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Hughes Hall and NHS entrepreneurship

Translating knowledge into improved healthcare

An important aspect of our college’s role is to equip our graduates to transition from university into their professional lives, enhancing their ability to make a powerful contribution in their chosen sector. Dr Stephen Axford, Governing Body Fellow and Director of Strategy and the Bridge, explains how the Bridge at Hughes Hall plans to develop a programme with the NHS that will enable clinicians to make an even greater impact.

We all feel that sense of excitement at those moments when a range of quite different and only loosely connected ideas come together and inspire thinking about just how much better the world could be. Over the past challenging year, the relatively small community of Hughes Hall has demonstrated a vast range of innovative and global activity that has attacked the pandemic and its impacts head-on. We are now building on this to focus on the wider relationship between the college and the public health community, exploring what we can do together to achieve a healthier and more resilient society.

Improving healthcare through clinical entrepreneurialism

If we want to improve healthcare – not a bad proposition during a pandemic – let’s think why the UK’s NHS is still seen by many, if not most, as the best example of public service health provision. Key to its success is its research activity, which takes place across the organisation, in hospitals, institutes, universities, and in partnerships with the private sector. As one organisation, it has access to the largest single patient body and associated records, and it provides an environment where innovation can flourish. However, for successful innovation, we need people to show creative flair, for that to be nurtured and encouraged, and for the incentives and processes to be in place to allow these individuals the space to be successful – both personally and for the benefit of healthcare.

This way of working is generally referred to as clinical entrepreneurialism. It’s a broad concept aimed in its wider sense at bringing together clinicians (from medicine, dentistry, nursing and the allied health professions) with entrepreneurs, business-focused support and education, mentoring and supporting structured access to potential funders. Whilst entrepreneurialism may primarily be commercial in focus, it may also be more socially directed. The strategy of clinical entrepreneurialism is advanced in North America, and to a lesser degree in other universities within Europe and the UK.

Professor Bill Irish

We are fortunate in having Professor Bill Irish as a Governing Body Fellow and Tutor at Hughes Hall. Bill is the Postgraduate Dean for medical training in the East of England, working for Health Education England (HEE), part of the NHS. One of Bill’s key areas of concern is how the NHS can improve its offering to medics on a senior career track who also want to explore their innovative and entrepreneurial ideas for improving healthcare, whether that’s through a new device, an app, a new way of working, a commercial relationship, or many other routes.

‘The NHS is very committed to this area – partly due to the commercial opportunities it presents for the UK, but mainly around potential transformational opportunities for healthcare within the NHS,’ Bill explains. ‘Interest is particularly focused around advancing clinical care through, for example, information technology and genomics, but also on efficiency gains, and early improvements in the quality of patient care.

‘The NHS offers a unique “space” to develop innovations and ideas as it provides seamless access to the entire population of the UK, within a closed and fairly tightly managed ecosystem. This is not available anywhere else in the world.

‘Within NHS England (the main commissioning arm of the NHS), the importance of this area is clearly recognised. For the last three years it has been supporting a modestly funded but reasonably successful clinical entrepreneur programme across the health professions. In conjunction with HEE, a pathway has been developed that allows flexible access to postgraduate medical training, combined with time and mentoring to allow trainees to develop their skills and ideas.’

Clinical entrepreneurialism at Cambridge

Hughes Hall combines a multidisciplinary academic body with a fellowship drawn particularly from education, business, medicine, genomics and bioscience, and a strong commitment to translating knowledge into practice through its Bridge initiative. Bill believes it is the ideal environment to take a lead in this area and develop this important and valuable opportunity.

His proposals centre on supporting an initially small number of the most promising clinical entrepreneurs and giving them the optimum support. In the longer term, the intention is to develop a higher-level offer which complements the NHS England scheme, but is more aligned to similar programmes offered by institutions such as Stanford and Harvard.

Bill Irish explains why he thinks Cambridge – and Hughes Hall – is so well positioned to implement this. ‘The East of England Deanery (part of HEE) educates 5,000 postgraduate medical and dental trainees to consultant and GP level on a hub-and-spoke model, focused around Cambridge. It is already very supportive of academic and entrepreneurial trainees through flexible and bespoke access to speciality training.

‘Cambridge offers a flourishing local ecosystem based on informatics, engineering, biotechnology and medicine. It also encompasses enterprise-focused providers such as the Judge Business School, which have programmes for (and a track record in) supporting potential and early career entrepreneurs.

‘At Hughes Hall, alongside our strong educational heritage we have world-leading researchers in many medical disciplines and a large cohort of student medics on the graduate medicine course. To further enrich the mix, we have great depth in business education and research, with several Fellows at the Cambridge Judge Business School. We have all the ingredients.’

A pilot scheme

The Bridge at Hughes Hall will develop a pilot over the next couple of years. Some of the things we might expect to see rolled out include:

  • flexible clinical training in a postgraduate medical speciality. This would allow breaks in clinical training to give ‘space’ for study and so develop skills in enterprise, business planning and seeking funding
  • an academic home at Hughes, with regular support from peers and interested Fellows
  • a wrap-around programme of seminars, potentially open to others interested in this area
  • partial or full bursary or scholarship support for the programme, to supplement their NHS salary
  • help to access funding and investment, and to connect individuals to the wider Cambridge landscape
  • ongoing mentoring through the remainder of their clinical training programme from the Judge and Hughes Hall.

Upskilling for impact

What’s really exciting about this potential programme is how it adds to our growing portfolio of activities that are concerned with ‘upskilling for impact’ – something the college is developing as a natural part of offering education that transcends the traditional boundaries of undergraduate and postgraduate teaching.

At the Bridge we already run our successful Impact Leadership Programme, aimed at early career researchers, and this broader educative approach is at the heart of other college projects such as the Centre for Climate Change Engagement and Chapter Zero (focused on business leaders), and the Digital Education Futures Initiative, looking at how everyone learns in a connected, digital society.

Clinical entrepreneurship is a very natural topic for Hughes Hall to pick up and run with over the coming years.

This article was published in the most recent edition of the College magazine, Hughes 32 which can be read in full here.

June 2021