Vice Provost's View: Professor Sir John Tooke's farewell reflections on UCL SLMS

As I approach my last few weeks as Vice-Provost (Health) at UCL, I hope you will indulge me in a few reflections and thoughts for the future of this great institution.

Clearing out my stuff, I came across my letter of application for the role, in which I emphasised three issues for the UCL School of Life & Medical Sciences (UCL SLMS): commitment to the whole translational spectrum whilst sustaining excellent discovery science; greater visibility of our core strengths; and the projection of SLMS as an intellectual hub for biomedical science, with effective partnership working at its core.

The power of partnership

In my last VP View I wrote about translation and our role as medical innovators. The restructuring of SLMS had served us well in this regard, emphasising our commitment to the full translational spectrum as well as projecting better our core strengths. So for this View, I'd like to reflect on partnership.

First, in its many guises, well-conducted partnerships help to generate high-impact research (both academic, and health and socioeconomic)[1]. Combining different disciplinary perspectives or 'interdisciplinarity', which for this purpose can be regarded as a form of partnership, is a critical success factor for much high-impact research, as well as being a particular strength of UCL. An interdisciplinary approach helps to generate novel insights at the interfaces between conventional disciplines and also increases the traction those new ideas achieve through dint of the multiple constituencies involved in their generation[2].

Collaborating with other institutions is also key to our success. We know that approximately 30% of SLMS's highly cited publications involve collaboration with institutions across the world. Regardless of the strength and scale of UCL, academics will rightly seek links with fellow academics, wherever they are based, who are best able to contribute to the resolution of the research question being addressed. This is fundamental to academic discourse and we should do everything we can to encourage it at an individual level.

When it comes to the development of institutional links that demand significant staff time and/or money, a more strategic view is necessary, not least to avoid the potentially huge opportunity costs if multiple initiatives are pursued, given the time and commitment required to sustain productive relationships of multiple initiatives. In SLMS, we have had a fruitful Partnerships Board to address such issues (and to consider the critical strategic question about the balance between building links with elite institutions and capacity-building initiatives with less-well-developed partners). I am delighted that UCL now has a well-articulated Global Engagement Strategy http://www.ucl.ac.uk/global/strategy to guide the development of our future international links.

Nearer to home, living up to our strapline of London's Global University requires us to partner effectively within the capital. In the health field, it has been revelationary to me how health and academic partners in north central and north east London have come together as UCLPartners, in pursuit of the supraordinate goal of improving population health. Given the mounting evidence of health advantage that UCLP has brought to the six-million population we serve, it is no wonder that our successful model has led to the creation of Academic Health Science Networks (AHSNs) across England, and that international alliances seek to learn from our experience. One just hopes that it will be appreciated that the trust and culture that underpins our achievements take years, not months to mature - the expectations of the new AHSNs need to be realistic. The creation of the London AHSC Executive, another partnership endeavour precipitated by UCL and UCLP, has drawn together the capital's three AHSCs to common purpose, and has enabled the formulation of London's Life Sciences Strategy and the launch of MedCity. Collectively, if it continues to work in this way, London possesses the biomedical academic credentials to rival any city in the world - and to attract the inward investment that assures such a status.

Future challenges and opportunities

So what of future challenges and opportunities? In order to remain globally competitive in biomedical research while other nations are investing more in this area, SLMS will need to rationalise and integrate core platform technologies. SLMS's widely distributed, often subscale capabilities are a legacy of our history - which involved the amalgamation of three medical schools and many postgraduate medical institutes. Where appropriate, investing in new facilities that enable us to bring together and further our strengths is an important step forward for SLMS. The groundwork is beginning in cell and gene therapy, an area in which we occupy a leading position in the UK, but the need is urgent in other areas as well.

Such facilities will be a pre-requisite for the world-class institutes that we plan to establish in dementia and mental illness, infectious diseases, precision cancer medicine with a particular focus on cancer immunotherapy, childhood rare diseases, loss of vision, immunity and transplantation and cardiovascular disease. Such institutes will need a high entry threshold. To ensure the quality of recruits, great emphasis should be placed upon applicants who have proven their competitiveness by being awarded blue-chip fellowships. Internally, we must continue to strive to make the most of all of our talent, a pragmatic reason to fully embrace the equality and diversity agenda.

Reflections on an oxymoron: 'academic management'

If all of this sounds rather managerial I make no apology, although I do accept that 'management' in the academic context is largely about facilitation rather than direction. Indeed, an overzealous managerial approach can stifle the very academic creativity that characterises UCL and that we seek to nurture. I do believe nonetheless that an institution of UCL's standing and potential has an obligation to innovate not just in its core activities, but in the ways in which it seeks to pursue its various activities. Such a commitment is consistent with our roots, heritage and values.

'Living the values' is arguably the most important characteristic of leadership when it comes to engaging staff. It doesn't matter how compelling the rhetoric is - people will disengage if the actions of leaders do not match their words. Every university, for example, will emphasise how much importance it places on education and the student experience, but if decisions reinforce the view that research is more important, then the ensuing cynicism among staff and students is inevitable. In this particular regard, I have every confidence in the leadership team within SLMS and wider UCL and I'm greatly encouraged by the attention now being given to the education agenda.

The health agenda and wider UCL

A final thought: health solutions in the future will be ever more dependent on linking with disciplines beyond SLMS for technical reasons (e.g. physical sciences, maths, engineering) or to address ethical, economic, legal and socio-behavioural dimensions. I hope that interpreting the future of health in this way helps to build the case for the large, expensive set of biomedical capabilities that SLMS needs, by demonstrating the added value a health focus can bring to disciplines beyond medicine and life sciences.

Back to the future

Any regrets? Simply that I didn't have the opportunity to conduct the more research-intensive part of my career in such a stimulating environment, with so much talent with which to collaborate. If Michael J Fox were to take his Back to the Future time machine to 2034, I trust he would find our institutes built, supported by superb platform technologies, Parkinson's Disease cured along with many other neurodegenerative conditions, and cancer immunotherapy and precision medicine living up to their promise. We would be acknowledged for our pioneering, enabling and confident approach to partnership working. And all of this with our values intact and with sustainable, world-class status secured.

To those of you I won't see to thank in person, thank you for the privilege of contributing to our activities over the last six years and for your efforts and support. Good luck in all of your endeavours.

Professor Sir John Tooke, UCL Vice-Provost (Health)

Footnotes

1. Wooding, S., Hanney, S., Pollitt, A., Buxton, M., & Grant, J. (2011). Project Retrosight. Understanding the Returns from Cardiovascular and Stroke Research. RAND Health Quarterly, 82.

2. Disis, M. L., & Slattery, J. T. (2010). The road we must take: multidisciplinary team science. Science Translational Medicine, 2(22), 22cm9-22cm9.

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