Pathways to patient benefit from innovation

Philippa Brice

31 July 2017

This month, the UK’s Department of Health and Department of Business, Energy and Industrial Strategy announced £86 million funding to speed up access to new medicine and technology. Shortly afterwards, several significant UK bodies released a joint statement promising support to help transform ideas and discoveries from researchers into ‘practical solutions and applications’.

Reaping rewards for society

The statement from the Academy of Medical Sciences (AMS), Wellcome Trust, Royal Society and Royal Academy of Engineering is titled Transforming UK translation and sets out commitments to transform the status quo into a ‘vibrant translation system’ over the next ten years, to maximise the benefit to society. They subscribe to a ‘creative, collaborative and bold approach to deliver continuous improvement and lasting change’; translation is defined broadly as including the exchange of knowledge and ideas, academic-industrial collaborations, creation of intellectual property (IP), spin-out companies, products, processes and enabling technologies.

These laudable aims are underpinned by specific commitments including fostering a system ‘that rewards and celebrates translation as part of research excellence’ rather than using publication records as a sole measure of impact, enabling cross-sector movement of people and ideas and a range of other measures to support translation in general. Whilst there is explicit recognition that commercialisation and ‘wealth creation’ are beneficial, they also say they will seek to maintain a primary focus on delivering benefits for society.

Towards patient benefit?

The National Institute for Health Research (NIHR) last year awarded a massive £816 million over five years in new funding for NHS-partnered Biomedical Research Centres (BRCs) across the country. The BRCs are intended to drive innovation in the prevention, diagnosis and treatment of ill-health through early translational research, and translate research advances into benefits for patients, the health system and for broader economic gain. Interestingly, the last funding round clearly noted that the focus of activity in each NIHR BRC ‘should be on early translational (experimental medicine) research’ to demonstrate proof-of-concept that a therapeutic, diagnostic or preventative intervention is feasible, rather than on translating these advances into patient or other forms of benefit. The stated expectation was that ‘other sources of public, charity and industry funding will be found for the later phase clinical research’.

The only point of potential concern is the policy and funding gap for beneficial but not necessarily commercialisable innovations that could aid patient care, and for widespread clinical implementation of innovations proven to be useful.

It seems slightly odd that the specifically NHS-linked BRCs are not expected to devote time to later stage translational research involving patients, despite being arguably the UK centres of research excellence most closely linked to clinical trial and implementation. However, this being the case it is heartening to see a commitment to translation from the Wellcome Trust (a foremost funder of biomedical research) and other leading bodies. The only point of potential concern is the policy and funding gap for beneficial but not necessarily commercialisable innovations that could aid patient care, and for widespread clinical implementation of innovations proven to be useful.

Cue the Academic Health Science Networks (AHSNs), which form a crucial part of the recommendations of the Accelerated Access Review (AAR) and have just received a no doubt welcome £39 million funding boost to ‘assess the benefits of new technologies and support NHS uptake of those that deliver real benefits to patients according to local need’. It is good news that someone is tasked with this, though there remain limitations in the reach of the AHSNs such that patient and clinician access to cutting-edge technologies is inevitably uneven, centred around centres of research and teaching excellence.

A new pathway to success

Potentially more significant is the news that the government is dedicating a further £6 million to a Pathway Transformation Fund to help NHS organisations ‘integrate new technologies into everyday practices’ – for example, by training staff. As PHG Foundation Director Dr Hilary Burton wrote in 2016, the ‘main barrier to accelerated access to innovation is the ongoing failure to deliver the prompt, pathway-specific and system-wide changes necessary to embed proven innovations into the health service’.

Six million pounds may be a mere drop in the funding ocean when set against the total given to the BRCs, but it is vital recognition of the need to support the roll-out of innovations exactly as the PHG Foundation recommended to the AAR, and heartily to be welcomed. It will be exciting to learn more about the Pathway Transformation Fund and to see how and where it is used in the near future; applied properly, the up-front investment should yield a massively increased benefit in terms of robust NHS uptake and patient benefit.