Millennium Gloucester Hotel, London, 24 November 2007

The past year saw the Association for British Healthcare Industries (ABHI) gain a higher profile among health policy-makers than ever before, through its advisory role in the new Office for Life Sciences (OLS) and its function as secretariat of the Ministerial Medical Technology Strategy Group (MMTSG), which provides the strategic direction for joint working by industry and Government.

Two major drivers affected UK healthcare policy development in 2009: the innovation agenda as defined by Lord Darzi's Next Stage Review, and the impact of the economic recession on the NHS. This year's ABHI UK Market Conference took 'The future business environment' as its theme, and attempted to define the relationship between these two drivers and to draw a road map for the medtech industry within the changing UK health system.

Opening session of ABHI UK Market Conference

Getting down to business

The Conference was chaired by Sir Chris O'Donnell, past CEO of Smith & Nephew and joint chair of the Healthcare Industries Task Force. He drew attention to the range of professions represented by the 300 delegates: the medtech industry, the DH, the NHS and a wide variety of agencies and consultancies. This, he noted, reflected the trend towards cross-sector dialogue and partnership working.

ABHI's Chief Executive, Peter Ellingworth, discussed the positioning of medtech in relation to UK healthcare. Crucially, he argued, medtech is focused on helping to spread healthcare across community and clinical environments, as well as improving patient safety and health service efficiency. This means it can play a key role in helping the NHS make major efficiency savings in the coming years. Improving the uptake of innovative technologies, Ellingworth stressed, is a process of give and take: the industry must provide the quality and kind of evidence needed to support uptake, and the NHS must develop an efficient uptake and utilisation process.

Jim Easton, NHS National Director for Improvement and Efficiency, discussed the challenges facing the NHS and industry. He noted that the NHS does not have "a particularly strong track record" when it comes to saving money by driving up quality. Part of the solution, he said, lies in moving care "upstream" to reduce the need for critical care. Achieving that requires active adoption of new technologies by trusts working together to implement community-based healthcare systems. In turn, industry needs to develop technologies that can "deliver service change on the ground" to improve both quality and efficiency. For companies that can provide effective solutions, he said, "the opportunities are enormous".

Mike Farrar, Chief Executive of the NHS North West SHA, looked at how medtech can work in partnership with the NHS to generate innovative healthcare delivery. He emphasised the need to move from the rhetoric of innovation to the practical reality. Discussing the reasons for slow and failed adoption, he criticised short-termism (on both sides) and the absence of a B2B culture. There is a clear need for SHAs to promote innovations that improve healthcare provision. Farrar pointed to the emergence of a new "regional innovation architecture" with the power to draw in new technologies. He called on industry to engage actively with SHAs in redesigning services, and concluded: "I'm optimistic because you invited me to speak here."

Mike Farrar

Breaking the barriers

Earl Howe, Shadow Minister for Health, outlined the Conservative Party's priorities for the NHS in a presentation that reflected the convergence of the major parties in health policy. He praised the work of the OLS, which he described as "potentially the most significant development of the last 20 years", in addressing the problem of slow NHS adoption. Changes in the working of NICE, he argued, would help to improve the uptake of new technologies.

Marg Parton, CEO of the NHS Technology Adoption Centre (NTAC), reported on the Centre's progress in two years of trying "to identify and overcome the adoption barriers for innovative technologies within the NHS". She identified problems with the reimbursement process in particular. The industry, she stressed, needs to address issues of clinical utility (such as service change and training) early in product development. An integrated adoption pathway remains some way off, she concluded: if the goal resembles a motorway network, the current reality is more like an archipelago.

John Warrington, Deputy Director, Department of Health, Procurement, Investment & Commercial, discussed the recent progress in the uptake of medtech by the NHS. The development of regional commercial support units for commissioning, he said, promises to give medtech an "intelligent client" in each SHA. He pointed to the recent HCAI Innovation Programme, which used hospitals to showcase new infection control technologies, as an example of successful partnership working.

Lord Darzi

The bigger picture

Following a lunchtime network-fest to make Spiderman jealous, the Conference resumed with a presentation from Andrew Dillon CBE, Chief Executive of NICE, on the Institute's new medtech evaluation pathway. Its purpose, he explained, is to support more organised and effective engagement between medtech and the NHS: it improves NICE's capacity to evaluate devices and diagnostics, and also gives support to medtech R&D.

Michael Wallace, Director, Health Economics & Reimbursement, Johnson & Johnson Medical Devices & Diagnostics, gave an industry perspective on the new medtech evaluation pathway. It offers a significant opportunity for industry to engage with a faster and more medtech-friendly appraisal process, he said, but issues around funding and adoption still need to be resolved. The industry needs to respond with the right evidence to help NICE assess the system impact and health benefits of each technology in the context of use.

The growing recognition by Government of the importance of medtech for the UK economy was shown by an eloquent presentation from Lord Drayson, Minister for Science and Education. As a qualified engineer and the driving force behind the OLS, Lord Drayson is a key link between politics and industry. He described the OLS as having brought together industry and the public sector "in a way that I'd never seen". The core principle of the OLS Blueprint, he said, is making the NHS an innovation champion. Its wider goal is to win global market share and investment for the UK life sciences. He went on to answer delegate questions on such issues as late payment (see our report on page xx) and support for export sales.

Andrew Haldenby, Director of the 'think tank' Reform, examined the role of the private sector in NHS service redesign. By contributing actively to the redesign of care pathways, he argued, industry can lead the shift of healthcare towards an integrated community-based model. It can also help to make NHS commissioning more effective. This partnership approach is critical, he said, if the NHS is to meet the challenges of the recession.

A networking session

Trouble ahead

A final ABHI panel discussion spelt out the key issues facing medtech in its dealings with the NHS. Are the positive messages from the NHS leadership getting through at the ground level of purchasing and commissioning? Will the new medtech evaluation pathway make a real difference to NICE's traditionally slow and cautious approach? Finally, is medtech ready to help the NHS go through the difficult years ahead by delivering consistent messages and practices? At the very least, the panel agreed, the industry had shown a clear "willingness to engage".

Chris O'Donnell noted that SMEs are likely to bear the brunt of the NHS funding crisis, and that the NHS needs to develop a strategy of "intelligent demand" rather than "supplier bashing". Peter Ellingworth pointed to the capacity of the OLS to mediate between industry and Government: "We need to work in a more co-ordinated way to get our points across." The role of industry trade associations (and of Medilink and related agencies) in empowering medtech companies has never been more vital.

Last words

Following this event, Peter Ellingworth commented to Medtech Business:

"The ABHI events programme focuses on delivering value to our members by bringing together key industry figures and Government officials, with a focus on informing our members and building strong relationships that are beneficial to both industry and the NHS. The UK Market Conference is our largest event, and I was pleased to that we were able to host key officials from the Department of Health and the Government. I look forward to delivering a series of similarly informative events throughout 2010.

"We are glad to have Great Ormond Street Hospital partnering us for this event. As a global leader in treating sick children and teaching and training of children's specialists, we are proud to work closely with them. ABHI's partnership with Great Ormond Street Hospital is a great example of how industry and healthcare professionals can work together to focus on the delivery of efficient and effective care."