1 Starting Up and Running Health Enterprise East Ltd A Case Study of a Limited Company Operating inside the National Health Service – and a Historical Perspective Masterclass March 12 th 2010 Professor Alan Barrell Chairman – Health Enterprise East Ltd

2 A Preview  The Nations Health and the NHS- Dilemmas and Challenges  Health Services in the East of England  A bit of history – healthcare Innovation is NOT easy !  Creativity and Innovation  Enterprise, Entrepreneurship and Enterprise Hubs  Health Enterprise East Ltd – Start Up, Progress and plans  Discussion and Debate

3 Chairman of Health Enterprise East, also wearing other hats Chairman – NHS Regional Innovation Council

4 change?.... Our context…. Does our “Eye on the World” see much change?.... Our context….

5 Dilemma – Population and Ageing More Healthcare – Reduced Budgets Innovation is Essential

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Crisis ? or Opportunity? 危机 Creativity and Innovation beat Despair any day! Call to action for Entrepreneurs

8 We will deliver year on year improvements in patient experience We will extend access guarantees to more of our services We will ensure that GP practices improve access and become more responsive to the needs of all patients We will ensure that NHS primary dental services are available locally to all who need them A better patient experience Improving people’s health We will ensure fewer people suffer from, or die prematurely from, heart disease, stroke and cancer We will make our health service the safest in England We will improve the lives of those with long term conditions Reducing unfairness in health Working with our partners, we will reduce the differences in life expectancy between the poorest 20% of our communities and average in each PCT We will ensure healthcare is as available to marginalised groups and looked after children as it is to the rest of us We will cut the number of smokers by 140,000 We will halt the rise in obesity in children and then seek to reduce it What we have PLEDGED in Healthcare for the East of England - MISSION

The Ten Programme Boards Staying Healthy Mental Health Maternity and Newborn Children's’ health Planned Care Acute Care Long Term Conditions Palliative and end of life care Patient safety Patient and carer experience

10 A new focus on our vision Quality Prevention Innovation Productivity EngagementAnalysisIdeas Leadership and Talent

11 Regional Innovation Fund £1.94M in 2009/10  Long term conditions - priority for our QIPP agenda  2009/10 RIF focused on Long Term Conditions innovations  Emerging priority areas:  Patient engagement and co-production  Personal health plans  Supported self care  Commissioning integrated pathways

12 Compact with industry  Two way communications  Set out vision and needs of NHS  Learn about range of products and devices  Translating NHS Long Term Conditions needs to industry  ‘Founder member’ of Cambridge Network healthcare special interest group  Sponsored ‘ Partnership with NHS’ award from Eastern Region Biotech Initiative

13 From a great man – Polymath – 600 years ago…. Starting our sense of History…. Our challenges in context Is all this anything new ?

14 He gave us beauty as well as science A Giant amongst men….

15 Leonardo….

16 Leornado Da Vinci…. But the History of Medicine and Great Discoveries goes back much further…. Chinese and Egyptian Discoveries and Practices have survived until today

17 Great Innovations can meet even greater opposition Ignatz Philip Semmelweis Wash hands Wash hands Classical work 1847

18 Adoption of the Semmelweiss Innovation – still not there TODAY !

19 Streptococcus pyogenes

20 “Chance favours only the prepared mind”Bacteria Louis Pasteur

21 Joseph Lister and Antisepsis Transformational work….Revolutionised potential for Surgery and Medicine generally 1.Anaesthetics – Horace Wells 2.Antibiotics – Alexander Fleming

22 What Alexander Fleming might have seen in 1928….and what doctors and technicians still see today…. Remember Louis Pasteur’s assertion – “Chance favours only the prepared mind….” A “failed” experiment – led to the discovery and development of Penicillin – and many more antibiotics….

23 Innovators and Entrepreneurs have often been great improvisers From old washing machines and car parts to….

24 Willem Kolff’s first Drum Kidney Machine

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26 Innovation is a journey – not a destination…. From drum to coil….and it goes on..

27 Sir Frederick Banting – Nobel Laureate – From Canada Diabetes – major killer INSULIN ! He was 21 when he made the discovery !

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29 Three Converging Revolutions Three Pervasive Technology Platforms – looking at Diverse Science and Innovation and how Science can become Products and Practice BioTech Pharmaceuticals Diagnostics Research/Info Tools Industrial Genomics Bioinformatics Proteomics INFO TECH Hardware Software Communications NANO TECH Electrical Structural Biomedical Energy & Environment Biosensors Biochips Bioelectronics Microfluidics Nanobiotechnology Drug Delivery Nanodevices Nanosensors Nanoelectronics

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31 Closeness of Learning, Research and Practical Application “The Innovation Campus” – Cambridge is one BIG Innovation Campus ! R&DEducation Applications Where open innovation, symbiosis, synergy and new companies can thrive

32 Converging Technologies in MedTech I.C.T. BioTech Advanced Manufacturing Engineering Medical Technology Electronics

33 Charactersitics of Regions planning to be Leaders in Sustainable Technological Development – including in Medical Sciences  Knowledge Centers  Entrepreneurs & Role Models  Money  Capital Markets  Infrastructure  Cluster Policy  Presence of International Companies  Networks  Government  Quality of Life MindsGlobal Mindset Minds without Borders – Global Mindset

34 From Idea to Reality – A New Enterprise - Free Standing – or in a Corporate Structure….

35 Patient Capital MedTech – from Idea, to Innovation to Reality – needs Patient Capital ….

36 Some Destinations on the Journey Put your own timescale in….and - imagine costs….££££  Ideas  Plans  Designs  Regulations  Multi-skilled teams  More Plans and Approvals  Prototyping and Validation  Manufacturing and Final Testing  Clinical Acceptance and Validation  Marketing and into use….REALITY!  Revenues, Profits, Returns, Patient Benefits

37 complexity Incubation and Implementation – MedTech – a world of…. complexity

38 But the Commercial Markets are BIG………and growing….

39 Medical Companies, like all others, that fall behind and don’t compete may not survive….Competition encourages Investment in Innovation

40 Innovation happens mostly with USERS not SUPPLIERS The Internet has REVOLUTIONISED Product Development and Innovation in many areas – including Healthcare

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44 And then….we have the Wireless Connection Revolution Will you have “Your GP in your Handset in the future ?”

45 Integrated Technical Skill Base LIFE SCIENCES CHEMISTRY & MATERIALS MICROFABRICATION OPTICS, ACOUSTICS & PHOTONICS ELECTRONICS & COMMUNICATIONS ENGINEERING Visions of the future A Multidisciplinary Company

46 An example already there today - Philips is present across the entire care cycle - extending healthcare from the hospital to the home-and moved its R & D to Cambridge in 2008 Diagnostics Treatment Follow Up Operating room Monitoring Imaging Intensive Care unit Monitoring Personal Healthcare Remote monitoring Diagnostics Imaging Pre-Hospital/Ambulance Monitoring Emergency Response Services Treatment Diagnosis Prevention Rehabilitation Management Consumer Healthcare Solutions Diagnostics “The array of health services and care settings that address health promotion, disease prevention, and the diagnosis, treatment, management, and rehabilitation of a disease, injury, and/or disability.” Center for Disease Control and Prevention (CDC), US Government`

47 IMAGINATION ? – It seems necessary…. How about some IMAGINATION ? – It seems necessary….

48 Einstein on IMAGINATION…. “ Imagination is more important than knowledge. Knowledge is limited. Imagination encircles the world” Albert Einstein

49 “You look at things and ask - why? but I dream of things that never were and ask - George Bernard Shaw why not?” Opportunities for Entrepreneurs - Healthcare needs them ! A matter of MINDSET

50 Implementing Innovation – looking for more innovators and heroes Against this history and background ….Health Enterprise East Ltd – facing the Challenges of Implementing Innovation – looking for more innovators and heroes  An NHS Innovation Hub part of the national NHS Innovations Network  A not for profit company limited by guarantee Five years old and going strong

51 A TOP TEAM – Ready and Willing to help YOU realise Opportunities

52 Health Enterprise East – Founded 2005 We provide advice, support and resources to turn the ideas of NHS staff into new products and services

53 Health Enterprise East  Helps NHS staff to identify and evaluate innovative new ideas  Provides funding for filing of patents, designs rights & other registerable IP  Development funding available to progress new ideas  Negotiates commercial deals on behalf of staff and their Trusts

54 Annual Innovation Competition  Open to all NHS staff in the Region  5 categories:-  Medical Technology  Software, IT and Computers  Infection control  Prevention & wellbeing  Publication & training aids  Celebratory Awards Dinner  £20k prize money  Sponsored by companies

55 Medtech Services – Helping Company Access and Getting Innovative Systems Evaluated – “Opening Doors”  Help companies access NHS expertise  Source of revenue for NHS staff  Expose NHS staff to the latest technological innovations  Industry Experts and IT and Software Executives in Team Dr Juan Roman, HEE Medtech Services Manager

56 Working together to PUT Innovative Products and Services to work – Some Issues for us all  Balancing Process and Safety with Innovation  Finding and Exploiting Innovation – Barriers  Adoption and Diffusion  The “Top Down” – “Bottom Up” Dilemmas  The Minefield of Regulatory Standards and Harmonisation in the EC.  Leadership and Creating an Innovative Mindset  Care “Everywhere” – Home, Community, Hospital, Work – and need for connectivity

57 In of Excellence ! In Pursuit of Excellence ! “ Excellence can be achieved, if we: Care more than others think is wise, Risk more than others think is safe, Dream more than others think is practical, Expect more than others think is possible.” Deborah Johnson-Ross Excellence in Medicine and Medical Technology is everyone’s dream and in the West our expectation