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With a stormy outlook predicted for health and care, Wilmington Healthcare’s Oli Hudson looks at the five critical shifts that pharma should focus on as it navigates its way through 2022.

With an NHS at breaking point and new COVID variants threatening to hit reverse on the progress made in our pandemic response, it’s fair to say that 2022 is cloaked in risks, many of them difficult to hedge against.

Yet there are pockets of solid ground upon which pharma companies can build. In particular, the reforms embedded in the Health and Care Bill that is currently making its way before parliament provide a clear direction of travel for the health and care system is concerned.

Barring any parliamentary disasters preventing the bill from going through, this legislation carries with it a high degree of certainty about what’s changing within the NHS while also bringing challenges for industry in terms of adapting to what is already a much-altered commercial landscape.

Here, then, are the five critical shifts taking place within the NHS, which the most successful commercial partners will base their strategies around in 2022.

1. The shift to whole system thinking

One of the most striking effects of current NHS reforms is the dissolution of the provider/commissioner split in favour of a new focus on system-based decision-making.

This will significantly change the context in which your customer contacts make decisions. They will increasingly have an active stake and interest in saving money on behalf of the whole integrated care system (ICS) and will therefore be weighing up a wider range of considerations than before.

Industry can make a significant contribution in terms of its knowledge and analysis of the profile of patients within a pathway – including where there may be pools of undiagnosed patients, where patients are not receiving optimal care or treatment or where there may be information gaps either for staff or patients.

The key, however, will be in translating this intelligence into actionable insights that can help inform strategic decisions, at a system level, about the future of services and care pathways. Solutions like Quantis are all about deriving hard insight from real-time data, and can help you meet this strategic need within the NHS customer base.

2. The shift from competition to collaboration

Accompanying the demise of the commissioner/provider split is an equivalent shift away from competition in favour of collaboration. NHS customers will be increasingly networked and incentivised to act collectively.

This will involve a significant rethink in the way industry approaches its brand planning and engagement activity. The emphasis will shift from engaging with decision-making units (DMUs) and key opinion leaders (KOLs) in individual trusts to working with clinical networks across a system or multiple systems.

The deeper significance lies in how pharma companies approach this new landscape of collective decision-making. It will no longer be enough to focus energies on a select group of favourable KOLs: you may need to engage a broader range of clinical decision-makers within a network to ensure your product or offer wins approval.

As such, drawing on a strong Strategic Account Management solution is important to help generate a broader and more multi-dimensional engagement approach than might have been considered previously. There is a particular need to enrich and continuously update your CRM with data-driven insights from your customer base, arming all external-facing parts of your business with an intelligent, 360-degree view of your customer.

3. The shift to neighbourhood and place-based planning

With the advent of provider collaboratives and primary care networks working within ICSs, we are seeing the gradual dissolution of the boundaries between primary and secondary care in favour of more integrated planning processes at neighbourhood and place-based levels.

The critical challenge for industry is how to reorganise field teams accordingly. Internal organisational structures based around outdated teams or territories and built around ‘hospital specialisms’ will no longer work. There is an urgent need to train and organise cohorts of pharma staff to manage engagement at system, place and neighbourhood levels.

A related issue involves the new structure and composition of formularies. Pharma will have to negotiate a more layered and complex environment for market access, sometimes with APC-ICS formularies at system level and ICP formularies making decisions at place/neighbourhood level.

It’s vital that brand planning and go-to-market strategies are aligned to these new realities. Commercial optimisation support can help organisations deal with the effects of these changes on issues like CRM, how customers are grouped or segmented, what kind of targets should be expected at each of these three levels and how different elements of the salesforce should be configured accordingly.

The shift from disease management to population health

Amanda Pritchard, the new Chief Executive of NHS England, has been clear that the central mission of integrated care systems should be to improve population health, with a key focus on prevention and early intervention within communities.

The corollary of this is that we should start to see the NHS moving in a serious way beyond just thinking in terms of disease management and instead focusing much more on population health.

At system-level in particular, the NHS will increasingly be looking at how to support whole populations with certain health needs, particularly by improving diagnosis and intervening earlier to prevent demand on specialist services.

It is therefore vital that pharmaceutical companies move ‘beyond the pill’ and cultivate new ways of supporting the NHS at a population-wide level.

Aligned to this is the challenge of working with systems to monitor variation in pathways and supporting value propositions that can demonstrate clear economic value by unlocking cost-savings. Our consultancy services can help you build this into your brand and business planning.

5. The shift from face-to-face to digital

Finally, industry faces the considerable challenge of adapting to the rapid shift in the mode of engagement with NHS customers, from face-to-face to digital.

None of us yet know whether the changes in working practices are likely to be sustained, but it’s clear that as operational stresses increase pharma must make sure every touchpoint with health professionals is supportive, relevant and aligned to their priorities, relationships and organisational realities.

Now, more than ever, it is important for pharma to enhance its digital engagement capabilities and adopt a ‘digital first’ mindset in terms of how it builds and sustains relationships with its customers. As with the other shifts, this reflects the overarching need to embrace and support the new working realities within the NHS.


At the Conservative party conference in autumn, the Health Secretary Sajid Javid pledged to make this “a year of recovery and reform” across the health and care system. With the NHS facing up to some truly daunting operational challenges, it remains to be seen how much of a recovery we see over the coming months.

What is inescapable, however, is the reality of a reform process fast reaching its culminating point. Understanding the contours of these changes – and embracing these five critical shifts – is the single most important thing you can do to get ready for 2022.

To find out more about how Wilmington Healthcare can support your organisation, visit

6th January 2022



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