Two years ago, Professors Richard Jones and James Wilsdon published the wide ranging Biomedical Bubble report that asked whether a policy and funding landscape dominated by the needs of pharma and associated biomedical industries had resulted in the neglect of research into the prevention of poor health.
Though controversial, the report prompted a long overdue conversation about the distortions – intellectual, financial and geographical – in the current health & life sciences funding landscape in the UK. When 80% of the spending of research councils and medical research charities is dominated by basic and translational biomedical research – much of it concentrated geographically in the so called ‘Golden Triangle’ – the authors (and indeed many others) have asked whether this ‘distorted landscape’ is able to bring economic and health benefits to the nation as a whole.
Fast forward to the present day and, as we wrestle with the multiple impacts of coronavirus on our health and our local economies, an update has been offered by Jones & Wilsdon. While acknowledging that it is far too early to reach firm conclusions, they ask: to what extent did the distortions highlighted in their original report – especially the lack of emphasis on research directly relevant to the public’s health – exacerbate the impact of the virus?
The Kings’ Fund, in a timely report, develop this theme further noting that ‘Covid-19 has starkly exposed the deep inequalities that exist across the nation’s health.’ As we emerge from the initial acute response to the Covid pandemic, the authors ask: how can we build on the learning and the research that emerged at unheard of pace when the NHS, academia and industry were forced together?
A unique opportunity
A critical question is how do we look beyond the transformation/responsiveness of hospital-based services to the outputs of biomedical research. Indeed, how do we rebalance this effort to deliver the benefits of research so that, rather than trying to fix an established health problem, we look towards an agenda of prevention and levelling-up our deeply entrenched health inequalities.
This is then a unique opportunity to refocus the biomedical research enterprise so that it more directly contributes to the improvement of the population’s health (and by derivation wealth) and can tackle – as part of a wider set of interventions -deeply entrenched regional health & economic inequalities.
How should our regional health and life sciences ecosystem respond to this challenge? What role can an organisation like Birmingham Health Partners (a structure that brings together a major Russell group university, two large NHS Trusts and an Academic Health Sciences network that covers the West Midlands geography) its people, its infrastructure, and the soon-to-be-built Birmingham Health Innovation Campus (BHIC) – play?
Birmingham: a city mobilised
Consider how we mobilised our local expertise in response to the Covid pandemic. Firstly: leveraging ‘traditional’ biomedical approaches – to address three key questions around how we develop testing infrastructure and importantly new testing methods for Covid. And secondly the remarkable steps that further embedded digital change within our NHS partners; the effective use of an EHR system; the data accrued from a high density of Covid patients that our hospital systems treated; and identification of risk factors for admission into ICU.
What these case studies demonstrate is the power of mobilising regional assets – co-located university and NHS environments like ours – and leveraging local industrial capabilities. This was not unique to the West Midlands – similar patterns of activity occurred across the country, but these efforts have been largely hidden from view thanks to media’s focus on the ‘golden triangle’. Additionally, one fifth of all 2019 intake MPs attended Oxbridge Universities and 55% of MPs studied politics, history, economics or law, which does not help the regional or science agenda.
Our challenge now is how to leverage our strengths and ability to be an effective collaborator – locally, nationally, and globally – into an offer that drives not just traditional biomedical research but identifies new opportunities to work with industrial partners and entrepreneurs. This relies on seeing the NHS as a driver of innovation and not just a market opportunity, and for our local and regional bodies to translate our expertise into improvements in the overall health and wealth of our region.
To do that we must a find a language and a way to mobilise that is directly relevant for our local health economy and NHS partners. We need to work with our city, Combined Authority and STP to ensure that the opportunities that arise from a powerful, innovative health and life sciences cluster at the heart of any new structure are understood – and that we have a clear offer of what it can contribute the health and economic challenges our region faces.
To enable this to happen, we need to look beyond the core capabilities of BHIC – as exemplified by the academically-led Birmingham Precision Medicine Centre – and ask what role the wider BHIC could and should play in driving health care transformation.
It follows therefore that we need to give further consideration as to how we embed NHS and local bodies in this offer both as a client, as a source of innovation, and as a market test bed. We need to embed regulatory excellence into our processes to ensure speed to market, and we need to ensure that we capitalise on our strengths with data to continually track the performance and safety of innovations.
We need to recognise that focusing solely on technology-led solutions excludes the development of an integrated offer that reflects the complexity – and wider market opportunity – of developing solutions to complex patient needs and products that can transform healthcare pathways and systems.
We should imagine an ecosystem that includes medtech and solutions providers; companies that are expert in behaviour change; analytics innovators and consultancy clients. We should look to build a regional health focused ‘skunkworks’ that can put together packages that can be ‘sold’ and adopted locally and nationally.
Most importantly of all we need to embed the voice of our communities to help co-create and own the opportunity to build a regional enterprise that speaks to a bold vision for health and economic wellbeing of our region.