Helping Patients Lead the Way in the New NHS

NHS England is currently undergoing profound changes to introduce a new culture where clinicians and patients are the new stars, where competition is mandatory, where everything rests on patient outcomes and where collaboration and innovation are being encouraged at the highest levels of command. The result is an extraordinary opening up of the health service to pharma companies for not just their money but also their commercial and leadership expertise.

But while pharma companies are being feted by the architects of NHS England, skepticism remains prevalent on the ground and local credibility is all-important, according to a new report from FirstWord. Caroline Dawe, managing director for the Northern Locality of Northern, Eastern and Western (NEW) Devon Clinical Commissioning Group (CCG) stresses the need for patience as these new bodies establish their priorities and find ways of working with industry where everyone wins.

One way may be to help get patients involved, a stated priority at all levels. The patient-centric NHS England has granted its customers a Charter of Patient Rights for the first time and is inviting them to make a contribution not only on the CCGs but also via two new forums where they are being encouraged to be involved in decision-making: HealthWatch and the Health and Wellbeing Boards.

The trouble is patients aren’t exactly scrambling to get on board. “CCGs across the country are really battling with how to build patient involvement through the locality structure,” says Dawe. “It’s difficult because it hasn’t been done consistently well before. How do you get something that starts from the bottom up to the top? How do you incentivise people to want to be able to do it? There’s no set formula and each area is different in terms of either its geography or the way that it’s constructed.”

Everyone is looking for innovative ways of working but, as the report stresses, that can only come from focussing on building trust and on knowing in some detail the local lie of the land, the people who make the decisions, the structures within which they must work and their capacity for innovation and collaboration.  Key account managers must move fast once access to their products is assured and not work in isolation. Collaborative long-term relationships need to be formed, not just by individuals who can leave a company, but by the company as a whole and via a cross-functional team approach. Key account managers need support to identify solutions that will help local health economies realise their objectives and the autonomy to see them through. They also need to learn the language of the new organisations as the CCGs are very different culturally from their predecessors, the Primary Care Trusts.

Some companies, such as Pfizer and Janssen, are focussing heavily on creating generic tested solutions that can be applied across therapeutic areas in keeping with nationally developed outcomes strategies. They have found there is not only a significant first-mover advantage to be gained from building local credibility but also there is a lot of opportunity for industry. Service redesigns, for example, rarely involve rocket science, says Jo Wales at Pfizer Health Solutions (PHS). “Mostly people know what the difficulties are and will have ideas of how to solve them,” she says. “But they just don’t have the time to make it happen. What we bring is the understanding that patients are very receptive to talking to somebody in a way that doesn’t involve their attendance at a formal clinic with a consultant. Patient follow up can be achieved in different ways. What we’re doing is using our experience from our telephone-based work to challenge people’s thinking on how they design and deliver services.”

Marco Mohwinckel, head of Janssen Healthcare Innovation, Europe, agrees there is lot pharma companies have to offer if they approach local NHS organizations in the right way. “We’re sitting on a wealth of information and experience that can be repurposed to support patient outcomes and service redesign,” he says. “There is a lot of inefficiency, fragmentation and inconsistency in the way healthcare is being delivered today and we want to bring that knowledge and expertise to bear in different ways.”

These are exciting times for pharma key account management teams. The conditions for pharma penetrating the clinical and management infrastructure of NHS England could hardly be more perfect.  According to a recent study by Primary Care Commissioning (PCC), more than a third of CCGs report they are either extremely or very concerned about balancing the books, When the moderately worried are added, the figure rises to 80 percent. But pharma companies must act fast to change the habits of a lifetime and focus not only on product sales but on what their payers want, which is a more efficient patient-centric service focused on improving health outcomes.

Jacky Law is Managing Editor at FirstWord.