Adopting stratified medicine in the NHS

The Academy today published two FORUM meeting reports, supported by NHS England, exploring the stratified medicine-based clinical approaches that the NHS could adopt for the treatment of diabetes and cardiovascular disease.

These meeting reports detail the discussions from two roundtables organised by the Academy, and supported by NHS England, which fed into NHS England’s vision for an approach to personalised medicine 'Improving outcomes through personalised medicine'. The proposed clinical pathways for a stratified approach in these disease areas can be used as exemplars for other conditions, facilitating the adoption of a stratified approach to patient care across the NHS.

The first roundtable meeting explored exemplar clinical pathways for a stratified approach to diabetes, specifically monogenic diabetes, while the second addressed a stratified approach to certain types of cardiovascular disease including familial hypercholesterolaemia and inherited cardiac conditions. Although the stratification of many types of cardiovascular disease and diabetes is relatively well understood at a molecular level, with established diagnostic tests and proposed clinical pathways for stratification, there are still challenges remaining to implementing a stratified approach across the healthcare system. Therefore these roundtables aimed to identify ways to address these challenges and to embed this approach in the NHS.

For the successful implementation of a stratified approach to both disease areas, participants strongly felt that there is a need for a national infrastructure that is able to address the current challenges around funding and standardisation of diagnostics. In addition, a systematic, informed approach to stratification of patients is key, and a clear economic case for the stratified clinical pathways to ensure equity of patient access across the country.

The roundtables highlighted that the implementation of stratified medicine in the NHS should be an iterative process, with the clinical pathways and infrastructure continuing to develop and refine over time. This is accompanied by the need for a general shift in mindset to recognise the spectrum of different types of stratification within a single disease, and building capability and capacity for such an approach within the healthcare system.

The reports from the roundtables on the ‘Exemplar clinical pathways for a stratified approach to diabetes’ and the ‘Exemplar clinical pathways for a stratified approach to cardiovascular disease’ can be downloaded from this page. For further information please visit the stratified medicine policy page and NHS England's personalised medicine page.


The Academy's FORUM

The Academy of Medical Sciences’ FORUM was established in 2003 to catalyse connections across industry, academia, and the wider healthcare sector. Since then, a range of FORUM activities and events have brought together researchers, research funders and research users from across academia, industry, government, and the charity, healthcare and regulatory sectors. Further information and details of future events can be found on the FORUM homepage.

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