Better understanding between entrepreneurs and the NHS and clearer routes to market are vital to improving healthcare through innovation in the UK, says MedCity Executive Chair Dr Eliot Forster

His comments come as MedCity launches the first three in a series of guidance for life sciences entrepreneurs and SMEs that address the main challenges they experience in commercialising their product or service – navigating the NHS, raising finance and accessing the right working space.

MedCity’s top tips:

MedCity’s Guide to Navigating The NHS

MedCity’s Guide to Raising Finance 

MedCity’s Guide to Finding The Right Space

UK universities are rated amongst the best in the world for medical research*, and the creation of Academic Health Sciences Centres and Networks, which began in 2007, is bringing education, training, clinical research, commercialisation and patient care closer together to translate innovation into better therapies and services.

However, says Dr Forster, many life sciences and med tech entrepreneurs cite difficulty in navigating the NHS as a key challenge when it comes to getting their innovative product or service to market. Issues raised include the lack of a clear path or single procurement route for companies looking to demonstrate their product, and many entrepreneurs report receiving conflicting advice and being passed around the system by staff who are themselves unsure of the correct process.

Dr Forster says:

“The UK is a nation of entrepreneurs; the barrier to medical innovation is not making discoveries and developing new technologies, but getting them accepted into a complex healthcare system.

“However there is a more that SMEs can do to maximise their chances. A great idea backed up by great science is only the start of the process; you also need to be clear about what gives your product an advantage over what is already available and how that addresses clinical and patient needs. Understanding the market is a crucial early steps to success.”

Orthopaedic surgeon and digital health entrepreneur Matt Prime has seen the innovation process from both sides, as a clinician who developed new software to manage the care of trauma patients within hospitals to replace the traditional paper-based system. He says:

“It always struck me as crazy that I could book a flight using my phone yet when I was at work I used scraps of paper and a pencil. On one particularly day, I had 25 plus patients who I had diligently recorded in my notebook, before scribing them onto the whiteboard and then further completing a handwritten theatre list. I came in early the next day to prepare for the morning trauma handover and was greeted by the cleaner diligently cleaning my ‘messy whiteboard’. Profanity and panic were the result.”

He trialled his new software product within his own department, where it was adopted after proving highly successful, and went on to co-found the company Open Medical to make the system available to other NHS trusts. However the process of introducing innovation more widely within the system proved more complicated than he expected. He adds:

“As a doctor I have been able to speak to and present at lots of orthopaedic departmental meetings. Senior clinicians are broadly supportive of implementation but there is generally a breakdown when it comes to ‘who pays’ and ‘who to speak to’. It seems to me hospital managers and IT managers are scared to try a new idea for fear of being blamed if it fails.

“The thing that would improve our business journey is knowing who to approach in a hospital and what they need us to do. I feel frustrated that the NHS is missing out on so many innovative ideas because it doesn’t want to do business with small enterprises.”

**see full details of Matt’s business and experience below**

The issue of how speedily the NHS adopts innovation has been at the forefront of the health agenda in recent years, with the creation of NHS Improving Quality in 2013 and the launch of the Government’s Innovative Medicines and MedTech Review in 2014.

MedCity launches its first Top Tips guides at WIRED Health, taking place on Friday 24 April at the Royal College of General Practitioners. See more at: http://www.wiredevent.co.uk/wired-health-2015

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Notes to editors

*World university rankings include:

QS World University Rankings (September 2014) – eight UK universities ranked in the top 50, including four in the top 10

http://www.topuniversities.com/university-rankings

THE World University Rankings (October 2014) – seven UK universities ranked in the top 50, including three in the top 10

MedCity’s top tips for navigating the NHS

  • Get to know the NHS landscape
  • Do your market research
  • Understand the multiple entry points
  • Use practitioners and influencers
  • Understanding commissioning and procurement
  • Design a pilot or case study
  • Avoid unpaid pilots and, if unavoidable, negotiate payback based on results
  • For digital products, consider extra issues such as privacy and security, which purchasers are likely to raise
  • Don’t underestimate change management
  • Don’t assume trusts talk to each other – be prepared to repeat the process

Entrepreneur case study – Matt Prime, Open Medical

Founded by orthopaedic surgeons Matt Prime and Harry Lykostratis with ICT and e-health entrepreneur Kostas Lykostratis, Open Medical designs software products that manage the care of trauma patients within hospitals as they pass between different teams. The products aim to improve on the traditional paper-based systems of managing patients, which are prone to inaccuracy, duplication and loss of information.

The systems have won commendation from clinicians for their usability and, three months after implementing their first system eTrauma in one hospital department, the team was able to demonstrate a 50% reduction in complaints.

The products also act as a secure central repository for historical data, which can be used to improve services. A service analysis for one client revealed a 25% increase in emergency admissions which led to an increased waiting time for theatre from an average of two to five days and an increase in patients’ average length of stay in hospital from 10 to 15 days. The detailed information enabled the trust to make changes to its service provision which managed the continued increase in admissions to maintain a waiting time for surgery of two days and an average stay of seven days.

Orthopaedic surgeon and company co-founder Matt Prime says:

“It always struck me as crazy that I could book a flight using my phone yet when I was at work I used scraps of paper and a pencil. On one particularly day, I had 25 plus patients who I had diligently recorded in my notebook, before scribing them onto the whiteboard and then further completing a handwritten theatre list. I came in early the next day to prepare for the morning trauma handover and was greeted by the cleaner diligently cleaning my ‘messy whiteboard’. Profanity and panic were the result.”

The team developed the new software product in response to this experience with the support of the hospital, which allowed them to trial it for a month alongside the paper system. Following the success of the pilot, the department gave up whiteboards and paper for good.

However, despite demonstrating the benefits of the products, the company has faced challenges in engaging other NHS trusts, including:

  • Clinical leads and service managers are enthusiastic but the company found it very difficult to translate that into a formal contract.
  • Feedback from one trust was that the company is too small to be considered as a supplier.
  • Lack of clarity about who the decision-makers in a trust are, and difficulty in getting feedback on why a proposal isn’t successful.
  • Challenges in engaging IT departments; at least two trusts rejected the proposal because the IT department promised to build their own system – one trust has just invited the company back 18 months later due to failure to deliver.
  • Success with one trust does not translate to success in others – each one has to be treated separately

Matt adds:

“Forming a business was an afterthought; we felt we had created something really useful and wanted other people to experience the same benefits. The biggest challenge has been trying to increase the uptake of products in NHS hospitals. As a doctor I have been able to speak to and present at lots of orthopaedic departmental meetings. Senior clinicians are broadly supportive of implementation but there is generally a breakdown when it comes to ‘who pays’ and ‘who to speak to’. It seems to me hospital managers and IT managers are scared to try a new idea for fear of being blamed if it fails.

“The thing that would improve our business journey is knowing who to approach in a hospital and what they need us to do. I feel frustrated that the NHS is missing out on so many innovative ideas because it doesn’t want to do business with small enterprises.”

The team has achieved some success by switching to a ‘freemium’ model, in which the company will install software for free for six months, perform a free-service analysis and thereafter move to an annual or monthly payment plan. This enables them to prove the worth of the system at no risk to the Trust.

They are now working with two NHS trusts and are about to begin trial periods with two more, which they hope will become paying clients.

www.openmedical.co.uk

About MedCity

Established by the Mayor of London with the capital’s three Academic Health Science Centres – Imperial College Academic Health Centre, King’s Health Partners, and UCL Partners – MedCity is a unique collaboration that brings together the outstanding life sciences strengths of London and the greater south east.

Over the next 20 years, MedCity will position the region as a world-leading, interconnected hub for research, development, manufacturing and commercialisation by championing collaboration and entrepreneurship, promoting a joined up and globally distinct life sciences offer, and providing a visible ‘go-to’ point for industry and investors.

www.medcitylondon.com