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Andrew Lansley, Secretary of State, Healthcare Innovation Expo keynote speech in full

March 11, 2011

I would like to welcome you all to the 2011 Healthcare Innovation Expo.  People have come from across the country and around the world to witness for themselves the future of healthcare.  And that future is right here under this roof.  

The Expo is an exceptional showcase for some of the most exciting technologies and techniques in modern healthcare, and I am sure you will all find a wealth of creativity and innovation that you can take back to your own organisations. 

For well over twenty years, I have stood up for the benefits of enterprise and innovation.  I believe these can energise our public services every bit as much as they have done the private sector.  Not in any way to inhibit the values of public service, but to empower public servants to deliver better care more efficiently. 

The NHS and the UK has a long history of innovation, from Ian Donald who pioneered the use of ultrasound in the 1950s to the Sanger Institute in my own constituency in Cambridgeshire, which developed the first working draft of the human genome in 2000. 

The creative spark that kick starts the long and often difficult journey from initial idea to widely adopted treatment is a precious and delicate thing.  We need to do all that we can to encourage that creativity within the NHS and to grow and propagate the ideas that clinicians and others have for the benefit of their patients. 

The modernisation of the NHS will encourage innovation in three main ways:

  • By placing the patient at the centre of decision making about their own care – so need drives innovation;
  • Through a resolute focus on improving health outcomes; so that the drive for results drives innovation;  
  • And by placing power in the hands of local clinicians while getting rid of the huge and wasteful bureaucracy that can so often strangle and frustrate innovation; so health professionals themselves drive innovation by their knowledge and drive for continuous improvement.

 Patients first

The worlds most successful businesses – people like Apple or Virgin or Tesco – all have one important thing in common.  They all start with an unwavering focus on the wants and needs of their customers.  The same should be true in public services. 

To create a health service that is truly excellent, our starting point must always be the individual patient.  We have passed the point where one size fits all.  The future is about personalising care.  About tailoring treatment to maximise outcomes.  And here I mean several things.  

At one end of the spectrum it’s about making the most of the latest technologies, of developments in genetics and genomics to improve the diagnosis and treatment of rare conditions or to tailor drug treatments to an individual person.  

At the other, it’s bringing together clinicians with their colleagues in social care to build personalised care and treatments packages for patients with complex long term conditions. 

And for everyone, it’s making sure that the patient is always a central part of the decision making process about their own care.  Making sure that, in all cases, there really is no decision about me, without me

By involving the patient in their own care in this way, a new perspective is brought to view.  

A consultation room becomes the meeting of two experts: the clinician being the expert on the treatment and the system; the patient the expert on themselves and their own wants and needs.  

And evidence from the UK and around the world shows that care and treatment that involves the patient produces better health outcomes, a better patient experience and in many cases, better value for money. 

Outcomes

Another change will be a focus on driving up the quality of care the NHS provides, not just the amount of care it delivers. 

The Outcomes Framework, which we published in December, sets the direction for the Health Service and will soon be the main means for holding the NHS to account for the quality of its care. 

The Framework as a whole and its constituent parts, set the direction for the NHS over the coming year, the health outcomes we want to achieve.  What it does not do is tell people how they should achieve them.  

That isn’t the job of the Department of Health, that’s the job of the clinicians who actually look after patients every day. 

The Outcome Framework was developed after consultation with the public, with NHS staff, patient groups and others.  We’ve included some areas purely because they received such strong levels of support.  The only problem is that, as yet, there are no clear indicators to measure against them.

So, for two outcomes included in this year’s Outcomes Framework –

  • for improving recovery from stroke and improving children’s and young people’s experience of healthcare, and for four more that I expect to see in future Outcomes Frameworks – 
  • for improving health outcomes for those with learning difficulties,
  • for children with long term conditions,
  • for children and young people with mental illness
  • and for enhancing the quality of life for people with dementia, we need your help. 

Outcomes will be the “must dos” of the national NHS. They must be the hard-headed drivers of change.  We need indicators that not only measure the rate of improvement but that also shepherd all developments within a particular field to a clear goal. 

So, I am today launching a competition to find those indicators over the next 12 weeks.  If you have ideas, we want to know about them.  If you’re working on something that might help, tell us.  The details of how you can become a part of marshalling the combined resources of the NHS for the benefit of patients are now on the Department of Health website.  

We will align every payment, every incentive, every structure behind those outcomes.  One way will be through the tariff, the way we will pay for the vast majority of NHS services. 

The tariff will not be about providing a particular type of treatment, but for delivering a particular quality of outcome.  This in itself will be a powerful driver of innovation within the Health Service. 

I was at Bart’s cancer centre last week, seeing their planned new Cyber-knife, a new technology that could provide better care for patients that would also be, as it happens, be more cost-effective than surgery. 

But at the moment, services are constrained from innovating up-front, because there is no specific tariff to pay for it. 

But by paying for specified outcomes rather than particular treatments we can free commissioners, in the shape of the new GP consortia, to pay for what in their judgement and the judgement of the patient will provide the best outcome.  If that is the new Cyber-knife, then there is nothing that will stand in their way. 

The result will be more money flowing towards the best, most innovative treatments.  Just like those promoted here at the Expo. 

We are opening up the Health Service to any provider who can deliver NHS services at or above stringent NHS quality standards and at NHS prices.  As patients gain control over their own care, as they get to exercise choice over what, where, when and by whom they are treated, providers will compete on the quality of care that they provide.  

Some worry that providers will compete on price, but with fixed national or local tariffs, this simply can’t be the case.  At the point of referral or choice, quality will be the only consideration, because price for all providers will be tariff based. Competition will be based entirely on quality. 

It will no longer be enough for a provider to presume that just being the closest hospital will be enough, not when patients can see quite clearly how well they’re performing – or not performing – relative to others.  

It will no longer be enough for a provider to rely on doing things the way they always have done, because they’ll be competing against other providers for their patients.  Other providers who might well be offering better care. 

This will drive competition based on the quality of care a provider can offer, the outcomes of their treatment and the experience of the patient. 

The role of government is not to enforce innovation – that’s impossible – but to create an environment that promotes it, that supports it and that spreads its benefits as widely as possible. 

In the past, the NHS has been as successful as it has been despite the system, not because of it.  Our plans to modernise the NHS will change that. 

Excessive bureaucracy often tolls the death knell for innovation – so we will strip it out.  We will replace top-down direction from Whitehall, from regional Strategic Health Authorities and from Primary Care Trusts with bottom-up, clinician-led, local decision making. 

Consortia of GPs, working with their clinical colleagues across primary, secondary and community care, local authorities and their local communities will design, plan and commission clinically-led health services as they see fit. 

When you start to bring together clinicians from across the NHS to talk about how best to design new services for patients, institutional distinctions quickly fall away.  Instead, the conversation becomes one of how best to improve the patient’s pathway of care, linking up all the different parts of care in an integrated way.  

By breaking down the walls that divide clinicians, we will start to mine a rich seam of ideas and creativity based around improving outcomes for patients.  Ideas that could never have come through a system of central command and control. 

We will start to see the results of this very soon.  Already, there are 177 Pathfinder Consortia, covering 35 million people, around two thirds of the population of England.  These pathfinders are leading the way to the new system, taking up the reins in their local areas, fighting for their patients. 

As well as a shake up at the commissioning level, we’ll do the same with providers.  Finally, long after the last government promised to do it, all NHS Trusts will become Foundation Trusts, free to compete in the business of being the very best.  

And as I said before, we will open up the provision of NHS services to any organisation that can provide NHS quality care at NHS prices. 

And as the money really will follow the patient, the quality of clinical outcomes that a provider can offer will determine their future success.  

That will depend on always being ahead of the game, on always giving their patients the very best healthcare and the very best experience of the NHS. 

Research Funding

Beyond being clear about what outcomes we seek, but then getting out of the way, there is another very important role for government.  We can do everything we can to make sure that the UK continues to be one of the best, if not the best place in the world to conduct cutting edge clinical research. 

On Monday, I announced £775 million of funding over 5 years through the National Institute for Health Research to promote translational research and development. 

A major increase in resources dedicated to delivering, from science and discovery, to benefits for patients. 

The funds will be available to any NHS/ university partnership, and collaboration with industry and charities will also be a central part of this.  

This money will drive innovation focussed upon some of our greatest health challenges – diseases such as dementia, cancer and heart disease. 

This is a second wave of this funding.  In the past, it’s supported:

  • new stem cell technologies to cure blindness by replacing damaged eye cells with new healthy ones;
  • the use of MRI scanners to diagnose autism with 85% accuracy along with a genetic test for autism; and
  • a new blood test to diagnose Alzheimer’s disease, and a new blood pressure watch  

When you think of the measures we are having to take across government to put our public finances in order, I hope you will agree that this represents a tremendous commitment.  We really are putting our money where our mouth is. 

NHS Global

For as Lord Howe will say in more detail tomorrow when he stands where I am now, the NHS is more than a means for improving the health of the nation.  It is also an engine for economic growth. 

The National Health Service, the world’s largest state funded provider of healthcare, also has a world wide reputation for healthcare.  Equity, excellence and innovation – a reputation I can only see improving in the coming years and a reputation that we can use to help put Britain back on the path to prosperity. 

Many of the freedoms we are giving providers – the autonomy, the ability to borrow and invest, to innovate and expand, the removal of the cap on private income – also present opportunities for growth here and abroad.  

Some NHS organisations are already reaching out, exploring new opportunities, seeking new collaborations.  

Moorfields Eye Hospital, with their new facility in Dubai, and Imperial College, with their diabetes clinic in Abu Dhabi, are pioneers, seeking new commercial opportunities for the NHS – providing new revinue streams to fund better care for NHS patients. 

And some Trusts with well-developed international reputations, such as Great Ormond Street, already treat international private patients here in England.  Private money that is invested back into the NHS to provide ever better care for NHS patients here in Britain. 

These are just some of the many opportunities that exist for NHS providers.  Others might include collaboration with global centres of excellence, data management, designing best practice guidance, accreditation systems, NHS technology and offering advice to other providers.  The only limit is our imagination. 

Conclusion

Of course, it’s not only the innovation itself that is important.  The speed with which it is adopted makes all the difference in the world.  New ideas need to have their moment in the spotlight, to be discussed, debated and adopted across the country. 

That is why this Innovation Expo is so important.  It provides that spotlight.  It brings people from the public, private and voluntary sectors together to share their ideas about how we can improve patient care and improve efficiency.  

So wherever you have come from, whichever organisation you represent, I hope that you enjoy your time here at the Expo. 

If you are from a provider of NHS services, I hope that you take the ideas and technologies that you see here over these next couple of days and spread the word.  Think about how you can use them for the benefit of your organisation and your patients. 

And if you are here to help those providers, if you have a new technology or technique, then I wish you the very best.  

We have under one roof the future of healthcare.  That doesn’t happen every day.  I hope you all make the most of it!

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