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Interview: What can the pandemic teach us about how to collaborate better?

Professor Mike Roberts is Managing Director of UCLPartners AHSN. We spoke to him about how collaborations across the London region have been leading the global fight against COVID-19, with UCLPartners involved in many of the innovations featured in our Unleashing Innovation report.

His experience highlights why the life sciences ecosystem is so special in our region – home to a formidable group of world-leading clinical, academic and industry bodies willing to work together to overcome challenges through research, innovation and collaboration. These connections have been tested and strengthened throughout the pandemic response, showing the important role that organisations like the Academic Health Science Networks and MedCity play in joining up the dots and bringing the right people together to speed up innovation.

Q. How have the AHSNs been involved at a national level in responding to the unprecedented challenges presented by COVID-19?

The AHSNs work together as a network, and also work locally in their regions alongside their local provider partners and integrated care systems. We have readymade networks and relationships which can really help in this kind of crisis situation.

But when the national and regional authorities first started thinking about their emergency plans, AHSNs weren’t really considered beyond our ability to source information locally. There seemed to be a lack of planning to devolve responsibility out to the regions. If instead they had given each NHS region the ability to work with its AHSNs to deliver technology solutions at that early stage, it would have been a much more effective way of delivering virtual first solutions in responding rapidly to the pandemic.

Since then there’s been a definite shift to involving the AHSNs more, with 70% of national commissioning funding now allocated to local plans. There’s a much clearer understanding that a lot of the solutions need to be sourced locally, rather than there being a central fix for everything.

Q. What role has UCLPartners played in trying to align work going on across the London region?

At the start of the pandemic it seemed obvious there was a lot of good work going on across the London region – in different parts of the NHS, in our Applied Research Collaborations (ARCs) and Academic Health Science Centres (AHSCs) – but no one was pulling it all together. So we tried to bridge that gap.

We went to the NHS leadership team in London region and suggested we needed some joined up discussions with everybody that could help support their work. We’ve now set up this group called the Evaluation Cell where the three AHSNs and three ARCs across London meet regularly with the NHS London region team, and identify areas which need researching or evaluating.

It’s taken us three months to get here, but we’ve now got something that works and could last well beyond the pandemic. It’s a way of actually aligning everybody, which has not happened before.

Q. What’s the value of cluster organisations like MedCity in supporting the work that you do, and what are the synergies between your work?

MedCity are able to help amplify our work, helping us to engage likeminded organisations with diverse skill sets so that we can better understand the most pressing issues faced by the NHS and collaborate to develop much needed solutions. They also can articulate the London wide narrative bringing together not only the UCLPartners story but that of the whole London research and innovation system.

Q. How have you helped share emerging learning during the response to COVID-19?

Through our connection with Barts Health, we were involved in setting up the Nightingale Hospital. We saw this as an opportunity to really do something different, so we suggested developing a learning health system there, to ensure we captured clinical learning in real time combining that with the latest research evidence brought in on an almost a daily basis to inform how teams could adapt care.

We also did some important work around intensive care. Early on in the pandemic we were hearing that people didn’t know how best to manage cases. With COVID-19 being a novel condition, the existing guidance for critical care didn’t really apply.

One of our team happened to be a senior member of the Intensive Care Society, so we formed a relationship with that organisation very quickly, helping to fund a number of workshops. These brought together a panel of experts to have a facilitated discussion with clinicians about what was working in their clinical care. Then we quickly pulled together a team of people who could synthesize this experience and produced consensus statements about best practice. That had great traction and was picked up all over the world, including by people like Don Berwick in the States. We developed contacts in France, Spain, Germany, China, the US, all over – helping people to understand what was going on. At the height we had over 5,000 clinicians getting our weekly bulletins.

Q. What other collaborative projects have you been involved with in the region’s COVID response?

Evidence shows that more people die in a pandemic from non-pandemic related health issues than from the pandemic itself. Our primary care team worked with the Clinical Effectiveness Group based at Queen Mary University to run algorithms on primary care records in order to identify the patients most at risk of deteriorating from their long-term conditions. We then created a package of digital resources and practical support to help primary care teams provide proactive remote care to those patients. That’s a big piece of work which has now been adopted for the whole of London.

We’ve also worked with the London region to reach a consistent approach to commissioning post-COVID rehabilitation services. There were lots of documents being produced by different groups, all covering various aspects. We brought together experts to pull out all the key statements and create one comprehensive document.

Q. What has been the biggest learning point along the way?

I think it’s all just highlighted how important good collaboration really is. Some of the work we’ve done ourselves, but a lot has been bringing other people together to do the work and just supporting them. The intensive care work is an example of that. We brought the right people together and suddenly we had a collaboration that could make a difference. We’re now doing a further piece of work to define a core data set for intensive care management of COVID-19, which will be vital during the second wave to help us understand what best care looks like.

Q. What changes implemented because of the pandemic do you think might be here to stay?

We’ve learned that we can engage a lot of people through remote conversations. In the future I can see us adopting a blended model, retaining some face to face events, but building on the virtual events to try and engage a wider audience.

The other big thing that I hope is here to stay is the much closer level of collaboration we have now across the research networks. Despite the pandemic, we’ve also just managed to launch the Genomic Medicine Service Alliance. An enormous amount of work has gone into bringing together nearly 30 trusts to sign a document of collaboration. All of this means that the levels of connectivity between all parts of health care, research and education will continue to be even stronger in the future.

To discover more ground-breaking projects that have been developed across the London region ecosystem in response to COVID-19, explore MedCity’s interactive COVID-19 Unleashing Innovation Map.

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