Please login to the form below

How can pharma engage with key stakeholders on NHS service transformation?

Steve How, Paul Midgley and Oli Hudson, of the Wilmington Healthcare consulting team, explain how pharma should make its case for change

Introduction

There is a real drive for change within the NHS to ensure its sustainability in the long-term. However, discussions and decisions about transformational change mostly take place within the highest echelons of local NHS organisations.  

When transformation teams do engage with staff from other parts of the service, it will generally be with small groups of clinical leaders; hence many ‘jobbing’ clinicians are left in the dark about change until it occurs.

However, NHS England’s ‘Planning, assuring and delivering service change for patients’, which provides a good practice guide for commissioners on the NHS England assurance process for major service changes and reconfiguration, states that clinical engagement and approval, and strong clinical evidence are key.
 

 Assurance for NHS management within this paper means: is there documented evidence that the transformation process has looked at clinical best practice and engaged relevant clinical stakeholders? If not, the clinicians have a route to challenge the proposed changes.  

Elements of the guide can be applied to lower levels of change, such as the introduction of new drugs to improve care pathways. This provides a powerful opportunity for pharma to activate clinicians to take a lead in service change and engage with other key stakeholders. It can also help pharma ensure that it fully understands the tests and assurance checks that should be applied to new drugs and services.     

Getting the message across to clinicians
   

Pharma should keep clinicians abreast of transformational change that is happening in relevant disease areas and make sure its customers are consulted on it. By ensuring proposals are in line with the NHS England guidance and gathering as much clinical, and ideally real world, evidence as possible about the benefits of a new drug or service within the whole pathway, pharma can then demonstrate how it could add value to the transformation process.    

Clinicians are very disease orientated, so for them the direct impact of a drug on patients, such as its ability to reduce side effects, is the overriding priority. However, commissioners are service focussed and such benefits are unlikely to be sufficient to convince commissioners to invest in a product since they are under pressure to deliver on much wider priorities, such as reducing the burden on A&E and on hospitals generally.  

Pharma can help this discussion by supporting clinicians in reframing clinical benefits to highlight wider service benefits within the whole patient pathway, even outside a specific disease area. For, example, they could show the current cost and workforce implications of patients who do not tolerate current treatments and potentially need appointments and reviews, versus the cost of new treatments with better efficacy or side effect profiles.  

NHS RightCare provides examples of this with its long-term condition scenarios, such as ‘Susan’s Story: Osteoporosis’, where costs are shown to be reduced by a factor of 10 if Susan is treated within an optimal care pathway. https://www.england.nhs.uk/rightcare/products/ltc/    

Engaging with other key stakeholders


Having the right evidence base and framing the right messages in the right way to the right clinicians is a key step. However, pharma also needs to engage with other key stakeholders involved in transformational change and ensure that its value proposition is tailored according to local budgets and priorities as well as national ones.  

This should involve developing messaging for the most senior NHS executives who are potentially focussing on four to five priorities, such as reducing pressure on A&E, the frail and elderly, or chaotic families. Industry should also refine its proposition for transformation leads, medicines management staff and other key opinion leaders (KOLs), who may have different drivers and priorities.  

It should also be noted that in the 14 areas, which are early movers from STP to ICS/ICPPs (Integrated Care Provider Partnerships), former low-mid ranking CCG commissioners and project managers are transferring across to these new care models. They are taking up roles such as service improvement manager within the ICPPs; hence they are prime pharma targets as they are now working very closely with clinical teams.  

Facilitating engagement between key stakeholders
 

There is also a role for pharma to play in assisting transformation leads within the Integrated Care System, or STP, to engage more widely within the NHS, particularly clinicians, when planning and implementing service change.

Networking between transformation leads, commissioners, service development managers, clinicians and patient representatives is vital and, if it is done well, it speeds up conversations, enables shortcuts, and helps change to happen faster and be shared more widely.

This is a key area where pharma can step in and get its customers, e.g. consultants and GPs, together to help them understand NHS transformation. Pharma could also offer to help transformation leads bring relevant stakeholders, such as clinicians and multi-service providers, together to better understand change and manage pathways.  

Conclusion
 

There is an opportunity for pharma to activate clinicians within service change by making them aware of what is happening in their area and ensuring they understand the benefits of a new drug or service from both their own and a wider commissioning/transformation perspective.  

Pharma can also take a lead in facilitating discussions between clinicians, transformation leads, medicines management staff and other key stakeholders/opinion leaders to help them better understand each other’s needs and priorities, and to ensure that proposals really will deliver the greatest possible value to the NHS.

Steve How, Paul Midgley and Oli Hudson are all part of Wilmington Healthcare’s consulting team. For information on Wilmington Healthcare, log on to
www.wilmingtonhealthcare.com

17th August 2018

Share

Company Details

Wilmington Healthcare

01268 495600

Contact Website

Address:
Beechwood House
2-3 Commercial Way
Christy Close
Southfields
Basildon
SS15 6EF
United Kingdom

Latest content on this profile

UNDERSTANDING THE ROLE OF PLACE WITHIN THE NEW NHS: FIVE THINGS INDUSTRY NEEDS TO KNOW
Operating a level below system, “place” is an increasingly important unit of NHS organisation, yet it remains an evolving concept that is not always well-understood among industry practitioners. In this latest quick-read briefing, Oli Hudson, Content Director at Wilmington Healthcare, lifts the veil on what place is, how it works and why it matters.
Wilmington Healthcare
MISSION CRITICAL: HOW PHARMA CAN HELP THE NHS IMPROVE CARE FOR OLDER PEOPLE
With around two-thirds of all hospital beds occupied by over-65s, the care of older patients has long been recognised as key to the sustainability of the NHS. So how is it responding to this challenge, and what can industry do to support it? Oli Hudson, Content Director at Wilmington Healthcare, explains what’s changing and how industry should respond.
Wilmington Healthcare
ALL CHANGE FOR SPECIALISED COMMISSIONING: FOUR THINGS INDUSTRY NEEDS TO KNOW ABOUT THE LATEST REFORMS
With a recent NHSEI policy document confirming that a major shake-up of arrangements for Specialised Commissioning is imminent, Oli Hudson, Content Director at Wilmington Healthcare (wilmingtonhealthcare.com), describes the key changes and why they matter for pharma and med-tech companies.
Wilmington Healthcare
HOW DID COVID-19 AFFECT PRESCRIBING BEHAVIOURS? FIVE KEY FINDINGS FROM A NEW STATE OF THE NATION REVIEW
Published earlier this month, Wilmington Healthcare’s new State of the Nation report draws on a raft of data from across primary and secondary care to show what actually happened to the NHS and its prescribing behaviours during the peak of the pandemic.  Oli Hudson summarises five of the key findings:
Wilmington Healthcare
ALL SYSTEMS GO: UNDERSTANDING WHO’S WHO IN THE NEW NHS LANDSCAPE
With the Health and Care Act safely passed, Oli Hudson introduces six key stakeholders that will loom large in the new landscape.
Wilmington Healthcare
Spending on anti-depressants soars as the pandemic’s effect on NHS prescribing patterns is revealed

Wilmington Healthcare