HM meets… James McArthur

James McArthur general manager, GenesisCare UK

Australian-owned GenesisCare has expanded rapidly since entering the UK market with the acquisition of Cancer Partners UK in 2015. Now, as cancer treatment races up the health agenda, UK general manager James McArthur tells HM how the business is on a mission to expand access and radically improve outcomes for patients

 

HM Can you tell us a bit about your background and how you came to head up GenesisCare in the UK?

JM I began working with GenesisCare when I was an advisor to the company and its major shareholders while I was part of the Investment Bank at UBS AG in Sydney.

During my time in investment banking, I specialised in healthcare growth companies, including those with private equity sponsors. While working with GenesisCare I felt connected to the mission and the innovative and patient centric drive to create something awesome for patients. I joined the business in January 2016 and worked in a number of roles including head of finance for Europe and international business development which gave me a unique insight into global markets, new market entry in Spain and most importantly how we build a service offering for our patients and clinicians which is world class, measurable and sustainable.

When the opportunity of taking on the position of UK general manager came in November 2018, I felt this was an opportunity for me to bring my experience to help GenesisCare take things to the next level in the UK.

I’m also passionate about what we’re aiming to achieve – changing the way people experience cancer care and this is what drives me to push myself and the team to deliver innovations and advancements in everything we do and, importantly, connect the care pathways ‘end to end’ for cancer patients.

I have three guiding lights in what I’m aiming to deliver; to influence and change the outcomes for cancer patients through quality of service, accessibility to leading edge treatments, and speed at which services are provided.

I hope to do this decisively but in a transparent and empowering way with our teams across the UK.

HM GenesisCare is now a global company. How would you describe the company’s ethos and evolution as an international healthcare business?

JM When I describe what we have built at GenesisCare, some retort with a quiet surprise having not heard much of GenesisCare and I like to think we are one of the best kept secrets in healthcare.

OUR APPROACH
ENSURES THAT WE
TREAT THE PATIENT
AND NOT THEIR
CANCER

We are relentless in our focus to deliver patient satisfaction and are in the top 1% of global healthcare providers with an average score of >95% for the last three years. From the outset, our founder and CEO Dan Collins set out to change the way people experience healthcare and was determined to go that little bit extra to make it the best experience possible. In the UK, our aim is to streamline and integrate cancer pathways to ensure the patient has a seamless experience and can access world-class care without delays.

Our patient focused approach also ensures that we treat the patient not their cancer. We know how important it is that patients get the best possible care, so we deliver a truly personalised service in surroundings that aim to relieve the stress people usually feel when visiting medical facilities. We also aim to treat the whole person and that’s why we’ve embedded two complimentary treatments – Exercise Medicine, which is proven to improve outcomes and the charity, Penny Brohn UK, which provides patients with holistic treatments such as counselling, acupuncture and reflexology.

Both of these services are provided at no additional cost to our patients and are included within their policies agreed with all insurers.

HM You entered the UK market with the acquisition of Cancer Partners UK in 2015. What attracted you to the UK and how has the company developed over the last five years?

JM Quality, access and efficiency are the key pillars for both new market entry and our focus on operational excellence.

In the UK, we saw an opportunity to improve within all of these aspects.

By bringing new world class technology including Surface Guided RT, spacers for organs at risk and exercise medicine, we could lift the standards of oncology care and connect more diagnostics to improve time to treatment.

Access to independent oncology care is relatively low outside of London and our mission remains to ensure world class private care is available to over 75% of the insured population within one hour of their home.

Efficiency gains were large in the UK, as we could bring our proprietary tools including AI and automation to accelerate the radiotherapy planning process as well as the benefits of a large global network in terms of procurement, centralised support and proven operational
models in our clinics.

HM The last year has seen GenesisCare make significant investment in new treatment modalities. Can you tell us about the range of diagnostic and treatment services you now offer patients in the UK?

JM That’s right – we are leading what I call a renaissance in radiotherapy. We have invested in developing stateof-the-art integrated care clinics and have equipped them with cutting edge technology.

For example, the MRIdian Linac at our centre in Oxford is the first of its kind in the UK. This innovative technology uses magnetic resonance imaging (MRI) to provide live, detailed images of the tumour and surrounding tissue. The live images mean that as the tumour or
surrounding tissue moves, the machine automatically pauses to avoid healthy tissue being damaged.

The increased accuracy from these images gives clinicians much greater confidence that they’re hitting the target 100% of the time and has shown to be particularly advantageous in treating difficult or previously untreatable cancers such as pancreatic, liver and certain lung cancers that haven’t spread, as well as prostate cancer.

HM How important is continued innovation in cancer diagnosis and treatment and does being a global organisation help keep you at the cutting edge of new technology?

JM Cancer care has come a long way in the last few years with significant advancements, particularly in radiotherapy and in techniques to enable us to personalise treatment for patients such as genetic and genomic testing. This means that we can now tailor treatments to the individual patient, minimising side effects and damage to healthy tissues and ensuring they get the best possible outcome.

The impact on patients is profound with treatments being delivered in as little as five treatments, which allows patients to carry on and get back to their lives with minimal side effects, knowing they’ve received the best possible care. But – we need to continue to push for advancements and innovations.

Being a global organisation means we have an amazing network of clinicians and technical experts and we have a strong focus on sharing learnings and experience across our organisation. Our ‘Service of the Future 2.0’ programme is in place to ensure that’s exactly what happens – designing and delivering the latest, proven treatments consistently across all 440 of our worldwide clinics, ensuring no matter where you are, the treatment you receive from GenesisCare is world-class.

HM Proton beam therapy has attracted much attention in recent years, yet you decided not to go down that route. Why is that?

JM At GenesisCare, we are always conferring with our clinical and academic leaders to evaluate innovations in cancer treatment that are proven to deliver improved outcomes for patients.

OUR AIM IS TO
STREAMLINE
AND INTEGRATE
PATHWAYS
TO ENSURE
A SEAMLESS
EXPERIENCE

Right now, the evidence base for proton beam therapy is limited to a handful of indications and clinical scenarios which are not all that common within GenesisCare, such as the treatment of paediatric cancers. We feel that, at the moment, we are using the best and most innovative technology, suited to our service, such as MRI guided Linacs. That said, we are always interested in innovation and technological advances.

We will watch eagerly for further evidence around the benefits of proton beam therapy in the treatment of adult cancers.

It is important to keep in mind Protons are not new and have been around for many years and are yet to establish clear and material outcome benefits for most cancers and hence we are focused on truly new innovations which allows us to see tumours in real time and deliver more dose with full confidence.

HM Since entering the UK market, you have collaborated with a number of established independent hospital groups, including Ramsay and Spire. How do these partnerships work and what can you bring to the patient pathway that hospitals would find it difficult to provide alone?

JM We work in close collaboration with a number of other independent cancer providers to deliver a seamless patient pathway. Our centres are often closely or co-located to our partner hospitals, ensuring that patients can easily access the various elements of their personalised care.

We are passionate about connecting the pathways for patients, and partnerships with independent providers are important as we do not provide inpatient admission services. Most recently, Bristol joined our network as part of an acquisition and partnership arrangement with Spire. This partnership aims to connect the pathways between the two
organisations, allowing each provider to bring scale and expertise in their respective elements of the oncology treatment pathway.

Although the care objective is seamless transition, the commercial arrangements are quite separate and each party contract and invoice independently with the insurers and the patients.

HM GenesisCare Foundation’s Compassionate Access Programme recently announced it was offering eligible NHS patients stereotactic ablative radiotherapy (SABR) using the UK’s first MRIdian machine at your centre in Oxford. Can you tell us more about the foundation and it’s work in the UK?

JM The GenesisCare Foundation is our charity arm that focuses on clinical research and improving patient access globally. We’re delighted that the Compassionate Access Programme is the first UK specific project. The programme is a collaboration among four key partners; the GenesisCare Foundation, the University of Oxford, with whom we have a ten-year partnership agreement, ViewRay, the makers of the MRIdian and the UK charity, Pancreatic Cancer Research Fund.

The programme means that NHS pancreatic patients from anywhere in the UK can access the MRIdian at absolutely no cost – even travel and accommodation will be covered by the programme.

The Compassionate Access Programme has two significant purposes. Firstly, to provide patients who otherwise would have limited, or sadly, no options with a really viable treatment option. Secondly, to help demonstrate the effectiveness of this treatment, with the ambition to make it available for all patients in the future.

We’re hoping that this is just the first of many programmes between the GenesisCare Foundation and our partners to help increase access to the best cancer treatments for as many patients as possible.

HM In common with other independent healthcare providers, you offered your services to the NHS during the Covid-19 pandemic. What role have you played to date?

JM As a healthcare organisation and a member of the Independent Healthcare Providers Network, we offered to support the NHS where and when they may need it – and this offer still stands. However, the reality is, we are an outpatient clinic and were therefore unable to support directly with Covid or critical care patients who require inpatient beds.

Nevertheless, what we did do, is ensure our centres remained open throughout and increased access to diagnostic services to ensure existing patients, and any new patients, including those concerned about cancer symptoms were able to access diagnosis or treatment without any delays.

We have ongoing discussions with a number of NHS trusts, to find ways that we can support them in the care of cancer patients. We have a number of agreements in place, such as our partnership with Royal Surrey NHS Foundation Trust, NHS University Hospital in Southampton and Taunton & Somerset NHS Foundation Trust, where we are able to take some of the pressure off the Trusts by taking care of their NHS and private patients within our centres.

HM NHS waits for cancer treatment and diagnosis were rising before the pandemic. How can a company like GenesisCare work with the health service in the long-term to build additional capacity into the system?

JM We all know that the NHS is under significant strain, not just through the pandemic but as you say, before with the target wait time for cancer treatment often being exceeded.

As an independent cancer care provider, we believe we can help alleviate this burden by ensuring that all patients with access to private health insurance use it. This will help to reduce the cost to the NHS and importantly reduce the waiting times for those who rely solely on the NHS.

Additionally, new technology such as the MRIdian can treat prostate patients in as few as five sessions, rather than the 37 sessions required under standard radiotherapy. MRIdian enables us to treat more patients as quickly as possible plus has significant benefits to the patients, allowing them to get back to their lives quickly.

HM Recent research from Healthcode found that in oncology, private patient activity was back to near pre-pandemic levels. What has your experience been as a company?

JM Throughout the pandemic all of our centres have remained open and have been treating patients without delay. This means that people who have already begun or have been recently diagnosed can be treated as quickly as possible, which we know has a significant impact on the outcome of their treatment. However, the impact we’ve seen is that many patients either don’t have access to diagnostic services – or are concerned about seeking out these services.

Since before lock-down happened in March, we have been taking additional measures to ensure we minimise risks to patients who may have compromised immune systems or who are concerned about the risks of being in a medical facility. We have adjusted all our protocols to ensure we can continue to provide much needed care to our patients. We are undertaking additional cleaning and reinforcing strict hygiene protocols and comprehensive use of PPE and social distancing.

We also have extensive screening both before and on attendance at our centres, plus testing for all patients and staff and we have restricted the number of visitors to ensure we keep our centres low footfall. In addition to these measures, we have also implemented telehealth, so our clinicians can carry out consultations via secure video conferencing where
appropriate. Our teams have worked hard to ensure everything still runs extremely smoothly for our patients and that they still feel cared for. We’d encourage anyone with concerns about symptoms to seek advice as soon as possible to ensure they can get the best possible outcome.

HM You have a history in investment banking and M&A. What are the growth opportunities for GenesisCare in the UK and do you have any immediate plans for expansion?

JM With one in two of the UK population likely to get cancer at some stage in their life, GenesisCare wants to ensure everyone has access to the best care possible. We currently have 14 centres throughout the UK with our latest centre, the GenesisCare centre for radiotherapy at Bupa Cromwell Hospital, recently opening in West London. This centre has
seen a £20m investment and refurbishment programme, making it a state-ofthe-art facility and will house three of the most advanced radiotherapy systems – the Varian Edge, Gamma Knife Icon and, early next spring, we’ll unveil the UK’s second MRIdian MR Linac.

The Varian edge is for a wide range of cancers, including breast and prostate, Gamma Knife icon for brain and upper spinal tumours and MRIdian MR Linac for prostate, lung, liver and pancreatic cancer. The first MRIdian is already providing treatment for these difficult-to treat cancers at our centre in Oxford and within nine months has already treated over 100 patients from across the UK.

In addition to these 14 centres, we have a number of additional projects in progress including a brand-new centre that is being built in Guildford in partnership with Royal Surrey NHS Foundation Trust. There are also a select group of new geographies under assessment, alongside an exciting programme to expand our capability and bring new technology within our existing footprint that will be executed in the next three years.

HM And what about the longer term? Are there any plans to diversify, perhaps into cardiology services? Or does the UK business have its hands full meeting demand for cancer treatment and diagnosis?

JM Certainly, the UK business has a major focus on cancer services and there are still so many people that can benefit from our services.

Cardiology is also an extremely important health concern in the UK and our service in Australia continues to grow and strengthen where we have ~100 cardiac clinics.

There are also some areas with concurrent healthcare needs, such as in cardio-oncology, which is an area that we are looking to pilot soon. This will enable us to bring expertise from our global colleagues to this area of healthcare. However, our mission is clear and focuses on delivering world-class end-to-end oncology care across the UK. We will not rest until this is achieved.