The Prime Minister's Council for Science and Technology has urged the NHS to be open to earlier and fuller engagement with innovative business of all sizes.

The Service has to become world-class at developing, testing and rapidly diffusing the best new technologies and practices, but its current structures and practices can get in the way of exploiting new opportunities, the Council warns.

Culture change needs to be led from the top, with strong leadership and accountability for innovation and business partnership at the most senior levels of the NHS, it says. The government also needs to identify and implement new ways to spread innovation more widely, through reward structures for both management and front-line staff, and consider incentives for NHS trusts to collaborate more widely.

Turning to research, the Council says that the NHS provides a unique opportunity for the development of public-private partnerships between the Service, research funders and industry that would put the UK in a world-leading competitive position to turn the results of research into new ways of preventing, diagnosing and treating disease.

To this end, it says, the NHS should work with research funders to create a pre-competitive partnership with business to help identify the best drug targets and pathways, using existing and emerging genomic data, and work to improve the speed of recruitment to clinical trials for stratified medicines.

Both UK and European regulators should be engaged "immediately" to identify more appropriate and faster pathways for high-efficacy targeted therapies, the report recommends. 'This may mean conditional approval for drugs in Phase III studies and also elimination of the requirement for extensive Phase III studies in drugs with outstanding efficacy that provide the results expected from stratification," it suggests.

The NHS has to demonstrate much earlier and more complete uptake of cost-effective new products, it emphasises. For example, it should reconsider the value of high-efficacy stratified medicines, taking into account the wider benefits to patients and their families, benefits to society outside the NHS, and “the longer-term benefits associated with the structural changes in health provision brought by high-efficacy therapies." 

Finally, it says, the National Institute for Health and Care Excellence (NICE) should work with industry to define unmet health needs and design appropriate clinical studies that could provide innovative cost-effective solutions tailored to the system’s needs “and where adjudication of value could be achieved more rapidly after regulatory approval.”