NHS: Health Improvements

Baroness Brinton Excerpts

Wednesday 26th November 2014 Grand Committee

[Baroness Brinton (LD)]

My Lords, I congratulate the noble Lord, Lord Kakkar, on securing this important debate on a key issue that is essential if the NHS is to be in the forefront of health improvement in the next few years. The noble Lord focused on the larger strategic picture, but I want to focus more on the impact on the patient and the citizen. The title of the debate refers to both innovation and research. I want first to talk about where innovation and research are providing improvement in treatment and in health, particularly the benefits of the new academic health science networks, which use pure and applied research to create very strong links between hospitals, commercial organisations and universities. These regional bodies are providing a country-wide system to deliver innovation.

I declare an interest as an arthritis patient; I am grateful to Arthritis Research UK for a briefing that it sent me. It has joined with the Medical Research Council to fund the Centre for Musculoskeletal Health and Work. Led by Southampton University, this centre seeks to find ways to reduce the impact of conditions that affect muscles, bones, and joints on the ability of people who work: people like me. At present, musculoskeletal conditions are the biggest cause of workdays lost through illness, with 30.6 million days lost a year. The cost to the economy is significant. For people with rheumatoid arthritis, seven out of 10 are unable to work because of the condition within 10 years of diagnosis. So research that is both scientific and applied can not only make a significant improvement to the individual and their condition, but can also reduce NHS costs and offer the chance of their returning to work and taking an active part in our economy again.

In another example of research innovation, Arthritis Research UK has joined with the Medical Research Council and other medical research charities to invest £230 million in a clinical research infrastructure initiative. This initiative will involve 23 key projects at centres across the country, and will use state-of-the-art technologies to find out how differences in the cellular and molecular make-up of people affect how they respond to disease and to treatment. It will take us forward on personalised treatment as that develops over the next few years.

Innovation does not automatically mean clinical research. The Scottish Health Informatics Programme is a good example, which we in England would do well to emulate. In a report to the APPG on Medical Research, a case study points out that SHIP is a Scotland-wide collaboration between the NHS and Scottish universities which analyses and links patient records. Although currently a developing resource, data linkage has also been used in a number of health studies in Scotland, using anonymous linked clinical diabetes and cancer data to show that patients using synthetic insulin were at no greater risk of developing cancer than those using traditional insulin.

That should be contrasted with some of the very practical problems of not linking data, where each hospital has its own patient number and does not allow data to be transferred between hospitals as a matter of course. A patient who has to have regular blood tests before treatment may have their test carried out at a GP surgery; it is then sent to the local district hospital, which will e-mail the result back to the GP, who often has to sign it off before the patient or the other hospital is allowed to know the result. The patient has to speak to the receptionist, sometimes to the GP as well, and the receptionist again when they go in to collect the blood test result. Because in this example the patient’s treatment is at a regional hospital, not their district hospital, they then have to text their consultant with the result to ensure that the treatment can actually be carried out. If the results are delayed for any reason, when they arrive at their regional hospital treatment may be delayed while a further blood test is carried out, and there is then a backlog of patients seeking treatment. All this is because the NHS cannot allow the transmission by e-mail of formal results. I am told that it is to do with data protection but if the Scottish system can make it work, surely the NHS can as well. Will my noble friend the Minister indicate whether England and Wales will follow the example of the Scottish Health Informatics Programme and solve what seems to me to be a straightforward and simple problem rather than the intractable and expensive problem that it has become?

There is another important area of innovation that provides significant health and well-being improvements, and that is the involvement of the citizen and patient in understanding their own disease and treatment. The National Institute for Health Research launched its “OK to ask” campaign on International Clinical Trials Day in 2013. More than 150 NHS hospital trusts took part and 80% of respondents who were followed up said that it had definitely helped to raise awareness of the importance of clinical research. The National Cancer Patient Experience Surveys of 2012 and 2013 show that only one in three cancer patients is having a conversation with their doctor about research. There is a good body of evidence to show that patients who talk to their clinicians and understand their illness and the treatments that are available—or even not available—are less likely to suffer from depression.

I have one anecdote from 10 years ago—I apologise for the aged anecdote. When I was the deputy chair of the East of England Development Agency, we did some work with the Williams Formula 1 team. As its social responsibility action, the team that changed tyres in the pits was working closely with the Great Ormond Street Hospital operating theatre teams to work out how they might be able to improve their performance to speed up operations. Both Great Ormond Street and Williams have found it extremely useful because Williams learnt something from it as well. That is an unusual form of innovation—actually, I think it is good lateral thinking—but it works very well in other ways. I know that many people involved in the Williams thing now sell that expertise for management teams to work better as teams in the future.

We have had some good cases this evening to show that the benefit of innovation is much wider than we imagine. Not only do Parliament and government have a key role to play but so does the citizen and patient. We need to ensure that innovation and research is at the heart of the NHS as it faces the challenges of the 21st century.