UK Leaders: Gilead's Hilary Hutton-Squire on building trust with the NHS

As general manager of Gilead UK and Ireland, Hilary Hutton-Squire has been at the forefront of bringing several innovative medicines to the NHS. She tells pharmaphorum why collaboration with the health service is so important and how both parties can bring more to the table to tackle upcoming challenges.

Hutton-Squire joined Gilead after working at Glaxo, IMS and Novartis. Her role now involves ensuring that Gilead is understood by external stakeholders within the UK environment and that the UK is understood by internal stakeholders within Gilead.

“On the one hand, I'm selling the UK to my stakeholders and the global organisation, and on the other hand I'm trying to explain what Gilead means and can offer to NHS, government, NICE etc. in the UK and Irish environments.”

When asked how she would like to see the relationship between the industry and the NHS develop, she says that all stakeholders need to think about life sciences sustainability as a bigger topic.

“In the UK we see ourselves as a hub of the life sciences sector, but we’re often focusing on startup companies. We need to look at the health of the whole system and how everything fits together. How do we pay for health at a macro level? What are the big challenges? How are we as an industry working towards that in collaboration with governments and payers rather than pulling against each other? Pulling against each other just wastes energy and resources that could be used for something much more useful.

“Having worked on medicines in difficult diseases like hepatitis C and HIV, Gilead understands what it takes to bring innovation to healthcare systems on a global level, so I think we have an important voice in the debate about how you make that sustainable for everybody in the future.”

Hutton-Squire says that the journey pharma and the NHS went on with hepatitis C elimination shows that when industry and the health service put their heads together they can have an “incredible impact” on patients.

“In some of these collaborations we're increasing the rates of diagnosis and treatment in hepatitis C tenfold just by bringing together expertise from people who all have a different piece of the picture. It's phenomenal what you can achieve.”

She highlights cell therapy, which Gilead entered after acquiring Kite in 2017, as another example of the power of collaboration between industry and the NHS.

“We've been one of the first countries in Europe to scale up treatment with cell therapy in a meaningful way.

“It's been a great start, and it has come about because there was a real understanding between NHS England, NICE and the pharma companies that working together on a common goal would get these therapies to patients as quickly as possible.

“There are people alive in the UK today because of that. I'm really proud that we had the opportunity to be a part of it.”

She says that all stakeholders in cell therapy need to ensure they don’t become complacent, as there are more and more treatments approaching the market.

“It's going to get very hard to get some of those therapies cleanly and quickly through NICE, if at all. We need to make sure we're not resting on the achievements we've had so far, which have been huge, and that we're constantly looking ahead to see what treatments are on the horizon.”

Finite resources

Nevertheless, Hutton-Squire believes that there is still a huge opportunity for the industry to think more broadly in how it works with health systems.

“The big challenge globally in the coming years is going to be workforce. There isn't a country in the world that has enough healthcare professionals for aging populations. We've got to start thinking differently about how we approach health more generally.

“We are used to thinking about the impact of healthcare innovations on patients, but are we spending enough energy on thinking about the impact on the healthcare system and on utilisation of these finite resources?”

She says that industry needs to look closely at the relationship between resource utilisation and medicines, and its ability to support healthcare systems through smarter use of medical innovations.

Meanwhile, health services also have a part to play in how they approach demand signalling.

“How the healthcare system values something has an impact on the medicines pharma then researches,” Hutton-Squire explains. “If the healthcare system gets it wrong, it can potentially switch off avenues of research that could have been impactful for patients.

“Particularly in the UK, which leads the world in thinking about how innovation is valued, we need to realise these conversations are having a global impact on what research is done. We've got to make sure we're clear on that link, and that between industry, healthcare systems, and decision-makers, we put the right value on innovation so that research happens in areas where patients need it the most.”

Trust and dialogue

All together these are some ambitious goals, but Hutton-Squire says that she sees a “huge amount of energy and passion” for this topic within the industry and a clear will to find different ways to solve things.

“More and more, I see a workforce who really wants to understand that they have a positive impact on health at a local and global level. I see a lot of energy from people who want to shake up the system.

“I've seen measurable shifts in the kinds of engagements we've had that make me think we could work together in completely different ways. This all builds on trust, and trust takes ages to earn and only seconds to lose. We have to value this trust between the private sector and the public sector.

“That said, I also see a lot of people feeling worn out because they've been down this road and haven’t seen anything change. They begin to feel that this is how things will always be. I think you can feel that about anything, but it doesn't mean that you stop trying.”

She adds that the industry needs to listen to what the NHS is really asking for, and stop assuming that they know what people want.

“We’re all scientists at heart, so we like to see a problem and find a nice scientific solution for it, but maybe we don't think enough about how that fits into the patients’ or the physicians’ lives.

“Once you’ve built up that dialogue and trust, people will come to you and tell you, early on, when they've got a problem. We then need to respond to those problems even if they’re not necessarily something we had in our plans.”

Despite the pharma industry’s cool reception to Brexit and its strongly-voiced concerns about the damage it could have on the sector, Hutton-Squire says that it has had some unexpected positive benefits by shifting the relationship between the industry and the Department of Health.

“They've actively asked for the industry’s help in navigating Brexit, and we have all ploughed in and helped with it in a constructive way. That's been really helpful for the trust between the industry and the Department. I hope we sustain that relationship.”

Ultimately, Hutton-Squire emphasises that the UK ecosystem, which has developed some amazing innovations in healthcare, needs to be sustainable for everyone in order to survive.

“It needs to be sustainable for health systems, it needs to be sustainable for the big life sciences companies, it needs to be sustainable for the startups and for academic centers. Everybody's role needs to be thought about and safeguarded in order for that fragile ecosystem to continue to flourish and deliver life-changing medicines to patients.”