Getting world-class technologies into the NHS has long been both a Holy Grail and a major headache for UK politicians. So far adoption of technologies, from improved prosthetic limbs to surgical devices, has been slow, mired in bureaucracy and wrangling over funds.
But all that will change if Prof Terry Young succeeds in the daunting challenge he has taken on.
Young, chair of health systems at Brunel University, spoke to The Engineer just days after receiving news that a bid for £3.3m in funding from the EPSRC had been a success. The cash will be used to create the Multidisciplinary Assessment of Technology Centre for Health (MATCH), which will help the progress of medical devices from concept to patient by developing criteria aimed at singling out promising technologies and helping them to market.
Academics have a patchy record of success with such initiatives, but Young is not a typical academic. He made the transition from industry just 18 months ago after spending almost 17 years at GEC/Marconi, where his work included building an internationally renowned simulation suite for integrated optics, as well as spending time at CERN.
His own academic credentials are strong – a degree in electronic engineering and physics and a doctorate in atomic physics. But it is all those years of experience of the world beyond the notoriously tangled undergrowth of the NHS that may give him a fighting chance of success.
So far Young says the transition from industry to academia has been enjoyable and he appears to be relishing the unique challenges and opportunities of his post. ‘I’m aware that my background is different from most academics, but having the chance to spend time on projects rather than having my direction changed if the market alters is a bonus,’ he said.
‘My aim is to get about £5m of funding for healthcare delivery research at the university each year. I want to help Brunel become a real centre of excellence and this is a great start.’
If he is to succeed Young will need to be something of a diplomat able to reconcile the needs of doctors, equipment manufacturers and, most crucially, patients.In an example of his eagerness to look beyond the NHS to show what can be done, he cited his involvement in a 1989 project to help the BBC install broadband fibre optics at its television studios in Cardiff, at a time when the technology was still in its infancy.
‘We had to work with the arty types – the producers and directors – as well as the engineers to interpret what they all wanted from the technology and what they hoped to achieve. It was quite difficult but very interesting,’ he said.
‘I was really fortunate to be working on integrated optics technology in the 1980s. It was an area that was well funded and at the cutting edge.’
It was clearly an environment Young thrived in, for by 1999 he was business development director for Medical Systems at Marconi. That was his last stop before Brunel in a career that had seen a growing interest in healthcare systems delivery.
According to a former close colleague, Young’s rapid progress in his new academic role should come as no surprise. Mike Ginn was director of GEC Marconi’s Chelmsford research centre, where Young spent much of his career with the company.
‘Absolutely nothing stops him,’ said Ginn, who explained how Young had been fired by enthusiasm for the work being done by Marconi’s US health systems business and persuaded the UK operation to raise its game in the field. ‘It wasn’t easy, as getting funding for that sort of thing can be hard. But he managed it.’
Once it is up and running MATCH will aim to create effective, affordable trials designed to minimise the cost of getting a device to market while ensuring its development mirrors patients’ needs. Young is well aware that the current labyrinthine development structure will take some untangling. ‘In the UK if you want to change a product’s function you have to go back to the regulatory stage. Or else you change it so little that you can argue that you haven’t changed it at all. This doesn’t help devices to improve and so it’s not good for the patient.’
According to Young, part of the problem lies in the fundamental nature of the health technology marketplace. ‘A lot of companies are making products for a niche market,’ he said. ‘This is completely different from the pharmaceutical industry, where companies can afford to invest huge amounts and be assured of a good profit at the end. If you have four or five ideas, you have to be able to decide which one you are going to run with. Also, if it turns out that the product actually costs twice as much to make as you forecast then it may not be suitable for the market.’
Young added: ‘Manufacturers see products in terms of cost, users in terms of their function, while the regulators are concerned with their reliability and value. It must be possible to integrate these views and come up with devices that everyone deems viable.’
Young clearly has plenty of theories on why the NHS’s technology programmes are going wrong and how they might be fixed. But behind the talk of business models and time to market is a strong conviction that the adoption of new medical technology within the NHS is currently inefficient and letting patients down.
But despite its shortcomings Young is a passionate defender of the NHS. ‘It really is one of the best in the world, in that the system cares for you from cradle to grave,’ he said. ‘In the US if you change jobs you may fall out of the system altogether.’The root problem, Young believes, may be more national than just the NHS. ‘I don’t think we do innovation very well in this country,’ he said. ‘It can be difficult to take a new concept and push it through into a real application. I once read a book which looked at a series of innovations in terms of military activity.
‘In the case of the aircraft carrier, the UK got ahead very quickly but didn’t really work out how it fitted into the overall system, unlike the Americans or the Japanese, so its lead was short-lived.
‘The NHS is one of the most complicated systems imaginable in terms of cost and politics yet it finds itself trying to change. In the commercial market, if you make a mistake the company goes bust but the market moves on. In healthcare, survival of the fittest doesn’t exist. Healthcare is different from other sectors but that doesn’t mean it can’t learn from them.’
Sidebar: For the record
Professor Terry Young joined the Marconi Research Centre in Chelmsford in 1985 fresh from completing a Phd in atomic physics at Birmingham University.
Over the next 16 years he held a series of research and strategy development positions at both GEC and Marconi, managing and developing photonic systems for the company as well as building up the company’s fledgling broadband services. Young was appointed GEC Marconi business development director for medical systems in 1999, working in the UK and US to develop healthcare delivery concepts for use on both sides of the Atlantic.
In 2001, after gaining a total of eight patents for his work developing optical networks, photonic components and minimally invasive surgery, Young left industry to become professor of healthcare systems at Brunel University.
As well as co-ordinating Brunel’s MATCH bid, Young is leading the university’s Research into Information and Gritty Healthcare Techniques (RIGHT) initiative, which aims to improve healthcare delivery by comparing existing systems with industrial and business delivery models.
He is also researching the impact of the use of tele-medicine on care delivery at a local hospital.