Plugging in to London’s Capital Markets and Support

The UK is at the forefront of life sciences innovation. Break through companies across the UK are creating cutting edge therapies, highly skilled jobs, and driving economic growth. But business and Government recognise that more still needs to be done to create stronger links between the life sciences and business community.

Large pharmaceutical companies, the likes of GlaxoSmithKline or AstraZeneca, may dominate the headlines and the attention of investors but the ground breaking work is often being done by growing and specialist firms. It is these companies that need our support if we are going to put the UK firmly on the global life sciences map.

The general pace of innovation taking place amongst these companies is astounding and we’re seeing biotech businesses look for funding. This is fuelling stock market listings and long-term investment in small and early stage biotech companies.

£2.4 billion was raised in IPO and follow on capital in the UK-listed life sciences sector in 2017, a 20 per cent increase compared to 2016. What’s more, funding was driven by companies returning to the market; over £2.1 billion was raised in follow on capital in 2017, a six fold increase compared to 2016.

Not only does this highlight long term investor appetite but London’s ability to finance life sciences’ company growth through access to  deep, liquid pools of multicurrency capital and blue chip investors with expert knowledge of the sector.

Another trend we’ve seen in 2017 is the public market’s ability to support innovation. Two specialist investment vehicles, US-based fund BioPharma Credit, a closed ended investment company focused on the life sciences industry, and Arix Bioscience, a firm focusing on generating value from health and life sciences, listed on the Main Market raising respectively $762 million and £100 million. BioPharma Credit became the first London listed fund to specialise in debt financing for the life sciences sector.

The float of Novacyt SA, a French diagnostics group, on AIM in November 2017, also highlighted the continued appetite for international life sciences companies to list in London. The firm is rapidly growing and aims to become leader in developing new products for the infectious disease and oncology testing markets.

Equity funding is the right sort of capital for these companies, be that angel investment, crowd-funding, venture capital, private equity or a stock market listing. We believe these firms should be spending as much as they can on Research & Development.

But the UK public markets are just one of the many ways in which London Stock Exchange Group supports fast growing life sciences firms.

ELITE, LSEG’s business support and capital raising programme for high growth private businesses, helps companies better prepare and structure for external investment. A number of UK and international life science firms have already joined the global ELITE community.

Oxford-based radiology firm, Adaptix, which provides low radiation & 3-D imagining, and Midlands-based, life-saving regenerative medicine company, Celixir, are just a few examples of British life sciences businesses at the cutting edge of healthcare innovation.

The excitement in life sciences is palpable across the UK. The building blocks are there and now we have the opportunity to capitalise on this progress. London Stock Exchange is committed through ELITE and its public markets, such as AIM, to foster the growth of home-grown and international life sciences businesses. Together with UK business and Government, we will ensure the UK retains its allure across the international life sciences community.

Written by  James Clark, Head of Tech & Life Sciences, London Stock Exchange

The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.

 

 

 

 

Making Life Sciences Fashionable – What Can We Learn?

Recently, I was fortunate to be invited to the Kruger Cowne Breakfast Club event held in London to hear two of their clients – Caroline Rush (CEO, British Fashion Council) and Millie Mackintosh (Entrepreneur, Designer, Model and Fitness & Health Ambassador) – discuss aspects of the fashion industry, supporting creative talent, entrepreneurship and business from their perspective. See some selected highlights at http://www.krugercowne.com/events/caroline-rush-millie-mackintosh/

Fashion may feel a long way from Life Sciences & Healthcare, but it was striking how so many of the challenges faced and advice given resonated with much of what I hear in our sector. The insight started during the networking beforehand in discussion with experts from a branding and PR company. We discussed the challenges of building trust with your target audience. Whether that audience is customers, stakeholders, investors, employees, colleagues or other depending on your specific company, how to engage and build trust in a technology-driven world is changing that engagement practice. Maybe our sector has much to learn from other industries in this regard as health technology and growing patient engagement are playing such a vital role in aspects such as early diagnosis, clinical trials and patient adherence. Interestingly, how to penetrate an industry sector such as Life Sciences, where terminology and a perceived desire to be closed to ‘outsiders’ was viewed as a challenge for those wishing to bring in new ideas and help.

As the main interview and audience Q&A of the Kruger Cowne Breakfast Club progressed, ably prompted by host Adrian Sington, the discussion revealed a number of common challenges (and similarities) across our two sectors. The increasing need to have multi-disciplinary teams to be able to create and position the value proposition to customers/investors is common to both. There was also discussion of the need to be relevant and in the moment, appreciating what is currently vexing and worrying the person you are pitching to at that particular time. Perhaps in Fashion, trends, technologies and customer needs move on faster than in our industry, although technology is changing our sector very rapidly.  Maybe staying timely and relevant is becoming increasingly important in aspects such as engaging patients, educators and investors.

One clear similarity in the Fashion and Life Science sectors is that talent is key. Creating new medicines is a very creative process and that, much like in Fashion, requires creative and innovative thinkers with the confidence to express their ideas. So where does that confidence come from and how can it be nurtured? The British Fashion Council takes a leading role for their sector by providing, awards and recognition to upcoming talent.  They have established the Fashion Trust to help entrepreneurs get started and address their business challenges, driving global platforms such as London Fashion Week to showcase designers and much more. There were also similarities in the skills arena. There was a feeling that our education system may be extremely well suited to developing new designers with the creativity skills and entrepreneurial drive required to start and grow new businesses. Success depends on many skills and functions such as machinists and pattern cutters to translate designs to products. Our education system may be less well suited to producing a deep labour pool in the production and manufacturing orientated roles which require different skills levels and aptitudes. These functions play no less an important role in translating a great idea into a great product than any other part of the process. If the UK is to grow the manufacturing and production side of the industry, scaling our businesses and driving economic growth it is important we enable an ambitious and entrepreneurial labour pool across all skills. This is not dissimilar to what I hear from our own sector. The Life Science Industrial Strategy seeks to address this issue through initiatives such as Cogent, increasing apprenticeship usage and investment in bio-manufacturing facilities with training. A desire to increase our innovation capacity. Another common challenge is how to capitalise on excellence in research and innovation to create jobs,  spreading the health and wealth benefits in regions neighbouring centres of research excellence yet not seeing economic benefit from those centres.

From an entrepreneur’s viewpoint, what were the key lessons?

Almost immediately it was set out that whilst the talent to design is essential in starting and growing your own business, an appreciation of what other parts of the business do is vital.. The founder needs to be aware of the importance of surrounding themselves with people with the complementary skills and competence required, so that they can focus on their value-adding role. An example given was how employment with an established company can provide exposure to, and hence appreciation of, the related administrative and support functions required to run a business. Such awareness being a big step on the way to a company founder assembling the right team to enable their success.

Enabling company founders to gain such awareness can be a challenge in our sector, especially where they focus on perfecting their scientific or technical skills. A small, focussed employer may not have the capacity to offer employees a rotation-style training programme where they spend time in other departments in order to understand the overall business. Such schemes are seen in larger employers, but less so in the small company space which accounts for a great deal of our industry. There is no compelling reason in my mind why universities are able to provide such an enlightening environment or should solely be charged with doing so. There are excellent examples of training in entrepreneurship and business skills, though that can only go so far perhaps. Work placements may be a scale-able and effective local solution whereby industry can play its full role too. I mention local since I feel there may well be a factor that some things happen best locally with central facilitation rather than control – the cluster effect! By helping students to gain awareness and insight of career possibilities (laboratory or business), organisations such as One Nucleus can make a useful contribution to developing a comprehensive talent pool for a cluster. Engaging our members in nurturing future talent in all roles is at the heart of a not-for-profit group such as ours.

We need to consider where the creative, and perhaps disruptive, ideas will come from.  At the Kruger Cowne Breakfast Club event, it was suggested that pathways need to be created for all. All sectors need to have a somewhat porous envelope that career builders can enter from multiple starting points, backgrounds and experiences. This is really about enabling true diversity in the sector. Access via multiple pathways, with guidance to those on their journey from established players, can avoid the industry sector being seen as too elitist to allow others in. A clear perception from the pre-session networking I mentioned above on this occasion. Elitism, real or perceived, increases the risk of a sector becoming less relevant, therefore not attracting the best talent. So I feel in our sector we must show due consideration to pathways – career pathways that attract, retain and enable the best talent and patient pathways that enable innovative solutions to be delivered with full engagement to improve outcomes.

So what do I feel I learned from the morning’s session? :

• I saw many parallels across the Fashion and Life Sciences industries that reminded me of the common challenges we face in sustaining and building upon the successes to date
• It also reminded me of what a highly creative and innovative powerhouse the United Kingdom is, in biomedical research, technology and design
• An industry cannot be closed to new, sometimes disruptive ideas if it wishes to stay relevant and competitive
• Access to capital at start-up and growth is key for all entrepreneurs

What I didn’t touch upon above was communication and engagement skills. Social media has changed society in terms of reaching customers, business partners, policy makers and talent. Maybe our industry starts from a difficult place to engage with non-specialists due to the complexity and terminology. Perhaps the Life Science industry has fewer good visual examples compared to Fashion when selling the product and engaging an audience.

The Fashion industry shows us however that creating excitement within your target audience, stimulating the conversation to get engagement and realising that people value the experience at least as much as the price when ‘buying’ are very effective. Our sector is increasingly enabling patient engagement by moving away from trade-trade dialogue to trade-patient dialogue. So we are adapting to a new landscape already. Our challenge is to expand that engagement to ensure we attract all the skills we need to grow our businesses, from high end science and business to technical, administrative and logistical support roles and those with the capital to join our sector on its journey to improving peoples’ lives. Creating the attraction not because it is seen as elitist, but because it is relevant, it makes a difference, is exciting and fashionable!

My thanks to Kruger Cowne and their clients for inviting me to the event and hearing their insights.

Written by Tony Jones PhD, CEO, One Nucleus

The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.

Artificial Intelligence and life sciences-the great coming?

The Prism Series “pop up event” Cancer research UK December 2017

Christmas comes but once a year. To most of us this is a really good thing as it costs so much. We look forward to all the festivities, parties and of course the consumption of too much food and drink. Part of the annual festivities is the annual Genesis Life Sciences conference held in London, pretty much on the same date every year. The conference which is the brainchild of Tony Jones and his team brings together all of the UK life science community to participate in discussions, exchange business cards and sometimes do fantastic deals. Tony has over the last few years come up with the idea of the Genesis Conference Fringe. Based on the Edinburgh festival but with less jokes, or maybe not, various ‘pop up’ events occur. These are at various venues all around London and on assorted topics appealing to most peoples Biotech tastes.

I had the pleasure this December to facilitate such a ‘pop up’ event on Artificial Intelligence and Life Sciences . The style of the event was that of a Prism Series, basically representing an open authentic discussion where the objective is engagement and community rather than the more traditional information transmission format (a dead duck!).

The event was held at the Cancer Research UK headquarters at the Angel Islington London. A really cool building with the sense of energy and purpose, an ideal setting to bring together people with interest and vision in what is artificial intelligence with in the arena of life sciences .

A really interesting and engaged group of individuals turned up. They looked good and even trudged their way through the sleet and snow to attend.Seeing life sciences from all sorts of perspectives from drug hunters to digital health, from IP lawyers to Ventures capitalists, they seemed a good bunch to get together.

The discussion was facilitated and ‘disrupted’ by myself and an interesting colleague Sanjeev Ahuja.  We have really different but complementary backgrounds My  perspective coming form many years in the Pharma world and Sanjeev from a deep Knowledge of Artificial intelligence .

The big question posed was is Artificial Intelligence just a buzz word for the moment. A catch all statement , the fantasy of science fiction or something turning up that will be so powerful our entire lives will change. Driverless  cars seem a reality ,is it possible  to  leave machines to discover novel therapeutics ie our lives in their hands! Humanity  seems to be putting both a monetary bet and almost a semi religious hope on computer power to solve the problems of an ever aging population and  new diseases. The Pharma industry rooted in  academic history relies on experimentation and hypothesis proposition using ‘wet work’ cells and tissues. Can algorithms and computers revolutionise this.

After a few hours of excited inclusive debate, covering aspects of  AI from literature mining, drug repurposing to  open innovation ,few big answers really emerged. The discussion and debate was the success of the event.

Will AI ever replace serendipity and human imagination. Some of the participants were hard on the old human . Humans can only deal with a couple of “vectors “at a time whereas computers can deal with many said one participant .The younger generation is more likely to trust the data ! Was another comment. Trust and value were clearly a key to people investing in the big bucks needed to set up artificial intelligence systems .How and at what part of the drug discovery sand development process could and should Artificial intelligence be  inserted.

-Healthcare is about treating mechanisms not diseases, phenomenological approaches to  treatment is over ! Maths and logic are the future

• Data consistency and curation are central
• -verification and validation to build trust is needed
• AI is being used at various parts of the discovery process not to speed up the process but for decision making

Some real power statements were made

-Artificial intelligence is the last great technological advancement humans can make …….WOW

• China is leading the strategic way ,pushing hard on this new technology
• US and China are in front.
• The uk has tremendous academic expertise but struggles to commercialize .Could the life science sector lead the way in capitalizing on AI
• If we are a knowledge economy we must be in this !

The meeting finished with high energy, people were inspired there was  the promise to have another event and event build an AI interest community. Lots of chat resulted and a great cappuccino of course  . The greatest complement came from a participant  who said they did not expect to say so much! this is the sort of event people want.

A lovely time and great people …..

To the next ………

Written by Tony Sedgwick @thoughtdisruptor.com

The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.

 

 

 

 

 

 

Why Opt-In Matters When Applying Digital Success Tracking to Patient Care

This is a guest post for One Nucleus by Toby Beresford. Toby is the Founder and CEO of success tracking network Rise.global. Previously he has worked as a developer of web based disease management for patients, dermatology tele-referrals for GPs and was deputy chairman of the public health sub-committee for Wandsworth Council. His email address is toby@rise.global

At the recent PRISM Series Dave Snowden told the story of how he self-managed his recovery from Type 2 diabetes – he called it his hero’s journey. It’s a story he has told before in a blog post “Early Detection, Fast Recovery”. Critically, he caught the disease early, refused to countenance “palliative” care and instead took control over his cure, targeting key factors such as diet and exercise. After 7 months he was rewarded with an all-clear diagnosis, saving himself from early death and the NHS from another expensive chronic patient.

Dave “self-optimised” to cure himself. He tracked his progress over time on key metrics and little by little he continuously improved his health.

I’d like to pick up on a key phrase from Dave’s story “My GP was happy to support the process but critically did not propose it.” What Dave is saying here is that this was a path to health not prescribed by his physician – instead he chose it himself, and that path less travelled made all the difference.

When a journey is optional to take, there is no prize for completing it and you track your progress along the way. When self-optimisation using data is wrapped in a digital medium such as a website or app, this is known as “success tracking” and it is growing in popularity.

The biggest advocates of the success tracking model are of course the makers of digital “fitness” pedometers such as those made by FitBit and its competitors. Indeed, this is already big business – Meticulous Research expects the worldwide success tracking for health market to grow to £2.8bn by 2022. So far so good, with many clinicians trialling a similar approach with their patients.

(Photo: fitbit dashboard by Toby Beresford)

However, it is all too easy for clinicians to ignore the design principles behind phenomenal growth of the activity trackers and default to the old-school “carrot and stick” model of motivation. They may expect to have the same take up with digital trackers for their disease area but by getting the motivational design wrong they may be surprised by their failure.

Daniel Pink, in his book Drive: the surprising truth about what drives us, calls the carrot and stick model “Motivation 2.0”. “If-then rewards” he says, “often do more harm than good.” It’s the next evolution of behavioural design, Motivation 3.0 that really works in the long term. Only when we give patients “Autonomy, Mastery and Purpose” will they truly succeed on their own.

Knowingly, or unknowingly, Dave Snowden’s “hero’s journey” used a classic Motivation 3.0 approach. He chose to ignore the palliative route for care expected of him and opted-in to a curative route. He tracked his own diet and exercise until he made a full recovery.

So, how can we replicate this new motivational model within the confines of our existing healthcare system and leverage the scale and affordability of a digital approach?

One key area to look at is preventative medicine. My next door neighbour, currently a few months shy of her 80th birthday, has recently joined a weekly “prediabetes” group after local screening highlighted her as being at risk. As well as attending training, she now tracks her cholesterol, weight, diet and exercise on a weekly basis. While not using a digital approach today, there is much in diabetes prevention that could be delivered more effectively and cost efficiently using a success tracking app.

It is in this sort of elective care that clinicians can most benefit from applying success tracking principles. There will be a huge difference in compliance when someone “owns” their journey as we tend to behave differently when we are measuring ourselves than when someone else measures us. For one, we are a lot more interested in the results.

As a regular swimmer I know this to be true in my own life. I now use a SwimTag at my local pool. It comes in the form of a bracelet, picked up at reception and worn during my swim. Later that day I always check the email notification to see how many lengths I managed. Sometimes I’ll drill down into the data to see how fast I swam and the stroke details within each length.

(Photo: SwimTag dashboard by Toby Beresford)

So, when it comes to health and digital disease management, patients who opt-in to take care of themselves are much more likely to achieve their goals than those who comply out of duty or subservience to authority.

How can we encourage patients to opt-in though?

Persuading patients to opt-in is of course the million dollar question. Clinicians vary in charisma and patients vary in their attitude and ability to comply!

While traditional persuasion techniques (ensuring full understanding, knowing the opportunities and risks, hearing stories from others who have travelled the same route, encouraging social support etc) will all be applicable, I’d like to focus on what we can do when designing the digital tools themselves. The medium is part of the message after all.

So, what should the tool do?:

Allow fast and granular opt-in and opt-out

I’d expect any tool to allow me to choose my privacy level. Maybe I could choose to appear on a benchmark ranking of other patients but appear as anonymous, or I could stay “unranked” but still see how I am performing against the average. Or, if I choose I could opt out all together. Few patients may choose this, but giving them the option to is critical to achieving buy-in. This level of privacy control is fundamental and implementing a patient success tracking program without it risks failure.

Connect to online social identities

I am much more engaged by results, scores and ranks put alongside my real name with my photo. If I’m comparing with others on the same journey then I’d like to see their current photo and name too. Facebook now has 2bn users, love it or hate it, integration with Facebook is de rigueur.

Feedback stories not just results

Human beings engage with stories more than they do with raw numbers. Data storytelling is a growing discipline and its principles should be used in any program. Telling someone they’ve hit a personal best this week is much more engaging than simply giving them their results and expecting them to work it out themselves.

Allow the magic of social proof to do its work

I’ve never forgotten my Psychology lectures with Solomon Asch. He showed that we will change our mind, even to the extent of declaring something patently false to be true, when confronted with a group of peers believing it. Conformity is a huge driver of behaviour change.

Provide easy ways to share progress back into social media

In his journey out of diabetes, Dave Snowden also talks about the value of his journey being made public, the fact that others were tuning in kept him on task. Now while a public figure like Snowden has many thousands of followers, there is no reason why this shouldn’t be true for every patient within their own social group. Sharing a health journey on social media may sound scary to Baby Boomers and Generation X but for Millennials it is close to being the norm.

What are the risks?

As with any new approach there are plenty of risks. Certainly any kind of behavioural approach, if designed badly, can have unwanted side effects. People respond to tracking programs in ways not easy to foresee when you are designing them.

One risk to be especially aware of is “gaming the system”. By ensuring there is no cash incentive or reward you cut out most of this (the only person a cheat cheats is themselves) but it is difficult to wipe out entirely. You could see patients focusing on one metric to an extreme degree – such as starving themselves to get their score (and weight) down.

Other unintended side-effects I’ve seen are where people take short cuts to achieve a higher score, clubbing together in cabals to beat the system. With people so focused on winning the “game” they are oblivious to what’s going on around them, even to the extent of breaking the law.

These issues are easy to identify but sometimes hard to prevent. That’s why following a good methodology can really help, or better still, getting motivational design help from an experienced “gamification” designer.

What are the opportunities?

But despite the risks, the opportunity for success tracking programs within health remains significant. Patients effectively treating themselves is a gold standard for public health – the closer to the patient you treat the disease the more cost effective it is. A hospital bed is an expensive way to care.

Success tracking apps can scale up and offer ways for patients to self-care, saving us all money.

Better health tracking can improve public health too. If we can avoid the development of more people with chronic diseases like diabetes the better it will be for society as a whole.

Trailblazed by FitBit, digital success tracking is at the beginning of what it can achieve in public health. I’m looking forward to seeing more programs developed over the next years – let’s just make sure everyone remembers to keep them opt-in!

 

   Written by Toby Beresford, Founder and CEO, Rise.global.

The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.

 

My Letter to you Dear Entrepreneur…..

Putting the c in Science – Commercialization, Community and Capital

by Sharon Vosmek

I am very much looking forward to my up and coming talk at the 2017 ON Helix conference. As an early stage investor, I especially enjoy opportunities to talk with and learn from life science innovators. You see, for me, science is quite personal.

My talk at the conference will focus on the three c’s of science: Commercialization, Community and Capital. This blog will give you a sample of what I look forward to discussing with the conference attendees. For me, these speaking opportunities keep me connected to innovation and markets – it is what I hear and learn, much more than what I have to say, that makes the travel and time worth every bit of it.

I recognize that you – dear entrepreneur – may not realize just how personal the decision to deploy capital can be for me, the early stage investor. Just as your entrepreneur’s passion connects you to your innovation, your customers’ needs, and your business, it is my passion that connects me to my investments and the innovations that each is driving to market.

My portfolio is made up of a combination of companies that make me feel like I am doing something meaningful with my money and contributing to something that has real value to society. This is especially true of my life science investments, many of which are seeking solutions for patients, doctors, and health care providers in previously underserved markets.

As an investor I have choices. I could invest in much safer things like public companies, real estate, or even shoes.  But my early stage, private company investing is personal. It is as much a statement of who I am as anything else I do.

Why should you the entrepreneur want to understand this? Because it is what makes us – you and I, dear entrepreneur – more alike than you might realize. And this alikeness, should you and I take the time to fully develop an understanding and appreciation of it, can be a powerful tool for your company and the opportunities you are pursuing.

We both want to change the world – for the better. We both want to be a part of something bigger than ourselves. And we both have a tolerance for the risk associated with these desires. These are all things that can create a solid foundation for our relationship – you as an entrepreneur and me as investor. And if we both commit to taking the time to listen to each other, before we commit to each other, these bonds can sustain us through the highs and lows of the startup journey. In my experience, if this foundation is strong, these aligned interests can even endure through the absolute failure of a business and carry us through together to your next innovation and my next investment.

Of equal importance is what makes us different. I have found that the most successful investor-entrepreneur relationships are also built on a clear understanding of what each can uniquely bring to the table. I chose you because of the unique opportunity that your innovation presents to me as it relates to my desire to change the world. I chose you because I believe in your innovation and I believe in you as the entrepreneur who will get it into the hands of the market. Equally, you, dear entrepreneur, should choose me for the opportunity I bring to your innovation.  Of course I bring the obvious capital. But if you choose me well, I can bring so much more.

I am surrounded by smart, experienced people who may just be your first or next customers, your trusted advisor, your next hire, your market analyst, your next investor. Once you learn how the innovation economy works, you will see that 6 degrees of separation is more like 2 or 3 in this slice of the economy and the possibilities of who I might be able to help you reach are limitless. This is my community and this is what I can bring to bear if, and only if, we have taken the time to listen to each other, articulate the full potential of your innovation in the market, and identify how together we can unleash the full power of this network.

You see, for life science entrepreneurs, it takes a unique combination of ability to commercialize, ability to engage a community, and an ability to raise capital that is aligned with your innovation.

As I said at the start of this post, I very much look forward to hearing the thoughts of the innovators at the ON Helix conference. I see the day as yet another opportunity for us to identify how we can together build greater understanding between entrepreneurs, investors, and markets so that the fruits of the lab can make it into the waiting hands of the patient.

Written by Sharon Vosmek, CEO, Astia

The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.

 

 

 

Digital Health, the Embassy, Russia and the Future

The Department for International Trade (DIT) is a specialised government body with the responsibility for promoting UK trade across the world and attracting inward investment. DIT initiated the 1st International Digital Health Conference in Moscow, April 2017.

A strong UK delegation of medical experts made their way to Moscow to attend a digital health conference, organised jointly by DIT Russia office and Moscow State University on 20-21 April.

What proved to be a great success started two years ago from an idea to bring UK digital technologies to Russian medicine. The idea was taken forward and developed into a niche industry event which attracted more than 200 healthcare professionals. This was also the flagship event of the UK-Russia Year of Science and Education 2017. “Health science is an area where the UK and Russia are working closely together despite political disagreements”, said Jonathan Brenton, Minister-Counsellor Prosperity at the British Embassy in Moscow, during the opening ceremony.

At the conference experts described how a digital approach can make medicine more effective. Dr. Ilan Lieberman, Clinical Director for Integration at the University Hospital of South Manchester (UHSM), shared his plans for the launch of high-tech medical devices. For example, a glucometer that measures glucose levels through the skin, without injections, and a mini-DNA sequencer integrated in a smartphone. These and other devices, according to Dr. Lieberman, will go into production in the UK in about three months. There are also developments in Russia: for example, electrocardiograms (ECG) using a smartphone and an app.

Data from such personal devices, along with other information about the patient, should be stored digitally. Ideally, the data storage system should be standardised throughout the country, but, as Gary Leeming, Director of Health Informatics at Greater Manchester Academic Health Science Network (GM AHSN), mentioned in his presentation, in Britain such a system is far from being standardised. “Five years ago, we started to create an integrated remote patient monitoring system. In the process it became clear that data on the treatment of patients is often disconnected, stored in different systems, while patients themselves are trying to remember what medical services they should receive in different situations. As a result, a project of a self-learning health system was born, involving the use of Datawell, a system of sharing information for use by clinicians, an innovative smart cities programme CityVerve and ground-breaking test beds such as the Salford Lung Studies.

In Russia, until recently, no unified system existed until the program for the implementation of the Unified Medical Information and Analytical System (UMIAS) was launched in 2011-2012. Despite the fact that the new system is not yet perfect, this is a big step forward.

If digital technologies are really capable of transforming health care in the same way as other spheres of our life, then what is needed for their full integration into medicine? Dr. Ilan Lieberman cited two different examples – Israel and the United States, where people participate in the financing of innovative projects through taxes and are generally ready to accept the risk for this. In Russia, there are a number of challenges, one of the biggest is that according to current legislation any medical assistance must be provided to the patient exclusively in person. To change the situation, a new law “on telemedicine” is being discussed in the State Duma (the lower House of Parliament), said Alexandra Orekhovych, lawyer at the Internet Initiatives Development Fund, who is also involved in the legislative process.

The problem of shortage of healthcare workers can also be solved by means of digital technologies, according to Brendan O’Brien, Consultant in Clinical Informatics of the Board of Health and Social Care of Northern Ireland. Historically, this part of the United Kingdom has a large number of hospitals but only 70,000 healthcare employees for a population of a 1.9 million. “Thanks to the introduction of the e-medicine strategy, we managed to provide the lion’s share of medical services remotely. There are already about 20 thousand online receptions per month, 90,000 prescriptions are being written out”, said Dr. O’Brien.

Liz Mear, Chief Executive of the Innovation Agency at Academic Health Science Network for the North West Coast, also reported that the work of the 15 branches of the Network was aimed at reducing health care costs through digital technologies. At the moment there are already 345 different software solutions to serve the purpose. However, according to Liz, the digital maturity of medical institutions in the UK is not high.

The second day of the conference was fully devoted to m-health technologies. Conference participants noted several major problems that impede development of the market. 2016 was a tough year for the sector. Developers have continued to produce new medical applications so that the total number of applications in the world reached almost 260,000. In the meantime, users were not in a hurry to install them on their smartphones. In 2016, the number of downloads of medical applications increased by 7 percent, although in 2014 and 2015 the growth was more than 35 percent annually. The reason is that consumers have begun to lose interest in medical applications.

About one third of mobile medical applications are now not designed for patients at all. Young and healthy users of technical innovations use mobile applications to count steps, calories, kilograms or pulse during training. But this information is not critical for them. “Of those who start using trackers – to count the number of steps – in two years only half continue to do this. For various reasons, they do not see any further benefits from this, “said Oleg Medvedev, Chair of Department of Pharmacology at the Faculty of Fundamental Medicine at the Moscow State University.

Experts are confident that m-health needs to be integrated into the healthcare system in Russia, provided that applications are of a high standard of quality, reliability and effectiveness and focused on solving the patient’s problems, said Pavel Vorobyov, Director of the Higher School of Therapists. Of course, payment for mobile applications via general medical insurance would mean a revolution in the Russian healthcare. Without the criteria of quality, reliability and effectiveness of m-health with reference to the evidence base, this simply cannot be done.

“A fast integration of medical and IT technologies sometimes leads to the emergence of products on the market which are not adapted to specific clinical problems, while the regulation mechanisms of this market are still not mature enough. There has to be a sufficient evidence base for the safety and effectiveness of digital health technologies to be used in both prevention and treatment of various diseases”, said Sergei Boytsov, Chief Specialist of the Russian Ministry of Health in the field of medical prophylaxis, director of the State Research Centre for Preventive Medicine.

Another question: If a patient decides to download a medical application, what shall he or she focus on? Experts are unanimous: in this case, the rating of medical applications with recommendations for patients will help. “One of the problems in Russia is that we do not have a common list of medical mobile applications. We do not have their ranking from the point of view of the doctor and from the patient’s point of view, “said Oleg Medvedev. Now, if a patient goes online and tries to find something, he can make a lot of mistakes. There should be an independent system for comparing and selecting such applications.”

One more problem. “Nowadays the Russian developers of mobile applications and devices first create a new technology, and then ask doctors to find where it can be applied,” said Oleg Medvedev. The results of such implementation are mixed. Is not this the source of a large number of “junk” developments? “For example, for several decades, a large number of Russian engineers have endlessly developed stimulants for biologically active points, which had no scientific basis,” said Medvedev. They have made a lot of such devices. The result of this activity was zero – a huge loss of time and deceived patients.” “A few years ago I was invited to the contest in Skolkovo, Russia’s largest science park, where I could not approve any development at all, e.g. devices for electronic acupuncture,” recalled Pavel Vorobyov. “We need to start, at the development stage, from what medical problem should be solved with the help of a mobile application or device,” according to Medvedev. We need to include all stakeholders in the process of planning – doctors, patient representatives, psychologists, service providers. And immediately we need to think about the quantitative measurement of the results of the introduction of our technologies.” The criteria for evaluating m-health, based on the evidence base, would serve as benchmarks for developers and would help cut off “garbage” applications even during planning. “It is possible to clarify the requirements for m-health through running several pilot projects,” said Boris Zingerman, Head of the Information Technology Department at the Haematology Research Centre of the Russian Ministry of Health. “For example, you can conduct pilots for such chronic diseases as arterial hypertension, diabetes, asthma and evaluate the result.”

The launch of the conference was marked by a reception at the British Ambassador’s residence in Moscow, where DIT Director John Lindfield said that he believed that the event was the start of a long and fruitful collaboration between the UK and Russia and eventually become a key event in the industry.

Written by Ekaterina Zhuravleva, Trade Adviser, Healthcare & Life Sciences, DiT.

The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.

Interdisciplinary Approaches to Uncovering Biological Computation

Biological computation is the information-processing that cells carry out to make the myriad of decisions required to grow and sustain life. Uncovering what this computation is, remains far from trivial – cells are infuriatingly complex, they are noisy, run multiple operations in parallel, and there’s a blurred line between what we might consider to be biological software and hardware. This motivates the need for interdisciplinary approaches to extract knowledge from data, and to formulate predictive, explanatory models of cellular decision-making that can be used in the future to guide experiments, and ultimately for the development of novel therapies in medicine.

The Biological Computation group at Microsoft Research focuses on developing theory, methods and software for understanding and programming information-processing in biology. Our research currently centres on three areas: Molecular Programming, Synthetic Biology and Stem Cell Biology. We tackle key questions in these fields through the development of mathematical models and domain-specific computational tools, first seeking to find the right level of abstraction to model the system under study, and second, by designing tools that allow us to extract knowledge from data that can be used to parametrise or constrain such models.

As one example, in collaboration with experimental researchers at both the Wellcome Trust-Medical Research Council Stem Cell Institute, University of Cambridge, and the University of Padua, we are investigating the information-processing that governs growth and development. Together we are studying the pluripotent nature of embryonic stem cells. Pluripotency is the unique characteristic of these cells to differentiate into all cell types of the adult body – from skin cells, to gut cells, to blood cells, to brain cells. This potency marks them as a potentially invaluable tool for medicine. Even more remarkably perhaps, is the discovery that the pluripotent state can be induced from fate-specified cells using only a handful of factors, which could allow us to bypass the embryo altogether. This paints a picture of a sort-of stem cell utopia: imagine being able to generate patient-specific pools of cells for those suffering from heart disease, Alzheimer’s or Parkinson’s disease, or even insulin-producing cells for those with diabetes?

While embryonic stem cells hold significant promise for cell therapies and regenerative medicine, we still lack a fundamental understanding of the molecular processes that determine how differentiation proceeds, and what directs an embryonic stem cell towards a specific lineage. ‘Reprogramming’ cells back to the naïve state is also poorly understood, it and remains an inefficient process. The goal of our interdisciplinary collaboration has been to derive the biological program governing installation and maintenance of the pluripotent state. To this end, we’ve borrowed techniques from the field of formal verification, which are traditionally used in computer science to verify the correctness of computer programs, or check for bugs in software. The aim here, however, is to verify that a potential biological program is consistent with what is known experimentally by translating experimental observations into formal specifications that must be satisfied by the model.

Models that simply explain what is already known are limited in their usefulness. Certainly, reconciling a large number of experimental results into a single model is a significant step, allowing one to capture the present state of understanding in the field, and even resolve counterintuitive results. However, if your model can be used to predict some as-yet untested behaviour, which is subsequently found to hold experimentally, then you gain confidence in this current explanation of biological function and have learned something new biologically to boot. Beyond this, an often-overlooked benefit of modelling is when your model fails to predict some untested behaviour accurately. Incorrect predictions can be extremely informative in that they expose a flaw in the prevailing understanding of the system, forcing you to reconsider the assumptions that you have made. Ultimately, the approach is iterative, and models will be refined as they are constrained against new experimental data – to paraphrase George Box*, no model will ever be perfect, but some models will be useful.

Following this approach, we have developed models of the information-processing at work at the transcriptional level in embryonic stem cells. First, by encoding previous experimental results as ‘program specifications’ we sought to capture an understanding of pluripotency that accounted for changes in gene expression due to changes in the cell’s environment, and as the result of molecular perturbations. Importantly, we could generate then predictions of untested behaviour, that were subsequently supported by experimental tests, underscoring the usefulness of this modelling approach. More recently, we have sought to apply this understanding to explain how the pluripotent state is established during ‘reprogramming’ of somatic cells to the naïve state, which has also allowed us to predict accurately how to accelerate and enhance the efficiency of this process.

Ultimately the tools that we are designing as a group, such as those we have applied to better understand stem cell decision-making, will be combined into a platform for programming biology. Such a platform will enable users to uncover the biological computation that governs cellular decision-making, and then to use this understanding to reprogram, design and engineer biological behaviour.

Sara-Jane Dunn will be giving a Keynote Address at ON Helix 2017. Come and find out more about the work Microsoft is doing in the life science sector. More information can be found here.

*A 20th Century British statistician

Written by, Sara-Jane Dunn, Scientist, Microsoft.

The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.

Why Life Sciences Innovators Need to Build the Right Teams

Great innovation needs great leadership.

The late, great Steve Jobs said: “Innovation distinguishes between a leader and a follower.” So, when it comes to spotting opportunities in the exciting cross-over fields of life sciences, technology, and consumer applications, the right leadership team is vital. Businesses may be set up with an original goal in mind, such as developing new tools for cancer screening. The potential applications for the technologies they innovate, however, could be far wider than the healthcare field.

Tarquin Bennett-Coles, Carmichael Fisher’s Principal Consultant in Life Sciences Practice, says the need for some members of leadership teams with broader skills and experience is now being widely recognised by companies in this cross-over space. The need for managerial agility in recognising skills gaps and plugging them with the right people is paramount for a successful business. “Original teams may well be very focused on the healthcare benefits of their potential projects and have extensive experience in that field,” he says. “Their skills may be highly specialised. “However, lucrative consumer applications could transform the future of a company. They could ensure its viability and its ability to carry out further research and development in important areas of life sciences.

“Failure to capitalise on these opportunities could have the opposite effect. Companies which fail to grasp them could be held back from performing important work. Leaders must be aware from the outset that there may be potential for the application of their technologies in different areas to those they initially target, and they must be open to the opportunities which arise. They must be open to changing direction. Then, people with the right kind of skills at every level must be brought in to develop these potentially lucrative consumer applications. As the project progresses, companies may need those with corporate skills or those experienced in the use of different technologies.”

Many of the consumer markets which may use applications may be radically different to the field of life sciences. “Leadership teams need people who understand these markets,” Mr Bennett-Coles says. “They also need those with excellent corporate skills. They will know whether companies need to be split and run separately to maximise the opportunities. There are also differences in timescales. In life sciences, teams might expect to see results after a five to twelve years development process. For those with experience of the consumer markets, they would perhaps be looking to develop a product or a service within 18 months. This speed is necessary to ensure the technology isn’t overtaken or another team moves more quickly to bring something to market.”

Two case studies show the importance of that approach:

How technology developed as a cancer diagnostic became a tool in the war on terror

TeraView Ltd, based in Cambridge, was originally set up as part of the Toshiba overseas research laboratories in the 1990s.

It began life as a way of researching cancer diagnostic tools using Terahertz light technology. X-rays give us images of our bones. Terahertz T-rays allow us to see molecular structures. TeraView uses T-ray light, which sits between microwaves and infrared, as a tool to carry out tests and inspections. The T-rays allow the creation of 3D images. Though the technology was originally developed as a tool in cancer diagnostics, it soon became obvious that it had several other applications which needed to be developed. Alongside medical testing, TeraView’s technology is used in the pharmaceutical, semi-conductor, and solar industries. It is also used to test for explosives, noxious gases, and non-metallic weapons.

Technology which began as a medical diagnostic is now an important tool in security screening. TeraView’s CEO Don Arnone says: “These opportunities became apparent quite early on. We could see there was potential in three or four different markets and we pulled in people with experience of operating in those markets. We knew we needed a team with the right technical skills and an entrepreneurial flair and professionals with a good knowledge of those markets to commercialise the technologies we were producing. Initially, we brought people in on a consultancy basis, then o contract. As we moved forward, they stayed with us. We brought in people who understand markets in the USA and those who have experience in the automotive market. As the company grew and we faced different challenges, we needed a technological team which could help us deliver solutions fairly rapidly. We also needed people who could develop and maintain customer relationships in our different markets. We’ve maintained a flat structure. We don’t have a bunch of expensive executives or vice presidents, for example.

“As we have developed, we have grasped opportunities and our team has developed knowledge and skill in different markets. We developed a product for the inspection of microchips in mobile phones for Intel in 2008/9. Since then, the team has developed contacts and experience in the semi-conductor industry after working with Intel’s engineers for eight years. As we’ve grown, our team has adapted to different markets and technologies, and there has been some convergence. However, there are still differences in markets which must be taken into account. Someone in sales in the semi-conductor market would not be particularly adaptable to selling in the automotive market, for example.”

Understanding different markets is helping one company expand overseas

For innovative company Ieso Digital Health, building a team with an understanding of different healthcare marketplaces has been a key building block to success. The Cambridgeshire company was launched in 2011. It delivers cognitive behavioural therapy (CBT) to patients through a ground-breaking online method. Its Director Dr Andy Richards explains: “There’s a well-known inhibition when a patient sees a therapist face-to-face. Freud recognised this. It takes several sessions to build trust and an honest dialogue. We deliver therapy online using a written method which helps our qualified therapists to develop trust with patients much more quickly than if they were physically seeing a therapist. Our system is highly secure and a written record of all sessions is kept – something which is useful to therapists and patients and allows improved protocols to be developed. Patients can access treatment via our online method more quickly than physically seeing a therapist, and out treatment has proved highly effective in many cases. We took the decision in the UK to work within the NHS, rather than privately, so our patients are referred to us by NHS trusts.

However, there is a growing market need for this approach overseas, and this is where the right leadership team has become an important element in Ieso Digital Health’s growth. Alongside skills in the commercial and technical fields, the company’s team has needed market-specific knowledge. Dr Richards says: “If you take the United States, the ‘behavioural health’ market is very under served, but healthcare is delivered in a very different way than within the NHS including Medicaid and the private healthcare segments. So, we have needed senior people with experience and skills in those markets, we have ‘aimed high’. An additional key factor for us is regulation. It can be a complex area. In the USA, regulation varies from state to state, and in Europe from country to country. We need people with a deep understanding of what’s needed to operate in these markets. Without the right people in place, companies will make a lot of mistakes.”

The opportunities in the cross-over space between therapy and technology are substantial. With one in four of us likely to suffer from mental illness in our lives, and a growing focus on preventative medicine for mental health issues, world-wide demand for online therapy is only likely to grow. For Mr Bennett-Coles, the lessons learned by companies like TeraView and Ieso Digital Health are vital for any forward-thinking business in the field of life sciences. Without the right skills and the right entrepreneurial spirit, teams will fail to take advantage of opportunities for experimentation and growth, he says. Future success starts with the visionary leadership to build those teams.

 Written by Tarquin Bennett-Coles, Principal Consultant at Carmichael Fisher and longstanding One Nucleus/ERBI member.

 The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.

 

 

 

One Nucleus Input to the Industrial Strategy

OPEN LETTER

Dear One Nucleus members and esteemed readers

As many of you will know, the British Government launched a Green Paper for wide consultation regarding its future Industrial Strategy.

One Nucleus is delighted that at least 3 of the 10 pillars of the draft strategy reference sectors, the importance of place and clusters. With this in mind, I decided that it was important for One Nucleus to input to the draft strategy.

Below you will see my letter/response to the Government in this regard. It is written after lengthy discussions with members, key stakeholders, regional and national Government and others. I do hope you feel it is appropriate and reflects the needs and interests of our much treasured One Nucleus membership.

Letter to BEIS (dated 3 April 2017)

As Chief Executive of One Nucleus and one of the Prime Minister’s Business Ambassador’s for Life Sciences, I am delighted to send you the One Nucleus input to the Industrial Strategy.

One Nucleus is the largest membership organisation for the life science and healthcare sector in Europe with over 470 organisations as members. Full details are at Annex A below.

This response is formed of three parts:

• Firstly, the role of Regions and Cities
• Secondly, what One Nucleus believes the UK life science and healthcare sector needs from the Industrial Strategy and
• Thirdly, what we believe the specific needs of the life science and healthcare sector across the Cambridge/London corridor are now and into the future (80% of our membership is based in this area).

I am intentionally not including a significant raft of data about the strengths of the UK life science and healthcare sector or the axis of Cambridge/London as these are very well known to HM Government. However, for ease of reference and background I attach:

• a brief summary of the Cambridge ‘cluster’ – Bidwells (March 2016) (via e-mail)
• a short overview of the UK sector compiled by UKTI (now DiT) that I use as core briefing in my Business Ambassador role (via e-mail)
• a report compiled by the Growth Commission for the London Stansted Cambridge Consortium – LSCC (July 2016) plus a range of life sciences specific reports to which One Nucleus has contributed for the LSCC (all links below):

http://www.lsccgrowthcommission.org.uk/?p=812
http://lscc.co/sectors-2/life-sciences/

The One Nucleus response is written after consultation with Cabinet Office and BEIS during recent meetings I attended. The feedback from BEIS team members was clear – to focus a response on tangible actions that can be taken. I have therefore adopted that approach but am very happy to discuss any or all of the content of this submission in more detail with HM Government.

The Role of Regions and Cities

It is heartening to see the Prime Minister’s significant emphasis on ‘place’ in relation to the Industrial Strategy and her plans for the UK’s growth. As an organisation that has most of its members in a ‘region’ ie: the Cambridge/London corridor, One Nucleus believes that clusters/regions play a pivotal role in the economic development of and commercial advantage for the UK.

That said, I would also like to emphasis the role cities play in enabling growth. The establishment of Local Enterprise Partnerships (LEP’s) and City Deals are very welcome. More needs to be done though. I would suggest localisation of a proportion of innovation funding to cities to enable them to more proactively plan and support business growth across life sciences and other sectors.

Cities are better placed than central government to respond to locally specific market failures – drawing on close relationships with local business leaders and local institutions, having a better understanding of the unique environment local firms operate in, and an enhanced insight into where future opportunities may align.

Devolving, or ‘localising’, a proportion of existing innovation funding to provide cities with a flexible innovation pot would enable them to support greater coordination within and across sectors and cities, and enable the business leadership required to meet the growth ambitions set out in the industrial strategy. By ‘innovation funding’ – One Nucleus means early stage R &D and importantly also broader business-based innovation/process innovation/market innovation for scientific/healthcare products.

What does the UK sector need from the opportunity afforded by the Industrial Strategy:

1. Patient capital and funding:

• Patient capital – must play a pivotal role – supporting the key themes of the (East of England) Science and Innovation Audit (SIA) as well as the emerging fields of eg: Artificial Intelligence; robotics; digital health; the Internet of Things. The recent collaboration between Syncona and the Wellcome Trust is an excellent blueprint for what can be achieved

• Funding: The BioMedical Catalyst Fund has worked very well – continuation of it/enhancement of EIS to encourage investment/an even more robust R & D tax credit system (particularly in light of BREXIT)/even more competitive levels of corporation tax

• HM Treasury to create a model to fill potential gaps with the demise of Horizon 2020 – HM Government has announced it will safeguard this funding but details are yet to be provided

• Broad reform of EIS and VCT reliefs to lock in cash for longer in return for enhanced tax reliefs to encourage enforced patient capital. It is our view that the tax system is the key way for universal behaviour change to be effected. In addition, if the scale threshold (the point at which EIS relief is lost) were increased significantly, it could allow a greater flow of new funds into EIS protected scale-ups. We also ask the Industrial Strategy to consider reliefs for small (innovative) businesses, which will support growth in new R & D sectors and regenerate geographies in the UK in need of growth

• Industrial Strategy Challenge Fund – market it well and in a timely fashion

• Support for Scale-up companies: a tailored package of support/incentives for companies that are seeking to remain and grow in the UK – rather than exit-sale or merger. This includes consideration of diversity of funding – helping SME’s to navigate late stage development and commercialise products without ‘selling out’ to big pharma

• Government funding to support academic GMP manufacturing and cell processing capacity

• Greater involvement of charities/patient groups in the creation of innovation funds (eg: a comparator for the Citizens Innovation Fund that is available in France)

2. People and Skills

• Creation of a UK BioPharma Academy – with graduate entry, external mentoring and coaching, growing the next generation of scientists and C level talent. One Nucleus would suggest this is an academy that industry is intensely involved in/supports in terms of funding and training resource

• Creation of a fast-track life sciences and healthcare visa scheme

• Support local institutions to maximise local strengths – and assess current networks and organisations on the basis of proven ability and reputation before creating new ones – against a clear set of criteria

• Establish a ‘National Recruitment Fund’ to grow the UK’s life sciences talent pool by supporting the attraction and retention of overseas and home-grown scientific and entrepreneurial talent

3. Regulation and Pricing/NHS

• Reinforcement of the Accelerated Access Scheme (AAS) to create new ways of addressing regulatory issues and encouraging the faster uptake of innovation by the NHS. The Innovation and Technology Tariff is a case in point – this needs to be truly capitalised upon for maximum patient benefit. Vitally getting the AAS to work smoothly and effectively should help keep the UK at the forefront of getting new, innovative drugs to patients

• The Early Access to Medicines Scheme (EAMS): this is an excellent mechanism from the MHRA/NICE and needs to be taken further. We suggest some products should qualify for EAMS sooner (perhaps in specialist clinical centres) so real outcomes and commercial data can be garnered for NICE assessment. Consideration to be given to granting EAMS on well conducted exploratory studies in areas of high unmet medical need and run in parallel with confirmatory clinical studies – with patients directed to the latter in the first instance. This would ‘telescope down’ the process of regulatory approval, NICE decision making and NHS adoption. Paying SME’s a nominal price for their product while under EAMS would also help bridge the funding gap for regulatory development

• Better access to clinical networks

• Establish a ‘UK Innovative Medicines Initiative (IMI)’ to ensure that UK companies and researchers do not lose out on opportunities to establish pre-competitive collaborations, which aim to speed up the development of better and safer medicines for patients

4. New Technologies

• Encourage the development and convergence of technologies

• A UK strategy for digital health – with the NHS better expressing what it’s needs are and assessments done to assess the market for mobile applications for health monitoring and companies and the NHS working more closely together

5. Department for International Trade (DiT)

• A clearly defined and well-resourced international trade and investment offer which recognises the importance of supporting SME’s, harnesses the abilities of our commercial teams in our overseas Embassies and Consulates for company benefit and markets opportunities for UK companies in a timely fashion eg: far better notice of upcoming missions/conferences required

• Recognition by the Department for International Trade (DiT) of the importance of SME’s both in biotechnology and medical technology (including devices and diagnostics). Business Plans from the Life Sciences Organisation (LSO) in DiT I have seen in the last several years have been very thin on actual practical support for SME’s in these areas. I am fully supportive of the ABHI (Association of British Healthcare Industries) response to the Industrial Strategy which I have been asked to contribute to, and have done so, by ABHI

What are the needs of the life science and healthcare sector across the Cambridge/London region:

Background

Life Sciences is thriving in this ‘region’ with exciting growth, relocations, company formations (and exits), academia-industry strategic collaborations and a strongly entwined ecosystem. 25% of the UK total of biotechnology companies and 38% of all primary UK R & D companies developing novel therapeutics or diagnostics are in this region.

The innovation strength of this cluster is of national and international importance and a reflection of the entrepreneurial ecosystem that exists locally where seasoned life science entrepreneurs interact seamlessly with more recent science graduates and PhD’s with high aspirations and appetites to learn.

AstraZeneca locating its global headquarters in Cambridge, next to the world renowned Addenbrooke’s and MRC LMB is no coincidence: a testament to the strength of the science being developed in and around the City and also the deeply collaborative spirit.

In London of course we have the ‘jewel in the crown’ of scientific endeavour which is the Crick Institute – globally appreciated for what it is seeking to achieve in developing better drugs and outcomes for patients through collaboration and partnership.

Cambridge Points to Make:

Whilst Cambridge is experiencing faster growth currently than China (at 7%), the city and its environment has challenges that the Industrial Strategy could help address.

One Nucleus welcomed HM Government’s recent commissioning of a Science and Innovation Audit (SIA) for life sciences for the East of England. It is our understanding that the findings of the audits are pivotal to Government decision making with regard to investment policy. I firmly believe that the audit will showcase the world class excellence of the East of England in life sciences – with a particular emphasis on:

1. Personalised medicine (drug discovery, development and diagnostics)
2. Regenerative medicine (cell & gene therapies)
3. Genomics
4. Med tech
5. Food, health and microbiome

Our recommendations:

• The need for a Master Plan for the East of England to manage its growth in a way that benefits all locally and importantly (as an engine for the UK) spreads that success across the UK. Cambridge is a city based on ideas and is a ‘safe’ place to do ‘risky’ things – it’s important for Cambridge to continue to do it’s amazing science and R & D and for the surrounding areas to be further developed around it which have the skills to support that work eg: manufacturing in Harlow; and recognition of the expertise of complimentary life sciences eg: food and the microbiome in Norwich. I regularly discuss the East of England region for life sciences with local and national Government and continue to reinforce the point that the incredible life sciences cluster that is Massachusetts is not just about Boston – it’s about what the whole geography brings to the table. Cambridge and the region needs to think like that and plan for 2020 and beyond with that in mind – with investment in land opportunities eg: along the A11 to Norwich and the A14 to Bury St Edmunds

• Retention of the two major cornerstone organisations: AstraZeneca and GSK

• Infrastructure: it is vital that traffic congestion into the city centre is reduced, that there are strong transport networks between key locations across the East of England so that companies can move their teams easily in and out of the city and around the circumference plus north (to Norwich) and South (to Stevenage) and development in outlying (and important) areas of:

• Affordable housing: for all levels of staff in organisations.

• Funding: the City Deal was good but £500 million is a small amount given what needs to be done

• Better planning: Councils are addressing planning needs but more could be done to release land for development more quickly to create more and better practical space, better shared facilities

• Support for start-ups is strong in Cambridge and the region with a vibrant biotech centre and centres of excellence across the area, with entrepreneurs, investors and a very strong mentoring/coaching community. But there is a need to support companies to scale-up

• Promotion of Cambridge internationally – a far better marketing machine is needed and a far better explanation of the impact Cambridge has both on the UK and overseas. The Cambridge Phenomenon books are exemplars but a Cambridge Promotion Agency is needed if the area is to continue to compete on a global stage and continue to win high quality foreign direct investment

• A robust review of the creation/building/growth of incubator/lab space available in the ‘region’. Many reviews have been compiled about what is available but someone needs to take charge of overseeing what is going up where with a ‘helicopter view’ – an Incubator Tsar!

• Create an even better Cambridge Science Centre to encourage science education

• Better wireless connectivity across the whole region

• Have Cambridge as a future City of Culture and create an International Visitors Centre – a one stop shop for tourists, investors, traders, students

London Points to Make:

The life science and healthcare sector alone in London generates over £21 billion GVA in London and the Greater South East. It is very important to harness the strength of London’s research base and support research and business collaboration nationally, across the EU and globally.

It will be critical for Government to continue to (at least) maintain existing levels of research spending in London and the Greater South East, including the level of research funding received from the EU, post 2020. It should also be remembered that there is clear evidence that the benefits of R&D spending are felt throughout the UK economy and not just in the region in which it occurs.

Our recommendations are:

• the importance of better housing supply particularly in terms of London and the Wider South East. Median London house prices in 2016 were (for example) 14 times median London earnings, compared to four times in 1997, and this poses a significant risk to London – reducing ability to attract talented people, particularly in lower paying (but high value-generating fields such as creative industries or scientific research

• Stronger access to finance – this remains a challenge for many businesses in London. Research by TheCityUK found that the UK has been less strong in equity financing than the US for a long time: for example, banks drive only 19% of external long-term financing in the US, compared with over 80% in the UK. [1] London ranks behind California and New York on the availability of mid-level growth capital[2], with these two hubs supported by a strong, risk-tolerant investor culture

• Investment in infrastructure – to support regional growth is responsive to the specialisations and comparative advantages of regions. This includes London, where for example Crossrail 2 is essential to London’s growth as it will underwrite London’s productive central core

• Deployment of research and proof of concept funding to tackle UK city-based challenges across MedTech and digital health applications (for example), using London and UK cities as a test bed

• Trial, in collaboration with other UK cities, new approaches to supporting business to business innovation – linking innovating SMEs to corporate R&D need, strengthening innovation and collaboration across national supply chains

• Create a science and technology inter-institutional collaboration fund across London and the Greater South East, which would be open to UK wide research and business partners

• Improve the linkages and broker relationships between higher education infrastructure/equipment and expertise and business innovation need (including mechanisms to better link up foreign direct investment and domestic business growth requirements with the existing institutional offer)

• Strengthen the entrepreneurial drive across London universities to inspire students, celebrate risk taking and failure, (for example, through drawing on the alumni base to advise and support existing student cohorts) and support a more commercial mind set across academia

My comments in relation to London are the result of consultation with the Greater London Authority (GLA) and London & Partners and the life sciences elements for London appear as part of their submission on the Industrial Strategy.

Harriet Fear
Chief Executive One Nucleus and UK Business Ambassador for the Prime Minister

[1] TheCityUK, 2013, Alternative Finance for SMEs and mid-market companies

[2] EY, 2015, Fintech – on the cutting edge, 2016; Pitchbook, Annual VC Funding Report.

What is Neurodiversity and what are the effects on Cambridge business when the NHS and local authority do not address dyslexia and Asperger Syndrome in adult life.

I write this blog to share a personal story of some of my experiences and knowledge gained after a later life diagnosis of Dyslexia and Asperger syndrome in Cambridge.

What does Neurodiversity mean?

A recent research paper published by ACAS on, ‘Neurodiversity at work’, by Bewley, H. and Anitha, G. (2016) state that ’Neurodiversity refers to the diversity of the human brain and neurocognitive functioning’. It expresses neurodiversity as the umbrella term to encompass neurotypical and neurodivergent. The neurotypical brain is associated with what is considered ’normal’ functioning, whilst the neurodivergent differs from this ‘norm’. The report suggests that, ‘The neurodiversity paradigm embraces all neurocognitive functioning equally and that, the individual minority types are natural human variations, which are authentic forms of human diversity and self-expression, rather than pathologies’.

Neurodivergent encompasses cognitive differences including; dyslexia, dyspraxia, and dyscalculia, ADD/ADHD, Autism Spectrum conditions including Asperger syndrome, OCD and Tourette’s syndrome. The British Dyslexia Association (BDA) highlights that, ‘there are more people with Dyslexia/neurodiversity than all the other disabilities put together’, yet little publicity is given to them.

The social model of disability, which is supported by the Equality Act 2010, states that, ‘It is the way in which society organises itself that creates disability’. The infrastructure required to support neurodiversity needs to start with education for all, so that policy, practice and procedure can be inclusive, in every facet of life. It is not the Neurodivergent individual who needs to be squashed through society’s one-size-fits-all hoop, rather it is society that needs to be educated to provide a choice, to allow everyone a hoop of their choice.

Cambridge is a magnet for neurodivergence, because of the, mathematical, high tec. and research industries in the region. This is further reinforced by Roelfsema et al (2011) who identified that there are significantly more children with Autism in IT rich regions and Wei et al (2003) who suggests that Autism Spectrum Disorder (ASD) students are more likely to choose STEM subjects. In addition, research by Julie Logan on dyslexic entrepreneur’s highlights that in the UK 20% of successful entrepreneurs have been identified as dyslexic and in the US the percentage is 13% higher. I would argue that the reason for this higher percentage is that the US are more open and forward thinking in the field of neurodiversity, resulting in this population flourishing.

The government has identified a goal to halve the disability employment gap by 2020. There is already legislation, indicated below, that should accommodate inclusion for this population. However, the lack of education in society does not allow this to follow through in practice.

• 2006 The Public Sector Duty
• 2009 The Autism Act –  It is identified that just 16% of Autistic adults are in full-time paid work and overall just 32% of Autistic adults are in some kind of work. (NAS) A talent pipeline waiting to be tapped.
• 2010 Equality Act.

My experience

It is my passion to communicate to the employment world the extreme lack of healthcare, education and diagnosis of dyslexia and Asperger syndrome in the UK and more particular in Cambridge. It is difficult to deal with a problem until you accept that it exists. There is no diagnosis for adults with dyslexia and no support except in the private sector. For the last eighteen years, the NHS have contracted Cambridge Lifespan Asperger Syndrome Service (CLASS), to diagnose Aspergers in adults, but there is no help or support after diagnosis. As a result there are no doctors in Cambridge who have any knowledge of dyslexia and Asperger syndrome in adults. This creates two issues 1) that they cannot diagnose and do not know how or where to provide support and understanding to improve the quality of life and 2) they do not know the effects on an Asperger person so do not know how to change their behaviour and comply with Public Sector Duty. This is not the case in other Cities.

Dyslexia

You may ask me how, I came to connect with dyslexia /Asperger syndrome as a mature adult. Well, I have spent a lifetime trying to find out what my differences were, with unaware doctors in the NHS and the education system. This is the story of many adults in the UK. It is so sad because we have lost a life of achievement. By the age of 7 a child knows that they are different from their peers, but they do not understand why and cannot express it. They then have to spend a lifetime hiding it, because education and employment condemn a person to believe that they are not bright, or good enough. I am sure you may know the saying ‘If you ask a fish to climb a tree it will believe that it is stupid for the whole of its life’. It is not the dyslexics who are stupid, it is society who is unaware of the challenges they face.

My first step on the road to diagnosis was in recognition of the difference between the wealth of knowledge in my head and the content of language that came out on paper or verbally. This recognition led me to question a friend on how she thought. I was aghast as she told me about a tick-a-tape of words running across her head. I could not comprehend that and I explained my own experience of visualising a beautiful, illuminated image with smaller detailed images springing up simultaneously within the main image. I don’t need words, I just know. However, the problem lies in when you have to tell other people what you know. The amount of information in my head at one moment in time, far exceeds my friend’s tick-a-tape of words, yet she would be regarded as brighter than me because she could just repeat a tick-a-tape sentence in an instance and I would struggle to be succinct. This is the story of a dyslexic. We are often highly intelligent, creative 3D thinkers who see the bigger picture. We have a different way of doing things and in seeing the world around us. It doesn’t make us dense, it makes us valuable. If you have a problem or a policy that is not working, find a dyslexic because their bigger picture thinking will provide a prompt, creative solution.

Dyslexia is about a spikey profile where some of your profile maybe in the 90 percentile whilst one or two may be in 30/40 percentile. The gap between the spikes is what dyslexia is. The low spikes tend to be in working memory and processing speed. In the non-dyslexic all the profile points would tend to be roughly along a straight line. In order for a person to understand their level of Dyslexia, an assessment needs to be performed by a trained expert. These are not provided free on the NHS or in education. Instead they have to be paid for privately. The cost is prohibitive at around £500-£600 per report. As they are in the private sector there is no standardised monitoring and critical research came out last year highlighting the poor performance of assessments.

Whilst the BDA currently advertise that 10% of the population has dyslexia, this was a view gained from the 1960/70s when a number of research documents were averaged. However, the government do not diagnose and there are many people who have dyslexia, but have not been diagnosed. So there is no capability to accurately identify the number of dyslexics in the UK.

There is a petition https://petition.parliament.uk/petitions/168137 which is trying to get a diagnosis for dyslexia carried out by the NHS. This is where it should be diagnosed because it is about a brain difference. The government’s response may claim that they already fulfill the diagnosis need because they already diagnose in schools and produce education reports for diagnosed children. However, these education reports are not acceptable in a court of law and the government will not accept them when allocating Disability Students Allowance. An expert’s assessment is required. Indeed, one education authority will not accept the educational report of another, so where is the value?

I feel that the symptoms of dyslexia are similar to the early symptoms of Alzheimer’s and I asked the research charity if there was a correlation. I was told that someone in Canada found a gene in dyslexia and Alzheimer’s but they would need funding to do the research.

Asperger Syndrome

I soon realised that dyslexia did not cover all my problems and started researching on the internet. I came across Asperger syndrome and believed I presented with its symptoms. I found CLASS and downloaded all the information to take to a GP to request a referral. I was refused an assessment by CLASS because my parents died when I was teenager. CLASS was set up by researchers who needed a population for their research. They wanted an outcome of Asperger syndrome or High Functioning Autism and therefore developed their assessment tools to meet those requirements. The difference is that someone with High Functioning Autism may not begin to speak until later childhood e.g. 9/10 or later, whilst an Asperger person would speak at the normal childhood rate. They recommended I approach Leicester NHS for an assessment.  It took me over a year to obtain a confirmation that I had Aspergers syndrome. I have spent over 40 years in the NHS with doctors who were unable to consider Asperger syndrome because of their lack of education. A copy of the report was sent to my GP and Cambridge and Peterborough Foundation Trust. (CPFT) with a request to provide a care package. They responded by stating they did not deal with Asperger syndrome and from this point my years of struggle with all the public sector in Cambridge began.

Legislation states that the NHS and local authority have a legal duty to provide an assessment of needs for a vulnerable person and this has been the case since 1990. Yet, the statements that came flying at me from the NHS/Local Authority were ‘They would not deal with me because I had an IQ over 70’, ‘they have no doctors who have any knowledge of Asperger syndrome’. I was denied counselling because ‘I was no different to anyone else with the same condition’. This was all very disheartening because had I lived in Leicester I would have readily been provided with help and support. A diagnosis as an adult in both dyslexia and Asperger syndrome is a life changing experience and to leave someone with no support and understanding is quite shocking and a damming indictment on Cambridge for failing to comply with their legal duties. Over the years nothing has changed, they are just pretending to address the issue, to tick the boxes.

Why is understanding neurodiversity so important to the present and future of Cambridge?

The failure to address late diagnosis clearly has an effect on the economy, health and judicial system, but it also affects the talent pipeline for business in Cambridge. There are no programmes in the DWP/Job Centre to provide support for this population in getting into work, however, if you are lucky enough to secure employment, there is ‘Access to Work’ from the DWP, which will help initially, in funding for technical/support equipment and training for the team. This is helpful, but what we need is ‘education for all’ to transform the culture and behaviour within organisations. Business has a right to expect that corporate and local taxes will ensure that Cambridge is one of the most neurodiverse knowledgeable cities in the UK. We have a rich supply of talent in Cambridge and many international employees will always want to have Cambridge on their CV. Would someone for Silicon Valley want to come and bring their family to Cambridge knowing there was no support in this area? Dyslexia is hereditary but the question is out on Autism. We have a responsibility to grow the seeds and nurture the neurodivergent population, whilst it is with us. How can organisations address Wellbeing and stress if they don’t address dyslexia and Asperger syndrome first? The NHS, Education and employment do not yet have the knowledge and skills to accommodate this, but must develop the enquiring mind to do so.

We are competing in the global market place for talent, but are those who manage the recruitment and talent pipelines educated and sufficiently accommodating, to be inclusive of the neurodivergent population? In the world outside Cambridge, many organisations are recognising and targeting this population. Cambridge is being left behind. In the US Microsoft https://news.microsoft.com/stories/people/kyle-schwaneke.html and in Europe SAP http://www2.cipd.co.uk/pm/peoplemanagement/b/weblog/archive/2016/05/16/sap-recruits-100-autistic-employees-in-three-years.aspx have been developing specific recruitment programmes for the autistic population. This is now being introduced in the UK in London https://news.microsoft.com/en-gb/2016/02/26/microsoft-extends-autism-and-inclusive-hiring-programme-to-uk/#sm.000qz6289173fd8ipv019xb9yiyky#ETprW4ZalYCh0gvk.97. GCHQ specifically recruit from the dyslexic population. http://www.dailymail.co.uk/news/article-2764078/Government-intelligence-agency-employs-dozens-dyslexic-spies-special-skills-help-crack-codes.html. What is Cambridge doing?

Cambridge Neurodiversity Hub

I want to help Cambridge build a bridge into my world, so that you too can see and share the quality skills of the neurodivergent population. Cambridge Neurodiversity Hub, aims to educate and facilitate learning for Business in Cambridge. We are looking to create a membership organisation and seeking four founder members to guide its development.

To provide a step into learning, Neurodiversity Educational Workshops will be held in Cambridge in the near future.

If you are interested please check out the website: www.cambridgeneurodiversityhub.co.uk  or email at info@cambridgeneurodiversityhub.co.uk

Written by Carol Fowler, Learning and Development Manager and Cambridge Neurodiversity Hub.

The One Nucleus blog is written by individuals and is not necessarily a reflection of the views held by One Nucleus.