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The UK: your partner for clinical services

Updated 3 March 2016

This promotional material was withdrawn on 2 December 2020

Department for International Trade withdrew this publication because it was out of date.

1. The UK: your partner for clinical services

If you are developing clinical health services, it pays to look at established systems with solutions to common challenges, systems with innovative ways of dealing with the needs of a growing, ageing population.

The UK’s National Health Service (NHS) is the model that governments and healthcare organisations across the world turn to. You too can access the same skills and experience that make the NHS one of the best health systems in the world.

Collaboration with NHS institutions and their private sector partners brings the latest approaches to front-line healthcare. They have the expertise to adapt tried and tested solutions for improving patient outcomes in a financially sustainable way.

Your partnership with these organisations can work in many different ways, including through:

• consultancy and professional services
  • everything from needs analysis and the design of clinical pathways to setting up and running better services
• local partnerships, licensing and franchising
  • running clinical services based on an NHS model via a range of operating arrangements
• remote service delivery
  • use internet technology to access services such as multi-disciplinary patient reviews, remote diagnostics, screening and distance learning

Your simplest way of accessing this expertise is through Healthcare UK, the UK government’s specialists in international healthcare partnership working.

2. Why partner with the UK?

The NHS’s sophisticated clinical services have evolved over nearly 70 years. These services are truly integrated, with every aspect based on evidence of what works.

International healthcare organisations use UK expertise because our care pathways for non-communicable diseases work for over 60 million people who access the highest quality of care, free of charge.

The NHS is genuinely world leading. That is not just our assessment.

In 2014 the Commonwealth Fund rated it as the best health system out of 11 countries studied.

The evidence is clear: clinical services based on UK expertise will deliver the safest and effective, patient-centred care at an affordable cost.

3. What makes the NHS so successful?

Integration is the key to the NHS’s success. Whatever type of care patients receive, they are part of a unified system that promotes information sharing and a holistic view of need.

Although the system functions as a whole, clinical services in the UK can be viewed as follows:

3.1 Primary care

Primary care services are delivered by a wide variety of providers including general practices, dentists, optometrists, pharmacists, walk-in centres and NHS 111.

There are more than 7,500 general practices in England providing primary care services and managing over 90% of patients’ problems. This can involve treatment for common illnesses, the management of long-term illnesses, such as diabetes and heart disease, and the prevention of future ill-health through advice, immunisation and screening programmes.

3.2 Acute trusts

Acute trusts provide secondary care and more specialised services. Secondary care usually involves treatment in a local hospital or clinic, as either an in-patient or an outpatient, with the initial referral being made by the primary care professional.

3.3 Tertiary and quaternary care

Occasionally a patient will need access to specialist treatment that requires tertiary or even quaternary care. There are a number of specialised hospitals that focus on a particular area such as cancer, paediatrics or cardiac and respiratory services.

3.4 Community-based healthcare

Community-based healthcare delivers care as close to the patient’s home as possible. Patients can benefit from services such as district nursing, health visiting and specialist support following discharge from hospital.

3.5 Mental health trusts

Mental health trusts provide the vast majority of community, in-patient and social care services for a wide range of psychiatric and psychological illnesses, usually in a community centre near the patient’s home, or from in-patient and outpatient facilities when needed. Mental health services can also be provided by other NHS organisations and the voluntary sector.

3.6 Ambulance trusts

Ambulance trusts manage emergency care for life-threatening and non-life threatening illnesses, and include the NHS 999 service. In some areas the ambulance trusts are also commissioned to provide non-emergency hospital transport services and/or the NHS 111 service.

4. The NHS approach

The NHS’s patient-centred approach means that teams of professionals work together not just within different types of care, but between the primary, secondary and tertiary layers.

This multidisciplinary approach is supported by the NHS’s single, comprehensive patient database so that information is shared between every professional involved in a patient’s care.

The NHS has constantly progressed since it’s foundation in 1948 and continues to evolve to meet the challenges faced in the UK and many countries around the world. The NHS 5-year forward view explores 7 new models of healthcare:

• multispecialty community providers
• primary and acute care systems
• urgent and emergency care networks
• viable smaller hospitals
• specialised care
• modern maternity services
• enhanced health in care homes

Developed over decades in response to changing needs, the NHS’s model can be adapted for your purposes, either to a specific type of service or as a whole-system approach.

For example many countries are working with the UK to create a primary care system.

5. The UK’s clinical expertise

You can draw on UK expertise across the whole spectrum of medical, surgical and mental health services, from the management of long term illnesses to diagnosing and treating rare conditions.

There are multiple UK organisations with the skills and resources to help you develop and run the sort of services described in this section, just contact Healthcare UK, for help with finding the ideal partner.

5.1 Elderly care and dementia

The UK offers comprehensive care for the elderly, with coordinated support from medical, nursing and social services professionals. Family doctors and community nurses are trained in dementia care based on national guidance.

A range of UK institutions can provide training and support so you can replicate this approach to:

• enable early identification and diagnosis
• care for patients in their own homes for as long as possible
• provide early warning of deterioration in health to trigger rapid additional support

UK-China joint venture opens it first health centre: Heythorp Healthcare and the CITIC Group

Heythorp Healthcare, a UK-based, China-focused health and care operator, opened its first healthcare facility in China in September 2015. The Heythorp CITIC Care International Health Centre, located in the booming city of Kunming, will be managed by Heythorp in a joint venture with the CITIC Group, one of China’s largest companies.

Heythorp will offer a range of health and social care services at the facility, delivered to UK standards, with an initial focus on GP and other primary care services, physiotherapy, sports injury and rehabilitation services, and a range of long-term condition management services, as well as home care and day care on a self-funded basis.

The facility is located within the CITIC resort developments that will, on completion, house up to 20,000 permanent residents, as well as attracting tourists from all over the South East Asia region. Kunming itself is a city of seven million people and is one of China’s largest transport and tourist hubs.

The facility will employ a team of up to 20 expatriate and local staff within the first year.

Heythorp has plans to expand the range and depth of services offered at the facility thereafter, to include frail elderly residential care and other services.

5.2 Cancer services

Cancer care is a good example of the NHS’s integrated approach.

Every case is discussed in a multidisciplinary team so that patients benefit from input from surgeons, oncologists, pathologists and radiologists.

Cancer care institutions carry out peer reviews of each other’s services to ensure continuous improvement.

If you want to implement best practice in multidisciplinary case management, specialists in the UK are available to help.

UK institutions can also help you to develop ‘hub and spoke’ cancer care delivery so that all patients can access the most appropriate specialist expertise and equipment.

Centres such as the The Royal Marsden Hospital, the Christie Hospital and Leeds Cancer Centre have the state-of-the-art equipment and highly-skilled specialists for every type of intervention.

Each cancer centre acts as the hub for a network of cancer units that deliver more routine treatments. You can partner with our leading cancer centres to develop care pathways, commission high-tech equipment and train staff.

Providing radiotherapy services worldwide: Leeds Teaching Hospitals NHS Trust

Leeds Cancer Centre, part of Leeds Teaching Hospitals NHS Trust, provides some of the most advanced treatment and care for patients with cancer. The centre is one of the largest in the UK, offering comprehensive cancer care services to a regional population of 5.4 million.

The centre offers state-of-the-art diagnostic services in radiology, pathology and leading-edge surgery to achieve the best possible outcome for patients. It offers some of the most innovative treatments in both radiotherapy and chemotherapy.

With 12 machines, Leeds Cancer Centre has one of the largest concentrations of highly complex linear accelerators (linacs) in Europe. The commissioning and maintenance of these machines is supported by a large multidisciplinary team of physicists and technologists, whose expertise is in regular demand both in the UK and internationally.

The team can advise on the selection and commissioning of high-value equipment, and mentors and trains medical professionals. Support to other centres includes commissioning of infrastructure and equipment to international (IEC) standards and the provision of quality assurance documentation and protocols to provide safe and effective work practices.

5.3 Genetics testing

Most of the leading genetic technologies originated in the UK. We are one of the few countries in the world that recognise genetic counselling as a standalone profession.

The UK has an extensive network of clinical genetics specialists capable of interpreting genetic results and giving clinical advice to patients and their relatives, as well as psychological support from nursing colleagues.

The UK has invested heavily to maintain its world-leading position in this area. Partnering with our sector experts can transform the quality of care for patients with genetic diseases.

This could include:

• better personalisation of services for those at risk of developing certain conditions
• more effective screening programmes for at-risk patients
• more staff trained in interpreting genetic test results
• better provision of psychological support to patients and relatives
• sharing the cost of investment in cutting-edge technologies for national scale operation

UK Genetic Testing Network

The UK Genetic Testing Network (UKGTN) is a national advisory organisation for NHS genetic testing services. It was set up by the Department of Health in 2002 to promote equity of access to gene testing within the NHS. It is a collaborative of clinicians, scientists, patient representatives and commissioners and has a membership of laboratories. A wide breadth of services is available including business and planning, clinical and laboratory services and training and education courses.

5.4 Stroke services

The UK’s stroke service is a proven life saver: no wonder it attracts so much international attention from health services.

The active treatment of strokes using ‘clot busting’ thrombolytic drugs has dramatically improved outcomes.

Stroke care in London provides an example of best practice. Our capital city is home to a number of hyper-acute stroke centres which all patients suffering a stroke are referred to.

There is a rapid pathway from the Accident and Emergency department to a CT scan and a decision from a senior doctor on treatment, including administration of thrombolysis therapy if appropriate.

The centres are monitored on their ability to deliver a door-to-thrombolysis time of around 30 minutes.

UK institutions can help you to set up this these services, including rehabilitation for patients so they can return home as early as possible.

London stroke services reconfiguration: NHS London

NHS London’s system-wide approach to improving stroke care is transforming outcomes for patients. A major consultation exercise on their proposed London-wide service model and collaboration with commissioners, operators, clinicians and patients enabled fast implementation.

The model of care includes 3 main elements:

• prevention through increased public awareness of the illness and healthy living advice
• specialist acute care
• integrated rehabilitation services

The previous service involved 34 different hospitals providing stroke care, but specialist acute care is now concentrated in eight Hyper Acute Stroke Units (HASUs).

Each unit is staffed by an expert multi-disciplinary team, including 24-hour cover from consultant medical staff. All stroke patients are taken by London Ambulance to the nearest HASU.

HASUs are supported by a network of 24 local stroke units and can refer patients to this network after assessment and treatment.

The outcomes from this reorganisation are impressive. The thrombolysis rate rose from 3.5% to 12% in the first year, the highest of any major city worldwide. Mortality from stroke has decreased, hospital stays are shorter and patient satisfaction is higher.

5.5 Emergency care for major trauma

If you need to develop major trauma centres to cope with every eventuality, 24 hours a day, 7 days a week, the UK has experienced providers to partner with. This could include facilities for:

• neurosurgery
• chest and abdominal trauma
• amputated limb rescue
• dedicated burns and plastic surgery units
• air ambulance services

There are 24 major trauma centres in England providing adult and paediatric services.

If you are developing or re-designing an ambulance service, locally or nationally, the UK has outstanding expertise to offer.

For example, in central London, a paramedic can be delivered to any point within 4.5 minutes of being called. This paramedic is fully-trained and equipped to perform an electrocardiogram (ECG), diagnose a heart attack, put in an intravenous line, administer life-saving drugs, intubate and ventilate a patient, as well as perform cardioversion.

5.6 Cardiac services

The UK is internationally renowned for its cardiac services. It is a matter of necessity: over a quarter of all hospital admissions relate to heart diseases and every UK hospital has a team of cardiologists.

The UK’s cardiac services include specialised centres with 24/7 cardiac angioplasty teams working to strict service standards. The maximum time from calling for help and receiving the angioplasty should be under 150 minutes.

As well as accessing expertise in general cardiac care, you can partner with centres that specialise in areas of cardiovascular medicine such as:

• cardiology services including the management of cardiac rhythm disorders, electrophysiology and chronic heart failure management
• cardiothoracic surgery
• heart and lung transplantation (including paediatric heart transplantation in a few cases)

World-leading institutions attract individual patients from around the world, and some cardiac centres offer initial clinical consultations overseas.

You can also join the many international institutions that send health professionals to the UK for continued professional cardiology training, or host UK courses in their own countries.

International partnerships: Royal Papworth Hospital NHS Foundation Trust

Having helped pioneer modern cardiothoracic surgery, Royal Papworth Hospital has a well-established international reputation as a leading specialist in heart and lung medicine.

Papworth includes the UK’s main heart and lung transplant centre which has recently pioneered Donation after Cardiac Death Heart Transplantation; performing the most cases in the world in 2015, Papworth is also well-known for lung surgery and hosts the annual international Video-Assisted Thoracoscopic Surgery symposium, this year in partnership with the Shanghai Pulmonary Hospital.

Papworth is one of a few of centres globally that regularly performs Pulmonary Endarterectomy (PEA) surgery and is also a dedicated Extracorporeal Membrane Oxygenation (ECMO) centre.

It has been providing highly acclaimed, international courses for ECMO, PEA and other specialist cardiothoracic training. As well as treating the largest number of NHS cardiothoracic surgery cases in the UK, and achieving some of the best survival rates globally, Papworth has a dedicated private patients centre for overseas patients and for those with private medical insurance.

5.7 Children’s services (paediatrics)

The UK has world-leading paediatric professionals and a number of specialist children’s hospitals, focused on providing care not only of the highest quality, but also in an appropriate environment and manner for children and their families.

Top UK paediatric institutions already work around the world, providing services overseas, supporting the development of children’s services, offering training and education to paediatric healthcare professionals, and, where highly specialised services are not yet available overseas, providing services to overseas private patients in the UK.

Supporting children with cancer in Kuwait: Great Ormond Street Hospital for Children NHS Foundation Trust

Great Ormond Street Hospital (GOSH) is renowned for its excellence in paediatric healthcare. The Kuwait Ministry of Health asked GOSH to set up a cancer treatment programme that would replicate the world-class clinical service provided in London.

GOSH support includes:

• a ‘visiting consultant’ programme where GOSH consultants will provide clinical support and training at Kuwait’s NBK Children’s Hospital
• training and education modules leading to advanced nursing knowledge and stronger leadership/ management
• ongoing advice and remote support
• on-site attachments at GOSH enabling Kuwaiti staff to observe how GOSH works in practice
• clinical service reviews resulting in recommendations and support from GOSH for service improvement
• a diagnostic confirmation service

5.8 Screening

There are UK organisations that are highly experienced at organising and delivering complex, nationwide screening programmes.

This includes strategies for raising public awareness of these programmes, including using social media.

You can work with a UK partner to develop a wide range of screening programmes.

• for children:
  • antenatal and new-born screening to test for Down’s syndrome
  • ultrasound assessment for foetal abnormalities, infectious diseases in pregnancy, antenatal sickle cell and thalassaemia
  • new-born and infant physical examination to identify abnormalities
  • new-born blood spot test for conditions such as phenylketonuria
  • new-born hearing screening
• for adults:
  • infectious disease screening for young adults, for example, chlamydia
  • cancer screening including cervical, breast, bowel and prostate cancer
  • long-term conditions screening including abdominal aortic aneurism, vascular risk, diabetic retinopathy
  • health checks which help prevent heart disease, stroke, diabetes, kidney disease and certain types of dementia

Developing newborn screening overseas: Public Health England

Public Health England (PHE) exists to protect and improve the UK’s health and wellbeing, and reduce health inequalities. It does this through advocacy, partnerships, world-class science, knowledge and intelligence, and the delivery of specialist public health services. The experience embedded in PHE can also be a valuable resource for overseas partners when designing preventative programmes, including infant and adult screening.

The UK has been a key player in newborn screening for almost fifty years. Its philosophy, firmly rooted in NHS values, emphasises a whole-system approach from the careful selection of conditions to screen to the effective referral and treatment of patients requiring follow-up.

Subsequent monitoring and review, together with the analysis of patient outcomes, ensures that screening is provided as a programme and not just a test.

UK newborn screening practitioners are already involved in projects in the Middle East, India and Bangladesh and have been approached by a number of other countries to share their experience and collaborate to establish new screening programmes.

In response to such requests PHE and its partners are developing business-focused partnerships that can provide robust and scalable support packages to emerging markets.

A new method for cancer screening and diagnosis: Tumour Trace

Tumour Trace Ltd is a company dedicated to finding innovative technological solutions for screening, monitoring and early diagnosis of cancer. Their technology is a fully validated in vitro device, with proof of concept of pre-clinical data in the UK, Serbia and India.

Currently Tumour Trace is focusing on cervical and oral cavity cancer screening studies with clinical partners in India in Mumbai at the Ninth Months Medical Centre, and in New Delhi at Oncquest Laboratories, and in the UK at Southend University Hospital.

Future software enhancements will optimise Tumour Trace device capabilities to enable the early detection of a wider range of cancers.

5.9 Ophthalmology (eye care)

The UK is world-renowned for being a centre of long-standing specialist expertise in eye care and has been providing care and sharing expertise overseas for a number of years.

Moorfields Eye Hospital, London, is the largest eye hospital in Europe and together with its research partner, the Institute of Ophthalmology, jointly works on pioneering research, focused on the basic science of eye disease and the development of new treatments.

Moorfields Eye Hospital Dubai

Moorfields Eye Hospital Dubai is the first overseas branch of Moorfields Eye Hospital London, the oldest and one of the largest centres for ophthalmic treatment, teaching and research in the world. Moorfields brings over 200 years of specialist eye care to the UAE.

Opened in 2007, Moorfields Dubai provides day case surgery and outpatient diagnostic and treatment services for most surgical and non-surgical eye conditions.

Moorfields has a team of resident ophthalmic professionals permanently based in the Middle East to maintain the quality and consistency of care. Since opening the purpose-built hospital, Moorfields has treated more than 30,000 patients from the UAE and wider Middle East.

It also conducts research and teaching programmes and partners with local organisations on initiatives such as vision screening and diabetes awareness campaigns.

5.10 Mental health

The UK has a coordinated, regulated and integrated approach to delivering mental health services through the NHS, private and independent sectors.

There is a very comprehensive range of different services that can be tailored and customised to each population’s needs.

Services that are provided in the UK range from acute interventions and forensic services delivered in hospitals, to art and music therapy and home treatment teams based in the community.

The UK has a range of mental health providers that can work with overseas partners to develop national mental health and wellbeing visions, strategies and regulatory frameworks, and support implementation.

Improving mental healthcare in Mongolia: Camden & Islington NHS Foundation Trust

Camden & Islington (C&I) are sharing their world-class approach to mental health care with Mongolia. The collaboration came about after C&I’s approach to delivering community-based mental health services greatly impressed a Mongolian delegation to London in 2013.

With support from the British Ambassador to Mongolia, C&I and the Mongolian Centre for Mental Health are now establishing long-term commercial partnerships.

6. UK partnerships in action

6.1 World-class clinical services in Dubai: King’s College Hospital, London

King’s College Hospital is developing a multi-disciplinary hospital and several day care clinics in Dubai in partnership with Ashmore Group Plc and Al Tayer Group.

After the successful launch of King’s College Hospital’s flagship Abu Dhabi clinic, which recently celebrated its first anniversary and continues to grow its patient base, Dubai is set to become home to an 80 to 100 bed world-class hospital facility and several clinics which will all be fully integrated with King’s College Hospital’s facilities in London. King’s College Hospital Dubai will be located in the premium community of ‘Dubai Hills’.

The first of the facilities to open their doors will be a number of clinics towards the end of 2016 and in 2017, in prime locations across Dubai. This will be followed by the 80-100-bed multi-speciality hospital scheduled to open in 2018. The hospital will offer four main specialties as well as other acute and general medical services:

• paediatrics
• endocrinology
• orthopaedics
• obstetrics and gynaecology

In line with the existing operating model of the Abu Dhabi clinic, all staff and services will be fully integrated with King’s College Hospital in London to ensure provision of quality, evidence-based healthcare to the UAE and regional population, with a significant proportion of experienced clinicians joining King’s College Hospital Dubai from the UK.

6.2 International collaborations and partnerships: the Royal Free London NHS Foundation Trust

The Royal Free Hospital in London is one of the most prestigious medical institutions in the world.

It is a tertiary care centre and its major specialities include:

• liver disease and liver transplantation
• immunology
• cardiology
• vascular services
• cancer services
• plastic and reconstructive surgery

Royal Free International promotes and develops international partnerships in:

• hospital development
• hospital operational management consultancy
• education, training and development
• medical research

Royal Free International’s successful collaborations include projects with hospitals in China and Pakistan.

They are also affiliated with Dar Al Fouad Hospital in Cairo, Egypt, in connection with their outpatient / day care centre in Kuwait.

7. Healthcare UK

The UK is internationally renowned for delivering excellent healthcare. Our National Health Service (NHS) is the world’s largest integrated health system. It has provided high-quality services for nearly 70 years, supported by academia and innovative commercial healthcare companies. This partnership creates breadth and depth of expertise that no other country can match.

Healthcare UK is your route to access this expertise. Whatever type of health facility, service or training programme you are planning, we can bring together the right UK organisations to meet your needs.

Our position in government gives us an excellent platform to support and promote international collaborations, working with the Department for International Trade’s (DIT) international network of offices in 107 markets around the world. As a joint initiative between the UK Government’s Department of Health, the NHS and DIT, we connect UK expertise to business opportunities, drawing on our broad network across the NHS, the private sector and academia.

This brochure is one of a set of 7 that explains the benefits you gain by partnering with UK healthcare organisations. The full set comprises:

• education and training
• healthcare infrastructure services
• digital health
• clinical services
• health systems development
• genomics and personalised medicine
• improving the quality and safety of patient care

To find out how you can draw on UK expertise to extend, improve and transform healthcare provision in your country email Healthcare UK

7.1 Disclaimer

Whereas every effort has been made to ensure that the information in this document is accurate, neither DIT, nor the Department of Health accept liability for any errors, omissions or misleading statements, and no warranty is given or responsibility accepted as to the standing of any individual, firm, company or other organisation mentioned.

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Published January 2016 by UK Trade & Investment

This was published originally by UK Trade and Investment which has since moved to the Department for International Trade (DIT).

URN: UKTI/ 2016/01