MedilinkUK Webcast

Launched Medilink UK - the first organisation to stimulate debate within the Life Sciences industry and form an on-line community. The organisation has three national products: Medilink.com - organisers of this webcast, the publication Medilink Review and the Medilink UK awards.

Today's webcast is to examine the theme 'Is the UK a Viable Market for Life Sciences?’ Introduction of panel of the four following speakers.

Outlined BIVDA's role as representing 100 companies engaged in analysing human samples and tissue, determining states of disease for the purpose of monitoring therapeutic processes.

IVDs represent around two per cent of total global healthcare spend. UK spend is the lowest in the EU, with Switzerland and Germany having the highest.

Recently returned after 25 years in the US. Introduced the BIA as having 300 corporate members in the Life Sciences and biotech industries investing in research or as service providers. While the UK styled itself the second largest biotech community globally, vying with Canada, strong competition is coming from Europe. The US leads the market, with China and India making progress.

A background as a medical doctor specialising in oncology with l7 years in pharmaceuticals and ten months with the ABPI – the UK trade association for pharmaceuticals with 70 member companies specialising in prescription medicines and investing around £4.5 billion in R&D. ABPI members produce around 80 per cent of all NHS prescribed medicines, representing around 70,000 workers.

Outlined the medtech and devices sector as being worth around £10.7 billion to the UK with six billion going into the NHS. Around 2,700 companies make up the sector, with 85 per cent of them small to medium firms together employing around 52,000. The ABHI represents around 200 companies – about two-thirds of the market by value.

Described the economic background for the debate. With the £15 billion Life Sciences sector set to contribute to a stronger UK economy and the Government seeking potential growth sectors to support, there is still a public spending 'hole' of £15 – 20 billion which could be an opportunity – or a threat – to UK industry.

Suppliers look in vain for a single point of contact, as there are big differences between healthcare in the UK and other countries, as well as national variations within the UK itself. Suppliers need to separate the market into ten different SHAs and further down into the Primary Care Trusts which control 80 – 85 per cent of the healthcare budget. The international aspect of the business should also be considered.

Believes the UK could be one of four major Life Science hubs if the initiative created by the setting up of the Government's Office for Life Sciences could be continued. A unified front made up of Life Science trade associations is a major force for change, and the industry must continue to press for OLS 2. Clinicians, surgeons and patients are also needed 'on side'.

The industry must act now on the recommendations in the Office for Life Sciences' blueprint report, initiating a change in culture and working with the NHS including its clinicians. Although one in five medicines presently come from the UK, the industry should not be complacent.

The Office of Life Sciences is a superb initiative. The NHS budget gap is an opportunity for the industry because devices could deliver improved healthcare leading to immediate savings. New ideas should be adopted and shared, which is not always happening.

Asked if the NHS's current behaviour including late payment and complicated procurement routes stifles economic opportunities.

SHA leaders need to streamline the procurement process faced with the challenge of improving healthcare with reduced funding.

BIVDA is already working with a forward-thinking SHA which believes in a more integrated approach and is due to publish three case studies exemplifying ways for the NHS to save cash, including early action at Primary Care level to improve the payment system.

Welcome changes are happening within the NHS but are hampered by it being a massive bureaucracy.

A cultural change is starting to happen within the NHS with Trust chiefs sitting down with representatives of the pharmaceutical industry.

The industry needs to take responsibility for the leadership shift and show how business techniques could improve patient care and save cash.

Companies need to look for ways to develop and publicise its convincing business cases.

The industry is starting to see a willingness to talk and look for innovative solutions.

Underlined the severity of the UK's In Vitro Diagnostics low spend and stressed the need for greater dynamism, although the attitude of SHAs in the West Midlands is more positive than anywhere else in the UK. However, for the individual budget holder, the savings that IVDs could achieve are savings in someone else’s budget in a different silo.

The NHS needs productivity initiatives to create internal imperatives to cut across the financial silos.

The NHS faces the choice of making either small savings across a range of areas, or re-engineering its whole structure. Geographically there are huge variations in the cost of pathology services and laboratory tests - a disparity which could be reflected across the board.

Agreed with the need to deal with silo budgeting, and to publicise examples of best practice in budget management.

Did solutions stemming from OLS proposals require investment in order for the UK to become a viable market?

No. Some come through structural and attitude change which do not necessarily mean huge investment but intelligent reorganisation of existing resources.

Agreed. Asked if case studies existed of successful attempts to re-educate policy makers in other countries.

Were there barriers to private sector supply and do these compare with supply to the NHS? Could streamlined procurement from the private health sector be used to improve entry to the NHS?

The private sector probably breaks down costs and analyses them more keenly. The Government has recognised that it has failed to move healthcare into the community. Patients need to return home sooner which usually means faster recovery – a measure which could rest with commissioners.

A shift is required to encourage the NHS to procure its services against outcomes rather than against a paper specification.

Did the panel believe there had been enough progress in the NHS to solve the procurement problems raised in the John McKellen Report of 2006 and the Anne Glover Report of 2008?

No. The proposed national procurement council needs to get on with the job. The current cost of serving the NHS is 'crazy'.

A simple system for logging indemnity agreements in one place is due to be dismantled from April, forcing suppliers to enter into individual agreements with separate trusts. This is a serious retrograde step.

Clinicians need to become more engaged with procurement and the Royal College of Surgeons needs to be back at the table.

Disruption between national, regional and local procurement systems leads to confusion which adds to the cost and places a burden on the industry. Better understanding is needed.

It is essential for the NHS to invest in technology and improve procurement procedures or a 'disaster' will follow. Private providers in the West Midlands are already offering diagnostics charging up to £400 a time. If the elderly are not ill enough or poor enough to get cost-effective help, their homes will be taken from them to pay the bill.

Industry needs to take a leadership role in these instances to ensure engagement with changes in the health service such as Quip.

It is very encouraging to see more than a hundred submissions of cost-saving, innovative medical technologies by the procurement director of DoH last year representing a potential saving of £5 billion. The NHS Life Science Innovation Delivery Board is now examining the submissions and the outcome is awaited.

Concerned about the message reaching the grass roots and whether innovative systems remain intact by the time they get there.

Against a background of an ageing population, around 650 cancer drugs are in development and innovations such as the Nottingham 'Happy Hearts' heart disease prevention programme has been introduced. The UK is now embracing personalised medicine. Such innovations need to be kept in the mix as well as budgetary issues.

A welcome spirit of collaboration is developing, but cuts cannot be made in every area. Despite some concerns, President Obama has nevertheless increased the US's Life Science budget to ensure the US keeps its premier world position.

Would it make sense to enforce certain compliance rules to ensure centrally-created initiatives are not diluted by the time they filter down?

The focus of CSUs is to support commissioners rather than suppliers.

The opportunities for improvement exist, but greater clarity is needed.

Outlined NHS inaccuracies and cumbersome bidding processes including inappropriately timed PQQ stages. The DoH has devoted its limited resources to the innovation agenda from which it should not be diverted.

At the front line, the NHS should consider patient outcomes rather than penny-pinching.

Summed up. Medilink was an opportunity to sustain conversation and live debate. The day's webcast is the first of a series to include podcasts, on future topics of interest and concern.