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NHS National Innovation Centre

Life science and healthcare technology industries are to make a major contribution to the future wealth of the UK

?Establishing a culture of innovation is essential for the NHS to meet any current economic challenges, and the Life Sciences Blueprint will help us continue to support this country?s knowledge industries and ensure that we benefit from the competitive edge which they provide.

Lord Darzi, Health Minister for Quality and Innovation

"By championing innovation, the NHS can support the life sciences industry in developing ways to improve people?s health. And we are changing how industry, academia, government and the NHS work together to create jobs and ensure a bright future for this country."

Lord Drayson, Minister for Science and Innovation

If the life science and healthcare technology industries are to make a major contribution to the future wealth of the UK, then it is imperative that the business of innovating in those fields is managed. Lord Darzi, former Minister for Health, and Lord Drayson, Minister for Science and Innovation at BIS, are agreed that we can no longer afford to leave innovation to chance. An educated public together with a weak economy are demanding quality healthcare and the highest standard of associated products ? and all for the same price or less.

Historically, leaving NHS innovation to chance resulted in good innovations never seeing the light of day or, if they made it, a slow takeup of ideas, or, worse s t i l l , d e v e l - opment going overseas so that IP haemorrhaged from the UK. The current pan-government emphasis on life sciences places a responsibility on the healthcare technology industry to become one of the future pillars of UK GDP and deliver economic value from its innovations.

Managing the innovation process

But this commercial approach to healthcare innovation isn?t new to one NHS organisation. Two years ago, the National Innovation Centre (NIC) embraced this joint policy agenda and has already delivered some startling results. Working with products in the pre-market stage, they are committed to the strategy of ?managing innovation?.

Brian Winn, who heads the NIC, says: ?We leave the creativity to the innovator, but we manage the process of making an idea a reality. The key success factors are to identify a genuine and important enough need, to manage the growth of the solution, show that it works in the real world and then to share it.?

In a nutshell, the NIC helps innovators by providing an infrastructure to support all of those key factors.

Identifying a genuine and important enough need

As a rule, human nature propels us towards solutions to problems, without first testing the importance of the need. The UK?s 2,000 life sciences SMEs will tell you that their job would be straightforward, not to mention more profitable, if only they could receive clearly articulated needs from the NHS. As it is, most suppliers design and develop in the dark and hope that their products hit the spot. Sadly, too many healthcare innovations are left sitting on the proverbial shelf.

In response to this problem, the NIC has teamed up with the Technology Strategy Board (TSB) to harness ?statements of need? from practising NHS clinicians. These are posted onto the NIC website ? http://clinicalneed.nic. ? and commercial suppliers can then respond. Some can partner an NHS Trust and apply to the local SHA to access the new innovation funds, or they can go to the NIC who will also give financial support to develop selected solutions. The clinical needs come from across the healthcare spectrum. Current examples include a need for a means to align bone screws with pelvic anatomy in Orthopaedic surgery and a need for an alternative method of foetal monitoring in problem pregnancies.

Another route to developing innovation is through a process known as ?Wouldn?t It Be Great If?? (WIBGI). This approach charges teams from industry and the NHS to identify both their clinical needs and the potential technology solutions. The NIC?s approach was first applied to Orthopaedics (knee and hip surgery) to support delivery of the 18- week programme. Professor Sue Hill and Paul Griffiths managed the process for DH?s 18-week programme, and used the approach to bring together both practising NHS professionals and industry to look at clinical needs. Nurses, physiotherapists, surgeons, industry and policy makers went on to select 5 high-impact technologies that they felt would have a major impact on reducing waiting lists. Professor Hill said: ?It seems another age now, but in 2007, cracking the long waiting lists in Orthopaedics was a huge challenge.

?I felt the clinical community in Orthopaedics knew the problems and many of the answers, and the WIBGI approach allowed us to get to those.?

?The key success factors to realising the value in innovations are identifying a genuine and important enough need, managing the growth of the solution, showing that it works in the real world and then sharing it.?

Brian Winn, National Innovation Centre.

More recently, the WIBGI approach was applied to the DH?s Healthcare Acquired Infection programme (HCAI). With HCAIs costing the NHS over £1 billion a year, the ?needs based? approach again brought the NHS, industry and design experts together to look at cross-infection issues and jointly develop solutions. Based on an ?open innovation? model, the approach overcame traditional barriers by working more closely with industry and directly linking health need to technology supply. The aim was to get products designed, developed and in place so that they could benefit patients as quickly as possible. The result was 17 new product designs in as many months ? a significantly faster solution than the traditional approach of waiting for the market to develop new products and then procure and implement them.

Open Innovation platforms

The NIC is currently using its novel approach in six other areas ? Blood Donation, Paediatrics, Urology, Ambulance Services, Heart Failure and Regenerative Medicine. Again working in partnership with the TSB, the NIC brought together clinical teams from each of the disciplines to first identify the needs. At subsequent meetings, NHS, industry and academia came together to outline the desired solutions, the business opportunities they might present and other requirements that might be needed to bring the concept to market. By using an ?open innovation? approach, the silos that are usually created around IP ownership, product development and procurement were avoided and all parties were able to focus their efforts on the outcome required.

Managing the growth of the solution

All of the WIBGI outcomes are now posted on the NIC website ChallengeList.aspx so that external suppliers can apply to address the needs. The NIC expects that some of the solutions will be met by industry with minimum input; others will demand more support from the NIC who will work with external suppliers to develop solutions to the articulated needs.

NIC will provide financial support to help commercial companies either develop ideas unilaterally or in collaboration with others. This is a structured process that involves the NIC liaising along the way with the NHS Supply Chain to support ultimately the take-up of the products across the NHS.

Showing the solution works in the real world

Demonstrating that a product works and validating its use is a critical part of the NIC?s function. Examples currently include software that helps protect staff from violent patients; the potential benefits to staff and the NHS are significant, and the system is being assessed in a growing number of Trusts. Another innovation is a technology that cleans instruments of bacteria (prions) that cannot be eradicated by traditional autoclaving. The NIC is aiming to set up demonstrations to show the efficacy of the process on known contaminated instruments

Sharing the results

Although the NIC?s job finishes once a product is market ready, it has strong links with the NHS Supply Chain who can give an early assessment of market potential and are kept informed of any products that are getting near to market. The NIC also selects examples of excellent innovation and showcases them on its website www.nic.nhs/showcase. It then brings this to the attention of the relevant interested clinical communities. Showing a new product every month, the NIC selects from across the innovation landscape, both UK and internationally. Using video footage and animations to illustrate the innovation, the Showcase offers an economic analysis of the value to the patient and the NHS as well as access to related research.

In October 2009, the site will also have a ?chat room? where interested parties can discuss the innovation privately with users. Current Showcase examples include a new surgical procedure in tracheal transplant, a clinical waste management system and a virtual reality (Haptics) training simulator.

The NIC?s Showcase acts as an open innovation platform where companies from the UK and overseas can have their products demonstrated, and where relevant financial organisations can learn about investment opportunities.

Stimulating the market

As well as proactively identifying needs, the NIC also receives hundreds of ideas each year that arrive unprompted from innovators. In order to respond to the huge number of ideas, the NIC has developed an innovation management system via a set of online tools and offline services. These provide a one-stop shop for innovators who want to assess their ideas and access commercial advice.

The key tool is a Scorecard that allows innovators to assess their ideas for themselves. As the innovator works through the Scorecard?s exacting analysis, he can get access to a wealth of additional information that will help him negotiate more rapid entry into the NHS. All of the NIC web-based tools comply with EU commissioning requirements and are ISO9001 accredited.

Commissioning innovation ? sharing the learning

As well as carrying out its dual policy agenda, the NIC also works, on behalf of the DH, across other government departments to develop innovative commissioning systems and measurement tools. One of the key aims in doing this is to share innovation across organisation boundaries in order to leverage success, minimise duplication of effort and maximise the potential to collaborate. The NIC is also developing a new service that will scan for new technology on the horizon - both in the UK and internationally.

Measuring innovation

Efforts to understand how we measure and absorb innovation in a public-sector context are being led nationally by DBIS and globally by OECD. As one of the future pillars of the UK economy, life sciences and healthcare technology will need to measure the impact that healthcare innovation programmes are making. The Department of Health and The NHS National Innovation Centre are playing an active role in evaluating progress.

Initial ideas include:

  • Measuring the value of innovations to UK PLC (a financial measure);
  • Measuring the value of innovations to patients (a QALY measure);
  • A measure indicating whether staff feel that the NHS is an innovative place to work (a staff survey measure);
  • A measure that shows the volume of ideas that are generated, grown and diffused in the NHS (a quantitative measure).

Thorough measurement will help to indicate if programmes are working and, importantly, reveal much sooner where goals are not being met. The programme will also develop a simple and useful set of organisational innovation metrics which will provide a diagnostic tool that organisations can use themselves to assess and improve their ability to innovate and/or contribute to the innovation ecology.

Back to the Future

The primary aim of the NIC?s emerging horizon scanning function, run on behalf of the DH, is to identify the existing medical technology innovations in other countries as well as the innovations that are likely to come to the market in five to seven years? time. The NIC horizon scanning service will also profile future technologies on its Showcase and the horizon scanning section of the website will provide decision-makers with easy, online access to innovation information to inform their strategic investment decisions.

Brian Winn says: ?Innovation is clearly the buzz word of the decade, but to realise its potential, we need to go beyond the word itself. We need to ask ourselves how we are going to get those innovations into use ? and quickly. We also need to make sure the lessons we are learning in healthcare are shared across the economy as a whole.?

?The NHS has an important role to play in the UK?s economic recovery by acting as a catalyst for innovation. The OLS blueprint provides some important mechanisms to help to achieve this important goal."

Sir Mark Walport, Director of the Wellcome Trust

"The life sciences industry has the potential to build on an established track record to be a real driver of innovation, helping the NHS maintain quality of healthcare and improve productivity. The package of measures announced in the Blueprint underlines how the NHS can contribute to a strong partnership with industry which delivers real health benefits as well as economic growth."

Mike Farrar, Chief Executive of the North West Strategic Health Authority

Case study ? prostate cancer ? the WIBGI approach

In summer 2009, the British Urological Institute and the Devices for Dignity HTC identified a number of important clinical needs within the Urology service. They said: ?Wouldn?t It Be Great If? we had improved biopsy analysis for suspected prostate cancer cases?. The organisations also suggested desired solutions, the business opportunities they might present and other requirements that might be needed to bring the concept to market.

Here?s what they said about the need:

  • PSA tests have led to a large increase in suspected cases of prostate cancer requiring an invasive biopsy of the prostrate.
  • The biopsy of the prostrate requires samples taken from multiple sites to ensure a representative tissue sampling, it is inaccurate and unpleasant for the patient and has significant complications.
  • In around 70% of cases, the biopsy process does not reveal a clinically significant prostate cancer which requires further surgical intervention.

Here?s what they said about desired solution attributes:

The main features should be:

  • Improved ergonomics for patient and surgeon;
  • Design to allow multi-site testing from single insertion;
  • Less painful for the patient;
  • A ?one-click? test;
  • New access route;
  • Metrics to identify aggressive cancer;
  • Less pain through local anaesthetics;
  • Less pain through ?micro-needles?;
  • Combine diagnostic with therapy;
  • Improved needle guidance;
  • Visualisation of prostate;
  • Less post-op bleeding;
  • Infra-red tissue imaging from rectum;
  • Contrast imaging for prostate;
  • Contrast that sticks to PSA;
  • Improved biopsy analysis to avoid need for cone biopsy;
  • Improved needle design (to avoid needle stick risk);
  • Acceptable cost to Trust.

Here?s what they said about business opportunities:

  • Men live longer lives;
  • Read across to/from other procedures;
  • 50% of world?s population as potential patients;
  • Market size to make business case;
  • No other solution imminent so wide window of opportunity;
  • Global market size;
  • Other solid organ cancers;
  • Reduce cost to NHS;
  • Cost to develop technology;
  • Risk: NHS not accepting the benefits;
  • Disposable commodities: business opportunities for service;
  • What is the purchaser?s view and tariff;
  • Screening entire population will follow if prognostic tests are effective;
  • Other cancer biopsy opportunities;
  • Cannot understand market failure;
  • IP;
  • Four/five different technologies need to come together;
  • Pharmaceutical solution would make device approach redundant.

Here?s what they said about research requirements:

  • Gather stats on outcomes of current surgical procedures;
  • Health economic questions;
  • How men die of prostate cancer after a reassuring biopsy result;
  • What percentage of cancers are aggressive;
  • Is oral/local pain therapy of any value;
  • Is workflow optimised;
  • Isolating/storing tissue for research;
  • Industry interest;
  • How to improve prostate contrast;
  • How many cancers are upgraded or downgraded by full prostatectomy;
  • Review surgical environment to be more procedure friendly;
  • Proper evaluation of disruptive technologies;
  • How many refuse biopsy because it is so awful;
  • Pain management: before, during, after
  • Idealised theatre layout;
  • Cost of ?missing? in first biopsy-CT;
  • Market drivers minimum sample size for validity;
  • Research technologies used in other areas (endoscopy etc);
  • What is approach in US/Japan;
  • Understanding risk factors, genetics, lifestyle, hormonal effects.

Here?s what they said about enablers:

  • Seed funding (e.g. for improved tool design);
  • Public health awareness of prostate cancer
  • Cool technology (e.g. Da Vinci machine);
  • Better treatment outcomes;
  • NHS approved;
  • Articles in lay press;
  • Pressure groups;
  • Competition incentive for industry to get involved.

For further information and application forms, see:

Stimulating the Market ? a case study

A Reading-based SME approached the NIC in 2007 with a prototype for a non-invasive blood glucose meter. The idea was that a hand-held meter would replace the finger stick methods currently used by people with diabetes to test blood glucose levels and, instead, would take a painless reading from the eye. MD, Dan Daly, said: ?I put the product through the NIC?s webbased ?Scorecard? to begin with, and carried out a confidential assessment myself of the device using the NIC?s rigorous tools. I then contacted the NIC and asked for further support. Their advice on markets, business strategy, legal requirements and arranging NHS introductions for validation was invaluable?.

Added the 05 October 2009 in category Healthcare

Related elements :

Innovation UK Vol5-1
Innovation - soup to nuts, served by the NIC
Successful innovation starts with identifying a need. It then grows the solution to that need and shares the results. The NIC can support commercial innovators at each of these stages.

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