Aligning Innovation with both Health Service Needs & Economic Opportunity Life Sciences International Summit 2010 Croke Park, Dublin 11th November 2010 Jim Breslin, Department of Health & Children
Research, Innovation & Health - Where have we come from?
Low tech &
Modest health outcomes
Where have we gotten to?
Complex & hi-tech
years to life &
life to years
Health Service Transformation - Today’s Drivers
Reducing budgets - Public health spending of €15bn represents
27% of public expenditure,
49% of total tax receipts &
133% of Income Tax receipts.
Public demand for access and quality
Biotech, genetics, convergence of products and devices, functional foods, remote diagnostics and healthcare delivery, etc
Demographics & growing burden of chronic illness
Integration between primary & secondary care
Health Service Transformation - Preferred Model
Safer, more efficient and more sustainable
Designed around the service user
Focus on chronic illness e.g. Programmes & Care Pathways covering Stroke, Heart Failure, Asthma, Diabetes, COPD, Rheumatology & Care of Older People
Prevention through screening (breast, cervical, bowel cancers, etc), lifestyle and other primary and secondary preventative measures
Introduction of multi disciplinary Primary Care Teams
Home care packages, community mental health teams and other community supports to maintain people at home
Health Service Transformation - Preferred Model
Centralisation of certain specialist services e.g. cancer services in 8 designated centres
Acute Medicine Programme to address current access & quality issues
Reconfiguration of hospitals based upon networks made up of regional centres and local hospitals
Shift to ambulatory care from inpatient treatment
Quality – external inspection and licensing
Health information and technology used for service delivery and performance management
Resource allocation to support preferred model
ALL OF THE ABOVE ARE ALREADY UNDERWAY BUT NOW NEED TO ACCOMMODATE SPENDING REDUCTION IMPERATIVE
The Role for Health Research: The Interconnections
Quality health services, a vibrant health research system and social and economic prosperity are not separate but inextricably intertwined.
High Performing Health Services Vibrant Health Research System Smart Economy
Health & Wealth – Evidence for the Virtuous Circle
Unemployed 17% 4.6%
Long Term Unemp. 10% 1.3%
Employed 1.1m 2.1m
Migration -23k +67k
Govt Deficit/Nat Income 9% 0.3%
Govt Debt/Nat Income 118% 25% (14% net)
Life Expectancy M 70 yrs M 76.8
F 75.6yrs F81.6 (1 yr > EU)
Circulatory death rate 464 209 (EU 246)
Infant mortality 7.9 3.2 (EU 4.5)
Daycases 88k 567k
Av. Length of Stay 7.3 days 6.2 (EU 6.7)
Public spend per capita $664 2,121 (OECD $1,684)
Using Health Research to Promote Both Health & Wealth
Strong health research system needed to support:
Transformation of health service delivery and patient outcomes
Economic agenda in developing new products and services
Health Research Pathway Translation & Application - Clinical & patient oriented research -Population Health Sciences -Health Services Research Basic Biomedical Research Transformation Health outcomes and system performance Commercialisation New technologies
The Health Outcomes Gap EXISTING HEALTH OUTCOMES Potential Health Outcomes Coordination of Treatments and Services Implementation Gap Scientific Knowledge Gap
The Health Outcomes Gap EXISTING HEALTH OUTCOMES Potential Health Outcomes Alzheimer’s treatments Thrombolysis delays in stroke treatment Late discharge summaries for GPs Service Coordination Implementation Gap Knowledge Gap
Action Plan for Health Research (2009)
The Health Research Group published the Action Plan in order to be accountable, to generate support and to build partnerships amongst diverse stakeholders with passion for research & innovation.
What will the Action Plan for Health Research Achieve?
Framework for co-ordination & accountability across diverse stakeholders.
National priorities for health research.
Enabling research infrastructure; in particular clinical research facilities in our main academic hospitals & scalable informatics and bio-banking solutions.
More clinical trials networks, internationally linked.
Focus on commercialisation & industry partnerships.
Streamlined and predictable regulatory environment.
What will the Action Plan Achieve?
7. More clinicians & health care professionals doing high quality patient focused research.
8. Rebalancing activity towards patient related outcomes.
9. Increased capacity for population health and health services research.
10. Transformation of care pathways informed by (locally adapted) international research evidence.
Mechanisms to monitor and evaluate investment, across both health and economic dimensions.
Action Plan – Year 1 Progress
Investing in Clinical Research Facilities Benefits to industry: - Access to Clinical Specialists and Networks - Access to Patient Cohorts - Research Nurse Support - Biostatistics & Informatics Support - Regulatory Support - Bio specimen Storage and Processing - Linkage with International Researchers & Funding Programmes
Other Highlights of Year 1 Progress
Growing & Networking Clinical Research Facilities
National bio-banking solution
Centre of Excellence for Successful Ageing approved
Revamp of Research Ethics Committee Structures
HSE research governance brought under Quality & Clinical Care Directorate & aligned with Clinical Care Programmes
HSE Quality & Clinical Care partnering with Enterprise agencies on Innovation
Year 1 Progress Contd.
Clinical Trials - Cardiovascular and Stroke Network under development
HRB awards have been aligned more towards patient and health service benefits
New HRB/SFI Translational Research Awards
SFI/HRB/Wellcome Trust Biomedical Research Partnership
International – Tripling in latest FP7 funding awards to €17.4. Strong Irish participation in Joint Programming in Neuro-degenerative and Food areas.