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“When I speak at events I introduce myself as a plumber from Essex,” says Tony Young, head of innovation for the National Health Service in England.
The irreverence — in his day job, Prof Young is a consultant urological surgeon at Southend University Hospital — is fitting for a man charged with persuading the NHS to embrace the benefits of innovation: only iconoclasts need apply.
At its foundation, the NHS’s mission was unambiguously to treat those who fell ill. But now a rising burden of chronic disease has created an imperative to find ways of avoiding or managing conditions that, in the past, many would not have lived long enough to develop.
In an interview with the FT, Prof Young reflects on changing expectations. “Perhaps the view when the NHS started 70 years ago was ‘you will come to the NHS and we can sort everything out,’” he says.
It is now, however, “moving away from a one-size-fits-all approach . . . to saying: ‘How can we build a bespoke, tailored, healthcare system around individuals, not just people who are sick?’”.
Not everyone, he concedes, “will want to have a tele-health consultation on their smartphone. Some people will still want to have face-to-face [contact].”
But he is clear that part of the solution lies in injecting fresh thinking, via partnerships with nimble tech start-ups and established large companies.
As well as being a clinician and academic, he has experienced the highs and lows of entrepreneurship, starting his first company at 30 before entering the senior ranks at NHS England as national clinical lead for innovation four years ago. A big part of his role is to run what he calls “the world’s largest entrepreneurial training programme in healthcare”, the NHS England clinical entrepreneur programme.
Open to doctors, nurses, dentists, allied healthcare practitioners, clinical scientists and pharmacists, it is designed to foster a new breed of clinician, helping them develop an entrepreneurial mindset while still training.
“I get to see the pitch events, the funding meetings, the latest ideas that are coming out but also I probably get to meet 500-plus companies a year,” Prof Young says. These, he says, “might be the global corporates — J&J, Medtronic, Google, Microsoft, Amazon, others — or it might be . . . little high-risk start-ups that the big guys wouldn’t necessarily take on until they’re proven”.
He cites OurPath, a company that has won one of four contracts for the National Diabetes Prevention Programme.
“They’re two young guys . . . who are passionate about doing something in diabetes and changing people’s lives,” Prof Young says, outlining their innovation: connecting “smart” weighing scales “via 3G to a smartphone app that’s a little social networking platform”, allowing diabetics to take control of their own condition.
Technology companies often complain privately about how difficult a customer the NHS can be, with multiple commissioners and a reluctance to embrace outside innovators.
Prof Young disputes this. “It’s easy to stand on the sidelines and criticise as some people do . . . I always push back and say ‘OK, well let’s have some concrete examples,’” he says.
He cites examples of successful NHS partnerships with outside players: Google DeepMind’s work with Moorfields Eye Hospital, using artificial intelligence to interpret and triage 3D retinal imaging and Microsoft’s collaboration with clinicians in Cambridge to speed up delivery of the right dose of radiation to cancer sufferers via machine learning and AI.
The NHS can and must do better, he makes clear. “Nowhere in the world has cracked the uptake of great innovation, rapidly, at pace, across their whole system,” Prof Young says.
He contrasts the uneven take-up of innovation with the seamless adoption of new medicines. “If you look at drugs, most of the developed world has really good pathways for drug testing, research, evaluation and then uptake across their system.
“But, if you look at devices, digital data and diagnostics, there isn’t an equivalent pathway anywhere to what has been developed over the last 50 or more years for medicines.”
Matt Hancock, health secretary, has vowed to change this, he says, and to make the NHS “your place of choice for testing and evaluating the latest innovations at scale across our system”.
Can technology save money for the NHS, which like most health systems is struggling with a mismatch between resources and demand? It can “really help us make a dent in the demand curve”, he responds.
“Some people say our technology is so expensive and how can we afford to [introduce it]? And my argument would be, we can’t afford not to,” adds Prof Young.
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