Professor Michael Sheppard, Chair of WMAHSN
Great challenges lie ahead for the West Midlands in the fields of health and care. We report on an economic summit where key decision makers came together to debate these issues.
Capitalising on Brexit and devolution
Can Brexit bring a boom, or will devolution deliver? The two seismic shifts in the political landscape and the opportunities they may create, dominated discussions at the third annual Economic Summit of the West Midlands Academic Health Science Network (WMAHSN).
2016 was a highly significant year for the West Midlands; the UK’s decision to leave the EU was coupled with the advancement of the regional devolution debate, which centred around the Midlands Engine and the development of the West Midlands Combined Authority.
At the WMAHSN’s Economic Summit held in Telford in Shropshire, more than 130 clinicians, academics and business leaders joined to discuss and investigate the challenges that these events have posed and the opportunities that arise from them to create better health and wealth outcomes.
Professor Michael Sheppard, chair of WMAHSN, explained: “When we held our first economic summit we didn’t know that it would be the success it has turned out to be. Our focus has always been, and remains, to investigate ways to improve health and drive wealth and there currently exists genuine opportunities for innovative healthcare.”
WMAHSN’s commercial director Tony Davis provided an update on the WMAHSN’s Seven Point Growth Plan: “When we launched our growth plan, we committed to promoting the West Midlands as a place in which to invest and deliver innovative life sciences and healthcare. We’re doing this on multiple levels through partnerships with Local Enterprise Partnerships in the region, the West Midlands Combined Authority, the Midlands Engine and across both the European Union and the global stage.
“Next, however, there are three specific areas we wish to focus on: firstly, providing support to seize the opportunities created by our decision to leave the EU; secondly, to look at how we can learn from the experience of Manchester in the process of devolution; and lastly to examine how we operate with regards to the goals of the regional Sustainability and Transformation Plans (STPs).”
Bullish about Brexit
Tackling the first of these areas was Kevin Wilson, sector specialist for Life Sciences at the Department for International Trade (DIT), who began with an overview of how to maximise global opportunities in light of Brexit.
“A UK/EU steering group has already been established to ease the path ahead. Within this new department, the Life Sciences Organisation (LSO) is specifically dedicated to providing impartial advice to the sector so that UK businesses can successfully trade in international markets, whilst overseas life sciences companies can invest in the UK.
“For example, the USA remains, by far, the largest market for UK life sciences products and services. US$3tn was spent there on healthcare in 2015 and it is anticipated that, by 2021, UK life sciences could enjoy exports worth £9.2m.
“Significant opportunities also lie in India, UAE, Japan, China, South Korea and Latin America and access to the Chinese market could expose UK exporters to as many patients as Canada, North America, South America, Australia and Europe combined - worth £2billion by 2021!”
During a thought-provoking panel discussion, Kevin Wilson, Richard Stone, chief executive at Medilink West Midlands and Tony Davis faced questions from the floor about the best way to realise any opportunities presented by Brexit.
Tony began: “Substantial effort has gone in to building and strengthening relationships between the private sector and academia across Europe and the challenge is now to maintain those collaborations and relationships, especially as most of those relationships have a global focus.”
Richard added: “Thinking specifically about SMEs, we need to ensure that post-Brexit they have access to prospects both on the continent and further afield. In the ‘new world’, the government needs to ensure that UK SMEs are given every chance to grow and that access to developments is made as simple and straightforward as possible.”
Kevin agreed, emphasising that Brexit will provide chances for UK industry: “The UK will be smaller and nimbler and we must, therefore, believe we’ll be in a better position to seize opportunities on the global stage.”
Dr Linda Magee from Greater Manchester AHSN was keen to hear how NHS organisations can contribute their experience to the international opportunities outlined by Kevin, who responded: “Healthcare UK is already the channel through which the NHS can input into major overseas projects such as hospital builds.”
Tony added: “The development of AHSNs has led to a very much more collaborative approach, where industry and healthcare come together and it is here that a solution for greater input to overseas projects can be created.”
Marie Jenkins from Advance your Wellbeing then asked: “As an SME, it is important for me to understand the procurement processes involved in accessing overseas opportunities - do these differ massively from one country to another?”
Kevin highlighted the resources on the DIT website, adding: “Local DIT advisers are well placed to provide guidance in this respect.” He also emphasised the importance of local experts who speak the language and know the local market well: “Cultures do matter and it’s imperative to have experts on the ground in all markets, not just those which appear different.”
Learning lessons from Manchester
The strategic opportunities for the life sciences and healthcare sectors presented by devolution were eloquently explained by Dr Linda Magee OBE, business development director at Manchester Academic Health Science Centre and executive director for Industry and Wealth at the Greater Manchester AHSN.
“The driving force for devolution across the English regions is ultimately focused on economic growth and for healthcare it’s a pragmatic means of delivering the NHS’s Five Year Forward View. In Manchester, devolution has been central to delivering the greatest and fastest improvement to health and wellbeing of the region’s 2.8 million people.”
She described a transformed health and social care system that focused on keeping people well and taking better care of those who are ill. This was achieved by aligning the system more closely with education, skills, employment and housing; so they could create a financially balanced and sustainable system which is guaranteed to be clinically safe at all times.
“What is different, is the role of the Greater Manchester chief officer to whom several services are delegated. These include budgets for public health; the delivery of dental care, pharmacy services and primary optical services; and the management of NHS England (NHSE) running cost budgets. Budgets for primary care services, including GPs, meanwhile are delegated to CCGs in a co-commissioning arrangement with NHSE.
“We’ve ensured that health is at the pinnacle of the devolution debate in Greater Manchester and have developed a strategic plan to support this. This plan is a fundamental change in the way people and our communities take charge of, and responsibility for, their own health and wellbeing.”
In a panel debate chaired by Dr Adrian Phillips, director of public health for Birmingham City Council, and featuring Dr Jane Moore, his counterpart from Coventry City Council, Dr Clive Winters of Coventry University and Dr Linda Magee, they discussed what opportunities devolution will create and how they can be maximised.
Dr Jane Moore set out distinct opportunities aligned to devolution: “We firstly need to reduce demand without increasing spending – there’s currently a 20-year gap in life expectancy between the poorest and most affluent in the West Midlands and through devolution we should be looking at both reducing demand and improving outcomes. We also need to reduce vulnerability and work to engage with our communities.”
Dr Phillips then added that the West Midlands Combined Authority has a vision to place the West Midlands at the pinnacle of mental health research: “With 50% of the 128,000 people currently drawing unemployment support allowance across the region suffering from some form of mental health problem, the significance this could have shouldn’t be underestimated.”
A question from the floor asked the panel to define the goal of devolution, given it will incur such a huge expense to achieve it.
Linda responded by explaining that whilst cost savings are important, devolution should also be about doing things in a different way.
Jane added: “Saving money is of course key, but we need to acknowledge that we’ve failed people for far too long. From the outset of devolution, we need to give every child the best chance in life and reduce the conditions that would otherwise lead them to excessively use costly services.”
The future of Sustainability and Transformation Plans (STPs)
Mark Rogers, chief executive of Birmingham City Council, began by providing the local authority perspective: “Chris Ham of the King’s Fund recently said that ‘STPs are the least bad option for trying to plan in a more coherent way in the NHS’. This made me think. Yes, who wouldn’t want better health and wellbeing? Who wouldn’t want a more sustainable system?
“But local authorities have been ambivalent about them, questioning whether the initiative could actually last. For me, I think their introduction was well intentioned but we need to move beyond Chris Ham’s assertion. STPs need to be considered in the whole place in which they occur; we need to consider whether they’re designed for the people they serve; and as we move forward, we need to dispel the growing perception that they’re a secretive NHS planning initiative. Simply we need to make them the best way forward, not the least bad.”
Andy Williams, lead for the Black Country STP, continued with the clinical commissioning perspective: “I focus on what we can achieve through STPs, and in the Black Country have worked to bring the 18 organisations within the STP together to agree on a clear set of goals.
“We’ve created a two-concept route to sustainability: firstly, to try and modify demand in the coming five years, and secondly to optimise efficiencies through back-office integration and the reduction of clinical duplication.
“It’s also imperative that we look at issues around housing, education and domestic violence and the Combined Authority will be key in pulling these all together. For me, the challenge we face is to spend our funding more wisely as it simply won’t meet demand otherwise.”
Terry Whalley, programme director of the Black Country Alliance, joined the debate, which resolved that STPs need to be utilised to get beyond organisational needs and place people first. Andy added the importance of technology and innovation:
“We need to use technology to allow people to engage in their own healthcare needs – there’s no benefit in having patients taking up beds simply because they’re seen as not allowed to go home. Similarly, innovation needs to deliver scale and better access to healthcare.”
Terry added: “We need to facilitate access to knowledge and information regardless of location – Pokemon Go was a great example of how couch potatoes could be encouraged to get up and out.”
Mark highlighted the importance of the third sector: “Now we’re at the delivery stage we need to be thinking bottom up, as well as top down and this is where there’s a real opportunity for greater engagement with the Third Sector.”
Working across the West Midlands
Closing the summit, Tony Davis stressed how important it will be for the WMAHSN to hear from clinicians, academics, business leaders and civil servants across the region so his team could engage fully in all their conversations.
As a central cog in the Midlands Engine, the WMAHSN has an important role to play in bringing the right people together to help progress the region’s plan for better healthcare and economic growth. “We will support the Combined Authority and regional STPs on the delivery of their plans as well as continuing our work across industry, academia and the health sector post-Brexit to ensure we’re seizing every possible opportunity for growth.”