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West Midlands NHS Innovations Conference 2006

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Title: West Midlands NHS Innovations Conference 2006


1
West Midlands NHS Innovations Conference 2006
  • sharing innovation for healthcare

2
Welcome and Introduction
  • Alan Wenban-Smith
  • Chairman
  • MidTECH

3
Conference Aim
  • To bring together key stakeholders involved in
    taking NHS innovations from idea to application
  • Share experiences best practice
  • Identify challenges opportunities
  • Celebrate success
  • Create contacts

4
Some different perspectives
  • Chief Executives view Mark Goldman
  • Innovation Hub view David Gleaves
  • Innovators view Monica Spiteri
  • Industry view Matthew Harte
  • Investors view Terry Swainbank
  • Panel discussion

5
Who is MidTECH?
  • Top down
  • MidTECH is the NHS Innovations hub for the West
    Midlands
  • Our job is to help Trusts to identify and manage
    innovations arising from their work
  • We provide expertise and resources
  • Bottom up
  • Innovation is a bottom-up process
  • We have a regional membership
  • We are there for all NHS Trusts in the region

6
What is MidTECH for?
  • Improving health care by making good use of new
    ideas
  • Realising potential income for NHS, Trusts and
    inventors
  • Generating employment in the national and
    regional economies

7
MidTECH Strategy
  • Membership
  • NHS Trusts in the West Midlands
  • Members service entitlement menu
  • Pay as you go also available
  • Resources
  • Core funding for sustainable capability
  • Exploitation funds for investment in projects
  • Operation
  • Not for profit commercial income ploughed back
  • Grow regional ownership, reduce central dependency

8
The MidTECH approach
  • Includes
  • clinical trials
  • access to staff
  • know how
  • Includes
  • prototyping
  • design
  • manufacture

9
  • New NHS
  • New Business Opportunities
  • Dr Mark Goldman
  • Chief Executive

10
The NHS
  • Conceived in 1948 after the 2nd World War
  • Healthcare free at the point of delivery
    according to need
  • The envy of the world

11
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12
The changing face of healthcare
  • Diversity of provision
  • Care in the community
  • Self help
  • Choice

13
Structure of the NHS
Secretary of State
Monitor
Department of Health
Private Sector
Strategic Health Authority
28
Primary Care Trusts
298
Foundation Trusts
Acute Hospitals
31
206
14
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15
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16
How can you help?
  • Understand us and our problems
  • Bring us solutions but respect our culture
  • Recognise our achievements

17
Whats in it for YOU?
  • Growing market
  • Recession proof
  • Global marketing opportunity
  • Under developed product ranges
  • Wide product requirements
  • New approaches to healthcare

18
The opportunity
  • 15 billion non pay expenditure
  • Massive Health Spend 10 GDP by 2008
  • Local Trusts
  • University Hospital Birmingham 300m
  • Heartlands and Solihull 240m
  • Manchester United 230m
  • Spend on equipment alone approximately 28

19
Markets
New
New market Existing product
New market New product eg innovation
Markets
Existing market Existing product eg business as
usual, Choice
Existing market New product eg new model of
healthcare
Existing
Existing
New
Products
20
Potential areas for development
  • Low Tech Opportunities
  • Cleaning materials
  • Disposable plastics/drapes/clothes
  • Manual handling equipment
  • Protective clothing
  • Wheelchairs/trolleys/stretchers
  • Tagging and security devices
  • Anti bacterial support
  • Furnishings, packaging

21
Complex products
  • Communication
  • Instrumentation
  • Software solutions
  • Implantable devices
  • Drug delivery systems
  • Lab equipment

22
Medipark
23
Purpose of the Medipark
  • Enhance research
  • Attract other organisations
  • Attract funding
  • Enhance reputation of HEFT
  • Recruitment and retention of the best people
  • Support regeneration
  • Jobs
  • businesses

24
Infection Control Working Together with
Industry
25
MRSA
  • Methicillin Resistant Staphylococcus Aureus
  • 30 people carry the germ
  • SA and MRSA not risk to healthy
  • 40 SA cases resistant to meth and antibiotics
  • The Chief Medical Officer report Winning Ways
    working together to reduce Healthcare Associated
    Infection in England
  • Everyone has a role to play - nurses, doctors,
    cleaners, patients, visitors

26
Research
  • Hygieia SkinSure barrier cream
  • Bioquell
  • 2 hour MRSA rapid test
  • Surface coatings

27
Practical application
  • Hand gel dispensers
  • Coated bags and aprons
  • Disposable bags
  • Cleaning systems
  • Voice activated alerts
  • Patient tagging
  • Telemetry

28
Learning together the Initial experience
  • Initial a cleaning company
  • Initial hygiene solutions
  • Initial public health education
  • Initial a partner in healthcare

29
Centre of excellence
  • National and international interest

30
Conclusion
  • Healthcare needs innovation and new products to
    deliver a new agenda
  • Healthcare is a global business opportunity

31
NHS Innovations in the West Midlands A
perspective from the NHS innovations hub
  • David Gleaves
  • Director
  • MidTECH

32
Ingredients for a successful Innovations Hub
  • Accessible to regional NHS
  • Capability Capacity
  • Networked

33
MidTECH Plan
  • 2004-5 Establish baseline capability client
    base
  • 2005-6 Demonstrate capability grow client base
    networks
  • 2006-7 Enhanced capability delivery

34
2005-6 Client Base
  • Client base of 33 NHS bodies
  • Increase of 100 on 2004-5
  • 66 of total

35
Coverage Birmingham the Black Country
36
Coverage Shropshire Staffordshire
37
Coverage West Midlands South
38
2005-6 Delivery
  • Over 90 Innovations registered
  • 60 increase on 2004-5
  • 10 Patents, designs trademarks
  • 3 times the number for 2004-5
  • First NHS-University agreement
  • 6 more in pipeline
  • 20 development projects
  • 2 licence deals

39
2005-6 Networks
  • Working relationships
  • Medilink West Midlands
  • HealthTech (WMG)
  • CHID
  • Regional design prototype community
  • Stakeholder relationships
  • DH, DTI, AWM, regional University sector

40
2006-7 Delivery Meeting clients growing needs
  • Working in partnership with Trusts to deliver
    their commercialisation plans
  • Joint ventures, spin-out companies, science parks
  • Developing regional differentiators
  • Capability mapping
  • Focus on design prototyping
  • Promoting regional NHS innovation
  • Conference
  • Competition
  • Surgeries
  • Local events

41
2006-7 beyond
  • Capability
  • Marketing Communications
  • NHS Designer (unique to UK NHS)
  • Embedded innovation champions
  • Plan to recruit senior innovation manager
  • Forming as CLG in March 2006
  • Secured 3-years further DTI support

42
Networks Partnerships
  • Working with AWM partners to deliver regional
    economic strategy
  • Improve industrial links through co-location with
    Medilink West Midlands
  • Develop regional NHS VC network
  • Improve links with NHS National Institute for
    Innovation Improvement, HPC, CEP, etc.

43
An Innovators Perspective
  • Monica Spiteri
  • Professor in Respiratory Medicine
  • University Hospital of North Staffordshire

44
Society has changed dramatically
  • The Public expects and demands scientific and
    engineering advances.
  • Immediate and rapid new solutions, new gadgets
    and new systems.
  • Improvement in quality of life and,
  • Aspiration to Dr Who-like immortality

45
Public Needs drive NHS Strategy
  • To enhance public health and well-being, the NHS
    has
  • To improve service delivery and patient access.
  • To invest in and deliver technological and
    pharmacological innovations.

46
What price to pay for innovation?
  • A delicate interplay
  • NHS resources not bottomless.
  • Which innovations, devices or drugs, are
    essential vs merely nice-to-have.
  • Patient benefit vs costs of scientific progress.
  • Safe clinically effective vs rapid development,
    commercialisation, implementation.

47
Recent NHS Initiatives
  • Healthcare Industries Task Force (2003)
  • Joint venture, NHS and Industry
  • Explored common grounds of working -
  • To stimulate/promote NHS innovation.
  • To facilitate commercial realisation.
  • To speed up implementation of target discovery
    into the clinical arena.

48
HITF actions - Crucial and timely
  • Medical device evaluation service
  • NHS Innovation Centre and hub
  • NHS regional procurement
  • Building RD capacity UK Clinical Research
    Collaboration
  • Training Education

49
Best Research for Best Health
  • NHS Science and Innovation Investment Framework,
    2006
  • A National Institute for Health Research
  • A Faculty
  • Academic Medical Centres
  • Expanded Funding streams and Technology Platforms
  • New Innovation funds

50
NHS NEW FUNDING SCHEMES
  • Responsive funds for applied and practice based
    research in areas important to front-line staff
  • Programmes of applied research allocated
    competitively to NHS trusts for areas of high
    priority to the NHS
  • Challenge fund for innovation - to encourage
    well-managed risk-taking and innovation in the
    NHS
  • RISC (Research for Innovation, Speculation and
    Creativity) awards - to ensure that new and
    radical ideas can be developed and tested.

51
EXCITING BLUEPRINT
  • a dream come true for NHS researchers
  • Or
  • just wishful thinking!

52
ENSURE DELIVERY, NOT FAILURE
  • Who can ensure it happens in the NHS?
  • How will the best ideas for patient benefit be
    heard in the NHS?
  • What medium is best placed to progress
    innovative ideas across traditional boundaries in
    the NHS, however daring at the time?

53
Time to change the balance?
  • From a loaded top-down approach (systems
    organised along Institutional agendas)
  • To a bottom-up approach (engaging and guiding
    teams of players at the clinical front).

54
Opportunities for Innovation in NHS
  • Largest skills-mix platform in UK (gt1M staff)
    greater than health-care technologies industry (
    2000 companies 50,000 personnel).
  • NHS staff already work in teams under diverse
    clinical situations for patient benefit.
  • First-hand knowledge of niche areas in diagnosis
    / therapy requiring urgent innovation and
    development.
  • NHS is universally established, visible to the
    Public.

55
Thus, the NHS community offers
  • Unique opportunity to drive growth of, and to
    implement, technological pharmaceutical and
    service innovations.

56
Difficulties of innovating in NHS
  • NHS staff struggle to establish research
    portfolios against a backdrop of heavy clinical
    commitments and targets.
  • Endless difficulty in getting ideas heard and
    securing support funds, losing out to
    university-based counterparts.
  • Academic agendas driven by institutional politics
    and research assessment exercises, not by patient
    / NHS needs clinical researchers left
    frustrated.
  • Intricate, but necessary, regulatory / legal
    requirements and systems process too complex!
  • Slow translation journey from idea to trials to
    clinical endorsement to bedside, delays patient
    benefit.

57
Future challenges
  • Urgent need for radical change in attitude to
    research across the NHS.
  • Encourage and stimulate an entrepreneurial
    culture amongst NHS employees.
  • Harvest, groom, and support... Allow thinking
    outside the box!.
  • Foster a pipeline of innovations from NHS
    grassroots.
  • Ensure NHS innovator owns and drives the venture,
    in partnership with industry feel good
    factor.

58
FUTURE CHALLENGES
  • Empower staff to venture into unfamiliar
    technological territories cross transfer
    knowledge and expertise.
  • Facilitate NHS Trust-Industry partnerships to
    enable cost effective, quick, safe, reliable
    products for our patients.

59
Reducing the Burden of Lung Cancer investment
in superior screening tools
  • A multi-disciplinary Team Project
  • University Hospital of North Staffordshire
  • working together with
  • Patient Groups (Macmillan BLF Breathe Easy)

60
CLINICAL NEED
  • Lung cancer leading cause of deaths in UK 1 in
    13 men and 1 in 23 women develop lung tumours.
  • Survival rates remain poor.
  • Only 13 can be cured, having surgery as first
    treatment option surgical rates in England lag
    behind US and Europe.
  • 85 of lung cancers originate within the
    bronchial wall lining and development is a
    multistage process over a long time period.

61
OCT PROJECT FOCUS
  • To develop safe, reliable, imaging device based
    on infrared technology, OCT.
  • To provide real time, ultrasound-like, optical
    histology of lung micro- structures.
  • To identify in situ pathological changes.
  • Ultimate OCT prototype to be cost-effective,
    portable and adaptable to the immediate clinical
    setting.

62
OCT Project Progress Time-line
  • 1999 March 2005 Idea, project design and
    initial studies funded by Trust charitable funds
    turned down by other sources.
  • April 2005 Nominated for MidTECH Innovations
    award.
  • May 2005 Start of collaboration with MidTECH.
  • June 2005 Preparations for IP protection.
  • July 2005 UHNS patent application for OCT
    development in the lung.
  • August 2005 First meeting with industrial
    partner.
  • September December 2005 Joint venture
    initiatives.
  • December 2005 5 year clinical technical plan
    established.
  • February 2006 First OCT system update
    delivered.

63
OCT Project adoption by MidTECH
  • Excellent example of energised progress of
    NHS-based innovation.
  • Our requirements were listened to, leading to an
    appropriate industrial partner.
  • MidTECH-mediated JV ensures that NHS staff
    continue to drive the innovation.
  • Whilst attracting third-stream funding from
    private sector, enabling seamless translation of
    device to clinical benefit.

64
An Innovators Vision
65
An Industry Perspective
  • Matthew Harte
  • Managing Director
  • BioCote Ltd

66
Why use Industry?
  • Potentially very attractive customer
  • Many strengths of industry
  • Flexible
  • Speed
  • Low Cost
  • Platform for innovation and ideas
  • Eager to provide solutions
  • However we need guidance
  • What does the NHS want?

67
BioCote Experience
  • Antimicrobial Powder coatings
  • Original Invention 1994
  • Lacked ability to commercialise
  • Financial backing 2001
  • Enabled commercialisation of technology
  • Continued technical development
  • Partner with existing manufacturers

68
BioCote Experience
  • Create solutions for existing products
  • Plastics, coatings and textiles
  • Silver based technology
  • Technology and support
  • Marketing
  • Microbiological
  • Wide range of applications
  • 40 Partners
  • Ability to create environments

69
Our Experience
  • NHS long and complicated
  • Who do we need to speak to?
  • PASA
  • Rapid Review Panel
  • Architects
  • Designers
  • Building Contractors
  • NHS Trusts
  • RD
  • Procurement
  • Infection Control
  • Chief Executive
  • Director of Infection Prevention and Control
  • Estates Facilities

70
Rapid Review Panel
  • Convened by the HPA at the request of The
    Department of Health
  • Winning Ways and Towards cleaner hospitals and
    lower rates of infection.
  • The panel provides a prompt assessment of new and
    novel equipment, materials, and other products or
    protocols that may be of value to the NHS in
    improving hospital infection control and reducing
    hospital acquired infections.

71
Rapid Review Panel
  • Received a rating of 3
  • More Clinical data required
  • How do we get clinical data?
  • Finance
  • Timescales
  • Will it make a commercial difference?

72
Help and Experience
  • Medilink WM
  • Guidance
  • Key contacts and events
  • Heart of England NHS Foundation Trust
  • Very receptive to new innovations
  • Provided opportunity to create Biocote
    environment within Hospital
  • Clinical evidence
  • Partner Companies

73
What can the NHS learn?
  • Innovation
  • Traditionally from smaller companies
  • Financial pressures
  • Time constraints
  • Innovator vs Commercial
  • NHS has a part to play
  • Backup clinical data
  • encouragement/direction (key proactive
    individuals)

74
What an Investor Seeks
  • Terry Swainbank
  • Investment Director,Rainbow Seed Fund
  • Midven

75
Content
  • Early stage investments
  • Risk / investment profiles
  • Tackle obliquely experience with PSREs
    Rainbow Seed Fund
  • - what it looks for
  • - some examples

76
Background
  • Midven Birmingham-based VC Fund Manager
  • Specialises in early stage investment and manages
    3 Funds
  • Advantage Growth Fund
  • Rainbow Seed Fund
  • HSBC Fund for the Midlands

77
Rainbow Seed Fund
  • A venture capital fund specialising in seedcorn
    investment to commercialise research and
    innovation
  • Risk finance not an alternative to grant funding
  • Investment opportunities drawn from dstl, 4
    research councils (CCLRC, NERC, BBSRC, ) and
    UKAEA Fusion
  • Another 6 PSREs will join shortly
  • 6m fund
  • DTI funded, through PSRE competitions

78
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79
Risk Funding for Technology Businesses
Capital required
20m
Trade Buyer or IPO
Mainstream VC
10m
Early Stage Venture Capital Funds
1m
Business Angels / RVCs
250k
10k
Stage of Development
80
The Rainbow Model
Initial filtering by TTO and RSF Investment
Manager
Quick and simple approval process for RSF
investments up to 25,000 on PoC, IP, market
assessment, etc
RSF helps to build management team
RSF follow on investment leveraged by other risk
capital, with help from RSF investor network

Trade sale, IPO or licensing deal
81
So Far..
  • 25 first and 9 further investments
  • 10 Spin-out companies
  • Over 2.5m committed
  • Over 11m of external finance raised by our
    portfolio
  • Portfolio value more than 0.5m above cost
  • Next Target realisations into cash (exits)

82
RSF Portfolio
  • Benefit from wide spread of research
  • Portfolio diagnostics / medical physics /
    biotechnology / space / security
  • Includes deliberately a spectrum
  • Modest service businesses which need to generate
    revenues early
  • More profound businesses but have to demonstrate
    progression to attract further investment

83
What will Rainbow invest in?
  • Required
  • Good science providing a platform for a
    differentiated product or service
  • IP properly protected and ownership untainted
  • Researchers (and their employer) keen to see
    their ideas commercialised
  • Experienced business managers willing to get
    involved
  • Proposed markets are preferably large and growing
    might though be an interesting niche
  • A clear business model dealing with the possible
    need for additional finance
  • Not Required
  • Scientists left to their own devices to
    commercialise

84
Appraisal
  • Will this investment make money?
  • Can RSF negotiate satisfactory terms?
  • Is there an exit for the investment?
  • Will more money be needed, and if so where will
    it come from?

85
Risk v Return
  • Market Risk
  • Maturity / Size / Barriers to Entry
  • Technology Risk
  • Timescales
  • Reliance on further cash milestones that need
    to be achieved
  • Lower risk 20 to 25 IRR target
  • Higher risk 50 to 60 IRR target

86
Appraisal Issues
  • Assessing technical merits
  • Use of research peers, specialist consultants
  • Technical advisory panel
  • Cautionary note best science might be elegant
    but not necessarily best in a commercial context
  • Assessing commercial potential
  • Market information often limited researchers
    have often not considered commercial potential
    (and indeed work of rival research teams)
  • Rainbow cash for independent market / technical
    studies

87
Intellectual Property Issues for both the
Investor and the Sponsoring Organisation
  • Assign or licence?
  • Knowhow / patents
  • Who meets patenting costs? If attacked what is
    the defence strategy?
  • Freedom to use
  • Dependence on IP held elsewhere
  • Pipeline agreements
  • Access to staff who created the IP to properly
    exploit the IP

88
Licence or Spin-out
  • Depends on scale -
  • single product aimed at a mature, concentrated
    market
  • platform technology in a fragmented or new market
  • Need for additional finance downstream
  • Management
  • Patent costs

89
Spin-outs
  • Management generally need to recruit from
    outside. Position of researchers /
    institutional goals?
  • Funding almost always needs 3rd party funding
    (grants / SFLGS / business angels)
  • 2nd Round Funding VC coolness to early stage
    investments

90
Example of RSF Investment L3 Technology Ltd
  • Initially 13k to fund proof of concept an
    accurate cholesterol diagnostic - in 2003
  • Followed by a 230k commitment to a spin-out
    which licensed the technology from CCLRC. RSF
    invested alongside others (total 1m)
  • RSF has an equity stake in the company as does
    CCLRC and two inventors.
  • Seeking early licence may need more cash

91
Example of RSF Investment Cellcentric Ltd
  • 250k to fund a dedicated research programme at
    Babraham in the field of epigenetics.
  • Cellcentric is developing an IP platform and has
    agreements over Cambridge and UCL IP. Likely
    revenues from cancer therapies,
  • RSF has a shareholding in the company. Babraham
    has share options which will crystallise when
    patent filings are made.
  • Will need to raise further (substantial) cash.

92
Example of RSF Investment Remo Technologies Ltd
  • Telemetry devices to monitor patients developed
    by Dstl and a third party
  • Modest markets mainly in research
  • RSF invested 75k
  • Company has to achieve profitability on this cash
    unlikely to attract significant additional
    funding
  • Might use this company as a route to market for
    related products

93
Further Information / Discussion
  • www.rainbowseedfund.com
  • www.midven.com
  • Terry Swainbank 07710 491589

94
West Midlands NHS Innovations Conference 2006
  • sharing innovation for healthcare
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