uclpartners annual report 2015/16uclpstorneuprod.blob.core.windows.net/cmsassets/u... · partners:...

UCLPartners Annual Report 2015/16

Chair’s statement 06

Managing director’s statement 07

Directors’ report 08

• Businessreview 09

• IntroducingUCLPartners–AnAcademicHealthSciencePartnership 10

• UCLPartnersAcademicHealthScienceCentre 12

• NorthThamesNHSGenomicMedicineCentre 15

• NIHRClinicalResearchNetworkNorthThames 16

• UCLPartnersAcademicHealthScienceNetwork 18

• Improvement,qualityandleadershipdevelopment 26

• Systemtransformationandpopulationhealth 30

• NIHRCollaborationforLeadershipinAppliedHealthResearch andCareNorthThames 36

• EducationLeadProvider 39

• Corporategovernance 40

• Financialreport 44

• Auditor’sstatement 48

Appendix1–Detailsofpartnershipmembers 49

Appendix2–Financialstatements 50

Theinformationcontainedinthisreportwascorrectatthetimeofpublishing(April2016)

Contents

UCLPartnersAnnualReport2015/16• Contents03

1. Dementia research: created a partnership withtheretailindustrytoprovidefundingfordementiaresearch.JoinDementiaResearchisincreasingthenumberofpeopleparticipatingindementiaresearchstudiesPartners:Universities,NHS,industry,philanthropy,AHSNNetwork,charities

2. Proposed Institute of Mental Health: supportedaproposaltocreatenewjointinstitutesformentalhealthandforeyesandvision,co-locatedwithinasinglecampusPartners:Universities,NHS,industry

3. The London Project to Cure Blindness: firstembryonicstemcellsurgerywasconductedtoreversevisionlosscausedbyage-relatedmaculardegenerationPartners:Universities,NHS,industry

4. The Zayed Centre for Research into Rare Disease in Children: supportingthedevelopmentofthelargestcentreforpaediatrichealthresearchinEuropePartners:Universities,NHS,charity,industry

5. Institute of Immunity and Transplantation: developingnewdiagnostictoolsandtherapiesforimmune-relateddiseasesPartners:Universities,NHS,charity,industry

2015/16Achievementsthroughpartnership

Discovery science

1. NHS Innovation Accelerator: createdanationalplatformsupportingentrepreneurstoacceleratetheuseofhighimpactinnovationsacrosstheNHSforpatientbenefitPartners:NHSEngland,HealthFoundation,AHSNs,industry(global),universities(global)

2. Care City: supportingthecreationofacentreforhealthyageing,innovation,researchandeducationPartners:NHS(acute,primarycare,community),industry,councils,voluntarysector,innovators,universities

3. DigitalHealth.London:buildingtheecosystem,marketandevidencebasefordigitalhealthacrossLondonPartners:LondonAHSNsandAHSCs,MedCity,GreaterLondonAuthority,NHSEngland,industry,NHS

4. Genomic Medicine Centre: atthecurrentrate,theNorthThamesNHSGenomicMedicine Centre is recruitingoveronequarterofallraredisease genomes in the countryPartners:NHS(acute),universities,NationalInstituteforHealthResearch(NIHR)

5. Improving outcomes for patients with atrial fibrillation: drivenimprovementand research across theatrialfibrillationpathwayincludingincreaseddetection,anticoagulation,andmedicinesoptimisationPartners:Pan-LondonAHSNs,NHSindustry,policymakers,universities

Innovation into practice

1. Essex Success Regime:supportingwholehealthsystemandsocialcaretransformationinsouthandmidEssexPartners:NHS(acute,primarycare,out-of-hospitalcare)acrosssouthandmidEssex,councils,regulators,patientgroups

2. The Newham partnership: supportingpartnershipsolutionstoarangeofhealthissuesinNewhamPartners:Voluntarysector,NHS(acute,mentalhealth,primarycare),schools,universities

3. i-THRIVE: supportingamajorservicetransformationforchildandadolescentmentalhealthservicesPartners:Charities,NHS(acute,mentalhealth,primarycare,NHSEngland),CLAHRC,universities(UKandUSA)

4. National digital maturity assessment: commissionedbyNHSEnglandtodeliveranationaldigitalmaturityscan,completedby99%oftheNHSPartners:NHS(acute,community,mentalhealth,ambulanceservices,NHSEngland),industry

5. Barts Heart Centre:developingsystemleadershipforcardiovascularcareand researchPartners:NHSEngland,NHS,universities,charity

Population health and place-based care

UCLPartnersAnnualReport2015/16•Achievementsthroughpartnership04

6. Bloomsbury Research Institute: planningpermissiongrantedforanewresearchinstitutetoundertakeworld-leadingresearchintoinfectiousdiseasePartners:Universities,NHS,industry

7. Africa Centre: submittedmajorfundingbidforresearch into infectiousdiseaseandantimicrobialresistance Partners:Universities,charity,industry

8. Cardiovascular Academic Medical Centre:deliveringajointcardiovasculardevicescentretofocusonpreventionandnoveltherapiesPartners:Universities,NHS,industry

9. Cancer Academic Medical Centre: buildingonscientificbreakthroughsandsupportingspin-outcompaniesinimmunotherapyPartners:Universities,NHS,industry

10. Cancer Research UK Major Centre: developedapartnershipproposaltodeliverworld-leadingresearch,improvedpatientcareandgreaterlocalengagement Partners:Universities,NHS,charity,industry

6. Increasing improvement capability: created a cohortofimprovementfellowstoembedimprovementacrossthe partnership to deliveringbetterresultsforpatientsandpopulations.Partners:Universities,NHS(acute,community,mentalhealth),councils

7. Quintiles Prime Site: UCLPartnershasthehighestrecruitmentofpatientstoQuintilestrialsintheworld,increasingpatientaccesstoinnovativetreatmentsandclinicaltrialsPartners:Industry,NHS(acute),NIHR

8. Neuroresponse: adaptingandscalinganurseled,24/7newmodelofcareforlongtermneurologicalconditionsPartners:NHS(acute,mentalhealth,111),voluntarysector,industry,YorkshireandHumberAHSN

9. Multiple sclerosis: supportingtheintroductionofnewpharmacologicalanddigitaltherapiesforapopulationof10,000patientswithmultiplesclerosisPartners:Universities,NHS,industry,NIHR,charities

10. Proton Beam Therapy: partnership supporthasenabledapprovalofanewworld-classfacilityatUCLHforthetreatmentofcomplexandhard-to-treatcancersinchildrenandadultsPartners:Universities,NHS

6. National Cancer Vanguard:supportingnationalinitiativestoimproveearlydiagnosis and preventionofcancerthroughformingpartofthenationalcancervanguardPartners:NHS(localandnationalpartners),universities

7. Dementia awareness training: helpingtoreducethevariationincareprovidedforpeoplewithdementiabytraining more than 40,000staffPartners:NHS(acute,community,mentalhealth)

8. Supporting sustainability and transformation plans: sharingknowledgeacrossUCLPartnerstoreducecosts,increasepaceandscaleofchangePartners:NHSEngland,STPsacrossUCLPartners

9. London devolution pilots: supportingnewwaysofworkingin partnership to transformhealthandsocialcarePartners:NHS(acuteandprimarycare),councils

10. Host pan-London neonatal operational delivery network: supportingimprovedoutcomesforprematurebabiesPartners:NHS(Londonacuteandambulancetrusts,NHSEngland)

UCLPartnersAnnualReport2015/16•Achievementsthroughpartnership05

These pages provide a snapshot of achievements delivered in partnership, highlighting the range of partners involved. Every area that supports healthcare delivery works in partnership with patients and/or patient groups and this is fundamental to UCLPartners’ approach.

UCLPartners has continued this year to make an important contribution to transforming the health of our population,

both within the local partnership and through our national connections and influence.

Thechangingandchallengingenvironmentinthedeliveryofhealthandsocialcarehasnotalteredthecompany’sdeterminationtodeliveroutstandingresultsonbehalfofthepartners.

Duringtheyear,UCLPartnershasrevieweditsmodel,andratherthanfocusingonpatientpathwaysforspecificdiseases,thecompanyhasadoptedanapproachtoplace-basedcare,buildingonexistingexpertisetosupportimprovementsforwholepopulationsacrossthepartnership.

Thisapproach-linkinguporganisationsinthehealthandcaresystemtoensurethathighqualitycareisdeliveredeffectivelyandefficiently-is

wholeheartedlysupportedbytheBoardandendorsedbynationalleaders.

ChampioninginnovationanditstranslationintopracticecontinuestobeakeyroleforUCLPartners,andwehavebeenprivilegedtohostandleadtheNHSInnovationAcceleratorinpartnershipwithNHSEngland,theHealthFoundationandthecountry’sAcademicHealthScienceNetworks.Followingarigorousrecruitmentprocess,17topinnovatorsfromacrosstheUKandoverseasarenowsupportedbytheprogrammetointroducetheirinnovationsintotheNHSatscaleandpace.Injustthefirstninemonths,theseinnovativenewproductsandserviceshavebenefitedoverthreemillionpatientsacross14%oftheNHSandhavegeneratedover£8minadditionalexternalincome.ThisisanoutstandingachievementanddemonstratesUCLPartners’expertiseandknowledgeinthisfield.Wewillbuildonthisprogrammeasakeypartofourongoingcommitmenttoinnovation.

Thisyearwehavehadsuccessinbroadeningourengagementstrategytoinvolvemorecolleaguesfromthesocialcaresector,whilstcontinuingtoengagewithandsupportpartnersacrosshealthcareandacademia.OurroleinDigitalHealth.Londonwillenableustofurtherconnectandsupportindustrypartners,andtheestablishmentofourImprovementFellowsProgrammeenablesustocreatewidernetworksforprofessionalqualityimprovement.

IamgratefultomycolleaguesontheBoard,whocontinuetosupervisetheevolutionofUCLPartners’strategicdirection,provideexpertinsightintothecompanymodelandapproach,andserveascustodiansofourvalues.

OnbehalfoftheBoard,Iwouldliketothankeverymemberofstafffortheircommitmenttoourmissionandforcontinuingtodeliveratsuchahighlevelintimesofchangeanduncertaintyforthehealthandcaresystem.Iwouldalsoliketothankourpartnersforcontinuingtoinvolveusintheirwork.ThroughtheBoard,ExecutiveGroupandothergroups,theyhavehelpedshapeourprioritiesandenabledustofocusonwhatmattersmosttopatientsandthepopulation.Wewillcontinuetodoallthatwecantoaddthegreatestpossiblevaluetotheseexceptionalorganisations.

Rt Hon Professor the Lord KakkarChair, UCLPartners

Chair’s statement

UCLPartnersAnnualReport2015/16• Chair’s statement06

When UCLPartners was first created in 2009 the founding partners recognised the need and challenge to learn and apply partnership skills

for the overall benefit of the populations served. This continues to be the sustaining foundation on which our work is built and today,

partnership approaches to health and care challenges and the need for every partner to develop and utilise these skills are at the forefront of the national and global agenda in discovery science, innovation into practice and population health.

Asthisreportexemplifieswehaveallmadeacontributiontorealandsustainablevaluetothepartnership,beyondtheindividualprojects.

Partnersinourregionarealreadyconsideredleadersinthedevelopmentoftransformationplans,includingLondon’sevolvingdevolutionpilotsandtheMidand

SouthEssexSuccessRegime.InLondon,fouroutofthefivedevolutionpilotsareintheUCLPartnersregionandwehaveengagedwithallfour,includingprovidingdirector-level

adviceandguidance,andencouragingknowledgesharingwithinandbeyondthepartnership.InmidandsouthEssex,ithasbeenaprivilegetopersonallysupportthetransformationacrossoneofthemostchallengedhealtheconomiesinthecountrythatisattheforefrontofradicalchangetodeliversustainablehealthcarefor1.5millionpeoplewhileclosingafundinggapofmorethan£200millionoutofa£2.1billionspendoverthreeyears.

Havingbeenpersonallyinvolvedintheworktosupportthereconfigurationofspecialistheartandcancerservicesinregion,Icongratulateallthestaffinthepartnershipwhohaveworkedsohardtomakesuchamarkeddifferenceforpeoplelivingwiththeseprevalentdiseases.AlmostoneyearonfromopeningthenewdedicatedspecialistcentreatBartstheresultsspeakforthemselves:thestandardisedhospitalmortalityindexatBartsis0.535(equivalentto340livessavedeveryyear);fasterinter-hospitaltransfers(targetnowexceededbyoneday);fullseven-dayemergencyandspecialistcoverforpatientswithseriousacuteheartconditions;cancellationsreducedbyhalf;andsavingsworthover£45mtotheNHSoverfiveyears.Forpeoplewithcancer,morearenowabletohavesurgerythatsparestheirkidneys(20%morethanthenationalaverage);andoverhalfofpatientswithsmallmasskidney/urologicalcancersavoidtheneedforanysurgeryatall.Thismakesahugedifferencetotheexperienceandthelong-termoutcomesforpatients.Theseachievementshaveonlybeenpossiblethroughthecommitmentandcollaborationoftheclinicalteamsintheregionwhosawsolutionsoverthelong-termandmadethishappen.

Indiscoveryscience,UCLPartnersissupportingthepotentialredevelopmentofthenewacademicmedicalcampusatStPancrasformentalhealthandophthalmology.Thisisagreatexampleofpartnersinhealthandlocalgovernmentworkingtogethertoaddevengreatervalueforpatients.

Therearemanyotherexamplesoutlinedinthisreportthatreflectourachievementsandchallengesthroughtheyear,anditisacredittoallthestaffatUCLPartnersthatwehavedemonstratedsuchprogressandresilience.

Asacompany,wehaveremainedtruetoourvaluesofpatientandpopulationfocus,developedinpartnershipanddeliveredatpace.Wehavereviewedourwaysofworkingtoensurethecompanyisbestpositionedandagiletorespondquicklytotheevolvingneedsofourpartnersinthecomingyears.

Professor Sir David FishManaging Director, UCLPartners

Managing Director’s statement

UCLPartnersAnnualReport2015/16• Managing Director’s statement07

UCLPartnersAnnualReport2015/16•Director’sReport08

Directors’Report

© QUEENM

ARY

UNIVER

SITYOFLO

NDON

UCLPartners’ commitment

UCLPartnersexistsforthreekeyreasons:

1. To give patients access to the most effective medical discoveries and innovation.Weworkwithpartnerstospeedupthepathwayfromscientificdiscoveryandmedicalinnovationtoclinicalapplicationinhealth andcare.

2. To transform the health of the local population. Wesupportandfacilitatemeasurableimprovements inthehealthandcaresystemsandapplyacademicrigourtoimprovethepatientjourneyfromdiagnosis totreatmentandaftercare.

3. To support a sustainable health and care system in England. Weworkwithpartnersandsupportsystemtransformationthataimstoclosegapsinhealthandwellbeing;careandquality;andfinanceandefficiency.

How do we achieve this?

In partnership:UCLPartners’fundamentalroleistosupportandfacilitateanethosofsustainablepartnershipworkinginareasthataddvalueforpartnerorganisations,patientsandpopulations,andtocatalyseimprovementsinhealthandcareatgreaterscaleandpacethanindividualpartnerscanachievealone.

Breaking down barriers:UCLPartnersbreaksdownthebarriersthatexistalongthepathwayofscientificdiscoveryandinnovationandalongpatientpathwaysfromprevention,diagnosis,treatmentandaftercaretoendoflifecare.Thisisachievedbybringingtogetherpeopleandorganisations,applyingacademicrigourandsupportingdeliveryofaportfolioofresearch,healthandsocialcareprogrammesthataddresstheneedsofthepopulationandthelong-termsustainabilityofthehealthandcaresystem.

Adaptability:Thecompany’sbusinessmodelisflexibletorespondtotheevolvingneedsofpartnersandthepopulation.Aguidingprincipleisthatdeliveryandoutcomesareattributedtopartnerorganisationsratherthanthecompanyitself.

Values driven: UCLPartnerssetsdirection,employsstaffandworkswithcolleaguesbasedoncorevaluesthatensureitsworkis:patient-led,population-focused,developedinpartnershipanddeliveredatpace.

Focus on delivery of solutions: UCLPartnersoffersarangeofsupportdeterminedbypartners’needs,rangingfromworkforcedevelopment;leadershipsupportandadvice;researchandevaluation.

Aboveallelse,UCLPartnershasanunrelentingfocusonchallengingthestatusquoforthebenefitofpatientsand thepopulation.

BusinessReview

UCLPartnersAnnualReport2015/16•IntroducingUCLPartners09

Introducing UCLPartners

UCLPartners is a leading academic health science partnership that brings together people and organisations to transform the health and wellbeing of the population. It was created in 2009 as a small partnership that has grown to one that now serves a population of over six million people through more than 40 partner organisations across the NHS, higher education and local authorities.

Partnership roles

Asanacademichealthsciencepartnership,UCLPartnersisuniqueinbringingtogetherawidesetofrolestoimprovehealthofthelocalpopulation.Theseroleshelpourcolleaguestocollaboratemoreeasily,andtobringaboutgreaterimprovementstotheentirehealthcarepathway;fromearlyresearch,throughimplementation,toevaluation.Theserolescover:

• Early research and discovery:TheUCLPartnersAcademicHealthScienceCentre(AHSC)harnessesworld-classacademicandclinicalspecialtyexpertisetospeedupthedevelopmentofnewtreatments,diagnosticsandpreventionstrategies.

• Clinical trials:UCLPartnersworkscloselywiththeNationalInstituteforHealthResearch(NIHR)ClinicalResearchNetwork(CRN)NorthThames,whichprovidessupportforclinicaltrialsandotherwelldesignedstudiesinallareasofdiseaseandclinicalneed.

• High science into practice:UCLPartnershelpedtoestablishtheNorthThamesNHSGenomicMedicineCentre,whichaimstohelpresearchersandcliniciansbetterunderstand,andultimatelytreat,rareandinheriteddiseasesaswellascommoncancers.

• Implementation:TheUCLPartnersAcademicHealthScienceNetwork(AHSN)improveshealthandcreateswealthbyenablingtheNHSandacademiatoworkcollaborativelywithindustrytoidentify,adoptandspreadinnovation,improvementandbestpractice.

• Evaluation:UCLPartners’workalignswiththeNIHRCollaborationforLeadershipinAppliedHealthResearchandCareNorthThames,whichconductsresearchintothequalityofhealthcareandpublichealthtoinvestigateitseffectiveness,valueformoney,appropriatenessandfairness.

• Education:UCLPartnersalsoleveragesotherrolesforthebenefitofthepartnership,tosupportthesystemwiththequalityofeducationandcapabilityofstaff.

UCLPartnersalsoworkstotransformsystemsofcarebasedonpatientandpopulationneeds.Thesystemtransformationteamworkstoimprovehealthoutcomesforpatientsandthepopulationthroughsupportingthesystemtoimplementandevaluateintegratedpathwaysandnewmodelsofcare.

Inlinewithourvalues,UCLPartnerstakesapatient-centredapproachtoimprovingqualityofcareacrossthesystem.Welinkimprovementinqualitytobetteruseofresourcesacrossthehealthsystemtosupportorganisationsandindividualstodevelopcapabilityandinfrastructuretoimprovequality,patientsafetyandexperience.Theimprovementprogrammeencouragesallservicesinvolvedtobeopeninsharinglearning,totakejointaccountabilityforaddressinggapsincareandfocussingeffortstoimproveonwhatmattersmosttopatientsandthepopulation.

Thedetailofthisannualreportisstructuredaroundthesepartnershiproles.

UCLPartners strategic priorities in 2015/16

FollowingthepublicationoftheFiveYearForwardViewinOctober2014,theNHSspentmuchofthisyearfocusingondeliveringtheprioritiessetoutforthesystem.Tosupportthepartnersindeliveringonthenationalpriorities,UCLPartners’strategyin2015/16focusedon:

• Improvinghealthoutcomesforpatientsandthepopulationthroughsupportingthesystemtoimplementandevaluateintegratedpathwaysand newmodelsofcare

• Supportingorganisationsandindividualstodevelopcapabilityandinfrastructuretoimprovequality, patientsafetyandexperienceandreducecosts

• Embeddinginnovationtodrivechangeatscaleandpace

• EnsuringUCLPartnersisasustainableorganisationtomaximisethebenefitstopartners,patientsandthepopulation.

Updatesagainsteachoftheseareasareprovidedthroughoutthisreport.



Looking to the future

Overthecomingyears,itisclearthatUCLPartnersneedstocontinuetosupportdiscoveryscienceandinnovationintopractice,butthegreatestnationalchallengebyfarissupportingthepartnerstoclosethehealth,qualityandfinancialgapsintheNHS.ThescaleofthenationalchallengeintheNHSisunprecedented,withdeficitprojectionsconsistentlyabove£20bnby2020.Onlybyclosingthisgapwilltherebeasustainablehealthandcaresystemforthecountry’spatientsandpopulations.

Asaresult,throughdiscussionswiththeUCLPartnersExecutiveandBoard,thecompanyhascommittedtosupportingthepartnersindeliveringasustainablehealthandcaresystemforpatientsandthepopulation.

Toachievethis,UCLPartnersisevolvingitsapproachtofocusonthreekeyareasthatwillachievethemostpositiveimpactonthesystem.ThepartnershipwillharnessthepoweroftheAcademicHealthScienceCentreandAcademicHealthScienceNetworktodrivesystem-wide,populationhealthimprovements,inanewprogrammecalledPopulationHealth.Thethreeprogrammeswillfeedintoeachotherasoutlinedbelow:

Discovery scienceharnessesworld-classacademicandclinicalexpertisetospeedupthedevelopmentofnewtreatments,diagnosticsandpreventionstrategies

Innovation into practiceenablesacademics,healthcareprofessionals,industryandpatientstoworktogethertospeedupinnovationintoroutinepracticeintheNHSandsocialcare.

Population health and place-based carewillleadUCLPartnersinsupportingpopulation-basedtransformationforthesixmillionpeopleservedbythepartnershipandthosefurtherafield.Thiswillincludeprovidingaplatformofsupportfororganisationsthatareconnectingacrossthesystemtodeliversustainablepopulation-based(orplace-based)care.

Theseareasoffocuswillbefurtherdevelopedin2016/17indiscussionwiththeExecutiveGroupandBoard,withdirectiondrivenbystakeholdersacrossthepartnershipandtheirpatientsandpopulations.

Inlinewiththesethreeareas,UCLPartnerswillcontinuetoensureitisasustainableorganisationthatprovidesvalueformoneyandcontinuestobuildontheachievementsthroughpartnership.

UCLPartners Academic Health Science Centre

UCLPartners is one of six accredited Academic Health Science Centres (AHSCs) in England. As an AHSC, UCLPartners aims to ensure that discovery science and medical breakthroughs lead to direct clinical benefits for patients. The AHSC harnesses the expertise of its eight partner organisations to set a new benchmark in what can be achieved through academic and clinical partnership.

UCLPartners’AHSCsitswithinthewideracademichealthsciencepartnershiptoensurediffusionofinnovationandbestpracticeacrosstheregion,andtoensurethatthefocusofouracademiceffortsisgroundedinthosehealthissuesofgreatestconcerntoourclinicalservicesandcitizens.

During2015/16ProfessorDavidLomasbecametheAcademicDirectorofUCLPartners,leadingtheAHSC,aswellasVice-ProvostHealthofUCL.Heassumedtheroleon1August2015,succeedingProfessorSirJohnTooke.

TheUCLPartnersAHSChassixAcademicMedicalCentres(AMCs):• Cancer• Cardiovasculardisease• Childhealth• Eyesandvision• Infection,immunologyandinflammation• Neuroscience

ProgressfortheAMCsishighlightedinthefollowingpages.TheAMCsalignwiththeNIHR-fundedBiomedicalResearchCentres(BRCs)withinthepartnership.TheBRCsprovidecriticalmassandresourcefromwhichtoenabletheAMCtranslationalstrategies.

TheAMCsaresupportedbytwocross-cuttingdomainswithintheAHSC,whichareintegratedintoalltheprogrammes:

Personalised medicine Thisdomainisacross-disciplinarycommunitythatharnessesthebreadthanddepthofrelevantresearchacrossUCLPartners,andsupportsthedeliveryofinnovativepatient-targetedmedicinesandtherapies.Thisyear,thedomainhassupportedtheAHSC’ssuccessfulparticipationintheNorthThamesNHSGenomicMedicineCentreandGenomicsEnglandClinicalInterpretationPartnershipdomains(GeCIPs),sevenofwhichareledbyresearchersinUCLPartners.Recognisingtheimportanceoftraininganddevelopment,thedomainlaunchedanEarlyCareersNetwork(ECN)inDecember2015,whichprovidesaplatformformentoring,careersadviceandthedisseminationofinformationabouttraining,fundingandjobopportunities.

Populations and lifelong health Thisyear,progressinthisdomainincludesthedevelopmentofacohortresearchstrategytoimprovesynergyacrossthepopulationandclinicalcohortsinUCLPartners.UCLandtheLondonSchoolofHygieneandTropicalMedicinehaveworkedinpartnershiptosubmitanapplicationforrenewaloftheWellcomeTrustMajorOverseasProgrammefundingfortheAfricaCentreforHealthandPopulationStudies,whichcarriesoutresearchonpopulationandhealthissuesaffectingtheruralpopulationinKwaZulu-Natal,SouthAfrica.


©BART

SHEA

LTHNHSTR

UST

Programmes and progress

TheAHSCisactivelyinvolvedinawiderangeofprojects,whichsupportincreasingalignmentbetweenNHSanduniversitypartnerstobenefitpatients.Somehighlightsofprogressduring2015/16areoutlinedbelow:

Cancer:

• TheAMChasdevelopedaproposalforaCancerResearchUK(CRUK)MajorCentreaward,involvingengagementwithCRUK,acrossUCLPartners,andwithexternalacademicpartners,includingtheFrancisCrickInstitute.CRUKCentresformanationalframeworktodeliverworld-leadingresearch,improvedpatientcareandgreaterlocalengagement.Theydriveaunitedstrategytoacceleratethetranslationofresearchintotheclinic.Ifsuccessful,fundingisprovidedforclinicalandnon-clinicaltraining,researchinfrastructure(researchnurses,technicians,equipment)andtoprovideseed-fundingfornewprojects.

• ApaediatriccancerstrategyhasbeendevelopedincollaborationwithGreatOrmondStreetHospital,whichincludesfacilitatingcancerpatientrecruitmenttothe100,000GenomesProjectviatheNorthThamesNHSGenomicMedicineCentre.

Cardiovascular:

• FollowingthesuccessfulopeningoftheBartsHeartCentreinMay2015,theNationalInstituteforCardiovascularOutcomesResearch(NICOR)hasmorecloselyalignedtoclinicalservicesbyrelocatingtoBarts.NICORhelpstheNHS,thegovernmentandregulatorybodiesimprovequalityofcarebycheckingthatthecarereceivedbyheartdiseasepatientsmeetsgoodpracticestandards.BeinglocatedatBartsHeartCentrewillensurecloseralignmentwithcardiovascularcliniciansandaccesstomoredata.

• Thepartnershavedevelopedajointacademicstrategytoworkacrossthematicareaswherethemostimpactandpatientbenefitispredicted.Theintentionistocreateatranslationalinstitutewithaone-stopdeviceinnovationinstitute-theJointQueenMaryUniversityofLondon/UCLCardiovascularDeviceInnovationCentreforIntegratedBiomedicalandBioengineering.Asitehasbeenidentifiedforthefacilityandabidfor£10.2mhasbeensubmittedtosupportthis,match-fundedbytheBartsCharity.

Child health:

• ThenewZayedCentreforResearchintoRareDiseaseinChildren,wasofficiallynamedataceremonyheldinSeptember2015.TheZayedCentreforResearchisapartnershipbetweenGreatOrmondStreetHospital(GOSH),UCLandtheGreatOrmondStreetHospitalChildren’sCharity.Itwillbringhundredsofcliniciansandresearcherstogetherunderonerooftodriveforwardnewtreatmentsandcuresforchildrenwithrarediseases.Oncecompleted,itwillwelcomeapproximately400academicsandclinicalstaffandfeatureover150laboratorybenchpositions.Theoutpatientfacilitywillaccommodatemorethan200patientsandaccompanyingfamilymembersatanyonetime.Thenewfacilityisscheduledtoopenin2018.

• ThreechildhealthprogrammeshavegainedfundingfromEUHorizon2020.Onesuchproject,SCIDNET,isfocusedonseverecombinedimmunodeficiency(SCID),whichisadevastatingraredisorderofimmunesystemdevelopmentaffectinginfants.TheprojectaimstoaddresstheunmetneedinSCIDbydevelopingcurativegenetherapytreatmentsfromearlyclinicaltrialsthroughtoalicensedmedicinalproduct.

Eyes and vision:

• AspartoftheLondonProjecttoCureBlindness,thefirstembryonicstemcellsurgerywasconductedtoreversevisionlosscausedbyage-relatedmaculardegeneration.ThefirstpatientwasrecruitedatMoorfieldsEyeHospitalforthePhaseI/IIstudywithinthenationalbenchmarkof70-days.

• AcollaborationwasestablishedwithGoogleDeepMindtoanalyseoveronemillionopticalcoherencetomography(OCT)images,whicharecross-sectionpicturesoftheretinawithintheeye.GoogleDeepMindHealthcollaboratesdirectlywithfrontlineclinicianstodeveloptechnologythathelpsimprovepatientcare,byprovidinganartificialintelligenceplatformthatusesalgorithmscapableoflearningfromdataforthemselves.


MoorfieldsEyeHospital conductedthefirst embryonicstemcell surgerytoreversevision losscausedbyage-relatedmaculardegeneration

st

Infection, immunology and inflammation:

• TheAMChasprogressedtheInstituteofImmunityandTransplantation,anewfacilityforaninternationalcentreofexcellenceinimmunologytransplantationresearchattheRoyalFreeLondon.TheinstituteisbeingdevelopedinpartnershipbetweenUCL,RoyalFreeLondonNHSFoundationTrustandtheRoyalFreeCharity.

• CamdenCouncilhasgrantedplanningpermissionfortheBloomsburyResearchInstitute,anewfacilitybeingdevelopedinpartnershipbetweenUCLandtheLondonSchoolofHygieneandTropicalMedicinetoundertakeworld-leadingresearchintoinfectiousdisease.Theinstitutewillbringtogethermorethan200scientiststofindnewtreatments,vaccinesanddiagnosticsforpreventionandcontrolofinfectiousdiseases.

• TheAMChasestablishedanewtuberculosisnetwork,whichhassecuredNIHRHealthInformaticsCollaborative(HIC)commitmentandfundingforinitialrollouttostandardiseTBdatacollectionacrossUCLPartnerstrusts(RoyalFreeLondonNHSFoundationTrust,WhittingtonHealthNHSTrustandUniversityCollegeLondonHospitalsNHSFoundationTrust).

Neuroscience:

• TheAMChasprogressedthedevelopmentoftheAlzheimer’sResearchUK(ARUK)-UCLDrugDiscoveryInstitute,whichwasawarded£10mbyARUKinearly2015.TheinstituteisoneofthreewithintheARUKDrugDiscoveryAlliance,workingalongsideinstitutesattheUniversityofCambridgeandUniversityofOxfordtoacceleratethediscoveryofnovel,effectivetherapeuticsforAlzheimer’sdiseaseandotherneurodegenerativediseases.Theinstituteislookingfortargetsthathavebeenunexploredbythepharmaceuticalindustry,broadeningthefocustonovelproteinsandpathwaysimplicatedinneurodegenerativediseasesanddrawingonacademicexpertisetofindthese.

• Tosupportworld-classdementiaresearchatUCL,theAMChasalsosecuredamajorphilanthropicagreementwithUKretailersIceland,Asda,Morrisons,Waitrose,WHSmith,Boots,PoundlandandHSSHireinauniquecoalition,pledgingfundsfromthenewlevyonsingle-usecarrierbags.

• UCLlaunchedanewmassiveopenonlinecourse(MOOC)indementia,entitled‘TheManyFacesofDementia’,inJanuary2016,whichreceivedover10,000registrations.Thefreeonlinecoursecoverssomeofthekeyissuesindementiacareandresearchthroughtheeyesofpeopleaffectedbythecondition,andworld-leadingexpertsatUCL.Italsorevealshowresearchintothesigns,stages,symptomsandcausesoflesscommonformscanbringusclosertotheaimofdefeatingdementia.

Contributing to economic growth

TheAHSC’sfocusonwealthgenerationhasenabledseveralsignificantsuccessesduring2015/16:

• A£40millionApolloTherapeuticsFundwaslaunchedthisyeartosignificantlyimprovethespeedandpotentialofuniversityresearchbeingtranslatedintonovelmedicines.TheinitiativeisacollaborationbetweenAstraZeneca,GlaxoSmithKline,Johnson&JohnsonInnovationandthetechnologytransferofficesofImperialCollegeLondon,UCLandtheUniversityofCambridge

• TwoSynconaImmunotherapycompanieshavebeensuccessfullyspunout(FreelineTherapeuticsandAutolus).SynconaisanindependentsubsidiaryoftheWellcomeTrustandhasinvested£55mintoSeriesAfinancingforthecompanies.FreelineTherapeuticswilldevelopandcommercialisegenetherapiesforbleedingandotherdebilitatingdisorders,whileAutoluswillfocusonthedevelopmentandcommercialisationofnext-generationengineeredT-celltherapiesforhaematologicalandsolidtumours.

• AthenaVisionhasbeenestablished,anewcompanyfocusedondevelopinggenetherapiesforeyediseasesbasedonresearchconductedatUCL.AthenahasenteredintoaglobalpartnershipwithMeiraGTxLtd.todevelopandcommercialiseAthena’soculargenetherapyprogrammesarisingfromresearchconductedattheUCLInstituteofOphthalmology.


UCLPartnersAnnualReport2015/16•NorthThamesNHSGenomicMedicineCentre15

North Thames NHS Genomic Medicine Centre

The 100,000 Genomes Project was launched by the government as part of its ambitious vision to sequence 100,000 whole human genomes by the end of 2017. The project focuses on people living in England with rare diseases and cancer and through 13 designated NHS genomic medicine centres began to invite patients to participate in 2015. The aims are to help medical teams provide better diagnosis or treatment for patients, create a comprehensive medical research resource, stimulate the development of new therapies and support a new era of personalised medicine.

TheNorthThamesNHSGenomicMedicineCentre(NTGMC)buildsonexistingandsuccessfulcollaborationthroughUCLPartnersandcoversapopulationofoversixmillionpeoplewithaprovendeliveryofgeneticsamplesandestablishedconsentprotocols.LedbyGreatOrmondStreetHospitalNHSFoundationTrust,thepartnersinclude:• BartsHealthNHSTrust• LondonNorthWestHealthcareNHSTrust• MoorfieldsEyeHospitalNHSFoundationTrust• RoyalFreeLondonNHSFoundationTrust• UniversityCollegeLondonHospitalsNHSFoundationTrust• RoyalNationalOrthopaedicHospitalNHSTrust.

TheNTGMCwasestablishedtogainabetterunderstandingofthegeneticcausesofcancer,raredisordersandinfectiousdiseasesandtocontributeto10,000rarediseasegenomesand5,000cancergenomes–asignificantproportionoftheoverallproject.

Progress highlights in 2015/16

• Allsixinauguralpartnersarerecruitingpatientsandtheirfamiliestotheproject.TheRoyalNationalOrthopaedicHospitaljoinedtheinitiativeinFebruary2016

• Thereisstrongengagementatexecutivelevelthroughthepartnerorganisations,creatingapartnershipapproachtotheinitiative

• Intermsofscale,theNTGMCisexpectedtorecruitmorepatientswithrarediseasesthananyothercentreinthecountry.AsoftheendofMarch2016,thecentrehadrecruitedover27%ofthenationaltotal.

• Thefirstpatientstoreceiveageneticdiagnosisthroughthe100,000GenomesProjectwerechildrentreatedatGreatOrmondStreetandparticipatedviatheNTGMC.Theresultsstandtohaveamajorimpactonmanyareasoftheirlivesincludingfuturetreatmentoptions,socialsupportandfamilyplanning.Theyalsohavethepotentialtohelpmanymorechildrenwithundiagnosedconditionswhomaybetestedforthesegeneticmutationsearlyonandbeofferedadiagnosistohelpmanagetheirconditionmosteffectively.

Overcoming challenges

AswiththeotherGMCsaroundthecountry,ourlocalcentrehasfacedanumberofchallengesinitsfirstyear,inparticularrelatingtopatientrecruitment.Recruitingandconsentingpatientstotheprogrammeiscomplexduetothewiderangeofcriteriatomeet,andengagementwithcliniciansinallspecialitieswillbecrucialtooverallsuccess.Despiteaslowstart,recruitmentforpatientsandtheirfamilieswithrarediseasesisprogressingwell,howevertherearestillsomeobstaclestoovercomeforinvolvingpatientswithcancer.Thiswillberesolvedthroughcontinuedpartnershipworking,localengagementwithtrustsandongoingconversationswithpatientsandtheirfamilies.

“What we hope to understand through genomic sequencing is what is causing the problem and how we might begin to tackle it..”

Professor Maria Bitner-Glindzicz, Academic Clinician, Great Ormond Street Hospital NHS Foundation Trust

©M

OORF

IELD

SEYEHOSPITALNHSFO

UNDAT

IONTRU

ST

The National Institute for Health Research Clinical Research: North Thames

Progress in 2015/16

TheCRNNorthThameshasfacedachallengingyearbuthasalsoseensomerealachievementsinimprovingbothpatientaccesstoinnovativetreatmentsandpatientoutcomesthroughclinicaltrials.

Highlights include:

• SinceApril2014,whentheCRNwasestablished,over117,000peoplehavebeenrecruitedtoparticipateinNIHRresearchwithintheregion.Thisisapproximately55,000participantsin2015/16.

• TheCRNNorthThameshasopenedmorestudiesinmultiplesitesinthelast12monthsthaneverbefore.Thecommercialportfolioopenedover700study/sitecombinationsandrecruited2,359peopletostudiesduring2015/16.

• In2015/16,thenetworkhasincreasedrecruitmenttostudiesinconditionssuchascancer,renalandmusculoskeletaldisease,aswellasincreasingrecruitmentactivitytothehealthservicesportfolioandprimarycaresetting.In2015/16,improvedrecruitmentinthecancerandpaediatricportfoliosmeantthatNorthThameswasthehighestrecruitingCRNinthecountryfortheseimportant areas and maintained this important top recruitingpositioninanumberofotherkeyspecialties(anaesthesia,haematologyandneurologicaldisorders).

• Thenetwork’sexcellentrecruitmentrecordin2014/15

resultedinanincreaseinfunding,whichhasenabledittodevelopinitiativestoexpandrecruitmentfurtherin2015/16.Thesehaveincludedestablishing‘champion’rolesforresearchnursesinmidwiferyandcancertoworkacrossthewholeoftheNorthThamesregiontohelpestablishnewrecruitingsitesandinspiremorenursingandmidwiferystafftoengageinresearch.AnotherinitiativehasbeentoappointGPchampionstohelpmorepatientswhoaretreatedinthecommunitytoparticipateinresearchstudies.

The National Institute of Health Research Clinical Research Network (NIHR CRN) is the clinical research delivery arm for the NHS. Over the last year, as one of 15 Local Clinical Research Networks, CRN North Thames has increased opportunities for patients to take part in clinical research.

Clinical Research NetworkNorth Thames

UCLPartnersAnnualReport2015/16•NIHRClinicalResearchNetworkNorthThames16

Commercial study sites opened800

600

400

200

02012/13 2013/14 2014/15 2015/16

Recruitment to portfolio studies120,000

100,000

800,000

600,000

400,000

200,000

0April2014 November2015 June2015 February2016


Overcoming challenges

ThisyearhasseenmanychallengesfortheCRNandthepartnershipasthegeneralfinancialpressuresontheNHSdistractfromresearch.Inthecomingyear,thenetworkplanstoincreaseengagementwithtrustsandGPpractices,andwillfocusonembeddingresearchintoclinicalpractice,includingdevelopingplanstofundnewconsultantsandclinicalfellowstohavededicatedresearchtime,andextendourchampionrolestootherspecialties.

IN FOCUS:

Increasing clinical research in primary care

WithmostpeopleaccessingthehealthsystemthroughprimarycareandGPservices,increasingGPinvolvementinresearchwasaparticularfocusforthenetworkin2015/16.

In2015/16,thenetworkhasincreaseddeliveryinthecommunitysetting,doublingtheactivitybyrecruitingalmost5,000morepeoplethaninthepreviousyear.Thenetworkalsosupportedthedeliveryofalocally-ledstudy–theEastLondonGenesandHealthStudy–linkingDNAsequencingtohealthrecordsofpeopleofBritish-BangladeshiandBritish-Pakistaniorigintocharacterisegeneticvariationbetweenthesetwogroups,andscopehowsomepeopleresponddifferentlytocertainmedicines.Thestudythataimstorecruit20,000patientsinthenextthreeyears.TheCRNhasprovidedfundingforseverallocalresearcherswhospeakanumberofsouthAsianlanguagestosupporttherecruitmentinGPpracticesinEastLondonaswellasatTheRoyalLondonHospital(BartsHealthNHSTrust).Thishasprovedverysuccessfulandthisyearthestudyhasrecruitedmorethan9,000people.

©M

OORF

IELD

SEYEHOSPITALNHSFO

UNDAT

IONTRU

ST

UCLPartners Academic Health Science Network

Spreading innovation, improving health, generating economic growth

UCLPartnersAnnualReport2015/16•UCLPartnersAcademicHealthScienceNetwork19

UCLPartnersisoneof15AcademicHealthScienceNetworks(AHSNs)inEngland,whichwereestablishedbyNHSEnglandin2013.

AstheonlybodiesthatconnectNHSandacademicorganisations,localauthorities,thethirdsectorandindustry,AHSNsarecatalyststhatcreatetherightconditionstofacilitatechangeacrosswholehealthandsocialcareeconomies,withaclearfocusonimprovingoutcomesforpatients.

AHSNsareuniquelyplacedtoidentifyandspreadhealthinnovationatpaceandscale;drivingtheadoptionandspreadofinnovativeideasandtechnologiesacrosslargepopulationsandgenerateeconomicwealth.

TheimpactofAHSNsrestsintheabilitytobringpeople,resourcesandorganisationstogetherquickly,deliveringbenefitsthatcouldnotbeachievedalone.

AllAHSNssharethefollowingpriorities:• Promotingeconomicgrowth• Diffusinginnovation• Optimisingmedicineuse• Improvingqualityandreducingvariation• Puttingresearchintopractice• Improvingpatientsafety.

ItisalsoafocusofAHSNstocollaborateonanationalscale,wherepossible,inordertobestspreadinnovationacrossthehealthandcaresystem.SuccessinthisareacanbeseeninthecontributiontheAHSNshavemadetotheAcceleratedAccessReview,ledbytheOfficeforLifeSciences;cross-boundaryworkingtosupporttheNHSInnovationAcceleratorprogrammeoutlinedbelowandthepartnershipworkingbetweenPatientSafetyCollaboratives.

Progress highlights for 2015/16

Promoting economic growth - fostering opportunities for industry to work effectively with the NHS

• UCLPartnershashostedtheNHSInnovationAccelerator,whichhashelped17innovatorstoattractover£8.3mininvestmentandbenefitedapproximatelythreemillionpatients(Findoutmoreonpage24)

• UCLPartnershassupportedfoursuccessfulbidsinexcessof£3millionthroughSBRI

• TrustsrecruitingpatientstoclinicalstudiesthroughtheUCLPartnersQuintilesPrimeSitereceiveapproximately£1mper100patients,andsaveanaverage£6mincosts.(Findoutmoreonpage23)

Diffusing innovation - creating the environment to identify and spread innovation at pace and scale, and supporting collaboration across boundaries to adopt and spread innovation at pace and scale

DigitalHealth.LondonThisjointinitiativebetweenthethreeLondonAHSNs,MedCity,GreaterLondonAuthorityandNHSEnglandwasformallylaunchedatCityHallbyGeorgeFreemaninFebruary2016.DigitalHealth.Londonincludesa12-monthacceleratorprogramme(£2.2mfundingoverthreeyearsfromtheEuropeanRegionalDevelopmentFund)tosupportupto30smallandmediumdigitalhealthbusinessesperyearforthenextthreeyearstoworkwiththeNHSandwiderhealthcaresystem.Thereisalsoanactivesupportnetworktobringtogetherstakeholdersacrossthedigitalhealthspectrumwithfrequenteducationalevents.


Optimising medicine use - ensuring that medication is used to its maximum benefit – improving safety and making efficient use of NHS resources

Supporting adoption of primary care interventions to manage atrial fibrillation

• UCLPartnershassupportedthedevelopmentofthenationalbleedingregistry(ORANGE)tobuildunderstandingoftherisksofmajorbleedsassociatedwithoralanticoagulants.In2015/16,sevenadditionalhospitalsenrolled(takingthetotalto32)and1,200patientswereaddedtotheregistry(makingatotalof1,700).Thetargetistorecruit2,000patientsbyOctober2016.

• ThethreeLondonAHSNsandtheLondonStrategicClinicalNetworkhaveestablishedwaysofworkingandengagedwithAtrialFibrillationAssociation(AFA)asapartnerforapan-Londonatrialfibrillationprogramme.Theprogrammehasstartedworkondevelopingtoolkitstosupportcommissioners,cliniciansandmanagerstoimplementlocalprioritiesacrosstheAFpathway.Theaimoftheprogrammeistoprevent1,777strokesandsave350-450livesoverafiveyearperiod.

Improving quality and reducing variation - spreading best practice to increase productivity and reduce variation, thereby improving patient outcomes

Neuroscience

• UCLPartnersworkedwithresearchers,cliniciansandpatientsacrosseightcountriestodevelopmentofwholepathwaypatient-centredoutcomemeasuresinstroke.ThisworkaspartoftheInternationalConsortiumforHealthOutcomeMeasures(ICHOM)hasbeenpublishedinthehighlyregardedpeerreviewedjournal,Stroke.

• UCLPartnerssupportedtheevaluationofnovelhyperacuteneurologymodelsintwoLondonNeurosciencecentres(KingsCollegeHospitalandUniversityCollegeLondonHospital).Thiswork,fundedbyNHSEnglandLondonregion,hasdemonstratedreductioninre-admissionratesandimprovedpatientandstaffexperiencefollowingtheintroductionofasevendayconsultantledserviceatbothsites.

• WorkingwithNIHRClinicalResearchNetworkNorthThames,UCLPartnershelpedopensevensitesforrecruitmenttoamultiplesclerosisregister,whichwilllinkpatientstoresearchstudiesacrosstheUK.Weexceededourrecruitmenttargetfortheyear(500)byanadditional147patientsin2015/16.

Enhancing the skills and knowledge of the workforce to provide the best care for patients

UCLPartnerswascommissionedbyHealthEducationEnglandtoworkwithpartnersinnorthcentralandeastLondontodevelopmaterialsanddelivereducationprogrammestohelpreducethevariationinthestandardofcareonthreecoreareas:dementia,mentalhealthandendoflifecare.

• Raisingstaffawarenessofdementiaintheacuteandcommunitysettings.UCLPartnershastrainedalmost40,000clinicalandnon-clinicalstaffinthebasicprinciplesofdementiaawareness(almost11,000trainedduring2015/16),andsuccessfullypilotedaprogrammeofmorepracticalknowledgeofdementiawith1,200staff.Adementiaawarenesspilotwasdeliveredto252staffin12Haringeycarehomes.Thedementiaawarenesstrainingprogrammewasafinalistinthe2015nationalDementiaFriendsAwardsforBestdementiafriendlyeducationalinitiative.

• Breakingdownthebarriersbetweenthephysicalandmentalhealthneedsofpatients.UCLPartnershascreatedandsuccessfullypilotedarangeoffree,bestpractice,coretrainingpackagestobeembeddedinthetrainingofprofessionalsintheacute,mentalhealthandcommunitysettings.

• Theendoflifecareprogrammeaddressesimprovingcareinacutehospitalsandthecommunity.Theteamhasidentifiedandtrained59acutecarestaffastrainersandover400staffhavebeentrainedintheacuteandcommunitysetting.Fundinghasbeensecuredtoevaluateandembedthetrainingin2016/17.

Allthreeprogrammeswillcontinuethroughout2016/17.

Improving outcomes for newborns

During2015/16,UCLPartnerscontinuedtobecommissionedbyNHSEnglandtohostthepan-LondonNeonatalOperationalDeliveryNetwork.Thenetworkhelpstoimproveoutcomesthroughthedevelopmentofsingle-operatingpoliciesandimprovedcostefficiency.In2015/16,thenetworkinnorthcentralLondonhasachievedthehighestsurvivalratesnationallyforbabiesbornat≤31+6 weeksgestation.

11,000 staff trained in dementia

awareness in 2015/16


Supporting the translation of research into clinical practice

• UCLPartnersremainsthehighestglobalrecruitmentsiteforQuintiles.In2015/16,619patientswererecruitedacrosstheUCLPartnersgeography.13%ofthesewererecruitedintorealworldlatephase(RWLP)studies.(Findoutmoreonpage23)

• UCLPartnersisafoundingpartnerinMedCity,whichaimstoattractlifescienceorganisationstoLondonandthesoutheastofEngland.UCLPartnersparticipatedintheproductionofareportintothewaybusinessesundertaketheirresearchanddevelopment.Findingssuggestthatlocationsthatcanofferthebestopportunityforbusinessestoworkwithastrongresearchbaseandeachotherareexpectedtoseethegreatestdemandinthefuture.TheSoutheast,LondonandEastofEnglandcollectivelycontain60%ofpharmaceuticalemploymentintheUK,and50%ofmedicalbiotechnologyemployment.Spin-outsemergingfromtheresearchspacetypicallywanttoremainclosetotheiroriginatingfacultyandattimesarenotfindingthisspacereadilyavailable.Thereisalsoevidenceofmulti-nationalcompanieswantingtoworkcloselywiththeresearchbasewhowouldfindthistypeofspaceappealing.Thereisaneedfor>250,000ft2ofspacetomeetdemand.Assuch,UCLPartnersisworkingwithindustrypartnerstodevelopthisofferingfurtherandhasidentifiedadequatefacilitiestohousethisinitiative.

Improving patient safety

TheUCLPartnersPatientSafetyProgrammeaimstoimprovethesafetyofpatientsthroughworkingwithpartnerstobothtackletheleadingcausesofavoidableharmtopatients,andbysupportingthedevelopmentofapatientsafetylearningculture.IncorporatingthePatientSafetyCollaborative,ourprogrammeempowerslocalpatientsandhealthcarestafftoworktogethertoidentifysafetyprioritiesanddevelopsolutionstobeimplementedacrossthepartnership.

ThePatientSafetyProgrammeestablishedtwosignificantworkstreamsduring2015/16usingtheInstituteforHealthImprovement(IHI)BreakthroughSeriesMethodology;onefocusingonacutekidneyinjury(AKI)andtheotheronsepsis.TheseconditionswereselectedasthefocusforUCLPartnersbecausetheyrepresentareaswheremostlivescanbesaved(togetherAKIandsepsisareresponsiblefortwothirdsofavoidabledeathsinEngland).

Theprogrammealsoaimstobuildqualityimprovementcapabilityinlocalteams,themethodologyofwhichcanbethenusedbytheteamsgoingforwards.

Progress highlights in 2015/16:

• UCLPartnersworkedwithtrustsafetyleadstosupportandensurealignmentofprioritiesandfuturesustainabilityofimprovement

• 13partnersareparticipatinginthesepsisworkstreamand9partnersareparticipatingintheAKIworkstream,withover150peopleinvolvedfromorganisationsacrosstheUCLPartnersgeography

• Trustsaresharingdataandlearningfromeachotherthroughfourface-to-facelearningworkshops,18onlinewebinarsandregularsocialmediainteractions

• Evaluationoftheprogrammeisunderwaywitharesearcherinresidenceworkingwithallinvolvedteams

• Adedicatedpatientinvolvementandengagementfacilitatorisworkingwithpartnerstoensurepatientinvolvementandengagementinthecollaborative.

UCLPartnersisalsoactivelyinvolvedinthenationalpatientsafetyclustersofAKIandsepsissharinglearningfromacrossNHSEngland.

“The network and support provided for ideas and shared learning is invaluable. Our sepsis champions have enjoyed being part of a larger network and can see how their role is vital to the sepsis improvement journey. The learning sets have provided time away to reflect on our data, storyboards have been great in hearing the approach other organisations have taken and also an opportunity to be in the loop with national/evidence based changes.”

Catriona Stapleton, Patient safety programme manager, the Royal Free London NHS Foundation Trust


©M

IDDLESEXUNIVER

SITY

The challenge:

HistoricallytheUK-andspecificallyLondon-hashadapoorreputationwiththepharmaceuticalindustrybecauseofitsslowapprovalsprocessesforclinicaltrials.Aspharmaceuticalcompanieswereabletoengagemoreparticipantsinothercountries,theydidnotfocusonopportunitiesfortrialsinLondon,andpatientsintheregionhadpooraccesstoinnovativepotentialnewtreatments.

Addressing the challenge:

ThroughUCLPartnersandthelocalClinicalResearchNetwork,hospitaltrustsinnorthcentralandeastLondonharmonisedtheapprovalsprocessfortrials,reducingaverageapprovaltimefrom104to17days.ThesuccessofthisworkledtoUCLPartnerspartneringwiththeworld’sbiggestclinicalresearchorganisation,Quintiles,tobecomeaQuintilesPrimeSiteinMay2013.

PrimeSitesreceivefirstnotificationofallQuintilestrialstakingplaceinEurope,providingopportunitiestoresearchersandpatientstoleadandparticipateinnationaltrials.Inaddition,QuintilesprovidesconsiderableinfrastructurecontributionsthatsupportstudyinitiationandrecruitmentandacommercialmanagementinputthathelpsthetrusttoplanforgrowthandthecompanytoattractmoretrialstotheUK.

SincetheestablishmentofthePrimeSite,UCLPartnershasbecomethehighestrecruitingQuintilessiteintheworld.

Expanding the reach:

In2015,UCLPartnersworkedwithlocaltrustsandQuintilestoexpandthePrimeSitebeyondnorthcentralandeastLondontoincludeEssex.Thismeansthatanadditionalonemillionpeoplewillhaveaccesstoclinicaltrialsinawaythattheydidnotbefore.

ThePrimeSiteisincreasingpatientaccesstoinnovativetreatmentandsupportingresearchcapabilitiesinourhospitals.

“It is well recognised that there is significant pressure to speed the drug development process in order to develop treatments that enable people to live healthier lives. We are proud to be working with the team at UCLPartners to further enhance our ability to recruit patients and investigators who are critical to an efficient and effective drug development process. We have gone from strength to strength since this relationship began and we are proud of what we have achieved together, for the benefit of London as a whole.”

Lindy Jones, Chair, European, Middle East and Africa Board, Quintiles

Impacts and outcomes:

• AnadditionalonemillionpeoplehavebetteraccesstoclinicaltrialssincethePrimeSitewasexpandedtoEssexin2015

• UCLPartnersisthehighestperformingPrimeSiteintheworld(inallcategoriesmeasured,including:recruitmentnumbers,recruitingtherightpatient,qualityandlowratesofnon-enrolees)

• BetweenApril2015andFeb2016,619patientsintheUCLPartnersregiontookpartinQuintilestrials,morethandoublingthetargetsetbytheclinicalresearchorganisation

• Forevery100patientsrecruited,atrustreceivesanaverageof£1m

• Forevery100patientsrecruited,atrustalsosavesapproximately£6mincostsoftreatmentifthosepatientswerenotontrialsandwereaccessingnormalcare


ThemodelhasbeensosuccessfulthatUCLPartnershasbeenapproachedbyotherindustrycompaniestoreplicatethemodelforthemintheregion.

Partnering with industry to increase patient access to innovative treatments and clinical trials

INFOCUS


The challenge:

AlthoughtheNHShasahistoryofinnovation,theFive Year Forward Viewrecognisedtheneedtobetterembraceinnovationinordertoaddressthepressuresthehealthandsocialcaresystemisfacing.State-of-the-artdevelopment,cost-effectivesolutionsandnewwaysofdeliveringcareareessentialtoimprovingpatientoutcomesandthehealthofthenation,butitisoftendifficultforinnovationstobeimplementedatscaleandpaceinsuchahugesystem.

Addressing the challenge:

Atthebeginningof2015,NHSEngland,UCLPartnersandtheHealthFoundationlaunchedacallforapplicationstotheNHSInnovationAccelerator.ThisnewprogrammeaimstocreatetheconditionsandculturalchangenecessaryforproveninnovationstobeadoptedfasterandmoresystematicallythroughtheNHS,andtodeliverexamplesintopracticefordemonstrablepatientandpopulationbenefit.

InJuly2015,17FellowsfromtheUKandabroadwereannouncedasthefirstcohortofinnovatorswhowouldreceivesupporttotaketheirinnovativetechnologiesandservicestothewiderNHS.TheUCLPartnersprogrammeteamprovidestheFellowswith:

• Mentorshipfrominternationalhealthcareleaders• PairingwithanAHSNlead• Quarterlylearningevents• Peer-to-peersupport• Adhocspecialistinformationsessions,asrequired(eg:

procurement,NHScommissioning,healtheconomics,businesscasedevelopmentetc.)

• NavigationtoexistinginnovationinitiativeslocallywithinAHSNs(eg:SETsquared)andnationally(eg:vanguards)

• Accesstoabursarytosupportdelivery• Optiontocontinuewithintheprogrammebeyondthe

initial12months.

Sincethebeginningoftheprogramme,UCLPartnershasworkedwiththeFellowstounderstandthebarriersandenablersexperiencedinimplementinginnovations;NHSEnglandhashelpedtounblocksystemicbarriers,andthecountry’s15AcademicHealthScienceNetworkshaveassistedinachievingadoptionintoclinicalpractice.


Withinthefirstninemonthsoftheprogramme,theFellowshavemadeaconsiderableimpact:

• Overthreemillionpatientsarebenefittingfromaccesstotheinnovations,including:apps,safetydevicesandon-linenetworks

• Anadditional68NHSorganisationsareusingoneormoreofthe17newinnovations

• Morethan£8minfundinghasbeensecuredfromexternalsources,aneightfoldincreaseoftheAccelerator’sinitialinvestmentof£1m

AselectionofNIAachievementsinclude:

• JoinDementiaResearch-anationalservicematchingpeopleinterestedinparticipatingindementiaresearchwithsuitablestudies-enrolled4,938dementiapatientsin62studiesacross115sites,andhasover17,000peopleinterestedindementiastudiesregisteredonthewebsite

• NeuroResponse-aspecialistelectroniccareplantobeaccessibleacrossprimary,secondaryandurgentcareforpatientswithlongtermneurologicalconditions-isnowintegratedwithNHS111.

• Nervecentre-awholehospitaldigitalplatformthatenablesdoctorsandnursestocarryoutpatientobservations,handoversandclinicalassessmentselectronically-isnowusedinover30trustsintheUK.Independentresearchidentifieda70%reductioninclinicalincidentssuchaspatientsdeterioratingbecauseofadelayinfindingtherightdoctoranda100%reductioninavoidabledeathsout-of-hours.

• HealthUnlocked-asocialnetworkthatallowspatients,caregiversandhealthadvocatestoconnecttootherslivingwithsimilarconditionsandhavingsimilarexperiences-hasgrowntomorethan500user-generatedspecialisedcommunities,andhasover3.5millionvisitspermonthglobally.

• MyCOPD-anonline24-hourself-management,education,expertadviceandpulmonaryrehabilitationplatformforpatientswithchronicobstructivepulmonarydisorder(COPD)-hasbeenimplementedbyanumberofCCGs.


AsecondwaveoftheprogrammelaunchesinJune2016,whichaimstorecruitafurthereightfellows.

NHS Innovation Accelerator: bringing innovative technologies and services to over three million patients

INFOCUS

Over3 million patients are benefiting from

access to new innovations



“I have used myCOPD for 9 months, I use it every day. Last year, before using myCOPD I had 12 exacerbations, this year I have had just 2. I now know when and how to take my medication, when to use my rescue pack and perform my rehab exercises most days.”

Paul, myCOPD user

UCLPartnersAnnualReport2015/16•Improvement,qualityandleadershipdevelopment26

UCLPartnersfocusesonfourkeyareasofworktosupportorganisationsandindividualstodevelopcapabilityandinfrastructuretoimprovequality,patientsafetyandexperience,alongsideincreasingefficiency.Theseare:

1. SupportthelocalhealthsystemandindividualstoimprovequalityandincreaseefficiencyandtosupportleadershipthatenablestransformationinlinewiththeFive Year Forward View

2. Supportourpartners,throughthePatientSafetyProgramme,toimprovethesafetyofpatientsanddevelopapatientsafetylearningcultureaswellasimproveefficiency(Findoutmoreonpage21)

3. Developadeeperunderstandingofhealthneedsandexpectationsforourpopulationbycontinuingtobuildstrongerpartnershipwith,andleadershipby,patient,carer,communitynetworksandorganisations

4. Supportthesystemtomaximisetheuseofinformaticsasanenableranddriverofhighqualitycarebothwithinorganisationandacrosshealtheconomies.

Patient engagement and involvement

Thepatientengagementandinvolvementprogrammeaimstoembedtheinvolvementofpatients,carersandthepublicintheworkofthepartnership.Thisyearhasfocusedonsignificantlyimprovingcollaborationandco-ordinationacrossmemberorganisations,andunderstandingthehealthexpectationsandchallengesfacingourpopulation.Progresshighlightsfor2015/16:

• 3,000patientsandcarerswereengagedthroughUCLPartnersprogrammes,collaboratingwithpartnersinthedevelopmentofnewsystemsofhealthandcare

• UCLPartnersdevelopedanInvolvementLeadsNetworkthatprovidespeersupport,guidanceandstrategiccollaborationtoinvolvementandengagementstaffacrossthepartnership,withan84%increaseinpartners’InvolvementLeadsengaged-totalling160people-duringtheyear

• Workinginpartnershipwithpatientsandstaff,forumeventsandmasterclasseswereheldonimprovingpatientexperienceandmethodsforbetterpatientinvolvement,bringing300attendeestogethertosharelearning.

Improvement, quality and leadership development

©ROYA

LFR

EELONDONNHSFO

UNDAT

IONTRU

ST

3,000 patients and carers involved

in UCLPartners projects

UCLPartnersAnnualReport2015/16•Improvement,qualityandleadershipdevelopment27

Developing capability within and beyond the partnership

UCLPartnersisworkingtosupportthelocalhealthsystemandindividualstoimprovequalityandincreaseefficiencyandtosupportleadershipthatenablestransformationinlinewiththeFiveYearForwardView.

Progress highlights:

• Launched,recruitedandcommenceddeliveryoftheinauguralUCLPartnersImprovementFellowsProgrammeduring2015/16–thefirstprogrammerunbyUCLPartnerstobuildimprovementcapabilityofindividualsacrossthepartnership.Througharigorousrecruitmentprocess,22peoplefromthepartnershipreceivedaplaceontheprogramme,whichprovidestheopportunityforopendialogueinasafeenvironment,awayfromtheusualworkplace.Itofferstimeandspacetoreflectandplanimprovementwork,andlearnfromtopimprovementexperts.

• SupportedtheHealthFoundationandNHSEnglandinthedevelopmentoftheQInitiative–bothinrelationtohaving10QparticipantsacrossUCLPartnersbutalsothroughinvolvementinanumberofdifferentdesigngroups

• Providedbespokesupportforanumberofchallengedtrustsinavarietyofways–fromleadingboarddevelopmentsessions,toconductingdiagnosticsofcertainservicesandfunctions

• TheModelforImprovementTraininghasbeenagreatsuccesswithsessionsbeingfullybookedandorganisationsenquiringaboutbespokequalityimprovementtrainingandsupport–ouraimistobuildonthesuccessofthisnextyear.

Supporting the development of informatics to drive high quality care

WithanationalfocusonjoininguphealthandcareservicesforthebenefitofpatientsandpopulationsthesustainabilityoftheNHS,connectivityofdatasourcesandinformationexchangebetweencareprovidersisvital.Byworkinginpartnershipandunderstandingthestrengthsofindividualandgroupsoforganisations,UCLPartnersisfacilitatingknowledgesharingthatwillhelptodriveimprovementsacrosstheregion.


• Sharinglearningfromapartnership-wideenvironmentscanledtoUCLPartnershelpingNHSEnglandtodevelopitsnationalDigitalMaturityProgramme.

• UCLPartners’supportexpandedintoleadingNHSEngland’smodeldevelopmentinconsultationwithotherAHSNs,amarketscanonsuitabletoolsfortheassessment,thendeliveringthesurveyandanalyticsbuild,whilstprovidingendusersupportthroughout

• TheDigitalMaturityIndexsurveywaslaunchednationallyinNovember2015,andanunprecedented>99%completionratewasachievedbyFebruary2016acrossallacute,community,mentalhealthandambulanceservicesinEngland.

Forfurtherinformation,pleaseseepage 29.

©BARK

ING,H

AVER

INGANDRED

BRIDGEUNIVER

SITYHOSPITALSNHSTR

UST

INFOCUS

UCLPartnersAnnualReport2015/16•Populationhealthandsystemtransformation28

Care City has two focus areas:

1. Healthy ageing: Frailolderpopulationsareagrowingproportionofsociety,withcomplexandmultipleneeds,andagroupwithwhomthewholesystemofcareinteracts.HaveringhasthedistinctionofbeingLondon’soldestpopulationandhasthehighestproportionoftheoldestold.

2. Social regeneration:BarkingandDagenhamhasboththehighestratesofunemployment(10%)andthelowestlevelsoflifeexpectancyinLondon(77formen,82forwomen).CareCityrecognisestheknowninterrelationshipsbetweensociety,employmentandhealth,sotheprogrammeaimstobringinvestmentandopportunitytoregenerateadeprivedpopulation.

Overthelastyear,UCLPartnershasworkedwithCareCitytosupportastrategicreviewoftheprogramme,groundingtheorganisation’sambitionsinwhole-systempartnershipforthebenefitofthecommunity.Witharevisedvisionandremit,CareCityhasbeenawardedtwoimportantdesignations,withleadership,academicandsystem-widenetworksupportfromUCLPartners.

InJanuary2016,CareCitywasannouncedasoneofsevenNHS Innovation Test Bed sites,andtheonlyoneinLondon.Overthenexttwoyears,the£1.8mgrantfromNHSEnglandwillenableimplementationandevaluationofnineinnovationsthatwillimprovecaredeliveredtopeoplewithlong-termconditions,improvetheexperienceofpeoplewithdementia,andimproveresilienceofcarers.ThreeoftheinnovatorsarepartoftheNHSInnovationAcceleratorProgramme.Thistestbedfundingwillenableinnovators,socialentrepreneursandsmallandmediumsizedenterprisestorapidlytestandimplementinnovationsinreal-lifesettings,anditerateandadjusttheirsolutionsbasedonevaluationtomaximiseimpact.AnembeddedresearchteamfromUCLwillcreatenovelmethodologiesforpragmaticevaluationthatwillsupportadaptationofinnovationsandimplementationapproachesasappropriate,andcreatethenecessaryevidencetosupportfuturespread.

InMarch2016,CareCitybecameoneoftenNHS England Healthy New TownsitesinEngland.Itwillensurethe10,800newhomesplannedfortheBarkingRiversideareanotonlyprovideanenvironmentthatpromoteshealthandwellbeing,butwillalsoensuretheysupporthealthyageing.Homeswillbeeasilyadaptableforchangingneedsandsocialspaceswillpromoteinclusionandparticipation.UCLPartnerswillworkwithCareCity,thecommunity,andwithlocalhealthandsocialcareleaderstodesignintegratedservicesforthelocality.

TheprogrammeofworkatCareCity-acrossfourdomainsofcommunity,innovation,researchandeducation-continuestoevolveatpace.UCLPartnersisdelightedtobeamemberoftheExecutiveGroupofCareCityandsupportitsongoingprogramme,andthesystemwidepartnershipthattheleadersacrossBarkingandDagenham,HaveringandRedbridgehavefostered.

“Care City was always very exciting but highly ambitious and therefore a risky proposal for the founding partners. On this basis the weight of UCLPartners and their continued presence and support for the project has been really important and is adding great value and credibility to Care City and its many innovative initiatives and plans for the future.”

John Brouder, Chief Executive, North East London NHS NHS Foundation Trust

Care City

Care City is a ground breaking new initiative to improve care for older people while also helping to regenerate one of London’s most deprived communities. Launched in January 2016 by North East London NHS Foundation Trust and the London Borough of Barking and Dagenham, Care City is a centre for healthy ageing, innovation, research and education based in Barking. Today it represents a system-wide partnership of north east London’s health and social care organisations, academia and the community.

INFOCUS


The challenge:

ThecomplexityofhealthcaredeliveryintheNHSmeansthatthereisaneedtofacilitateappropriateaccesstopatients’informationateachstageoftheirjourneythroughthehealthcaresystem,nomatterwhereorwhentheyreceivecare.Inordertojoin-updataacrossorganisationsandcreateapaperlessNHS,ithasbeenessentialtofirstunderstandthebaselinelevelofdigitalmaturityofprovidersandlocalhealtheconomiesacrossthecountry.

The benefits:

Havingjoined-up,paperlessinformationacrossthehealthandcaresystemhasclearbenefits.Ithasthepowertosupportpeopletolivehealthierlives,whileimprovingtheirexperienceandempoweringthemtotakeamoreactiveroleintheirhealthandwellbeing.Itcanenhancepatientoutcomesashealthcareprofessionalshavetherightinformationattheirfingertipseverytimeandcareservicesacrosslocalhealtheconomiescanbedeliveredmoreefficiently.Justasimportantly,itcanunlockinsightsforpopulationhealthatscaleandsupportthedevelopmentofnewtreatmentsthroughhavinganoverviewofawholecommunity.

Facing the challenge

Throughsharinglearningfromascanofthedigitalenvironmentacrossthelocalpartnership,UCLPartnerswascommissionedbyNHSEnglandtodevelopandsupportitsnationalDigitalMaturityProgrammetounderstandwhereweareasanationalsystem;highlightingkeystrengthsandgapsinproviders’abilitytooperatepaper-freeatthepointofcare.

UCLPartnersworkedinpartnershipwithotherAHSNstoconductaliteraturereview,supportthecreationofthesurvey,evaluatetoolsfortheassessment,delivertheonlinetool,andcreateananalyticsplatformfortheresults.WorkingwithBilue,asmall-mediumsizedenterprise,UCLPartnerssupportedNHSEnglandinpresentingtheresultsinameaningfulwaybothtoprovidersandCCGsleadinguptothepublicationofresultsonMyNHS.

Moving towards a paperless NHS


BetweenNovember2015andFebruary2016,thedigitalmaturityindexsurveyreceivedanunprecedentedcompletionrateof99%acrossallacute,community,mentalhealthandambulanceservicesinEngland.

ThishelpsNHSEngland,andUCLPartnersforthelocalarea,understandthereadinessoforganisationstobecomepaperfree.Itshinesalightonthosefurtheralongontheirjourneytoadoptingdigitalworkingpracticesfromwhomwecanlearnimportantlessons,andallowsustoseewhereextrasupportisneeded.Throughself-assessment,providerswerealsoabletoindicatecapacityandcapabilitygapsinlocaleconomiestotransformservicesandoperatepaperfree.

©BART

SHEA

LTHNHSTR

UST


Population health and transforming systems

UCLPartners aims to improve health outcomes for patients and the population through supporting the system to implement and evaluate integrated pathways and new models of care.

Oursystemtransformationteamfocusonthreekeyareastobringasystem-wideapproachtoinnovationintopracticeandimprovementtohelpthehealthandcaresystemtodeliverthebestpossiblecareforpatients:

1. Supportingthedevelopmentofintegratedpathways,withagreaterfocusonprimarycare,prevention,earlierdiagnosisandparityofmentalhealth

2. Enablingorganisationstodevelopoutcome-drivensolutionstothemostpressinghealthcarechallenges,throughsupportingtheimplementationofexistingevidenceandgenerationofnewevidence

3. Supportinglocalpartnerships,includingthosedesignatedasnationalorlocalvanguards,toimplementandevaluatenewmodelsofcareandsupportwideradoption.

Progress highlights of 2015/16

Supporting the implementation of Academic Medical Centres to create leading centres of discovery science and clinical practice

Improving specialist cancer and cardiac care

FollowingcommissionerapprovalforthereconfigurationofspecialistcancerandcardiovascularservicesinnorthcentralandeastLondonin2014,UCLPartnershasbeensupportinghealthandacademicpartnerstoestablishthenewintegratedsystemsofcareforthesedebilitatingconditionsthatcausealmosttwo-thirdsofprematuremortalityinourregion.


Cardiovascular care

• TheBartsHeartCentre–thenewhubforspecialistcardiovascularcareinnorthcentralandeastLondon– officiallyopenedinMay2015.Sincefacilitatingthereconfigurationofcardiacservices,UCLPartnershascontinuedtosupportthedevelopmentofthecentrewithdirector-levelrepresentationontheBartsHeartCentreboard.

• ThecentreistheUK’slargestheartcentre,andthebiggestcentreofexcellenceforadultswithcongenitalheartdisease.Sixmonthsafterthecentreopened,itsstandardisedhospitalmortalityindex(SHMI)was0.535,whichisequivalenttoavoidingapproximately340deathsperyear.Otherimprovementsincludequickerinter-hospitaltransfers(targetnowexceededbyoneday),halvingofhospitalcancellations,andfullcomplianceagainstreferraltotreatmenttargetsacrossallspecialties.Sevendayservicesareinplaceforemergencyelectrophysiologyandacrossarangeofsub-specialties,andatUniversityCollegeHospital(forgeneralcardiology).

• UCLPartnershasengaged14ClinicalCommissioningGroupsinthedevelopmentandimplementationofnewmodelsofcareforpeoplewithheartfailureandatrialfibrillation(thelatternowadoptedpan-London).Theprogrammehassupporteda12%increaseinanticoagulationratessince2012/13leadingtoanestimated100strokespreventedacrosstheregioneveryyear.BartsHeartCentrehasnowappointedaClinicalLeadforpreventionwhowillworkwithUCLPartnerstotransformcardiovascularoutcomesforthepopulation.

Cancer care

• Duringtheyear,UCLPartners’London Cancer teamsupportedthetransitionofspecialistcancerservicestotheAcademicMedicalCentreatUniversityCollegeHospital,supportedbyTheRoyalLondon,StBartholomew’s,TheRoyalFreeHospitalandQueen’sHospitalinRomford.Improvedoutcomesarealreadybeingdelivered,forexample:~ Inrenalcancer,surgicalcomplicationand mortality

ratesattheRoyalFreeLondonarebetterthanthenationalaverage.Ratesforkidneysparingsurgeryare20%higherattheRoyal Freethannationally.

~ Inprostatecancer,roboticsurgeryatUniversity College London Hospital has resulted in fewer complications for patients, including incontinence and impotency.

Amanagementpathwayforsmallmassrenalcancerhasresultedin55%ofpatientsavoidingtheneedforsurgicalintervention,withincreasedpatientsafetyandbetteroverallexperience.

• London Cancerhasalsofocusedonimprovingearlydiagnosisrates,patientexperienceandsupportforpeoplelivingwithandbeyondcanceracrossnorthcentralandeastLondonandwestEssex.Highlightsinclude:~ 91%ofpatients(totalof75)havebeenoffereda

firstappointmentwithinfiveworkingdaysofGPreferralthroughanewrapidaccessdiagnosticcentreforsuspectedgastro-intestinalcancers

~ Dataforone-yearsurvivalshowscontinuedimprovementwithintheregion,butthereiscontinuedvariationacrossthesystem

~ AlleightpartnersofLondon Cancerarenowdeliveringholisticneedsassessmentsforpatientsacrossfivetumoursites

Improved survival for patients with heart disease, equivalent to

340lives saved per year

©QUEENM

ARY

UNIVER

SITYOFLO

NDON

~


~ AtBarking,HaveringandRedbridgeUniversityHospitalsNHSTrustandUCLHtherehasbeena61%increaseinthenumberoftreatmentsummaries

~ Therehasbeena15%increaseinthenumberofpatientsattendinghealthandwellbeingeventsposttreatment.

• FurtherfundinghasbeensecuredfromMacmillanandCancerResearchUKtocontinueprogrammesonearlydiagnosisandpatientexperience.

• UCLPartnerssupportedUniversityCollegeLondonHospitalsNHSFoundationTrust(UCLH)initsbidtobedesignatedasoneofthreedeliveryarmsofthenationalCancerVanguard.TheChiefMedicalOfficerofLondon CancerhasbeenappointedtotheUCLHcancercollaborativetosupportthenationalvanguard.

Proposed academic health campus at St PancrasUCLPartnersissupportingpartnerstoworktogetherontheearlystagesofplanninganacademichealthcampusatStPancras,focusedoneyesandvisionandmentalhealth.Iftheproposalmovesahead,thiscouldbeanexcitingopportunityforajointcampussupportingtheaspirationsofmentalhealthandeyesandvisionwithsharededucationfacilities,sharedresearchonearlydetectionofdementiathroughchangesinspatialawareness,andothertestsofcognitiveimpairment.

Supporting the development and implementation of new models of care for children and young people

Duringtheyear,UCLPartnershassupportedtheimplementationofi-THRIVE,amajorservicetransformationforchildandadolescentmentalhealthservices(CAMHS)

• i-THRIVEisnowbeingimplementedacross11acceleratorsites,inpartnershipwiththeTavistockandPortmanNHSFoundationTrust,AnnaFreudCentreandtheDartmouthCenterintheUS

• HalfofCAMHStransformationplansinEnglandandWalesnowreferenceintentiontoadopti-THRIVEprinciples

• Thei-THRIVEteamhassecuredover£1mingrantfundingtosupportfurtherdevelopmentanddelivery ofthemodel.

50% of CAMHS transformation plans

in the country intend to adopt the i-THRIVE principles

©QUEENMARYUNIVERSITYOFLONDON


Supporting the development of system-wide planning

Throughout2015/16,UCLPartnershasprovidedbespokesupportforpartnersindevelopingplace-basedsystemsofcarethatwilldeliverimprovedpopulationhealthandgreatersustainability.

• TheLondonDevolutionPilotswereannouncedinDecember2015,withfouroutoffivelocatedwiththeUCLPartnersregion.UCLPartnersisworkingwiththeLondonHealthandCareDevolutionProgrammetosharethelearningbetweenandbeyondthepilotsandisdevelopingaplatformtosupportsharedlearningandwiderdisseminationin2016/17

• UCLPartnershasprovideddirector-levelsupporttothedevelopmentoftheBarkingandDagenham,HaveringandRedbridgeprogramme,inlinewiththeCareCityTestBedsiteandtheHealthyNewTownsdesignationforwhichwehaveprovidedon-sitedirectorsupport.(Findoutmoreonpage28)

• UCLPartners’ManagingDirectorservedasinterimchairoftheMidandSouthEssexSuccessRegimetosupportthepartnersintheproductionofadetailedimplementationplan.WithcontinuedsupportfromUCLPartners,thegrouphascreatedaconsensus-agreedplantoresolveissuesintheregion.

Gaining new insights to improve commissioning decisions and delivery of new models

UCLPartnershasworkedwithmultiplepartnersthisyeartohelpthemunderstandmoreabouttheneedsoftheirpopulationsandhowtocommissionthemosteffectiveservices.During2015/16,UCLPartnershas:

• ConductedasystematicreviewwiththeCLAHRCNorthThamesintointerventionsandinitiativesthatdelivercostsavingswithoutcompromisingquality.Theaimofthereportistohelpinformcommissioningdecisionsinsupportoflocaltransformationplans(tobepublishedinMay2016)

• Completeda‘rootcauseanalysis’studyof110patientsonbehalfofCamdenClinicalCommissioningGrouptounderstandthefailuresinpreventionthatledtopatientssufferingamajorcardiovascularevent

• Evaluatednewacuteneurologymodelsacrossthreehyper-acuteneurologyunitsinLondontoinformtheworkoftheStrategicClinicalNetworkinextendedtheapproachtocaretootherhospitalsinLondon

• Completedanevaluationintothechildren’shospital@homemodelinWhittingtonHealthtosupportoptimalmanagementofchildrenathome.Theevaluationassessedinitialevidenceoftheabilityofhospital@hometoreducechildhospitalattendances.Initialfindingssuggestthatpatientshadaverygoodexperienceofcareundertheprogrammeanditresultedinareductioninhealthcareresourceusethatequatedtoatotalaveragesavingof£928perpatient.Asaresultitislikelytheserviceiscostneutral.Thegreatestcostsavingwasforpatientsaged3to5,withatotaladjustedcostsavingperpatientof£1,763comparedtonon-hospital@homepatients.Thefullreportwillbeavailableinsummer2016.

• Developedandtestedtheperinatalmentalhealthscorecard–whichaimstoimproveoutcomesfor0-5childrenandtheirfamilies-withfourpartnerorganisations.Thescorecardusedinonesiteshowedasignificantincreaseinscreeningforbothantenatalandpostnataldepression,andwasshowntobecost-effectiveinthemodelledcost-effectivenessanalysis.UCLPartnersrecommendsrefining,upscalingandevaluatingthescorecard;evaluatingitseffectivenessasaQItool;carryingoutfurtherworkonthevalueofthescorecard;andprovidingcapacitytospreadthemethodologytootherareasofhealthcare.

• WorkedinpartnershipwithaSMEtodevelopachildhealthinformaticsplatformtoimproveunderstanding oflocalpopulationneedsandpilotedthisinNewham.

INFOCUS

UCLPartnersAnnualReport2015/16•NewhamPartnershipProgramme34

The challenge:

TheLondonboroughofNewhamhasoneofthemostdiverseandmostdeprivedpopulationsinthecountry.Theboroughhasaboveaverageprevalenceofdiabetes,childandadultobesity,andahighpopulationturnover.Theneedforhealthimprovementisurgent.

Addressing the challenge

NewhamClinicalCommissioningGroupandUCLPartnershavebeenworkingtogethersince2013tofindnewsolutionstoarangeofhealthissuesaffectingthepopulationofNewham.TheNewhamPartnershipProgrammeaimstoimprovehealthoutcomesthroughharnessingeducationandresearchforthepopulationofNewham,andissupportedbyarangeofpartners,including:theLondonBoroughofNewham,voluntarysectororganisations,EastLondonNHSFoundationTrust,BartsHealthNHSTrust,localschools,UniversityofEastLondon,QueenMaryUniversityofLondonandUCL.

Theprogrammeharnessescollaborationbetweenhealth,academic,educationandimprovementexpertsontheissuesthatmattermosttoimprovingthehealthoflocalpeople.

Impacts and outputs:

Stakeholdersintheboroughidentifiedeightchallengestoaddresstohavethemostpositiveimpactonthehealthoftheborough.Duringtheyear,thefollowingtwoprogrammeshavebeencompleted:

• Building emotional resilience in young people - More than Mentors

UCLPartnersdevelopedandtestedthefeasibilityofimplementingabestpractice,peermentoringprogramme.Followingproofofprincipleinthesuccessfulpilotstudy,theprojecthassecured£550,000fromaDepartmentofHealthvolunteeringfundtoscaleuptheschemeineastLondonoverthenextthreeyears.

• First4Health Federation WorkingwiththeClinicalEffectivenessGroupat

QueenMaryUniversityofLondontoapplyQualityImprovementmeasurestoenableimprovementacrossarangeofmetricsforparticipatingpractices.Byestablishingaperformancedashboardforimprovement,theFirst4HealthFederationachieved:~ Increaseduptakeofchildhoodimmunisations~ Improvedthechronicdiseasecontrolofpatients

withcoronaryheartdiseaseacrossthepractices~ Increasedrecruitmenttoestablishedresearch

trialsbybuildinglinkswiththePrimaryCareResearchNetwork.

Newham Partnership Programme

Highlights from ongoing programmes include:

• Building an understanding of pre-diabetes to provide joined-up information about risks, and piloting a patient pathway.

UCLPartnersconductedthefirstmappingexerciseofpre-diabetesriskinNewham.Throughthisprocess, wenowknow:~ 38,980peopleinNewhamareathighriskof

developingdiabetes~ 8,781peopleinNewhamarecodedwithpre-

diabetesonthediabetesriskregister~ 35%ofwomeninNewhamprogressfrom

gestationaldiabetestotype2diabetesinfiveyears. Followingthefindingsofthisworkstream,Newham

wasannouncedasafirstwavepilotfortheNationalDiabetesPreventionProgrammeinNovember2015.

• Exploring the scope and feasibility of a peer-supported diabetes self-management programme for young people.

Sincejoiningtheprogramme,youthmembersofthesupportnetworkhavehadnoA&Eadmissions.FindingsfromthegroupsarecurrentlybeingusedtoredesignthelocalYoungAdultService,soitbettermeetstheneedsofNewham’syoungpeoplewithdiabetes.

©ADAMSCO

TTB

ASILD

ONANDTHURR

OCK

UNIVER

SITYHOSPITALSNHSFO

UNDAT

IONTRU

ST

UCLPartnersAnnualReport2015/16•NewhamPartnershipProgramme35

• Mitigating the impact of a transient population on primary care services.

UCLPartnersanalysedthemobilityofthepopulationinNewhamtohelppartnersaccuratelypredictthedemandforservices.ForthefirsttimeinNewham,wenowknow:~ Thereis20-40%annualturnoverinNewhamGP

patientlists~ Akeyissueislatepatientregistrationwith

practices,resultinginlatepresentationofdiseaseinprimarycareorA&E

~ Therearedifferentbehavioursindifferentcommunitieswhichwillneedtobeaddressedaspartoftheco-designofinterventionsinthenextphaseoftheproject.

• Enhancing the diagnosis and prevention of cardiovascular disease through integrated use of e-health records. Evaluating and redesigning the health check into a personalised system that empowers patients to modify their risk.

ClinicalpathwayEMISandCernatemplatesfordiagnosisandmanagementofcardiovasculardiseasearecurrentlybeingrolledoutinpilotpractices.ThehealthcheckworkhasbeenpresentedatanationallevelattheNHSAnnualHealthCheckconference2016.

• Improving quality in primary care through training, testing new approaches and implementing systematic Quality Improvement (QI) approaches.

AsmallscaleQualityImprovementcollaborativewaslaunchedwithninepracticestoapplyimprovementscienceintheirpracticesettingstoimprovethecareprovidedtopatients.Keyimprovementswerefoundinmedicinereconciliationandresultshandling.ThesuccessandlearningfromthisworkwillfeedintotheproposedNHSNewhamCCGQIAcademy.ThisworkstreamhasrecruitedsevenQIfellowsandhassupportedthefurthereducationofthreeGPsenrolledinMScprogrammes.AllofthesearePrimaryCarestaffworkinginNewham.

• Co-creating a prediction and prevention programme to enable evidence-based practice for low birth-weight babies

UCLPartnersconductedresearchintotheprevalenceoflowbirthweightbabiesinNewham.ForthefirsttimeinNewham,wenowknow:~ 10.4%ofbabiesborninNewhamin2013weighed

under2500gcomparedto7.4%inEngland~ 62%oflowbirth-weightbabiesinNewhamare

bornearly~ 18ofNewham’s20wardshaveratesoflowbirth-

weightbabieshigherthantheEnglandaverage

Thenextstepistoco-designapreventionprogrammeandpilotinanumberofpracticesinNewham.

UCLPartnersAnnualReport2015/16•NIHRCLAHRNorthThames36

NIHR CLAHRC North ThamesThe NIHR CLAHRC North Thames conducts ground-breaking research that will have a direct impact on the health of patients with long-term conditions, and on the health of the public. The CLAHRC brings together world-leading universities, the NHS, UCLPartners, local authorities, patients, the public, industry and charities in a 55-strong partnership.

Progress highlights from 2015/16

Increasing uptake of bowel cancer screening

The challenge:BowelcanceristhesecondcommonestcauseofcancerdeathintheUK.EarlydiagnosisimprovessurvivalandtheNHSBowelCancerScreeningProgramme(BCSP)inviteseveryoneaged60and74inEnglandtotakepartinscreeningeverytwoyears.Onlyaroundhalfofthoseofferedscreeningtakeuptheoffer.Pooruptakeofbowelcancerscreeningleadstolatecancerdiagnosisandcanresultinpreventabledeath.

Meeting the challenge: TheASCENDstudy(fundedbyaNIHRProgrammeGrantforAppliedResearch,andledbyCLAHRCresearchers)comprisedfourmajorpopulation-levelclusterrandomisedcontrolledtrialsconductedintheEnglishBowelCancerScreeningProgramme.

Theresearchteamdevelopedandexaminedtheeffectivenessoflowcost,simpleinterventionsinincreasingoveralluptakeofbowelcancerscreeningandinreducinginequalitiesinuptake.Theyfoundthatamendingthescreeninginvitationbyaddingasimpleendorsementbytherecipient’sgeneralpracticeincreaseduptakeoverall.

Outcomes and impact:Basedoncurrentnationalscreeningfigures,includingasimpleendorsementfromapatient’sGPwouldresultinalmost40,000extrapeoplescreenedeachyear.Thisislikelytoamounttoanadditional165peoplewithpolypsclassedashighorintermediateriskand61peoplewithacolorectalcancerbeingdetectedeachyear.TheresultswerepublishedintheLancetinDecember2015.

Giventheimpactatzerocost,theUKNationalScreeningCommitteeapprovedimplementationofGPendorsement,andtheBCSPLondonHubagreedtoimplementGPendorsementimmediately.NHSEnglandLondoniscurrentlyupdatingGPpracticenamestoallowforinitiationofGPendorsementbyApril2016.

Evaluating co-location of GPs and welfare advice

The challenge: NHSClinicalCommissioningGroups(CCGs)faceextensivechallengesinsettingfundingpriorities.DemandonGPsfrompatientsforsupportrelatedtobenefitsclaimsandsocialproblemsassociatedwithlowincomeanddebthasbeenestimatedtoaccountforaconsiderableproportionofconsultations.CCGsareseekingrobustevidenceonwhetherco-locatingwelfareadvisersinGPpracticesresultinimprovedwellbeingofpatientsandreducecostlydemandsforhealthservices.

Meeting the challenge: SinceDecember2015,aCLAHRC“embeddedresearcher”hasbeenworkingcloselywiththeLondonBoroughofHaringeyCounciltoevaluatewhetherthisco-locationimprovespatients’mentalhealth,andsubsequentlyreduceshowoftenpatientsvisittheirGP.Phase1ofthiscontrolledevaluationisbeingconductedacrosstwoLondonboroughsandwillcompleteinJuly2016,usinga“beforeandafter”modeltogaugetheimpactonpatients’mentalhealthandsubsequentsupport-seekingbehaviour,withcomparatordatafrompracticesnothostingwelfareadviceservices.

Inparallel,theCLAHRCisalsointerviewingwelfareadvisers,practicestaffandcommissionerstoelicittheimpactofco-locationontheirworkandhealthoutcomes.Finalresultswillbepublishedinearly2018.

“The research input is brilliant. It’s helping to develop robust evidence on the effectiveness of advice hubs in health settings to secure future funding and maybe scale up this initiative across the borough.”

Tamara Djuretic, Assistant Director of Public Health, Haringey Council

Collaboration for Leadership inApplied Health Research and Care

North Thames


Building research capacity – the CLAHRC North Thames Academy

Inthelastyear,theCLAHRC’strainingarm-theAcademy-hasexpandedallthreeofitsprogrammestobuildresearchcapacity.

• Short courses TheAcademydeliveredsixshortcoursesto160front-

lineNHSandpublichealthstaffin2015/16.Theone-daytrainingprovidesstaffwiththetoolsandmethodstheyneedtoapplyresearchbasedapproachestoassessmentofservicesanddecisionmaking.CoursesincludeIntroductionstoevaluationandeconomicevaluationandGettingresearchintopractice.Duetopopulardemand,theCLAHRChasdevelopedanonlineversionofitsIntroductiontoevaluationcoursesothatmorestaffacrosstheregionareabletotakepartinthisvaluabletraining.

• PhD doctoral programme ThePhDdoctoralprogrammehasrecruitedninestudents

thisyeartojointheYear1intakeofeight.StudentsundertakeappliedhealthresearchwhichisofdirectrelevancetotheNHS,patientsandthepublic.TheCLAHRCprogrammesupplementshostinstitutions’graduateschemes,creatingacommunityofstudentstraininginappliedhealthresearchwithastrongemphasisondevelopingpracticalskillstoflourishinbothhealthandsocialcaresettingsandacademia.

• Fellowship programme TheCLAHRCAcademysecuredafurther£500,000

awardfromHealthEducationEngland,toextendtheFellowshipprogrammetodevelopresearchleadersofthefuture.Thescheme,aimedatnurses,midwivesandalliedhealthprofessionals,enablesFellowstoworkonsecondmenttotheCLAHRCfourdaysperweekforoneyear,toworktowardsanapplicationforexternalfundingtocontinuetheirresearchstudies.ExistingFellowsincludeapharmacist,aphysiotherapist,amatron,nurseandhealthvisitor.

Challenges, solutions and future directions in the evaluation of service innovations in health care and public health

The challenge:IntheUKandinternationally,newmodelsofcaretoincreasequalityandefficiencyareconstantlyemergingandevolving.Thereisapressingneedtodevelopmethodstomeaningfullyevaluatethesecomplexinnovationsinchangingenvironments.

Meeting the challenge:TheCLAHRCconvenedandledahighlysuccessfulinternationalmeetingonthemethodologicalchallengesinLondoninJune2015.Thissymposiumaimedtosharenewandemergingapproachestotherobustevaluationofcomplexinterventions.ThemeetinginvolvedanunprecedentedpartnershipbetweenNIHR,theMedicalResearchCouncil,TheHealthFoundation,UniversitiesUKandAcademyHealth(thelargesthealthserviceresearchorganisationintheUSA).

Outputs and impact: Tosharelearningfromtheconferencewiththewiderhealthandcarecommunity,thekeyspeakerscombinedtheirpresentationswiththeoutputsfromin-depthdiscussionsatthemeetingtoproduceeightessays.Theessayswillbepublishedasane-bookinMay2016andcitedonPubMed.Theentireprocessfromideainceptiontopublicationofthee-booktook15months.


Highlighting and addressing sub-optimal asthma control in schools

The challenge:Asthmaaffectsapproximately1.1millionchildrenintheUK.Improvedasthmacontrolandincreasedself-managementcanreducehospitalisationsandmortalitysubstantially.

Meeting the challenge: ACLAHRCNorthThamesprojecttoassessasthmacontrolandmedicationadherenceamongstsecondaryschoolstudentswithasthmainLondon,hashighlightedthechallengesfacedbypupilsinmanagingtheircondition.

TheresearchteamvisitedsecondaryschoolsacrossLondonbetweenNovember2014andOctober2015tocollectdatausinganonlineassessmenttool.Theonlinequestionnaire,whichincorporatedtheAsthmaControlTest™(ACT),wascompletedby766participantsfrom24schools.Questionscoveredsymptomsandmedicationusageoverafour-weekperiodaswellasschoolabsencesduetoasthmaandhealthcareusageoverafourweek-period.Resultsshowed45.7%ofparticipantshadsub-optimalasthmacontrol,and56.4%ofparticipantsforgottotaketheirpreventerinhaleratleastsomeofthetime.

TheCLAHRCisworkingwithyoungpeopletodevelopasuiteofresourcestoencourageopendiscussionoftheconditionandimproveunderstandingamongpeers.Thisincludesaschool-basedself-managementinterventionconsistingofeducationalboardandcomputergamethatimprovesknowledgeoftriggersandinhalers,aswellasencouragingdiscussionofasthmabetweenpupils.Followingcompletionofthequestionnairedata,theresearchteamconductedfocusgroupsinfourschoolswith58participantswhopreviouslycompletedthequestionnaire.Thesefocusgroupsincludedtestplayingoftheboardgame,aswellasfeedingbacksomeoftheresultsofthequestionnairetoparticipants.Discussionsregardingpossibleexplanationsfornon-adherencewithasthmamedications,andideasforfutureinterventionswerealsoincluded.Theoutcomesofthequestionnairedatawillbeusedinconjunctionwiththefocusgroupdataandasystematicreviewofaschool-basedself-managementinterventionstoinformthedevelopmentofaschool-basedself-managementinterventiontobepilotedinLondon.

UCLPartnersAnnualReport2015/16•EducationLeadProvider39

Education Lead Provider

In 2015/16 UCLPartners continued to be commissioned by Health Education England to deliver postgraduate medical and dental education in 45 specialties across north central and east London, parts of Essex and Hertfordshire, with some programmes extending across the whole of London. Responsible for over 3,000 trainees, UCLPartners is the largest lead provider in England and has the opportunity to make a difference to patient care by adding value to the standard national training curricula.


• Adding value for educators UCLPartnersbelievesthatitisessentialtohave

highlytrainededucatorsandsupervisorsfortrainees.UCLPartnershasprovidedanumberdevelopmentprogrammesforeducationandclinicalsupervisorstosupporttheminachievingaccreditationinthoseroles.Atotalof905supervisorshavebeentrainedsince2012,with170receivingaccreditationin2015/16.Recognisingtheimportanceofsupportstaff,wehaveestablishedatrainingprogrammeformedicaleducationmanagerswhichhassofarinvolved13trustsfromtheregion.

“This programme has helped me to recognise the different ways I can help my trainees in identifying, planning and achieving their training objectives. It has especially helped build confidence in supporting trainees who may be in difficulties.”

DrMohanBhatt,DirectorofMedicalEducation,NorthEastLondonNHSFoundationTrust

• Adding value for partners Therehashistoricallybeenavariationintheavailability

ofresourcesandopportunityfortrainingacrosstheregion.Toaddressthis,UCLPartnershasdevelopedfacultygroupsinsimulationtrainingthatprovideforthemovementofequipmentandtrainingstaffacrosssitestosupporttrainingwherevertraineesareplaced.Inaddition,UCLPartnersestablishedamulti-professionalleadershipdevelopmentprogrammeforjuniordoctors,nursesandalliedhealthprofessionalstodevelopcoreskillstosupportafutureseniorNHSleadershiprole.Atotalof35stafftookpartinthe10-monthprogrammeduring2015/16.

• Adding value for trainees UCLPartnersaimstoequipalltraineesforawiderange

offutureroleswithintheNHSbyprovidingtrainingingenericskillssuchasleadership,qualityimprovementandpatientsafetymethodology.Wepromotecross-specialtycollaboration,forexample,paediatricandpsychiatrytraineesworkingtogethertobetterunderstandthementalandphysicalhealthinteractionsinchildren.

• Adding value for patients Engagingpatientsineducationandtraining,and

informingeducationandtrainingwithpatientexpertiseiskeytobetterpatientcare.TheUCLPartnersannualeducationconferenceinOctober2015focusedonpatient-centredcarewithexcellentfeedbackfromtheinteractionbetweenpatients,traineesandtrainers.Ourcurrenteducationprogrammeembedspatientinvolvementinallwedo.

“As a carer to young children with complex healthcare needs, I am continuously impressed by the openness and genuine desire on UCLPartners’ part to listen to and involve patients in their education programme.”

SibylleErdmann,PatientRepresentative

Looking to the future

Inlate2015HealthEducationEnglandcommissionedareviewoftheLeadProvidersystemoperatingwithinLondon.FollowingadetailedinspectionoftheUCLPartnersprovisionofeducationandtraining,weawaitthereportwithrecommendationsdueforpublicationinMay2016.

Wearealsoawareofthefinancialsavingsrequiredofthehealtheducationsectorduring2016/17.TheonusisverymuchonUCLPartnersandoureducatorstodelivervalueformoney.WeintendtodothisthroughanambitiousprogrammeofactivitieswhichunderpintheUCLPartnersstrategyforeducationdesignedtosupportourtraineestoprovidethecarethatourpatientsreallyneed.

©M

IDDLESEXUNIVER

SITY

GovernanceUCLPartners BoardTheroleoftheBoardistoactasthecustodianofUCLPartners’values–tobepatient-led,population-focused,developedinpartnershipanddeliveredatpace.ItsmemberschampionpartnershipworkingandcreatecollaborationbeyondthepartnershipwithorganisationsthatshareUCLPartners’strategicgoals.TheBoardoverseesthedevelopmentanddeliveryofUCLPartners’strategyandisaccountableforensuringthatcompanyrisks,legalresponsibilitiesandresourcesaremanagedeffectively.MembershipoftheboardincludestheChair,ManagingDirector,AcademicDirectorandChiefFinancialOfficerofUCLPartners,withseniorrepresentativesacrossthepartnershipaswellasindividualsexperiencedinprimaryandcommunitycarecommissioning,mentalhealth,wealthcreationandlocalgovernment.

Name Organisation Appointed Nominations Audit and risk Remuneration committee committee committee

Chair • •ProfessortheLordAjayKakkar UCLPartners March2014 (Chair)

Managing DirectorProfessorSirDavidFish UCLPartners Oct2009 •

CompanySecretaryDianaRawstron GoodmanDerrickLLP Oct2014

JohnBacon BartshealthNHSTrust Sep2015 •

PhilipWright BartsHealthNHSTrust April2015– • • August2015

CliffPrior BigSocietyCapital March2013 •

ProfessorSteveField CareQualityCommission March2013

LizChidgey EssexCares Sept2013

BaronessTessaBlackstone GreatOrmondStreetHospitalfor July2010 • ChildrenNHSFoundationTrust

ProfessorMartinMcKee LondonSchoolofHygiene& Feb2015 TropicalMedicine •

ProfessorBaronPeterPiot LondonSchoolofHygiene& Jan2014– • TropicalMedicine Feb2015

AndrewNebel MoorfieldsEyeHospitalNHS April2015 • FoundationTrust

ProfessorSimonGaskell QueenMaryUniversityLondon Oct2011

ProfessorRichardTrembath QueenMaryUniversityLondon Oct2011– Aug2015

DrDennisGillings Quintiles Sept2013

DominicDodd RoyalFreeLondonNHS July2009 • • • FoundationTrust (Chair)

ProfessorMichaelArthur UCL Sept2013 •

ProfessorSirJohnTooke UCLPartners,UCL Jan2010– Jul2015

ProfessorDavidLomas UCLPartners,UCL Oct2015

HelenJameson UCLPartners Oct2015

RichardMurley UniversityCollegeLondon July2010 • • • HospitalsNHSFoundationTrust (Chair)

UCLPartnersAnnualReport2015/16•Governance40

AllinformationandfilingsoftheUCLPartnersBoardareavailableontheCompaniesHousewebsite.

Sub-committees

TheUCLPartnersExecutiveGroup(forAHSNreporting)andtheAHSCBoardbothreportintotheUCLPartnersBoardandhaveacloserelationship.WhiletheCLAHRC,CRNandGenomicMedicineCentrehaveresponsibilitytoreportdirectlyintotheNationalInstituteforHealthResearchandNHSEngland,theyalsoreportinformallytotheUCLPartnersExecutiveGrouptoalignwiththewiderUCLPartnersstrategy.

Committeeroles:

• Remuneration committee:Ensurestheremunerationpracticeofthecompany,encouragesenhancedperformanceand,inafairandresponsiblemanner,rewardsindividualsfortheirpersonalcontributiontothesuccessofthecompany.

• Nominations committee:EnsuresUCLPartnershasaboardwiththerightcompetencies,skills,experienceanddiversitytoassisttheorganisationtodevelopanddeliveronambitiousstrategiesforthefuture.ItisresponsiblefortheselectionofcompanyBoardmembers,theChairandtheManagingDirectorofUCLPartners.

• Audit and risk committee: ConsidersissuesrelatingtoUCLPartners’internalcontrolframeworkhavingregardtothecompany’ssizeandthesimplicityofitsgovernanceandfinancialarrangements.ItreportstotheUCLPartnersBoardontheadequacyandeffectivenessofUCLPartners’arrangementsfor:riskmanagement,controlandgovernanceandthecompany’sfinances,includingtheintegrityofUCLPartners’financialreportingarrangementsandthefinancialresponsibilitiesincumbentonthecompany’sdirectors.

AHSC BoardUCLPartners

Executive Group

Population health and place-based care

Innovation into practice

Discovery science

UCLPartners Board

Risk & Audit Committee


Remuneration Committee

Nominations committee

UCLPartners’ governance structure

Directors’ Report

Strategic risks

AcomprehensiveriskmanagementprocessexistswithinUCLPartners,coveringalltheassetsandactivitiesoftheorganisationanditsstrategic,project,operationalandfinancialrisks.

TheBoardanditssub-committeestakeaccountofriskaspartoftheirdeliberations.Project,operationalandfinancialriskismonitoredbyoperationaldirectors.AnyissuesarisingarehighlightedatAuditandRiskCommitteemeetings,orescalatedforactionsoonerifnecessary.

Inregardstoconflictsofinterest,UCLPartnersasksallmembersoftheBoardtodeclareconflicts,andactionistakenasappropriateonacase-by-casebasis.

Principal risks and uncertainties• Future structural changes to the health system. The

changeinNHSstructure-withtheestablishmentofNHSImprovementandSustainabilityandTransformationPlan(STP)footprints,alongwiththeoutcomesoftheCarterReview-hasthepotentialtochangeUCLPartners’positioninthehealthandsocialcarelandscape.Inspiteofthis,UCLPartnersisalreadydeliveringsupporttopartnersinsystem-levelchangetoreducegapsinhealthandwellbeing,careandquality,andfinancialefficiencyinlinewiththeFive Year Forward View.Thecompanyworksatanationalleveltoensureitisalignedtofuturestrategies.

• Increasing financial pressures causing reduced collaboration across the partnership. Financialpressurescancauseorganisationstoconcentrateonindividualinstitutionalpriorities,andtoneglecttheneedsofthewiderpartnership.Thisleadstoslowerprogressonpartnershipprojectsandreducedimpactinprovidingbenefitstopatientsandthepopulation.UCLPartnerscontinuestodeveloprelationshipsbetweenpartners,respondingtotheirprioritiesandsupportingthehealtheconomytocollectivelydelivertheFive Year Forward Plan,asanoverarchinggoal.Thebindingofthepartnershipwillfollowthedeliveryofagreedobjectivesthatalsosupportprovidersustainabilityandcompetitiveglobalacademicexcellence.

• Organisational fragmentation across UCLPartners designations. Withanumberofdifferentrolesandresponsibilities,thereisacorporateriskthatUCLPartnerswillnotmanageitsdesignatedroleseffectively.Failingtoensurealignmentoftheserolescouldleadtodiminishedoutcomesforthepartnershipandrisktheorganisation’sreputation.TheAHSNstakeholdersurveyconductedinsummer2015highlightedsomeconfusionovertheroleofUCLPartners.Tomitigatethisrisk,thecompanyhasestablishedcentralreportingandgovernancetokeepprogrammesanddesignationsalignedwiththeoverarchingaimsofthepartnership.Itisalsotakingstepstoimproveclarityofthedesignationsthroughimprovedcommunicationwithstakeholders.

• Failure to engage CCGs, primary care providers and social care. Asanorganisationthatwasinitiallycreatedtosupportacuteproviders,thecompanyhasmostengagementwiththesepartners.TheorganisationcannotsupportthesystemtodelivertransformationandSTPswithoutstrongrelationshipswithprimarycareandlocalauthorities.Throughthisyear’sworkonSTPs,devolutionpilotsandtheEssexSuccessRegime,UCLPartnersisharnessingcloserrelationshipswithawiderrangeofstakeholdersandwillcontinuetoexpandengagementandinvolvementinUCLPartnersprogrammes.

TheBoardissatisfiedthatarigorousprocesshasbeenfollowedtoidentifytheserisksandthatsuitablemitigationisbeingundertaken,orisplanned.TheBoardrecognisesthat,duetoexternalinfluences,theorganisationcanonlyprovidereasonableassuranceandnotguaranteethatmajorriskswillbeadequatelymanagedbythepartnership.


People UCLPartnersprovidesemploymentto116people(equivalentto80peopleworkingfulltime);73aredirectemployees,40areworkingonasecondmentbasisfrompartnerorganisations,and3agencystaffhelpwithshort-termprojects.

Themajorityofoursecondeesareclinicalandacademicleadersfrompartnerorganisations,whohelptodrivetheworkofUCLPartnersinawaythatbenefitspatientsandstaffonthefrontline.WeencourageoursecondeestosharetheknowledgetheyhavegainedatUCLPartnersandtoembeditwithintheirownorganisations.UCLPartnerscontinuestosecondourteammemberstoprovidersinthepartnershiptoprovidebespokesupportasneeded.

Staffareencouragedtolookaftertheirhealthandtomaintainahealthywork-lifebalance.Theorganisationhaslaunchedanumberofhealthandwellbeingactivitiesduringtheyear,including:freeyogasessions,avirtualstepchallengefromJohnO’GroatstoLand’sEndandcharitywalks.Thenumberofworkdayslosttosicknessleavetotalled207.5for2015/16,whichisequivalentto0.8%ofthewholestaffor1.8daysperemployee.Thisnumberhasincreasedsince2014/15,butisconsistentlybelowtheaveragefortheNHS,whichis6.7daysperemployee. Aspartofthecompanyemploymentpackage,UCLPartnersoffersagenerouspensionschemetoallstaffwhojointheorganisation.UCLPartnerscontributes10%ofanemployee’ssalaryintothescheme,andstaffarewelcometocontributeaslittleorasmuchastheywish.

UCLPartnersreliesontheknowledgeandskillsofitsstafftohelpthepartnershipimprovehealthandincreasewealthfortheregion.Ensuringthatstaffareengagedandenthusiasticabouttheaimsoftheorganisationisintegraltothepartnership’ssuccess.Communicationwithstafftakesplaceatalllevels,withtheaimofensuringthattheirviewsaretakenintoaccountwhendecisionsaremadethatmayaffecttheirinterests.Channelsforengagementinclude,butarenotlimitedto:

• Monthlywholestaffupdateledbytheseniorteam• Weeklystaffnewsletter• Staffintranet• Regularteammeetingsledbyoperationaldirectors.

The environment

UCLPartnerscontinuestomakeeffortstominimiseitsimpactontheenvironment.Staffareencouragedtousepublictransportwhentravellingbetweenpartnersandtoreducepaperusagebyonlyprintingwhatisnecessary.Thecompanyhasarecyclingschemeinplaceformixedrecyclablesandfoodwasteandtheofficeusesenergyefficientlighting,whichismotionactivated.


UCLPartnersisacompanylimitedbyguarantee,bypartnerNHSanduniversityorganisations.Themajorityofrevenuereceivedisfromthepublicsectorandothernot-for-profitorganisations.Inkeepingwiththis,annualsurplusesarenotdistributedbutarereinvestedinfurtheranceofourprincipleaimsandobjectives.Areserveismaintainedtosafeguardthefinancialsustainabilityofthecompany.

Business development

UCLPartnershasonceagainachievedyear-on-yearrevenuegrowth(seefigure3)throughcontinueddevelopmentanddiversificationactivities.In2015/16thishasbeenachievedthroughfocusingonkeyprioritiesthatalignwithnationalpriorities:

• Improvinghealthoutcomesforpatientsandthepopulationthroughsupportingthesystemtoimplementandevaluateintegratedpathwaysandnewmodelsofcare

• Supportingorganisationsandindividualstodevelopcapabilityandinfrastructuretoimprovequality,patientsafetyandexperienceandreducecosts

• Embeddinginnovationtodrivechangeatscaleandpace

• EnsuringUCLPartnersisasustainableorganisationtomaximisethebenefitstopartners,patientsandthepopulation.

Ourpartnersandotherbodieshavefundedustoenabledeliveryofthesepriorities.Thethreelargestcontractsdeliveredin2015/16were:

• AHSNgrant(£3.1m)fromNHSEnglandwhich,despitean21%reduction(from£3.9min2014/15),hasenabledUCLPartnerstodeliveragainstarangeofobjectives.Progresshasbeenmadetowardsspreadinginnovation,improvingcapabilityanddeliveringsystemtransformation.Forexample,improvingmentalhealthandoutcomesforchildrenandyoungpeople,andexpandingtheQuintilesPrimeSiteintoEssextoimproveaccesstoclinicaltrialsforanadditional1millionpeople.Wehavealsocontinuedtodeliverourpatientsafetyprogrammeforwhichaproportionofgrantfundingisring-fenced,establishingtwosignificantworkstreamsforacutekidneyinjury(AKI)andsepsisinwhich9and13trustshaveparticipatedrespectively.

• LeadProvidercontract(£1.7m)commissionedbyHealthEducationEnglandtoensurethequalityofpostgraduatemedicalanddentaleducation.During2015/16keydeliverableshaveincluded:170educationandclinicalsupervisorstookpartintheUCLPartnersdevelopmentprogramme;and35staffjoinedtheleadershipdevelopmentprogramme.

• NHSNewhamCCGsponsorship(£1.4m)toaddresseightidentifiedhealthchallengesintheborough.Twoprogrammeswerecompletedin2015/16,“Buildingemotionalresilienceinyoungpeople-MorethanMentors”and“First4HealthFederation”whichhasincreasedtheuptakeofchildhoodimmunisationsintheborough.Keymilestonesinthesixongoingprogrammeshavealsobeendeliveredincludingfirstevercollationofdataonlowbirth-weightbabiesandpre-diabetesrisk.

• Inadditiontotheabove,during2015/16wehavedeliveredworkonafurther19contractsvaluedatover£100,000each.

Financialreport

Revenue growth

2015/16

2014/15

2013/14

2012/13

2011/12

2,000,000 4,000,000 6,000,000 8,000,000 10,000,000 12,000,000 14,000,000 16,000,000

Expenditure Turnover

Figure 3. Revenue and associated expenditure growth over five years.

UCLPartnersAnnualReport2015/16•Financialreport44

ThesebusinessdevelopmentshaveledUCLPartners’turnovertoincreaseby5.0%to£15.4m(2014/15:£14.7m)withassociatedexpenditureincreasingby4.4%to£15.2m(2014/15:£14.5m),seetable1.Thishasenabledthedeliveryofasurplusof£219k.

Asourportfoliohascontinuedtoexpandouraveragewholetimeequivalentstaffnumbershavedecreasedby9%(from87.8to80.0)andtheaveragestaffheadcounthasdecreasedby18%(from142to116).Thisdemonstratesanefficientuseofourworkforce.

Table 1. Company growth

Ourcapitalassetbasehasdecreasedby54%to£260k(2014/15:£566k)followingthedisposaloftheleased4thfloorpremisesat170TottenhamCourtRoad.

Netassetshaveincreasedby75%demonstratingourincreasedsustainability.Thecurrentratiohasincreasedfrom0.99to1.04reflectingincreasedworkingcapitalavailabilitytosupportongoingdeliveryofouractivities(seetable2).

Table 2. Financial ratios

2011/12 2012/13 2013/14 2014/15 2015/16

Currentratio1 0.92 0.96 0.97 0.99 1.04

Cashratio2 0.60 0.32 0.57 0.63 0.49

1Thisratiomeasuresthecompany’sabilitytopayshort-termobligations,whichisthecompany’scurrentassetsdividedbyitscurrentliabilities.

2Thisratioisameasureofacompany’sliquidity,whichisthecompany’scashdividedbyitscurrentliabilities

2011/12 2012/13 2013/14 2014/15 2015/16

Turnover£’000s 2,768 4,764 9,539 14,698 15,439

Expenditure£’000s (2,768) (4,765) (9,407) (14,496) (15,221)

Surplus(Deficit)£’000s 0 (2) 132 144 219forre-investment

Thisisinclusiveofcorporationanddeferredtaxcharges


RevenueOurexistingandfutureplannedrevenuescomefromvarioussources,with46%ofourrevenuecomingfromNHSEnglandin2015/16,19%fromClinicalCommissioningGroupsandNHStrusts(excludingpartnercontributions)andafurther18%fromHealthEducationEngland.Theremaining17%ofrevenuescomefromavarietyofsourcesincludingcharitiesandindustry.

Revenuesarederivedfromacombinationofgrantfunding,partnershipcontributionsandcontractstodelivercommissionedprogrammesofwork.Programmesandprojectscanrangeinlengthfromonemonthtofiveyearswhichhelpstoensureasustainablebusinessmodel.Thisisalsoshowninouryearendcashbalanceof£5.6mwhichisprimarilyallocatedtoon-goingprojectsthatspan2015/16and2016/17.Seefigure4forourrevenuesplit.

Figure 4. 2015/16 Revenue analysis

Figure 5. 2015/16 Expenditure analysis

NHS England 46%Health Education England 18%Clinical Commissioning Groups 14%Partner Contributions 8%Charities 6%NHS Trusts 5%Other 3%

Pay costs 42%Projects 27%Education 7%Property 7%Research 6%IT & Telecommunications 5%Governance & other support costs 4%Consultants 2%

ExpenditureApproximately42%ofourexpenditureispayrelated.Ofthis,67%isforemployedstaffand30%forstaffsecondedtousfromourpartners,toprovidespecialistandclinicalleadershiptoprogrammes.Theremaining3%isforagencystaffwhoarerecruitedtoenableustostartprojectsquickly,whilstwerecruitaccordingly.Themajorityofournon-paycostsaredirectlyrelatedtodeliveringourprogrammes.

16.4%oftotalexpenditureisattributabletocorporatecosts.Asthecompanycontinuestodevelop,weremainfocusedonensuringallcorporatecostsareminimised.Seefigure5forourexpendituresplit.

2015/16 Revenue analysis

2015/16 Expenditure

analysis


Financial governanceAsrevenueandexpenditurehascontinuedtoincreasewehavecontinuedtofocuseffortsonmaturingourfinancialgovernanceandsystems.In2015/16,thishasincludedconductingareviewingofourcontrolsandprocessesusingtheCharityCommission’sself-assessmentchecklist,“Internalfinancialcontrolsforcharities”;althoughUCLPartnersisnotaregisteredcharityweaspiretoembracethegeneralprinciplesofgoodgovernancetheCommissionhassetoutinrelationtofinancialmanagementandsafeguardingoffinancialassets.

Going concernAftermakingdueenquiriesandundertakingnormalbusinessplanningandbudgetingprocedures,thedirectorsconsiderthatUCLPartnershasadequateresourcestocontinueinoperationalexistencefortheforeseeablefuture.Accordingly,theyhavecontinuedtoadoptthe goingconcernbasisinpreparingtheFinancialStatements.

Statement as to disclosure to auditorsUCLPartnersdirectorsapprovethatasfarastheyareaware,thereisnorelevantauditinformationofwhichthecompany’sauditorisunaware.Thedirectorshavetakenallthestepsthatoughttohavebeentakenasdirectorsinordertomakethemselvesawareofanyrelevantauditinformation,andtoestablishthatthecompany’sauditor isawareofthatinformation.


©BART

SHEA

LTHNHSTR

UST

City

Trusts1 Barking,HaveringandRedbridgeUniversityHospitalsNHSTrust2 Barnet,EnfieldandHaringeyMentalHealthNHSTrust3 BartsHealthNHSTrust4 BasildonandThurrockUniversityHospitalsNHSFoundationTrust5 CamdenandIslingtonNHSFoundationTrust6 EastLondonNHSFoundationTrust7 GreatOrmondStreetHospitalforChildrenNHSFoundationTrust8 HertfordshireCommunityNHSTrust9 HomertonUniversityHospitalNHSFoundationTrust10 LutonandDunstableUniversityHospitalNHSFoundationTrust11 MidEssexHospitalServicesNHSTrust12 MoorfieldsEyeHospitalNHSFoundationTrust13 NorthEastLondonNHSFoundationTrust14 NorthMiddlesexHospitalNHSTrust15 ThePrincessAlexandraHospitalNHSTrust16 RoyalFreeLondonNHSFoundationTrust17 RoyalNationalOrthopaedicHospitalNHSTrust18 SouthEssexPartnershipUniversityNHSFoundationTrust(SEPT)19 SouthendUniversityHospitalNHSFoundationTrust20 TheTavistockandPortmanNHSFoundationTrust21 UniversityCollegeLondonHospitalsNHSFoundationTrust22 WestHertfordshireHospitalsNHSTrust23 WhittingtonNHSTrust

Affiliated organisations1AngliaRuskinHealthPartnership2NIHRClinicalResearchNetworkNorthThames3NIHRCollaborationforLeadershipinAppliedHealthResearchand

Care(CLAHRC)NorthThames4HealthEducationEastofEngland5HealthEducationNorthCentralandEastLondon

Clinical Commissioning Groups1 BarkingandDagenham2 Barnet3 BasildonandBrentwood4 Camden5 CastlePointandRochford6 CityandHackney7 Enfield8 Haringey9 Havering10 HertfordshireValleys11 Islington12 Luton13 MidEssex14 Newham15 Redbridge16 Southend17 Thurrock18 TowerHamlets19 WalthamForest20 WestEssex

Higher Education Institutions1 AngliaRuskinUniversity2 CityUniversityLondon3 LondonMetropolitanUniversity4 LondonSchoolofHygieneandTropicalMedicine5 LondonSouthBankUniversity6 MiddlesexUniversityLondon7 QueenMaryUniversityofLondon8 UCL9 UniversityofEastLondon10 UniversityofEssex

Appendix1 Partnership organisations

UCLPartnersAnnualReport2015/16•Appendix148

Appendix2Financial statements - available on the UCLPartners website

UCLPartnersAnnualReport2015/16•Appendix249

uclpstorneuprod.blob.core.windows.net/cmsassets/UCLPartners_Signed_Financial_Statements_2015-16.pdf

Bringingtogetherleadersincutting-edge researchandinnovationtocreatemeasurablebenefitsforpatientsandpopulations

Get in touch

www.uclpartners.com

[email protected]

@UCLPartners

020 7679 6633

uclpartners annual report 2015/16uclpstorneuprod.blob.core.windows.net/cmsassets/u... · partners:...

Documents