Commissioning Development Programme Building choice of high quality support for commissioners Academic Health Science Networks Universities UK Meeting July 2012

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Innovation Health and Wealth Innovation Health and Wealth was launched in December 2011 by the Prime Minister alongside the Life Sciences Strategy It is the NHS’s contribution to the Plan for Growth Why is innovation important to the NHS? What should be done to drive innovation? 1.Innovation transforms patient outcomes 2.Innovation can simultaneously improve quality and productivity 3.Innovation is good for economic growth 1.Reduce variation and increase compliance of NICE guidelines 2.Publish uptake metrics 3.Establish a more systematic delivery mechanism 4.Align incentives and rewards 5.Improve procurement 6.Develop our people and hard wire innovation into training 7.Strength leadership in innovation 8.Identify and mandate High Impact Innovations

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Academic Health Science Networks Academic Health Science Networks are: A “more systematic delivery mechanism for diffusion and collaboration” To “align … clinical research, informatics, training and education and healthcare delivery” To “improve patient and population health outcomes” Innovation Health and Wealth says Public commitments: The NHS Chief Executive and the Chief Medical Officer will work with the NHS and industry to designate these networks with the first to go live during 2012/13 We will publish details of the AHSN designation process in March however it was not possible to publish in March because of purdah

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 What is an Academic Health Science Network? An Academic Health Science Network provides a systematic delivery mechanism for the local NHS, universities working with industry and other partners such as local government to transform the identification, adoption and spread of innovations and best practice. It is a partnership organisation in which the partners are committed to working together to improve the quality and productivity of health care resulting in better patient outcomes and population health. The AHSN aims for universal participation by bringing together a range of partners who are primarily focused on a defined geography, including Clinical Commissioning Groups and providers of primary, community, secondary and tertiary NHS services in a defined area, higher educational institutions active in health care, representatives of industry, local government and other partners. The AHSN will need to develop links with levers and functions that benefit from and support innovation including research, education and training, service improvement, wealth creation and information.

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Clarity of Purpose Key Linkages and Levers that enable the core purpose of AHSNs to be delivered Additional functions that locally the partners want to deliver through the AHSN Core Purpose Identification, adoption and spread of innovation and best practice

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 All AHSNs will have access to world-class research and teaching Academic Health Science Centres where they exist, they will nest within AHSNs Essential Levers and Linkages: to support the core purpose of innovation Driving service improvement Promoting participation in research Collaborating on education and training Wealth creation Creating patient centred information Translating findings into practice and knowledge management NHSIndustry Academia

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Participation in AHSNs (1) There is great enthusiasm to participate in AHSNs – we must build on this and allow local flexibility in how bodies participate. Thus participation is voluntary and we need to make the case as to why organisations would they not want to participate For commissioners – because They want to know that they are commissioning services that reflect state-of-the art proven innovations and best practice They want to be assured that the CQUIN payments are going to providers that are benefiting from the sharing of learning and expertise about innovation and best practice in an innovation network. For all providers and multi-disciplinary clinical teams – to work within and across organisational boundaries in developing and testing innovations and in learning from others to ensure they deliver state-of-the-art services For higher education institutions – helps demonstrate impact of research as part of the life sciences agenda but the offer needs to be attractive and tangible For industry – helps creates the new relationship that is described in Innovation Health and Wealth

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Participation in AHSNs (2) NHS commissioners and providers of NHS services would aspire to participate in their local geographical AHSN and could be affiliated to other AHSNs for particular themes or projects, such as specialised services All local relevant Higher Educational Institutions will hopefully want to participate in their local AHSN and may want to engage with other AHSNs on specific projects and themes. AHSNs need to work together - there could be the development of a network of AHSNs (or an Academy of AHSNs) to work together to spread innovations and have a national voice.

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Governance of the AHSN The participants in the AHSN should work together to design the governance model but this must meet minimum national expectations. The AHSN will probably be an incorporated body with a clear public interest with its own local participation model. (note VAT issues linked to non-NHS partners) There should be Board providing leadership to the AHSN with an independent chair and an accountable officer. The Board should have governance links with the LETBs and CRNs Further work is needed to think how industry participates in the governance of the AHSN. There would be conflicts of interest if specific companies are involved but there should be other mechanisms.

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 The designation process The NHS CB agrees with partners to create an independent panel to review AHSN applications The Independent Panel makes recommendations on each application The AHSN Is awarded a 5 year licence “to operate”

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 The licence The designation will lead to a five year licence from the NHS Commissioning Board to the AHSN that would be: An agreement between the members of the network and the NHS Commissioning Board that they will work together to improve patient care and population health; A “contract” to deliver defined tasks and outcomes for which network will receive significant annual funding from the NHS Commissioning Board, including local resources that the members will contribute. The Sunset Review will help identify funding that is available from 2013 onwards. These tasks will support delivery of the NHS Outcomes Framework. AHSNs will be able to bid for other contracts and they may decide to work together to bid for contracts at a national level

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 AHSN delivery chain The local AHSN Delivers services to its members Delivers contracts With the NHS CB Eg SBRI, HIIs Delivers contracts to other parties including industry and overseas bodies The national network of AHSNs NHS CB seeks advice from the AHSN network Other national bodies commission work from the AHSN network

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Research Excellence Framework (1) The Research Excellence Framework will require HEIs to submit case studies to demonstrate the impact. The pilots in clinical medicine (2010) - included the sort of projects that AHSNs will look to support and promote: Clinical trial outcomes inform changes to NICE guidelines for the management of hypertension Creation and commercialisation of a global, cost-effective cure for Hepatitis C infection Development and initiation of UK-wide programme to change the nutritional management of obesity Improved treatment of children with Crohn's Disease Research from the Child Protection Systematic Review Group enhances management guidelines for child abuse

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Research Excellence Framework impact (2) The Panel made comments on the clinical medicine pilots – AHSNs could help address many of these: Case studies were mainly showing improvements in healthcare and/or economic benefits BUT few showed public engagement Recognised “early stage/proof of concept” had some impact but that this was not yet as significant as later stage impact Balance to be struck between crediting specific centres but not discouraging multi- centre and collaborative projects Reach – ideally as wide a geography as possible but 4* rating was possible for a major benefit in a defined geography Links with the “environment” section of REF to describe the impact strategy and mechanisms

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 Expressions of interest Expressions of interest in submitting an application to become an AHSN should be submitted by 20 July and feedback will be provided by end of July. This will cover footprint and links with key other parts of the architecture We suggest that there are between 12 and 18 AHSNs in England covering a population normally of between 3 or 5 million hopefully with all local NHS organisations and all relevant local Higher Education Institutions as participants. Footprints need to be large enough for the AHSN to deliver at scale and do not need to be based on existing SHA or SHA cluster boundaries though alignment/nesting with other geographies, such as clinical senates and LETBs is encouraged.

Clinical Transition Programme - Presentation to David Nicholson – 12 January 2012 STAGE 1: For 20 July 2012 A short expression of interest in making an application setting out the proposed footprint and links with other functions STAGE 2: Round 1 for September 2012 An application to a panel with three elements: 1.The AHSN model: Overall vision and goals of the AHSN, the challenges it will address and partners/footprint; The development of clinical and organisational partnerships on innovation in the patch The track record of working together on innovation in the patch The mechanisms and levers that the network proposes to use The approach to delivering the specific functions in relation to research; The measures by which the AHSN will measure its progress; The governance, leadership and culture model of the proposed AHSN; 2.Evidence on demonstrable progress and collaborative working on the adoption and spread of the High Impact Innovations and the iTAPP push technologies; 3.The draft business plan for the proposed AHSN setting out its ambitions for the next 5 years in each area of its work. The proposed application process STAGE 3: Round 1 in autumn 2012 An interview with the panel