Unlock Your Global Business Potential : The UK Medical Imaging opportunity

1. Unlock Your Global Business Potential: The UK Medical Imaging opportunity

2. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL Government commitment to Life Sciences and Healthcare “In December 2011 I made a firm commitment to re-establish the UK's global leadership in the life science sector, announcing the Government's ten-year Strategy for UK Life Sciences.” “By more closely integrating the UK's unique strengths, I believe that we can improve healthcare for patients, attract new investment to the UK, and create new jobs and business opportunities in an increasingly competitive and international industry.” David Cameron Prime Minister • The Strategy makes the most of the UK’s core strengths: • Basic science in universities • Translational and clinical research excellence • Industry and supply chain • The National Health Service (NHS) Life Science Strategy and Innovation Health and Wealth are the UK government’s response to a global sector under pressure

3. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • New UKTI team – the Life Science Investment Organisation (LSIO) • Combines private-sector expertise with Government teams • Charged with • A new approach to promoting UK health science excellence • Translatingbenefits of the UK’s Life Science Strategy and capabilities for business x10 x20 • Creating focused messaging matching UK strengths with global business needs x30 x20 x30 x10 • Catalysingand empowering the UK Life Science community to work with international business

4. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • Despite a difficult economic climate in which other sectors have struggled, the UK Medical Technology sector has rapidly grown over the last 4 years, with an increased turnover of 50% between 2009-12. • A third of the companies in this sector have significant R&D and Manufacturing activity in the UK • The number of medical technology companies in the UK increased by 12% from 2009-12 in line with this sector growth, the number of people employed in the sector increased by 40% in the same period. • The wider UK market opportunity for your medical technology business The UK medical devices market was valued at £6.4bn in 2013 The UK medical devices market is rising by 7.3% per year reaching £9.1bn by 2018 The sector is comprised of 3,129 UK-based companies which employ just over 71,000 individuals The global medical technology market is expected to double to approximately £300bn by 2015¹

5. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • The UK medical technology landscape has a rich heritage of innovations in medical imaging • The use of ultrasound equipment in medicine has transformed diagnosis and the observation of prenatal development. • The invention of a commercially viable CAT scanner in the UK opened the door to a new branch of imaging which has become a mainstay of diagnostic imaging. • The discovery of the potential of nuclear magnetic resonance to visualise internal structures has transformed diagnostic imaging.

6. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • The UK medical technology landscape has a rich heritage of innovations in medical imaging • The innovations in robotics and the medical adoption of robotics for minimally invasive surgery are providing quality benefits to patients undergoing surgery. Academics at University College London and the University of Houston aim to solve cancer staging and healthcare challenges through the application of advanced magnetic sensing technology and nanotechnology Norman McDicken's group at Edinburgh University developed a technique called tissue 'Doppler imaging', which improved ultrasound images.

7. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • The UK medical imaging market opportunity • A growing market • The UK market for diagnostic imaging is estimated at US$1,836mn in 2013, equal to 18.6% of the total market, by product area¹ • Medical device market by product area • From 2013-2018 the Diagnostic Imaging projected CAGR is 8.6%¹to reach a total value of US$2,769mn in 2018and is the fastest growing market across the medical devices sector.

8. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • The UK medical imaging market opportunity • High growth sub categories • Within the diagnostic imaging category, the following are set to grow the highest amount: • Electrodiagnostic apparatus (incl. MRI and ultrasound apparatus) set to expand to a CAGR 7.5% from 2013-18 • Radiation apparatus set to expand to a CAGR 7.2% from 2013-18 • Imaging parts & accessories (incl. contrast media) set to expand to a CAGR 10.2% from 2013-18¹ • Growth being driven by • The need to procure ,around half of all CT and MRI scanners and linac machines, which are due for replacement. The National Audit Office estimates the cost at £460 million² • Increased demand for scanning equipment, driven by a focus on reducing waiting times, and increasing clinical application of the equipment across the NHS. For example, the ability of scanning equipment to allow early diagnosis and provide timely intervention within areas such as cancer, stroke, dementia and major trauma²in addition to the Department of Health’s aim of increasing cancer patient’s access to radiotherapy³ • The UK’s world-leading excellence in medical imaging continues to flourish: • Ranked first for relative world impact in the neuroimaging field⁴ • Third for relative world impact in radiology, nuclear medicine and medical imaging (closely behind Germany and the USA)⁴ • Third for relative world impact in imaging science and photographic technology(behind the USA and France)⁴

9. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL The UK market opportunity for your medical technology business • Your business can access the UK medical technology market and supply chain by engaging with a range of UK healthcare markets: • The UK in 2011-12 collectively spent approximately £128bn on the National Health Service, a publicly funded healthcare system which is free at the point of service. Within England some Specialised Services (such as Proton Beam Therapy) are centrally commissioned with the majority of the remaining services/technologies being procured by regional NHS organisations. • Break down by region (2011-12): NHS Scotland£11.5bn Department of HealthSocial Services and Public Safety, Northern Ireland£4.4bn Department of Health in England£106.6bn NHS Wales£6.3bn • The UK private sector healthcare market was valued at £30.4bn in 2010. The UK private sector healthcare market is estimated to reach £35.9bn by 2015. • The Social care market, dominated by assistive technologies, is set to grow from £2bn in 2012 to £6bn in 2020.

10. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • The UK government has introduced fiscal measures to stimulate innovation and growth for companies • A business environment that supports and rewards innovation Pbox £300m 23%Corporation tax will drop further to 20% R&D tax credits for SMEs worth approximately 25p on every £1 (7p for large companies) Patent box: 10% corporation tax on qualifying profits To stimulate R&D partnerships between universities businesses & charities £180m Low corporation tax rate currently standing at 23 per cent decreasing further to 20 per cent by April 2015. Biomedical Catalyst = £180m programme of public funding for growth • The Technology Strategy Board is to invest up to £4.5m in collaborative R&D to Improve cell and tissue analysis competition for stratified medicine for collaborative R&D funding • Smart is a grant scheme which offers funding to small and medium-sized enterprises (SMEs) to engage in R&D projects in the strategically important areas of science, engineering and technology, from which successful new products, processes and services could emerge.

11. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL The UK medical technology opportunity • The UK offers your medical technology business: • A nationalised health service providing unrivalled access to a single healthcare market of over 60 million people • World-class resources, academic institutions and research to prove concepts for innovative medical technology • Manufacturing capabilities to design, prototype and engineer medical technologies • A national clinical research infrastructure to translate research, access patients and validate and design, utility and effectiveness of your medical technology • A fast and supportive regulatory system for CE Marking • Health economic assessment to build evidence towards early adoption and market entry • Access to anonymised patient data • Access to government incentives and tax breaks • A supportive investment environment for your business’ growth • Support available from UK Trade & Investment (UKTI) to help launch your business into the UK and then into international territories. R&D based on unmet clinical needs Determine gaps in care Health technology assessment and market entry Designprototype and manufacture Anonymised patient data Iterative development Show value Clinicians and Patients Test Efficiency Validate Regulatoryapproval Clinical studies Supportive funding and investment environment

12. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL Determinegaps in care • 1. R&D based on unmet clinical needs • Treating almost 1 million patients on a daily basis, with 1.7 million employees across England, Wales, Scotland and Northern Ireland, the NHS is the largest unified healthcare system in the world and is one of the world’s largest employers. • World-class resources, academic institutions and research to prove concepts for innovative medical technology. The UK has the highest number of skilled engineers and scientists in Europe and four of the top six universities globally. • The National Institute for Health Research funds a range of clinical research infrastructure which function across the innovation pathway. A number of these are supporting the medical device and diagnostic industries in their clinical research. 1 R&D based on unmet clinical need CliniciansandPatients Clinicians and Patients • Imaging focused Biomedical Research Centres provide a direct route to work with the UK’s leading investigators and clinicians with the expertise to translate fundamental biomedical research into new and improved approaches to healthcare. • NIHR Translational Research Partnerships— Enabling technologies and infrastructure, including imaging, biobanks, accredited laboratory facilities. Cancer Research UK and the Engineering and Physical Sciences Research Council (EPSRC) are together committing funding of £35mn for four cancer imaging centres Five Academic Health Science Centres lead university, NHS and industry collaboration in imaging research.

13. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • 2. Design, prototype and manufacture Design, prototype & manufacture 2 • The UK has a rich heritage of innovative medical engineering and continues to rely heavily on engineering to deliver improved prevention, diagnosis and treatment of illness. • The UK has a range of globally renowned academic institutions maintaining strong engineering research departments with close links to global industry. • UK med tech companies benefit from a comprehensive supply chain offering professional support, contract services for product development, design and prototyping, through to manufacture, supply and distribution. Iterative development Clinicians and Patients British design and engineering institutions and consultancies: The Design Council, The Royal Academy of Engineering, Helen Hamlyn Centre for Design at the Royal College of Art High Value Manufacturing Catapult helps businesses work with leading scientists and engineers through £1bn of private and public sector investment The High Value Manufacturing Catapult transforms brilliant manufacturing ideas into valuable products and services

14. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • 3. Clinical studies • The combination of the uniqueness of the NHS linked to a clinical research infrastructure offers a whole range of activities across the development life of a product to build this evidence early and on an on-going basis as your business moves through the medical technology development pathway. • The NIHR Office for Clinical Research Infrastructure (NOCRI) in England enables you to demonstrate the clinical performance of your medical technology at pace. The research infrastructure works with industry to design protocols, providing access to world leading academic and clinical expertise, enabling you to output high quality evidence. Clinicians and Patients Clinical studies 3 TestEfficiency • Unlocking data to drive innovation • Clinical Practice Research Datalink • Health and Social Care Information Centre • Hospital Episode Statistics (HES) NIHR Medical Device and Diagnostics Industry Partnershipshelp device and diagnostics companies produce innovative products successfully NIHR Clinical Research Network support set-up and delivery of medical technology research studies. NHS Research Scotland provides support for clinical research, In Wales: The National Institute for Social Care and Health Research supports health and social care research In Northern Ireland: Health and Social Care Research and Development, funds clinical research networks

15. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • 4. Regulatory approval • The European Union’s regulatory system for medical devices has proved highly successful, and is recognised as setting a high standard for patient safety. • The MHRA is an Executive Agency of the Department of Health and has UK-wide responsibility for the regulation of medicines and Clinical Trials and is the Competent Authority in regulating medical devices in the UK, supported by accredited Notified Bodies. Regulatory approval Validate Clinicians and Patients 4 The MHRA Innovation Office helps you navigate around the UK and EU regulatory landscape. The MHRA is launching an ‘Innovation Office’ to help organisations who are developing innovative medicines, medical devices or novel manufacturing processes navigate the regulatory processes in order to be able to progress their products or technologies. The Integrated Research Application System (IRAS) is a UK-wide system that streamlines the process for applying for permissions and approvals to conduct health and social care research, including clinical investigations of medical devices. It allows users to enter the information for the relevant permissions and approvals once, instead of having to complete several separate application forms for each review body.

16. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL Show value • 5. Health technology assessment and market entry • By basing your business in the UK, you gain access to the largest national healthcare system in the world. The NHS. Whilst the Government’s Strategy: Innovation, Health and Wealth report aims to embed and spread the uptake innovation at pace and scale • The UK is a world leader in health technology assessment and home to the National Institute for Health and Care Excellence (NICE) Clinicians and Patients Health technology assessment and market entry 5 NICE’s Medical Technologies Evaluation Programme identifies medical technologies that have the potential to offer substantial benefit to patients and/or to the NHS and are likely to be adopted more consistently and more rapidly if NICE develops guidance on them. Emerging Academic Health Science Networks will facilitate access into the NHS and align education, clinical research, informatics, innovation, training and healthcare delivery providing a network aimed at facilitating the adoption and dissemination of innovative technologies. • The NICE Interventional Procedures programme evaluates the safety and efficacy of new interventional procedures. • The Technology Appraisals Programme (TAP) • The Medical Technologies Evaluation Programme (MTEP) • The Diagnostics Assessment Programme (DAP)

17. Appendix

18. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • Cancer Research UK and the Engineering and Physical Sciences Research Council (EPSRC) are together committing £35 million for five years to four separate cancer imaging centres across the country, helping to cement the UK’s position as a world leader in cancer imaging research. • The cancer imaging centres will serve as focal points of world-class research using a variety of techniques, such as optical microscopy, MRI (magnetic resonance imaging), functional MRI*, ultrasound, and PET (Positron Emission Tomography) • The four imaging centres to receive funding are at: The University of Oxford, The Institute of Cancer Research, London, a joint imaging centre between King’s College London and University College London and a new collaboration between the University of Cambridge and University of Manchester.  • Cancer imaging is set to get a major boost from a £35 million nationwide initiative to develop cutting edge imaging technologies for basic and clinical cancer research. • “This investment will help drive major improvements for cancer patients in the future. Research is unlocking cancer’s secrets and our ability to see what is going on with cancers is essential to better diagnose, monitor and treat cancer patients.” Dr Iain Foulkes, Cancer Research UK’s executive director of strategy and research funding. • EPSRC and Cancer Research UK fund four cancer imaging centres to further research in cancer imaging

19. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • Academic Health Science Centresin England continue to develop as the NHS opens up to work in research partnerships with industry. The role of the Academic Health Science Centre is to develop and take the discoveries made through research partnerships and translate them into new therapies and techniques, and promote their application in the NHS in as fast a timeframe as possibleEngland is currently home to five Academic Health Science Centres. • The current Academic Health Science Centres have the following imaging capabilities: • Imperial College Healthcare • Imaging Sciences Centre (ISC): • Computer Vision and Medical Imaging • Cambridge University Health Partners • Information Engineering Division, Department of Engineering • Digital Technology Group, The Computer Laboratory • King's Health Partners, London • Department of Imaging Sciences and Biomedical Engineering , active research departments in Cardiovascular and Cancer Imaging and the Osteoporosis Unit • Department of Informatics (Algorithms and Bioinformatics) • Manchester Academic Health Science Centre • Wolfson Molecular Imaging Centre • UCL Partners • Centre for Medical Image Computing • Centre for Health Informatics and Multiprofessional Education (CHIME): • Academic Health Science Centres furthering medical imaging research

20. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • The National Institute for Health Research is funding research centres which link Universities to an NHS trust, mandated to test proof of concepts and validate innovative solutions in specific disease areas. • NIHR Biomedical Research Centresprovide a direct route to work with the UK’s leading investigators and clinicians with the expertise to translate fundamental biomedical research into new and improved approaches to healthcare across a wide range of disease and clinical areas. The Centres are based within the most outstanding NHS and University partnerships in England. • NIHR Biomedical Research Units focus on translational research in individual priority clinical areas. They provide access to internationally recognised research leaders working in areas of high disease burden and unmet clinical need. Biomedical Research Centres and Units have links with other research specialties across their host institutions and can provide access to expertise in areas such as engineering, to support prototype development and refinement. • The National Institute for Health Research Infrastructure has a range of medical imaging focused BRUs and BRCs

21. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • NIHR Diagnostic Evidence Co-operatives (DECs) have been set up to improve the way diseases are diagnosed. DECs will focus on clinical areas or themes where evidence of the clinical validity, clinical utility, cost-effectiveness and care pathway benefits of in vitro diagnostic medical devices (IVDs) has the potential to lead to improvements in healthcare services and the quality of life of NHS patients. Based in NHS Trusts in England, DECs will bring together a range of experts and specialists from across the NHS, patients, the IVD industry, pathology services, NHS commissioners and academic researchers. • The NIHR Horizon Scanning Centre aims to supply timely information to key policy and decision-makers within the NHS (for example, NICE) about emerging health technologies that may have a significant impact on patients or the provision of health services in the near future. • NIHR Translational Research Partnerships bring together world-class investigators in the UK’s leading academic and NHS centres to support collaboration with the life sciences industry in early and exploratory development of new drugs and other interventions. • Translational Research Partnerships offer an internationally unique approach  to support open innovation and collaboration with the life sciences industries.  Collectively they bring together: • Recognised experience in current exploratory development protocols, expertise in pathophysiology and disease mechanisms, expertise in modelling. • Enabling technologies and infrastructure, including imaging, biobanks, accredited laboratory facilities. • Cohorts of well-characterised patients available for clinical development studies. • NIHR Healthcare Technology Co-operatives have since established eight NIHR Healthcare Technology Co-operatives, based within NHS Trusts, as national centres of expertise in developing new concepts, demonstrating proof of principle and devising research protocols for new medical devices, healthcare technologies or technology-dependent interventions in areas of unmet clinical need. The Health Technology Co-operatives with Imaging themes are: • Cardiovascular HTC • Colorectal Therapies HTC • Brain Injury HTC • The National Institute for Health Research Infrastructure links universities and NHS Trusts to translate research into trials

22. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL The Northern Ireland Clinical Research Network develops close partnerships and productive working relationships with key individuals and groups across the Network and the wider research community and ensures that targets, including accrual of patients into trials, and enabling technologies such as imaging are achieved and maintained. Scotland Interface provides a matchmaking service, linking businesses and investors to the world-class expertise and research facilities available in Scottish universities and research institutes. The service also provides information on the range of funding opportunities available to nurture collaborations between academia and industry. Scottish Imaging Network: A Platform for Scientific Excellence: SINAPSE is developing a world class future in medical imaging for Scotland by drawing on the combined expertise of is a consortium of six Scottish universities; Aberdeen, Dundee, Edinburgh, Glasgow, St. Andrews, and Stirling.¹ • Imaging research and development capabilities across the Devolved Administrations In Wales: the National Institute for Social Care and Health Research (NISCHR) Biomedical Research Centre (BRC) and Units (BRU) were established to support high-quality translational research in Wales. The Centre/Units have the highest quality research records and are based on health areas of particular importance to Welsh Assembly Government. BRC and BRUs are partnerships between the NHS and universities. Advanced Medical Image Analysis and Visualisation Unit s a partnership between the NHS in Wales and Aberystwyth, Bangor, Cardiff and Swansea Universities, and is based at the Research Institute of Visual Computing (RIVIC) in Bangor.The Unit provides leading expertise in Wales in the area of medical image analysis and Visualisation to facilitate a translation change in support of medical practice.

23. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • .  • Advanced Forming Research Centrefocuses on developing forming and forging technologies to support the design and manufacture of products, across a range of sectors including Aerospace, Automotive, Energy, Medical Devices and Marine. • Advanced Manufacturing Research Centre focus on High-performance machining to improve production efficiency, Assembly for low-volume, high-value systems and difficult-to-handle components, Innovative manufacturing techniques for composite materials, Advanced structural testing of components and assemblies, Design for manufacturing. • The Centre for Process innovation utilise proven assets and expertise taking products and processes to market faster. There is no down time in production as all of the process development is completed offsite, technology transfer and engineering teams help to transfer the product or process into full scale production at speed. The HVM Catapult's network consists of seven technology and innovation centres, established and overseen by the Technology Strategy Board, with over £200 million of government investment • High Value Manufacturing Catapult network works with industry to incubate and develop new technologies through to commercial reality Advanced Forming Research Centre The Centre for Process Innovation Advanced Manufacturing Research Centre

24. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • Manufacturing Technology Centre focuses on Intelligent Automation, Advanced Tooling and Fixturing, Electronics Manufacturing, High Integrity Fabrication, Manufacturing Simulation and Informatics, Metrology and NDT and Net Shape and Additive Manufacturing. • National Composites Centre pre-preg and dry fibre solutions, with thermoset and thermoplastic resin systems, a wide range of manufacturing technologies and equipment including hand lay-up, robotic fibre placement, tri robot cell, resin infusion, hot drape forming, press forming, with both in and out of autoclave curing.  • Nuclear Advanced Manufacturing Research Centre aims to enhance the capabilities and competitiveness of the UK civil nuclear manufacturing industry, and help British manufacturing companies compete for nuclear contracts worldwide. • Warwick Manufacturing Group focus is on Lightweight Technologies and Energy Storage and Management • High Value Manufacturing Catapult network works with industry to incubate and develop new technologies through to commercial reality Nuclear Advanced Manufacturing Research Centre Warwick Manufacturing Group Manufacturing Technology Centre National Composites Centre

25. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • In the UK, your business will have access to unrivalled, clinically-coded health data and bio- repositories, including linked datasets to understand care pathways • Unlocking Data to Drive Innovation More than 60 million people are served by a National Health System • Example data resources: • UK Biobank is a unique resource of data and samples linked to medical histories and health records from 500,000 adult participants • Clinical Practice Research Datalink (CPRD) enables observational studies, clinical trial feasibility and protocol optimisation, and post-market surveillance • NIHR BioResource enables recall to clinical studies by genotype and phenotype and helps stratify and select patients for trials “We have had a very productive relationship with the Cambridge Bioresource (CBR) over the last two to three years where collaboration has resulted in provision of genetic resource, conduct of clinical and translational trials, and publication of both clinical and immuno-inflammatory mechanistic study results related to pharmacogenetic interactions. The initial interactions between us (industry) and CBR have been very successful and this is a collaboration we are keen to maintain and develop.” Simon McHugh, Director of Scientific Operations at GlaxoSmithKline

26. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL Who are they? What do they do? • The new NHS Structure in England • NHS England are responsible for directly commissioning: • Pharmacy services • General practice • Dentistry services • Specialist services (specialised services that are required by a limited number of people) Clinical Commissioning Groups (CCGs) are overseen by the executive non-departmental body: NHS England, which make sure that CCGs have the capacity and capability to commission services successfully and to meet their financial responsibilities NHS England • Clinical Commissioning Groups will be responsible for directly commissioning or buying health and care services including: • Elective hospital care • Rehabilitation care • Urgent and emergency care • Most community health services • Mental health and learning disability services There are just over 200 clinical commissioning groups each will have different and distinct characteristics. Each CCG will have an average budget of more than a £100m and will together manage some £70 billion of NHS funds ClinicalCommissioning Groups (CCG) Made up of care providers, i.e acute trusts (mainly foundation), community services, mental health services Contract Providers Provide care to patients and manage allocated budget CCGs are groups of GPs that have formed from April 2013, they will be responsible for designing local health services In England. They are managed by NHS England.

27. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • In early 2012, the government stated with better purchasing at least GBP1.2bn could be saved over four years in health service savings. The government also announced plans for a world class procurement system that would incorporate a cash fund to enable the bulk purchase of equipment like MRI scanners and ultrasound machines. The Department of Health said it is developing a system of placing bar codes on medical products to help hospitals negotiate better prices • The second report 'Managing high value capital equipment in the NHS in England' was published in March 2011. It covered a specific set of products: CT scanners, MRI units and linear accelerators. Many of the report's main findings echo those of the report into consumables: • Trusts assess demand for high value equipment largely independently of each other. With a few exceptions such as stroke or cancer care, there is little co-ordination of planning across the NHS. • Half of all the machines covered by the report are due to be replaced within three years, and 80% within six years, based on a ten year lifetime for such equipment. • Fragmented procurement means that Trusts often pay more than they need to for new equipment, and there is little assessment of maintenance costs within and between Trusts.. • Trusts face competing demands on their capital budgets, so will look at extending the life of existing machines, alongside other options such as leasing equipment or contracting out, as well as replacement. • Contracting of NHS diagnostic scanning is more common, with around 10 per cent of MRI scanners providing NHS services managed by the private sector.¹ • New NHS Procurement Review aims to drive better value

28. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • The Department of Health has announced that two Trusts in England have been chosen to develop Proton Beam Therapy centres¹: • The Christie NHS Foundation Trust hospital in Manchester • University College London Hospitals NHS Foundation Trust. • A Proton Beam Therapy that will treat up to 1,500 patients per annum over two sites with around 300 of these patients as Paediatric. This is in line with the Government Policy, Improving Outcomes and A Strategy for Cancer (2011). • Up to £250 million will be invested by the NHS to support the build up of these services • The development of the service will be closely monitored and should further capacity be needed in the future, the preferred third site is University Hospitals Birmingham, subject to normal business cases processes and the views of NHS England. • Opportunities: • Supply of Proton Beam Therapy Equipment; • Supply of Proton Beam Therapy Services; • Installation of Proton Beam Therapy Equipment; and • Maintenance of Proton Beam Therapy Equipment. • UK Proton Beam Therapy Centres

29. Case Studies

30. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL Lightpoint Medical receives award from Technology Strategy Board to develop hand-held imaging technology • Lightpoint Medical is an early-stage medical device company dedicated to improving health outcomes for cancer patients through image-guided surgery. • The company’s hand-held molecular imaging technology, based on Cerenkov luminescence imaging, has the potential to detect cancer in real-time during surgery, thereby providing more accurate cancer treatment while sparing healthy tissue. • The technology’s 100-fold lower cost and size relative to a PET scanner make it a potentially disruptive technology. • “Nearly 1 in 4 patients who undergo surgery for early-stage breast cancer will require repeat operation. We aim to address this enormous medical need through our proprietary molecular imaging technology. This award builds on our successful private fundraising and previous Technology Strategy Board grants.” • Dr David Tuch, CEO of Lightpoint Medical

31. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL University of Leeds Medical Technologies Innovation and Knowledge Centre forge R&D partnership with Siemens Healthcare • Senior researchers at Leeds Musculoskeletal Biomedical Research Unit (LMBRU) are working with Siemens Healthcare to develop an advanced MRI imaging technology. The team is developing the new technology for orthopaedic medical device new product development applications and to improve support for clinical trials and therapeutic decision making. This latest MRI technology is providing an earlier and clearer understanding of implant performance, principally by delivering surrogate outcome measures for fixation failures. These measure are expected to be notably valuable in patients and studies related to implanted devices where soft tissue related data is either unseen or distorted in current MRI technologies.

32. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL Toshiba Medical Visualization Systems Europe (TMVS) expands its R&D operations in Edinburgh • Voxar, an Edinburgh-based technology start-up specialising in advanced visualisation software for the medical imaging sector was acquired by Toshiba Medical Systems Corporation, forming TMVS, now a major R&D centrefor Toshiba’s medical business internationally. The products and expertise of TMVS support a diverse range of imaging systems, such as CT, MR, Ultrasound and X-ray systems, together with associated informatics solutions.   • In December 2010 TMVS, aided by a Scottish Enterprise R&D grant of approximately £3m, saw a significant expansion of its R&D operation in Edinburgh stimulating innovation to provide cutting edge medical imaging solutions to improve the quality and efficiency of patient treatment. • “In a global economy, Toshiba’s decision to site a major R&D center in Scotland is noteworthy. In a technically challenging and rapidly evolving sector such as ours, access to the best talent, expertise and research facilities is paramount. The UK not only offers this, but also the infrastructure and environment to foster innovation and help continue to keep our business at the leading edge.” • Ken Sutherland, President, TMVS, Europe Ltd

33. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • IXICO and Cambridge Cognition combine brain imaging with computer-based tests to improve dementia diagnosis • A collaborative project led by IXICO is developing a novel, cost-effective digital healthcare system to enable earlier diagnosis in dementia. The system will be deployed in a memory clinic or a local brain health centre and will combine computerised cognitive testing and quantitative brain imaging, aiming to provide doctors with a quality of information currently available only in highly specialist centres. The project was awarded funding from the government funded Biomedical Catalyst in 2012. • “In medical imaging, and in the clinical aspects of medical imaging, the UK is especially strong. We have on our doorstep world experts we can engage as consultants, and bright scientists and research groups developing new technologies. The NHS structures are rapidly evolving to make it a superb platform for assessing new technology, and combined with health economic expertise, the UK can help us demonstrate the value of our technology in a way that can help translate to larger global markets.” • Derek Hill, Founder and CEO, IXICO

34. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • Imaging excellence through a unique academic partnership • Imaging is fast becoming one of the most effective means of detecting disease and tracking progression, even in the earlier stages. The UK offers imaging expertise, facilities, and clinically-annotated datasets to enable patient selection, clinical trials, and diagnostic development. • Imanova is a unique partnership between the Medical Research Council, Imperial College, University College London and King’s College London. Building on current strengths in neuroscience and cancer imaging and developing novel applications, Imanova is a national hub with world-class imaging facilities and a focus for academic and commercial collaborations. • “Our Company is developing novel imaging probes to investigate key disease pathways in dementia and oncology, such as neurodegeneration and apoptosis, which will provide invaluable information for the development of new drugs and patient stratification. New imaging tools could transform the drug development process in these debilitating diseases.”Kevin Cox, CEO Imanova

35. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • Development and validation of a method for Diffusion Tensor Magnetic Resonance Imaging (DT-MRI) in the human heart • Hypertrophic Cardiomyopathy (HCM) is a genetic heart disease – one of the known conditions to cause ‘sudden death syndrome’ in even the fittest of athletes. • Current tests to detect indications of HCM include electrocardiography and echocardiography. Whilst these techniques display decreased cardiac function and a thickening of the myocardium, they may not reveal the condition before it has significant impact on the patient. • Researchers at the NIHR Royal Brompton Cardiovascular Biomedical Research Unit (BRU) are leading in the development and validation of a method for Diffusion Tensor Magnetic Resonance Imaging (DT-MRI) in the human heart. • Director of Cardiovascular Magnetic Resonance, Professor Dudley Pennell has said: “As a leading innovator in cardiovascular MR, the NIHR Royal Brompton Cardiovascular BRU is helping to gain a further understanding into a condition that still poses a great threat to high-risk, potential sufferers. Our collaboration with Siemens has translated into outstanding results constantly leading to better knowledge of how to diagnose, predict and manage hypertrophic cardiomyopathy”.

36. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL University of Warwick and Bosch Healthcare launch research facility • The Institute of Digital Healthcare (IDH) in Warwick Manufacturing Group (WMG) at the University of Warwick and Bosch Healthcare have launched a major research facility for developing digital healthcare technologies for people with life-threatening and chronic illnesses. • WMG at the University of Warwick is working with Bosch Healthcare, Warwick Medical School and other partners on selected healthcare activities. A new IDH Learning Lab will design and trial novel digital healthcare technologies and will aim to understand and evaluate the effectiveness of digital programmes in the health service. • “This approach is at the very heart of our healthcare products, which connect patients to services and assist them in having more control over their own wellbeing. It is therefore, very exciting for Bosch to be a founding partner of the IDH Learning Lab, which will enable new technology to be developed and tested and we look forward to the results it will produce.” • Peter Fouquet, President of Bosch, UK

37. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL Healthbox Europe supports entrepreneurs • Founded by US incubator and venture capital firm Sandbox Industries, Healthbox supports healthcare entrepreneurs by providing early stage businesses with seed capital, business coaching and connections to organisations and individuals from across the healthcare spectrum, including private and public providers, investors, retailers, business experts and national health stakeholders • Sandbox Industries recently launched Healthbox Europe, which invested £50,000 in seven selected healthcare start-ups who moved from across Europe to London to participate in the programme • “London was the obvious place for us to launch our first Healthbox programme outside of the United States given the world-renowned academic institutions, focus on improving health and growing technology community.” Nina Nashif, CEO, Healthbox

38. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL Hitachi links up with the Greater Manchester health ecosystem • Japanese technology giant Hitachi has established a presence in Manchester to work with the Manchester Academic Health Science Centre (MAHSC) and Network (GMAHSN) building on the expertise of North West eHealth and the NHS in Salford. The collaboration aims to develop IT designed to manage and improve patient care and population health. • The discussions between Hitachi and the Manchester health ecosystem have been supported by UK Trade & Investment (UKTI) and the Department of Health. • “The UK has a huge amount to offer in health innovation specifically within the health informatics space. The NHS with 60+ million patients has access to unrivalled, clinically coded, granular health data, providing a unique opportunity to test innovative approaches to health informatics in order to meet end patient benefit.” • Mark Treherne, Chief Executive, UKTI’s Life Science Investment Organisation (LSIO)

39. UNLOCK YOUR GLOBAL BUSINESS POTENTIAL • How UKTI can help you work with and establish new connections in the UK • Our practical help and advice is free and confidential UKTI’s professional trade and industry advisers operate in the UK alongside a global network of experts based in all British diplomatic offices overseas • Links with centres of excellence (e.g. universities) • Information on tax, regulatory and business planning issues • Information on financial incentives if applicable • Information on staff recruitment • Site and Property search assistance • Building key contacts – we can provide introductions to service providers, local, regional and national government and trade organisations. • Aftercare through on-going support • Maximising your global potential – Once you are established in the UK, we can help your company to take advantage of newbusiness opportunitiesand branch out to new locations – both in the UK and overseas.