the excalibur medical network - developing markets chris... · formed and financed 13 years ago by...

Excalibur Healthcare

Private and confidential

Excalibur

• World class track record in medical infrastructure and investments over 30 years

• Created over 50 medical and health companies from scratch worth over $5bn

• IPO’d 21 companies on worlds stock market

• Constructed 270 different laboratories/clinics

• Built over 65 office buildings and premises for own companies

• Built over 40 advanced manufacturing facilities and production plants

• Raised >$2bn for cancer research in 40 areas of cancer

• Over 200 new medicines in development

• Over 20,000 patients in clinical trials

• In 1996 Sir Chris first entrepreneur to develop new stem cell technology inEurope

Company Date Initial Value Peak Value

Chiroscience PLC 2003 $1.0m $1,000m

BioVex Inc 2011 $2.0m $1,000m

Vectura PLC 2008 $1.5m $1,100m

Ark Therapeutics PLC 2007 $2.0m $560m

Piramed Limited 2009 $0.5m $200m

Neurotech 2011 $0.5m $165m

Arakis PLC 2005 $0.4m $160m

Celsis International PLC 2008 $0.3m $150m

Santhera AG 2007 $5.0m $125m

Plethora PLC 2007 $0.1m $120m

Wilex AG 2007 $7.0m $120m

Noxxon AG 2011 $6.0m $120m

ReNeuron PLC 2006 $1.0m $100m

Cyclacel Inc 2003 $3.0m $90m

Neuropharm PLC 2007 $0.2m $75m

Microscience Limited 2006 $1.0m $65m

Toad PLC 2000 $0.1m $65m

Virgin Health Bank Limited 2010 $2.0m $45m

Derms Development Limited 2007 $4.0m $45m

Energist Limited 2010 $5.0m $35m

Destination Skin Limited 2008 $3.0m $35m

Cambridge Biotechnology Limited 2007 $0.5m $25m

TOTAL $46.1m $5,500m

$5 Billion of Value by Sir Chris Evans and Excalibur Team

Leadership

EHC is led by Professor Sir Christopher Evans OBE, Europe’s foremost biosciences,medical and healthcare entrepreneur who has:

• Advised four UK Prime Ministers on biomedical and healthcare policy

• Chaired the EU “BEST” Taskforce overseeing 19 million small businesses acrossthe European Union

• Advised the governments in London, Wales, Denmark, Finland, Malta andQatar

• Led the creation and growth of several billion dollars’ worth of advancedmedical companies

• Built this team of UK experts to provide medical facilities and services, toadvise on setting health care policy and a long-term strategy for healthcareneeds.

Globally Recognised UK Based Health Experts

Core Consortium Members

The Excalibur Healthcare Consortium

• Extensive experience in healthcare facilities construction and management

• Delivered over 2500 hospitals, labs, clinics and other healthcare infrastructure globally,including:

Primary Healthcare Centres

General and Acute Hospitals

Specialist and Tertiary Hospitals

Mental Healthcare Facilities

Medical Research Facilities

Specialist Training Facilities

• Includes some of the UK’s finest medical experts and practitioners – Royal Colleges, NHSTrusts, leading Universities and Medical Schools.

• Enjoys the full support of the UK government through co-operation with UK Trade andIndustry (UKTI) and Healthcare UK.

The EHC Offering

• Hospital management and operation

• Staffing – clinical, technical, support and management staff

• Strategic direction - improved patient care and outcomes, system efficiencies

• Mobile primary health care facilities

• Trauma & rehabilitation

• Training and education

• Modular hospitals

• Refurbishment of existing healthcare facilities

• Conversion for healthcare use

• Permanent hospitals

• State of the art mobile hospitals

• Medical equipment and pharmaceutical supplies, supply chain management

Impact

• Improved patient outcomes

• Consistently applied protocols and practices

• Clinical delivery to highest UK standards

• Operational and management efficiency

• Sustainability through training and education

• Continuing development of local staff

Private and confidential 9

Clinical-stage, UK-based cell therapy business

Highly scalable stem cell expansion technology – off-the-shelf (allogeneic) cell therapy candidates

Principal therapeutic programs target: stroke disability critical limb ischaemia retinitis pigmentosa

Leading position in exosomes

Formed and financed 13 years ago by Prof. Sir Chris Evans

Led transformative fund raise in summer 2013

Ground Breaking TherapyReNeuron plc

12

BioVex

BioVex Inc

$1 Billion

Medical Technology

Cash Raised by Sir Chris and Teamfor Cancer Research

$2.0 billion


There are over 150 million people living today with cancer

There are over 200 different types of cancer and 1 and 3 people on earth will be struck by cancer within their lifetime

Every year, nearly 10 million people die of cancer and every year there are nearly 15 million new cases of the disease

1 in 4 of all British deaths are from cancer

During the lifetime of this existing global population over 2,000 million people will at some stage have had cancer

Cancer – A Global Disease

Cancer must be controlled


Cancer - A Commanding Speciality

Best elements from the finest Cancer institutions around the world:

• Early screening using modern imaging techniques and molecular pathology• Rapid diagnosis supported by excellent radiological opinion• Ground-breaking therapies, radiology and outpatient chemotherapy delivery• “Distributed clinic” model:

• national centres of excellence;• local cancer centres, clinics, and mobile clinics

• UK leading institutions:• second opinions, knowledge transfer, support and training

Countries with National Cancer Plans

21Private and confidential

Source: UICC

Cancer in Algeria

• Fourteen regional cancer registries covering 37.7% of population

• Existing valuable data

• Top cancer types identified

• A well researched comprehensive National Cancer Plan (NCP) in place


Male Female

Lung Breast

Colon-rectum Colon-Rectum

Prostate Thyroid

Hematopoietic Cervix

Bladder Ovaries

Cancer – Key Areas of Improvement

The NCP has identified key areas of improvement

• Equity

• Patient experience

• Surveillance

• Prevention

• Screening

• Diagnosis

• Therapy

• Palliative care

• Support Organisations

• Regulation

• Training

• Research

• Communication


Cancer Plans – Need to be Implemented

• The National Cancer Plan puts Algeria in top 20 countries with focus on CancerCare

− Great recommendations and findings

• Only top five countries have actually invested in cancer care consistently over manyyears in an attempt to implement their plans, with mixed results

− USA

− UK

− Sweden

− Canada

− Australia


Challenge: How to short circuit 10 years of talking / planning / meetings and starttaking action NOW

Optimal Implementation Process


Time Line – Months

High Level Plan for Development of Cancer Services 0 - 3 4 - 6 7 - 9 10 - 12 13 - 15 16 - 18 19 - 21 22 - 24 25 - 27 28 - 30 31 - 33 34 - 36 37 - 39 40 - 42 43 - 45 46 - 48 49 - 52

Key Actions

Diagnostic to define and assess needs of the health economy

Agree principles of early deployment of facilities and cancer services to have a visible impact on the care of patients

Roll out mobile diagnostic facilities (wet lease) - example breast screening units, mobile clinics to take cervical smears

Build diagnostic facilities in the communities - increase capacity within the CAC rapidly to improve early detection rates

Design World Class Cancer Centre drawing from experience for similar institutions internationally

Build World Class Cancer Centre that will deliver complete range of high tech diagnostics and specialised therapy. This will form the basis of a hub and spoke model.

Deploy World Class Cancer Centre - provides specialised care for a wide range of complex cases with the latest in diagnostics and treatment

Procure Staffing for Cancer Centre - specialist pathologists, radiologists, radiographers, surgeons and other support personnel. Potentially internationally to build capacity.

Build Therapy Centres - Radiotherapy - existing 7 projects that need to be completed

Design Population Surveillance for ongoing information of changing demographic and incidence patterns

Develop and Deploy Population Surveillance with appropriate IT support allowing information analysis and data mining

Design Screening Programmes - for specific conditions such as cervix, breast, bowel, colo-rectal cancers

Roll out Screening Programmes - for specifc conditions such as cervix, breast, bowel, colo-rectal cancers

Annual review of surveillance and screening

Define national requirements for additional specialised hospitals, diagnostic centres and therapy clinics

Develop local clinica - polyclinics, diagnostic facilities

Develop post treatment support - after care, rehabilitation following complex surgery

Develop and deploy palliative care - for end of life care patients, residential facilities away from hospital

Build and deploy additional diagnostic facilities - specialised centres that provide pathology, radiology and in certain cases cytogenetics

Build and deploy additional therapy facilities - Radiotherapy units, day case units that can provide chemotherapy drugs as day patients

Develop Cancer Networks - to facilitate expert opinions, rapid decisions on diagnosis and management and knowledge sharing

Develop existing diagnostic departments (histopathology) - increase the capacity and capability through training of various staff and recruitment of trained staff

Understand training needs of various groups of staff such as doctors, primary care physicians, paramedics, radiographers.

Develop & Deploy training programmes for undergraduates

Develop & Deploy training programme for professionals (medical/paramedical/technical)

Develop and implement regulatory frameworks - to support prevention programmes for environmental, lifestyle and occupational risksDevelop Research Plans

Design and build Research facilities including modern facilities for cyto genetic research

Conduct research - existing facilities - large teaching hospitals and specialist centres

Operate new research facilities - research into the management of cancers with international cooperation and collaboration

Meeting the Challenge – Immediate Steps


Build cancer network to make available nationally

Early screening

Rapid diagnosis

Access to treatment

Distributed clinic model

Cancer centres

Local clinics

Mobile clinics

Multidisciplinary teams

Best-in-class equipment

Ground-breaking therapies

Distributed Clinic Model


Cancer Centre• Comprehensive cancer care• Best in class • Referral from local clinics

C Local Clinics• Screening / diagnosis• Treatment

M Mobile Clinics• Screening / diagnosis• Treatment

Linked to leading UK Cancer Institutions

Algerian Cancer Council

Cancer Centre

Cancer Centre

Cancer Centre

Cancer Centre

Cancer Centre

C

CM M

C

C

C

M

Best-in-Class Cancer Centres

Private and confidential

Peter MacCallum Cancer Institute, Melbourne (cgi)

Oxford Cancer Centre, Churchill Hospital

Memorial Sloan Kettering, New York Mayo Clinic, Rochester

Guys and St Thomas’ Cancer CentreLondon (cgi)

Karolinska Institute

Local Cancer Clinics – screening, diagnosis, treatment


Jackson County, Oklahoma

Oxford Day Centre, Perth

Ozark, Missouri

Billings, Montana

Cabrini Centre, Melbourne

Cabrini Centre, MelbourneBeatson West of ScotlandCancer Centre


Each cancer centre will have:

• Rapid on site screening and diagnostics -

− Modern imaging techniques and molecular pathology

− Clinical decision-making supported by excellent radiological opinion

• World-class branded clinical and outpatient chemotherapy delivery -

− Delegation of responsibility to highly trained chemotherapy nurses

− Support from oncology pharmacists

− Molecular markers to improve precision of cancer treatment

• Multidisciplinary team working to advanced guidelines and SOPs

• Portable electronic patient data linked to national network

• International second opinion service through link to Oxford Cancer Centre

• Clinical Trial infrastructure

Cancer Centres: The Excalibur Model

Advanced Infrastructure needed in the future


Brooks-Wilson Genome Sciences Lab, British Columbia

Crick Institute (proposed)

Rinecker Proton Therapy Centre Munich National Cancer InstituteRockville Maryland

RadioImmuno targetingLund Sweden

Highly Advanced Mobile Screening


Mobile mammogram units

Prostate

Breast

Nationwide Coverage via Mobile Treatment


Mobile Chemotherapy Units

Protate

Mobile Radiation Therapy Units

Delivering Best in Class Cancer Patient Pathways


• Co-develop global/local cancer care pathways & guidelines and protocols &multidisciplinary teams

• Train and build capacity - clinic doctors/nurses/pharmacists

• Telehealth services for diagnostic (complex cases, 2nd opinion) and trainingpurposes with UK institutions

• Develop cancer database (clinical outcomes)

• Develop patient reported outcome measures (PROMs)

• Develop app-based technology for side effect management, follow up etc

• Patient education – wellness, nutrition, symptoms & treatment

• Patient support and well being

• Cancer prevention programs

• Stratified analysis

Breast Cancer - Diagnosis


Breast MRI ScanCancer Research, London

Mammography, Toronto

Mammography - Royal Marsden Hospital, London

Lauder Breast Cancer Centre, Sloan Kettering

Breast Cancer – Treatment


Chemotherapy suite

Radiation Treatment UHN Toronto

Endocrine Therapy

Adjuvant Systemic TreatmentLumpectomy, MastectomyConservation Surgery

Lung Cancer - Diagnosis


Diagnosis

Bronchoscopy, Henry Ford Hospital, Detroit, USA

Chest X-ray, Oxford University Hospitals, UK

CT ScanRoyal Marsden Hospital, London

Sputum Cytology, Pathology laboratory, Princess Margaret Cancer Centre, Canada

Lung Cancer – Treatment


Robotic Lobectomy (surgery), Toronto General Hospital, Canada

Radiotherapy, Peter MacCallum Cancer Centre, Australia

Stereotactic Body Radiation Therapy (SBRT)Stanford Clinical Cancer Centre, USA

Chemotherapy, Targeted Drug Therapy,Royal Free Hospital, UK

Colorectal Cancer - Diagnosis


Diagnosis

Flexible SigmoidoscopyOdette Cancer Centre, Canada

Virtual Colonoscopy (CT scan), Guys’s & St Thomas’ Hospital, UK

Endoscopy,Memorial Sloan Kettering Cancer Centre, USA

Fecal Occult Blood Test Fecal Immunochemical Test

Colorectal Cancer – Treatment


Transanal endoscopic microsurgery- rectal tumor, Massachusetts General Hospital, USA

External Radiotherapy, Addenbrooke’s Hospital, Cambridge, UK

ColostomyChurchill Hospital, Oxford, UK

Chemotherapym, Targeted Drug Therapy,John Hopkins Cancer Centre, USA

Specific Infrastructure Requirements

• Build / set-up comprehensive cancer centres

• Build / set-up network of local cancer clinics

• Provide mobile clinics for screening, treatment and palliative care

• Provide specialist equipment for radiotherapy, CT, PET, MRI, X-ray, US,Endoscopy, etc

• Supply cancer drugs

• Build immunological and molecular analysis facilities

• Build nursing homes, residences and/or hospices

• Provide eHealth tools for patient support and data


Detailed Manpower Requirements

Histopathologists 930

Radiologist 1700

Haematologist 635

Palliative Care Physicians 215

Diagnostic radiographers 8400

Therapeutics radiographers 1515

Medical physicist 865

Based on current assumptions, not necessarily exhaustive.


• Cancer Centres: 4• Cancer Clinics: 8-12 • “Hub & Spoke” clinical model –

fixed & mobile• Program budgeting• Tele-Health assessment

• National Cancer Strategy• Clinical guidelines• Standardisation• Clinical outcome analysis• Need & benefit analysis• Cancer database

• Multi-disciplinary teams• Translational Medicines • Diagnostic & therapeutic

equipment – fixed & mobile• Access to Expert Network / Key

Opinion Leaders

• Clinical Pathway Redesign• Screening, diagnosis &

treatment• Mitigation of risk• Active management• Living with and beyond cancer• Sharing community

experience

National Cancer Network

Structure & Governance

Infrastructure & Manpower

Equitable & Quality Patient Care

43

World Class

Cancer Care

A Modern Cancer Plan

Investment

Professor Sir Christopher Evans OBEDSc, PhD, BSc, ARCS, F.Med.Sci, FR Eng, FRSC, FRSA, FIBiol, FIOM, CCMI, C.Biol., CSci, C.Chem

the excalibur medical network - developing markets chris... · formed and financed 13 years ago by...

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