1. The Vision, priorities &
approach for UCL Partners
AHSN
Amanda Begley | Director of Innovation and Implementation | UCL
Partners AHSN

2. Academic Health Science Partnership
Dr Amanda Begley, Director of Innovation & Implementation
13th June 2013

3. On the 20th of May 1747, I selected
twelve patients in the scurvy, on boar
the Salisbury at sea. Their cases were
as similar as I could have them. They
all in general had putrid gums, the
spots and lassitude, with weakness of
their knees. They lay together in one
place, being a proper apartment for
the sick in the fore-hold; and had one
diet common to all, viz. water-gruel
1795
Routine adoption:
lemon juice to
whole fleet
1747
Lind‟s Trial
1753
Findings Published
1794
Lemon juice issued on
non-stop voyage to India
Delayed adoption: wasted opportunities; lost lives

4. 4
Clinical Procedure Landmark
Trial
Rate of
Use study
Rate of
Use %
Annual increase
in Rate of Use %
Flu Vaccination 1968 1997 55 1.9
Thrombolytic therapy 1971 1989 20 1.1
Pneumococcal vaccination 1977 1997 35.6 1.8
Diabetic eye exam 1981 1997 38.4 2.4
Beta Blockers after MI 1982 1997 61.9 4.1
Mammography 1982 1997 70.4 4.7
Diabetic footcare 1983 1998 20 4.0
Cholesterol screening 1984 1995 65 5.9
Fecal occult blood test 1986 1993 17 2.4
Research into routine practice = 17 years
Average annual rate of adoption = 3.2 %
Balas, E. A., & Boren, S. A. (2000). Yearbook of Medical Informatics: Managing Clinical Knowledge for Health Care
Improvement. Stuttgart, Germany: Schattauer Verlagsgesellschaft mbH.
How fast do useful new treatments get to patients?

5. The scale of the task
An average of 17 years for
proven innovation to be
rolled out into practice
“Brownian motion”
diffusion along a pipeline
Organisational boundaries
Funding silos
Vested interest
Lives lost
Resources wasted
The result
The barriers
The problem

6. UCLP spans a wide range of partners, collaborating to achieve
measurable health gain for a population of six million
6m population
across NE and
NC London,
Herts, Beds and
Essex
• 19 Clinical
Commissioning
Groups
• 24 healthcare
organisations
(acute trusts, mental
health trusts;
community
providers)
14 Higher
Education
Institutes and
research networks
26 local authorities
6
Including in London:- City of London
LB Barking and Dagenham
LB Barnet
LB Camden
LB Enfield
LB Hackney
LB Haringey
LB Havering
LB Islington
LB Newham
LB Redbridge
LB Tower Hamlets
LB Waltham Forest

7. Discovery ImplementationClinical Trials Evaluation Capability
Academic
Health Science
Centre
Local Clinical
Research
Network
Academic
Health Science
Network
Applied Health
Research
(CLAHRC)
Local Education
and Training
Boards
Improving patient and population health, supporting economic benefit
for UK PLC
OUTCOMES
Values Relationships AlignmentCo-creation

8. The AHSN will achieve its vision through five major programmes
‘Integration
Programmes’
Collaborate to
create and apply
innovation at a
system level
Cancer
Research
Education
1
8
Cardiovascular2
Mental health3
Co-morbidities4
Life course for women and children5
Together account
for > 80% of
amenable
premature
mortality and
current healthcare
spend
Quality&Value
Informatics
Innovation
System & Programme Enablers

9. Examples of Programme objectives
Integrated
cancer
Integrated
cardio-
vascular
Integrated
mental
health
1
2
3
• Improve one year survival for all cancers, with 250 fewer patients
dying per annum from 2016/7
• Offer every patient the opportunity to participate in a well-designed
clinical study during their cancer care
• Identify and treat/tackle 25% more CV risk factors which will result in
reduced major acute coronary events by 2017
• Develop a „First in Man‟ devices centre, making the most of the
Yale/UCL-QM/Anglia Ruskin Med Tech collaboration to assess and
introduce novel cardiovascular devices
• Improve recovery rates in child and adolescent mental health with
a stretching target of 50% by 2016
• Reduce long-term unemployment in mental health patients by 10%
by 2016 through better integration with major employers and making
employment a key focus of mental health services
9

10. Co
morbidities
Life Course
4
5
• Empower patients to self manage with access to personalised health
records
• Embed enablers of care organised around patients – education,
informatics, tariff etc.
• Establish paediatric chronic disease management networks to improve
diagnosis and management of chronic conditions from childhood
• 400 more Health Visitors by 2015
• Create Schools Network bringing agencies together to address
absenteeism and outcomes
10
Examples of objectives under development for newer programmes

11. LondonCancer
Infectiousdiseases
RareDiseases
Immunology&Transplantation
Cardiovascular
Maternal,Child&AdolescentHealth
OralHealth
Neurosciences
MentalHealth&WellBeing
ENT
Eyes&Vision
Personalised
Medicine
Discovery - Academic Health Science Centre
Life-Long Health Neuroscience

13. Some examples of Joint Working with industry
Discovery Implementation
Ranked as first in the UK for
academic-industry partnerships
(Nature Biotech., 2013;31,383)
Early target area of rare diseases
Joint partnership with the GSK/
Stevenage Bioscience Catalyst and
University of Cambridge
Job Exchange:
- UCLP & GSK,
- Moorfields & Novatis
NICE TAs:
- Amgen & London Cancer
- NIC, GSK & Co morbidities
- TBD & Cardiovascular
Service:
Electronic discharge summaries
PREMs

14. AHSN collaborations for scale – trials, rare diseases, diffusion
• Improvement Science London
• Joint collaboration with London Medicine
• Scoping how to create a centre of excellence for genomics
Pan
London
AHSCs
• Cancer: work on patient experience and A&E presentation, agreed a
single holistic needs assessment tool and preferred referral pathway for
suspected colorectal cancer, work programme started on chemotherapy,
• Mental health: supported by the Strategic Clinical Network, each AHSN
will lead on different aspects of mental health. UCLP will lead on
depression and the pan-London Clinical Commissioning Group network
• Frailty – London wide value based healthcare network established
Pan
London
AHSNs
• Eastern and UCLP (n = 11m). Collaboration to create a presence at
Stevenage Bioscience Park
• Oxford and UCLP: collaboration to create Centre for the Advancement of
Sustainable Medical Innovation (CASMI)
UCLP
Boundaries

15. “Success depends on shared values,
strong partnership working, local
leadership and energy, and clarity on
operational delivery…rather than a single
system of control”
David Fish,
Managing Director of UCLPartners,
Lancet, June 27th 2012
Find out more: www.uclpartners.com
amanda.begley@uclpartners.com

16. Clinical Commissioning Groups (CCG) Guidance on
Promoting Innovation
Promoting
Innovation to
deliver better
quality at less cost
for your local
population
Guidance Note :
8 questions for
CCGs to
consider
Checklist:
10 potential
actions, aligned
with the
commissioning
cycle
Supplementary
Guidance 1:
What is
innovation?
Supplementary
Guidance 2:
Leadership,
culture &
values
Supplementary
Guidance 3:
Engaging,
networking,
partnering
Supplementary
Guidance 4:
Accountability
Endorsed by: