Introduction by the founder of Snedden Campbell
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nedden Campbell (SC) is a Callendar-based recruitment firm for the global medical technology sector. It was founded by me and my wife, Jennifer Snedden, in 2001 as a recruitment partner for medtech firms in Europe and beyond. We find senior, skilled people and we make board placements in companies that are involved in a range of areas, including life sciences, biomedical, diagnostics and medical devices. Working directly with company management or engaged by external investors, we have placed skilled staff in companies in the UK, Spain, France and Denmark and we have attended meetings in Germany, the Netherlands, the Czech Republic and Dubai. As a small company with a global audience, we are one of only a small number of recruiters with more than two decaces of experience in medtech recruitment and we have an enviable and hard won reputation for quality, effectiveness and dependability, which benefits from a large amount of repeat business. We bring a specialist understanding of the medical technology industry to the business, plus a mix of experience, curiosity and creativity to help find the best possible candidates available for your company. We’ve also been told on many occasions that working with us is an enjoyable experience. I have been in candidate search for more than 30 years. Prior to launching Snedden Campbell, I held senior roles for some of the UK’s biggest recruitment companies. Fed up with men in grey suits, pointless KPIs and sharp practice, I decided to launch a new kind of retained medical technology search consultancy that would bring
approachability to headhunting, where clients and candidates would be treated equally and where nobody ever said ‘touching base’. I now spend my time meeting clients and delivering on projects around the UK, Europe and worldwide. Regular business trips always include a visit to the nearest art gallery or cathedral. Outside of work, I love exploring Scotland on foot and usually in the company of Ziggy, the office wonder dog. If the weather is bad, I’ll head to my bench where I’m making a 1:48 scale, air force in plastic. Jennifer leads our market analysis and candidate search function, as well as providing operational support for Snedden Campbell. She has played an important role in making the company what it is today, primarily by not putting up with my madder ideas. Away from the office, Jennifer relaxes, by designing and making soft furnishings, especially lampshades.
Ivor Campbell CEO of Snedden Campbell
From a Cinderella sector to the belle of the ball The next big test for the diagnostics industry could be meeting public expectation By Ivor Campbell
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ne of the biggest impacts of the Covid pandemic on our culture has been the way it has popularised the issue of diagnostics in our national discussion. The UK’s perceived failure to contain the initial spread of the virus was, we were told, in part due to a lesser focus on test and trace procedures than in some other parts of the world, and that was down to us not having a tradition of diagnostics in this country. The subsequent rolling out PCR testing and the speed with which we have seen how effective, and relatively inexpensive, tests can be in halting the march of the coronavirus, has convinced us of the value of diagnostics. The truth, as opposed to the convenient myth, is that diagnostics is not quite the Cinderella sector it was made out to be. In fact, Britain has the fifth largest In Vitro Diagnostics (IVD) market in Europe. Estimates of its worth vary – MedTech Europe puts its value at around £1billion while the Office for Life Sciences reported in 2018 that it accounts for around 27% of the £24billion turnover generated annually by the UK’s med tech sector. The high profile now given to PCR testing in the UK, most recently to contain the Delta variant, and the launch of reliable antibody tests now being produced at scale, have given the sector an unprecedented prominence. The daily press conference at 10 Downing Street and exhaustive media attention have contributed to a belief that the way forward after Covid, and for healthcare in general, is for greater collaboration between industry, the NHS and government with diagnostics front and centre. So, if we are entering a new era for the med tech sector, what other opportunities are out there, and what can the industry do to exploit them? The immediate challenge for the industry is to move the conversation about the value of diagnostics in tackling Covid, to a broader one about its value in tackling wider healthcare challenges. Before Covid, the UK spent £12 per head on IVD products – around half that of Germany and two thirds that of France – according to MedTech Europe. Again, before the pandemic, the UK carried out about 900million tests each year and was a net exporter of IVD products.
Covid has been a game-changer in more ways than one, however. As well as highlighting the value of diagnostics, it has also been responsible for routing attention and resources away from other areas of the health service. Significant capacity and capability continue to be appropriated to support test and trace, with much of the NHS’s activity put on hold, leaving many patients facing long waits for routine treatment and an already overburdened workforce under further strain. Across the UK, radiology departments are understaffed by around 43%, while only 3% of histopathology departments have enough staff to meet clinical demand. On the other hand, patients’ expectations that a quick diagnostic test will be available for everything has never been higher and solutions already exist for quickly testing and diagnosing of a range of illnesses, including bowel can-
cer, influenza, pre-eclampsia, and heart failure. With virulent diseases, you want to know right now if you are infected and whether you are visiting a GP’s surgery or an A&E department, doing a rapid test makes sense both for you and for the physician who is then able to accurately prescribe something. Not all conditions are easily treatable, if at all, so although it may be possible for doctors and other health professionals to administer a rapid test for oncological or degenerative conditions, such as Alzheimer’s, what happens, from a service delivery perspective, if the test comes back positive in five minutes? Then, what was a routine, ten-minute GP appointment turns inevitably into a two-hour unplanned counselling session. This is not how GP surgeries and primary care providers want to work, nor it is the way the health service is intended to function.
Clearly, administering a test is the quickest and easiest part. Taking the necessary action to manage patients’ needs once you have the results, including meeting their mental health needs, requires much more time and staff resources. Sometimes, it is simpler to send a daily batch of tests to the lab and a get the results at the end of the week. Several companies are already in a race to produce what is effectively a Star Trek-style ‘tricorder’ – a simple blood spot test which can provide a multiplex diagnostic for 30 or more different targets. As well as telling you if you have cancer, Alzheimer’s, or liver disease, it will measure if your cholesterol is too high, if your kidney function is not great or if you have any number of hormone related issues. The theoretical value of this to a patient’s health, longevity and quality of life is enormous. While no types of dementia can be cured at present, if caught early enough mitigation is possible to benefit the sufferer and their families. Further down the line, it may save on the cost of prescribing expensive pharmaceuticals and of specialist care. And yet there is a strong argument against over-diagnosing. Many patients live with conditions they never know about, and they die with them but not of them. No one has perfect health, and if
a physician tests for 100 things, they are bound to find something wrong. There is also the issue of insurance risk. If an insurance company knows that a patient has something that’s likely to kill them over the next decade, will they take them on as an insurance risk?
Probably not. Investors in diagnostics already include some large insurers who want to know what risks they are taking with every policyholder. A corollary of having an all-singing-all-dancing tricorder test available on the shelves at every neighbourhood pharmacy, is that you
may be required to take one before being considered for health, life or even car insurance. Resistance to the exponential growth of diagnostics might even come from within the NHS because, as technology develops, it will inevitably face greater and more detailed diagnostics reporting requirements. There could be echoes of the current dichotomy faced by health service providers who have to meet a growing requirement to hit or exceed outcome targets while, at the same time, coping with ever greater demands on service capacity, with finite resources. Medical diagnostic technology will continue to improve, and the ongoing trend towards using ever more artificial intelligence in finding increasingly faint signals in ever-growing datasets will allow physicians ever greater accuracy and understanding. However, collecting and interpreting the vast amounts of raw information from these enormous datasets requires a set of human skills that is not yet widely available. Ivor Campbell is Managing Director of Stirlingshire-based Snedden Campbell, a search company for the medical technology industry.
diagnostics because it was something of regional centre, but that has changed dramatically. Of the activity and interest which we’ve seen in the past 12 months, almost all the enquiries we’ve had
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It’s difficult to identify anyone for a leadership role with higher-level technical requirements at less than £100,000 have been based here in the UK. Since May last year, 80% of people we have placed have been with new companies which didn’t exist five years ago. It’s also noticeable that there is a lot of new clients in companies of all sizes, none of whom we were working with two years ago. Activity remains heavily focused on the med tech clusters in Oxford, Cambridge, London, the North-East and North-West of England and Central Scotland.
NEW TECHNOLOGY: Around 80% of people placed by Snedden Campbell are with companies that didn’t exist five years ago
Healthy rewards Salaries in the medical technology sector have seen significant growth as the global Covid pandemic has boosted demand for top diagnostic recruits, says IVOR CAMPBELL
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igher level earnings in the medical diagnostics industry have risen significantly since the start of the Covid pandemic and some are now double what they were five years ago. Board level executives with technical, scientific, or engineering qualifications now routinely command salaries around £150,000-a-year. Experienced engineers involved in research and development and transfers to production are regularly employed on salaries of £120,000. The sudden expansion of the UK medical technology industry, particularly in the field of infectious disease diagnostics, in the past 12 months has led to companies offering significantly higher wages to attract the best
people. Government investment in Covid-related research and the higher public profile enjoyed by the diagnostics industry, have seen the launch of several new specialist firms, as well as established companies expanding their activities and product ranges. The Government has thrown hundreds of millions of pounds at diagnostics in the UK and that has had various knock-on effects. What we are seeing is a confident sector, whether it has anything to do with Covid or not, hiring more people, looking at hiring people and increasing their product ranges. It has also made for a scarcity in the number of qualified and experienced people who really know what they are doing in designing, developing and manufacturing these things and, as a result, we are seeing demand for their services grow,
with far fewer quibbles about salaries. Until 2018, salaries had remained virtually static since the 2008 financial crash. We are now at a stage where we are getting consistent, six-figure salaries with senior people in medical diagnostics businesses of all scales. They are catching up with those in equivalent positions in the pharmaceutical, finance and information technology industries in the south-east of England. We are working on an engineering production management project for which, five or six years ago, salaries would have been around £60,000 to £70,000 – now they are £100,000 to £120,000. Clients who would have put the phone down 12 months ago are now nodding through inflated salaries because they accept that rates have gone up. Engineers earning £120,000 a year ago would have been unlikely – now it’s the cost of doing business. For a board-level appointment, we are now in £150,000-a-year territory for someone with a technical, scientific or engineering qualification. Engineers and scientists, skilled in research and development with some product launches to their names and transfers to production, can expect to earn over £100,000.
It’s difficult to identify anyone for a leadership role with higher-level, technical requirements at less than £100,000. The UK diagnostic sector appears to be generally growing faster than other European countries, with some exceptions in Spain and Scandinavia, where there has been a rise in activity
since the start of the pandemic. It’s always been the case that the UK represented about half of what was going on in
The UK’s place at the Med Tech top table could be under threat By Ivor Campbell
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A seat in the Boardzoom Remote working has seen more top med tech executives recruited by overseas companies
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he mass switch to home working caused by the coronavirus is having a major impact on the UK’s recruitment practices, with companies now enabled to hire significantly more overseas-based executives. More firms are prepared to have senior decision makers located abroad after discovering the effectiveness of remote working. And while it has had a positive impact on industry, widening the talent pool available to UK firms, the trend could mean less tax revenue generated by the Treasury as many of the workers won’t pay UK tax. More than 90% of Snedden Campbell’s business is now done for UK-based companies, many of them start-ups and pre-revenue, compared with around half prior to the pandemic, We have done business from San Diego to Dubai and, when I look at what we’ve been doing for the last six to nine months, almost everything we have done has been in the UK, which is completely different from the situation before Covid. One thing that has come through, that’s genuinely interesting, is that prior to the pandemic, if you were going to place someone in a senior role, the expectation was that they
would be there on your premises one hundred per cent of the time unless they were in front of a client at a tradeshow or travelling to be in front of a client or at a tradeshow. What we have found now is that companies will more readily accept that a lot of roles can be done remotely and it’s win-win because, they can now put their hands on people whom they would never have been able to hire before because they would have had to relocate them – they would have had to pay a fortune to get them to come wherever they are – always assuming that the candidate was willing to relocate in the first place. If they can live with that individual coming in one day a week or five days a month, and doing the rest of the role remotely, then all of a sudden, they have a much bigger talent pool than they had 12 months ago. We’ve all learned how to use Zoom
and it works. Everyone is a convert. You just have to get your head around the fact that your business meetings are not going to be in person around a table in Oxford – they will be around a virtual table and there will be one person from the US, one person from India and three people based in Europe. As well as saving employers the cost of relocating senior executives from overseas, typically mainland Europe but also the US and, increasingly South Asia and Asia Pacific, they are also able to pay local rates and taxes if most of their work is done in their own countries. The trend has been fuelled by an exodus of overseas workers caused by Covid and Brexit, according to the Chartered Institute of Personnel and Development (CIPD) which recently reported a sharp decline in the numbers of EU workers in the UK, hence the increased interest by employers to allow remote working for people who won’t now cross the Channel and to fill the remaining gaps with
talent at much greater distances. At the same time jobs website Adzuno found the number of overseas job searches from western Europe and North America had halved to 250,000 since the start of the pandemic. As with the 2008-09 financial crisis, there is always the possibility that the risk appetite of candidates falls and this hurts earlier stage, and by definition riskier, businesses disproportionally. However, the ability to work remotely will help to override labour shortages in scientific, technical and engineering sectors. We continue to place more people in the most senior roles – they are also a reflection of confidence out there in that they are not replacements but a product of an expanding sector. These are new people, either for established companies that are growing, or new companies that have significant investments and are bringing people on to convert that investment into profit. It’s not steady state, there is clear growth there. Around 40% of what we’ve done since things started to come back after the lockdown last summer has been through companies that are new to us. Of that, the majority have been companies that are relatively new, early-stage businesses. Mostly, it’s companies that have seen growth because there has been greater interest in diagnostics. A lot of them have nothing to do with infectious disease, they are dealing with other things.
ne of positive outcomes of the UK’s response to the Covid pandemic has been a significant growth in our medical technology industry. From nowhere a year ago, PCR testing is a term now familiar to the public. Existing medical technology companies are reconfiguring their operations to address a burgeoning demand for diagnostics equipment and new companies are springing up all the time. So why, in the face of this unprecedented demand, are we now faced with an impending shortage of world-class scientists, engineers and technologists? Growth in demand for diagnostics business specialists in the past year has effectively vacuumed up all of the existing talent, with companies being forced to pay ever higher salaries to existing industry specialists. Board-level executives with technical, scientific, or engineering qualifications, now routinely command salaries around £150,000-a-year, while experienced engineers involved in research and development and transfers to production, are regularly employed on salaries of £120,000. In some cases, those are double what they could have expected five years ago. However, the pipeline of top overseas graduates from China and the Far East, that this country has traditionally relied upon to meet ongoing demand, appears to be drying up. Companies are increasingly reporting that research students are being put off coming here because of a perceived resistance to immigration herefollowing Brexit and greater hurdles. Peter Hewkin, founder of the Cambridge-based Centre for Business Innovation and head of the global Microfluidics Consortium, recently told me that, rightly or wrongly, since Brexit, the UK is now perceived as less friendly to overseas students, not just from Europe, but from further afield. A secondary effect is that British companies are hiring these graduates, not into Britain but into overseas outposts – places like Vietnam, Taiwan and Malaysia.
IT’S TIME TO PUSH CANCER DIAGNOSTICS UP THE WAITING LIST
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THROUGH THE LOOKING GLASS Diagnostics firms are in a race to discover the ‘holy grail’ of virology – a rapid test biosensing device for Covid, according to IVOR CAMPBELL
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he race is on in the diagnostics industry to develop a device that instantly detects coronavirus for use in large public spaces and airports. The biggest companies are chasing the ‘holy grail’ of a rapid-test, biosensing device – similar to that used to test blood sugar levels in diabetic patients – that will identify whether a patient has Covid within a matter of seconds. While several firms are continuing to commit resources to producing lateral flow and PCR tests in bulk to service government contracts, their research and development focus has switched to the creation of a more sophisticated test. Now that the dust is beginning to settle, and the sense of emergency has faded, companies are now looking to develop more sophisticated ways of detecting Covid, because they know it will be with us for the foreseeable future. There are already lobbyists for the pharmaceutical industry
telling governments and anyone who will listen that ‘you’ve had your pandemic, that’s the first one in a century but who’s to say the next one won’t be next month’. Companies are now directing specialists in all areas of physics and chemistry to work on this single priority. While it’s too early to develop a prototype, directors and sales teams want to know what the tests are going to look like. It won’t be long before the current lateral flow test, which involves sticking a swab up your nose, will look crude and outdated. While it has served a purpose, in that it’s relatively quick, it’s also intrusive and unreliable and totally unsuited for use in public spaces. The PCR test is more accurate, but it is hopelessly slow. What policymakers are demanding is a multi-use device that combines the accuracy of PCR with the speed of the lateral flow test, like we currently have to test for diabetes. The speed at which patients receive test results is the
Companies are directing specialists to work on a portable Covid testing device, similar to those currently used to test for diabetes, inset. most problematic obstacle to life returning to normal in many parts of the world. In the UK, people have to wait up to 72 hours to get their PCR tests results but, in many other countries, including in some parts of the US, the wait is up to 14 days. In addition, some tests return a false negative result of up to 33%. Among ideas currently being considered by next-generation test developers are wearable devices that could be used to record patients’ health data, providing an early Covid diagnosis,
even when they are asymptomatic. Researchers at Imperial College London and the University of Freiburg have suggested that such devices, which record ‘quantified self-movement’ could take the form of clothing, masks, contact lenses or even tattoos. Intelligent face masks are already used to detect other health data so it may be possible to adapt them for use as Covid tests by monitoring the air around the wearer, alerting them to the presence of harmful airborne molecules, according to Dr Firat
G�der from the Imperial’s Department of Bioengineering. While the industry’s focus has been on the developed world, there is also everywhere
south of the Mediterranean and South America to consider and it is now several leagues ahead in its thinking. The industry has had a shot in the arm as a result of government investment over the past 16 months, and it’s now looking ahead to the long term. The money is there and the manpower and capital equipment are in place, so it’s only a matter of time before we
begin to see a new generation of highly sensitive, and suitable for point-of-care testing, which could significantly facilitate the testing of Covid-19.
ne of the side effects of Covid is that nothing else is really being tested. Other things have been put on hold and the big thing is oncology. People were either scared to turn up to a hospital where they might get Covid and were suffering in silence, or they just couldn’t be seen by doctors who were putting things off, or there were waiting lists for non-urgent scans and tests. There is going to be a bulge in cancer diagnostics and people who would have been caught a year ago at stage one for an easy treatment such as melanoma, are now much more advanced, and it is either going to kill them or they are going to be a lot sicker for a lot longer. The companies that are doing early-stage cancer testing, accurately and cheaply screening, can expect to have their products out there sooner. They can do well by doing good. They may be interested in diagnosing cancer much earlier because they have people in their families who have died from it. There are people interested in neurodegenerative disease, perhaps because they have family members with dementia of sorts, and it would be great to get ahead of things like that. The public now understands that you can do diagnostics on viral diseases. The country is beginning to understand that you can do the same quality and calibre of tests on cancers and screening for cancers. We have mammograms, cervical smears, faecal tests etc, but there are now companies who can find the tumour cells or the effects on DNA for those tumour cells before they even show up in somebody’s bloodstream. The NHS is notoriously reactive, it treats us when we are sick. It doesn’t stop us getting sick in the first place. It is good at treating us if we present with a lump but it’s less good at screening us for years before the lump occurs. The greater our understanding is of diagnostics, we are coming to realise that, if we can fight Covid successfully, we can do the same with cancer.
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