From supplier to partner – how industry can work better with the new-look NHS

A move towards integrated care systems (ICS), complete with new primary care roles, and a greater focus on public health is shaking the healthcare system to its core. But what does this mean for industry?

The NHS is going through its biggest change since the 1990s – and offering pharma a golden opportunity to shift from “supplier to partner”.

That was the message at Driving Forward Access in the New NHS Environment, a seminar organised by Mtech Access and held at the Royal College of Physicians last week.

David Thorne, director of NHS Insights and Interaction at the health economics consultancy, said the NHS-wide move away from payment by results presented industry with fresh challenges and opportunities.

“The only changes that have even come close to those that we are seeing today are the ones I saw in 1990/91, when the internal market was created. Much of what we are seeing today is the reversal of that 30 years of policy,” said David, a former nurse who is also chair of Washington Community Health Care and non-executive director at the City and Vale GP Alliance (York).

The changes, outlined in what he described as the “aspirational” NHS Long Term Plan, fundamentally restructure the health and care service to focus on system working.

They seek to build an integrated “one team NHS local family” and while industry has a role to play in this, many are unsure as to how to proceed, David said.

He said: “What is happening is not unprecedented, but the way it is happening is highly challenging because it is characterised by an absent road map and highly varied local implementation.”

Integrated care

At the top of the newly proposed architecture sit ICSs, which bring stakeholders including healthcare trusts, local authorities and the third sector together to focus on public health across their “patch”.

Hospitals, the new vision sets out, are then consolidated into larger groups, possibly through integrated care partnerships (ICPs), and GP practices are in the process of forming Primary Care Networks (PCNs), each responsible for between 30,000 and 50,000 patients.

The idea is that a more holistic, proactive approach will keep people out of hospital while overcoming the threats posed by funding and workforce shortages

This fundamental shift brings with it a new lexicon, new roles, new decision-making processes and new attitudes to medicines that NHS partners and industry players need to adapt to, David explained.

Local priorities mean national variation

Mike Proctor, recently retired chief executive of York Teaching Hospital NHS Foundation Trust, said industry could become a crucial part of this new world – but routes to success vary across the country.

He advised delegates to adopt a flexible, regional approach, be prepared to move from national to local priorities, and to build relationships with the new decision makers.

“There is a dream of a truly integrated social care, primary care, secondary care and mental health care. We do believe this is the right thing to do but the bottom line is there is no one size to fit all,” he said, adding that the only unifying factor was reducing hospital admissions.

“Don’t sell boxes, sell solutions. Develop products that keep people out of hospital – that is key. If you can find ways to keep people out of hospital and you can support that in some way, the door is open,” said Mike.

Sharing data skills

Hilary Snowden, management lead at the West Northumberland PCN, explained that some networks were still in development, while others were firmly established.

That means pharma needs to understand the landscape, decision-makers and decision-making processes at each local level. By doing so, delegates would be able to creatively re-think their offer in a way that could help each area meet its individual challenges, she said.

One possible opportunity for joint working, particularly in the developing PCNs, revolves around data analytics.

“We are drowning in data, really rich data that could improve the health of our patient populations, but we don’t know what to do with it. You guys are really good at turning data into insights and information. We need those skills,” said Hilary.

Adding value

As networks adapt to an integrated way of working, they are also in need of organisational and leadership development – both areas in which industry could offer to share its expertise, she added.

James Roach, Director, West Essex Integrated Care Partnership and Managing Director of Conclusio Limited, said that now more than ever, the NHS needed to have a strong relationship with industry.

“Given the challenges in the landscape and the changing tone at NHS England and the Department of Health and Social Care, the industry has a new opportunity to position itself as the catalyst for change,” he said

Medicines optimisation, a crucial part of the Long-Term Plan, is another area that pharma was perfectly placed to partner on, said James, before listing a number of ways in which industry could “add value”.

These included providing disease area specialist expertise, training, education and communications and helping healthcare systems to maximise the outcomes from therapies and technologies.

Articulating the true cost and impact of interventions though real-world evidence, and pump priming innovation and new service developments would also be useful, but initiatives needed to be built to suit local priorities, he said.