Taking NHS expertise overseas – preparation, prospects and pitfalls

Seminar S169

Taking NHS expertise overseas – preparation, prospects and pitfalls

Chairman:Professor Rory Shaw MD MBA FRCPMedical DirectorHealthcare UK

Taking NHS expertise overseas – preparation, prospects and pitfalls

Chairman:Professor Rory Shaw MD MBA FRCPMedical DirectorHealthcare UK

Taking NHS expertise overseas – preparation, prospects and pitfalls

• Welcome to our overseas guests from the People’s Republic of China representing:

• Shandong

• International Health Exchange and Cooperation Centre (IHECC), Ministry of Health

Taking NHS expertise overseas – preparation, prospects and pitfalls

09:30Introduction and welcomeTaking NHS Expertise overseas

Prof Rory Shaw

Establishing an international collaboration for research, education and training - experience with King Hussein Cancer Centre, Jordan

Dr Geoff Hall Associate Medical Director for Cancer Services, Leeds Cancer Centre

Global opportunities in public healthDr David RhodesPublic Health England

Observations and opportunities:a perspective from Hong Kong

Prof Sian GriffithsCentre for Global Health, Hong Kong

Panel discussion and Q&A Prof Shaw, Dr Hall, Dr Rhodes, Prof Griffiths

Summary and round-up Prof Shaw

10:30 Seminar closes

Expertise from the NHS, DH and UKTI brought together

Understanding of

the requireme

nts of overseas

health systems

In-depth knowledge of the

NHS, private sector and

academia

To help British organisations to expand overseas, Healthcare UK will:

share qualified market intelligence

disseminate opportunities throughout the network

catalyse the creation of UK consortia

enable entry into overseas markets through campaigns

Establishing an international collaboration for research, education and training -experience with King Hussein Cancer Centre, Jordan

Dr Geoff HallAssociate Medical Director for Cancer Services, Leeds Cancer Centre

Establishing an international collaboration for research, education and training

The Leeds Experience with the King Hussein Cancer Centre, Jordan

Dr Geoff HallAssociate Medical Director for Cancer Services, Leeds Cancer Centre

Leeds Cancer Centre

• Leeds Teaching Hospitals Trust• One of UK’s largest Trusts• 1,950 beds, 1.2 million patients/year, £1 billion budget• 800 consultants, 14,000 staff

• St James’s Institute of Oncology – clinical care / trials• Opened in 2008, £220 million development• 3rd largest cancer centre in the UK (66,000m2, 350 beds)• Unites cancer surgery, non-surgical oncology, pathology, radiology

• Leeds Institute of Molecular Medicine – laboratory research• £21M development, opened 2005• >7,000m2 building linked to existing research laboratories

Leeds Cancer Centre – clinical care

• 12,500 new cancer diagnoses

• 6,500 radiotherapy patients

• 90,000 fractions of radiotherapy

• 5,000 cycles of chemotherapy

• 11,700 elective NSO admissions

• 3,500 acute NSO admissions

• Specialist surgery

• 38 Site specific MDTs

• 250 oncology specialists• 31 clinical oncologists• 24 medical oncologists• 22 haematologists• 33 histopathologists• 42 radiologists• 70+ surgeons

• 430 consultants in MDTs

• 1240 nurses

Leeds Cancer Centre – clinical and academic research

• Cancer Research UK Centre• Director – Prof Tim Bishop

• Genetics and epigenetics of cancer• Targeted therapies• Early phase and randomised prospective clinical trials• Biomarkers and pathology

• Leeds Institute of Molecular Medicine• Director – Prof Peter Selby

• Genetics; Molecular Gastroenterology, Neurosciences• Experimental Cancer Therapeutics • Experimental Haematology• Targeted Cancer Therapies • Cancer Pathology, Tumour Biology

Leeds Cancer Centre and Jordan

• Nov 2012 approach from UK Trade & Investment• Would Leeds consider a collaboration with King Hussein Cancer Centre,

Amman, Jordan ?

• Established cancer centre• “Leading comprehensive cancer centre

in Middle East”

• Provides cancer services to Jordan• 30% of patients from Middle East

• Iraq, Syria, Lebanon

King Hussein Cancer Centre, Amman, Jordan

King Hussein Cancer Centre, Amman, Jordan

• Plans for expansion• ↑ cases from 3000 to 9000 / year• ↑ beds from 170 to 352

• Ambition to• ↑ research• ↑ molecular diagnostics

Collaboration with KHCC – for mutual benefit

• Could we support training and education in Amman ? • Medical and non-medical staff

• Short term observation posts• 6 month to 1 year fellow ships

• KHCC to send fully funded Jordanian trainees to Leeds• 17 medical posts covering all aspects of oncology• Programme of specialist oncology training for nursing staff

Collaboration with KHCC – for mutual benefit

• Could we support their quality programme ?• Review of clinical services at KHCC

• According to UK peer review• Combined with seminars from visiting experts

• Leeds team to support Peer Review in Jordan• Education re process from Leeds and National teams• KHCC team to observe External Peer Review in Leeds• 5-year programme to deliver External Peer Review in Amman

Collaboration with KHCC – for mutual benefit

• Could we support clinical research ?• Joint clinical trial protocols• Training for research staff• Advice on regulatory process

• Support development of research team• Joint proposal to AACR / EORTC Flims Workshop

Collaboration with KHCC – for mutual benefit

• Could we support academic research ?• Host Jordanian trainees in CR-UK labs• Support development of molecular diagnostics

• Support development of cancer genetics service• Deliver molecular diagnostics for KHCC• Support and develop molecular diagnostics• Offer research positions to KHCC trainees• Exploring potential to develop funded research positions

Collaboration with KHCC – for mutual benefit

• Could we collaborate with Clinical informatics ?• Shared interest in open-source EPR• PPM, the Leeds EPR underpins recent MRC award

• Collaboration with Leeds and CR-UK to share website• Support Arabic translation of cancer information• Develop common methods to analyse outcomes

Collaboration with KHCC – for mutual benefit

• Could we support clinical management ?• Virtual MDTs• Transfer of complex patients to Leeds

• Exploring CISCO solution to deliver common platform• Transfer of digital radiology plus review of histology• Transfer of digital pathology

Collaboration with KHCC – for mutual benefit

• Timeline• Nov 2012, initial visit to KHCC by Leeds• June 2013, return visit to Leeds Cancer Centre• October 2013, memorandum of understanding signed

• KHCC and Cancer Foundation• Leeds Cancer Centre• British Embassy, Jordan & Healthcare UK

• December 2013, second visit to Amman• Peer review in gynae cancer• Expert lecture in gynae cancer• Development of training plans

Summary

• King Hussein Cancer Centre, Jordan• Has world-class cancer facilities• Offers world-class cancer care

• Leeds Cancer Centre• Offer support in clinical management• Support training and education• Support development of clinical and academic research• Deliver and support development of quality programme

Global opportunities in public health

Dr David RhodesPublic Health England

International opportunities in public health – what have we learned?

David Rhodes, Deputy Director & Head of Business Development

Sender bodiesThe existing health organisations and functions that contributed some or all of their staff to Public Health England include:

– Health Protection Agency

– National Treatment Agency

– Department of Health

– Strategic Health Authorities

– Primary Care Trusts

– Public health observatories

– Cancer registries

– National cancer intelligence network

25 Opportunities in public health

– Quality assurance reference centres (QARCS)

– Specialist dental commissioners

– Specialist commissioners

– NHS cancer screening programme

– UK national screening programmes (non-cancer)

Mission and priorities

26 Opportunities in public health

“To protect and improve the nation’s health and to address inequalities, working with national and local government, the NHS, industry, academia, the public and the voluntary and community sector.”

The three domains of public health

27 Opportunities in public health

– Inequalities

– Education

– Housing

– Employment

– Family/community

– Lifestyles

– Surveillance and monitoring of specific diseases and risk factors

– Clinical effectiveness

– Efficiency

– Service planning

– Audit and evaluation

– Clinical governance

– Equity

– Infectious diseases

– Chemicals and poisons

– Radiation

– Emergency response

– Environmental health hazards

Health Improvement Health Protection Healthcare Public Health

* Definitions from the Faculty of Public Health, 2013

Technical support for pharmaceutical m

anufacture

Smart procurement

Source of innovation for the vaccines industry

Trai

ning

and

skill

s

Stim

ulati

ng in

nova

tion

Enga

ging

with

indu

stry

bod

ies

Testi

ng e

valu

ation

and

qua

lity

assu

ranc

eSu

ppor

ting th

e uni

versi

ty se

ctor

Promoting t

he UK ove

rseas

Route to fu

nding for U

K companies

Speciality products for UK distrib

ution

Assisting businesses to conduct specialised operations safely

Scientific resource for the private health sector

Working with companies who provide healthy choices

Partnership with industry to develop new medicines

Assisting with development of specialised facilities

Building a regulatory framework for new UK industries

Cutting-edge gene sequencing technology

Thought leadersh

ip

Skilled employment

Facilitating industry to contribute to public health challengesContri

buting to th

e Olym

pic leg

acy

Licensing and spinouts

PHE

External incomeExternal income by category

Innovations Services

Products

• Spinout company Syntaxin valued at ~£100m• Sterilisation technology licensed to BiotAK,

Voraxase to BTG, polio vaccine to GSK• Specialist training delivered in UK and overseas• Biological materials and quality assurance

schemes distributed internationally• Development contracts with US and European

vaccine companies

Opportunities in public health 29

North America• Vibrant healthcare sector

• Strong government support

• US Government prime contractor status and FARs

• Commitment to infectious disease sector

30Opportunities in public health

Europe• Stable European Union funding sources

• Some limitations to cost recovery

• Strong life sciences sector

31Opportunities in public health

International commercial opportunities• Trade events and missions

• Need for strong governance framework

• Support from UKTI, Healthcare UK, embassies and consulates

• Transactional costs can be high

• Need for good websites

32Opportunities in public health

International interest in public health

33Opportunities in public health

Barriers to be overcome• Marketing and transactional resources

• Local representation

• Understanding procurement regulations

• Overseas legal jurisdictions

• Language barriers generally manageable

34Opportunities in public health

Recent highlights• Several key contracts and opportunities in Gulf states

• 2012 Olympics experience in mass gathering medicine now offered internationally

• Microbiology training in former Soviet Union countries

• Trade missions to Saudi Arabia, Qatar, Brazil, India and China

• MoUs announced last week during India trade mission with Jawaharlal Institute of Postgraduate Medical Education and Research and Public Health Foundation of India

• Opportunities for joint and collaborative funding

35Opportunities in public health

Lessons learned• Need for a ruthless focus on what adds value to both parties

• Requires strong governance and management processes

• Lack of resources “on the ground” will necessitate external support

• International opportunities are very real and bring real benefits• not least in market testing our cost-effectiveness

36Opportunities in public health

Observations and opportunities:a perspective from Hong Kong

Professor Sian M Griffiths OBE JP

MB BChir( Cantab),FFPHM, FHKCCM, FRCP, FRCSDSector Specialist for Healthcare UK Emeritus Professor , Chinese University of Hong Kong Visiting Professor , Imperial College , LondonSenior Adviser on International academic development , CUHK

Hong Kong

39

SARS

[email protected] march 2014

Lessons from SARS

[email protected] march 2014

•Communication

• Collaboration

•Cooperation

•Capacity

[email protected] march 2014

[email protected] march 2014

Healthcare in Hong Kong

[email protected] march 2014

[email protected] march 2014

Health Care in Hong Kong: The Hospital Authority

[email protected] march 2014

45

2014-15 Budget Highlights – 26th Feb

• Over the past 5 years, the Government’s recurrent allocation to the Health Authority has increased by $15billion, or nearly 50%– the total recurrent provision for 2014/15 exceeds $47 billion

• Hospital redevelopment – New builds as well as upgrading facilities

http://www.budget.gov.hk/2014/eng/budget34.htm

[email protected] march 2014

Public hospital building programme • HK$55 billion to enhance hospitals .

– the new Tin Shui Wai Hospital– Hong Kong Children's Hospital– redeveloping Kwong Wah Hospital, Queen Mary Hospital and

Kwai Chung Hospital,– expanding the United Christian Hospital and Red Cross Blood

Transfusion Service Headquarters.It will add 1,400 hospital beds.

• The government is also studying on the construction of an acute general hospital in the Kai Tak Development Area.

[email protected] march 2014

Improving and upgrading facilities • renovation of over 500 wards in 34 hospitals• provision of around 800 additional beds in 11 hospital• expansion of operating theatres, accident and emergency

departments, and general out-patient clinics• setting up additional endoscopy centres and ambulatory facilities  • comprehensively upgrade the major electrical and mechanical

engineering installations in hospitals • strengthen the Universal Accessibility Programme

It is estimated that the grant will be used to implement about 5,000 projects

[email protected] march 2014

Increased funding for elderly services • Strengthen support for frail elderly persons living at home;

increase rehabilitation • upgrading 51 social centres for the elderly to neighbourhood

elderly centres• enable all subvented elderly centres to increase their manpower

as well as programme expenses• enhance care and support for the elderly in nursing homes as well

as more places • purchase of residential care places from elderly homes run by

Hong Kong non-governmental organisations in the Mainland.• Consider vouchers

[email protected] march 2014

PPP: increasing the private sector • Sustainable development of our dual-

track healthcare system, • Government is considering a voluntary health

protection scheme to encourage those who can afford it to make greater use of private healthcare services

• Consider providing tax reliefs for subscribers of regulated insurance products after a consensus is reached in the community.

[email protected] march 2014

Prevention and primary care • Disease prevention and control forms an important line of

defence in public health.  • Government has endeavoured to strengthen primary care,

including proactively promoting healthy living, as well as strengthening disease prevention strategies and surveillance systems, with a view to lowering risks of disease and hence expenditure on healthcare.

• In the coming five years, Government will allocate additional funding of over $420 million for the study and implementation of a pilot programme to subsidise colorectal cancer screening for specific age groups.

[email protected] march 2014

Tobacco control • Increase the duty on cigarettes by 20 cents per stick with

immediate effect. • This will bring the proportion of tobacco duty to the retail

price of cigarettes to about 70%– meets the minimum level recommended by  WHO. 

• Not a budgetary measure to increase revenue– continue to strengthen smoking cessation services,– publicity and law enforcement on tobacco control. 

• The Customs and Excise Department will step up enforcement against different forms of illicit cigarette trading.

[email protected] march 2014

Opportunities

[email protected] march 2014

•Communication

• Collaboration

•Cooperation

•Capacity

Thank you for listening !

[email protected] march 2014

“Manpower, land supply and an ageing population are the major constraints to

Hong Kong’s future development. To overcome them, we must endeavour to

nurture a wealth of suitable talent for the future, increase land supply to expand the scale of the economy, and plan well

ahead for an ageing society. ”

Panel Discussion and Q&A

Moderator : Prof Rory Shaw

Panellists: Dr Geoff HallDr David RhodesProfessor Sian M Griffiths

Summary

The vital partner in global health

Seminar S169

Taking NHS expertise overseas – preparation, prospects and pitfalls

Chairman:Professor Rory Shaw MD MBA FRCPMedical DirectorHealthcare UK