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Personalised health and care should be the norm by 2030, says Javid

Personalised health and social care in England should be “the norm” by 2030, the health and social care secretary has said.

In a recent speech on healthcare reform at the Royal College of Physicians, London, Sajid Javid said more than 2.5 million people have already benefitted from personalised care in England. By March 2024 he hopes that as four million people will have received personalised care – a term he said covers “everything from social prescribing to support plans”.

Javid said: “Preventing long-term conditions is an essential part of our health agenda. But equally important is improving the quality of life and care for the millions of people who are already affected by their multiple long-term conditions.”

“For people with multiple chronic diseases, healthcare is too often focused on individual diseases rather than the person as whole. It is often fragmented across a range of providers, specialists and sectors rather than being part of a longer-term plan for their overall health and their quality of life. I know this causes frustration to patients, their loved ones - and clinicians too. Among people with multiple conditions, there are over 60,000 unique disease combinations. It’s clear so many of these people can benefit from personalised care,” he said.

What is needed are multistakeholder discussions on how the NHS can best fund cell and gene therapies and other cutting-edge treatments and agreement on new payment models that address affordability

Within the concept of personalised care is the provision of personalised medicine. Javid used his speech to highlight how the cost of innovation in this area is falling.

Javid said: “The UK is a global superpower in life sciences: people then rightly expect to see the latest treatments on the NHS – even when the cutting edge doesn’t come cheap. Technological change accounts for a significant proportion of the increase in healthcare spending growth in recent decades. But there are areas where the cutting edge is getting cheaper. For instance, the cost of sequencing a whole human genome has decreased by 98% since 2010. Genomics is the future of post-pandemic healthcare.”

“In the not-too-distant future, medicine will be personalised in ways that were previously unimaginable. Detailed understanding about how genes affect different people’s physiology will make gene therapies ubiquitous, and dramatically improve our ability to prevent, detect and treat ill health,” he said.

Life sciences expert Helen Cline of Pinsent Masons said: “The health and social care secretary, talks about reforming the health system with a focus on prevention, personalisation, performance and people, empowering us to take control of our own health. However, as our expectations of healthcare are changing so are the affordability and accessibility challenges.”

“One area where we are already seeing these challenges playout is in cell and gene therapies (CGTs), where a single dose can provide a durable therapeutic effect but at a cost. Legacy single payment funding models are not appropriate and although access agreements have been reached on some CGTs, patients are being denied access to other potential cures. The problem will become more acute as more CGTs become available,” she said.

“What is needed are multistakeholder discussions on how the NHS can best fund CGTs and other cutting-edge treatments and agreement on new payment models that address affordability. With reform of healthcare centred around personalisation and prevention firmly on the government’s agenda there is no better time to get developers, payers and patient groups around the table,” Cline said.

In his speech, Javid also confirmed that the government will publish a digital health and care plan this spring. The plan will cover both health and social care, he said.

“We want a digital future for the NHS that works for everyone, not just digital natives,” Javid said.

“Health needs to embrace the revolutions that have already come to banking and shopping – it needs to be as easy for doctors and patients to order a blood test as it is to order a burger – or a salad – on your phone,” he said.

The health secretary also set new targets for health trusts and social care providers to adopt a ‘paperless’ approach to managing patient health records.

“I’ve set the ambition for electronic records to be rolled out to 90% of trusts by December 2023, and 80% of social care providers by March 2024,” Javid said. “These are modernisations we cannot afford to live without.”

The Health and Social Care Bill is currently before parliament. It is designed to better integrate the provision of health and social care in England and provide for new funding arrangements. However, some of the government’s plans for capping care costs have met opposition from UK parliamentarians.

Health expert Joanne Ellis of Pinsent Masons said: “The rejection of clause 155 from the Health and Social Care Bill, which covers the cap on care costs for charging purposes, brings into sharp focus the overwhelming need for a clear plan from government around the future of social care funding. The sector is crying out for a solution that creates a sustainable care system that is fair for everyone, ensures that vulnerable people can be cared for and offers wages that attract people to the roles. The government needs to listen to the sector to understand where their ideas fall short and to make the changes that are needed to finally provide some certainty for both service users and operators.”

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