Academic Health Science Centres

Lord Butler of Brockwell Excerpts

Tuesday 2nd July 2019 Grand Committee

Asked by

[Lord Butler of Brockwell]

To ask Her Majesty’s Government what is their policy and timetable for re-designating academic health science centres.

[Lord Butler of Brockwell (CB)]

My Lords, I thank those other Members of the House, some of them very distinguished in health issues, who have put their names down to speak. Someone pointed out to me that if I were unfortunate enough to suffer a stroke, this would be the moment to do it.

I declare an interest as recorded in the register of interests. I serve as a non-executive member of the board of an AHSC—namely, King’s Health Partners, which includes King’s College London, King’s College Hospital, Guy’s and St Thomas’ and the South London and Maudsley NHS Foundation Trust. From 2009 to 2014, I chaired the board of King’s Health Partners.

I need not remind your Lordships what an exciting time this is for advances in medical science. The concept of academic health science centres offers a means to exploit those opportunities for the benefit of people locally, nationally and across the world. By bringing together great biomedical research institutions with outstanding teaching and clinical hospitals, it offers the opportunity not only to trial advances in medical science but to bring them to fruition for the care of patients.

Apart from the United States, which pioneered the concept of AHSCs, the United Kingdom is perhaps the country best equipped to make the most of those opportunities. In London and our great academic centres, we have ground-breaking research universities: colocated with long established and world-famous teaching and clinical hospitals. In 2009, the NIHR accredited the first five AHSCs: three based in London, one in Cambridge and one in Manchester. In 2014, following a further competition, they were reaccredited and a further one in Oxford was added. The accreditation was for five years and is due to be renewed in 2019.

It is important to recognise that this was simply a structural initiative. No extra money was provided and the institutions remain fully within the state sector. King’s Health Partners is the AHSC which I know best. This year, we celebrated our 10th anniversary. I believe that our achievements over that time, stimulated by the AHSC initiative, have been impressive. Brilliantly led—indeed, driven—by its chief executive, Sir Robert Lechler, assisted by a small but outstanding team, the reach of King’s Health Partners has been remarkable.

As I said, the underlying concept of AHSCs is to bring together frontier-breaking research with teaching and clinical care. Sir Robert approached this in King’s Health Partners by establishing 22 clinical academic groups, embracing the full range of medical specialties and bringing together from the four institutions the leading members in each.

King’s Health Partners has a number of assets which have assisted in making the most of those opportunities: two NIHR biomedical research centres, which provide unparalleled facilities for experimental medicine and in which 600 clinical trials are current at any one time, covering more than 3000 patients; the leading research institute in the country in psychiatry, psychology and neuroscience, colocated with the leading hospital in the care of mental illness, which has enabled advances to be made from the increasing recognition of the links between physical and psychological illness; and a diversity of population in south London, where the widest range of physical and psychological conditions give unique opportunities for research and treatment.

In addition to the advances made in individual specialities, King’s Health Partners has pioneered a number of other advances. As a response to the ever-increasing demands on health services, it has pioneered the concept of value-based healthcare and preventive measures, not least through the concept of the vital five factors in the prevention of disease—blood pressure, obesity, mental health, alcohol intake, and smoking habits—which have been promulgated through KHP’s academic health science network in south London. This work will make a real difference in reducing future demands on the health services, as well as giving people the prospect of happier and healthier lives, and is of course a key plank in the long-term plan for the health service.

At a recent seminar to celebrate the 10th anniversary of the AHSC, we had presentations of some of the advances made in patient care over the last 10 years that have made a major contribution to the life prospects of patients. They include: treatment for Hodgkin’s lymphoma avoiding the side-effects of radiotherapy in children; advances in the application of naloxone for heroin addicts; genetic treatment to reduce inheritance of breast and ovarian cancer; separation of the elements of cannabis so that the benign element can be used in patients; a new approach to recognition and treatment of prenatal eclampsia; MRI recognition of scar tissue to assist life-saving treatment of heart attacks; and improvements of means to prevent rejection in organ transplantation. On top of that, we can be immensely proud of the contribution that British science has made to dealing with the Ebola epidemics in Africa. There is so much going on that it is impossible to cover it all in one speech—for example, exploitation of the opportunity provided by informatics to join up patient records across our health system.

I am sure that the other AHSCs can tell a similar story. The nub of it is this. Certainly on the basis of my experience, the concept of AHSCs has been an outstanding success. They promote a national asset in which the United Kingdom is a real world leader. They are a magnet for talent and worth investing in. At a time of severe pressure on resources, they make a major contribution to more cost-effective healthcare for our National Health Service. There is great potential still to be tapped.

Reaccreditation will provide both a stimulus and an opportunity. It would be cost effective if that were accompanied by a modest financial grant. We are talking of only a small handful of millions, which would make a big difference—chickenfeed in relation to the overall cost of the NHS. Therefore, I hope that in her reply the Minister will provide that encouragement, and in particular give us a firm timetable for the process of reaccreditation. King’s Health Partners has been preparing itself for that and is waiting for the signal.