A BBI

Sir George Alberti, head of emergency care for the UK's National Health Service (NHS), said improvements in that area over the past two years have transformed its emergency care performance so that "it is now the envy of the world." Speaking at a late-October breakfast reception at the home of Prime Minister Tony Blair for frontline NHS staff from all over the country, Alberti said that at the beginning of 2003, almost one-quarter of patients spent more than four hours in Accident & Emergency (A&E) units. Now, he said, "it is less than one in 20 patients [and] in just over two months, it is set to be just one in 50 or less."

Alberti said the NHS's target for improvement in the A&E area "was groundbreaking and more ambitious than any international equivalent." He said that two years ago, a Commonwealth Institute report on emergency care included England as one of the countries in which waiting was a fundamental challenge – together with the U.S., Canada, New Zealand and Australia.

At this year's 10th International Conference on Emergency Medicine, he said long waits were highlighted as a continuing issue around the world. "By contrast," Alberti said, "the NHS in England was hailed as an exemplary success." He said new investment in the A&E area "has led to more doctors and nurses than ever before, ensuring [that] people have swifter access to medical advice, swifter access to hospital beds and swifter access to specialist services such as mental health."

In a report to Blair and Health Minister John Reid titled "Transforming Emergency Care," Alberti describes what he terms "a revolution in the delivery of emergency care for people in this country."

Main findings of the report include:

Despite continuing high demand for emergency services, people are receiving faster, quicker, personalised treatment and are more satisfied with their experience of A&E.

More doctors and nurses now work in emergency care and there has been a significant development in skill mix with nurses, paramedics and allied health professionals expanding their roles.

The entire health and social care system is working together in new and better ways, such as ambulance trusts and A&E departments.

The NHS is moving toward providing a seamless service for patients, by bringing together services provided in the community and in local hospitals.

Reid said, "This report shows that 19 out of 20 people are seen, diagnosed and treated within four hours in A&E. They can now get the right treatment wherever and whenever they need – be it at a walk-in-center, minor injury unit or A&E department."

Lynda Holt, who chairs the Royal College of Nursing Emergency Care Association, said the four-hour target for A&E treatment "has made us look at how we work, and at who does what. For nurses, and many other health professionals, it has been a catalyst for role development and greater clinical freedom to use our expertise more fully. For patients it means quicker access to someone who can make decisions, and, in many cases, manage all their care needs."

On a recent visit to study the modernization of emergency care in England, Professor Christopher Baggoley, chairman of Australia's National Institute of Clinical Studies, said, "The timeliness of care in English emergency departments is becoming the envy of the world."

Universities create molecular diag firm

Belgium's Flanders Interuniversity Institute for Biotechnology (VIB) and Ghent University have created a joint subsidiary called Peakadilly NV (Ghent, Belgium) to develop and market a new generation of molecular diagnostics known as protein biomarkers. Peakadilly has a proteomics technology platform developed by VIB, which is the company's principal shareholder, having put up most of its capital of EUR 2 million. Peakadilly is housed in the VIB bioincubator in the Technology Park of Ghent University (Zwijnaarde, Belgium) and four VIB employees have transferred to the new company.

Peakadilly CEO Koen Kas, who played a key role in the development of the technology, told BBI's sister publication, BioWorld International, that they had found a "chemical trick" for pinpointing the first identifier of a protein, which permitted the large-scale and systematic analysis of large numbers of proteins. In addition, VIB had succeeded in slashing the time required for validating a newly discovered biomarker by using a synthetic version of it. The technology has allowed Peakadilly to identify and characterize proteins related to particular diseases or to the activity of potential drug candidates. Armed with that knowledge, the company is developing biomarkers to speed up the development of diagnostics and therapeutics for the early detection and treatment of life-threatening diseases such as cancer.

Kas said one of the advantages of biomarkers is that they "measure cellular activity downstream from protease activity." By bridging the preclinical and clinical phases of the development process, bio-markers can help determine at an earlier stage whether a drug candidate will prove effective, thereby reducing development costs and lead times. In addition, they make it possible to determine in advance whether a particular therapy will work for a patient and to target therapies specifically at those patients who will benefit.

He explained that the technology had been validated in three research collaborations with pharmaceutical companies covering different stages of the drug discovery and development process, from the pre-discovery phase through mouse models to clinical evaluation in humans. Peakadilly is focusing its in-house activities on oncology, and Kas said the first product from that program would be a stand-alone biomarker for use as a diagnostic tool to help biopharmaceutical companies measure the potential anti-cancer activity of new chemical entities.

While he declined to name Peakadilly's three existing partners, Kas said it was negotiating additional deals with two pharmaceutical companies and one biotechnology company. As well as sharing its technology through collaborations, he said Peakadilly would grant exclusive licenses to third parties for other disease areas, such as inflammation, central nervous system disorders and cardiovascular disease. He added that it had no potential value in some areas, such as metabolic diseases.

Peakadilly is negotiating an extension and enlargement of an existing collaboration, and if finalized it would give the company funding to last into 2006. Kas said signing two deals, entailing up-front payments as well as research and development funding and milestones, would give it financial autonomy for the foreseeable future. Failing that, it might approach venture capital funds in early 2005. But Kas did not expect that would be necessary, as the industry has demonstrated "surprising enthusiasm" for Peakadilly's technology.

UK to undertake bowel cancer screening

The UK plans to roll out a national screening program for bowel cancer, the first cancer-screening program in England for both men and women and one of the first of its kind in Europe, beginning in April 2006. Some 37.5 million will be spent over two years to fund the program.

Speaking at the Britain Against Cancer conference in late October, Health Secretary John Reid said, "Preventing cancer and improving services for those who develop the disease continues to be a priority for this government, and we have already made significant progress in reducing deaths from cancer." He said the UK has "the fastest-falling premature death rates for lung cancer in men and for breast cancer in women in Europe," citing a 10.3% reduction in deaths in the under-75 age group since 1996. "This year, the figures have improved further, with a 12.2% reduction."

Julietta Patnick, director of National Health Service cancer screening programs, said, "We are looking forward to offering a national screening program to men, as well as women, for the first time. Our impressive track record in delivering world-class national screening programs means we are ideally placed to implement this."

The UK government made a commitment to introduce bowel cancer screening in the NHS Cancer Plan in 2000. The Department of Health began pilot programs in 2001 of a screening method that involves looking for blood in stools (fecal occult blood testing). In its announcement of the new program, it said: "There is clear evidence that using this method can cut the death rate for bowel cancer by 15%. As a result, this type of screening will be introduced in phases among men and women in their 60s [beginning in] April 2006."

Large-scale pilot programs of a second method of screening involving endoscopies – flexible sigmoidoscopy – also will be carried out, involving people in their late-50s. Seven regional and three national endoscopy training centers were established last year to train more people to carry out endoscopies and ready the NHS for a screening program. By the end of 2004-2005, there will be 345 newly trained endoscopists and 88 new trainers, the Department of Health said.

Imaging applications lab in Varian's plans

A day after completing its acquisition of a UK maker of magnetic resonance imaging (MRI) magnets, Varian (Palo Alto, California) reported plans to build the first imaging applications laboratory in that country. The new laboratory, to be located at Magnex Scientific Ltd.'s (Oxford, UK) Magnet Technology Center northwest of Oxford, will expand Varian's existing imaging application capabilities, which include an imaging laboratory in Palo Alto. Varian completed the purchase of Magnex Scientific on Nov. 3, in a deal involving payment of $32 million in cash and assumption of the company's net debt.

The new laboratory will allow for closer collaboration on magnet and gradient development, Varian said, and will allow it to better serve its MR imaging customers. The company said the imaging applications facility would be available to scientists in medical, pharmaceutical and pre-clinical research areas conducting magnetic resonance studies, such as examining a drug's possible side effects.

Noting that Varian "has been making substantial investments to provide our customers with world-class solutions, particularly in the area of information-rich detection," President and CEO Garry Rogerson said the acquisition of Magnex "allows us to meet our imaging customers' requirements for leading-edge magnet technology. With the new imaging applications laboratory, we are taking the next step toward a world-class solution by providing the applications expertise and collaborative opportunities to support our customers, especially those in Europe."

The imaging applications laboratory is the first of three laboratories to be built on the same site. Two other laboratories – addressing analytical and nuclear magnetic resonance applications – will complement the imaging applications lab. Together, they will make up a new Center of Excellence in the UK. Varian currently operates Centers of Excellence in Darmstadt, Germany, and Les Ulis, France, serving scientific instruments customers in Europe.

UK plans new walk-in centers

As it is for many in these harried times, fitting a visit to a doctor into a busy schedule often is next to impossible for many persons who live or work in some of the UK's largest cities. However, thanks to a National Health Service plan calling for development of new general practitioners' (GPs) offices near rail and subway stations in four cities, commuters in those cities will soon find it easier to fit seeing a doctor into their schedules.

Health Minister John Hutton announced plans last month to build seven new NHS Walk-in Centers within a few minutes walk of popular commuter stations in London, Newcastle, Manchester and Leeds. London will get four such centers, with one each in the other cities. The Department of Health said that if the clinics – which initially will operate under a five-year pilot program – prove to be a success, several more could be rolled out in other major cities across the country.

The department is seeking bids to run stand-alone Walk-in Centers for the first time as part of the department's push to increase the availability of primary care provision. Some 25 million will be invested in the seven centers over the first three years.

The new commuter walk-in centers will offer the same range of services patients traditionally receive from a GP practice, but, said the Department of Health, "without the need for an appointment and in a more convenient location for commuters." The centers, which also will be open to local residents, will offer services tailored to patients' needs, such as physiotherapy and monitoring of long-term conditions through blood pressure checks; treatment for minor injuries; prescriptions and pharmacy services. They will be open from 7 a.m. to 7 p.m. without having to book an appointment.

Hutton said the new centers "will make it easier for commuters to fit seeing a GP or nurse around their daily lives. The 12-hour opening hours and convenient location are ideal for meeting the needs of today's patients." He said the walk-in centers "will improve access to primary care for a proportion of society that has traditionally been poorly served [and] will improve choice and convenience for patients, while adding extra primary care capacity in the areas where it is needed most."

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