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How will the Tories’ historic win shape the NHS?

Paul Midgley and Oli Hudson, of Wilmington Healthcare, explore the impact of December’s General Election result on 2020 and beyond

Introduction

Additional NHS funding and staff, and new hospitals, were key commitments in the Tory manifesto, which also pledged to legislate to support the implementation of the NHS Long-term Plan.

The importance of the NHS was later reinforced by Prime Minster Boris Johnson, following his General Election win, when he promised that it would be “his top priority in government.”

Integrated care

The Tories’ win has provided assurance that there will be 100 percent Integrated Care System (ICS) coverage across England by April 2021, as promised in the Long-term Plan. We also expect to see Clinical Commissioning Group (CCG) mergers continue apace.

Integrated Care Providers and Partnerships (ICPs) have been springing up across the country to aid collaborative working, and we expect the ICP standard contract launched in 2019 by NHS England to be widely used between CCGs and ICPs in 2020. Primary Care Networks (PCNs) will also play a key role.

Funding

Base funding for the NHS will increase by 29 per cent - £650 million extra a week - by the end of the Parliament. But is this enough to get the NHS out of trouble? Bodies such as the Nuffield Trust think it might be – and speak positively about the Tory spend in relation to the other parties. However, it is less clear how social care will be paid for and this will have a huge impact on demand.

The manifesto suggests that there will be investment in prevention.  However, it is difficult to determine if it will be enough to effect real change, especially since no figure has been put on it. We wait to see if it will mean a growth in CCG and ICS budgets.

Brexit

If Brexit does hit the supply chain, UK pharma companies with branded drugs could leverage an advantage over companies selling generics sourced from abroad. This is because UK branded drugs manufacturers tend to have greater warehousing capacity in the UK, so they are not as reliant on ‘just in time’ delivery and getting stock through ports to wholesalers.

The greater availability and stable cost of these branded drugs could increase their attractiveness for two reasons. Firstly, if generic drugs shortages occur, this may drive up tariff prices for these products and secondly the NHS might come under pressure to maintain continuity of care for certain critical medical conditions where it  is not possible to get generic medicines through border controls quickly enough to meet demand.

Workforce

The plan to recruit thousands more nurses, in addition to the 6,000 extra GPs also promised by the Tories, relies heavily on recruiting talent from abroad. However, this is likely to be problematic in light of Brexit. Boris Johnson has promised a new “NHS visa” to make it easier for doctors and nurses from around the world to work in the UK.  However, at the moment, it is an unknown quantity.

Buildings

The Tory manifesto says that 40 new hospitals will be built over the next 10 years – a promise that seems, at first glance, to be at odds with the Long-term Plan’s ambition to take more care out of hospitals.

However, given funding constraints and Long-term Plan ambitions, it is likely that building work will involve reconfiguring existing sites to make them more efficient and cost-effective, rather than constructing new hospitals from scratch.

Digital

Digital technology is central to the NHS Long-term Plan. In light of workforce challenges, the ability for healthcare professionals to provide online consultations, diagnose many ailments digitally and monitor conditions remotely, has huge potential for the NHS.  For example, with long term conditions such as asthma and diabetes, remote monitoring enables better self-management, which in turn, should lead to fewer hospital admissions, less face-to-face contact with GPs and practice nurses and better patient outcomes.

Market Access

As online consultations make it easier for HCPs to work remotely, arranging face-to-face visits in the surgery could become increasingly challenging for sales representatives.

Digital communication and education around disease areas will, therefore, become ever more important. However, as HCPs work in multidisciplinary teams across integrated care organisations, communications campaigns should not simply be targeted at single HCP groups.

All health economies must produce ‘place based’ plans for their localities in response to the Long-term Plan. These plans may impact on which drugs are used and how care pathways evolve and integrate. It will, therefore, be essential for pharma to take a locality by locality approach.

Conclusion

While questions remain unanswered on many key issues, particularly around Brexit and the NHS workforce, the Tories’ decisive General Election win has delivered certainty on key NHS Long-term Plan ambitions.

There is much that pharma can do to support the NHS in 2020 and beyond, provided it seeks to understand the needs and challenges of individual health economies, and thinks more broadly about how it can help the NHS to deliver whole system benefits within the integrated care environment.

Ends

Paul Midgley is Director of NHS Insight and Oli Hudson is Content Director, both at Wilmington Healthcare. For information on Wilmington Healthcare and to find out more about the latest developments in the NHS, visit www.wilmingtonhealthcare.com

19th February 2020

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