While agricultural policy and fishing quotas have dominated coverage of Scotland’s relationship with Europe, the country’s reputation in health across the continent has been growing momentum. This has coincided with health becoming central to the European Commission’s ‘Europe 2020’ growth agenda, which recognises health spend as investment in citizens.
Scotland’s participation in the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), set up by the EC to address societal challenges of an ageing population through innovation, has seen two ‘three star’ evaluated reference sites. The national telecare programme, which ran from 2006 to 2011 was recognised, along with the joint improvement team’s work on anticipatory care planning. This has helped foster Scotland’s reputation on the European stage.
This year the EC has launched Horizon 2020, the biggest EU research and innovation investment programme ever. Among other things, this vast financial instrument will distribute money to two new Knowledge and Innovation Communities (KICs). The idea is to link education and entrepreneurship with research and innovation to produce EU-wide societal benefits.
Edinburgh University, along with the newly established Digital Health Institute (DHI) in Edinburgh, is leading a bid to establish one of these new KICs, centred on healthy and active ageing. Six co-location centres spanning Europe are involved in the bid, including southern Denmark and Galicia and the Basque Country. It is hoped each centre will attract at least €10m per year in funding. If successful, the UK collocation node in LifeKIC will be hosted in Edinburgh and the overall LifeKIC will also be headquartered in Edinburgh. This will enable the university to participate as an “innovation hub”.
However, in 2009 the university led a failed bid for the first round of KICs, this one for ICT innovation. The successful bid had a longer run-in time and more political support. “Our mistake was not understanding that the other bids were doing so much political lobbying. We know that the bid that beat us, ‘ICT Labs’, had support from prime-ministerial level in both France and Germany, and we just didn’t have that. The Scottish Government were very supportive of us but in the European Commission’s eyes, they’re not the UK national government, and we hadn’t got to the point with the UK national government where we had letters of support from them, etc. So that’s something we learned in the process. We really should have done that,” says Professor Mark Parsons, Commercial Director of the National e-Science Centre. This time, he and colleague Professor Stuart Anderson have been careful to garner broader support.
As well as research funding, a successful bid would benefit Scotland, according to NHS 24’s Medical Director Professor George Crooks. “First of all, it will allow us by building this community to accelerate both our knowledge and understanding, and also the deployment of new services to cope with the challenges the health and care sector is facing today across Scotland. The ageing population, the increases in long-term conditions, the fact people have more than one long-term condition, and how we manage that. In the past, we’ve always felt we’ve had to reinvent the wheel, and that is wasteful both in terms of time but also in money, and therefore sharing with other leading regions can actually speed up those processes. It’s all about sharing and cooperation and knowledge exchange, so we don’t all make the same mistakes. The other thing it will do is it will generate economic benefit for Scotland,” he tells Holyrood.
Partnership working must include patients, the public sector, academia and, crucially, industry, according to Crooks. Although the entrepreneurial spirit of the private sector has been met with suspicion in the past by public health authorities, it is now widely accepted by the NHS and the Scottish Government that innovation in health can have long-term benefits. Linking the silos is a central aim of the DHI.
“So we’re slowly moving, and KIC will actually accelerate the shift, creating opportunities and potential. At the end of the day, my key driver is I’ve got to deliver services that are not only safe and of high quality, but they have to be sustainable into the long term. Technology is key to that, but it’s not about replacing nurses or doctors or anyone else with machinery, it’s actually driving up efficiency and doing what our citizens actually want. You and I want to take as much responsibility for our own health and wellbeing as we can, but we find it difficult to do so, and through KIC we’re going to explore how we can use technology, how we can use existing networks and new networks to make that more easily accessible and more achievable for us all,” says Crooks.
Justene Ewing, CEO of the DHI, says: “The opportunity to utilise the widely recognised excellence that Scotland delivers in collaborative and partnership working, diversity and invention to develop innovative products, services and training in a specific area of the economy so it can help overcome some of society’s main challenges in that field is something Scotland and its partners are very well placed to do. The Digital Health Institute is very excited to be a part of this fantastic opportunity.”
Professors Anderson and Parsons say innovation is not just about technology, but how it drives the capacity of ideas. Anderson, of the School of Informatics, says: “Health and care is kind of an information game. It’s who knows what, and who’s comfortable with who knows what. OK, we have a big and potentially complicated infrastructure but actually, the ideas that’ll make a difference are things that have broad applicability and to some extent, they’re simple. Important things will be things like increasing community capability to deal with care needs, for example.”
The French region of Aquitaine has a pilot scheme where postal workers will go into the homes of elderly people to make sure they are taking correct medication. Parsons believes it is an example of how working in big European networks can enable idea-sharing. “Telecare and telehealth devices and solutions on their own can’t save you money. They need to be coupled with systemic change, and some of those changes look extremely simple in terms of what the idea is and they don’t involve technology but they do need to happen if you’re going to change the way health and care are delivered in tandem with the sort of devices we see coming out,” he says.
Anderson agrees: “More and more, there are all kinds of sources of information. If you go to your gym, the machines will be picking up a lot of data about you. Somebody was talking to me about a car that’s going to have an EPG monitor built into the steering wheel. If you look at the sorts of sources of information, the question then is how do you make sense of it and share it appropriately, and at the same time maintain safety and the duty of care. That’s what the innovation centres are going to help people to work towards.”
The KIC bid is a “great opportunity” for Scotland, says Crooks, “because so often we hide all our successes quietly in a corner because we don’t like boasting. It’s the Scottish way. But we need to recognise we’re at the cutting edge of this agenda, and we need to turn that to our own advantage. Putting forward a successful KIC bid is another step on that path.”
Aileen McLeod MSP, who is the EU reporter for the Health and Sport Committee, also sees the KIC bid as an opportunity to build on Scotland’s continental relationships. “There’s a lot of interest in Scotland, and you know, it shows in terms of the relationships we can build. Not just with European countries but also within the EU institutions themselves, that we have a growing reputation and credibility,” she says.