A conversation with Richard Phillips — Taking the pulse of UK Healthtech

In 2020, CPI entered into a partnership with ABHI to stimulate innovation development and fuel growth of the UK’s SME HealthTech sector. Cristina Blood, Strategic Marketing Manager for Pharma and Medtech at CPI, caught up with Richard Phillips, Director of Policy & Communications, on the trends for the sector.

Q. Richard, you and your colleagues at ABHI live and breathe HealthTech – what sort of trends are you seeing?

We see a number of trends that are driving change across our membership, and importantly, how these relate to the ambitions set out by what is effectively their only customer in the UK, the NHS. There are three broad trends we see as being significant over the next decade: 

• Traditional medical devices will remain the mainstay of treatment.
• There will be significant advances in innovative surgical interventions.
• There will be significant convergence of traditional device, diagnostic and information technology.

Q. That’s interesting…to pick up on the first trend, when we are often told about all the changes in HealthTech, it will in fact be traditional devices that will remain the mainstay of treatment?

Yes, to provide you with some context, the UK population is predicted to increase in size, from 65.6 million in 2016 to over 74 million by 2039, and older people will increasingly outnumber people of working age. Whilst life expectancy increases modestly, the proportion of life spent in ill health or disability is projected to increase. It is these well-rehearsed demographic trends that continue to drive demand for what might be considered as traditional treatments. 

Cataract extraction, joint replacements and other planned surgery all help people stay independent and yield important quality of life gains. 

In the 1990s and 2000s, the NHS made large investments to reduce waiting times for planned surgery. Referral to treatment times remain low by historic standards, and GP referrals are flat, but in recent years treatment capacity has not grown fast enough to keep up with patient needs, and the number of patients waiting longer than 18 weeks has been steadily increasing. The situation has been dramatically exacerbated by the COVID-19 pandemic. 

The potential for new technology to transform the way many of these patients are treated is significant, but in the near term, it will be traditional methods that the NHS will be focussing on to tackle the waiting lists. 

Q. And when it comes to surgical interventions, what kind of innovations are you seeing here?

To quote Lord Ara Darzi, surgery is a discipline that has and continues to move from ​“saws and scalpels to robots and lasers.” Significant developments over a number of years have occurred in minimally invasive approaches, smaller incisions have reduced procedure times and complications, and increased safety and patient satisfaction. Many surgical disciplines have benefitted, from gall bladder and hernia treatments to endovascular interventions for a range of cardiovascular diseases. Progress is likely to continue and is leading to the development of techniques that reduce the number of incisions needed, such as Laparo-endoscopic single-site surgery (LESS) and Single Incision Laparoscopic Surgery (SILS). Natural orifice transluminal endoscopic surgery (NOTES) goes a step further. Also known as ​“surgery without scars,” NOTES involves a planned incision through the wall of natural orifices to access the peritoneal cavity and perform a surgical procedure avoiding skin incision altogether. To facilitate these further improvements in surgical techniques, new devices will develop to provide access via different approaches, and surgical tools are likely to become smaller, more dexterous and ​“intelligent.”

Perhaps the highest-profile element of minimally invasive surgery is that which is robot assisted. There are some barriers to overcome in terms of perceived costs and practicality, but they are starting to become relatively routine in areas such as orthopaedics, colo-rectal and cardiothoracic.

Furthermore, new surgical robots will include systems to record the entire procedure, as well as capturing telemetric data from the robotic arm and associated instruments. This could allow better evidence-gathering, audit, the refinement of surgical techniques and, ultimately, improved surgical outcomes.

Q. Fascinating! And finally, can you tell us more about the convergence of technologies?

The most commonly cited driver of change in the HealthTech sector is digitisation. ​“Digital health” is such an all-encompassing term that ABHI has long abandoned attempting to provide a concise definition. What is clear is that rapid developments in information technology, particularly wireless technology, are driving the convergence of hitherto discrete disciplines.

Perhaps the most obvious example is the explosion in the use of ​“Smart Devices.” The term refers to medical devices that have become more portable, or wearable, thanks to advances in miniaturisation and wireless connectivity. These devices can encompass a range of product types, from activity monitors and smartwatches to wearable patches and smart clothing. This type of technology does present significant challenges, especially where HealthTech meets mainstream information technology. Tech-savvy patients with access to Apps available on Open Source are already beginning to interact with their own medical devices out of sight of manufacturers and regulators alike. It is definitely one to watch. 

In the management of asthma, for example, smart inhalers, with extra digital features that link to Apps can alert patients when they are in high pollution or high pollen areas, send appropriate reminders, or check inhaler technique. They can also reliably record inhaler use, aiding clinical decision-making.

Of course, the patient benefit should be the driving force behind any change, with new products co-developed with patients from design to implementation. Technological advances and a greater focus on prevention, health and wellbeing will bring major improvements in patient outcomes and change the nature of how HealthTech is considered and deployed.