Harnessing the AHSC Partnership Dr Philip Baker Dean, Faculty of Medicine & Dentistry University of Alberta.
Download ReportTranscript Harnessing the AHSC Partnership Dr Philip Baker Dean, Faculty of Medicine & Dentistry University of Alberta.
Harnessing the AHSC Partnership Dr Philip Baker Dean, Faculty of Medicine & Dentistry University of Alberta Overview of Today’s Presentation • • • • • • • The AHSC – providing solutions The UK call for RFP’s UK competitive process Manchester bid Progress to date with Manchester AHSC Lessons for Canada The emerging Alberta AHSC Changes in Healthcare and Society in the 21st Century • • • • • • Ever higher expectations from public and patients Demands driven by increase in aging population Health in an age of information and connectivity Changing nature of disease Advances in treatments Changing health workplace AHSCs offer a means of addressing needs for the future of healthcare 1 AHSCs: core purpose is to make new discoveries and promote their application and dissemination 2 AHSCs: through strategic and functional partnerships, connect the outcomes of research to patient care 3 AHSCs: address the need to compete internationally for healthcare and economic benefits that flow from successful partnerships 4 AHSCs: foster an environment for developing and diffusion of innovation Bring together world-class research, excellence in patient care and excellence in education – for the benefit of all Leading to outcomes including: Patient Care Application of research & education for benefit of patients Education Evidencebased care to improve patient outcomes & research Vision Partnership Governance 1. Attraction of world-class staff and external partners 2. Translational research 3. Collaborative training and working across different professions Research 4. Adoption of evidence-based practice for patient care and Develops education evidence base for 5. Redesign of care pathways better care & teaching The UK Experience UK Landscape • University hospitals & universities – Publically owned – Report to separate ministries • NHS – Publically owned, funded by taxes; owns healthcare institutions – Provides ‘free healthcare to all’ • Biomedical Research – 2nd in the world (to US) in impact and quality – Developed many of basic tools in modern medicine: penicillin, DNA structure, advances in molecular biology • Less successful translating to therapies and outcomes – 19/27 mortality for stroke, low 5- year cancer survival rates UK Landscape cont’d • ‘Cooksey Report’ (Dec 2006) identified 2 gaps: – Transforming discoveries into ideas and products – Bringing new advances into everyday practice • Funding pledged – MRC & NIHR: £1.7B by 2010 Gaps in the Discovery-Care Continuum Cooksey D. A review of UK health research funding. Norwich: Stationary Office, 2006. http://www.hmtreasury.gov.uk/d/pbr06_cooksey_final_report_636.pdf High Quality Care For All NHS Next Stage Review Final Report June 2008 Roles and Expectations for AHSC’s “…a small number of health and academic partners to focus on world class research, teaching and patient care…” “…they will compete globally with established centres such as those in US, Canada, Singapore, Sweden and the Netherlands…” “…clear governance arrangements…will be very important. A number of governance models have emerged to suit local circumstances …we are open to proposals for different forms of governances…” “…we will establish an international panel of experts…Those who have self-designated AHSC status will be subject to review by the international panel of experts” The Designation Process Part 1 Short Listing Part 2 / Interviews Provision of evidence: excellence in research, education and patient care International panel shortlisted applicants for Part 2 submission: vision, strategy, partnership, governance International panel conducted interviews in London Nov ’08 Part 1 deadline 9th Jan 09 Jan ’09 Part 2 deadline 18th Feb 09 2,3,4 March ’09 Announcement Successful applicants granted AHSC status March ‘09 Landscape: NHS North West: the Strategic Health Authority • Almost 7 million people • Largest geographical area • 5 Major Teaching Hospital trusts • 24 Primary Care Trusts • 39 NHS Trusts • One of two with an R&D department Source: Healthier Horizons Landscape: The University RAE 2008 Medical subjects, ranked by research power: 1 University College 2 King's College 3 Imperial College 4 Oxford 5 Manchester 6 Cambridge 7 Edinburgh 8 Newcastle RAE 2008 Research quality 1st: Cancer, Dentistry, Nursing & Midwifery 2nd: Primary Care, Pharmacy 3rd: Biological Sciences, Human & Pre-clinical Biological Sciences Source: Research Fortnight Landscape: Birth of the NHS Aneurin Bevan 5 July 1948 Park Hospital, Trafford, Manchester Manchester: Health Disparity • 11% of working age population on incapacity benefit Manchester life expectancy at birth 72.3 yr • Highest level of long term mental health problems • More than 25% of children live in poverty • 23% of adults are binge drinkers Kensington life expectancy at birth 80.8 yr Track Record Changed NHS practice • Suicide prevention • Prevention of falls in the elderly Changed NHS policy • Payment for general medical services • Dental screening Influenced NICE guidelines • Psychiatric illness, stroke, psoriasis MIMIT has developed • Objective grading system for prostate cancer • Non-invasive embolus detection device Background • 2001 Wellcome Trust Clinical Research Facility • 2004 Greater Manchester Research Alliance • 2005 Manchester Cancer Research Centre • 2006 External Review of Research Strengths • 2007 NIHR Biomedical Research Centre • 2008 MAHSC created; Company Limited by Guarantee Strategy Six NHS organizations in Greater Manchester and The University of Manchester An AHSC which covers the full spectrum of health care acute specialist mental health primary care commissioning £2.3 billion annual spend 35,000 people employed Manchester Academic Health Sciences Centre To be a leading centre nationally and globally for the uptake of innovative health research and education into health care Innovation driven by the extreme ambition of our researchers Health care: Safe, Effective, Personal University of Manchester Salford Primary Care Trust The Christie Foundation Trust Salford Royal Foundation Trust Manchester Mental Health and Social Care Trust University Hospital of South Manchester Foundation Trust Central Manchester University Hospitals Foundation Trust Imperial College London Manchester Academic Health Sciences Centre Governance, Management & Organization • Federated rather than integrated model • Enabled by not-for-profit Company Limited by Guarantee (CLG) – Board of Governors: Chief Execs NHS Trust; U of M President; MAHSC Director, others – Strategic direction, approves budgets, monitors performance against goals, appoints/reviews Director, etc – Mechanism to integrate, intellectually and operationally, the research and innovative potential of the partnership Governance, Management & Organization • Executive Management Team – Supports MAHSC Director and COO – Consists of: • • • • • MAHSC Deputy Director Board level members of each NHS Partner Assoc Dean Research, U of M Medical Faculty Deputy Dean Clinical Affairs, U of M Medical Faculty 9 Academic Section Heads – Input into: business planning, project proposals – Active championing of MAHSC activities within their own organizations Clinical Academic Sections NEED fulfilled NEED unmet Cancer Cardiovascular Human development Inflammation and repair Mental health From laboratory to community Enabling Academic Sections Enabling science and technology NEED unmet Repositories -omics Imaging Informatics Epidemiology Clinical trials CLRN Statistics Governance Implementation Health economics Health services Primary care E-health Quality assessment Metrics NEED fulfilled Education and Training Sections NEED unmet Enabling science and technology Clinical trials Implementation Education and training Postgraduate Integrated academic training programme HIECs NEED fulfilled Manchester Academic Health Science Centre Focus • Clinical trials • Enabling infrastructure • Implementation and assessment • Communication and engagement • Education and training Example: Clinical Trials From the 5 year vision • An integrated facility accessible via single portal enabling studies from biomarker and first-in-man to population level interventions From the Key Performance Indicators (KPIs) • Recruited 25 academic staff (statistics, health economics, clinical pharmacology) • Established dedicated training for nurses & other trial support staff • Trebled the number of patients entering trials Example: e-Laboratory From the 5 year vision • e-Lab infrastructure gives access to anonymized linked records • from all aspects of NHS care for a population of 2.5 m (by 2014) From the Key Performance Indicators (KPIs) • At least one new birth-cohort study attracted to Manchester by 2014 • All Greater Manchester PCTs participating MAHSC Partners Manchester City Council Industry • UK Trade and Investment • AstraZeneca • GlaxoSmithKline • Medilink NW • ICON AHSCs • University of Pittsburgh • University of Nijmegen The Designation Process Part 1 Short Listing Part 2 / Interviews Provision of evidence: excellence in research, education and patient care International panel shortlisted applicants for Part 2 submission: vision, strategy, partnership, governance International panel conducted interviews in London Nov ’08 Part 1 deadline 9th Jan 09 Jan ’09 Part 2 deadline 18th Feb 09 2,3,4 March ’09 Announcement Successful applicants granted AHSC status March ‘09 March 9th 2009 NHS patients to benefit as top flight Academic Health Science Centres named Health Secretary Alan Johnson today announced the successful Academic Health Science Centres (AHSCs) following peer review by an international panel of experts. England’s 5 academic health sciences ‘super trusts’ announced March 2009 • Cambridge University Health Partners: Cambridge University; Cambridge University Hospitals, Papworth Hospital, and Cambridgeshire and Peterborough foundation trusts • Imperial AHSC: Imperial College London and Imperial College Healthcare trust • King’s Health Partners: King’s College London; Guy’s and St Thomas’, King’s College Hospital, and South London and Maudsley foundation trusts • Manchester AHSC: Manchester University; Central Manchester University Hospitals, Christie Hospital, Salford Royal, and University Hospital of South Manchester foundation trusts; Manchester Mental Health and Social Care trust; Salford PCT • UCL Partners: University College London; University College London Hospitals and Moorfields Eye Hospital foundation trusts; Great Ormond Street Hospital for Children and Royal Free Hampstead trusts MAHSC: Progress to date Officially opened: 20 November 2009 • Initiated three pilot programs: – Collecting blood samples to look for genetic markers for patients suffering from more than one illness • e.g. diabetes and cardiovascular disease – Developing public engagement in health research – ‘Citizen Scientists’ – Industry liaison program run through MIMIT® targeted at SMEs in health technology MAHSC ‘Harmonization’ • Pioneered developments in management of research infrastructure and integrated research governance for UK – Research Passport • Leads for each work program: – – – – Research and operations Staffing and appointments Research funding Business development and external relations • Extended Teams – Practice and protocols – ongoing improvement • ‘Advancing Quality Program’ 10 Year Vision Goals & Measurements of Success • More than 10 demonstrable health benefits • More than 100 new senior national/international health researchers • More than 1,000 research-enabled healthcare workers trained • Trebled commercial partnerships in drugs and devices • Ethos of team science in health care, and superb research enablers • Health-conscious population of “citizen scientists” created Lessons Learned for Canada Key Challenges Build a well-oiled machine targeting research to patient need and rapidly translating the results into patient benefit • Integrate research and education with NHS Trust service • Avoid duplication of effort and parochial decision-making • Improve communication, strengthen the brand, raise ambition • Research infrastructure and academic appointments • Resources – clear identification Lessons Learned for Canada Key Enablers • Resources – To ensure vision becomes reality • Resources – Incentivize partners to come together • Resources – Avoid perception of taxation Alberta Academic Health Sciences Centre (AAHSC) Province of Alberta Age North 1 to 19 124,973 20 to 44 152,936 45 to 64 98,742 65+ 35,430 Total 412,081 < • • • • • Edmonton Central Calgary South Total 271,794 405,032 285,995 121,733 1,084,554 117,888 145,005 111,516 55,620 430,029 322,460 497,372 332,473 123,359 1,275,664 75,220 91,617 68,170 36,298 271,305 912,335 1,291,962 896,896 372,440 3,473,633 Approaching 3.6 million Centred around 2 main cities Elderly population growing ‘Contained’ population: clinical trials Service to outside of Alberta The Opportunity Potential Partners • University of Alberta – 2008 QS-Times Higher Education • Jumped to 74 from 97 in 2007 in World University Ranking • Ranked 45 in life sciences and biomedicine - worldwide – Research InfoSource 2008 • Ranked 2nd Top Research Universities in Canada – Medical School – recent updates • University of Calgary – Research InfoSource 2008 • Ranked 7th Top Research Universities in Canada – Medical School – recent updates • Alberta Health Services – Restructured May 2008: 12 separate regions to pan-Alberta integrated system AAHSC Mission: Support Patient Care and Improve Health System Performance Through Education and Research Basic Research Clinical Research Education Clinical Service Basic Research Clinical Research Education Clinical Service Tripartite University of Calgary Mission: Clinical Research & Trials Education Quality Clinical Service/Care University of Alberta Alberta Health Services Quality care Cost effective Research Education Goals: Health Research • Synergies: in health research resources • Align research priorities: three partners & government • Focus health research strength on health/service problems affecting AHS and Albertans • Translating research discoveries : better care; products • Improve processes: contracts, research protocols, and ethics • Alberta-wide clinical trials: advantages • Advancing knowledge: scientific literature & discoveries • Increased research funding: ‘translational’ environment Goals: Clinical Care • • • • Bring standards of ‘lagging’ clinical areas up to the rest Involve patients and users of health services early on Recruit best staff and provide ongoing training Create research oriented clinical environment: patients and staff • Target initiatives to meet unmet clinical need • Adopt robust implementation strategies with agreed goals and metrics to assess achievement • Work to ensure sustainability Goals: Education • Establish Provincial Office of Medical Education – – – – System for simulation: support all levels of training Sharing of faculty and other educational resources Integrated province-wide system for CME Rationalization across post-graduate programs to serve evolving manpower needs of Alberta health system – Joint international presence in medical education research Joint Vision & Framework University of Calgary Basic Research Clinical Research Education University of Clinical Service Alberta Alberta Academic Health Science Centre Shared Provincial Vision: quality cost-effective care, education, research Innovation Translation Employment Improved Care Discovery Commercialization Quality care Cost effective Research Education Alberta Health Services AHSCs are Here to Stay Need to ensure that they improve on the delivery of the key processes of research, care and education that rest at the heart of their social contract