Date of Meeting:   
17 March 2014 
Agenda Item:  
 
3 - Paper:   LHB 2014-16 
Title of report: 
 
Promoting Growth and Jobs in Life Sciences 
Report Author:  
 
Carolyn Ruston, Senior Policy Adviser, London Health Board 


Telephone 020 7934 9638 email Carolyn.ruston@londoncouncils.gov.uk 
For:   
 
 
Approval 
 
 
1. SUMMARY At its inaugural meeting members of the London Health Board agreed that it should make 'Promoting growth and jobs in Health and Life Sciences' one of its strategic priorities. In broad terms this was because evidence collated by the GLA, NHS London and the three Academic Health Science Centres (AHSCs) in London demonstrated that although London was seen as a strong international competitor in  bio-medicine, comparable to places like Boston USA, it was not attracting a proportionate share of investment in bio-tech, pharmaceutical and medical technology.  The Board asked for proposals to be brought to its March 2014 meeting as to how whole sector growth and related health and economic benefits could be realised for London. Views have been sought from a range of high level stakeholders to identify potential barriers to growth in London and opportunities to further realise London's market potential. (See anonymised summary at Appendix 1). 

2. RECOMMENDATIONS 
The London Health Board is asked to: 

i. 
Make representation to the Board of 'MedCity' to prioritise the following: 
 The development of a single gateway/access point into the life sciences sector in 
London to be created with involvement from key partners including AHSC's, the London Enterprise Panel (LEP) and industry to enable effective navigation through the health system in London. 
 Ensuring the development of strong and effective links through the Global Medical 
Excellence Cluster (GMEC) in order to develop and foster strong ties to neighbouring life sciences 'hubs' in Stevenage, Oxford and Cambridge.  
 Work with the LEP and other partners to develop key enablers to increase the 
number of start-up lab, office (both virtual and physical) and grow-on space in 
London. And explore jointly with the AHSCs and AHSNs, opportunities for some provision to be co-located on existing healthcare or science and technology sites. 

 Work with NHS England and other partners to address the following improvement 
areas relating to data and technology. (Note -This work will involve links across to the improving patient experience workstream agreed at the December meeting of the LHB): 
 Increasing the use of Electronic Patient Records (EPR) in London  Options for enabling interoperability of systems through the use of 
'Middleware' technology, especially between Primary and Secondary 
Care  
 Marketing London as a single virtual site or access point for clinical 
research.  
 
ii. 
Commission the London Academic Health Science Centres (AHSC's) and Academic Health Science Networks (AHSN's), with support from the Office of the London Health Board (OLHB), to lead a programme of work with Primary Care to increase public and patient participation in clinical trials in London with a specific focus on rare 
diseases. 
iii. 
Request that the OLHB convene a Task and Finish group to produce an submission to the LEP to draw down funding to commission a feasibility study into options for piloting a campus style accommodation model of affordable accommodation for people working in the Life Sciences industry on an existing healthcare or academic site or sites with a view to determining the role/impact housing plays on London's global competitiveness. 

## 3. Main Body Of The Report 3.1 Background

The UK has a strong history of global innovation in the life sciences sector leading the world in key areas of research and development (R&D) such as regenerative medicine, robotic surgery, and drug development. In vitro fertilisation, development of MRI and CT scanning, the portable defibrillator, genetic fingerprinting, the disposable syringe and the contraceptive pill are just a few of the breakthroughs made by British clinicians and scientists. The UK currently has 77 Nobel Prizes for contributions to biomedical science. 

The UK has a uniquely powerful combination of world-leading universities and science institutions, well established R&D, manufacturing and supply chains, globally renowned research charities, a National Health Service (NHS) with 60+ million patients and access to health data that tracks patients throughout their care pathway. 

3.2 
National Context 

The UK life sciences industry is highly innovative and dynamic; it is growing faster than the economy as a whole and is a key source of high-skill, high-tech jobs. Pharmaceuticals, medical biotechnology and medical technology sectors together comprise around 4,500 firms, employing 165,000 staff, with R&D spend of nearly £5bn and an annual turnover of 
 
over £50bn. Over 300 pharmaceutical companies are based in the UK employing nearly 
78,000 people, with an annual turnover of £31bn. The medical technology and medical biotechnology sectors represent over 4,000 companies employing 87,000 people. However it was acknowledged by the current Government that the life sciences industry was changing and the UK needed to adapt and grow in order to ensure its continuing competitiveness globally. The Office for Life Sciences (OLS) estimated that between 2011 and 2016 there would be an opportunity for 36.4% growth for combined global pharma, biotech, life sciences, healthcare equipment and supplies market. 

To help realise this in 2011 the Department for Business, Innovation and Skills, OLS published its strategy for UK life sciences. The strategy was published in response to growth and emerging markets in countries such as the USA and the need for the UK to remain competitive, be at the forefront of leading development in the sector as well as developing an infrastructure that connects academia, industry, investors, clinicians and the NHS. The OLS identified five key contributory factors to the strength of the UK life sciences industry, in summary these were: 
 

o A strong academic and science base o A collaborative environment between industry, academia, the NHS and the 
Government 
o The benefits of a single NHS o A facilitative environment for clinical trials, and o A supportive business and regulatory environment to incentivise 
commercialisation of discoveries. 
 The OLS describes the following 'bench to bedside' approach as key to a successful UK life sciences environment: 
 

## 3.3 London London Benefits From £16Bn Of Public Sector Healthcare, Research And Teaching Spend Annually. It Is Home To A Number Of World Class Healthcare, Science, And Academic

"London was the obvious place for us to launch our first Healthbox programme outside of the United 
States given the world-renowned academic institutions, focus on improving health and growing 
technology community." Nina Nashif, CEO, Healthbox © 
 
institutions providing the capital with a strong base to compete globally in the life sciences industry. 

London boasts 41 NHS acute trusts including 10 teaching hospitals and 4 specialist hospitals some of which are internationally respected employing world leading clinicians in speciality areas such as liver, haematology and fetal medicine. London is also home to 85 life sciences companies, 750 healthcare companies, 350 medical equipment manufacturers and over 50 clinical research centres. London also has more biotech venture capital firms than the top ten other European cities combined. London is a leading global finance centre which has enabled the creation of a supportive environment for start-up companies with the provision of skills and services that support major investment from pharmaceutical companies and venture capitalists (VC). London also possess a number of complementary industries and related skill base, has unrivalled transport links and is close to other life science clusters such as Oxford and Cambridge. However over recent years a range of different reviews into the London sector by the three AHSC's, McKinsey Group and London and Partners demonstrated that London is not fully realising its potential market share and growth targets within the sector when compared to other global 'hubs' for life sciences such as San Francisco and Boston. In broad terms the outcome of these reviews identified the following issues needed to be actioned before the London market could develop further: 

 Creating a focus on greater health and wealth opportunities in London  Creating more employment opportunities in London especially high value jobs  Attracting greater investment into London life sciences and related industries  Leading the way in R&D projects that drive large scale health improvement  Becoming a global hub for high quality researchers and students  Development of real opportunities for collaboration  Enabling access to the London healthcare system and population demographic  Creating an access point into life sciences across the UK 
 A comparison diagram between London and San Francisco and Boston prepared by the McKinsey Group is attached at Appendix 2 to this paper. The diagrams attached at Appendix 3 and 4 show a comparative performance baseline in terms of commercialisation and London's position in terms of the number of life science patents. More recently key decision takers, opinion shapers and industry are keen to realise growth in London through a commitment to effective partnership working which can already be seen in areas such as Med City, The Francis Crick Institute and the creation of Academic Health Science Centres and Networks. A more detailed summary of these partnership areas is attached at Appendix 5. 

3.4 Stakeholder Analysis A range of different high level stakeholders were interviewed by the Office of the London Health Board in order to gather expert opinion as to what the major challenges or barriers are to growth in the life science's sector in London. A number of common themes emerged which, in summary are: 

 The lack of a single gateway or access point into the London market and inability to 
communicate the 'London offer' 
 Insufficient start up and incubator space  Interoperability of clinical data systems and access to patient information 
electronically 
 Housing prices and transport connectivity  
 Opportunities need to be realised for increased participation in Clinical Trails 
 
A more detailed summary of these theme are set out at Appendix 6. 

4. IMPACT ASSESSMENT/LINKS TO BOARD PRIORITES 
Promoting growth and jobs in the life sciences sector in London was identified as one of the Boards priorities. The recommendations contained within this report will not only seek to ensure London redresses the balance in terms of competitiveness and market share at a global level but will also benefit the London and UK economy. Growth in the life sciences industry in London will also help to improve patient outcomes through increased health research and participation in clinical trials. 

5. CONCLUSION  
 
Increased investment and growth in the life sciences sector in London will improve the London economy as well as the wider physical and mental health and well-being of Londoners through increased employment and training opportunities, improved housing and transport infrastructure through wider investment in the capital and through more access to participation in clinical trials. There is also added potential in terms of London's existing teaching hospitals and colleges, who have some of the world's best treatment and research offers, to contribute to economic growth and jobs. The recommendations contained within this paper aim to provide leverage to address some of the main barriers and open up opportunities to realise growth with the life sciences sector in London. 

Organisations/Institutions 
 
AHSCs/AHSNs/Academia 
King's Health Partners Health Innovation Network South London Imperial College Health Partners King's College London 
University College London Partners 
The Crick Institute 
Central Government 
Department for Business Innovation and Skills All Party Parliamentary Group on Medical Research 
Industry 
London Bioscience Innovation Centre Association of British Healthcare Industries One Nucleus 
Stevenage Bioscience Catalyst 
Creabilis SA 
Local Authority/NHS  
London Borough of Sutton London Borough of Camden London Borough of Bexley London Borough of Harlow London Borough of Lambeth London Councils London CCGs 
NHS European Office 
 
Regional Government 
Greater London Authority 
Private  
London and Partners Price Waterhouse Cooper 
Third Sector/Charitable 
Wellcome Trust National Housing Federation 

 
List Stakeholder Organisations interview and Summary Responses 

## Annotated Summary Of Responses To The Question - What Do You Feel Are The Main Barriers Or Challenges Preventing Growth In The Life Sciences Sector In London? "There Needs To Be Sufficient Incubator Space To Ensure London Can Provide Sufficient Challenge To The Global Market Place."

 
"Science Entrepreneurs make discoveries with a potential to solve critical unmet health needs so it is important for London to play a big part in this." 
 
"Cambridge worked well because of the close proximity or clustering of small and larger scale companies to each other and benefits of opportune meetings can bring in terms of sharing of information etc." 
 
"There should be opportunity and affordable access to resources to carry out high risk activity in a low risk environment. Venture Capitalists needed to become more risk adverse." 
 
"There are wider determinates that prevent investment in London such as housing and transport connectivity". "Access and the sharing of clinical trial data is a barrier" 
 
"There are problems getting good people (scientists) to come to London from elsewhere because of cost and quality/nature of available housing." 
 
"Affordable Housing in London is a really barrier to people staying in London."  
 
"Science is dependent on continuing and growing cohort of young Doctors." 
"Life sciences can drive economic growth through inward investment and by attracting major international companies - London needs to be up there" 
 
"Analysis and sharing of data is a major issue to attracting global investment and start-up companies to the UK". 

 
"Given the Pharma focus on rare diseases there are real opportunities for London to increase public participation in Clinical Trials." 
 
"The patent box legislation has had a positive effect but needs to go further" 
 
"Affordable housing is key to attracting people to set up life science companies in London." "London needs to take steps to maximise its potential and this is possibly an area for MedCity." 
"There are missed opportunities with GPs and Primary care in terms of participation in Clinical trials." 
 
"Connectivity across the system is an important factor in growing and sustaining the life sciences sector in London." 
 
"London needed to create an environment that was conducive to productivity". "The LEP has a remit to promote science and technology" 
 
"There is a desperate need for more lab space and equipment available in London." 
 
"There is a need to drive better coordination in the sector to deliver larger scale improvement and promote education and enterprise across the sector." 
 
"AHSCs need to work together and not compete." 
"From a health improvement perspective GPs and the AHSCs should work to increase uptake in clinical trials." 
"London needs to provide more opportunities for small business start-ups and access to lab, office and virtual space as well as grown-on space." "There are lots issues relating to data which could be a whole piece of work in itself". "There is no single front door into the London market." 
 
"There isn't much space for start-up businesses in London". 

 
"We need to jointly find the right solutions." 
 
"Infrastructure in terms of lab facilities is key" 
 
"There needs to be planning for longer terms success linked to the wider economic and health issues." 
 
"In terms of access to data there are some real opportunities in the context of linking primary and secondary care. 

 
"Inability to access data held by the NHS is a barrier". 

 
"No one is championing the sector at a London wide level." 
 
"There is a disconnect with data sharing across the global life science industry - the number of people involved is bewildering and there is no 'joined up-ness' to see how things all fit together." "There needs to be something put in place to help potential investors navigate the London system." "London can't describe its 'offer'." "Difficulties around interoperability between information systems are an area which should be looked at." 
 
 
"London is less than the sum of its parts in terms of this agenda." 
"London needs to maximise its chances of joining up and provide a single forum or contact point where agencies meet because they see the value in doing so." 
 
"London needs to be at the forefront of wealth creation in life sciences." 
 
"Integrated care is key as is sharing of data and learning between care sectors" "Lack of start-up space is a real challenge for London." 
 
"The creation of a single clinical trials site would help enormously". 

 
"Interoperability of clinical data systems is a real problem" 
 
"People who work in the life sciences sector bring economic benefit to that area so attraction into London and retention is key". 

 
"Key influencers need to lobby globally to encourage and protect inward investment." 
 
"There should be a single research site or hub for London." 
"Increased use of Electronic patient Records (EPR) would be of immense benefit across the system." "Access and the sharing of clinical trial data was a barrier." "London needed to create an environment that was conducive to productivity in the sector." 
 
 "More longitudinal data needed to be available" "Appropriate and affordable accommodation for Post Docs is an issue" "There needs to be more clinical trials conducted in London and conducted in a more joined up way". 

## Appendix 2 - Diagnostic Of London Vs High-Performing International Clusters

| Characteristics of                                     | London                                        |
|--------------------------------------------------------|-----------------------------------------------|
| high performing                                        |                                               |
| clusters                                               |                                               |
|                                                       |                                               |
| World-leading talent base, with a strong mix of        |                                               |
|                                                       |                                               |
| 3 world class universities, a high quality of life     |                                               |
| World-leading talent                                   |                                               |
| base                                                   |                                               |
|                                                        |                                               |
| and the pre-eminent location for funding attract       |                                               |
| talented staff. A high cost of living and declining    |                                               |
| economy threaten the region's competitiveness.         |                                               |
| -                                                      |                                               |
| Distinctive talent                                     |                                               |
|                                                       |                                               |
| Innovation training programmes at world class          |                                               |
| pool & strong life                                     |                                               |
| science pipeline                                       |                                               |
| -                                                      |                                               |
| Strong mix of                                          |                                               |
| scientific and business skills through emerging local  |                                               |
| schemes, such as the London-based biotechnology        |                                               |
| YES programme and a sustainable talent pipeline led    |                                               |
| by the presence of loading universities with a strong  |                                               |
| history of high impact publications 9over 39,000       |                                               |
| publications in London alone between 2005-2009, NCI    |                                               |
| = 1.88) and industry players                           |                                               |
| business schools e.g. UCSF's QB3, include              |                                               |
| engaging with an entrepreneurial community             |                                               |
| which ensures scientists possess a mix of skills.      |                                               |
|                                                        |                                               |
|                                                       |                                               |
| Could be more commercially focussed                    |                                               |
|                                                        |                                               |
| scientific and                                         |                                               |
| commercial skills                                      |                                               |
|                                                       |                                               |
| Broad 'genetic variety' required to create productive  |                                               |
| Diverse Networks                                       |                                               |
|                                                        |                                               |
|                                                       |                                               |
|                                                        | UCSF has major collaborations with big Pharma |
| and leases office space to VCs on campus. All          |                                               |
| universities have local incubators for stratus and     |                                               |
| it is a highly networked community.                    |                                               |
| -                                                      |                                               |
| Diverse                                                |                                               |
| stakeholders                                           |                                               |
| networks is present - London is host to 995 life       |                                               |
| science companies. 12 teaching hospitals, more         |                                               |
| biotech VC companies than the top 10 European          |                                               |
| companies combined, 8,000+ healthcare companies,       |                                               |
| over 50 clinical research centres. The Wellcome Trust, |                                               |
| MRC, and Imanova, as well as the Crick centre.         |                                               |

- 
Creative platforms for engagement and partnership 
 Connections and collaborations among the players 
 
A myriad of collaborative approaches are evident in the area. VCs and Pharma with offices on University campuses, mixed-tech 
incubators spawn integrated technologies. 
must be strengthened 
 Schemes such as Early Access IP, initiated by 
 Well networked community with purpose built 
infrastructure outside San Francisco. 

## Culture Of Innovation

 A shortage of incentives suggests organic 
universities to promote ways of sharing IP, and the establishment of tech transfer offices linked to charities and universities lead the way. 
growth is expected from a mature cluster 

- 
Commercial mind set 

 Could do more to instil a greater commercial mind set 
 Half the world's venture capital is deployed from 
northern California. Considered to be the best 
place in the world for late stage private funding 

- 
Collaborative, competitive environment 

and entrepreneurial spirit in scientists at all levels from graduates to leadership, driving research from the lab to the bedside at a faster pace than is seen currently and create greater transparency around contribution 
of life sciences to wealth agenda. 
 Operating environment with generous tax credits in 
 Minimal government support for marketing as 

## Supportive Infrastructure

comparison to international centres and accessible translational funding. 
 Challenging to navigate with poor networking between 
reputation alone attracts collaboration opportunities: marketing efforts are predominantly on the company and institution scale  

- 
Effective operating environment 

groups and perceived high costs, prohibitive regulation and lack of lab space. 
 Cluster is the showcase for the global life 
 Platforms and infrastructure is not developed to get 

- 
Favourable policy 
- 
Accessible financing 

science industry. Gilead ($9b rev) and Genentech (purchased by Roche for $47b) amongst others have grown global brands with 
R&D facilities and sales forces worldwide 
more than the sum of the parts from what London has (e.g. information, role of TTOs, single access portals, 
marketing London as a centre). 
 One Nucleus, spanning London and Cambridge, is 
 Academic entrepreneurs are heavily involved 

Active promotion and outreach 
- 
International marketing 

with their start-ups.  A bench to bedside mentality pervades the community as launching a new venture is a status symbol.  Furthermore, failure in a new venture is not a stigma upon one's career. 

- 
National success 
stories 

 Many successful serial entrepreneurs and 
one of the few organisations that promotes London life sciences to the international market, however, despite this organisation improving connectivity, supporting collaborations and inward investment, London is still viewed as being closed for business due to the lack of 
a single go-to portal leading to issues with accessibility of research. 
angels remain involved for the challenge; scientists and entrepreneurs are amongst the most respected professions. 

 Top medical and engineering schools bolster a 

world class talent pool of scientists and academics. Commercial talent is evident but over two thirds of jobs are in start-ups. Job market is very competitive with staff being poached or 
leaving after short tenures. 
 Strong supply of scientists being trained in contact 
with business schools and an entrepreneurial community provides a world class array of skills 
across sectors. 
 Recent recession and difficult tax regime has seen 
the late stage VCs depart the region however the early stage and scientific communities are integrated and vibrant 
 Tight knit community the utilise local institutions as 
hubs for networking due to a predominance of 
early stage companies 
 Prime location for founding a start-up: good 
infrastructure, experienced management, cutting edge science, global pharmacos. 
 Some state tax breaks and credits exist  Strong local government support for the industry 
through trade organisations and funding. 
 Financing sufficient for early research and 
entrepreneurship (but challenging for scaling up 
and clinical development) 
 Numerous PR organisations are bolstered by the 
gravitas of the local universities. Cluster has long been recognised as an industry leader internationally, perhaps disproportionately so to emerging competitors such as the research triangle who as 4/5ths the workforce. 
 Covidion ($10.4b rev), Boston Scientific ($8b rev), 
Biogen Idec (£4.9b rev), Parkin Elmor ($1.8b rev), Genzyme (acquired by Sanofi-aventis), Millennium 
(acquired by Takeda for (8.8b) 
 A strong entrepreneur culture pervades the cluster 
and academia however many start-ups originate from a small clique of proliferative senior 
academics who can't contribute hands on involved 
to each of them. 
 Close-knit, well networked early state community 
provides intense competition amongst emerging technologies making the cluster a hot bed of disruptive technologies. 
 
MedCity - Cited in the Mayors 2020 vision for London, a £1.12m LEP seed fund allocation was granted for the creation of a 'MedCity'. In addition the outcome of a £3m bid to the Higher Education Funding Council for England (HEFCE) is currently awaited. Once fully established MedCity will aim to build on key infrastructure development in East London and address some of the core growth challenges in the sector in London. The project is a collaboration between the GLA, London & Partners, LSIO (Life Science Investment Organisation), Wellcome Trust, AHSCs/AHSNs, and other university and business partnerships. Its aim will be to create and promote a joined up and globally distinctive life sciences offer; act as a visible go to point for businesses and investors (whether local or global), provide a strong voice for the sector, champion its strengths, and raise awareness of the factors impeding further growth to catalyse positive change. 

The Francis Crick Institute - In 2015 the Frances Crick Institute will become Europe's largest centre of biomedical research bringing together a consortium of six of the UK's most successful scientific and academic organisations - the Medical Research Council, Cancer Research UK, the Wellcome Trust, UCL, Imperial College London and King's College London in order to drive innovation in new technologies. The Crick will play a crucial role in translating research discoveries, as it is the only institution in the world that will bring together clinical academics and clinicians through the three London hospitals aligned to the AHSCs and AHSNs. The Crick will be one of the most significant developments in UK biomedical science for a generation. 

Academic Health Science Centres (AHSCs) - AHSCs have related functions to AHSNs 
(see below) but are of smaller scale (in terms of geography and organisations). They were established primarily on the basis of internationally recognised excellence in experimental medicine and strong collaboration between academia and healthcare to enable translation into patient benefit. London is home to three AHSC's and all three centres have recently been re-accredited and the new licences include an explicit requirement to link up to other bodies such as other AHSCs and academic and healthcare organisations. In London there is already a joint commitment to set aside competition issues. This has been key to driving the growth and wealth agenda in terms of the collaborative environment this creates, opportunities for service improvement and efficiency and shows London as a more attractive option for inward investment.  
 
Academic Health Science Networks (AHSN's) - AHSNs play a crucial part in the translation of research into practice, and compliment the role of the AHSCs. London has three Academic Health Science Networks. The aim of the networks is to help pull together the adoption and spread of innovation with clinical research and trials, informatics, education, and healthcare delivery by building strong relationships with their regional scientific and academic communities and industry. 

Gateway and Industry Accessibility There is strong feeling from  stakeholders that a major barrier to investment is that there is no single 'one stop shop' point of contact for industry or other interested parties to enquire about the London offer, nor is there any current platform for London to give investors greater exposure to emerging investment opportunities. One of the main drivers for MedCity will be to promote London to the world and facilitate businesses and investors to navigate 

"The NHS is one of our greatest assets and its standardised system of data collection has the potential to help transform healthcare and support new discoveries and clinical research."  David Cameron 
the London system. A fully coordinated and navigable London life science sector would enable the Capital's strengths to be fully communicated to the global industry and inward investment enquiries handled in a cohesive and informed manner.  
 
Start up and Incubator space The majority of respondents expressed that there are insufficient start-up and grow-on spaces in London. The need for more incubator space and science park provision; similar to those in Cambridge and Oxford has been a regular topic of discussion over several years and is cited as a major barrier to investment in a number of recent reviews into the London sector. Current provision is limited to the London Bioscience Innovation Centre (LBIC) in Camden, the Queen Mary Innovation Centre in Whitechapel, the Imperial Incubator in Kensington and Imperial's ThinkSpace facilities in Hammersmith, the Imperial West site will open in 2016. The provision of laboratory, office space and virtual tenancy's are key to pipeline development and crucial to sustaining London's position in a globally competitive market. 

 
Patient Data and interoperability Life science is informed by real world data and information. Patient data can provide great insight for health research, which in turn improves the quality of diagnosis, treatments and other interventions as well as providing better quality of care and reducing the cost of care e.g. through reducing the number of re-admissions. The smooth flow and interoperability of data and information between systems is essential to making this happen. An Electronic Patient Record (EPR) is a digital record that brings together key clinical and administrative data about a patient in one place. From a life sciences perspective having the ability to analyse data from interoperable systems would contribute to faster drug development and help facilitate multinational clinical trials. There are also greater opportunities to increase participation in Clinical research and to generate new medical and healthcare knowledge, technology, innovation and research on a global scale. 

Clinical Trials High quality clinical research innovation and improvement across health services is central to the UK's pharmaceutical, biotechnology and medical devices industries. It is a key goal of the NHS for every willing patient to be a research patient, enabling them to access novel treatments earlier. The greater the number of patients involved in research, the wider the public benefit. However the UK clinical research base is increasingly under threat from global competition and the time and cost of research and development continues to be a major challenge nationally. London has one of the most diverse urban populations in the world and as such is well placed through our health care and academic infrastructure to run studies into conditions or diseases not able to be considered elsewhere, especially in speciality areas such as rare diseases. 

 
There is currently a lack of robust epidemiological (related to the frequency, distribution and control of diseases), clinical and health economics data for most rare diseases. For example, the natural history of many rare diseases is still unknown, information is spread out across care providers and patient organisations, and there is a lack of longitudinal health outcome data (data on the long term changes in people's health).Therefore, estimates about the health and social care 'burden' associated with rare diseases are inadequate. This stops commissioners implementing evidence-based policies for providing care and measuring improvements in care against known benchmarks. Increased participation in London would contribute to this agenda. 

Housing Interviewees felt that issues relating to access to affordable and appropriate housing was a barrier to growth in the life sciences sector in London. 80% of London employers think the lack of affordable housing is stalling economic growth and the Confederation of British Industry suggests a lack of housing is the second biggest problem facing their members. The Mayor's Housing Covenant recognises a lack of housing as a cause of economic inefficiency and highlights the need to ensure there's housing for people who are crucial to the capital's prosperity. The Francis Crick Institute have identified access to affordable housing poses a significant threat to the Cricks success impacting on their ability to attract and retain the best scientific talent both within London but also within the UK industry. Research undertaken by the Crick showed that nearly three quarters of their staff agreed that the availability or the cost of housing would be a factor in their next career move. 60% of staff had personally experienced difficulties finding suitable accommodation in London and nearly half were not satisfied with their current accommodation. The findings also showed that Postdocs working in the sector were spending more than 40% of their salary on accommodation.