The Week

The Week 26 May 2023

Patrick King
Senior Researcher

This Monday saw the launch of the first of Labour’s five missions for government, which focuses on building an NHS “fit for the future”.

Its headline ambitions, for a “prevention revolution” and for much more care to be delivered out of hospitals and in the community, are familiar — yet welcome. For a summary of our thoughts, see this thread from our health lead, Seb Rees.

One thing that really stands out is the prominence of the life sciences in Labour’s plan. As the document says, the UK has a “world-class” life sciences sector, underpinned by Europe’s best university sector, a clinical research community that punches well above its weight, and the NHS’ unparalleled datasets.

But resting on our laurels leaves this at risk (we’re told that we’ve already dropped below Spain, France, and Italy in the global rankings). Key to the future of the life sciences is proper support for clinical research, a sufficiently rewarding payment mechanism for new technologies and drugs, and an agile regulatory environment. It is encouraging to see each given their dues in Labour’s vision.

Of course, much ink has been spilt making the same points in the flurry of life sciences reviews and reports we’ve seen in the last few years (the Bell Review, 2021 Life Sciences Vision, or the upcoming Vallance report, anyone?). However, key policy commitments around how the NHS can facilitate life sciences innovation — whether through smarter commissioning of innovative technologies or streamlining bureaucratic processes to bring new products to market — are clear statements of intent.

Also fundamental to turning this vision into reality will be boosting our capacity to carry out clinical trials. Those looking for ideas in this space would do well to start with today’s O’Shaughnessy Review. We’ll be poring over the detail this weekend, but here are some recommendations worth your attention.

First, the review recommends building on announcements made in the Spring Budget, by boosting funding to the MHRA (the medical devices regulator), to “tackle delays in the clinical trial approval process”, and enabling it to achieve “more ambitious KPIs”. This is something Reform called for in our report on the life sciences last year, and will help return the MHRA to its more flexible pandemic-era regulatory practices.

Second, the review calls for a specific clinical trials career path, to overcome the “lack of incentives” for researchers to take part in commercially funded research (compared to academic studies). Sensible. As evidence submitted to the Lords Science and Technology Committee suggests, it can be hard for staff to carve out the time for this research, particularly in parts of the country where there’s a large clinical workload.

Third, there is a recommendation to promote more “decentralised” clinical trials (that take place in settings such as people’s homes or pharmacies). This is an example of an area where other countries — from the United States to Denmark — are adopting a more innovative regulatory approach. We know that primary care is a very small part of clinical trial activity, despite its huge potential for population-scale trials, so breaking our “reliance on hospital settings” would be a good move.

Onto our recommended watch (not read!) of the week…

PAC’s evidence session on digital transformation with Alex Chisholm, the Government’s COO, made for positive viewing on Monday. We’re told that recent investments in remediating legacy IT, and transforming digital and data, have been the “most positive and significant” yet. In turn, fuelling an impressive expansion in digital, data and tech skills in government (there are now 26,000 employed in the profession, compared to 19,000 in 2021).

Regular meetings between departments’ Permanent Secretaries and digital leaders, through the Digital and Data Board, also help secure buy-in for transformation projects, as does the new “digital excellence programme”, which is specifically designed to equip senior civil servants with essential digital skills.

There’s still work to do (digital, data and tech professionals comprise only 4.5% of Whitehall, compared to 8-12% in industry, and issues remain around data-sharing between departments, for example). But an increase in the civil service’s digital capability, and progress, from the One Login programme to a reduction in the number of “high risk” legacy technologies, is certainly worth celebrating.