The NHS’s imperatives are on the one hand to improve the efficiency of its processes and the existing healthcare pathways, and on the other to significantly shift efforts from treatment towards prevention, whilst empowering citizens to take charge of their health. Facilitating access to the most advanced personalised medicine whilst keeping costs under control is an additional challenge. In this context, real world data’s (RWD) role at the centre of the healthcare system and as a source of innovation is spectacularly reinforced. Leading hospitals have already taken ownership of this topic, with one renowned professor and research officer confiding off the record:
“As a specialty hospital, our primary business in the future will be data analytics”.
In this perspective, for companies aiming at rolling out a new healthcare solution with the NHS, it is vital to provide solid evidence, not only of the additional patient benefit vs. the existing options, but crucially also of the additional costs in relation to the long-term savings that would be generated by the new technology. Demonstrating this through real-world data massively increases the chances of NHS adoption. According to IQVIA, “In 2017, only 12% of initial submissions to NICE that included RWD received a negative recommendation vs. 24% for those without”.
As a taxpayer-funded healthcare system, the national health care system (NHS) has a responsibility to develop a vision for its sustainable future.
Enhancing the competitiveness of the UK life sciences system has always been a key policy objective, but it is finding a new relevance with the UK’s forthcoming departure from the EU.
The 2017 and 2018 Life Sciences Sector Deals, the latest two sets of measures and funding packages aiming at fostering R&D in the sector, placed a particular emphasis on RWD.
From an industrial policy point of view, Healthcare Data is an invaluable asset for the UK. The universal healthcare system provides a whole – and extremely ethnically diverse - population perspective. Granularity is made possible by the NHS Number, which acts as a unique identifier per patient. The broad ecosystem of records and registries with historic data comprise data pools that are second to none, in Europe and further afield. The Life Sciences Deals entail a whole set of measures to unlock the potentials of this asset.
First, access to data by industry and applied research stakeholders needs to be considerably eased. The ambition is to ‘transform a store of record to a store of value’. Health Data Research UK was created in 2018 to consolidate health data assets across the UK and to support organisations in the identification of and access to data pools relevant for their needs.
Secondly, new sets of data necessary for personalised medicine are being created and will be incorporated into the new architecture. Genomics data is key; the UK has outlined its goal to sequence one million genomes in the next five years. Wearables and self-monitoring devices are also perceived as important instruments, notably to collect behavioural, social care-related and quality of life measurement data. The NHS is extremely interested in expertise around how to reconcile these new datasets to the legacy data, and qualitatively connect them to the patient pathways.
What is the data of the future? What should the governance of the data ecosystems look like? What is the value of the data? How can/ should it be monetised? These are the fundamental questions that will need to be addressed to achieve the objective of the NHS Long Term Plan to support a ‘digital first’ healthcare infrastructure.
Recommendations for Swiss companies interested in business and R&D collaborations
Collaborations between Switzerland and the UK are naturally legitimated by their leading role as Life Sciences innovation hubs, but also by the close proximity of their business cultures, respect for intellectual property, alignment on data privacy questions and concept of public service. Both countries are home to some of the world’s leading life sciences companies, their universities and research institutions rank among the best in the world, and their technologies are capable of building a strong infrastructure layer that allows for interoperability, access and security of data architecture.
Committed to fostering business and R&D collaborations, the SBH and the Embassy of Switzerland in the UK have conducted an in-depth market analysis and mapping of both countries’ capability, and have engaged with the most prominent UK stakeholders and industry. Recommendations to Swiss companies can be summarised as follows.
1. Consider the big picture:
It is critical that any Swiss company wishing to enter the UK market understands where their product/ solution fits in the wider context of NHS and industrial policy. Referring to the key strategic documents, notably the NHS long-term plan, will help to elevate the discussion and establish qualitative relationships with key opinion leaders. Cardiovascular stroke, diabetes, mental health and cancer have clearly been defined as priorities; the Swiss company’s team at all levels should be able to demonstrate how their solution will impact the patient pathway. They must be clear in assessing in what way their technology will enable each specific stakeholder to achieve their strategic objectives.
Companies should bear in mind that it will be vital to scale their efforts to the system as a whole, beyond their point of entry.
2. Think about the cost versus benefit:
Improved efficacy is not enough. A pitch needs to articulate the cost vs. savings achieved by the product, taking into consideration the whole value chain and longer term perspective. When possible, this should be backed up with real-world data. NICE’s view is that the economic benefit data should ideally be assessed simultaneously with the efficacy data. The NHS procurement processes are stringent, so the case must be consistent with the evaluation guidelines and concisely demonstrate the value proposition.
3. Make use of the supporting instruments:
It can be difficult to navigate the various innovation support organisations in the UK. On a national level NICE, HDRUK, AHSNs and the Digital Health Hubs (see Appendix) notably have dedicated teams to support industry engagement. If the Swiss company’s objective is to pilot a solution, it is however usually still more efficient to pursue specific practitioners with targeted trusts and CCGs, but it will be necessary to engage with very different stakeholders with sometimes contradictory motivations for a commercial roll-out. Finally, a partnership with existing well-introduced players is a route to market that should be seriously considered.
4. Contribute to the debate:
The data revolution is fresh and dynamic and we are only at the start of the journey. New business models will appear, new skills are needed, new regulatory means will be introduced, and new job types will be created (e.g. data roboticists). Swiss businesses need to contribute to this ongoing debate and think about their position in this changing ecosystem. Having a proactive position and clear messaging is key to elevate their profile. In particular, the issue of data initially gathered by the public service being monetised by industry is very sensitive. There is also a certain nervousness around the ethics of data (the idea of ‘AI in the wild’) and the risks linked to poor data management in the long run inducing automation bias. AI should be explainable, and its performance in real-world settings transparently evaluated vs. the training and testing phases.
5. Seek advice:
The Swiss Business Hub UK & Ireland is the key contact point for Swiss and Liechtenstein SMEs looking for export opportunities in the United Kingdom and Ireland market. The team provides individualised consulting and expertise for current and aspiring exporters. Services include partner searches, market analysis and events. Whether a company is a start-up or SME, whether it is looking to sell its product in the UK or to set up R&D partnerships, the Swiss Business Hub can guide it through the process.