For much of the past two decades, I had the privilege of leading one of the world’s top academic health science centres developed in collaboration with University College London, sharing outstanding clinical and academic staff . Our mantra was to excel in delivering "top quality healthcare, outstanding education and world-class research", embedding this throughout the organisation. This could only be achieved through the dedication and professionalism of all our staff, with a sense of pride in being part of something special.
The extraordinary affection for the UK's National Health Service (NHS), and its top international ranking (in 2016-17 the OECD rated four English universities in the world’s top 10) is remarkable because the UK spends only 9.9% of GDP on healthcare, compared to the US, which spends a whopping 16.6% without getting better outcomes. Top-quality healthcare and financial prudence go hand in hand, a relationship always at the forefront of political debate.
The assertion that “the NHS is the closest thing the English people have to a religion” goes some way towards explaining how much we value what we have created, and the outcry when anyone suggests an alternative to our comprehensive system, free at the point of access. The concept of “free” healthcare has been drummed into us from infancy, so much so that many of us now take it for granted.
Biomedicine teaching and research has become such a dominant subject in university curricular that the symbiotic relationship with healthcare and hospitals has created London’s three outstanding Academic Medical Centres, bringing ﬁrst-in-man research discoveries, through translation, direct to the patient bedside. Nowhere is this more evident than in the recently opened $1bn Crick Institute, named after a London based Nobel prize-winner. It’s a new approach to biomedical research and is fast becoming one of the world's leading medical research institutes. Uncompromising commitment to excellence, emphasis on multidisciplinary research, focus on emerging talent and on novel ways of partnership working are setting new standards in world-class research. Sustaining this excellence is one of the most exciting challenges facing NHS management today.
London continues to lead the world in many areas; for example, we were ﬁrst to centralise the management of new stroke patients, where we can now evidence dramatic improvements in patient outcomes – lives have been saved and suffering reduced at no extra cost. We have concentrated the provision of the most complex cardiac, neuroscience and paediatric specialities with remarkable improvements in patient mortality rates. Other international cities are following London’s lead and will reap similar beneﬁts.
Alongside the NHS, the private sector, with its epicentre in Harley Street, houses a selection of internationally renowned hospitals, with medical staff drawn from the nearby major teaching hospitals. New market entrants, such as the world-class Cleveland Clinic, for decades the top cardiac centre in the world, will be a potential shock wave for existing centres. This and other developments will consolidate and strengthen London’s leading international position as the safest and most comfortable place to be treated.
Sir Robert Naylor is the former Chief Executive, University College London Hospitals NHS Foundation Trust