Despite its size, speciality and reputation, Newcastle Upon Tyne Hospitals Foundation Trust (NuTH FT) has been underdeveloped in its commercial functions and so has missed opportunities for improving trust services. To address this, prior to the pandemic, NuTH FT began a process to increase its commercial capacity, which involved exploring how to engage with international organisations.
Despite its minimal commercial functionality, NTH FT has pre-existing commercial experience in treating patients with severe combined immunodeficiency syndrome (SCIDS), a collection of rare, inherited disorders that cause major abnormalities of the immune system in children. The Great North Children’s Hospital is one of only two trusts in the UK to offer bone marrow transplants for these patients, along with Great Ormond Street Hospital. For several years the trust has treated children from the Middle East with SCIDS, primarily with stem cell transplantation.
What the organisation did
The trust sought to develop its existing commercial offer, primarily to deliver additional revenue to reinvest into core services.
To date, the income has been used to support the funding of an additional band 7 nurse coordinator post. This coordinator is available to manage the efficient pathway for all bone marrow transplant patients across trust.
It has also allowed the trust to develop its home parenteral nutrition service and improve the bone marrow transplant pathways for all.
Whilst the primary goal of this work was to deliver financial revenues, there have been multiple non-financial benefits that have become major drivers to continuing the work.
As the trust’s international reputation has grown and international centres increasingly send patients, NuTH FT is able to increase its expertise and experience even further.
Furthermore, as a direct result of the work with international patients, the team has identified new molecular diagnosis and pioneered new techniques.
NuTH FT believes that the volume of patients being treated is the contributing factor to its world-leading outcomes, as well as making it an attractive centre for industry wishing to conduct clinical trials.
The trust’s results mean that there is now a constant queue of overseas doctors who want to come to train, either as observers or international fellows. They then go back to their centres and often start up transplant programmes for these patients.
Additionally, many of the team have a high profile internationally, in terms of speaking engagements at conferences, educational meetings, writing guidelines and responding to requests for clinical advice.
The programme required significant commitment in terms of staffing resource and physical capacity, including theatre time and bed occupancy. Sometimes this meant being unable to pick up international activity when it was offered, but the trust is clear that NHS patients come first.
On a more commercial basis, risks relating to non-payment are very real and are minimised through the use of a third-party agency that guarantees payment. This provides reassurance that there is no financial risk for the trust and the company also provides other valuable services, including travel and accommodation arrangements, family liaison and translation services.
COVID-19 has reduced the trust’s capacity to take on international work, and demands on capacity for COVID-19-related care and for the recovery programme have taken away flexibility. However, the trust has have moved to a block contract for NHS work, which makes international work increasingly attractive.
The trust sees opportunities in the aftermath of COVID-19 and plans are already underway to ensure appropriate capacity and infrastructure is in place to progress these opportunities. The trust plans to work with stakeholder groups in the hospital to develop the right strategy to take this work forward.
In the longer term, NuTH FT hopes to expand its commercial presence internationally to cover a greater number of specialist areas. There are also hopes to expand the international consultancy offering over the next 12 -18 months in line with the trust’s strategy and values.
While COVID-19 has been a challenge, NuTH FT continues to use the opportunity to develop its proposition and to strengthen partnerships to ensure that it is ready to operationalise this aspect of recovery planning.
The trust is currently taking time to review its international offer, working with directorates to understand what can realistically be delivered in the current climate.