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Window on a world of devolved health and social care

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The Five Year Forward View (5YFV) has been dramatically changing the face of the NHS in 2016, particularly at a local level with the planned introduction of Sustainability and Transformation Plans (STPs), which have been the subject of much controversy and debate.

STPs will see NHS health and social care plans combined for the first time and tailored to meet the population needs of 44 individual, geographical areas, or ‘footprints’; This will give rise to the possibility of 44 different versions of the NHS and the prospect of a truly devolved health and social care system.

STPs, which have already begun to publish draft plans in some areas, against Government orders, are designed to help achieve the 5YFV’s vision of better health, patient care and efficiency. They will involve a shift of services away from hospitals to community settings, and a consolidation of hospital units as already seen in London.

They will present many opportunities for pharma to shape the way that services are delivered by working with a variety of different stakeholders, many of whom they may have had limited, or no contact with, in the past, such as local authorities, charities and patient groups. Joint projects with these stakeholders could include new research and existing NHS Digital data analysis, and educational campaigns.

To capitalise on potential opportunities next year, pharma needs to be opportunistic and to keep abreast of local STP plans and board meeting reports from stakeholders, such as CCG Chief Officers, which keep members up to date with local developments.

NHS Vanguards which have been tasked with trialling new ways of running primary and secondary care services in their local area, have also been coming to the fore in 2016. A report by NHiS earlier in the year, entitled ‘The Role of Vanguards in the Development of New NHS Commissioning Structures’, provides fascinating evidence of how NHS vanguards have been redefining patient pathways and trialling new ways of working.

The report showed, for example, how the use of modern technologies, such as smartphones, Skype, decision support and risk stratification software, is key to switching the main focus away from care management towards disease prevention and early diagnosis. However, it should be noted that whilst investment in suitable technologies is clearly needed to improve outcomes, it must be justified in terms of the tangible efficiency or health improvements it will bring, otherwise it will not be commissioned in the current economic climate.

In conclusion, 2016 has been a year of immense change as the Government has pressed ahead with the implementation of its 5YFV vision, particularly in relation to STPs. The foundations are now in place for a devolved health and social care system. This will bring both challenges and opportunities for pharma in 2017, requiring the industry to work with new stakeholders and to communicate and capitalise on the expertise that it can bring to a challenged and fast changing NHS.

Sue Thomas is CEO of the Commissioning Excellence directorate and Paul Midgley is director of NHS insight at Wilmington Healthcare.