The UK has the science, policy ambition and institutions to become a global life sciences leader. Here, the authors discuss why this moment feels different. Together, they explain why health is an investment, how innovation can support NHS reform and what practical action is needed to deliver its full value today.

After decades working across UK life sciences, they have both seen no shortage of strategies, reforms and declarations of intent. Amy has spent around 25 years in pharmaceutical commercial leadership, working across areas including immunology, dermatology, gastroenterology and pulmonary arterial hypertension. Nina’s career has taken her from the civil service to NICE, NHS England and the Office for Life Sciences, helping to create some of the systems through which innovative medicines are evaluated and made available.

Both have heard the UK’s ambition to become a global life sciences leader before. Yet both believe this moment feels different.

Amy Grey (AG): We have always had the ambition to be a leader. Throughout my career, we have talked about the strength of our science, our universities, our research base and the NHS.

What feels different now is the alignment. We have the NHS 10 Year Health Plan, the Life Sciences Sector Plan and the National Cancer Plan all pointing towards earlier diagnosis, more personalised care and greater use of innovation. The ingredients are already here.

The opportunity now is to turn that ambition into delivery. We rank near the bottom of comparable countries for preventable and treatable mortality.

It shows how much potential there is to improve people’s lives if we can make the system work differently.

Nina Pinwill (NP): I agree. Having worked across NICE, NHS England, government and industry, this is the first time I can remember so many policy levers moving in broadly the same direction.

Historically, reform has tended to happen in parts. Regulation improves one process, commissioning another, service delivery another. Each part may work hard and optimise its own area, but the patient experiences the whole pathway.

AG: What motivates me is hearing from patients whose lives have been transformed by treatment. There are people alive today who might not have been alive without access to a particular medicine. That is an extraordinary privilege, and it is what gets me out of bed in the morning.

The change I have seen during my career is remarkable. When I started in dermatology, treatment was largely creams, emollients and steroids. Today, targeted biologics and increasingly personalised approaches are changing what is possible for people living with chronic immune-mediated diseases.

Across gastroenterology, dermatology and rheumatology, earlier and more effective intervention can help control disease, reduce flares and, in some cases, limit irreversible progression.

But the value is not only clinical. Better disease control may allow someone to remain independent, stay in work, care for their family and avoid repeated hospital appointments or hospital-based care. Chronic conditions place significant pressure on specialist services, outpatient capacity and people’s day-to-day lives. If we can support earlier diagnosis, better pathway design and more appropriate use of innovation, there is an opportunity to improve outcomes while also reducing avoidable pressure on services. A treatment that can be delivered closer to or at home, where appropriate, may make life easier for patients and support the NHS shift from hospital to community.

That is the true value of innovation – clinical, social and economic value being realised together.

Research suggests that increasing access to innovative medicines could deliver £17.9 billion in productivity gains and more than 400,000 additional years of perfect health.1 Those numbers represent real people living healthier, fuller lives.

NP: Oncology offers another powerful example of how innovation can change not only survival, but the way people are able to live with, and beyond, cancer. Earlier in my career, we often discussed treatments that extended life by a relatively small number of months, frequently at a very advanced stage of disease.

Today, advances in diagnosis, treatment and personalised care mean that some people with cancer are living longer and, in some cases, managing their disease over a much longer period.

I still remember discussions at NICE about chronic myeloid leukaemia and the impact of treatments that enabled people to return to work and resume everyday life. That is when innovation becomes tangible. It is not simply about survival. It is about living.

But the science can only create that value when the system is ready to deliver it. In oncology, the promise of precision medicine and advanced therapies such as CAR-T depends not only on the treatment itself, but on timely access to diagnostics, biomarker testing, clinical capacity and pathways that can identify the right patients quickly and equitably.

Too often, innovation and implementation are treated as two separate stages. A medicine may be ready, but the diagnostics, workforce, commissioning arrangements or service model needed to help it reach patients may not be in place at the same pace.

That is particularly important in precision medicine. Around 48% of eligible cancer patients either do not receive biomarker testing,2 or are unsure whether they have received it. Due to testing delays or unavailability, some patients may not be identified for the most appropriate treatment at the right time. This can affect outcomes for patients and reduce the value that innovation can deliver for the NHS.

Industry therefore has a responsibility to engage early and appropriately with the NHS, clinicians, patient organisations and other partners to understand patient needs, generate relevant evidence and support practical planning for implementation. Those conversations are most valuable when they happen early, transparently and with a shared focus on patient outcomes, system readiness and evidence-based decision-making.

Early engagement does not mean every innovation should be adopted unquestioningly. It means asking the right questions sooner: what diagnostic capacity is needed, what pathway changes are required, what evidence matters to decision-makers, and how can the system prepare so that proven innovation reaches eligible patients in a timely and equitable way?

AG: Access is where innovation becomes real. I have a close friend in his 50s who appears to be living with symptoms of plaque psoriasis and is not yet receiving the specialist support he may need. For him, the issue is not whether innovation exists in theory; it is whether the pathway helps him receive appropriate care in practice.

We also see innovative medicines positioned later in treatment pathways because they are viewed primarily through a budget lens. By the time a patient receives them, some of the value of earlier intervention may have been lost.

In some therapy areas, uptake following reimbursement can still be slower or more variable than expected, reinforcing that reimbursement is only one stage in a much longer implementation process.

Innovation should not sit at the edge of the system as an additional cost. It should be embedded within care pathways as part of the solution to better outcomes and NHS sustainability.

It can also support the three shifts set out in the 10-Year Health Plan: from hospital to community, treatment to prevention and analogue to digital.

Home and community-based models can reduce pressure on hospital beds, infusion suites and outpatient capacity. Earlier treatment can help prevent progression of disease and reduce future demand.

At J&J, we see innovation and implementation as inseparable. Our role is not simply to develop medicines, but to help create the partnerships and pathways that allow them to reach patients effectively.

NP: The operational reality must be recognised too. NHS organisations are managing workforce shortages, capacity constraints, bed pressures and competing priorities every day. Even when a pilot works, sharing and scaling it can understandably move down the list.

There are many examples of excellent practice across the NHS. The challenge is maintaining focus and creating the infrastructure to spread this best practice more broadly.

Industry can help by bringing expertise, evidence and learning across the system. We can help identify bottlenecks, support pathway redesign and spread effective models so that every locality does not have to reinvent them.

AG: Too often, we behave as though every problem requires a completely new model, when excellent approaches already exist.

I recently heard about integrated dermatology and rheumatology clinics delivering more joined-up care. The question should not automatically be: ‘What else can we invent?’ It should be: ‘How do we replicate what is already working?’

Silos are a major barrier. Different organisations own different budgets, measures and priorities, so people naturally optimise their own part rather than the whole outcome.

The multidisciplinary team is a useful model. Better decisions are made when different experts come together around the patient. We should apply that same principle to wider system reform, aligning policy, diagnostics, commissioning and service delivery from the outset.

Scaling requires shared objectives, empowered people and the freedom, time and resources to innovate. Too often, innovation depends on local determination rather than being consistently enabled by system-wide infrastructure.

NP: No single organisation has full visibility of the entire healthcare system, so no single organisation can transform it alone.

That is why the future I want to see is one where science is developed here, clinical research takes place here and UK patients benefit here. We have the foundations. Failing to capitalise on them would be a missed opportunity. Frustration comes from knowing it could be so much better. But that is also what makes the opportunity exciting.

AG: I would like the UK to move from the lower end of international outcome rankings to becoming a country others look to for best practice.

We are often very good at putting ourselves down. We describe NHS change as like turning an oil tanker, as though progress must always be slow. Sometimes those assumptions become barriers in themselves.

Industry has responsibilities too. This cannot be a conversation only about what government or the NHS should do. We must engage earlier, explain value more clearly, understand service pressures and take shared responsibility for implementation.

The job is not finished when a medicine is discovered, approved or reimbursed. It is finished when it reaches the patient and improves their life.

The UK does not need another ambition without delivery. It needs a shared mission that connects science, research, evaluation, implementation and access, with patients at the centre and practical delivery planned from the start.

The next step is clear: access, adoption and implementation must be treated as one connected agenda. By planning earlier for diagnostics, pathway capacity, workforce readiness and evidence generation, the UK can turn scientific progress into better outcomes for patients, a more sustainable NHS and a stronger life sciences environment. The opportunity is already in front of us. Our collective task is to now realise it.

References
1. ABPI (2025). ‘Delivering a voluntary scheme for health and growth
2. Bell D, Bryce R, Delfino R, Godin-Heymann N, Horne J, Jäger L, Jones M, Magnell N, Sharma V, Shera D, Ratcliffe MJ, Walls K, Mughal R. Access to treatment-guiding biomarkers in the UK: surveys of cancer patients and healthcare professionals. Future Oncol. 2025 Aug;21(20):2625-2636. https://doi.org/10.1080/14796694.2025.2535098. Epub 2025 Aug 8. PMID: 40778415; PMCID: PMC12344809.