Karen Taylor (00:00:00): Welcome to “Life Sciences Connect”, Deloitte’s Podcast on the Life sciences and healthcare industry. This series features conversations with leaders from across the health ecosystem sharing their insights on the critical issues facing the industry today. My name is Karen Taylor and I lead Deloitte Center of Health Solutions, an independent research hub that supports Deloitte’s Healthcare and Life sciences industry teams. In today’s podcast we will discuss our recent predictions report, 'The future unmasked - Predicting the future of healthcare and life sciences in 2025'. This report evaluates ten predictions of what the healthcare and life sciences ecosystem might look like in 2025. The key constraints that have to be overcome to realise the future in 2025 and also the evidence today help us predict tomorrow. These predictions have inevitably been informed by emerging evidence of the impact of the COVID-19 pandemic on society and the health ecosystem, and have been brought to life through a series of portraits that imagine what the experience of individuals might be like in 2025. They have also been shaped by our research, insights and insights provided by many of our colleagues in our global 2040 Future of Health campaign. Today I am joined by Hanno Ronte, one of our Partners who leads the life sciences and healthcare team in Monitor Deloitte; Shivani Maitra, who is a partner who heads up our Future of Work campaign; and also Sara Siegel, who is the UK Public Sector Healthcare lead. Could I ask you to introduce yourselves?
Hanno Ronte (00:01:45): Yeah, Hanno Ronte, as Karen said, a partner in our life sciences work. And I focus most of my work and my thinking around how companies both in the life sciences space, pharma and medical devices, can really change and adapt to really deliver the promise of medicines and health for patients, for individual patients but also for societies at large. And we see so many seismic shifts not just driven by COVID but by all the different technological developments both in R&D and in Science but also in terms of digital therapeutics and digital engagement, and simply the data that we have that will actually create a completely new era for healthcare and for us as patients and for us as societies.
Karen Taylor (00:02:33): Thank you Hanno. Sara, would you like to go next?
Sara Siegel (00:02:27): Sure. Thank you Karen. Hello everyone, I am Sara Siegel. I lead our healthcare practice in the UK, that is our work with public sector health bodies including all parts of the NHS and the Department for Health and the other Centre for Health bodies. Our practice of late has been very focused on supporting the government’s response to Coronavirus and I think it tell us a lot about how much we can actually accomplish in a really short period of time. And when it comes to predictions and a forward look I am hopeful that we will take so many learnings from the experience that we have had over the past eight months and apply it to evolving the sector faster and using a lot of the innovation that have been so quickly brought to us recently.
Karen Taylor (00:03:20): Thank you Sara, and Shivani?
Shivani Maitra (00:03:21): Thanks Karen. Hi everyone. I am Shivani Maitra. I am a partner in Human Capital and I lead our Future of Work thinking for the private sector in the UK. And what that really means is what we are, what we have been talking about for the last three to four years around the intersection and the interconnectedness between work, where work gets done, work place where work gets done and who does the work. How does that all come together is really about the future of work. And in the last seven months what we have observed is what we thought would happen, or play out in the last five to ten years has been accelerated quite significantly. And this has been pan-sector, pan-industry. I don’t think there is any organisation that has been untouched by what the last seven months have played out. It has been difficult and at the same time I think there are lots of good learnings that organisations should look to bottle and take forward into the future, and hopefully we can share some of that.
Karen Taylor (00:04:29): Thank you very much. That’s really exciting, and some really great different perspectives that we will be able to bring together in our discussion. Before we start the discussion, I just wanted to provide, set the scene by providing an overview of the predictions report. As I said there are ten predictions, we can’t possibly do justice to them today on a podcast. But I will just set the scene. And leads on from what Shivani was just saying, the unprecedented nature of the pandemic has had an indelible impact on our industry, both healthcare and life sciences. There’s also been unimaginable human loss and lasting changes to the way people perceive healthcare risks. There’s also a new appreciation of the contribution made by life sciences and healthcare organisations and a new era of collaboration that are coming together to identify, implement new solutions for problems we face. All stakeholders across the health ecosystem have seen a dramatic acceleration in the pace and scale of technology-enabled transformation, and this has clearly informed our predictions. A legacy of the pandemic is likely to be new relationships based on partnerships, goodwill and heightened levels of trust. Attitudes to both public and population health have changed with the shift in emphasis to prevention and acknowledgment of the importance of the social determinants of health, and the need to reduce health inequalities, and improve healthy ageing for all. Traditional boundaries are becoming more porous, creating an opportunity for new healthcare behaviours, new business and funding models, and more effective collaboration among stakeholders. All of this is leading to new services from both incumbents and new entrants. Critical enablers to all of our predictions are the improved knowledge of genomics, artificial intelligence and digital health, the emergence of new skills and talent, access to robust interoperable data and analytics and insights. There are also new approaches to regulations we are seeing as we accelerate the search for treatments and vaccines for COVID-19. And these enablers can help to lead to a future for healthcare that is more predictive, preventive, personalised and participatory. Clearly making predictions is never easy but we hope that we have captured a lot of the things that we see will happen in 2025. So I am going to ask our guests now to join me in the discussion and certainly provide an overview, an initial overall reaction to what they see are the key things that they believe will influence healthcare and life sciences in the next five years. And if we start perhaps with Hanno?
Hanno Ronte (00:06:55): Yeah, I mean I think for… I mean Thank you Karen and thank you all for sharing the highlights from the predictions report which we are all very excited about because we see so much of that already happening today and it’s really a glimpse into the future based on what we already see today. And if I had to summarise based on what I think are the three core themes that I think will really shape the healthcare and the life sciences sector together. It consists of really three things for me. One is a real sense that data and digital are going to be much more pervasive. We are collecting much more data. We are expecting much more from data. And we are trying to act and decide, make decisions based on data, whether that is individual decisions to decide how much fitness to do, how much to eat down to what the best clinical treatment is, down to how we would shape public health interventions. So data and digital are going to be very much more pervasive than they already are, and they are going to be an integral fabric of our lives, privacy rules notwithstanding. I think the second thing that I think will really drive and shape is that COVID, more than anything, has shown that actually industry and healthcare, patients and players and governments, can actually be true partners. And actually this sort of sense of trust that has developed I think can be the foundation for many great things to come. And I am a relentless optimist that some of the lessons that we have learned now can actually lead us into the future and this sort of collaboration, this belief in giving people the benefit of doubt that we actually want to do the right thing will actually help us shape the better healthcare systems and better health for all of us. That then leads to my third observation that I do think for all parties concerned business models will change and evolve. So I think pharma and medical devices will have to change their business models but I think also the healthcare system will have to adapt to that. And actually for example be much more cognisant about how industry with its knowledge, expertise, data can actually be an integral part of the healthcare system as opposed to simply a deliverer of tablets or pills. That’s my view.
Karen Taylor (00:09:07): Thanks Hanno. And I think that leads us neatly into a talk to Sara and ask her for her reactions. And for me one of the things that really stood out is the appreciation of the role of a robust public health infrastructure and the importance of actually having investing sufficient into our public health system. And I don’t think we realised quite what was needed and I think what we see now will be sustainable going forward, and in fact public health will become much more important. But Sara, what are you seeing and what’s your view?
Sara Siegel (00:09:40): Yes I would echo a lot of the things that Hanno said. I mean I think that we are very fortunate in the UK to have such a robust public health infrastructure, you know, with such a good spread of services for the population. You know what we didn’t have was a strong diagnostics capabilities. But what we have done is built one very quickly. And again it was a massive collaborative effort between governments, private sector, public sector, military, etc. And I think for the future there is lots of learnings in that, including you know how we use all of the parts of the economy to best effect for the skills that they bring. We have also done a lot with science in an incredibly rapid way, and I think time is still to tell how that plays out but I think it has forced a bit of a shake-up in terms of, you know, were we following the best possible process in bringing new innovations to market. Were we thinking about things in the most efficient and expedient way? Now I don’t know, you know the vaccine situation is still early days. But I think whatever we settle on will be a better version of what we had before. And I think it will be rigorous and I think it will be faster in terms of bringing scientific innovation to market. So, the UK has built a significant diagnostic capability very quickly. And that will allow the NHS to tool up and use this capability into the future, and not just for Coronavirus testing but also for broader diagnostic use cases. I think that is a very important thing for the NHS which always needs investment and support and you know, labs need to be improved in terms of the technologies that they use and the investment that they get. So I think it is a wonderful thing that in this horrible time, in this very difficult crisis we have been able to put investment towards the NHS that they can use going forward.
Karen Taylor (00:11:26): Thanks Sara. Shivani, a lot of our predictions, in fact all of our predictions, highlight the challenge and one of the constraints – the need for new skills and talent. And of course we have a specific prediction on the who, what way of work we architected. Could you say something about what you are seeing and how that aligns to what you just heard from Hanno and Sara.
Shivani Maitra (00:11:51): Quite a bit actually. And I am pleased to hear that what the scientists are saying aligns with what Human Capital has been researching in the last six to seven months. In fact very recently we conducted the European Voice of the Workforce survey – ten thousand people in the workforce across seven European nations – and some of the findings there tell us that work five years from now is going to be very very different. But the shift is not going to be revolutionary, it is going to be much more evolutionary because organisations are going to keep learning every step along the way. But what really is going to be different? I think the first thing that is a definite given is that all organisations, and I have spoken to a lot of my clients in life sciences, is that they will move towards a hybrid way of working. So a much more considered approach to how the workplace is used. The people coming to the workplace what they use it for, and how organisations then enable the virtual working environment. That’s one. The second, and that’s a knock-on effect from the first, is the workforce. I think what this does is very exciting in that it opens up absolutely no new talent pools for organisations. You really don’t have to move to a city or a town where the big pharma or the big healthcare organisations are. You can live anywhere you want, and still work for the organisation you want to work for. So the whole talent narrative shifts. I guess the third bit is technology, and the fact that digital is going to be the DNA that is going to hold organisations together. And what I mean by this is a lot of focus has been on external digitalisation of organisation and what’s going to be much more important and much more critical is the internal digitalisation. People operate inside the organisation the same way they are operating and dealing with their customers, and therefore my final prediction really is that people centricity is at the heart of patient centricity.
Hanno Ronte (00:14:00): Shivani, I really like what you are saying here. But I think if I combine that a little bit with what Sara said, I think you know for me the upshot becomes how do people actually adapt and change in this new world because it will require many new skills. And I think in particular with this sort of, what both Sara and I were talking about, this new collaboration with industry requires from, across healthcare across the spectrum, requires much greater tolerance, openness and flexibility around working beyond the border of your own organisation, and accepting different things, taking different kinds of risks. And I am really, I suppose despite my innate optimism, one of the things that I am concerned about is to what extent, especially at the beginning the pandemic created a unifying common enemy that would enable people to behave much more better together and behave more healthily. And I think we already see how difficult it is now to get consensus around even simple behaviours in the public health space, and even what the scientific approaches are going forward. So I think for me this is going to, this will impact the way how people work, way people are trained, who does the work – as you said before Sara, Shivani – and also Sara how you articulated what the type of collab capabilities are that even countries need to build.
Shivani Maitra (00:15:22): Absolutely Hanno. And I think the only point I would add to that is one of the other, I was talking about bottling some of the brilliance of the last seven months, one of that that’s come out loud and clear is that people had to work on their own. So there’s been greater autonomy that’s been given to people. They have experienced greater trust from their leadership – more openness, more cross-functional workings. So, I think Hanno you were talking about the shift in business models, we are going to see more business models change, fewer organisational functional hierarchies and more team-based working. And the second bit is around the workforce. The workforce, not just the people who are on your payroll, your permanent employees on your balance sheet, but your wider ecosystem. And I just wonder in the next five years might we see a shift where that trust, openness, autonomy permeates organisational boundaries.
Karen Taylor (00:16:22): I think that’s a really good statement there because one of the things that I have seen as a non-executive on a hospital board is trusting staff to make the right decisions, giving permissions to just develop innovations, to work, try things out in a way that in the past was actually quite difficult to do. And we have obviously seen a lot around change. But I have seen some amazing evolution of developments because they needed to and because people do have really good ideas. And Sara in your work with the Department of Health, what sort of trusted environment do you see emerging from all this?
Sara Siegel (00:17:03): I am definitely happy to talk about the central example. But I think the thing that strikes me first when you talk about that Karen is actually the massive shift that we have seen in terms of the changes in the ways of working in General Practice. Think about how long General Practice has been a 99 percent face-to-face model. A little bit of telephone triage perhaps, a little bit of calling in a prescription to a pharmacy, but it’s always go and see the GP. And now through necessity they have shifted 75 percent and more of their volume into either virtual or phone, and I am sure that there is a need to get a little bit back from that to some more face-to-face because GPs do play an important community linking role as well, as we know. But think about the innovation that we have been able to forge in terms of GP practices. Most of them didn’t have a video link capability before Coronavirus. Now they all do. So we have seen a huge change in the way of working at a very very important you know gate keeper and connectivity partner of the healthcare service. And then I think at the central DH level – the stakeholders are always changing, but I think what we have seen in the last eight months with Coronavirus, is people from across government pitching in to help. So it’s not just been Department of Health, it has been people from MoD, all kinds of other government departments who have gotten involved and lent their skillsets. One of the things that I think isn’t apparent to the outside world is that something like standing up brand new testing infrastructure isn’t just about science, it’s not about the labs, it is about the labs, but it is not just about the labs, it is about building an entirely new sector in the economy which takes a ton of different skills. And sometimes when people talk about the lack of scientific involvement, some scientists critic this – they forget that a) there are a lot of scientists involved, but b) it is not just scientists who need to do this. You wouldn’t ask a pilot to build an airport. You would get architects and construction firms, and others involved to do that. So it is the other skills – the digital skills, the logistic skills, the supply chain skills, etc., the operational efficiency skills, the analytic skills – that you need to build around that. So it is all of those different skill sets that we have seen sort of just pitch in, help and work in a really collaborative and multi-disciplinary way over the past eight months.
Hanno Ronte (00:19:14): For me, if I may build on that, I think what I am really struck by is we are in a world where actually the norms and paradigms are shifting. Who would have thought that you can put a vaccine on to the market in eight, nine, ten months, which it will hopefully be, whereas normally it took ten years? Even previously the examples where real world evidence was used to approve the new pharmaceutical drug were few and far between. I think the fastest that we have had before the pandemic was eleven days, based on real world data for rare disease. But the implication here is that our norms are changing, and they will form based out of experience and a sort of a new consensus that is emerging. But I am just really interested around how, how we as different actors in the system could actually help establish new norms and consensus – that includes all the things that you have talked about Sara – which is around, actually what is the right balance of face-to-face treatment vs not. What can we do remotely? You know last week I think there was one of the first reports of actually a robot operating somebody in the US from Edinburgh. These are sort of changes which change our norms and I would be really interested Shivani in what your view is about how corporate norms and how these new ways of working actually form? And is that a matter of leadership, or is that a matter of simply everybody doing the same? What gives the spark to create a new consensus, a new paradigm?
Shivani Maitra (00:20:49): You know Hanno I was just thinking of how I would respond to what you were saying because as you know I work in the area of organisation transformation, be it a big technology implementation, operating model change, whatever it might be. And you go in and you talk to organisations and the response generally is transformation is hard, and change takes years and we need to build consensus. I want to go back to all these organisations and ask them what happened in the last seven months that you were able to take decisions so quickly. I mean from simple things like in our local grocer where people moved from serving fresh foods to just stacking shelves that very shift in job description to, as you just said, getting a vaccine out in such a short period of time, getting it approved, making sure that we can actually have a vaccine that works. What happened? And in my view what happened was, never before has the urgency been this clear, never before has the north star been this clear, and never before has the leadership definition meant not an individual but a team and these are the three things that you need to sustain and take forward. Why would now organisations stall around and say I need time to build consensus, come back to the last seven months and remind yourselves how you built consensus at pace, remind yourselves how easily you were able to define your objective, your mission, your north star. Leadership is going to have a very fundamental role to play in this absolutely defining. But the second, and the second more important bit is recognising that we are living in a world where in position of ways of working, culture, norms can’t anymore be top-down, they are going to be much more bottom-up. Because again back to my earlier point, people want greater autonomy, people want greater trust, they want much more of a say in how they approach work. These two elements of how leadership behaves now going forward and how employees or the workforce influences how organisations operate, it is just going to be fascinating.
Karen Taylor (00:23:15): Thanks Shivani. Perhaps bringing in one of the other stakeholders that are involved in all this and that’s the citizen or the patient. And how all these changes might appear to them and what their role will be in this new paradigm that we are describing. I don’t know who wants to go first, but talk amongst yourselves about this.
Hanno Ronte (00:23:38): I am happy to go first and I would be interested in how Sara would contextualise it. I suppose my slightly provocative view is I think with a lot of the things that we have been talking about, we sort of always assumed that data, earlier decision making, early interventions, better awareness, will actually help people make better decisions and behave better. I think despite some of the positive things around with the experience of COVID we have also seen that people do not always want to behave in the interest of their own health – either because they can’t because of the circumstances they live in or frankly simply because they don’t want to. I always joked that in lockdown at least half of my friends seem to have got a lot bigger, and half of my friends seem to have got a lot smaller than they were before lockdown. And everybody had the same amount of time and the same amount of lock-ins. And so I am really interested in this question around what is our societal expectations around behaviour and cohesion, and what the responsibility is towards one’s own health and how can industry and the healthcare system and frankly, also governments and social norms actually encourage that? But I would be interested Sara, what are your views on that?
Sara Siegel (00:24:37): Yeah I think those are interesting points Hanno. I mean I think the thing that I have witnessed which I have found fascinating is a shift in the attitudes of citizens/patients over the last eight months. So for the last fifteen years as a native-born American living in the UK, I have been saying citizens are like healthcare consumers. They make their selection of the choices they want for healthcare. But in this country people are largely sort of takers of the service that are offered to them. They don’t exercise a lot of choice, even when it is given to them. But that’s not what we have seen in the last eight months. You know it is very interesting to me. Nobody wanted a Coronavirus tests in March and April, and then comes September when everyone came from summer holidays and all their kids went back to school, everybody wanted a Coronavirus test and if they couldn’t get one same day within a ten minute drive from their house they were really cross about it, which you know put a lot of pressure on the testing programme. But I was really pleased to see that because it was a really strong vote for consumerism in the healthcare space, which in the UK we haven’t traditionally seen a lot of. And I think that is a really positive step. I think it was unrealistic for millions of people to want to be able to get a test on the same day, but I think it was a great sentiment. And I think more of that will be really helpful to Hanno’s point around people taking charge of their own healthcare and trying to steer the direction of the industry, which will only mean positive things. It will mean a stimulation of innovation, competition for good customer service and all of the benefits to the individual healthcare consumers that come from that.
Karen Taylor (00:25:06): Thanks, and that’s a really good thought. It’s always been a challenge for us to describe the users of services because they don’t like being called customers, they don’t like being called consumers, and they are not patients other than in that one intervention when they are seeing a clinician. So, looking at that and the lessons we have seen from that, I think it will change how we can engage with patients, but also make them part of the solution, part of the, contributing to the decisions about how their health will be managed going forward. So Shivani, in terms of the future of work, what is it about, how will our healthcare professionals really be able to embrace those positives that you have described, and have you got any views on that?
Shivani Maitra (00:25:53): I think the future is all about capability. I think it was Hanno or maybe Sara I forget, who talked about the new roles and the new skills that are coming up in life sciences and healthcare, I think Karen you mentioned this morning about new roles in MedTech. The World Economic Forum wrote a couple of years ago that sixty five percent of kids in primary school today, will be in jobs that don’t event exist, right? So the future is really about capability. It is about reskilling. And a capable organisation is a resilient organisation. That’s how you tackle what the external environment throws at you. So I think for the healthcare professional it is really going to be about how organisation is equipping them for the future. Our US firm recently did a report, and I think there was an article in Healthcare Dive in May of this year which talked about eleven thousand percentage increase in telemedicine this year, which is fascinating right? But is it as straight-forward as that? Are you really equipping your people to be able to work in this new virtual, technology enabled environment? That’s going to be quite important. How do you make the balance between efficiency – so AI, Robotics, Cognitive – and really focusing on what the healthcare professional is bringing to the table, which is around their specific skill sets. So the focus for the healthcare professional has to be about capability, it has to be about how the organisation is going to equip them. I think all healthcare professionals will need to participate in much more multi-professional training which is delivered through new training models focussed on adaptive, agile ways of working, how do you operate in virtual reality – all that will have to be considered. Five years from now who knows what the healthcare professional will be dealing with, and therefore the only way to keep them equipped going forward is – I stress again – will be around capability.
Karen Taylor (00:28:10): Thanks Shivani. We are starting to come towards the end of the session. So I want to give each of you a chance to provide our audience with one takeaway that you would like to keep utmost in their minds as we go forward into the next five years. And I will start with Sara, if that’s okay?
Sara Siegel (00:28:30): I guess one key takeaway that we have probably learned from the last eight months is that, especially from the last few weeks with the wonderful vaccine news we have been hearing, is that no matter what crazy things get thrown at us in the world and how bleak things may seem, you know the power of human ingenuity is just incredible and when we work together, put our skills together, we can solve almost anything. So seeing us starting to pull through this gives me such hope for the future – not just for the Coronavirus situation but all kinds of situation that we can solve working together with science and other skills that we bring to the party. So ending on a message of hope there, Karen.
Karen Taylor (00:29:10): That’s great, a great way to start our final messages. Hanno?
Hanno Ronte (00:29:14): I mean, I have to say that I am very similar to Sara is that I could talk about technology, digital and all those sort of rational things but my hope for the next five years is actually about humanity and it is about trust, and giving people the benefit of the doubt and actually trying to create a positive way forward to say that let’s take the best way forward out of all things that we have just experienced in the last year and leverage the power of technology, not just digital but of science, as Sara said about ingenuity, to address some of those problems, but also be very cognisant about what the role of leadership is, and I don’t mean that in the sort of big L you know as the president of a country, but I mean at an individual level what it means to lead your own health, what it means to lead within your family, and within your organisation to actually create this better world for all of us.
Karen Taylor (00:30:08): Shivani?
Shivani Maitra (00:30:09): I think Karen the last seven months, based on the conversations I have had both within Deloitte and also with so many of my clients, has given me cause to introspect a lot on what worked and what didn’t work. I think the only thing I would say is for organisations to, when the time is right, pause and take stock of what’s worked and bottle it and keep it for the future. Because we know that the only constant is change. And there will be much more that will be thrown at us.
Karen Taylor (00:30:37): Absolutely. I would like to thank you all, Hanno, Sara, Shivani, for your contribution. And what we have heard is more about the challenges we have faced and how we have overcome them. But those all allowed us to predict what we think the world might look like in 2025. It is a very optimistic view of the world, but I think the prize is so important that we need to be optimistic. And lot of what you have just said feels that’s right, and that’s the way that we need to go. So thank you very much. And also thank you to our audience for listening to our podcast, and I hope you will join us again in our next episode in the Life Sciences Connect podcast series. For now, thank you and good bye.
