How to engage with the new NHS
In the run up to Engage with the new NHS in September, eyeforpharma asked some of our key speakers for their insights on the proposed reforms to the English National Health Service. Here's what they had to say...
By on Jul 4, 2011Is it possible to have a win-win-win for pharma, the NHS, and the patient?
Christine O'Connor, chief executive, Catch On Group: Yes, it is possible to achieve the win-win-win but clearly this depends on the evidence base for the product, its usability for the patient, and the potential benefits realization for the NHS. So, basically, does the product do what it says on the tin and is it as cost neutral or less than others that are almost the same? Will the patient find it easy to comply with the product and will it encourage self-management? Will the product have a good enough profile to be recognized as an alternative intervention that could prevent or reduce the need for hospital out patients or because of the support package help the patient feels sufficiently confident in the support structure to avoid A&E? In other words, does it deliver to the QIPP agenda in terms of quality, innovation, prevention, and productivity?
Allan Mackintosh, PMAP Coach, Grunenthal: If pharma and the NHS work together to offer more effective medicines and services then the patient must win in all of this, provided the services are implemented effectively with patients groups potentially involved as well.
Julian Given, director, Clarity Healthcare Consulting: It is. The paramount consideration for the NHS and commissioners is financial balance and QIPP delivery. Authorization testing only reinforces this paradigm. With this in mind, any partnership working or offerings pharma can make that align with a clinical commissioning group plan for reductions in referrals or avoidable non-elective admissions will make real contributions to the balance of budgets (good for the NHS), will allow for care closer to home rather than having to go to the hospital and inconvenience of out patient appointments, car parking, etc (good for the patient), preventative care through the change of care, case finding or treatments using different drugs could reduce non-electives so providing less disruption and a better quality of life to our responsible patients (good for patients again). And if there is a change of drugs, true partnership working, this would be good for pharma in terms of both sales and market access.
Michael Holden, chief executive, National Pharmacy Association: Yes, improved adherence should deliver a win for all parties-better health outcomes/Quality of Life for patients; improved VFM for NHS (improved outcomes, reduced waste, reduced hospital admissions, etc); improved outcomes and persistence for pharma.
Mark Wilkinson, director, Life Sciences Innovation, NHS Trust: Yes, but not on every subject! So, topic selection is crucial, particularly as collaboration can feel risky and time-consuming.
Helena Bargiel, Corporate Manager SFE, Leo Pharma: Yes, I do believe it is possible. It is important, though, to follow the legal aspects, especially regarding contact with patients.
Richard Lomas, national commissioning specialist, Genzyme Therapeutics: Yes, a win-win-win is possible but requires some faith and perseverance from all the stakeholders and a will to keep focus on the patient.
What are the first steps a pharma company should take to partner with the NHS?
O'Connor: First steps should include understanding who your customer is. Are you seeing the right person with the right message? Understand the real influencers in the system and the decision makers, especially in this changing world. Understand local strategies and drivers. Position to need. Build trust and credibility.
Mackintosh: Sit down and talk! What are the needs and challenges of both the NHS and pharma? Where can one assist the other? Have joint goals that are centered on patient care.
Given: Seek first to understand. Rather than approaching a potential NHS partner with a pre-prepared offering, understand what the priorities are of the NHS/commissioners/payers and then respond to those priorities so that there is mutual benefit for both parties if goals are achieved. Preparation and understanding of the customer are key.
Holden: Work with and through other stakeholders who already have relationships, utilizing them as a gateway; e.g., local pharmaceutical committees.
Wilkinson: Collaboration is a contact sport. Get in contact, start a conversation.
Bargiel: Customer insight, meaning: Understand their environment, daily challenges, tasks, and needs.
Lomas: Building trust and respect.
Do you use the term ‘value-based selling'? What does it mean for your company?
O'Connor: Value-based selling in terms of QIPP and the commissioning agenda is all about pharmaceutical efficiency and how the product as an intervention adds value to the delivery of the strategy and the patient experience. Are you selling a product or are you selling an alternative intervention with an implementation and support package to ensure it is embedded in the system?
Mackintosh: We are starting to use it and the term 'value proposition'. We still have to fully define what it means for us and our customers as, although we have various 'service' offerings, they tend to come from various functions independently and as yet are not co-ordinated into one 'package'.
Given: As an NHS commissioner, we haven't come across the term VBS as an organization. However, I personally do have knowledge of it and it is an approach that we would very much embrace from prospective and current partners.
Holden: Outcomes are the only agenda, so value for money is critical. This is not the same as lowest cost, as costs should be viewed in the whole, which will include drug, administration, accessibility, etc.
Bargiel: Yes, we do use that terminology. Sorry to say, but so for it has not meant more than the field force has started to use a new sales technique. What we have done and are doing now is to have a customer insight and understanding-based starting point when we initiate new projects/framework/guidelines.
Lomas: We sometimes use the term 'value-based selling' but not routinely.
How do you think the reforms will affect your company and the pharma industry as a whole?
O'Connor: The reforms, I believe, should force the industry to rethink the way in which it interfaces with the customer. This will mean having an in-depth knowledge of the implications of the reforms in real time not just from a theoretical base. We can all say what the reforms are but what does this mean in reality for a general representative or for a hospital specialist? There will be a skill in working a defined health economy to give the win-win-win. This is what the industry has to get to grips with.
Mackintosh: Depends what you mean by 'reforms', as these vary depending on which part of the UK you come from. Overall, because the NHS is quite diverse in its approach across the UK, pharma has to be very flexible in how it structures itself across the UK. Structures will have to be tailored to meet needs locally, and this will result in regular changes to both structures and roles as we constantly adapt. Roles will also have to become more flexible as a Key Account Management approach is adopted. If people aren't flexible in accepting (and driving) change to their roles and responsibilities, then they will struggle in the new pharma environment. Senior management in pharma will also have to accept this change and will have to empower local managers to make the decisions that are right for the business at a local level. The one size fits all model is now not appropriate for the vast majority of pharma companies. (For more on Key Account Management, see Getting to grips with KAM, How to make KAM work for the pharma sales force, What pharma can learn from the use of KAM in other industries and Pharma sales: Clearing up KAM confusion.)
Given: Once again, as an NHS commissioner in the primary care sector, the reforms fundamentally affect us for obvious reasons. I believe the majority of players in the pharma industry will be affected as GPs see the world of medicine/drugs differently than PCT commissioning managers. They understand the impact of the medicines they prescribe and how this affects the patient and their health. Therefore, this could potentially change the activity that we have traditionally seen for healthcare interventions and their delivery location setting; i.e., in the community rather than in the secondary care environment.
Holden: The challenge will be the increased number of stakeholders who will need to be engaged with (NHSCB, PHE, CCGs, HWBs, etc), which will require new skill sets and increased resources. Pharma will need to step up against the QIPP agenda and support a supply+ approach. There is an opportunity for facilitating business/management skills development.
Bargiel: There is a need for a different kind of approach toward our customers, more based on partnership. New roles will be needed with much broader skills and competences.
Lomas: Reforms will increase the level of local diversity, which will necessitate very professional field-based teams with much wider skill sets than in previous years.
For more on the NHS reform process, join the sector's other key players at Engage with the new NHS on September 27-28 in London.
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