Academic Health Science Centres

Baroness Blackwood of North Oxford Excerpts

Tuesday 2nd July 2019 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, I thank the noble Lord, Lord Butler, for raising this question on AHSCs. I pay tribute to his work as the former chair and now non-executive director at the King’s Health Partners AHSC and to his speech setting out some of the achievements that have been delivered. This has been a supremely expert debate, so I feel somewhat cautious in summing up. I thank noble Lords who have spoken this afternoon about their work in AHSCs, notably the noble Lords, Lord Kakkar, Lord Patel and Lord Darzi, and my noble friends Lord Prior and Lord O’Shaughnessy, who have been so instrumental in developing the system to where it is today. This is a timely debate because, as many noble Lords said, we are developing policy options for AHSCs going beyond the current designation. As noble Lords know, it is due to end in December this year. I acknowledge that this is a tense time for AHSCs, which will now be thinking about planning their future strategy. I am grateful to the noble Lord, Lord Willis, for making the point that this is a cross-party issue and that there is wide agreement across the Chamber about the importance of AHSCs. I will say at the front that there is also consensus about the need to go forward to designation; the question is how we do that.

First, in response to some of the wider points that were made in the debate, I say that the Government recognise the critical role that health research plays not only in fuelling the life sciences sector, which is one of the most productive within our economy, but in driving up the quality of diagnosis, treatment and care in the NHS. We are committed to creating the best environment for clinical research and to achieving the ambition set out not only in the life sciences strategy but in the sector deals. This is the only sector to have two sector deals, and that is because of the quality of the sector and the relationship between research, industry and the NHS, which has developed into an outstanding ecosystem in the past few years. We have to pay tribute to the role that the NHS long-term plan will play in that, due in no small part to the leadership role of my noble friend Lord Prior.

This country is a world leader in health research, with a world-class science base and three of the top 10 globally ranked universities. As my noble friend Lord Prior said, we have an extraordinary life sciences sector, and we must be as ambitious as we possibly can be in driving it forward. We are investing more than £1 billion per year through the NIHR to fund research, skills and facilities to enable high-quality research. I can answer the noble Baroness, Lady Donaghy: about £100 million of that was invested in a range of training programmes, and we have also created the NIHR training academy so that we can think about how we link that to international training.

We must ensure that we protect the valuable collaborations that we have because that ensures that we have the highest quality clinical research in the world. The commitment to increase our R&D investment from 1.7%, which has quite frankly not been good enough, to 2.4% and beyond that to 3% was hard won from the Treasury. I know that because I was one of the first to campaign on this as chair of the Science and Technology Select Committee some time ago. I will be one of the first to join noble Lords across the Committee in campaigning to drive further and faster, as we must not only have this commitment from our leadership candidates—and I am sure that others will join us in that—but keep driving forward blue-sky investment and further investment through the people, programmes, centres of excellence and the NIHR. That is how we will have an integrated health and research system which is one of the best in the world, designed to transform scientific breakthroughs into life-saving treatments.

The noble Baroness, Lady Donaghy, is right that we should be proud of what we have already achieved. Between them, the existing AHSCs cover health research and education in a wide range of clinical disciplines including mental and physical healthcare, cancer, cardiovascular and inflammatory diseases. It would not be right it we did not pay tribute to some of that today. Noble Lords have already done that. While we do not fund the AHSCs specifically, of the 20 NIHR biomedical research centres, 12 are at the heart of these six AHSCs, representing more than £700 million of NIHR investment over five years from April 2017. This significant NIHR-funded research infrastructure is key to enabling its engines for world-class excellence in early translational biomedical research.

The existing AHSCs were designated based on recommendations made by an independent panel, which we heard about from the noble Lord, Lord Darzi. On the regional spread, I am afraid that the noble Baroness, Lady Masham, will be disappointed that they can be designated only in England, not in Scotland, but it is open to the new designating committee to consider the regional spread as that goes forward.

Over the past 10 years, the six AHSCs have facilitated the strategic alignment of some of our leading NHS providers and their university partners in world-class research and health education, leading to improvements in patient care and playing an important role in driving economic growth through partnerships with industry, including life sciences companies, which is one of our key priorities. It is through this strategic alignment that these partners have secured funding. An example is the £10 million funding from UKRI for a new centre for medical imaging and AI at King’s Health Partners as part of the industrial strategy challenge fund. The noble Lord, Lord Kakkar, spoke about the success of UCL Partners, which has, among many things, been leading on the adoption of a learning health system to standardise data entry. This has allowed seven CCGs to trial and support interventions into early detection of atrial fibrillation, which is a key priority of the long-term plan, and for primary care networks. Specific examples are the ways that we are going to change healthcare for individuals. Imperial AHSC has supported North West London STP’s integrated care record to bring together the health and social care information of 2.3 million patients in the sector, enabling the identification of patient cohorts and the evaluation of service developments.

London’s three AHSCs are collaborating through the MedCity initiative to grow the life sciences cluster of London and the greater south-east, working with the Oxford and Cambridge AHSCs. In Manchester—not in the south-east—the AHSC is working with the AHSN to align research and education into the health and social care priorities of the Greater Manchester population. A single blood test-driven decision aid for patients presenting with chest pain at the emergency department is being rolled out. Since June 2016, more than 7,000 patients have been treated using this tool and the diagnosis of acute myocardial infarction was ruled out in more than 99% of cases, with patients returning home within hours of their arrival in the emergency department. This is evidence of how the AHSCs have changed clinical practice on the ground. Additional data published today by the NHIR clinical research network shows that NHS trusts which are part of the six AHSCs have undertaken more than 3,600 clinical studies and recruited 148,495 participants in 2018-19.We know that other academic health science partnerships have formed, further strengthening the health research and health education interface in London but, as my noble friend Lord O’Shaughnessy said, we must ensure that the deep research base that we have in this country is matched by a health system that embraces innovation and translates research funding into improved patient care, so that innovators can develop, test and deliver those products that patients and clinicians need and so that examples such as those I have just given can be adopted.

We know that in the past the system has been too fragmented, too complex for innovators to navigate and too slow to adopt promising technologies. That is why last summer, at my noble friend’s instigation, the department undertook an innovation landscape review, which identified the need for a system which was more joined up between healthcare partners, and for improved support for late-stage evidence and a better strategic alignment of priorities, such as how we support emerging technologies, including AI, drug discovery, mentioned by the noble Lord, Lord Kakkar, and precision medicine.

As my noble friend Lord Prior pointed out, it is also important to recognise the role of collaboration between NHS, industry and academia. During the landscape review, we found huge appetite for change and more ambition within the healthcare stakeholders who need to implement it. That is why the sector deals, the NHS long-term plan and the tech vision have all begun the process of transforming a significant part of strategy within government policy. Through the establishment of the accelerated access review and NHSX, as has been mentioned, we have started to build the necessary infrastructure effectively to support health innovation in this country. Under the expert leadership of the noble Lord, Lord Darzi, the AAC brings together senior leaders from the key government, NHS and industry partners with patient and clinician representatives to promote innovation within the NHS. Already, the AAC has made significant progress in supporting uptake.

We must agree that AHSCs and other structures must work hand in hand with AHSMs and wider innovation infrastructure to ensure that this is wired into the ARCs and will be in AHSCs. This is why I have asked the AAC to consider AHSCs, to ensure that the whole system is joined up, because that is what it is leading on. It is important that we give the AAC and the noble Lord the opportunity to build a cohesive health, research and innovation ecosystem that meets the challenges that we have set and the ambitions that we need our life sciences sector to deliver. That is why I have asked the AAC to consider AHSCs’ role within the health system as part of the boost agreement. That will ensure that the future designation of AHSCs complements the innovation support landscape, rather than adding further complexity. The AHSCs will therefore support the AAC in achieving its new objectives, including commitments to establish globally leading testing infrastructure, improving the system’s capacity to adopt innovation.

We plan to extend the existing DHSC AHSC designation until March 2020 to enable that new designation process to be held. We will announce the timescales soon. I appreciate that is not necessarily the answer that noble Lords want, but I hope that the strategic vision, the need for ambition and the purpose, which is to deliver innovation for patients which changes their quality of care and the ambition of our life sciences ecosystem is understood as the reason for that change.