Health Horizons

Understanding cancer and its prevention.

RICHARD: Good morning, everyone.

And welcome back to health horizons.

Today we're discussing transformations in cancer care and how organisations can support their employees affected by cancer.

Let's begin by highlighting why this topic should be a priority for every business.

Nearly one in two people will be diagnosed with some form of cancer in their lifetime and demonstrates how cancer will affect us all at some point.

By 2030, the number of people working age living with cancer in the UK is expect to rise to 1.15 million.

Cancer will become even more common in the workplace.

The encouraging news is that we know around 40% of cancers are preventable.

These stats point to a growing challenge for organisations and highlight the need to not only support employees throughout their cancer journey but also play a proactive role in prevention.

Today we have a really insightful discussion planned that explores transformative role of cancer care and important role prevention can play to lower cases of cancer.

Early detection tools like genomic tools and AI and strategies that organisations can adopt to better support their people with cancer.

I'm delighted to be supported by Dr. Rebecca Rohrer and she leads Clinical Innovation strategy and played a key role in developing the My Genomic Health Product and we'll hear about it later in the session.

Welcome, Rebecca.

We also have Dr. Crispin Hiley and UCL and UCLH and Dr. Crispin works at Cromwell Hospital providing specialist care to people with cancer.

Morning, Crispin.

And Dr. Tim woodman, and he's responsible for providing clinical oversight and support to development and clinical care within Bupa.

Morning.

Tim Rebecca had first hand insights with cancer and we'll share those insights later in the show.

Send us your questions in the Q&A throughout the show and we'll have the polls going through.

Let's get started.

I'm going to come to you first, Tim.

To set the scene, could you share what current research tells us about the cancer land scale scape in the UK?

DR. TIM: Certainly, Richard.

It's interesting.

At the moment about 3.5 million people living with cancer in the UK, and we expect that to rise to over 4 million in the next five years or so.

As you've said, by the end of the decade, over a million people of working age living with cancer.

What's important to say is one of the reasons why the numbers are so high is people are living longer and average survival for all cancers now is ten years.

Now, that's great.

But it does mean there's some cancers where survival is still a lot less than that, and some cancers where survival is a lot longer.

On average, that's improved an awful lot in recent years.

death rate haves dropped by over 20%, 22% in the last 50 years, which I'm said to say is over the length of time I've been training and practice.

People are more aware of cancer symptoms and publicity around cancer and also massive advances in diagnostics and treatment and we'll talk about those later on.

It's not all perfect though.

We still only have about 54% of cancers being diagnosed early and obviously the earlier you can diagnose cancer, the more likely you are to be able to treat it effectively.

That figure remained pretty stagnant for the last ten years.

Screening programmes are also helping.

They save thousands of lives annually, particularly the screening for bowel cancer, fit test.

There's a drop off in people attending for breast screening and other cancers that we don't have current screening programmes.

RICHARD: Lots of advancements but more to do.

Crispin, 1 in 4 cancer in the UK are preventable and what are the measures or screening innovations making the biggest impact in reducing cancer cases?

DR. CRISPIN: It's great opportunity for preventable cancers out there.

We shouldn't underestimate lifestyle interventions and talking about other things here today, lifestyle interventions are key.

So it's not smoking, supporting patients or people with smoking sensation, you know, thinking about healthy diets, regular exercise and all of those things are really important.

Then beyond those critical things, really about having access to a GP for symptoms when you have symptoms that may be associated with a cancer to see someone quickly.

It's really difficult being a GP.

Molecules of what GPs -- most of what GPs see are not cancer and it's hard to see your GP quickly if you have symptoms you're worried about.

Good to go back and see your GP if they don't resolve.

And I think, you know, the great thing in the UK is that we have a number of screening programmes, and certainly the big thing at the moment is lung chancier screening.

One of the things I do a lot of is looking after patients with lung cancer, and it's great in this country we're rolling out a national lung cancer screening programme.

Certainly in my part of the world in north London, it's the first place that's completed all of the screening of eligible patients and that's great for people that fall into that category, which is sort of 50 -- who smoked and evidence-based way of detecting cancer earlier and making it more treatable and more curable, but unfortunately not every person falls into that category.

We're starting to learn a bit more from lung cancer from around the world where lung cans service connected more common in people that have never smoked and thinking about lung cancer screening in the patients you haven't got classical factors like smoking history.

RICHARD: Interesting how it evolves and develops over time.

The point around GPs is quite interesting, isn't it, because they often get quite a bad rap and don't think about the fact they see hundreds of people all the time with

-- DR.CRISPIN: I said in a way, my job is relatively straightforward.

By the time patients come to me, they have a diagnosis, I'm an oncologist and really it's about supporting those patients and picking the treatments and right sequence and getting them to the treatment as quick as possible.

I think being a GP is a difficult job generally, and I think it's lot of the GPs particularly for rarer cancer types might only ever see one of them in their entire career, and that's the challenge.

RICHARD: Absolutely.

Coming to you, Tim, what's the business case of preventing and prevention and how can analytics prevent high cost cancer claims?

DR. TIM: It's really important that actually good preventive care makes sense to businesses.

If you can help prevent cancer starting in the first place, that'll reduce the demand for treatment and reduce costs overall, which if you're buying insurance for your employee, that's going to make it cheaper.

Any employer can provide access to exercise, access to healthy food and drinks, and encourage active social networks at work.

They all help to raise awareness as well as preventing or reducing the risk of getting some cancers.

Now, we use a lot of analytics in insurance and these can identify who's at particular risk of developing certain cancers and these are predictive analytics.

What they will do is enable you to make targeted interventions, maybe invite people earlier for screening.

For example, it's been shown that if you've got a high predictive risk score, polly genic risk score for breast cancer, that's the same for a BRACA mutation for breast cancer and significantly increases risk.

You might want to get your employees to have the breast screening earlier.

Also enables you to make more informed decisions for them about other lifestyle interventions.

If you can get diagnosis earlier, that means treatment is probably less invasive, more likely to actually be curative and they won't be off work as long.

All your employers can use factors to raise awareness of cancer and risk factors and where to go for further information if needed.

RICHARD: Setting up the environment to encourage all the right behaviours, isn't it?

Rebecca, how can invoter native in technology help people at higher risk know earlier and help with prevention?

DR. REBECCA: There's so much in technology space on our radar and a couple of things to highlight.

AI analytics, super exciting.

This is using AI to be able to analyse really big data sets.

The inclusion of medical records, pathology images to be able to better identify people at risk and then better risk stratify those who are being diagnosed.

There's legitimate concerns about the use of data, and people's willingness to be able to do that but these are validated medical tools, data is kept really securely.

That's very much something that we're considering.

I think digital pathology is also something and that's the use of images taken from biopsy and then the overlay of AI algorithms to analyse those better to really be able to detect the really subtle changes that the naked eye may miss or be really difficult to do that.

That allows us to be able to better diagnose and also be able to reduce the rate of misdiagnosis within those.

genomics is an vary we're heavily invested in and we'll speak about that later and deep dive that.

RICHARD: Thank you very much.

Lots of stats and completely eye opening and shows how important to understand the cancer risk and how we manage prevention and the more we know, the better choices we can make.

Before we move on, we'll get to our first poll.

Eagerly awaited, I know.

Do you believe your organisation is doing enough to help employees understand and reduce their cancer risk?

Yes or no?

We'll tell you what you came up with later on.

Innovation in detection and treatment Now, for the next part of the session, we'll look at how technology is transforming cancer detection and treatment and driving better outcomes for patients.

We'll also discuss practical ways to support employees returning to work after cancer and take a look at exciting innovations on the horizon.

Crispin, coming to you first, what challenges are patients facing in assessing timely care -- sorry, accessing timely care, and how can private healthcare compliment NHS pathways?

DR. CRISPIN: We know early treatment are associated with better outcomes and in the UK, there's a fantastic institution and the NHS has set itself for time to diagnosis and treatment and not meeting those in most places in the country.

There's a place for people who have private insurance and wish to use that to get a diagnosis because, you know, there's situations where getting that diagnosis as quickly as possible is meaningful.

Certainly both in terms of long term outcomes and in terms of patient anxiety.

We all know that there's -- that period in between a diagnosis or that period before patient starts treatment, generates a lot of anxiety for patients and families.

Everyone, no matter the healthcare sector I work in and I work in both, I try to do everything to minimize that.

Certainly in the private sector, there's certain bottlenecks that have been addressed in terms of things like reporting of scans and that's often something that can happen more rapidly in the private sector.

Again, as we've talked about digital pathology and digitising pathology slides and, you know, being able to prioritise those and perhaps using different sort of AI models so a pathologist can get to the most important ones quickly.

You know, in reality, we don't have enough pathologists in the country.

We don't have enough radiologists to read scans and we need more oncologists and need to employ for consul tans and puts pressure on the system and good for patients or those worries for diagnosis of cans tore field a pathway for diagnose and treatment and helps them and their family.

RICHARD: Absolutely.

Tim, coming to you, then at Bupa we have Cancer Promise, could you outline what this means for our patients and and customers and what support is available to them at each stage?

DR. TIM: It's a "We'll be there for you." I've got skin in the game and been on the other side of the fence with this and I've used Bupa to deal with cancer, and it's been amazing.

What do we actually offer?

If you're diagnosed with cancer or even worried you might have cancer, you'll get support every stage of the way.

For example, if you are a Bupa customer, you're worried you might have cancer, you can access expert advice and speak to a Digital GP and going to a clinic speaking face-to-face with somebody.

If you're worried you might have skin cancer, there's a remote skin assessment service with rapid diagnosis and reassurance.

I think the key thing, Crispin said earlier, GPs don't see a lot of cancer and I was a GP for a good number of years.

It's really important to point out when people think they have cancer, 90+% of the time they haven't.

What we can offer is rapid access to reassurance as well as diagnosis.

We do this -- one way is through the specialist centres and specialist centres for breast cancer, bowel cancer and prostate cancer and enable you to have rapid access to a specialist, get the right diagnostics as quickly as possible and in some cases get reassurance you've not got cancer on the same day you're there and certainly a couple of days.

If there's a possibility of cancer, move onto more detailed diagnostics and treatment.

Typically if you need treatment for Bupa customers and breast cancer patients and that's half the NHS target and that's a target the NHS hasn't hit for over a decade and we're really proud of that.

Obviously I know from experience that cancer can take a real toll on your mental health and physical health.

Also those around you and loved ones and friends and family.

And Bupa customers have access to 24/7 mental health support whether that's counsellors, therapists and even psychologists and Bupa is holding why r hand all the way.

RICHARD: Thank you.

I think Crispin articulated the worry around cancer and take it away and whilst you're non-never going to take the worry away, it's getting people the support.

Rebecca, how is genomic testing improving cancer care from early prevention to reducing unnecessary drug use?

DR. REBECCA: It's a great tool and allows us to use inherited pre-dispositions to understand risk.

Risk in healthy individuals around their likelihood of developing cancer in the future and that interaction between their genetic risk and lifestyle resident and can how it combines.

Therefore what they can do to prevent it.

I think during treatment, cancer genetics is really interesting and allows us to be really precise with the treatment we give, how we follow people up.

I think across those two areas, it really acts not just to prevent cancer in the first place, but then to be able to diagnose it in earlier stage and be able to treat it even more effectively with precision and also to reduce the toxicity of some of the cancer treatments.

That means that people are better able to tolerate treatment and to be able to maintain a really good quality of life during treatment as well.

RICHARD: Great.

Getting onto it sooner potentially but much more specific treatment.

Crispin, recent report shows a 626% rise, wish we could have that in my salary.

626% rise in robotic-assisted procedures across NHS and private sector between 2017 and 2024.

How is this technology transforming cancer treatment outcomes?

DR. CRISPIN: I think there's lots of great technology transforming cancer outcomes and robotic surgery is one of them.

I'm not a surgeon, but work with many that have access to the robotic surgery.

Certainly that's allowing more minimally invasive surgery both for things in the pelvis and things in the lungs.

Patients in and out of hospital more quickly, less side effects from surgery, less complications and those are the rationales.

We have technology innovations in other areas and I'm a lung cancer doctor and able to take samples from other parts of the lung for a diagnosis with areas that were more difficult to reach.

In the treatment perspective and one reason I got involved in healthcare in the private sector was to access technology I couldn't access in the NHS and MR-guided radiology and it's a MRI scanner built in to give precise treatment and not needed for every patient, but when it is it's really useful.

Access to proto be tons in this country-specific -- protons for patients in the country and having experts to know when you need it's and when it's not necessary.

Genomics, another rapid advancement in the last ten years and stratify patients with a cancer into different groups and not just a lunger cancer, it's lung cancer with a certain mutation.

Lung cancer 10, 15 years ago and one of two treatments and now it's slice of lung cancer with different targeted and drug treatments.

There's a emerging technology of circulating and tracking markers of the patient's cancer in the bloodstream and allowing us to dictate recurrence more earlier and sort of working out how to use that best and doing trials to look at how we treat patients effectively, combining all of the different pieces of information with the DNA and imaging and clinical assessment.

Across the board, it's a really interesting time to be working in healthcare and there's lots of great advancements, not just around AI but even without AI there's fantastic technology and laying AI on top of that and how it might help us satisfy patients and prioritise different investigations, I think that's a really exciting time to be working in healthcare.

RICHARD: Great.

Feels like all this technology is enabling us to be much more specific how you treat a individual with a reflection whether it's genomics or different tech and so on.

Where am I going next, coming to you, Rebecca.

Heard about the impact of genomic testing.

Can you tell us exactly how Bupa implemented this innovation into the services and what specific products are currently available to the client s?

DR. REBECCA: First thing to say is we've implemented it carefully and we've come to an end of a trial and the colleagues in Spain and Poland to do whole genome sequencing on certain population and results on the 15,000 and 5.7% of the people showed a high risk variant like the BRACA gene and had numerous individuals that have gone through preventative surgery to be able to prevent a cancer from forming in the future.

There's a raised poly genic risk like cardiovascular, breast cancer, lung cancer.

100% showing some variance how to might respond to common medications, antibiotics, Ibuprofen and antidepressants and other therapy medications we use.

81% showing relation to lifestyle and nutrition and activity.

I'm a GP and spend a lot of time talking about common sense things around prevention and everyone get it is but it's really difficult to implement it and the beauty is it's truly personalised and we relate to future risk, we're seeing that people's ability to be able to implement that advice in a meaningful way, whether that's losing weight, whether that's reducing alcohol intake and stopping smoking is really good.

And we've launched two products off the back and had medication check and saliva test and do it at home and sent away and two to three weeks at home showing how the genomics react to medication they take at the moment or may take in the future.

That comes with GP times to contextual that information for people to have the time to answer any questions and make any prescribing decisions off the back of that.

We've also integrated some poly genic risk scoring into health assessments.

So four people that meet certain criteria, we're able to do poly genic risk scoring for breast cancer, cardiovascular cancer and other cancers.

They can have an understand of the risk and how it relates to current measures of weight and blood pressure and all the things that we know we should be aware of.

DR. CRISPIN: That's really interesting as you say we do -- we have advanced testing and it's in the access of genetic advice, but it's about nudging people in the right direction, isn't it, to live a healthy lifestyle and dot right things.

It's sort of in a way, there's all the sort of wearables that many of us have.

The things they do is to really -- really nudge people in the right direction to say I need to move a bit more, I need to sleep a bit better, I need to eat better.

It's all those things just ultimately helping nudge people towards a healthy lifestyle and then taking symptoms they may have more seriously and going to the GP and not sort of putting it off and putting off.

Particularly in the workplace, everyone is busy.

We've got jobs, we have families.

You always are connect to work with your phone and easy to just not think about your own health and sometimes these things just help nudge people towards making sure they stay healthy and don't ignore things and that really does result in early detection of cancer when it is there.

That remains key.

Regardless of all advancements we're making in advanced disease and treating patients with stage 4 cancer is early diagnosis.

RICHARD: Absolutely.

If this helps one person get in and change their lifestyle and stay healthy, absolutely: I had a genetics test and I was quite nervous to start but getting my head around these are risk factors and not a diagnosis but also the medication check is great.

Flags out what will work and what's not going to work and helps you get to the answer quicker.

DR. REBECCA: We've talked about a move to prevention for so long in healthcare, but actually we're still really reactive.

Anything we can can do to just make it okay and normal to have a conversation about what is normal for you and what to lookout for and personalised adjustments to make to be healthy in the future.

That's all for the good.

RICHARD: I didn't know fatty liver disease was a thing until I got tested.

Okay, coming back to you then, Crispin.

As a Professor, I imagine you're always looking ahead.

Are there any other future trends that come to mind?

DR. CRISPIN: Yeah, it's a really interesting time to be in healthcare.

There's a lot of things here.

Some of the AI tools so Ambien AI and listening devices in consultations to focus on the patient and that's key and enabling doctors to build those relationships and hear everything the patient is saying.

That's great.

Not constantly having to type on a computer or write notes and we're using AI in terms of lung cancer screenings to see which need looked at first and AI is here and implemented in healthcare.

Certainly there's lots of things that are coming.

I think we're early cancer detection tools and blood tests along with both sort of things we might find in the blood that were evidence of cancer and poly genic risk factors are emerging and how to use AI to assist in my area particularly, radiotherapy and how to use AI to assist with planning and delivery of the treatments to get that treatment delivered more quickly is a really exciting area.

And then we've talked about different types of cancer not just having a lung cancer or breast cancer or colon cancer really defined groups in that and that'll continue to expand.

Also we're learning more and more about cancer every day and immunotherapies will change and more trials on the cancer vaccines and by academic institutions.

Where I am at UCL and those are potentially could make huge impacts on patients with cancer.

RICHARD: Great.

Fast changing and Rebecca, back to you.

Beyond genomic testing and what other innovations in medicines are you most interested in and how could they change cancer treatment outcomes?

DR. REBECCA: What I'm interested in is what can it -- what can improve the lives of the consultants delivering the care, the teams delivering the care, what actually do you need from a patient perspective to feel oriented and cared for?

On the delivery side, we've talked about circulating human DNA so that area of kind of liquid biopsy and multi-nomics and lots of dirt areas of information and enable real-time monitoring and enable monitoring before we can recognise on scans, et cetera.

It's going to become really power and feel use of AI is to build these predictive models using imaging pathology and molecular data and drawing it all together to risk stratify who's at resident and can how they'll respond to treatment.

There's a really interesting area of emerging digital twins where we can trial regime and assess how to respond to it.

Some of the stuff is certainly in the distance, but it's starting to emerge, and it'll come before we know it.

And I think this area of immunotherapy to tailor treatment to individuals and for me, it's about using this technology and translate that for customers to feel really cared for.

There's a lot of uncertainty within that and we could do this or that.

The communicating of that correctly to patients.

DR. CRISPIN: That's really challenging to have people that can articulate uncertainty with the newer technologies so nothing is ever always a never.

You have to -- being able to articulate and truly understand that is really important.

You need both physicians that are literate in modern healthcare advances be it genomics or AI or pathology or digital twins or foundational models and exciting things.

I work on some of this from research, and that's fantastic and need literate physicians, but you need fantastic support staff.

You need really good nurses and cancer nurses throughout the process and maybe going through the investigation of cancer and there's a lot of anxiety and urn certainty.

Alongside all the advancements and exciting tools and there's needs to be support and patients can be communicated and monitored and supported and all the other things important going through the process of sleeping well and being supported for that and all the things as oncologists and sometimes when we're in the deep down in the nitty-gritty of genomics and it's easy to miss the patient needs a bit of help and support.

RICHARD: Great.

The Advancement is moving so fast and sounds like exciting time for the individual and personalised health and much more specific and wrap around care a lot as well.

I'm interested in what employers should be doing or could be doing to support their people and, you know, what steps could they take to really get into this space?

Anyone have any views on that?

DR. TIM: We've heard a lot from a scientific background about cancer becoming more defined and fragmented into specific little subtypes and how we're looking at the person and we're coming out with really we're all different.

Our cancers are all different.

I think trust worthy a personal experience point of view, you immediate to bear that in mind and sit there as a patient living with -- or a person living with cancer and you cease to be a patient at one point.

There's a little box of pills and calendar saying when you're having radiotherapy and chemotherapy and can plan all that.

You can't plan for the day you don't want to get out of bed or the day you're throwing up.

To support people, for organisations to support people, you need to recognise that unpredictability.

You can plan the treatment but can't plan the side effects.

Also, nothing is ever normal again.

So somebody might come back to work and might think they're absolutely fine and behaving just like they did but never quite know what's going on inside them.

For employers, it's very much about being flexible, being empathic, understanding the uncertainty and understanding about not asking questions about what's next because they may not know.

Being flexible and understanding and adaptable.

All this stuff is absolutely great.

What this means is there'll be more and more people living with cancer because ultimately we'd like, obviously, to reduce the instance of cancer.

Prevent cancer 100%, who knows.

But there's a massive lead time on that because there's a lot of people like me around, and it's the 20-year-olds that with adopt the healthy lifestyle now and not get cancer later on.

So there'll be a long period when the number of people living with cancer goes up and living longer with it, and that'll have an impact on their work.

RICHARD: Absolutely.

Supportive all the right behaviours and when someone is in that position and coming back into the workplace and knowing like most things in horizons, knowing your people and creating a good environment and being supportive.

DR. REBECCA: The time to get to know people is not when they're going through cancer treatment, it's before.

It's leaning into health assessment data and leaning into the -- their approach to stuff like genomics and that's going to make you understand like what is your employee's approach to risk?

What is their approach to making lifestyle and physical changes?

Then that's going to allow you to be able to create really good plan Bs that if the worse comes to the worse, somebody is diagnosed with cancer, these are the things that work for that employee specifically, but for of course the other employees around them because it has, you know, it has waves, seismic effects.

DR. CRISPIN: And I often say, you know, to patients that I almost actually think the hardest part is after the treatment is finished.

You're having the treatment, that's difficult but we're really good at, I think, managing side effects and supports patients through the treatment and often it's the afterwards and having regular follow ups and scans and blood tests and things we've talked about.

It's that period of uncertainty.

I think having the flexibility that, you know, to patients that have bye bye bye through that and they know they -- been through that and have the flexibility in the workplace for access of healthcare and support they need, especially if they have young families and things like that.

It's incredibly challenging for people to go through all that and go back to work.

It's just I'm always amazed when patients do.

Some of the patients I've met along the way and perfectly professional people with amazing jobs and go through all that and go back to work, and I find that really inspiring.

Having that permitted and supported and people feel like they have time to care for themselves and access healthcare and support when they need it.

RICHARD: It's the right environment that encourages people to invest in themselves and their own well being and being flexible and having support mechanisms there.

Great.

Thank you very much.

So we'll come to your questions in a second.

I've got a few, but get more in if you want to ask them.

Before that we'll come to the next poll: Would you feel confident that employees in your organisation could get fast access to cancer diagnosis if they needed it, yes end Audience Q&A or no?

Questions from the audience Krebs, first to you, Crispin.

How have new technologies and treatments been tested before available to the public?

DR. CRISPIN: Everything goes through a trial so there's always some trials.

Very early trials to look at if it's safe or a treatment is safe, and then there's advanced trials to look at how well a treatment works.

We practice evidence-based medicine and only using treatments that we think will help.

There's evidence for that now.

The problem is that every patient is different and every patient doesn't necessarily fit into the criteria of a clinical trial done and you have to use the evidence base you have and apply to a individual patient.

There's absolutely circumstances where the level of evidence doesn't perhaps meet what the NHS wants to see to make it nationally available and good evidence and randomized data and it's helpful treatment with a drug or radio therapy treatment for patients and that's where it's genuinely sensible with an open dialogue of this in the best interest of the patient?

I think every oncologist in the UK is a very sensible oncologist and do things that we think will help patients.

We have all the great tools and only deploy them in the best interest of the patients.

RICHARD: Rebecca, coming to you, what Bupa doing to ensure a more seamless journey?

DR. REBECCA: It's limiting that process around the beginning and speaking as a cancer patient in the past, that uncertainty in the beginning is really, really difficult.

Just by having pretty seamless access and quick diagnosis and minimizing that period of uncertainty until you can start treatment is really impactful.

The phone line services that we have in terms of any time health line, in terms of specialist oncologist network is really important.

If you wake up at 2:00 in the morning and have concerns and questions, actually there's somebody to talk to.

That's really important.

And I think also all of the wrap around services in terms of the mental health support, in terms of GP support for strange symptoms you might get and don't know if it's associated with cancer treatment or not like fatigue or brain fog, that's all really important.

Then I think that dialogue and relationship with the clinical oncologist is a very, very close one actually.

You're entirely dependent on them and having really good access to a clinical oncologist to trust and bailed relationship with is critical.

RICHARD: Tim, how can we support our work force from a proactive angle of cancer awareness and detection?

DR. TIM: Advancements today are massively helpful, but also sign posting your staff.

People who are worried that they may have symptoms suggestive of cancer, there's reliable information sources like People Website and like Prostate Cancer UK, like in my case, and like the NHS and important to point people to the right sites and not rely on them Googling things on their own.

Also, poster campaigns in the workplace.

Social networks, social media networks within the workplace as well and people feel able to speak more about what's happened to them or their concerns and where there's a lot of peer support built into those things.

And also fostering a healthy lifestyle environment at work.

I was horrified when I walked into an NHS hospital, not that many yearsing a, there was a Burger King inside the door.

That's not a good look for healthcare facility.

And having a break area and people can go outside and get fresh air and work out and things like that.

DR. CRISPIN: Tim is right.

Even if the workplace is doing a Vibe posting people to what screening programmes are available, that's huge.

By having today means that some of the workplace staff here go out and see the staff we have working for us know they might be eligible and fall in the criteria for lung cancer screening, that could be huge and save lives just from today.

So it sometimes just pointing people in the right direction and making sure they're aware of what they are eligible for is a big thing, and that's a responsibility that workplaces do have.

RICHARD: Didn't even know that people were eligible for lung cancer screening.

DR. CRISPIN: Exactly.

RICHARD: What's the access to that?

DR. CRISPIN: This is the thing.

Actually the simple thing is saying the same thing over and over again because people don't know.

Everyone is busy, we have busy lives.

You don't know.

That letter comes through and you miss it, you don't see the text message.

I think it's just sometimes you're saying the same thing over again to staff and supporting them to access whatever screening or lifestyle interventions might help them is a really important thing to do.

RICHARD: Great, thank you.

Rebecca, double header but both in genetics.

Is medication check available for everyone, members and non members?

If so, how do you get on?

DR. REBECCA: Available for Bupa members and people not Bupa members as well.

It's -- you go to the website and you order it, put in your details and a small box coming through your letter box.

It's a 2 mill saliva sample and prepaid postage back and readily available.

RICHARD: Thank you very much.

Secondly, for family member with cancer, how do you get tested to see if you're genetically more at risk for developing cancer?

DR. REBECCA: It's the type of cancer the circumstance.

My answer is always and if you have questions or worried, as a GP, if you're worried, I'm worry sod come and talk to me about it.

GP is good first place to call to be able to identify what your next step might be and whether you might be eligible for any genetic kind of screening.

The criteria can be quite tight in the NHS so always work speaking to GP and certain places like Jewish, people of Jewish background for example, eligible for free BRACA screening and it really varies by different cancer types.

DR. CRISPIN: And lung cancer is a great example for this.

For people that don't smoke, there's a risk associated with family history.

So a lot of screening done in the Asian -- people of Asian origin are based on a family history because it's a bigger sector.

We don't know the variance but there's some associated risk there.

You can do the tests and need to have access to someone that can interpret that test, and that's what the system is design to do.

DR. TIM: That's really important is having these tests just as part of a process.

You need to have a discussion, informed discussion before you even think of having the test, and particularly informed discussion after to look at results.

Go online and buy a genetic test.

I can go online and buy a spanner, doesn't mean I can repair a Ferrari.

There's a lot more than just having the test.

DR. REBECCA: Those genetic tests are not always a slam dunk.

It's like the risk of developing it.

It's not a crystal ball.

May not provide the certainty that you want at that point.

RICHARD: Probably better than Google though?

Cool, thank you very much.

That's all of our questions.

Any final builds any of you would like to make?

DR. TIM: I think we're in a really exciting period at the moment.

We've talked about a lot of different technologies, and they're all starting to come together.

I actually once they call come together, the potential is limitless.

We can use AI to design drugs and rapidly reduce the amount of time to bring a drug to market.

We can look at side effects of drugs and re-ennear drug molecules to -- re-engineer drug molecules to get rid of some of the side effects.

I've seen some of the AUs and it blows my mind and really exciting time for cancer treatment.

C word is a horrible word, but actually if you want to talk about it as a battle, it's a battle that we're winning.

RICHARD: Great.

DR. CRISPIN: And I think that's true.

I would echo that, and it's an exciting time and I love all the great technology and I'm a real geek with genome Icks and precision therapy and it comes back to lifestyle intervention and early detention of cancer make as huge difference.

Focus on that as a employer, you know, that's the thing that will make the big difference.

Yes, make sure your staff have access to all the advanced technologies and policies allow them to access those when they need it.

Come will and you want to have that, but the biggest difference we'll make is lifestyle modification and early detection.

RICHARD: Thank you very much.

Thank you to my panel today and thank you very much.

Advancement moving so fast and exciting times as Tim just pointed out in the end.

As a employer, create the right environment and know your people really, really well in case the worst happens.

Encourage everyone to be healthy and create time to be flexible with them and enable them to live their best life effectively in case the worst should happen.

That brings today's session to a close.

We had a great discussion today about latest technology in cancer care, and importance of prevention and flagship and sustainability programme in cities and returning in June and encourage your team to take up healthy acts as we've talked about.

If you'd like to get your employees involved in the 30-day movement challenge, speak to our account manager and they'll help you out.

Keep an eye out for the resources including Bupa academy materials and we'll be back in the new year with more insightful discussions and stay tune to find out what happens next.

Thank you for joining us today, and we look forward to seeing you next year.

The current landscape & why personalised healthcare matters

Good morning everyone and welcome to our first health horizon session of the year and for the first time coming to you

live from our new accelerate space at Bupa ace in Manchester.

It's great to have you with us today.

We'll be discussing the growing shift towards personalized healthcare and what it means for organizations looking to

better support their people through proactive preventative approaches.

To set the scene, let's highlight why

personalized healthcare is becoming such an important topic for employers and employees.

36% of UK adults say standard GP prescribed medicines often fail to meet

the need their health care needs.

58% of people believe that access to both standard and personalized medicine is

important and for every one pound invested in prevention employees see an average productivity return of4.

These

statistics highlight a growing opportunity for organizations to harness the benefits of personalized health care

and strengthen the overall well-being of their workforce.

It is no longer enough for healthcare providers to just treat

illness.

We need to work together with employers to predict, personalize, and prevent illness.

And that's why today

we're really proud to be announcing that we are the first major private medical insurer in the UK to offer fully

integrated genomicsled personalized and preventative health care as part of our standard cover.

This is how we plan to

redefine healthcare by giving all of our customers access to genomics to help them better predict their health risks

and proactively manage these with our new prevention pathways.

We'll be hearing from Dan on the details a bit

later on.

We've got our resident personalized health experts with us today.

And I'm delighted to be joined by

Dr.

Rebecca Rora, clinical innovations and genomics director at BER.

Uh Dr.

Rebecca leads Booper's clinical innovation strategy and has played a key role in developing our My Genomic Health

product.

Welcome Rebecca.

Uh we've got Dan Sullivan, product and proposition director at BER.

Dan is responsible for

defining our UK insurance product and proposition strategy.

Morning Dan.

You and Dr.

to Ravi Luca who is one of our

medical directors at ber.

Part of Ravi's role is being responsible for providing clinical oversight and support to the

development and delivery of clinical pathways within ber.

Morning Ravi.

Right, as always, please send us your

questions throughout the session.

We'll answer as many as we can later on in the Q&A.

And of course, we've got those

lovely polls that you all love so much.

So, look out for those along the way.

Right, lots to get through.

Let's get

started.

I'm going to come to you first, Robbie.

So um health care systems both public and private seem to be facing

increasing pressure.

Can you explain what is driving that?

Yeah absolutely.

So um both public and

private healthare systems are facing unprecedented pressures um due to a number of different convergent forces.

So first of all we have an aging population.

So we're living longer which is great but unfortunately we're spending more of that time in ill ill

health with long-term conditions things like metabolic conditions like type 2 diabetes.

adding in um pressures after

the pandemic and um rising drug and treatment costs um and we have a system

that's increasingly focused on treating illness late rather than preventing it earlier.

In fact, the most expensive

care care occurs when disease is advanced uh complex and avoidable.

Think

late cancers versus early stage cancers.

And health systems still spend the majority of resources at the end of that

pathway rather than upstream.

But these pressures also create a huge opportunity.

Um, prevention and

personalized medicine allow us to identify risks earlier, target intervention to those who benefit most

and keep people healthier for longer, which is our purpose here at BER.

Um, that's better for patients, better for

productivity and society, and ultimately ultimately the main sustainable way we can address these pressures.

Sounds like a bit of a no-brainer to me.

Really?

Absolutely.

I would say that given we're launching any product today.

[laughter] Okay, Dan,

coming to you.

So preventive health has been talked about for decades as a solution.

Why hasn't it why hasn't it

delivered until now and what's made it difficult to include these types of benefits in private health insurance

policies.

I think that's a great question.

I think before we do a bit of a reveal of what makes up um our new preventative

benefits just want to talk a little bit about some of those challenges that you put out in your question there Richard.

So more broadly, you know, I think preventive health has been thought of as a silver bullet for some of the challenges that that Ravi shared with

us.

But when you look at some of the preventative health strategies we talk about, particularly in some of our workplace, but more broadly for us, they

tend to have been quite generic.

So we've asked people to think about exercising better or having a good diet

and nutrition or avoiding certain risk factors like smoking, you know, or alcohol.

But what is really challenged

when you think about both first maybe for a consumer or an end user of healthcare is it hasn't felt very

personalized or tailored to them like what are their health risks what are their health goals and also how can they

see some progress you know about doing some of those right things when you turn them to an employer you know we

recognize that employers under a lot of pressure in terms of cost in their workplace scheme.

So it's been quite

difficult for employers to be able to point to the return on investment from investing in preventative health.

It's a

bit easier to you know understand why you might want to fix something but making an investment before something

you know has become a health event it's quite tricky and quite challenging unless you can see a a clear outcome from that and then when you think about

as a health insurer as a health insurer if we put you know and as we have but you'll see our thinking is a bit

different but if you put preventative health benefits whether that's screening or preventative treatment into a product

it's quite hard to make sure that the right customers will use those pathways and those services and will benefit or

you won't get the wrong customers using that potentially repeatedly which is then driving up repeated you know

ineffective cost in terms of the product.

So we think you know that's why

that prevented health has taken this long and it's actually taken us quite a lot of work to get to this point today

and that's why health insurance is typically then focused on fixing acute short-term conditions and hasn't moved

in a really significant way into this step before.

So it's really moving from sort of more generic to much more

specific.

The science catching up in a way.

Yeah.

Okay.

Um so Rebecca, what's different now in terms of technology and

data that makes preventive and personalized healthcare uh genuinely viable for the first time?

Yeah, I mean techn technology is like a really key enabler for all of this and it's only really at this point that it's

enabled this proper shift from reactive to proactive healthcare.

I think there's a couple of factors there.

The first is

the genomic technology that we've got.

You know, the technology that takes a DNA sample and it sequences it and then

it puts it into a piece of code.

That the price of that has gone down significantly um over the last 5 years

and we're still seeing you know that that technology get cheaper and cheaper.

It's also faster.

I think the second

thing is around the data that we get from those insights um and you know the

evidence level that we have around translating what genomic factors you have to the risk of that causing a

disease and then what interventions are going to work afterwards.

So it's that kind of genomic technology coming

together with the scientific literature.

Um and then of course the use of data integration technology like AI to be

able to bring that all together to make those insights really rich.

That's important for us as clinicians because it allows us to be really confident that

the recommendations we're made may we're making are you know evidence-based and they're safe but also allows us

importantly to be able to translate that into a really easy to way to understand for customers as well um and for us to

be able to consult in a different way.

Great.

And it's important to say isn't it this is risk factors rather than you have got something.

Totally.

Yeah.

Okay.

Cool.

Dan, so coming to you, uh, what gives ber a unique advantage in delivering

personalized preventative health compared to other UK insurers?

Yeah, I think I think it builds on what

Rebecca talked about there, but I think about there's three key enablers and that's why now is the moment that we can

go and start to launch.

And actually we talk about you know the first step for us is personalized health we think is

going to be a big macro trend in healthcare and it's something that we and b are investing a lot in and we think it was going to define the next 5

to 10 years of how we think about our services within that I think there are three key bits.

So first up is

healthcare data.

So I touched on earlier unless you can spot the right customers who will benefit from investment in

preventative healthcare you'll really struggle to make the economics.

So if you think about the data we have from

our genomics pilot of 12,000 people, we've understood better in terms of how genomics and health and how customers

respond to that.

Next up is we do a lot of preventative health already things like health assessments.

So we

understand different risk factors that we see coming through and we're also in the fortunate position of having one of

the UK's largest healthcare databases being such a large health insurer in terms of claims data.

So all of those

things come together give us a really unique view in terms of how these health risk and these factors interact.

Next up

then is connected care.

So personalized and preventative health programs are a

bit more complex often but to simplify those and make sure that customers get a really good experience we have the

ability to manage that end to end.

So being able to deliver the genomic services inhouse, the primary care

appointments with GPS, geneticists, some of our specialist oncologists for example, all of those services can be

delivered end to end through a booper journey.

So customers aren't left navigating because some of the broader

healthare system, you know, might not know how to interact with that.

So really important that we can do that through the connected care pathways.

And

then the third bit is digital guiding customers through those journeys, tracking the outcomes, nudging them to

engage with the next step in that journey because of my ber because of the millions of customers you now have access to that we can guide them through

that well in a really intuitive and easy to follow way.

Great.

So really moving beyond being a

funer and and powering you know provision knitting it all together so we can give the full end to end experience.

Exactly.

This is really integrated

healthcare you know I think at probably one of our best examples to date.

Great.

Okay.

Thank you very much.

Well,

well, that's a great start.

Thank you very much.

Okay, it's been great to hear how the landscape is evolving and the

insight about technology finally enables us to deliver preventive and personalized health.

Um, plenty to think

about.

We're going to move on in a second, but before we do move on, I know you've all been waiting.

Here's the poll.

Uh, right.

Does your organization

currently offer any personalized health benefits to employees?

Yes or no?

And we'll come back with the answers later.

Bringing it to life – Bupa’s solutions, new innovations & future outlook

Okay.

Uh, so let's move on to the next part of today's session.

We'll look into the latest innovations and what the

future looks like for preventative and personalized health.

And we'll also explore how BER can support your

employees with preventative care.

And we'll be asking Dan to recap on the exciting news that we announced today

that we will make personalized and preventative care available to all our insurance customers.

Right, let's get

going.

Coming to you Ravi, first um could you talk us through the personalized health plans a bit more?

what uh do they involve and how will they support our customers with preventative health?

Yeah, sure.

And as we've discussed already, these are bringing these ideas of what we we think the trends are, what we know the trends are into reality.

So,

our personalized health plans are built on that kind of foundation principle that everyone's health journey is different.

What works for one person

doesn't necessarily work for another person.

So, these plans are about um designing it specific to people so it's

relevant to them.

So they sit in the my booper app going back to that that integration point that we just discussed

and offer clear easy to follow advice tips and tools tailored what someone wants to work on.

Members start with a

short questionnaire which gives them their own lifestyle insights um on things they want to focus on whether

that's fitness uh sleep diet or mental well-being.

From a preventive health point of view the focus is on those

early practical uh action and insights.

Each plan runs over three weeks.

Uh has

written uh video and audio content from guides and recipes to meditations and

fitness sessions.

And it's all introduced by one of our clinical leads.

So it's really exciting.

This is just

the beginning.

Uh as we expand the range of plans, we're building something that helps people take those next positive

steps in prevention again and again.

Great.

Okay.

Thank you very much.

So I'm going to come to you Rebecca to talk

about businesses.

So could you talk us through the benefits that personalized health brings to businesses and why it

should now be a priority for organizations across the UK?

I mean I always find it amazing that 80%

of our healthcare outcomes are affected by things that are completely outside traditional healthcare.

So genomics,

lifestyle, behavior, the environment that we live in and that we're not operating in a healthare system that

really accommodates that.

So that's what's so exciting about about this move.

Um why it's important for

employers is because um you know that cookie cutter approach um you know

one-sizefits-all just you know it doesn't it doesn't need to operate like that anymore.

Um and actually they're

able to be able to you know understand the risk within their population and then to be able to tailor plans and

benefits based on that risk going forward.

We know from your stat earlier that that leads to improved

productivity.

It also leads to improved retention.

We know that threearters of employees would rather stay with an

employer uh who offered some personalized health benefits.

So it really does make sense from the from the

employer and the employee side.

I think really importantly for employees, we also know that if you're receiving

personalized insights, you're more likely to stick with them.

You're more likely to actually um you know make that

part of your lifestyle.

Um and and so it it offers wider benefits as well.

Great.

Thank you.

So we've heard about the employee Ravi employer Dan.

Today we're announcing uh the launch of our

new prevention pathways.

Can you explain what what this means for customers?

I think we've teased enough now in terms

of what they are.

So now we're going to get into the uh into the grand reveal.

So you know we are really excited.

We

think this is probably one of the biggest developments in in private medical insurance um in many years.

So

um building on all that you've heard from from Dr.

Ravi and Rebecca there.

Um, our new preventative pathways will

initially cover four areas.

So, first up for that is uh we'll offer a breast

cancer prevention pathway.

We'll offer type 2 diabetes prevention pathway, a cardiovascular disease pathway and also

our metich medication check sorry product that helps spot for customers if they're taking regular medication

whether those medications will be suitable and work for them or maybe they should take an alternative.

Um so this

is a big shift.

Um customers won't need to be symptomatic to benefit from these

and they will take um digital assessments in our my booper app to understand using clinical um risk

assessment tools as well as genomic testing their risk of disease for these um and then we'll proceed through a

preventative pathway.

So if I zoom in on the uh breast cancer prevention pathway,

customers answer a series of questions.

um if they come up at an elevated risk they will be offered then genetic

testing including high-risisk gene uh panel which will test the things like the bracka genes.

If customers then have

a risk identified through that even when not asymptomatic they will then be offered preventative treatment which

clinically medication like temoxifen or um preventative surgery like a masectomy.

So really powerful statement

of intent and I think we're really proud of how we're leading the market in our cardiovascular disease um and also type

two diabetes pathways.

Very similar model digital assessment looking for risk factors.

Um we will then offer

customers our um capabilities around nutrition but also our weight management

products with funding available there to access GLP medication where clinically suitable for them as well.

So it's both

medication really um I think thoughtful risk assessment using digital tools and clinical including genetic testing but

then treatment as well and these will be offered as standard uh for all of our theme and consumer so we back that this

is going to have a really impactful impact so we're putting a standard into those products and for our corporate customers they'll be able to choose this

as an optional benefit so currently the medication check product is available for customers to opt into uh for

corporate customers they can choose to switch all of these pathways on uh from September.

And we've likened it a little

bit like your house insurer offering to pay for your smoke detectors, right?

You know, this is really invest this is

really rethinking right what insurance is there for rather than funding when an adverse event happens like a diagnosis

of disease.

This is actually funding and managing preventative health care before the event.

So, you know, we think um

we're just getting started, but we think this is going to be a really important step into a new era of how private

health care works um in the UK.

Great.

So employers can really empower

their people to manage their health proactively um for the first time with some interventions off the market

and I think every you know employees will then have a really good understanding of the health risks that they face and they can make some very

specific choices whether that's diet whether that's exercise whether that's thinking about you know going into um

having preventative treatment but very specific to their own individual risks.

Great thanks Dan.

Okay.

So, Ravi, from a

clinical perspective, what are the most important elements in designing a seamless and safe experience for employees using personalized and

preventative initiatives?

Yeah, sure.

So, there's a number of um clinical elements that we've already touched on but are really important in

in the design of these types of initiatives.

So, firstly, it's about clarity.

People need to understand what

the initiative is for, what it's telling them, and what, if anything, they need to do next.

So if we think about our

type 2 diabetes prevention pathway, it's about identifying those risks early, explaining clearly what those mean

without any jargon and so it's clear to each individual and what they then need to do next if anything at all.

Um

secondly, it's about safety and proper medical oversight.

So all these types of initiatives have to be um

evidence-based, clinically overseen, and have a clear route to follow up again if there is anything that's identified.

Thirdly, and this is really important, it's trust.

Employees must be confident that their data is confidential and used

responsibly.

Especially if we think about things like genetic data, that's obviously really important and paramount to any uh type of initiative.

Um, and

underpinning all of those for me is is integration, which Rebecca touched on already.

If we think about how

somebody's health exists and also their life, we can really build something that's personalized for them that's going to really help them engage in and

not exist in a silo or in isolation.

Right.

Thank you.

I love that clarity point in particular is you know people

[clears throat] worry don't they about their health a lot and actually giving you know real clarity around what the risks are and what you can do about it

is super important and Rebecca coming to you so looking ahead at future advancements what should

we be excited about in the world of personalized healthcare I mean I think we should be excited about everything I mean this is this is going to become

the new norm right so um I think there's there's three things I'm super excited about so I think anything as a clinician

that will allow me to be able to predict risk better is great, right?

So, you

know, if I can predict risk of developing cardiovascular disease or diabetes or breast cancer in my patient,

uh then that totally changes the kind of recommendations I can make to them.

It totally changes the consultation type

that I can have.

We can make some shared decisions around what is best for that particular customer um given their, you

know, lifestyle and and the things that makes us all unique.

For medications, I'm super excited about it.

So, you

know, Dan mentioned that medication check is is going to be one of the, you know, the elements introduced for

consumers andmemes.

That means that actually we're able to make recommendations around what

medicines work for people or don't work for people based on their genetics.

Um,

that covers super common medications like anti-depressants, antibiotics, but

also over-the-counter painkillers and some of those really specialist hospital medicines.

And actually that allows me

to be able to prescribe the right dose to the right patient first time.

Um and

that that's a total gamecher.

So we see in self-insured populations in the US that actually taking a very bespoke

approach to prescribing can reduce impatient and emergency admissions by 39%.

Because it, you know, allows you to to not try multiple drugs.

You can get straight onto the right drug.

You have

fewer adverse effects because you know what's going to work for you.

So actually it has really long-term financial benefits as well.

And I think

the the third is around the clinical pathways.

We're all used to having clinical pathways that everybody goes

through.

Actually the ability to be able to bespoke that to our own risk and the way that we might like to receive and

you know the best way that we're going to respond to care is super exciting and it's something that we've we've wanted to do for a long time in healthcare but

we've just not been able to get there.

Great.

That 39% is huge, isn't it?

So taking out the trial and error.

Yeah.

That's massive.

Okay.

So, uh, Ravi, what's the biggest misconception you see about gene testing and how would

you explain the reality?

Yeah, and you already touched on this already, Richard.

For me, the biggest misconception that I see about genetic

testing is that it always gives you a clear answer about what will happen to your health.

Uh, and that's just not the

case.

Um, for many tests in particular, and I'll touch on a few later, what it does tell you about is about risk, uh,

not certainty.

uh and that fits on fits in with um a variety of other information like your lifestyle

information, wearable data can feed into that.

The environment, family history and other things.

So you kind of kind of

put got to put the picture all together.

Um there are some important exceptions and we've already talked about some of

these exciting ones already or important that we identify them and deal with them appropriately.

So some tests do look for

specific genes such as you might have heard of the bracka genes in in uh breast cancer which really does increase

your your your risk.

Um and in those cases the results generally shape you know how we how we deal with patients

from a risk reduction perspective.

Um and that needs careful explanation again around that clarity point about what

that means and what somebody needs to do to address that.

Uh and again that's part of our breast cancer prevention

pathway.

Um it's also used to help with medications as Rebecca just said through our medication check.

um product.

And

again, it's something I'm really excited about because for the first time ever in in my career, you can really personalize

the the medication that we prescribe that we might nag someone to take.

We know that this is going to a work

effectively, but also have a a lower risk of causing adverse effects or or

side effects.

And that's for really common medication.

So, so we're really building into that personalized picture,

uh which is super exciting.

Um and so so ultimately it sits on a spectrum from

those higher risk rarer diseases to medication guidance to also those kind of broader risk insights thinking more

about our cardiovascular disease and type two diabetes prevention pathways that helps guide the prevention that you

can do kind of downstream.

So it's not about labeling people it's about giving that clear information earlier so it can

inform uh better decisions over time.

Great.

Thank you.

Um, so just we we've

got a couple more set questions and then we're going to Q&A.

So get your questions in.

There are a couple uh quite a few actually coming up.

Dan,

you're definitely going to be in the chair and myself just just to let you know.

Before we get to that though, uh I'm going to come to you on this one.

There's often a perception that more preventative benefits could increase the overall cost of private healthcare.

From

your perspective, will these uh benefits help address the challenges of rising demand and cost pressures or add to

them?

Yeah.

Yeah, we're very mindful of the the right to demand for those who came to our accelerate event in January.

You

know, that's a key focus for us this year in terms of being able to sort of drive cost efficiencies and help

employers manage the sustainability of their healthare schemes going forward.

If you look at the drivers of some of

the inflation we've seen coming through, it's a lot about incidents.

So, more people claiming on their private

healthcare because they need more support, but also severity, right?

you know in terms of us seeing more complex

latest stage and I think Ravi talked about this latestage cancer claims coming through.

So if we could intervene

and spot some of those cases earlier this will then have a positive impact.

Um I also talked about the four pathways

we've been very thoughtful about which pathways we start with where we have really robust claims and clinical data

that suggest this is going to have a positive impact on the sustainability of that scheme.

So our ambition is is this

is about moving money to focus on doing the right things with the right impact rather than having a significantly cost

inflation view, you know, in terms of these healthcare schemes.

And what we expect to see is that for employers, you

know, where they embrace preventative health, they should start to see then their workforce becomes healthier.

They

start to see some of those instances of verity movement move in the right direction.

But also one thing that employers have often struggled with and

I think we see it here at BER is engagement with health care has been tough.

But when you're equipping

customers with a personalized view and you've got really convenient, easy to access well-being and intervention

services, engagement with health, we think will also increase as well.

And just to finish, you know, one of the big

use cases, you know, we talked about Ravi and Rebecca about medication check.

You know, one of the biggest drivers of

uh health inflation has been mental health.

And actually for medication check, one of the very common outcomes

we see for medication is customers aren't respond that customer might not be responding to anti-depressant

medication.

That means that customer then mental health isn't improving.

They then become chronically unwell that puts

then higher cost psychiatry services demand on that healthare scheme and then all of the absence.

So this would have a

really powerful way of actually intervening is what's a very common driver of healthare costs at the moment.

Great.

So it's kind of multi-layer benefits, isn't it?

hopefully control medical inflation for the employer who's looking to afford this for as many

people as possible, but actually for the employee or the consumer, you know, much more engaging and hopefully get better

quicker or get intervention faster and ultimately, you know, have a longer, healthier, happier life.

Exactly.

It's like I worked our uh [laughter] our purpose into that, isn't it?

Seamless

almost by mistake.

Right, Rebecca, coming to you.

So, can you share some of the clinical thinking behind our

ambition for preventative benefits and how it supports improved outcomes across the four pathways we're launching today?

There's a lot of really clever science in in these pathways uh and in this benefit, but fundamentally it comes down

to a pretty simple clinical uh principle which is if you can understand somebody's risk of developing disease,

you can intervene earlier.

And by intervening earlier, you can either avoid that condition from happening in

the first place or you can diagnose it earlier and therefore avoid cost and

adverse outcomes further down the the line.

So, you know, that that's what I

always keep top of mind as a clinician.

What I love about it is it allows us to

consult in a completely different way.

It allows us to have much more rounded conversations with customers about their

lifestyle, their underlying risk factors, their family history, what is important to them.

Um, and you know,

we've mentioned a lot about people um engaging in these pathways, but actually if people don't want to engage in those

pathways, that is a really helpful conversation for us to have with them as well.

Um, so you know, by by being able

to open up those conversations and by them having the information to feel that they're in the driving seat of their

health, that they can have autonomy over their own healthcare, we can have some really good shared decision-m around

what the best treatment for them is and how they like to receive it.

Great.

Thank you very much.

Right, set

questions done.

There's lots on here.

Uh, but another poll.

Another poll.

Okay.

Uh do you feel your organization understands the value of personalized health for employees?

Yes or no?

And uh

hopefully we'll have the uh outcomes later on.

Right.

I've got questions for all of you here.

So I'm going to come to

end Audience Q&A

you Dan first.

Um firstly, is there an additional cost to employers for

switching on the new pathways?

First question.

Yeah, there will be.

So there will be a risk based charge that applies.

So um

it'll depend on the type of scheme.

So for corporate they will make a choice about how that is applied in our theme

policies we're reviewing the premiums.

It's actually a very modest increase to premiums.

If you then look at the way um

these benefits are structured for medication check where the benefit is get as many of the employees or the

customers screened in terms of their medication outcomes.

Um there are no co-pays or um any excesses or benefit

limit impact for the individuals but it would feed into policies um for our preventative pathways.

A very small

co-pay of100 pounds applies to each access to that pathway.

Great.

Thank you very much.

Okay, Ravi,

I'm going to come to you now.

So, do you think we will end up in a world where every single person has a wearable and

without this, do you think we can really move to personalized health?

Good question.

I'm slightly biased.

I

have two wearables that I use.

Um I think look it's the um it's absolutely

the direction of travel because as I said it's part of that suite of information that tells us more about an

indivi individual.

There's that [clears throat] risk part of it but also what are you doing um may I say

objectively as well what are you doing on a on a consistent basis if it's related to activity sleep what I use it

to personally for and how I can improve it.

So absolutely it adds into that kind of um information that we can then use

as clinicians to really guide that that personalized um messaging for each individual but also that prevention

piece as well which is what's most important about that type of data coming in.

Wearables also have really important

things such as uh high-risisk things they might tell somebody if they go into at a regular heart rate and then

somebody can go to their GP and deal with that appropriately and we're going to see technology within wearables just

improve over the next few years let alone kind of decades or so.

So I think it is really really important stuff each

obviously to their own.

you might focus it more on a um optimization kind of point around what how you want to go,

you know, be better at cycling or running or something like that or it might be more focus around your kind of health if you've got a chronic disease.

So, it's, you know, they're really flexible and useful for all.

Yeah.

Great.

Thank you.

I know in our Sanas business in Spain, they the

wearables like work with the app and so on and and the GPS.

It's super smart.

Hopefully, we'll get there.

Okay, Dan, I'm going to come back to you.

So, um there are a few for you by the way.

[laughter] Sorry about that.

Extended session session with Dan.

Uh so uh you talked about the pricing impact.

Um can we use this data to inform our pricing?

Yeah.

No is the simple answer.

So so

we're subscription um subscription we sign up sorry to the AI code on genetic testing.

So you we think this should be

a very positive uh impact on customers and I think Rebecca talked about trust

being so important in terms of how our customers engage.

So by being signed up to the ABI code what that means is we

would never compel a customer to take a genetic test.

They are always optional and you can proceed into the prevention

pathways without taking a genetic test if that's your preference.

What the ABI code also means is that we can't use any

of the genetic uh data that we gather to either deny or change the price for

cover.

So it has absolutely no impact in terms of your insurance premium or your availability of insurance.

It's it's

purely about adding value and personalizing healthcare to you as an individual.

So it's just about empowering the

employee or the consumer to take action.

Yeah, we have really strict privacy safeguards.

So we want customers to feel

in control of their health data and really using it to drive what they want and that's a key key part really of

that.

Okay, great.

Thank you.

Uh Rebecca coming to you.

So what barriers are there to people wanting to use genomic

testing that you see from customers and how do booper plan to overcome these?

I think genomics is a bit like wearables.

You know the best wearable and the best genomics test is one that a

customer will use.

So um you know part of the rationale for having medication check and the those defined pathways is

that there are different genomic tests depending on what your particular personal concerns are.

Right?

So, if you

are on long-term medication and you are concerned whether or not that's working

for you, then medication check is great because it allows you to be able to

understand for your current medication, but also for any medication that you might happen happen to be on in the

future, how that interacts with your genetic profile, and you get some GP time to be able to discuss any concerns

or any prescribing guidance based on that.

Right?

If you've got particular concerns about cardiovascular disease,

diabetes, uh breast cancer, then actually that allows you to to be able

to to look into those um concerns in detail um through you know the the

digital algorithm and then any genetic testing and then obviously um any onward

pathways.

So what we don't want is people lying in bed at night thinking, you know, gosh, I'm really worried about

that breast cancer risk.

You know, a friend or my sister's just been diagnosed.

I'm really worried about it.

We don't want you to be worried about

it.

Come speak to us.

We can help to, you know, allay and to manage that risk.

Right?

So, I really think that um you know that there's there's a genomic test available

for everybody based on their particular concerns essentially.

Great.

Thank you very much.

Okay, Dan,

there's a request.

Can you recap on which conditions the new prevention pathways will cover and do you have any

plans to open these pathways to more conditions specifically mental health?

Yep, good question.

So to recap, so the

the four um prevention pathways we're talking today.

So uh breast cancer.

So any customer at risk or thinking they

might be at risk of breast cancer can take a digital assessment.

We will then look at for genes.

We will test for the

bracket genes as well as other high-risisk genes.

Um and then we will offer preventative treatment including

medication um and surgery.

So masectomies and ofctomy which I think I got right take I can't spell it but I

can say it now.

So um and that takes it all the way through to treatment and then risk mitigation.

Uh we also then

have a type two diabetes pathway that includes access to nutrition and also

our weight management service.

And then the cardiovascular disease pathway is similar.

So digital assessment access to

u in bluer we have exercise we have fitness and programs but that those customers in that pathway have also got

access uh to the weight management service from ber those three pathways will launch as standard to all theme and

consumer customers from the 1st of September.

They'll also available to corporates for their renewals starting

uh on the 1st of September and my booper will be at the center of how customers use and navigate those pathways.

The

fourth we talked about is medication check.

Medication check will be available to all customers from the 1st

of June inme and consumer and our corporate customers can already add that

uh to their products today.

Great.

Thank you.

And coming next?

Yep.

Coming next.

Yeah, I'm not going to do a grand reveal, but yeah, we have not

stopped here, right?

So, um we are thinking really carefully about where we go next.

Mental health is one of the

things we're looking at.

Um it's quite a broad spectrum.

I'm not a clinician, so I'll leave it to my clinician colleagues here.

That's quite a broad spectrum of

things but you know there are other cancers uh in particular that we're looking at.

So you know we think there

are a number of areas but we want to do is to make sure that we do this in a really sustainable way so our customers

can understand the benefits and then we start to expand those as we see that claims and that healthcare data coming

through.

Yeah, great.

Thank you very much.

Uh, got any builds comments?

I think for for me on the places where we started for type two diabetes, cardiovascular disease and breast cancer

in the first instance, what's really important about that, I started off by saying we're we're living longer, great, but in poor health and those are really

important conditions that are driving that.

Um, and what's great is this information isn't academic.

We know what

we can do to address it if somebody is found to be at higher risk.

Dan mentioned with regards to breast cancer, the very specific things that people can

do if they have these high-risisk genes, but also for cardiovascular disease and type two diabetes, there's there's

things that we can do or advise people to do with support from BER that will help um reduce their their risk.

And

then comes in that engagement piece, that personalization piece about how them it works best, whatever exercise

mode that is, um whatever diet it is that works for them, and it's supporting them through that journey that we all

frankly live with dayto-day.

Right.

Yeah.

Yeah.

I think is right in saying that the for diabetic customers when they then go into hospital setting they

are much more complex and expensive for us to treat.

So this has a a broader

impact just behind that particular disease as well.

Yeah.

Great.

That's a good case for it all

around I think.

Uh so Rebecca coming to you.

Uh can you talk to the results of the my genomic pilot um that BER ran?

um

were there any long-term benefits you can talk to and will there be any further information released?

Yeah, so the genomic health pilot for those of you who weren't aware was a was a global pilot of 12,000 participants uh

in the UK, Spain, um and and some other markets around the world as well.

Um and

that looked at whole genome sequencing for actionable conditions.

So we were only testing conditions that we knew we

could do something about.

That's really really important.

we are not in the business of telling people about genomic risk that we can't manage right um and

that that gave some insights that I think directly impacted you know the direction of travel that we've gone so

99% of those individuals had a uh genomic variation that impacted common

medication um so as I mentioned before um you know that that includes things

like common anti-depressants that I would prescribe you know in my in my job as a GP antibiotics painkillers, um

things like ibuprofen that you can get over the counter, but also things like chemotherapy agents that that you might

have in hospital.

Um so, you know, just given the the huge number of people that

were impacted by that, and we've had people who um you know, have been on long-term uh tummy protection

medication, but still symptomatic with it, have had camera tests and lots of other invasive testing, and actually,

it's just turned out that they've been on a medication that they just weren't responding to.

So, we've been able to switch their medication.

They've been

symptom free.

Uh Dan talked about the anti-depressant uh case example.

That's

really important because if I'm prescribing an anti-depressant and somebody comes back to me and they're not feeling any better at the moment, I

don't know whether I need to increase the dose of the current medication, whether actually something else is going on and they may need a bit more support.

Actually, with these kinds of insights, I can just make sure that they're put on the right anti-depressant first time and I'm even even able to dose adjust on it.

The other thing that was really telling was that uh about three quarters of individuals had a polygenic risk score.

That's where lots of genes come together to affect the risk of cardiovascular disease, breast cancer uh and um and

diabetes.

Um and that's directly resulted in the in the pathways that we see today because actually we were able

to understand how you communicate that risk to customers, how we intervene and

the long-term effects.

And you know in the case about breast cancer we've had individuals come through with

preventative mistctomies and frectomies as a direct result of of a bracka new bracka diagnosis and that's you know

proven that actually that that saves lives in the long term.

Super exciting.

Right.

Thank you very much.

Ravi got

another one on wearables.

You're becoming our wearable expert.

How reliable is wearable data for detecting

early signs of illness?

Yeah.

So, um I suppose it depends on specifically which

illness um that that someone might be referring to.

And as I said before, a lot of this technology is is developing.

Um so, one thing that wearables actually has been have been focusing on is actually mental health, which I'll

start, which is quite interesting.

Uh understanding if somebody's maybe displaying signs of anxiety um or or

stress different to their baseline.

That's why it's so useful because it knows your baseline from however long you've been wearing wearing it for for

that that that period.

Um so that's one example of where it might give a signal

a sign.

It's not necessarily diagnostic but it can support that conversation you have with your clinician.

Um the example

I gave before the condition is called atrial fibrillation or AF.

Essentially that means an irregular heartbeat and

that's really important because it can give you symptoms such as palpitations but it can increase your risk of having

a stroke.

Now they have been validated for um for for diagnosing those

conditions or at least again pointed to the signs that you then get an ECG and further test.

So for example the Apple Watch I'm wearing can do that if you

just put your finger on the dial and it can can measure that within uh 30 seconds.

So again, they're definitely

developing in in that space.

But but to really hit home the point, it's about giving more information to the

individual who can then take it to their clinician and say, "This is what I felt and this is some also some objective

measures as well that's coming up with my wearables that will help support each individual disease diagnosis and then

you can go through the kind of gold standard proper diagnosis.

" So it's about bringing all the data together as you said before really isn't

it?

All the different data sources.

Yeah.

Because personally I I love that if somebody has that more information including that objective information

then you can really go off that um and and build this picture of someone to then give that that definitive

diagnosis.

Great.

Thank you very much.

Okay Dan, uh is this just a UK initiative?

Will it be

extended to Ber Global for example?

Yeah, so our ber global customers will be able to benefit from preventative um

benefits and services already built into their product.

little bit different um but yeah there are we have got a lot of

ambitions to roll this out more broadly also our businesses in Spain and also

Australia are also investing and have got similar pathways that are under development as well so this is a big you

know Rebecca talked to around a global pilot for genomics that this is something that the ber group is doing

you know across the piece as well yeah it's about being appropriate to location isn't it exactly and different products have

different design right so the way that this works will be slightly different but sharing some of those common themes particularly around uh personalization

of health.

Yeah, great.

Thank you very much.

Look, thank you very much.

What a great discussion.

Um it's been really good to

learn all about genomics and that brings today's session to a close.

We've had a

great discussion uh about the latest innovations in personalized health and the growing importance of prevention.

With prevention in mind, a quick

reminder that our healthy cities program is back in June.

Great way to encourage your teams to get moving.

Uh if you want

to get your people involved in the 30-day challenge, please speak to your account manager and they'll be able to

uh to sort you out.

Look, I hopefully it's come across today.

We are passionate at BER about our opportunity

to play a big role in employees and consumers health by um really living our

purpose to help people live longer, healthier, happier lives.

We're uniquely um positioned um to be able to offer not

just the funding, but also the health care that goes around all that.

And we we believe it's our privilege to be able

to bring that to you.

So, I hope you've enjoyed the first uh launch of that and and much more to come.

So, uh that's it

for today.

Uh and health our health horizon session will be back in May focusing on mental health.

Stay tuned

for more details and thank you for joining us.

We look forward to seeing you very soon.