The Excalibur Medical Network - Developing Markets Chris Evans... · The NCP has identified key...
Transcript of The Excalibur Medical Network - Developing Markets Chris Evans... · The NCP has identified key...
Excalibur
• World class track record in medical infrastructure and investments over 30 years
• Created over 50 medical and health companies from scratch worth over $5bn
• IPO’d 21 companies on worlds stock market
• Constructed 270 different laboratories/clinics
• Built over 65 office buildings and premises for own companies
• Built over 40 advanced manufacturing facilities and production plants
• Raised >$2bn for cancer research in 40 areas of cancer
• Over 200 new medicines in development
• Over 20,000 patients in clinical trials
• In 1996 Sir Chris first entrepreneur to develop new stem cell technology inEurope
Company Date Initial Value Peak Value
Chiroscience PLC 2003 $1.0m $1,000m
BioVex Inc 2011 $2.0m $1,000m
Vectura PLC 2008 $1.5m $1,100m
Ark Therapeutics PLC 2007 $2.0m $560m
Piramed Limited 2009 $0.5m $200m
Neurotech 2011 $0.5m $165m
Arakis PLC 2005 $0.4m $160m
Celsis International PLC 2008 $0.3m $150m
Santhera AG 2007 $5.0m $125m
Plethora PLC 2007 $0.1m $120m
Wilex AG 2007 $7.0m $120m
Noxxon AG 2011 $6.0m $120m
ReNeuron PLC 2006 $1.0m $100m
Cyclacel Inc 2003 $3.0m $90m
Neuropharm PLC 2007 $0.2m $75m
Microscience Limited 2006 $1.0m $65m
Toad PLC 2000 $0.1m $65m
Virgin Health Bank Limited 2010 $2.0m $45m
Derms Development Limited 2007 $4.0m $45m
Energist Limited 2010 $5.0m $35m
Destination Skin Limited 2008 $3.0m $35m
Cambridge Biotechnology Limited 2007 $0.5m $25m
TOTAL $46.1m $5,500m
$5 Billion of Value by Sir Chris Evans and Excalibur Team
Leadership
EHC is led by Professor Sir Christopher Evans OBE, Europe’s foremost biosciences,medical and healthcare entrepreneur who has:
• Advised four UK Prime Ministers on biomedical and healthcare policy
• Chaired the EU “BEST” Taskforce overseeing 19 million small businesses acrossthe European Union
• Advised the governments in London, Wales, Denmark, Finland, Malta andQatar
• Led the creation and growth of several billion dollars’ worth of advancedmedical companies
• Built this team of UK experts to provide medical facilities and services, toadvise on setting health care policy and a long-term strategy for healthcareneeds.
The Excalibur Healthcare Consortium
• Extensive experience in healthcare facilities construction and management
• Delivered over 2500 hospitals, labs, clinics and other healthcare infrastructure globally,including:
Primary Healthcare Centres
General and Acute Hospitals
Specialist and Tertiary Hospitals
Mental Healthcare Facilities
Medical Research Facilities
Specialist Training Facilities
• Includes some of the UK’s finest medical experts and practitioners – Royal Colleges, NHSTrusts, leading Universities and Medical Schools.
• Enjoys the full support of the UK government through co-operation with UK Trade andIndustry (UKTI) and Healthcare UK.
The EHC Offering
• Hospital management and operation
• Staffing – clinical, technical, support and management staff
• Strategic direction - improved patient care and outcomes, system efficiencies
• Mobile primary health care facilities
• Trauma & rehabilitation
• Training and education
• Modular hospitals
• Refurbishment of existing healthcare facilities
• Conversion for healthcare use
• Permanent hospitals
• State of the art mobile hospitals
• Medical equipment and pharmaceutical supplies, supply chain management
Impact
• Improved patient outcomes
• Consistently applied protocols and practices
• Clinical delivery to highest UK standards
• Operational and management efficiency
• Sustainability through training and education
• Continuing development of local staff
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Clinical-stage, UK-based cell therapy business
Highly scalable stem cell expansion technology – off-the-shelf (allogeneic) cell therapy candidates
Principal therapeutic programs target: stroke disability critical limb ischaemia retinitis pigmentosa
Leading position in exosomes
Formed and financed 13 years ago by Prof. Sir Chris Evans
Led transformative fund raise in summer 2013
Ground Breaking TherapyReNeuron plc
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There are over 150 million people living today with cancer
There are over 200 different types of cancer and 1 and 3 people on earth will be struck by cancer within their lifetime
Every year, nearly 10 million people die of cancer and every year there are nearly 15 million new cases of the disease
1 in 4 of all British deaths are from cancer
During the lifetime of this existing global population over 2,000 million people will at some stage have had cancer
Cancer – A Global Disease
Cancer must be controlled
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Cancer - A Commanding Speciality
Best elements from the finest Cancer institutions around the world:
• Early screening using modern imaging techniques and molecular pathology• Rapid diagnosis supported by excellent radiological opinion• Ground-breaking therapies, radiology and outpatient chemotherapy delivery• “Distributed clinic” model:
• national centres of excellence;• local cancer centres, clinics, and mobile clinics
• UK leading institutions:• second opinions, knowledge transfer, support and training
Cancer in Algeria
• Fourteen regional cancer registries covering 37.7% of population
• Existing valuable data
• Top cancer types identified
• A well researched comprehensive National Cancer Plan (NCP) in place
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Male Female
Lung Breast
Colon-rectum Colon-Rectum
Prostate Thyroid
Hematopoietic Cervix
Bladder Ovaries
Cancer – Key Areas of Improvement
The NCP has identified key areas of improvement
• Equity
• Patient experience
• Surveillance
• Prevention
• Screening
• Diagnosis
• Therapy
• Palliative care
• Support Organisations
• Regulation
• Training
• Research
• Communication
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Cancer Plans – Need to be Implemented
• The National Cancer Plan puts Algeria in top 20 countries with focus on CancerCare
− Great recommendations and findings
• Only top five countries have actually invested in cancer care consistently over manyyears in an attempt to implement their plans, with mixed results
− USA
− UK
− Sweden
− Canada
− Australia
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Challenge: How to short circuit 10 years of talking / planning / meetings and starttaking action NOW
Optimal Implementation Process
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Time Line – Months
High Level Plan for Development of Cancer Services 0 - 3 4 - 6 7 - 9 10 - 12 13 - 15 16 - 18 19 - 21 22 - 24 25 - 27 28 - 30 31 - 33 34 - 36 37 - 39 40 - 42 43 - 45 46 - 48 49 - 52
Key Actions
Diagnostic to define and assess needs of the health economy
Agree principles of early deployment of facilities and cancer services to have a visible impact on the care of patients
Roll out mobile diagnostic facilities (wet lease) - example breast screening units, mobile clinics to take cervical smears
Build diagnostic facilities in the communities - increase capacity within the CAC rapidly to improve early detection rates
Design World Class Cancer Centre drawing from experience for similar institutions internationally
Build World Class Cancer Centre that will deliver complete range of high tech diagnostics and specialised therapy. This will form the basis of a hub and spoke model.
Deploy World Class Cancer Centre - provides specialised care for a wide range of complex cases with the latest in diagnostics and treatment
Procure Staffing for Cancer Centre - specialist pathologists, radiologists, radiographers, surgeons and other support personnel. Potentially internationally to build capacity.
Build Therapy Centres - Radiotherapy - existing 7 projects that need to be completed
Design Population Surveillance for ongoing information of changing demographic and incidence patterns
Develop and Deploy Population Surveillance with appropriate IT support allowing information analysis and data mining
Design Screening Programmes - for specific conditions such as cervix, breast, bowel, colo-rectal cancers
Roll out Screening Programmes - for specifc conditions such as cervix, breast, bowel, colo-rectal cancers
Annual review of surveillance and screening
Define national requirements for additional specialised hospitals, diagnostic centres and therapy clinics
Develop local clinica - polyclinics, diagnostic facilities
Develop post treatment support - after care, rehabilitation following complex surgery
Develop and deploy palliative care - for end of life care patients, residential facilities away from hospital
Build and deploy additional diagnostic facilities - specialised centres that provide pathology, radiology and in certain cases cytogenetics
Build and deploy additional therapy facilities - Radiotherapy units, day case units that can provide chemotherapy drugs as day patients
Develop Cancer Networks - to facilitate expert opinions, rapid decisions on diagnosis and management and knowledge sharing
Develop existing diagnostic departments (histopathology) - increase the capacity and capability through training of various staff and recruitment of trained staff
Understand training needs of various groups of staff such as doctors, primary care physicians, paramedics, radiographers.
Develop & Deploy training programmes for undergraduates
Develop & Deploy training programme for professionals (medical/paramedical/technical)
Develop and implement regulatory frameworks - to support prevention programmes for environmental, lifestyle and occupational risksDevelop Research Plans
Design and build Research facilities including modern facilities for cyto genetic research
Conduct research - existing facilities - large teaching hospitals and specialist centres
Operate new research facilities - research into the management of cancers with international cooperation and collaboration
Meeting the Challenge – Immediate Steps
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Build cancer network to make available nationally
Early screening
Rapid diagnosis
Access to treatment
Distributed clinic model
Cancer centres
Local clinics
Mobile clinics
Multidisciplinary teams
Best-in-class equipment
Ground-breaking therapies
Distributed Clinic Model
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Cancer Centre• Comprehensive cancer care• Best in class • Referral from local clinics
C Local Clinics• Screening / diagnosis• Treatment
M Mobile Clinics• Screening / diagnosis• Treatment
Linked to leading UK Cancer Institutions
Algerian Cancer Council
Cancer Centre
Cancer Centre
Cancer Centre
Cancer Centre
Cancer Centre
C
CM M
C
C
C
M
Best-in-Class Cancer Centres
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Peter MacCallum Cancer Institute, Melbourne (cgi)
Oxford Cancer Centre, Churchill Hospital
Memorial Sloan Kettering, New York Mayo Clinic, Rochester
Guys and St Thomas’ Cancer CentreLondon (cgi)
Karolinska Institute
Local Cancer Clinics – screening, diagnosis, treatment
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Jackson County, Oklahoma
Oxford Day Centre, Perth
Ozark, Missouri
Billings, Montana
Cabrini Centre, Melbourne
Cabrini Centre, MelbourneBeatson West of ScotlandCancer Centre
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Each cancer centre will have:
• Rapid on site screening and diagnostics -
− Modern imaging techniques and molecular pathology
− Clinical decision-making supported by excellent radiological opinion
• World-class branded clinical and outpatient chemotherapy delivery -
− Delegation of responsibility to highly trained chemotherapy nurses
− Support from oncology pharmacists
− Molecular markers to improve precision of cancer treatment
• Multidisciplinary team working to advanced guidelines and SOPs
• Portable electronic patient data linked to national network
• International second opinion service through link to Oxford Cancer Centre
• Clinical Trial infrastructure
Cancer Centres: The Excalibur Model
Advanced Infrastructure needed in the future
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Brooks-Wilson Genome Sciences Lab, British Columbia
Crick Institute (proposed)
Rinecker Proton Therapy Centre Munich National Cancer InstituteRockville Maryland
RadioImmuno targetingLund Sweden
Nationwide Coverage via Mobile Treatment
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Mobile Chemotherapy Units
Protate
Mobile Radiation Therapy Units
Delivering Best in Class Cancer Patient Pathways
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• Co-develop global/local cancer care pathways & guidelines and protocols &multidisciplinary teams
• Train and build capacity - clinic doctors/nurses/pharmacists
• Telehealth services for diagnostic (complex cases, 2nd opinion) and trainingpurposes with UK institutions
• Develop cancer database (clinical outcomes)
• Develop patient reported outcome measures (PROMs)
• Develop app-based technology for side effect management, follow up etc
• Patient education – wellness, nutrition, symptoms & treatment
• Patient support and well being
• Cancer prevention programs
• Stratified analysis
Breast Cancer - Diagnosis
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Breast MRI ScanCancer Research, London
Mammography, Toronto
Mammography - Royal Marsden Hospital, London
Lauder Breast Cancer Centre, Sloan Kettering
Breast Cancer – Treatment
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Chemotherapy suite
Radiation Treatment UHN Toronto
Endocrine Therapy
Adjuvant Systemic TreatmentLumpectomy, MastectomyConservation Surgery
Lung Cancer - Diagnosis
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Diagnosis
Bronchoscopy, Henry Ford Hospital, Detroit, USA
Chest X-ray, Oxford University Hospitals, UK
CT ScanRoyal Marsden Hospital, London
Sputum Cytology, Pathology laboratory, Princess Margaret Cancer Centre, Canada
Lung Cancer – Treatment
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Robotic Lobectomy (surgery), Toronto General Hospital, Canada
Radiotherapy, Peter MacCallum Cancer Centre, Australia
Stereotactic Body Radiation Therapy (SBRT)Stanford Clinical Cancer Centre, USA
Chemotherapy, Targeted Drug Therapy,Royal Free Hospital, UK
Colorectal Cancer - Diagnosis
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Diagnosis
Flexible SigmoidoscopyOdette Cancer Centre, Canada
Virtual Colonoscopy (CT scan), Guys’s & St Thomas’ Hospital, UK
Endoscopy,Memorial Sloan Kettering Cancer Centre, USA
Fecal Occult Blood Test Fecal Immunochemical Test
Colorectal Cancer – Treatment
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Transanal endoscopic microsurgery- rectal tumor, Massachusetts General Hospital, USA
External Radiotherapy, Addenbrooke’s Hospital, Cambridge, UK
ColostomyChurchill Hospital, Oxford, UK
Chemotherapym, Targeted Drug Therapy,John Hopkins Cancer Centre, USA
Specific Infrastructure Requirements
• Build / set-up comprehensive cancer centres
• Build / set-up network of local cancer clinics
• Provide mobile clinics for screening, treatment and palliative care
• Provide specialist equipment for radiotherapy, CT, PET, MRI, X-ray, US,Endoscopy, etc
• Supply cancer drugs
• Build immunological and molecular analysis facilities
• Build nursing homes, residences and/or hospices
• Provide eHealth tools for patient support and data
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Detailed Manpower Requirements
Histopathologists 930
Radiologist 1700
Haematologist 635
Palliative Care Physicians 215
Diagnostic radiographers 8400
Therapeutics radiographers 1515
Medical physicist 865
Based on current assumptions, not necessarily exhaustive.
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• Cancer Centres: 4• Cancer Clinics: 8-12 • “Hub & Spoke” clinical model –
fixed & mobile• Program budgeting• Tele-Health assessment
• National Cancer Strategy• Clinical guidelines• Standardisation• Clinical outcome analysis• Need & benefit analysis• Cancer database
• Multi-disciplinary teams• Translational Medicines • Diagnostic & therapeutic
equipment – fixed & mobile• Access to Expert Network / Key
Opinion Leaders
• Clinical Pathway Redesign• Screening, diagnosis &
treatment• Mitigation of risk• Active management• Living with and beyond cancer• Sharing community
experience
National Cancer Network
Structure & Governance
Infrastructure & Manpower
Equitable & Quality Patient Care
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World Class
Cancer Care
A Modern Cancer Plan