Lisa Kerr — Patient Engagement, Lived Experience & Why 95% of Eligible Patients Never Join a Trial

**Adam Walker:** I'm Adam Walker, a biometrics consultant, and this is the Pharma Prescribed Podcast, where leaders, innovators, and hidden voices in healthcare open up. No sound bites, no spin. Just raw insight, one prescription at a time. In an industry driven by data, protocols, and pressure, we rarely pause to ask the human questions. What drives us? What breaks us? And what truths live behind the titles we wear?

**Adam Walker:** Today's guest is Lisa Kerr, Head of Patient Engagement at Evinova, AstraZeneca's health tech business, where she brings over two decades of experience spanning global pharmaceutical and health tech organisations. Lisa has built a career on getting to the root cause of issues that others walk past. A passionate advocate for inclusion and equity, Lisa founded AstraZeneca's Safe Space employee resource group and the inclusion and diversity network at Evinova, creating spaces where people can show up fully as themselves. A champion for LGBTQIA+ rights, neurodivergent communities, and trauma survivors, Lisa is channeling that passion into voluntary trustee work with charities at the sharp end of mental health and diversity.

**Adam Walker:** Lisa, it's a pleasure to welcome you today. For those of our audience who are not familiar with you, what is the mission you're on?

**Lisa Kerr:** Thanks, Adam, and it's lovely to be here. The mission I'm on — and I've taken my time and my career to get here — is really to champion the role of lived experience in the decisions we make in the healthcare industry, both in the work we do with and for patients, and as employers with our employees and throughout the wider community. We have so many intelligent, wonderfully talented people in our industry who don't truly understand what it's like to live with the conditions we look to treat, and don't design our products or our trials for them. That's what I really want to change.

**Lisa Kerr:** I have a degree and a PhD in chemistry. I joined AstraZeneca fresh out of my PhD and worked in the analytical labs in drug development — learning the ropes on how you develop active drug substances, the tablets, the inhalers — and got a good grounding in the science. All I ever really wanted to do was be successful, go up the ladder, fulfill the academic promise that everyone saw in me. And I went up that ladder, and I got, around 40, to the role I thought was my career goal: global pharmaceutical project director in the CMC world. You're accountable for the development from raw materials to finished product and all the regulatory filings for a set of development projects or commercial brands, and you sit on those global product teams with commercial, regulatory, clinical, operations — really understanding how the business works. It was the most interesting, most full-breadth role I'd ever been in. And when I got to that point, I thought: there's gotta be something else.

**Lisa Kerr:** Where the something else came from was rooted in my personal life. I'd always been the good girl — straight As, first in her degree, followed the path. But with that expectation of perfection comes a huge burden, and that manifested in my life as depression. I lived with it all my adult life. In the critical 30 to 40 range I had an experience that really changed things. I was married, had a four-year-old and a one-year-old, and realised I was in a relationship that didn't serve me and didn't allow me to be fully who I was — not an example I wanted to set for my daughter. So I got divorced. And when you're a single mum with a busy career, I had what I call my fall-off-the-cliff-edge-of-life moment. I pulled myself up several times, then one more thing happened and I crumbled. I was an outpatient at the Priory for three months. My psychiatrist told me I had moderate to severe clinical depression at the time; when I was well, he told me it was severe. If I hadn't been a single mum with those two beautiful children, I would've been an inpatient. That's how unwell I was.

**Lisa Kerr:** I was lucky in that I got access to healthcare quickly, and I got it because a very dear friend of mine at work had been through similar struggles and had been really open about it. He did one of those things I always advise people to do — ask people how they are twice. He caught me at the coffee tin: 'How are you?' 'Eh.' 'No, how are you really?' And I told him. When I had my fall-off-the-cliff-edge moment I rang him and said, 'Chris, I'm not well. What do I do?' He said, 'Right, get a pen and paper. Go to your GP. Tell them you want a referral to the Priory. Ring the Priory. Here's the AXA number for the healthcare we have through AZ. You'll be there within a week. Do them in that precise order. And I'm coming round to have coffee.' That was the start of my real journey into mental health advocacy — because I honestly don't know where I would've been if I hadn't had Chris. I have a PhD in chemistry and I'm really clever, but I couldn't have found my way through all the different places where that information lived on the internet. I was barely capable of getting out of bed and having a shower and eating breakfast.

**Adam Walker:** For many people these days, it's harder and harder to get hold of those mental health services, is it not?

**Lisa Kerr:** It is so hard. Ever greater need, further demand. Mind released a report this week on the lived experience of people trying to access healthcare, and they rated the experience as either, 'you're too unwell and we can't treat you,' or 'we're not going to listen to you.' So people with serious disorders — schizophrenia, personality disorder, bipolar — are told 'you're complex, you don't fit in my box.' Or people with stigmatised conditions are told they're paranoid or can't make decisions, so their views aren't considered in their own healthcare. Or people at the opposite end with depression are told to cheer up. I remember someone telling me when I was really ill to just pull my socks up, and I was like, 'I can't even find my socks, never mind pull them up.' Those people are told they're simply not ill enough.

**Lisa Kerr:** Where I've seen that firsthand is in child and adolescent mental health services. Two of the three children who live with me have had their challenges with the mental health service. When you go to the GP with scars because your children are self-harming, and you're told that doesn't meet the threshold for referral to CAMHS, for many people there isn't another option. It's like telling someone with a broken ankle to sit over there for six weeks and wait for it to fix itself. We didn't get a referral to CAMHS until overdose territory. And even then they recognised the private support we had and said, 'we're not going to be able to give you any more than that.' It's a social divide that's really unfair — the people who often need it most are those who don't have access, and you don't get access until it's too late.

**Adam Walker:** You've taken that lived experience into your working life and made enormous changes within an organisation as large as AstraZeneca. You must have overcome an awful lot of inertia to get it to a place where there are thousands of people dialing in every week to different safe spaces.

**Lisa Kerr:** I started informally talking about my experiences when I got back to the office because I knew how impactful it had been for me. A colleague in HR said, 'we kind of have this dirty underground network of people who know that I've been there, you've been there, you're safe to talk to.' Nobody was talking about it in public. Then we got Workplace — the Facebook for work. I saw the AZ Pride stuff and joined the Pride Network. I thought, 'there must be something for mental health on Workplace.' There wasn't. So I made a page — anyone can make a page. I was going through a challenging period, accessing therapy services, and I posted about it. I recorded a video: 'this is how I'm feeling, and these are the things I've done to get help.' I felt physically sick. Is this the end of my career?

**Lisa Kerr:** The response was amazing. I invited 50 people I knew and it snowballed. We ran an event at Macclesfield for Time to Talk Day. Juliet White became our sponsor — 'Juliet, can you give us money for cakes?' 'Absolutely.' Someone from the Network of Women told me: 'Lisa, this is really good, but you need to be an ERG because that gives you the structure.' We went through the formal application process, became an employee resource group properly backed by the business, and it expanded — chapters in about eight different countries as well as the global network. COVID blew the roof off. All organisations recognised the need to support people with massive change. In 2020 we'd set a goal to raise awareness, and COVID did that for us.

**Lisa Kerr:** We had a fantastic tool we developed in our first year as an ERG: a simple flowchart. Remember me talking about not being able to find the information I needed? We had lots of routes — the employee assistance program, five sessions of counseling, referral through healthcare to full psychiatric inpatient care — and people weren't always being directed to the right one. So we put together a flowchart: 'Do you need immediate help? Yes/no. Do you want help inside the organisation or outside? Are you having a life event and need some help, or are you feeling really unwell and need proper support? Here are the numbers to call. Here are the people to email.' We handed it out on leaflets at events.

**Lisa Kerr:** In COVID that turned into the global mental health e-book — a flowchart for every country. And in our tech world it became not a PDF but an app called Healthy Mind inside Microsoft Teams. Microsoft loved the idea so much they did it for free, because it's simple and it's brilliant. So in Teams you go to any country in any language and understand what support is available, and managers can look at what support is available in other countries — which matters in a global organisation. It still shocks me that it started with a Workplace group and a video. But it did. And it's honestly the thing I'm most proud of in my career — other than my children — in my life.

**Adam Walker:** How on earth do you do that alongside being a working mum and holding down a very senior role?

**Lisa Kerr:** People ask me all the time. Talking about my mental health was challenging to start with, but it brought meaning to my experience. Each difficulty and challenge in my life — something has come out of it. It means there's a point to me having gone through it. If I can share what I've been through and help one person, then good has come from the pain I've lived through. That's what sustains me. I do it because it genuinely gives me energy. In my day job there were serious business problems and also very boring checking of spreadsheets, budgets and resource planning. But this gave me energy, meaning, alignment with purpose. Fundamentally, I think I was put on this earth to do good — to help people live better, be happier — and to have fun too. Some safe space conversations were deep and moving, but we also had a lot of fun. In the Priory, group therapy separated the alcoholics from the people with depression — we called ourselves the glummers and the gluggers. Being able to have a sense of humour about it is really important. If people think my ideas are a bit crazy, I'm like, 'yeah, I know — I have a clinical diagnosis for that, so it's fine.'

**Lisa Kerr:** What I learned in there — I think everyone should just go and have a spell in there, to be honest. What I learned about people and the different challenges people have — often it boils down to some kind of event that causes people not to be able to cope, and they find unhelpful coping strategies. Self-harm is one my kids have used. Alcohol was one I used. For some people it's controlling their food intake and exercise. There was a young man in one of the therapy classes who'd been the short one, didn't grow until 17 or 18, had a challenging self-image, then shot up to 6'4" and couldn't cope. He would restrict calories and also exercise to absolute exhaustion. It's so interesting to see how different people's brains work and the choices they make to cope with whatever life throws at them. I met so many amazing people in there. It's a valuable experience that teaches you a huge amount about life.

**Adam Walker:** Your lived experience and patient engagement go hand-in-hand, don't they?

**Lisa Kerr:** The role I'm in now is the most closely aligned to purpose I've ever had. I'm the voice in the room that says, 'do you understand what you are asking of people?' Clinical trials are designed by scientists for regulators and payers. Sometimes we do patient insights as part of the process — but more often the protocol is locked in, handed over to ClinOps, and then we start thinking about recruitment, retention and patient-facing materials. We almost treat patient recruitment as a numbers game. My role sits within the innovative patient recruitment team and I think it's the best place to start with patient engagement. We design a study, decide this is what's going to make us money and change health outcomes, list all the endpoints we need for approval. Patients either get access because their doctor said, 'I think this might be a good option,' or — more often in rare disease and oncology — they're actively looking. But most people aren't even aware clinical trials really exist or what they're for. A lot of people think they're only a thing for cancer. They're actually a healthcare option to access innovative treatment and move research forward — but we don't present it like that.

**Lisa Kerr:** We recently published a report with ISPEP — the International Society for Patient Engagement Professionals — on innovation in patient recruitment. We have the EACH framework: Education and awareness, Accessibility, patients as Consumers, and Healthcare collaboration. If AstraZeneca was Adidas, we'd be out of business — Joe Public wouldn't pay us for what we deliver. If you actually treat a clinical trial as a product for the person going to invest in it, we think that's the business — the investors. They invest money. Patients invest their time, their own health, and their trust — and not just their time, often their family's time too. That's a huge investment, and they give it to us for free. Most trials, people aren't compensated, and often patients have to stump up travel costs upfront. My mission is to say: this isn't the way to help people, and it's not a very sensible way to do business either. If you want people to join your trials, design trials for them.

**Lisa Kerr:** As an industry, about 5 to 7% of eligible patients ever join clinical trials. So 90 to 95% of eligible people don't. That figure has shifted by 1 or 2% over the last 10 years, depending on therapy area. We've gone through digitisation and healthcare transformation and haven't done anything. We're still chasing the same slice of people who know about or see a physician involved in clinical research. We need to be talking about it a lot more as an industry, and we need to design trials for patients and with patients — because what doctors think patients need is not what patients need. If I — top few percent of educated people with a great support network — couldn't access the mental health information I needed when I was unwell, then for people in less fortunate positions we're making it impossible. We have to do better.

**Adam Walker:** I was recently diagnosed with a condition, and only because I mentioned I worked in clinical research was I offered the chance to fast-track a procedure via a trial. A year-long waiting list — potentially six to eight weeks through the trial arms. If you don't ask, you don't get. The services and offering of clinical trials should be far more embedded, particularly for underserved groups, pediatrics, elderly people who can't ask for themselves.

**Lisa Kerr:** 100%. We're lucky we have the NHS. The situation in other countries with insurance-based healthcare is even more desperate — the role of clinical trials is even more important there in providing people access to things that can otherwise be beyond many people's reach.

**Lisa Kerr:** AI blows the excuse out of the water that personalised communications, education and bringing patient insight data into design is too slow and too expensive. It is not. Asked on a panel recently what two things I'd tell the industry to do tomorrow: first, get access to structured patient insight data. There are loads of companies with this data now — you can look at concerns, barriers, opportunities for a given patient population and segment it by gender, geography, and so on, in hours. No excuse. Second, compute that into the success of your trial. Build the patient experience into the probability of technical and regulatory success (PTRS). If you haven't thought about the patient population and haven't designed for patients, your probability needs to come down — make trials less investable if they don't actually address the patient experience.

**Lisa Kerr:** Third, on communications and social media: pharma is very quiet and traditionally conservative. There's a huge amount of misinformation out there. AI is really good at answering a question in a confident, coherent manner — and hallucinating where it doesn't have information or is pulling from the wrong information, because most standard LLMs pull from what's publicly available while the good scientific data sits behind paywalls. I use AI myself — for supporting my parents I've got them running ChatGPT on their own scan results — but I read through it, double-check the terms, make sure it makes sense. That's because of my scientific background. Most people don't have that, and confidently-sounding wrong answers can be really dangerous. Analyses have shown AI misses when people really need to go to the or sends them to the when they actually just need a plaster and some ice. We have a role to play as custodians of the science to combat misinformation — the people spreading unverifiable supplement claims aren't bound by the regulations we are.

**Adam Walker:** Are you able to reassure our listeners that is happening within AstraZeneca and their competitors?

**Lisa Kerr:** It absolutely is. We're building AI tools that pull from the right systems and building profiles within the agents that pull from interviews with clinicians and scientific experts — accessing the vast databases of years of rigorous scientific research. Responsible, scientifically led AI is what Evinova is about — both in making drug development faster and improving the service from clinical trial recruitment through to support in our digital trial apps. That's 100% what we're about.

**Adam Walker:** One piece of advice you would give to your younger self?

**Lisa Kerr:** Back yourself, you're more awesome than you think. And — I'm going to do two, because it's me — don't stop singing.

**Adam Walker:** Top three qualities you value most when building a team?

**Lisa Kerr:** Honesty. Diversity — I love working with people who have different experience and understanding to me. And a sense of humour. You spend a lot of time at work, and if it ain't fun, that's a bit rubbish, innit?

**Adam Walker:** Favourite thing outside of work?

**Lisa Kerr:** Singing. I sing in a rock and pop covers band. It is the most enjoyable thing you can legally do in public.

**Adam Walker:** Number one golden rule in life and in business?

**Lisa Kerr:** People are awesome.

**Adam Walker:** Lisa, you've brought so much truth and honesty to this conversation. What's the best way for anyone to get in contact with you?

**Lisa Kerr:** You can find me on LinkedIn — Lisa Kerr. And if you're interested in my singing, the band I'm in is called The Torrists — T-O-R-I-S-T-S. We're on Instagram and Facebook.

**Adam Walker:** Thank you so much, Lisa. It's been a delight to welcome you on Pharma Prescribed today.

**Lisa Kerr:** Thank you so much for having me. It's been so much fun.