major players in its evolution about their vision for its future.

at having a Precision Technologies Accelerator (PTA) on the campus site. “The organisation was set up to work and innovate for health impacts across the age range. We have to decide how we make best use of our resources, harvest the ideas and thoughts of key leaders in our sector and to prioritise strategies which will deliver the best patient outcomes,” he says. “We are uniquely placed to add value and growth to the local and regional economies, and we also have a critical role to play, not just within Birmingham, or in the new West Midlands Combined Authority, but nationally, and also internationally. “The strong relationships we have with the city’s LEP, and local authorities, will be crucial in delivering a pipeline of attractive and high-value jobs, and in helping to deliver our ambitious and innovative agenda. “In that context, Battery Park presents a unique opportunity to leverage our ambitions

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Dr John Williams

for health impact, across the city and the region, and its co-location to our teaching hospitals and our multi-disciplinary hospital trusts enables us to create a genuinely innovative offer in life sciences. “We are now working with key stakeholders, consultants and the government to bring forward the most appropriate offer, which will attract foreign direct investment, create high-value jobs and skills, and also establish the campus as a leading location for innovation in drugs, medical devices and diagnostics. “We already have tremendous infrastructure in place, but we need to engage with local and regional SMEs to establish and grow an industrial base here, and to ensure that the industrial eco-system we create will help drive the regional growth agenda. “The offer will recognise that we have internationally recognised expertise here, in (for example) Big Data, and we also have a very strong genetics programme. BHP, our partners, the West Midlands Academic Health Science Network and others are now ideally place to accelerate life sciences innovation.” GBSLEP chairman, Steve Hollis, has been a passionate supporter of the LSP concept since it was first mooted, and his organisation provided a crucial £5m tranche of early-stage funding through the Growth Deal. “In the early days – for this site, and for

Councillor John Clancy

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Steve Hollis

“Battery Park presents a unique opportunity to leverage our ambitions for health impact.”

the Greater Birmingham healthcare and life sciences sector – we went through a phase of financial leverage. Now, with the opening of the Institute of Translational Medicine (ITM), we are seeing the first blush of intellectual leverage. “Having a PTA on the campus will be another significant step forward, in demonstrating to audiences at national and international level, to potential investors and to potential tenants on the LSP, that there really is a joined-up strategy in place and that there is also a powerful focus on delivery. “Outline discussions are already happening between BHP and other stakeholders, and it’s really encouraging to see that a very powerful business case is being assembled.” City council leader, Councillor John Clancy, is another long-term supporter of the LSP initiative, and his relationship with Hollis has been critical in progressing the complex proposals. “Healthcare and life sciences are already important strategic sectors for the local and regional economy, and will become driving forces of our future economy,” he says. “I was delighted to be able to open the ITM,

even though it clashed with the Tory Party conference in Birmingham, because it is such a key component of what we are all trying to achieve here. “We’re all involved in backing the LSP, because we believe Birmingham has something genuinely radical to offer in terms of healthcare. We have a very young and diverse population, and I believe we have the most diverse and comprehensive research data-base on blood anywhere in the world. “As the park evolves, it will be very attractive to Big Pharma, SMEs, start-ups and manufacturers of medical devices, and there will be an explosion of creativity. “We have always stuck to a very practical timetable; to assemble the site, decontaminate it, and then to promote it, and now it’s going to the UoB. The park will complement the ITM and help to transform Birmingham into a global hub for medical research. “This is a fine example of partnership working, bringing together the city council, the UoB and GBSLEP to deliver something that will create jobs and wealth for the economy and, crucially, develop new healthcare technologies for improved patient care.” n

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Facing the cyber threat

he major security concern for healthcare used to be all about patient confidentiality, typically relating to treatment which patients were receiving. Now though, the biggest issue is about the integrity of the data, and how that can be maintained. “A hacker could, for example, hack into a hospital’s data-base and change information about blood groups, for a particular individual, or a group of patients. Someone could also hack into a digital platform which was delivering data to clinicians about what dosage levels to give. “Even a few years ago, such actions would have sounded like sci-fi, but now we’re seeing cyber-criminals accessing hospital data-bases, taking control of their systems, and demanding ransoms to be paid, usually in bit-coins. “So far, the only reported attacks have been in Germany and the United States, but there’s clearly a potential threat to hospital trusts and healthcare institutions anywhere. In these instances, the systems were corrupted by ransomware, and hackers demanded payment for the data to be ‘released’. “It seems that these attacks were opportunistic; hackers were seeking notoriety, trying to make political statements or hoping to make easy money. However, a much greater threat is posed by organised crime gangs, looking to extract confidential data which they can then sell on the dark web. “Such activity has happened for years. A hotel chain’s reservation system might be hacked, for example, but that’s a relatively low level issue. Now though, hospitals have systems which are so data-rich, that

they are very tempting targets for sophisticated cyber-criminals. “We’re also now seeing teams of hackers linked to nation states, such as China and Russia, which is a modern version of industrial espionage. It’s quite possible that one group could hack another nation’s healthcare systems, to steal data not just about its patients, but about its intellectual property. “If hackers can reach data about new medical devices, products or services, they might sell that information to manufacturers, and at worst, illegal drugs are later sold online. There was a case in 2015, when a student from Shropshire bought what she thought were ‘fat-burning’

Andrew de Ruiter, risk advisory director at Deloitte UK’s Birmingham office, looks at cyber-security issues facing the healthcare and life sciences sectors. pills, and they were really industrial chemicals. “Many recent instances of hacking come when criminals take a scattergun approach, they buy bulk e-mail addresses and send them out to see who ‘bites’. They don’t target a specific sector, they’re just looking to get malware installed into someone’s computer system to then see what they can find of potential value. “The basic technique of a cyber-attack hasn’t really changed since the 80s, but now they’re much easier to carry out, and of course the arrival of bit-coin has enabled hackers to access ransom payments with little fear of being caught. “It is an issue of which NHS Trusts are aware and increasingly concerned. I’ve visited several hospitals and healthcare providers recently, and have been talking to their boards who want to understand issues about the possible hacking of their data, and the loss of integrity of that data. “In turn, the board members are asking questions of their management and technology teams, but as always, it’s about skills and resources, about how the NHS can identify people with the right experience and expertise, and then if they can afford to recruit them. “Nationally, the NHS is looking at this issue, through its NHS Digital programme, for example, but can the ‘centre’ provide the information, the guidance and the systems which the regional trusts will require? “At the moment, my perception is that there needs to be more from the centre, and that the trusts need greater resources and guidance to tackle these issues, or tensions will be created.” n

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Take care to protect your bright ideas Dr Jennifer Bailey, a senior associate at Marks & Clerk’s Birmingham office, says an Intellectual Property strategy is crucial, especially in such a fast-growing, competitive and lucrative global sector as healthcare.

For more information please contact Jennifer Bailey Senior Associate E: jbailey@marks-clerk.com T: +44 121 643 5881 W: www.marks-clerk.com

Greater Birmingham’s life sciences economy has an international reputation for the quality of its research, and partnerships between its academic institutions and the NHS have already spawned an array of healthcare innovations; from drugs and treatments to medical devices and diagnostics. However, the R&D teams, entrepreneurs and academics whose talent delivers these breakthroughs must always ensure their bright ideas are legally protected against predatory rivals. Marks & Clerk is one of the UK’s largest firms of patent and trade mark attorneys, and was established in Birmingham in the late 19th century. Co-founder George Marks designed the Bridgnorth Cliff Railway, and astutely realised that his designs and inventions, like his innovative funicular design, would be stolen by others – If they weren’t protected. “Put simply, it’s vital for people to realise what areas of their research can be protected, what can’t, how a patent can help defend a company’s market share, and how the certainty which a patent offers can be a powerful tool to attract external investors,” says Bailey. She completed her PhD in molecular microbiology at the University of Birmingham, before qualifying as a Chartered Patent Attorney in the UK in 2012, and as a European Patent Attorney a year later. Bailey was promoted to her current position last August, and it’s easy to see why her refreshing ability to understand the intricacies of complex business sectors and sophisticated IP issues, and to explain both in everyday language, appeals to her clients, which include the University of Birmingham, SMEs, global corporations and law firms around the world. “The University of Birmingham is a long-standing client. One of the reasons our relationship with them has continued is that we understand the competing interests that all universities face; the need to protect commercial and intellectual interests versus the need of academics to publish.” says Bailey.

“We work very closely with Alta Innovations, which is the University of Birmingham’s commercialisation arm, and also with academics to understand their inventions and help the university to maximise the commercial value of its research. “With all clients though, we’re trying to discover if an invention or bright idea might be ‘novel’ and ‘inventive’, to judge what protection it could be given, and to help our clients navigate the complex patent application process. “Sometimes, we might have to file a patent application with less information than is ideal, for example prior to a product launch or conference, since it is critical that inventors do not disclose their inventions to the public before their application is filed. “Equally, there are other occasions when we can work with companies and inventors to help them plan experiments which will support their patent application, or to see if there are any other aspects of their research that could potentially be patented. “People sometimes think that because they have acquired a patent, they can do anything they like. However, it is also important to consider whether, by carrying out your invention, you might infringe rights owned by others.” To the uninitiated, patents are something which purely protect products, but that isn’t so, as Bailey explains. “A patent might be for new uses of an existing product, a new method of production, or even a new method of diagnosis. There are also issues around geography, as patents are territorial, and the laws in each jurisdiction differ, particularly for medical inventions relating to therapeutics, diagnostics and DNA. “The life of a patent can be up to 20 years, so when making decisions about filing a patent application you need to look several years down the line. An IP strategy therefore needs to be carefully considered and coherent. IP can be complex, but could potentially provide significant value to a business if done well.” n

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s t n u o c e r a c l a i c So , a partner Matt Wort d social care n a h lt a e h and inghamm ir B t a t s li specia ony Collins h t n A d e s a b akes a Solicitors, m plea for an e t a n io s s a p roach to p p a d e t ra g inte social care.

he social care sector in the West Midlands is reaching breaking point. Faced with a funding crisis and the complex care needs of an ageing population, care providers are struggling to cope, and it’s essential that local authorities, the NHS and private firms work together to find a solution. “From ensuring procurement processes are fair and consistent throughout the region, to pooling together staffing resources to combat employment issues, a joined-up approach, in which the region’s first mayor should be the catalyst, must take centre stage. “A mounting problem for care providers is the huge inconsistency in procurement protocol across the region’s council districts. “For example, Staffordshire County Council’s price-driven procurement strategy focuses almost solely on securing the lowest fee level possible, however this merely succeeds in creating a ‘race to the bottom’ where firms bow to intense cost competition to succeed - often at the detriment of care. “As well as reducing standards, this is a breach of Care Act responsibilities, which states that bodies must place the needs of an individual ahead of anything else. This approach must be eliminated. “The West Midlands will soon elect its first

mayor, providing an opportunity for the region to claim autonomy over its future. “One of the mayor’s first priorities should be to act as a figurehead to stimulate conversations between the West Midlands Combined Authority, representatives from the wider Midlands region, the NHS and care providers. “If West Midlands communities are to prosper, it is vital that these parties work together to agree consistent procurement standards across the region, as well as a renewed focus on best-value outcomes for the end user, ensuring dignity, accountability and a high standard of care… not a postcode lottery. “In the recent budget, Chancellor Philip Hammond finally acknowledged the need for an immediate injection of capital into the social care system, pledging £2bn in additional funding over the next three years. “Whilst this is clearly only a short-term solution, care providers in the region need to act quickly to take advantage of the availability of funds, including renegotiating rates to accommodate for increases to the National Living Wage and the introduction of the Apprenticeship Levy. “The Chancellor also promised a Green Paper, which must look past current financial pressures and focus on fixing a broken system -

introducing legislation that better regulates how to cap catastrophic costs for individuals and how to fund care in a more creative way. “Businesses in the West Midlands should lobby for their own interests, to make sure the region is not left behind when this paper is published in the summer. “In the meantime, care providers should begin to take steps to ease financial pressures. With expensive agency workers often running up huge costs for providers with staffing shortages, there are opportunities to drive savings, but only if local providers work together. “By creating a regional ‘bank’ of staff, providers can establish a ‘pool’ of temporary employees in a local area. A potential business opportunity, this would significantly reduce costs, cutting out agency margin. “There is no denying the financial strain facing adult social care in the West Midlands, with procurement and staffing issues pushing care providers to the limit. “However, the focus now should fall on the need to re-evaluate tender processes, promote collaborative working and capitalise on robust leadership. Local authorities and care providers must work together to ensure the region is equipped to deal with these challenges now, and for future generations.” n

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BioHub wins out

for spin-out Linear Diagnostics Ltd (LDL) is a fast-growing spin-out from the University of Birmingham (UoB), specialising in rapid diagnostic platform technology, as co-founder Dr Matt Hicks explains.

y previous role was in academic research and teaching, at the University of Warwick, and LDL’s other co-founder is Tim Dafforn, a professor at the UoB and now also the government’s chief scientific advisor at the Department of Business Innovation & Skills. “Our research led us to realise that we could take long, thin molecules along a narrow tube (like sticks in a stream), could detect how they were aligned, through a special type of polarised light, and then use them to detect different types of bacteria, so potentially, a very easy-to-

use diagnostic device. “There wasn’t a Eureka moment, it was a combination of a lot of smaller moments. Much of the work was about building technology to enable the theory to be proven. “Then, when we knew the theory was valid, we knew we needed to make a machine that was smaller, easier to operate and about 100 times lighter than our original, because the device had to be portable and hand-held. “We had set up LDL in early 2011, and fitted the work in around our day jobs, but when we

realised it was a viable commercial proposition, we knew one of us would have to devote a lot more time to it. “Tim was at a crucial moment in his academic career, but I was at a point where I could take a year’s break. From then, it’s been about making steady progress, evolving the technology, winning enough grants to fund ourselves, and then finding space where we could grow the business. “We realised that our technology platform had multiple potential uses; including medical, veterinary, defence and security, food safety and agriculture, but we also knew we had to be careful not to over-stretch our resources. “Urinary tract infections are a very common complaint, so we chose that as our initial focus, because our technology offered potentially huge benefits. At the moment, test samples for these infections have to be sent away to centralised laboratories for full testing, which is expensive and time-consuming. “Now though, if our handheld device was used, in just two minutes there’d be more information available than you could get from a dipstick test, which would help reduce the issuing of antibiotics, a major issue for the NHS, and help target the right drugs to the right people personalised medicine. “We’ve been very successful right from the start, at winning financial support, and soon we’ll be looking at raise another £300,000 or so, to take our first product to market, probably in mid-2018. “Later, we’ll need to raise another £2m so we can scale up LDL’s operations, in the UK and also in the US, but for now, we’re settled in nicely at the BioHub, the workforce is up to ten, and as we grow, we can lease more lab benches on the ground-floor and take more business space on the second-floor. “At some point, we’ll obviously outgrow the BioHub, but it’s been great for us, and I’m sure it’ll be as attractive for future spin-outs when they need to find commercial research and test space.” n

“ Research scientist Lorea Oreuta with Matt in the LD lab

“We’ve been successful right from the start, at winning financial support, and soon we’ll be looking to raise another £300,000.”

Promotion

Circle set to square the Pebble Mill concept Birmingham’s next landmark healthcare scheme is almost complete, as BQ hears from Calthorpe Estates’ director of development, Ralph Minott.

Pebble Mill Birmingham Calthorpe Estates, 76 Hagley Road, Edgbaston Birmingham B16 8LU +44(0)121 2487676 www.calthorpe.co.uk

‘Location, location, location’ has been the mantra of estate agents for decades, but in healthcare, colocation is the secret of strategic success. Pebble Mill is still better known to the wider world as the home of the BBC’s Birmingham studios, but observers of the health sector, and commuters who use the adjacent Bristol Road highway, realise that something special is being created there. Already, the 27-acre site owned by Calthorpe Estates houses the new £50m Dental Hospital and School of Dentistry, which occupies some 170,000 sq ft of space, and a 62-bed private care home operated by Bupa is currently being built. The former - the first such project to be delivered in the UK for almost 40 years - opened in April 2016, and will provide learning and research facilities to more than 600 students a year. Construction of a private hospital for Circle Health is now underway, and further details about that project are expected to be revealed before summer 2017. The site’s remaining plot has a proposed 53,800 sq ft medical hub building, floors available of 13,000 sq ft GIA with full medical use approval. All told, Pebble Mill represents a development value of some £200m. “Yes, it is a major project, and it’s certainly been a long-term project, but I think people really began to understand our vision for the Pebble Mill site, after the opening of the dental hospital and school,” says Calthorpe’s Minott. “We invested more than £3.5m here, just on infrastructure, but it’s worth it, because it’s a genuine landmark location, so everything has to be just right. “We spent significant sums in creating public realm and landscaping in keeping with the site’s healthcare uses, allowing the two brooks which have always run across the site to form a ‘green’ corridor and then meet in the tranquillity garden, created for the Pebble Mill workforce and students, local

community and visitors to the site to enjoy. “I suspect there’ve been moments, since we acquired the site, that some people thought we weren’t sure what to do with it, but we’ve always been prepared to take our time.” The spread of healthcare uses at Pebble Mill testifies to its appeal, especially to a sector which has the resources and the ambition to be effectively footloose. Minott believes a key reason that the location proved so attractive was because tenants bought into Calthorpe’s strategic vision. “We’ve always said that we wanted to make Pebble Mill a world-class destination for healthcare and medical sciences, and have never deviated from our original intent. It has been and is a significant investment for a family-owned property and development business such as Calthorpe.” However, he readily accepts that its co-location with other major elements of Birmingham’s healthcare and life sciences community was also a powerful influence. “For sure, the site is ideally placed for anyone wishing to engage with, work with, or simply visit the rest of the city’s healthcare cluster, and we’re just a few minutes walk away from the University of Birmingham and the Queen Elizabeth (QE) Hospital site. “When you work in the same city as the QE, you become so familiar with its presence that you don’t think of its international reputation, but it has the largest solid organ transplantation programme in Europe, the UK’s largest renal transport programme

“

“Pebble Mill is a genuine landmark location, so everything has to be just right.”

Promotion

and the world’s largest single-floor critical care unit. “Pebble Mill is also close to the proposed Birmingham Life Sciences Campus, where the University of Birmingham and its stakeholders will deliver something like 400,000 sq ft of new space for healthcare and life sciences uses.” The final development phase at Pebble Mill will be to bring forward almost 54,000 sq ft of new space, and Minott says several uses are being considered by Calthorpe and its agents. “It’s often said that Birmingham lacks office space with large floor-plates, but at Building 4 we will be doing just that for medical use, offering complete open plan flexibility to operators within 13,000 sqf floor plates on a single floor, plus parking for 150 vehicles. The floor-to-ceiling distance has also been pitched relatively high, so the space will be flooded by natural light. “The beauty of being such a long established family-controlled developer and investor is the ability to make fully considered views, so we

Artist impression of Building 4, 53,800 sq ft state of the art building at Pebble Mill

“

“I think people really began to understand our vision, after the £50m dental hospital and school opened.”

aim to ensure we strive for the best long term deal for this final plot. It might go to a single tenant, or be taken as individual floors. “When we first began working with Birmingham City Council and the regional development agency, Advantage West Midlands, we shared a vision of what this site could become and I am sure it’s almost as pleasing for all our partners as ourselves, to be on the cusp of completing our delivery of that vision.” Minott also believes that Calthorpe’s strategic vision for Pebble Mill, and for the wider Edgbaston Medical Quarter (EMQ), is now understood at an international level; by potential investors, tenants and members of the healthcare and life sciences community. “Arab Health the Middle East’s largest medical congress and exhibition, is a good example of this. it’s held annually in Dubai, and this

February, we attended for the third time. We were establishing, and then raising, our profile in 2015 and 2016, but this time, we exhibited in the UK Pavillion opposite the Association of British Healthcare Industries’ stand. “The amount of interest we had in Pebble Mill and EMQ was very pleasing. By the end of the event, we’d had eight or nine serious inquiries, mostly about primary care centres, but also about physiotherapy and cancer-related treatments. “These are early-stage inquiries, of course, but I thin k to attract so much detailed interest, when there were around 4,000 exhibitors at Arab Health, shows what a strong and very positive brand that Calthorpe, and Birmingham’s healthcare and life sciences community, have been able to build on a global stage.” n

Pebble Mill Birmingham PLOT 1

Proposed 53,800 sq ft Medical Hub Building, floors available of 13,000 sq ft GIA with Full Medical Use Approval

University of Birmingham and QE Hospital

Battery Park

BUPA

BUILDING 4

62 bed private care home OPENING SPRING 2018

PLOT 1

Bris

tol R oad

TRANQUILLITY GARDEN

to B

irm

PLOTS 2-3

PLOT 4

PLOT 5

ing

ham

city

cen

tre

PLOT 5 CIRCLE HEALTH PRIVATE HOSPITAL

PLOTS 2 - 3

Up to 161,000 sq ft (14,957 sq m)

Persh o

re Ro ad

DENTAL HOSPITAL & SCHOOL OF DENTISTRY

OPENING 2018

NOW OPEN

Join a world class destination for healthcare and medical sciences www.pebblemillbirmingham.co.uk Another development by:

0121 265 7500 david.kerr@dkahp.co.uk +44 (0)2076 377 298

douglas.bonham@colliers.com

gva.co.uk

george.jennings@gva.co.uk carl.potter@gva.co.uk

0121 248 7676 enquiry@calthorpe.co.uk

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Taking the pulse of our health economy The Silk Report is Birmingham’s strategic stepping stone to its future healthcare economy. BQ2 invited Graham Silk to give a personal opinion on the sector’s current state-of-play.

am most impressed by the quality of strategic leadership. You look at (for instance) Sarah-Jane Marsh, Julie Moore and Tim Jones. The pressures on the NHS mean they must always be mindful of day-to-day issues, but they are also looking very clearly at tomorrow. I’m also pleased at the innovative approach by the Institute for Haematology, who are working very closely with Big Pharma, to help in-patients become out-patients, so they don’t need nurses, or porters, or kitchen staff, or any other of the NHS’s precious resources. They are treated at home, they feel happier, they probably get back to work more quickly, and then they start earning and paying taxes again. However, it’s worth noting that haematology is the one area (in the UK) where we are ahead of the game on five-year survival rates. This approach also frees up hundreds of bed-days in the main hospital, which although it’s not a huge number in context, does prove that the strategy is correct. Across the whole healthcare/life sciences piece, there are signs that people are starting to think of new ways of doing stuff, which

“

was a central point of my report. New drugs are starting to come through faster and more effectively than they once did, which is better for patients and for the NHS’s finance. I’m also delighted to see that Birmingham’s hospitals are sharing best practice with hospitals outside the region, and I’ve heard of new relationships developing as far away as Leeds and Southampton. Also, the Trials Acceleration Programme developed around haematology is now being adopted in other areas of healthcare, which is strengthening the relationships with Big Pharma, helping drive the intellectual property community, and starting to evolve a 21st century health model. The formation of the M40 Alliance, where the University of Birmingham and Oxford University are working together to create a ‘corridor’ of consultants, clinical researchers and nurses between their two cities is also an excellent initiative. Again, it’s an approach welcomed by Big Pharma firms and the Association of the British Pharmaceutical Industry, because it accelerates the development and the testing of new therapies.

“When someone has a medical issue, their data should be available right at the first point of contact.”

Each university is putting something like £3m into this alliance, and the Kennedy Trust for Rheumatology Research has given them £7m to speed up the delivery of novel treatments for arthritis. Now the Institute for Translational Medicine is open, it’s great to see that we’re looking at much rarer diseases, and taking a more precise and tailored approach to medicine, which is often called the ‘stratified’ approach. The area’s growing expertise in Big Data is also tremendous news, as to me, patient data is the lifeblood of the NHS. When someone has a medical issue, their data should be available right at the first point of contact, whether that is a paramedic at the roadside, the GP in your local surgery or someone at a hospital. I understand that the word ‘data’ in a health context scares some people, but if we just called it ‘patient information’ would anyone be concerned. In many other sectors, such as retail, for example, people hand over their data without stopping to think, yet their health data could save their lives. In many ways, I’m pleased at the progress being made towards what I call an ‘arena of knowledge’ in healthcare and life sciences. My only significant cause for concern is that people do need to become more savvy about commercial opportunities and about accessing private sector finance. n

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The Institute of Translational Medicine (ITM) is a world-class research institution which will progress the latest scientific advances into innovative treatments. Ian Halstead met its director, Professor Subrata Ghosh.

Innovation T

from bench to bedside

he strategic leaders of Birmingham’s healthcare community may be purposeful and refreshingly positive - given the challenges faced by the NHS - but they’re not usually prone to heaping accolades upon a newcomer before they’ve even reached the city. However, when it was revealed in early 2016 that Subrata Ghosh had agreed to relocate from Canada, to become the ITM’s first director, the excitement was evident. There’d been a global search for someone to lead this £24m institution, housed snugly inside a lovingly-restored Art Deco building on the sprawling QE site, which aims to bring together clinical expertise, pioneering science and academic excellence. Even the usually phlegmatic Professor Charlie Craddock was a-buzz to discover that the world-renowned specialist, noted for his novel therapeutic approaches, and an international specialist in inflammatory conditions, such as Crohn’s Disease and colitis, had been persuaded to come to Birmingham.

As was Ghosh; a genial and charming individual, with a rare blend of professional passion, academic detachment and entrepreneurial nous. “I’d spent eight years as professor of medicine at the University of Calgary, and was very happy. I enjoyed doing both research and clinical care, and delivering a major centre for colitis, which I’ve been interested in for many years. “On a professional level, I’d really enjoyed creating innovative treatments, bridging gaps in existing care, having a leadership role, and also being able to mentor young students too. “On a personal level, my wife was also happily settled, and I have always loved skiing in the Rockies. I’d been visiting them on holiday every two years or so for a long time, and in Calgary, the mountains were just 45 minutes away. “However, when I knew of the ITM, talked to Birmingham Health Partners, met Steve Hollis from the LEP and chatted with

Charlie Craddock, it was clearly an irresistible opportunity, and a challenge I really wanted to take on. “I’d been driving our vision for precision medicine in Calgary, and have always believed in delivering the benefits of scientific advances much more quickly to patients - what we call the ‘bench to bedside’ approach - and here was somewhere where that could be achieved. “Having a platform, to bring innovation in drugs, diagnostics and devices forward through new and efficient collaborations really resonated with me.” Even before the removal vans reached his Calgary home, Ghosh was already dreaming about what the ITM could deliver, and it’s a vision he shares with typical enthusiasm. “There are huge benefits to be gained from having patients, clinicians and research co-located on the same site, and we can also build on Birmingham’s very impressive record for clinical trials. “At the same time, we also have the

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â&#x20AC;&#x153;Having a platform, to bring innovation in drugs, diagnostics and devices forward through new and efficient collaborations really resonated with me.â&#x20AC;?

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technology here which allows us to understand that not all drugs benefit all patients. It’s not just a case of patients suffering bad sideeffects. The same drug might work for one patient, but not for someone else with the same condition. “If we can identify the drugs which won’t work for some patients, it would have massive benefits; for patients, for clinicians and the health economy, because at the moment, millions of pounds are being wasted each year, because they’re being given to patients who receive no benefits. “Progress for new drugs, along the ‘bench to bedside’ pathway, was always very slow, it might take ten years or longer, and patients die waiting for the right drugs, which is why Charlie came up with his concept of accelerated trials, which has been remarkably successful in tackling blood cancers. “It’s also about bringing the right people with the right skill-sets together at the right time. For example, you might have a very bright scientist working very hard to develop a molecule which can tackle a certain disease, but he’s only working with mice, so the outcome might just be healthier mice. “In most cases (if not all), that individual

needs to be given advice and support, and to engage in wider collaborations, not least to discover if the pharmaceutical industry would be interested in this molecule. “Even if the molecule is successfully developed, many scientists don’t find the right partner nationally or internationally, or the right company to work with. I suspect that only 20% of these molecules (at best) are ultimately used to generate better outcomes for patients.” There’s a smidgeon of professional frustration in his remarks, and Ghosh confesses that he thinks Britain’s healthcare economy needs a good dose of entrepreneurial culture to be found most visibly in North America. “Everyone understands the major challenges around healthcare provision in the US and Canada, but that doesn’t mean other countries can’t learn from them. In Calgary, for instance, my oldest faculty members were in their 80s, but they were still productive and still thinking like entrepreneurs.” “The more we can encourage academics, researchers, clinicians and everyone else in the healthcare community together, and at the early stage of projects, the more can be achieved.” Birmingham-based Glenn Howells Architects

took on the painstaking task of converting and refurbishing the QE Hospital building, built in the 1930s, into a home fit for the ITM in a digital era, and Ghosh has been impressed by their vision and the quality of their work. “We have six floors here, and lots of space for people from different disciplines to mix and meet has been built in, which is perfect because such inter-location is a huge driver of innovation. However, we can’t rely on random meetings, because while one chance encounter might work, nine more may never happen. “We want to do things differently here, and we want do to things better, so we deliberately encourage disruptive ideas and debate, about drugs, devices, new approaches or technology. Everything has to be about delivering better outcomes for patients, and no-one should lose sight of that goal. “I’ve always been a supporter of brainstorming, which nowadays appears to be called ‘swarming’, so we bring lots of people to the area behind our cafe, which was designed for such sessions, and throw challenges at them. “They might be researchers, clinicians, bio-engineers… anyone in the healthcare community, and we ask them to think and interact in new ways. Doctors, in particular, are

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often surprised and impressed to discover what other people do. “We are also seeing people from industry here in growing numbers; to help people here develop their ideas, and to ask people here to help them develop their ideas. Big Data is crucial, so we can understand potential opportunities and also understand how treatments can be effective on patients in very large numbers. “Digital technology is equally important, and we’re bringing forward the concept of virtual clinics, so patients don’t have to travel for hours to be assessed, and specialists from different disciplines can interact with each other and the patient from remote locations. “University Hospitals Birmingham NHS Foundation Trust (UHB) has been identified as a centre of digital excellence, and for innovations in healthcare IT, and you can see the expertise in healthcare informatics. “It’s one of the best examples of how all the elements of healthcare can interact for the benefit of patients, if the systems and the structure are in place.” Understandably, patients have embraced the

“

rationale for the ITM’s creation, and the ‘can do’ mindset of Ghosh and his colleagues, because it offers them hope. “Almost every patient we speak to has a challenging disease, whether it is cancer, colitis, arthritis or another serious illness, and you feel a real sense of optimism from them. Patients love to come here, because they know innovations are happening here which may be able to treat their condition. “We search for people with specific conditions, and contact them to see if they’d become involved in novel forms of treatment - which are proactive, not reactive - and almost all volunteer to take part in research trials. “We do early-stage tests of new drugs, to see if they will deliver better and earlier results than existing drugs, and at this stage, pharma companies get involved, often through the Trials Acceleration Programme. “We’ve been generally successful in winning grants from the pharmaceuticals industry, because of our expertise at clinical trials and because we genuinely believe in collaborations between the NHS and the drug manufacturers.

“The Wellcome Trust gave UHB £13m over five years, the Biomedical Research Centre provided more than £12m over the same period, and Cancer Research UK recently granted another £7m, and all this vital funding came here because of the ITM’s existence. ”The entrepreneurial culture isn’t generally found in hospitals, or in the wider economy, but we can only make scientific advances if we have the finance available, to employ like-minded people, with the right skill-set and experience, and to acquire the very expensive equipment we need. “I know that some people in the NHS, and in the wider health community, look at business with a degree of caution, and even with distrust, but that’s a mindset I’ve been eager to change since my first day. “Just one of the machines here costs £500,000, and I have never seen anything ‘wrong’ with entrepreneurs benefiting from bright ideas and innovations which provide clear benefits to patients. To me, everything we do has to be for patients, and we always need to remember that common purpose.” n

“Patients love to come here, because they know innovations are happening here which may be able to treat their condition.”

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Scientists

Gary Middleton

talking science Birmingham has a global reputation for stratified medicine; allowing patients to receive treatments as personalised as their conditions. Ian Halstead talked to two specialists at the University of Birmingham who are tackling the scourge of lung cancer.

o those unfamiliar with the arcane jargon of cutting-edge medical research, Mastering the Matrix could be the long-awaited reboot of the dystopian sci-fi classic. Instead, it’s the catchy phrase which the University of Birmingham’s genial Professor of Medical Oncology, Gary Middleton, uses to describe the challenge which he faces, as the national lead of the personalised lung cancer treatment programme, known as MATRIX. Until a decade or so ago, the same drugs were given to all victims of lung cancer, although it exists in many forms, and the chemotherapy used to tackle the most common form had multiple side-effects because of its toxic nature. However, MATRIX is an innovative and hugely ambitious attempt to precisely match sub-groups of patients to new or existing treatment regimes, which address the cancers more effectively and accurately, and also reduce or remove the painful side-effects. Middleton is certainly not alone in this Herculean task, and modestly makes the point on several occasions that a host of clinicians, researchers, data specialists and PhD students, in Birmingham and throughout the UK, are also working on these trials. He arrived in Birmingham to take up his current role in January 2012, within the Department of Immunology and

Immunotherapy at the University of Birmingham (UoB) and started on his present project as a joint initiative with Cancer Research UK. MATRIX itself follows the second phase of the UK’s Stratified Medicine Platform, known in the healthcare world as SMP2. “One element which gives Birmingham a huge advantage in healthcare is our ability to do large-scale screening, then to carry out accelerated clinical trials, and this initiative has now become the largest lung cancer research programme in Western Europe, and quite likely, in the world,” says Middleton. “Essentially, we take tissue which has been left over from earlier biopsies on patients, and use it to identify changes in their DNA which related to their cancers. We’re looking at 28 separate genes, because we think these are the most important ones in the evolution of lung cancer. “We then match up a drug to a particular gene - which has mutated to allow the cancer to grow - and use targeted drug therapies to ‘switch off’ that molecule. Next, we take what data we have discovered, from a small number of individual patients, to look at the generality of lung cancer treatment. “Once we have discovered which therapies work best on particular genetic structures, we can then really start to evolve our approach to

Chris Bagnall

treatment by carrying out tests in a real-world context. “Each stage naturally takes a great deal of time and effort, so everyone in the MATRIX team is also constantly looking for ways to make the research process and the trials quicker and more efficient, so we can deliver these new treatments more quickly to patients.” The MATRIX programme is led by Middleton and his Birmingham-based team, but they also work with researchers, data analysts and principal investigators at 18 Experimental Cancer Medicine (ECM) centres across the country. “Everyone involved in the SMP2 platform meets very regularly,” says Middleton. “It is a complex process, but it operates very efficiently. In recent years, the UK has been behind the game in addressing lung cancer, but the presence of the NHS enables us to work in ways which wouldn’t be possible in the US, for example. “It isn’t simply academic research, the programme is deeply embedded in the day-to-day workings of the NHS, which is a

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“An ever-present challenge is the need to recruit new patients for the trial stages, as some of the current patient cohorts are very small.”

huge advantage. It’s also a tribute to the great reputation which Birmingham has acquired for taking an outward-looking approach, that MATRIX is led from here.” Although some of the trials use existing drugs, there is an intense focus on using existing drugs in new ways, and in developing novel and experimental immunotherapies, which are tested on patients who have the specific genetic condition (bio-markers) for that particular treatment. An ever-present challenge is the need to recruit new patients for the trial stages, as some of the current patient cohorts are very small. “At the moment, we’re screening around 1,200 patients with lung cancer every year, but we’d like to get that up to around 2,000 to ensure all the data can be validated,” says Middleton. “We’d like to open some more ECD centres in the UK, and I’d hope that this time next year, they’d be operating and the patient numbers would be rising. By then, we’d also expect to have published our top-end clinical data so the benefits of MATRIX become clear.” The research is sponsored by UoB, and although AstraZeneca, the giant British-Swedish corporation, is the biggest external partner, it is very much Middleton, and not Big Pharma, who

is in charge. “This is our study, and its foundation is academic research which was initiated by us. We have funding up to mid-2018, and we’re thinking about internationalising the programme, once we can fully demonstrate that these studies can deliver valuable data.” As Middleton stressed, a pyramid of talented researchers, data analysts and clinicians underpins the MATRIX programme, and one such is Chris Bagnall, an immunotherapeutics support officer, within the UoB’s Human Biomaterials Resource Centre. He qualified as a biomedical scientist, then trained at Birmingham’s City Hospital, and worked there, specialising in histology, for 15 years, before joining the UoB team. Bagnall works with the tissue bank, analysing samples and looking for different types of tumour, with the aid of some seriously clever software and expensive hardware. “I help people speed up their research, and our Vectra 3.0 pathology imaging system is a tremendous benefit,” he says. “In a routine laboratory, a pathologist can look for one type of cell via a microscope, but this machine allows you to look for six types simultaneously. “As it’s digital, it can count millions of cells, rather than the pathologist having to laboriously take notes, so although it won’t

Slides of tonsil tissue, ‘stained’ on the Leica Bond RX machine, using PerkinElmer’s Opal dyes, then imaged on the Vectra 3.0 system by Chris Bagnall.

replace pathologists, it speeds up the process enormously. Gary comes with ideas about which direction the research should take, then we aim to identify what is happening to certain cells. “We are looking for biomarkers, which allow us to monitor and predict the health ‘states’ of individuals, or patient groups. Essentially, it’s about identifying which cells are impacted by different forms of lung cancer, and what happens to different patients when they are given different treatments. “We have a database of archived material, so we can learn what happened to patients in the past and see what the outcomes were. At the moment, our work is mainly about discovering what is happening within tumours, but we’re also starting clinical trials with patients, using biopsies from before and after surgery. “We’ve probably got 200 patients on earlystage trials, and as the programme progresses, we discover new avenues, and can take the research in new directions.” Bagnall also had a notable ‘Eureka’ moment a year ago, when he developed a new protocol for the Vectra system - allowing it to analyse ‘stained’ tissue samples at far quicker speed than previously. “It used to take us a week to run the six colour slides through, but we’ve since got that down to a day, and sometimes even less,” he says. Now, it takes a lot to make the US company which designs and manufactures the Vectra equipment take note. PerkinElmer Inc. did around US$2bn of business in 2016, and they’ve been devising industry-leading detection systems for more than 80 years. However, when they heard of Bagnall’s breakthrough, he was awarded its much-prized ‘Key Opinion Leader’ status, of which he is understandably proud. “Since joining in 2015 I have been able to use my expertise as a biomedical scientist to help increase the quality and speed of work in a research setting, to make it easier to ‘reproduce’ the work, as well as developing new and exciting protocols,” he says. “I really enjoy the challenges, the direction in which my career has taken me, and am very appreciative that the QEHB charity has funded my post, as without them UoB might not be advancing as quickly as it is.” n

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Health challenges under the microscope

BQ2 invited three high-profile members of Birmingham’s professional services community, to give their personal opinions on the challenges ahead for the region’s healthcare sector.

li Breadon, the government and public sector lead for PwC in the Midlands, believes devolution can be the catalyst for a new era of reform. “While the Spring Budget’s injection of £2bn for social care over the next three years was welcome, the reality is that it is not a substitute for the longterm solution to the huge pressures that services face. “PwC’s research into the health and care system, Redrawing the Health and Social Care Architecture, shows that, the balance of power needs to be shifted to local areas so that political accountability, financial responsibility and operational control are better aligned at the local level. “The West Midlands mayoral elections in May will see devolved power become a reality for the region. However, if we are to make health and social care devolution a success there are a number of factors to consider and challenges to overcome. “A place-based approach is important to successful health and care devolution, or integration, and depends on stakeholders placing more focus on a collaborative impact for people in their place, instead of individual organisational interests. “A broader approach to long-term reform will reap dividends. Given that the majority of health outcomes are determined by factors other than the care people receive, a more radical approach is needed to also tackle wider socioeconomic issues, such as unemployment, poverty and housing. “Too many people are being kept out of productive work due to poor health, therefore improving health and social care services will have a wider economic impact by contributing to economic growth, as well reducing pressures on public services. “Whilst there is a challenging journey ahead for health and social care organisations, having a shared mission and sense of purpose will be critical. Devolution should give us the impetus to come together, tackle public service reform and deliver better outcomes for people and places.” Julian Smith, a partner in the healthcare practice at Mills & Reeve, is impressed by the strength of Birmingham’s healthcare economy and progress on the city’s new Life Sciences Park.

“Healthcare remains a safe bet for investors, despite the UK’s relatively shaky macroeconomic landscape. Private equity, which currently accounts for half of the sector’s buying activity, sees it as one of the most Brexit-proof sectors for many reasons - and not least the market fundamental of patient need. “At a local level, the Midlands has a strong position in the UK healthcare sector, driven by large-scale research and innovation projects such as the University of Birmingham’s latest 9.9-acre development, which is set to become a leading life sciences location and drive new technological advancement. “Pair these strengths with an increasing demand for capacity, innovation and skills to support the NHS and the region is well-placed to capitalise on new investment opportunities. “The wider sector is also seeing rising global activity; more Mike Steventon

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overseas healthcare businesses are bidding for UK opportunities in the market, opening up more options for the Midlands. “In March, the Qatar-UK Business and Investment Forum took place in Birmingham, aimed at strengthening ties between international investors and the region’s life sciences, highlighting opportunities and building long-term relationships - a promising sign for the future of the sector in the region. “However, healthcare is not completely immune to the pressures that other sectors are facing as a result of uncertainty surrounding Brexit, particularly the right to work implications for a large proportion of its workforce. “Natural staff wastage isn’t being replenished quite as easily from the EU, as it was pre-Brexit and finding and retaining people is an increasing challenge. “What independent sector health needs is wider recognition of the crucial role it performs in supporting the NHS and certainty for its current and prospective EU employees. But in the meantime, healthcare continues to be bought and sold at a rate that will keep it at the heart of the Midlands economy.” At KPMG, Birmingham-based partner Mike Steventon, who chairs the UK public sector and healthcare teams, admits that integrating Ali Breadon

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“Healthcare is not completely immune to the pressures that other sectors are facing as a result of uncertainty surrounding Brexit”

healthcare and social care at regional level is a major challenge, but highlights the region’s expertise. “Like all of our regional economies, the Midlands faces a real challenge in providing efficient and effective healthcare as it manages the increasing demand from an ageing demographic. “How we integrate healthcare and social care at a regional level is one of the biggest challenges that devolution has had, however, the Midlands is at the forefront in a lot of these areas. “For example, the work being done by Prof Charlie Craddock and Prof Subrata Ghosh in Birmingham, in identifying new treatments for patients across a range of major health issues. “What’s also unique is the diversity and stability of the multicultural population we have in the Midlands, making it the perfect base to run clinical trials for new treatments. “Additionally, across the region, we have some of the UK’s leading universities developing medical devices as well as treatments. “The importance of community and

collaboration between academia and the private sector is essential, and we have clusters of life sciences organisations that are working closely together, particularly around University Hospital Birmingham. “Healthcare and life sciences organisations are taking fundamental steps forward as the industry evolves from curative treatmentbased solutions to increasingly preventative treatments that predict diseases and detect early signs. “In the future, we’ll see things like telematics and other tools being used more to monitor our health, exercise and dietary intake, as well as helping to identify symptoms. “Other UK regions see life sciences as a critical industry and need for investment, so it’s important that we build on past successes and treat this as a sector that needs to be encouraged, supported and invested in across the Midlands. “Healthcare and life sciences will also be crucial in the future in providing a financial contribution to our economy, not just in the ways that we treat and look after our citizens.” n Julian Smith

Promotion

Catalyst for healthcare innovation Birmingham City University has established an Institute for Health and Quality of Life. Its director, Susannah Goh, explains more about this ambitious initiative to Ian Halstead.

For more information please contact Susannah Goh, Director – Institute for Health and Quality of Life

University House 15 Batholomew Row Birmingham B5 5JU T: +44 (0) 121 202 8648 M: + 44 (0) 7718 972 362 W: www.bcu.ac.uk

Birmingham City University (BCU) is one of the region’s largest providers of qualified healthcare professionals to the NHS, and its new School of Health Sciences will underpin its fast-growing presence in the healthcare sector. The latter, to be based in Edgbaston, will include specialist laboratories, and deliver an array of courses in health, nutrition and biomedicine when it comes on stream this autumn. So, given BCU’s expertise - and major investment - in the healthcare and life sciences sectors, it was no surprise to see that one of its new ‘Innovation Institutes’ should focus on health and quality of life issues (the other two focus on sustainable futures and creative innovation). The institutes have been created to help companies, entrepreneurs and organisations from the private, public and third sectors devise and deliver innovative solutions, at the individual or business-wide level, via collaboration with BCU’s academics and specialists. It is a hugely ambitious initiative, but Susannah Goh clearly believes the goals are achievable, as she explains the strategic rationale behind the establishment of the Institute for Health and Quality of Life (IHQL). “We pride ourselves on being a modern university in every sense. We’re one of the UK’s post-1992 universities and have a strongly practice-based and civic ethos,” she says. “We have a very long history of working with the business community, in the Birmingham area and further afield. Our heritage was derived from arts, design, engineering and manufacturing, all sectors for which the city has been noted for over the centuries. “Our approach to innovation is inspired by the history we share with Birmingham. Design-centred thinking has long been at the heart of our strategic vision. Traditionally, design meant predominantly producing products and processes. But, at BCU, design is also a strongly people-focused endeavour, from the development of medical devices and

healthcare services, to the creation of sustainable and citizen-centred built environments. “The IHQL works closely with BCU’s academic faculties on a daily basis. Our collaborative innovations with industry partners, whether they are social, scientific or technological, are strongly evidence- based. Sound research and analysis, and their application to real-world situations, comprise the touchstone of what makes us BCU.” Goh and her Institute colleagues provide a conduit between BCU’s vast array of academic expertise, knowledge and research data, and the entrepreneurs, SMEs or major corporates looking to progress their healthcare projects. “It’s all about collaboration, but to do this well, you must first find the right people to assist you. We identify the best people for each proposal put to us, working across the various disciplines to make this happen. “We are, for example, creating technological solutions to enable people to enhance their health, and the teams brought together for each particular initiative will include specialists from several fields, as diverse as, say, visual communications, machine learning, architecture and physiology. There’s an equally powerful employment focus about the strategy which underpins the work of the IHQL, and the new School of Health Sciences. “When the School of Health Sciences opens fully, it will specialise in areas such as biomedicine, diet, nutrition and biomechanical engineering. We have always had expertise in those sectors, but now we’re building very powerful teams. It’s a great time for us.” “You would be failing as an institution of learning, if you didn’t structure your courses to consider routes to employment, and didn’t engage with

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“Design-centred thinking has long been at the heart of our strategic vision”

Promotion

and services, as well as managing complex workflows. “With increasing expectations of a rapidly available user experience, technologies such as virtual reality (VR) and augmented reality (AR) are critical enablers to user take-up. Our Digital Media Technology Lab team uses these technologies, and more, to address areas as diverse as dentistry, oncology and medical education. “Our growing cadre of Health and Life Sciences teams have allowed us to take our research

your students to consider potential areas of employment, right from the outset,” says Goh. “Many of our courses at the new school will include professional industry placements. We’re about creating jobs for the present and for the future. “We believe in the benefits of ‘crosspollination’, for instance, placing a biomedical engineering student into an SME specialising in design, and vice versa. We want to help students to navigate the world beyond ‘university’, which, as you know, does not fit into neatly-classed disciplines. “We’ve been working with local businesses for over 100 years. Our students hail from 80 countries, but around half of the student population comes from the West Midlands. This informs our solid commitment to local employment and wealth creation. “A central element of the IHQL’s strategy is to develop long-term relationships, whether we’re working with a big plc, or an SME. “The catalyst for our initial collaboration might simply be the need for a single product evaluation, but because we have expertise in other areas, we end up exploring further and larger projects, which is very pleasing - and productive for everyone concerned.” IHQL helps industry partners to access core areas of expertise such as data analytics, genomics, enterprise systems, sports, exercise and performance, and biomedical engineering, to name a few. It’s an imposing array of subjects, but Goh talks with confidence and knowledge as she outlines

the rationale for those choices. “There are many fields that I could talk about and it would be impossible to do justice to all of them in this interview!” Goh notes, enthusiastically. “However, as a flavour of what we do, across disciplines, I’d like to mention some areas that are likely to strike a particular chord with BQ audiences. “We have an excellent array of expertise within data analytics, informatics and psychology. For example, our Data Science and Big Data Analytics Research Group and Centre for Applied Psychology cover areas that help industry partners spot vital trends and even predict human behaviours- all crucial to staying ahead of the curve in creating products

and evaluation offering to new heights. What is especially great is that our head of school of allied and public health professions, has recruited teams with form in not just academia, but also in practice- and that includes working in both private and public sector environments. “Overall, this dynamic brings with it great enthusiasm from - and, vitally, competence in staff - working with our neighbours in the life sciences community, including Subrata Ghosh and his team at the Institute for Translational Medicine, Medilink, the West Midlands Academic Health Science Network and Birmingham Science City, as well as national and international partners. “IHQL, in close partnership with the BCU faculties, offers a clear point of entry through which to gain that nuanced approach to achieving a leading edge in health and healthcare markets, as well as truly appropriate solutions to maintaining societal wellbeing.” n

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Secrets of our success Deborah McKee

Mark Garrick

The University Hospitals Birmingham NHS Foundation Trust was named as a centre of digital excellence, by Health Secretary Jeremy Hunt. Ian Halstead discovers more.

n our digital era, organisations which can devise and deliver new platforms and operational models are the ones who lead where others can only follow, and for both innovation and sheer consistency, the trust which runs Queen Elizabeth Hospital Birmingham is something special. Its reputation for digital excellence is based on a long-term track record of successful collaboration with partners here and overseas, and a demonstrable willingness to deliver new solutions within the primary and community care sectors. No surprise that NHS England awarded the QEHB trust ‘centre of excellence’ status, and considers an exemplar to help it achieve its own ambitious digital aspirations. Mark Garrick, director of medical directors’ services, makes a passionate advocate for his organisation’s expertise, as he discusses its work with Deborah McKee, the trust’s head of clinical systems development. “Many of the systems we use now were originally developed here, and then evolved, over the last 15 to

20 years,” he says - with understandable pride. “The University of Birmingham’s school of computer science has an excellent reputation, for breakthroughs in the theory and practice of new systems and applications, and has become a magnet for talent.” “Our USP is that we create digital innovations for the benefit of patients, and that all our programmes are clinically-led,” says McKee. “We’re all working very closely with doctors, consultants and research nurses, to ensure that technology is being used to deliver benefits for patients and to help healthcare staff who are in the front-line work more effectively and productively.” Each QEHB ward has multiple hand-held devices and laptops, plus digital ‘dashboards’ detailing every aspect of a patient’s care, condition and treatment. “Healthcare IT is an enabler, allowing hospitals to meet their operational priorities, and make the very best use of their resources,” says McKee. “We have, for example, a big focus on missed drug doses to understand why they happened, and

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to build in more effective systems so that the number of such doses is driven steadily downward, and we’re also using IT to drive down the length of patient stays.” Inevitably though, any trust which acquires such digital expertise discovers that its staff become potential recruitment targets, for employers in the public and private sectors. “Some people will always move on, but we’ve focused on creating clear career pathways for individuals, so there are always opportunities for people to progress,” says Garrick. “We regularly bring our clinicians and IT people together, so they realise just how valuable each other’s insights can be. We moved our informatics team off-site, but we bring them back for half-a-day every week to make sure they’re always fully attuned to the healthcare environment. “We also encourage them to engage in less formal ways, to share ideas and experiences, because it’s surprising what benefits can ultimately result from the simplest conversation. One crucial area of activity was about how risk assessments were being carried out. ”Setting up interactions between junior doctors and members of our team, perhaps in the Institute of Translational Medicine, allowed us to identify what we might call ‘aberrant’ ways of working. “We found, for example, that some doctors were waiting for test results to come back from the labs, rather than contacting the labs directly, and that some were waiting for other doctors to do something, rather than taking action themselves. “Once we put all the data together, and adjusted how the system worked, we were able to implement a much more efficient system which improved patient care, and also helped the junior doctors. “Once they understood that the IT teams were there to help them, the feedback was tremendously positive because they were getting real-time feedback, and they understood more about how everything worked.” There’s so much enthusiasm in the room that

the two almost collide, as they lean forward to outline the many ways in which IT and Big Data come together to deliver better outcomes for patients and hospital staff. “We do take a multi-disciplinary approach to all issues and challenges, because it’s only once everyone starts to interact and interpret what is happening that solutions start to appear,” says McKee. “As an example, the coders need to understand the requirements of the healthcare teams, the clinicians then start to see new ways of working, and we’ve also developed business analyst roles, for people who understand the business model and the systems.” “Exactly, and when everyone gets together, it’s remarkable what can be achieved,” adds Garrick. “Just as one example, I remember when one of the leads from an intensive therapy unit outlined one change he’d like to see, and the programmers said it couldn’t be done. “Six weeks later, they came back with a solution which was even better than the consultant had hoped for. Once you’ve got teams which are genuinely integrated in their approach to challenges, the benefits just start to flow. “Change can’t be driven from the top, and the most rewarding aspect is often when people come to us with ideas which no-one else has considered.” Innovation comes in many forms, of course, and such new ways of working also require

new structures, and the recruitment of people with different skill-sets from those traditionally employed within the NHS. “We have created a new role, quality development leaders, and we now have around 80 of them, as a conduit between the clinicians and the data teams,” says Garrick. “You also need a framework in which to work effectively, which usually didn’t happen in the past, and also a very good ‘governance’ model. At the moment, the digital/data department employs almost 270 people, so structures must be in place to make sure you create the best outcomes.” Given the enormous pressures throughout the NHS - to gain maximum benefit from scarce resources, and to ensure that productivity increases are achieved - Garrick, McKee and their colleagues must also constantly deliver both new solutions and complete ongoing projects. “We’ve made excellent progress on storing all our in-patient records digitally, so we can continue to take more paper out of the system,” says McKee. “In the coming year, we’re also focusing on the creation of virtual health clinics so patients can be assessed and monitored without needing to travel to hospitals, and continuing to develop the MyHealth@QEHB portal which at the moment allows something like 13,000 patients to securely access their records online.” n

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Banging the genomics drum Charlotte Hitchcock talks about her work as Genomics Ambassador in the West Midlands.

he 100,000 Genomes Project is an innovative and transformational initiative, which comes in the wake of our ability to sequence the human genome. “It’s an innovative combination of both research and healthcare, and the information which is obtained if fed back into the patient’s record. “The basic aim of the project is to sequence 100,000 genomes of NHS patients, who are suffering from certain rare diseases and specific cancers. “Our hope is that their genetic components can be identified, and that by doing so, we can then look to provide answers to those individuals who have unexplained and unnamed conditions, and to build that information into future screening for cancers. “The sequenced data could also then be looked at by researchers to develop precision and personalised medication. “In November 2015, I became one of three Genomics Ambassadors for the West Midlands Genomic Medicine Centre (WMGMC), funded by the West Midlands Academic Health and Science Network (WMAHSN). “Each of us covers four trusts within the Midlands Region; my host trust is Royal Wolverhampton Hospital Trust, and I also cover Dudley Group Foundation Trust, Walsall Healthcare Trust and Worcestershire Acute Hospital Trust. “My background is in nursing - though not in

research or genetics, but in theatre - and more recently in clinical informatics. “I always make this point to people who ask me to explain my role, as I feel it is crucial for everyone to understand that this project is not the sole remit of scientists, but is a true collaboration between research and healthcare. “My enthusiasm for the 100,000 Genomes Project is born of frustration with the many unanswered questions relating to genetic impact on health, and also a strong belief in the need for all healthcare professionals to embrace research as part of their routine practice. “My role is extremely varied, but the main element is to act as a representative of both the WMGMC and the WMAHSN to facilitate the implementation of the project at each site. “This involves engagement with clinicians, support services, patients and patient groups, education, project planning and management, public speaking and the identification of potential participants. “However the remit goes beyond this; we are also there to represent the clinicians and patients through our General Medical Council to Genomics England. “Whilst the project has a set timeline for the sequencing of 100,000 genomes, the work does not end there. Our long-term goal is to embed the genomics service into routine healthcare, and to transform how healthcare is delivered in the future. “Not only are we hoping for sequencing to

become the norm, but also that the treatment of patients will start to move toward the delivery of more personalised and precision medicine. “For me, an important aspect of my practice is talking with nursing groups and individuals to discuss how we can ensure the genomics factor is incorporated in our practice, our education and therefore our future. “Much is changing already about how the project is perceived, with clinical nurse specialists introducing the project and its ethos to patients in their care, and in some cases nurse specialists are identifying, informing and recruiting eligible participants. “The 100,000 Genomes Project is a change platform for transformation of the provision of healthcare in the UK. We are at its heart - it is at the heart of my beliefs and actions, and I feel privileged to be taking part in this initiative.” n

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“Our long-term goal is to embed the genomics service into routine healthcare, and to transform how healthcare is delivered in the future.”

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Let’s get health and social care working together Mark Stocks, the Birmingham-based head of Grant Thornton’s public sector assurance practice in the Midlands, and national lead of its health audit practice, looks at the regional healthcare economy.

he biggest element of my ‘day job’ is to carry out audits for several NHS Trusts, and for several Clinical Commissioning Groups (CCGs). As an outsider looking in to the NHS, I identify four key issues for the healthcare

economy: collaboration and support, the interaction of healthcare and social care, new models of care and efficiency savings. Governance has been a major challenge since the government closed all Strategic Health Authorities at the end of the 2012-2013 financial year. A raft of new bodies has been set up, but nobody has control of the whole system. Everyone’s had a go at setting up Sustainability and Transformation Plans (STPs), but so far, they’ve been very difficult to deliver. There’s also great uncertainty in the sector about the governance of these STPs. In terms of collaborations, I see lots of great examples happening now between University Hospitals Birmingham NHS Foundation Trust and Heart of England, for example - and also lots of collaborative discussions about the future, between Birmingham and Solihull CCGs, for instance. However, as to how they will really work closer together, it’s not yet clear. Trusts and CCGs are already being pushed very hard to break even, which creates pressure on their

structures and on their people. Everyone knows that the interaction of healthcare and social care is simply not working. If you can’t keep people out of hospital by offering them support in their community, and can’t get them out when they’re ready to leave, that’s a disaster for the health service. We can see a scenario, in the West Midlands and nationally, when councils have to make more cuts in their social care budgets because of the financial constraints they’re under, and the current problems will be magnified. New models of care are the future, and the NHS needs to invest more in evolving and delivering them; particularly in primary care, community care and mental health. I do see a willingness to innovate among NHS Trusts here, and there are some interesting changes in primary care. We’re also starting to see more integrated models of care, but it is patchy, and there are places that haven’t changed at all. In general, it comes back to the quality of leadership. It requires a lot of skill and thought to devise new models of care, and clear strategic analysis is vital. In some ways, efficiency savings should be a relatively easy challenge. People know what to do - but they often don’t do it. There may be underlying reasons why trusts can’t find enough doctors or nurses, but if they don’t, they end up in a bidding war with other trusts for locums and agency staff. We are seeing costs come down in some places, but again, it’s down to effective and timely leadership. In the worst instances, we find a doctor saying: ‘Quality, quality, quality’, but the finance director saying: ‘We haven’t got the money’. We all see the outcomes when the trade off between quality and finance gets out of synch, but at the best places, genuine conversations are taking place about getting the balance right. The Carter Review, in 2015, about ways of increasing productivity in Britain’s hospitals was bang-on; but the NHS can’t implement its recommendations, partly because of the lack of finance, and partly because of the lack of strategic leadership. n

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Professor Michael Sheppard, Chair of WMAHSN

Tony Davis, Commercial Director of WMAHSN

Kevin Wilson, Department for International Trade

What is the best way forward for better health and wealth? CAPITALISING ON BREXIT AND DEVOLUTION Can Brexit bring a boom, or will devolution deliver? The two seismic shifts in the political landscape and the opportunities they may create, dominated discussions at the third annual Economic Summit of the West Midlands Academic Health Science Network (WMAHSN). 2016 was a highly significant year for the West Midlands; the UK’s decision to leave the EU was coupled with the advancement of the regional devolution debate, which centred around the Midlands Engine and the development of the West Midlands Combined Authority. At the WMAHSN’s Economic Summit held in Telford in Shropshire, more than 130 clinicians, academics and business leaders joined to

Great challenges lie ahead for the West Midlands in the fields of health and care. We report on an economic summit where key decision makers came together to debate these issues. discuss and investigate the challenges that these events have posed and the opportunities that arise from them to create better health and wealth outcomes. Professor Michael Sheppard, chair of WMAHSN, explained: “When we held our first economic summit we didn’t know that it would be the success it has turned out to be. Our focus has always been, and remains, to investigate ways to improve health and drive wealth and there currently exists genuine opportunities for innovative healthcare.”

WMAHSN’s commercial director Tony Davis provided an update on the WMAHSN’s Seven Point Growth Plan: “When we launched our growth plan, we committed to promoting the West Midlands as a place in which to invest and deliver innovative life sciences and healthcare. We’re doing this on multiple levels through partnerships with Local Enterprise Partnerships in the region, the West Midlands Combined Authority, the Midlands Engine and across both the European Union and the global stage. “Next, however, there are three specific

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Dr Linda Magee OBE, Manchester Academic Health Science Centre

Dr Clive Winters, Coventry University

Richard Stone, Medilink West Midlands

areas we wish to focus on: firstly, providing support to seize the opportunities created by our decision to leave the EU; secondly, to look at how we can learn from the experience of Manchester in the process of devolution; and lastly to examine how we operate with regards to the goals of the regional Sustainability and Transformation Plans (STPs).” BULLISH ABOUT BREXIT Tackling the first of these areas was Kevin Wilson, sector specialist for Life Sciences at the Department for International Trade (DIT), who began with an overview of how to maximise global opportunities in light of Brexit. “A UK/EU steering group has already been established to ease the path ahead. Within this new department, the Life Sciences Organisation (LSO) is specifically dedicated to providing impartial advice to the sector so that UK businesses can successfully trade in international markets, whilst overseas life sciences companies can invest in the UK. “For example, the USA remains, by far, the largest market for UK life sciences products and services. US$3tn was spent there on healthcare in 2015 and it is anticipated that, by 2021, UK life sciences could enjoy exports worth £9.2m. “Significant opportunities also lie in India, UAE, Japan, China, South Korea and Latin America and access to the Chinese market

could expose UK exporters to as many patients as Canada, North America, South America, Australia and Europe combined - worth £2billion by 2021!” During a thought-provoking panel discussion, Kevin Wilson, Richard Stone, chief executive at Medilink West Midlands and Tony Davis faced questions from the floor about the best way to realise any opportunities presented by Brexit. Tony began: “Substantial effort has gone in to building and strengthening relationships between the private sector and academia across Europe and the challenge is now to maintain those collaborations and relationships, especially as most of those relationships have a global focus.” Richard added: “Thinking specifically about SMEs, we need to ensure that post-Brexit they have access to prospects both on the continent and further afield. In the ‘new world’, the government needs to ensure that UK SMEs are given every chance to grow and that access to developments is made as simple and straightforward as possible.”

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Kevin agreed, emphasising that Brexit will provide chances for UK industry: “The UK will be smaller and nimbler and we must, therefore, believe we’ll be in a better position to seize opportunities on the global stage.” Dr Linda Magee from Greater Manchester AHSN was keen to hear how NHS organisations can contribute their experience to the international opportunities outlined by Kevin, who responded: “Healthcare UK is already the channel through which the NHS can input into major overseas projects such as hospital builds.” Tony added: “The development of AHSNs has led to a very much more collaborative approach, where industry and healthcare come together and it is here that a solution for greater input to overseas projects can be created.” Marie Jenkins from Advance your Wellbeing then asked: “As an SME, it is important for me to understand the procurement processes involved in accessing overseas opportunities do these differ massively from one country to another?”

“The government needs to ensure that UK SMEs are given every chance to grow and that access to developments is made as simple and straightforward as possible.”

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“There’s currently a 20-year gap in life expectancy between the poorest and most affluent in the West Midlands”

Kevin highlighted the resources on the DIT website, adding: “Local DIT advisers are well placed to provide guidance in this respect.” He also emphasised the importance of local experts who speak the language and know the local market well: “Cultures do matter and it’s imperative to have experts on the ground in all markets, not just those which appear different.”

employment and housing; so they could create a financially balanced and sustainable system which is guaranteed to be clinically safe at all

City Council, Dr Clive Winters of Coventry University and Dr Linda Magee, they discussed what opportunities devolution will create and

LEARNING LESSONS FROM MANCHESTER The strategic opportunities for the life sciences and healthcare sectors presented by devolution were eloquently explained by Dr Linda Magee OBE, business development director at Manchester Academic Health Science Centre and executive director for Industry and Wealth at the Greater Manchester AHSN. “The driving force for devolution across the English regions is ultimately focused on economic growth and for healthcare it’s a pragmatic means of delivering the NHS’s Five Year Forward View. In Manchester, devolution has been central to delivering the greatest and fastest improvement to health and wellbeing of the region’s 2.8 million people.” She described a transformed health and social care system that focused on keeping people well and taking better care of those who are ill. This was achieved by aligning the system more closely with education, skills,

times. “What is different, is the role of the Greater Manchester chief officer to whom several services are delegated. These include budgets for public health; the delivery of dental care, pharmacy services and primary optical services; and the management of NHS England (NHSE) running cost budgets. Budgets for primary care services, including GPs, meanwhile are delegated to CCGs in a co-commissioning arrangement with NHSE. “We’ve ensured that health is at the pinnacle of the devolution debate in Greater Manchester and have developed a strategic plan to support this. This plan is a fundamental change in the way people and our communities take charge of, and responsibility for, their own health and wellbeing.” In a panel debate chaired by Dr Adrian Phillips, director of public health for Birmingham City Council, and featuring Dr Jane Moore, his counterpart from Coventry

how they can be maximised. Dr Jane Moore set out distinct opportunities aligned to devolution: “We firstly need to reduce demand without increasing spending – there’s currently a 20-year gap in life expectancy between the poorest and most affluent in the West Midlands and through devolution we should be looking at both reducing demand and improving outcomes. We also need to reduce vulnerability and work to engage with our communities.” Dr Phillips then added that the West Midlands Combined Authority has a vision to place the West Midlands at the pinnacle of mental health research: “With 50% of the 128,000 people currently drawing unemployment support allowance across the region suffering from some form of mental health problem, the significance this could have shouldn’t be underestimated.” A question from the floor asked the panel to define the goal of devolution, given it will

Andy Williams, Sandwell and West Birmingham Clinical Commissioning Group

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incur such a huge expense to achieve it. Linda responded by explaining that whilst cost savings are important, devolution should also be about doing things in a different way. Jane added: “Saving money is of course key, but we need to acknowledge that we’ve failed people for far too long. From the outset of devolution, we need to give every child the best chance in life and reduce the conditions that would otherwise lead them to excessively use costly services.” THE FUTURE OF SUSTAINABILITY AND TRANSFORMATION PLANS (STPS) Mark Rogers, chief executive of Birmingham City Council, began by providing the local authority perspective: “Chris Ham of the King’s Fund recently said that ‘STPs are the least bad option for trying to plan in a more coherent way in the NHS’. This made me think. Yes, who wouldn’t want better health and wellbeing? Who wouldn’t want a more sustainable system? “But local authorities have been ambivalent about them, questioning whether the initiative could actually last. For me, I think their introduction was well intentioned but we need to move beyond Chris Ham’s assertion. STPs need to be considered in the whole place in which they occur; we need to consider whether they’re designed for the people they serve; and as we move forward, we need to dispel the

Mark Rogers, Birmingham City Council

growing perception that they’re a secretive NHS planning initiative. Simply we need to make them the best way forward, not the least bad.” Andy Williams, lead for the Black Country STP, continued with the clinical commissioning perspective: “I focus on what we can achieve through STPs, and in the Black Country have worked to bring the 18 organisations within the STP together to agree on a clear set of goals. “We’ve created a two-concept route to sustainability: firstly, to try and modify demand in the coming five years, and secondly to optimise efficiencies through back-office integration and the reduction of clinical duplication. “It’s also imperative that we look at issues around housing, education and domestic violence and the Combined Authority will be key in pulling these all together. For me, the challenge we face is to spend our funding more wisely as it simply won’t meet demand otherwise.” Terry Whalley, programme director of the Black Country Alliance, joined the debate, which resolved that STPs need to be utilised to get beyond organisational needs and place people first. Andy added the importance of technology and innovation: “We need to use technology to allow people to engage in their own healthcare needs – there’s no benefit in having patients taking up beds simply because they’re seen as

Dr Jane Moore, Coventry City Council and Dr Adrian Phillips, Birmingham City Council

not allowed to go home. Similarly, innovation needs to deliver scale and better access to healthcare.” Terry added: “We need to facilitate access to knowledge and information regardless of location – Pokemon Go was a great example of how couch potatoes could be encouraged to get up and out.” Mark highlighted the importance of the third sector: “Now we’re at the delivery stage we need to be thinking bottom up, as well as top down and this is where there’s a real opportunity for greater engagement with the Third Sector.” WORKING ACROSS THE WEST MIDLANDS Closing the summit, Tony Davis stressed how important it will be for the WMAHSN to hear from clinicians, academics, business leaders and civil servants across the region so his team could engage fully in all their conversations. As a central cog in the Midlands Engine, the WMAHSN has an important role to play in bringing the right people together to help progress the region’s plan for better healthcare and economic growth. “We will support the Combined Authority and regional STPs on the delivery of their plans as well as continuing our work across industry, academia and the health sector post-Brexit to ensure we’re seizing every possible opportunity for growth.” n

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Shout out and

stand out

Tony Davis, commercial director of the West Midlands Academic Health Science Network, explains why he thinks this region’s healthcare and life sciences sectors must do more to highlight their achievements and their goals.

hat is unique about life sciences and medical technology in the West Midlands and who needs to know about it? In the government’s recent industrial strategy green paper, life sciences and medical technologies were identified as a key sectors for driving economic growth. Both the devolution-inspired West Midlands Combined Authority and the government-endorsed Midlands Engine have published strategies which also identify the importance of the sectors. However, many regions in the UK consider life sciences and medical technologies to be important sectors of their regional economy, so what makes the West Midlands stand out from the crowd? To me, there is a significant number of reasons why this region is well placed to be considered the ‘capital of the UK’ in terms of accelerated access to medicines, treatments and medical technology. These include the development of the West Midlands Genomic Medicine Centre, the trials acceleration programmes, the Institute for Translational Medicine, the University of Birmingham BioHub, Keele University’s MED Innovation Centres, Serendip - the WMAHSN’s digital health incubator and accelerator - and a whole raft of existing and planned programmes and initiatives,

So who needs to know about this unique proposition? Firstly, the citizens of the West Midlands. As a region, it is crucial that we get the message out to the public that by engaging in research and development, trials and evaluations, and by consenting to the appropriate and secure sharing of their data with the NHS, West Midlands citizens will benefit by having accelerated access to cutting edge treatments, medicines and technology. This access will improve their engagement with health services and most importantly, produce positive healthcare outcomes, improving the quality of life for individuals and their families. Secondly, we need to let life sciences and healthcare industries know that the West Midlands is the number one destination for the rigorous, time and resource efficient testing and evaluation of their technology, treatment, diagnostic or drug. By working and investing in the West Midlands, national and global life sciences and healthcare industries will be benefiting from access to a regional population that is not only the size of Scotland’s, but ethnically

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diverse - a population which is stratified and understandable through being able to access a number of regional data lakes. But more importantly, if we can get the above message out and produce a population that is educated and knowledgeable regarding the benefits in engaging in trials and evaluations, we will ultimately produce a population that is innovation receptive and actively ‘pulling’ new treatments, technologies and medicines into service for the ultimate benefit of all. The West Midlands has invested in developing capacity and creating centres of excellence in life sciences and medical research which are on a par with many parts of the UK. As a region, we have now invested in additional capacity for supporting translation and acceleration of that research which is truly unique in a UK perspective. However, if we can clearly articulate our objectives to the public and to our industry partners and ultimately create an environment of rapid uptake and adoption of technologies and treatments, we will have an offer that is globally significant and unique. n

“We need to let life sciences and healthcare industries know that the West Midlands is the number one destination.”

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THE WEST MIDLANDS ACADEMIC HEALTH SCIENCE NETWORK 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.

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.

To contact us and ﬁnd out more: www.wmahsn.org | info@wmahsn.org | @wmahsn | 0121 371 8061