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How can pharma support NHS service transformation?

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Wilmington Healthcare’s recent webinar explored how pharma can assist the NHS in delivering integrated care

To help pharma companies keep abreast of the unprecedented scale and pace of change within the NHS and identify how they can provide support, Wilmington Healthcare recently hosted a free webinar.

The guest speaker at the event entitled “How can pharma support NHS service transformation?” was David Thorne, Managing Director at Blue River Consulting, who discussed the issues alongside Steve How, Business Development Director at Wilmington Healthcare.

The webinar was chaired by Oli Hudson, Content Director, at Wilmington Healthcare, who kicked off the proceedings by asking the speakers about the scale of NHS transformation and the extent to which pharma should be engaged with it.

Steve commented: “I often say this is the biggest change since 1948. The pressure is really, really on. The change is occurring at a scale and pace that I don’t think many people can keep up with.”

David agreed, adding: “The difficulty is that so much of the change is happening within small groups of people in the NHS. It is really difficult for people in pharma to access the information and define what their possible contribution could be.”

One key challenge is that Sustainability and Transformation Partnerships (STPs), Integrated Care Systems (ICSs) and Integrated Care Partnerships (ICPs) are all non-legislated bodies. This means they do not have to publish board papers making it difficult for the public to follow their progress.

However, it was stated in the webinar that key performance indicators (KPIs) for these non-legislated bodies may be published and embedded in Clinical Commissioning Group (CCG) board papers and in NHS Trust papers that are publicly available.

The speakers discussed how NHS bodies are uniting into integrated care systems that can deliver services under a single contract. This style of working is being mirrored in other healthcare systems across the world.

Steve commented: “The accountable care organisation style structure, which serves a population of 30-50,000, is happening across the globe. It’s being modelled in America, Spain and other European countries.
“It seems to be the way all health systems are going. Therefore, whatever governments are in play; whatever happens with Brexit, this trend will continue. I think that is a really important point.”

The speakers agreed that putting patients’ needs at the heart of NHS service delivery and then designing care pathways around them were key objectives for integrated care systems. They also said that this holistic approach and the speed at which change is occurring could bring opportunities for pharma.

David said: “There is an opportunity for pharma to express its value proposition across a coherent pathway, so this should be a great time for industry. I bet there are key account mangers out there who have been working on diabetes, for example, and who, for the last 10 years, or even the length of their career, have been frustrated when trying to show how their product can make a saving in a particular area because someone will say it’s not relevant to them because, for example, they only control the primary care drug budget rather than the whole pathway budget.”

Steve said: “The scale and pace of change that is going on out there is so fast, that most clinicians do not know what is happening around the services that they are actually involved with. Pharma can really support this engagement, understand what is happening around the services and then communicate that back to the whole clinical team.”
Since integrated care systems are seeing people from a wide variety of backgrounds, including Social Services and housing, getting involved in decision-making for the NHS, the speakers agreed that pharma must tailor its approach to these new and often non-clinical stakeholders.

David said: “It could be a real problem for pharma if, in a typical Clinical Commissioning Group (CCG), a key stakeholder doesn’t really understand the clinical aspects of different drugs. Pharma really needs to confront that problem and create some kind of programme of awareness.”

Pharma must also prove to all stakeholders that its products can add value across the whole care pathway. Some examples of the way this could be achieved were outlined by Steve, who said: “Pharma needs to be thinking, does my product actually reduce failure rates or reduce emergency admissions? These are issues that are really important within the contracts. Does it reduce handoffs? Does it reduce the amount of staff necessary for other aspects of care within the pathway?

“Aligned with this integrated approach, the NHS used to focus on one-year budgetary cycles but, now with these longer-term contracts, there is the opportunity to think about cost savings over, ideally five years, but realistically three years.”

David said: “If you were creating a new diabetes pathway across an ICP, reducing say foot amputations would clearly be a massive outcome. But people need to understand what the value of your product is in achieving that long-term objective and you might be dealing with people who don’t actually understand that, so you really need to think about how you engage with those audiences.”

The speakers talked about ICSs and specialised commissioning. It was stated that some aspects of specialised commissioning were likely to move over to ICSs when they were covering a population of around 3m.
Looking to the future, Steve said: “I think we are going in the direction of bigger ICSs and more ICPs. Personally, I also think CCGs may disappear in two years. I think you will see hubs of care, that will be very localised and placed based operating under ICPs, perhaps looking like Primary Care Groups (PCGs) used to but bringing all the services together.”

Dave said: “I agree with Steve and I also think we are going to see fewer hospitals but much bigger hospitals which will be very interesting. Saving workforce time will be key and pharma needs to factor this into its outcomes-focussed propositions. This could involve, for example, using drugs delivered via subcutaneous injection in a community setting rather than infusion in a hospital.”

Watch the full webinar discussing how pharma can support NHS transformation.