The NHS in 2022: how pharma can contribute to new models of care

James Roach, Director, Accountable Care Partnership, West Essex Health and Care System is one of the frontline NHS leaders given the huge task of transforming fragmented local health and social care services into integrated systems.

This momentous shift in thinking is necessary to create a sustainable system based around patient needs - but this reconfiguration must be achieved while the service struggles with ever-growing demand and restricted budgets.

James will be sharing a platform with other NHS and pharma industry leaders at the PME and IQVIA event on new models of care in London on 30 October.

Here he talks to PME about the potential of the new models of care – and how the pharma industry can help the NHS in this ambitious undertaking.

In its 70^th year, the NHS is a cherished national institution, but clearly under a lot pressure. From your perspective, what are the biggest pressure points?

The one that springs to mind immediately is workforce – this is a very big challenge for the NHS. There are thousands of vacant posts in key roles such as GPs, therapists, community nurses and domiciliary care, so much so that we have to question how we can resource the laudable ambition of Integrated Care Partnerships and new models of care.

The other burning issues here are retention, capacity and capability – we need to ensure we are maximising the skills and experience of the workforce we have. We can do this through integration of teams at the point of need and by giving them capacity, flexibility and autonomy to act.

New models of care, such as Integrated Care Systems are seen as central to making the NHS sustainable over the coming decades. Can this be achieved, and what are the vital factors to making this happen?

Yes, they absolutely can be achieved, and there are many good examples of this happening on the ground. These are key factors to ensuring success as I see them:

• Trust – the traditional purchaser /provider split has impacted on relationships, there is a need for a more open, transparent dialogue
• Developing new contractual models and financial currencies – Payment by results (PBR) generates perverse incentives and systems should be mandated to develop capitated joint budgets with a focus on achieving outcomes rather than focusing solely on outputs
• Aligning clinical ambition through whole system pathways and models of care.
• Commitment to a population health model

How do you see pharmaceutical companies contributing to this focus on new models of care?

Given the challenges in the landscape, and the changing tone at NHS England and the Department of Health and Social Care (DHSC), the industry has a new opportunity to position itself as the catalyst for change.

Having a comprehensive offer can add value to systems in many different ways. That would probably include providing specialist expertise in a disease area, and articulating the true cost and impact of a disease and treatment through real world evidence (RWE). Other areas would include:

• Maximising the outcomes from new therapies and technologies
• Pump-priming innovation and new service development
• Training, education and communications
• Applying industry rigour and commercial acumen to inefficient high cost service models

What sort of fundamental shifts does the industry, on its side, and correspondingly the NHS on its side, have to make to accommodate greater joint working?

The industry should fully commit to joint working arrangements in real terms with equal risk and gain share on both sides. We need to foster a business-to-business type relationship, and set a clear direction of travel over the next 5-10 years - and one that isn’t inhibited by governance.

I believe significant opportunity will be generated if both sides can come together in a common purpose of prevention, reducing health inequalities and in optimising therapies.

REGISTER NOW FOR OUR LIVE EVENT:

New Models of NHS care – New Models of Pharma Response? Tuesday 30 October 2018