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NHS Whispers 2021 Insights Advent Calendar

NHS Whispers Advent Calendar - 2021: 24 insights, comments, and reflections on the NHS and the UK market access environment

In the lead up to Christmas 2021, our UK market access team shared a daily insight, reflection, or comment on the NHS and the UK market access environment on our NHS Whispers LinkedIn page. This insights advent calendar followed the success of our 2020 calendar.

Below we bring together all 24 of these insights.

Congratulations to an ICS leader

Congratulations to Claire Fuller on being named Chief Executive Designate of the integrated care board in Surrey Heartlands ICS.

Claire spoke at our webinar in August 2020: ‘Integrated Care Systems: Separating fact from myth – insights from a system leader’.

Insights from Strategy Huddles

In our Strategy Huddles, we bring together clinical, operational and strategic leaders to share their insights with our Pharma and Medtech clients. These three statements are direct quotes from different NHS associates who participated in strategy huddles in 2021. They are, sadly, reflective of the challenges faced across the NHS in 2021:

“There are 14 ambulances on the ramp of our A&E unit as I speak”

“Yesterday, for the first time ever we exceeded 1,000 attendances at A&E in one day”

“Awful day. Several urgent cancer referrals for people who just should have been seen back in lockdown.”

Primary Care Networks looking for support

We recently brought together representatives from 13 Primary Care Networks (PCNs) from across England, and what did they say?

That they are crying out for operational support and want to engage with commercial companies, but can’t find the right kinds of support. Can you help?

Cursor led prescribing

Are you truly sure on cursor led prescribing?

We believe all 2022 plans should have content on cursor-led prescribing. That goes for brand and local account plans, as well as primary and secondary care.

The algorithm that guides the mouse held by the clinician needs to absolutely understood.

Take care

This will be a particularly hard Christmas for many. If you are struggling, there are people to talk to in confidence at samaritans.org

A population perspective

System – Place – Neighbourhood – These terms direct us to view NHS services from a population perspective.

But what does that mean in practice?

And what can we expect in terms of variation, given that this is the first, ever, NHS legislation predicated on difference?

Strategic objectives behind NHS integration

What is the strategic objective behind integration?

The proposed move towards Integrated Care Systems (ICSs) is designed to make it easier for NHS organisations in England to collaborate around the planning and delivery of services, including with social care providers.

What does that really mean for market access?

How ready is pharma, really, for engagement with social care and the VCSE sector?

Primary Care Networks in 2022

Don’t assume Primary Care Networks (PCNs) will look the same next year.

Look out for at least one example of a new PCN formed from practices managed by a sub-co of a major NHS Foundation Trust.

What does that mean for formularies, guidelines, pathways and procurement?

Top questions asked by UK market access professionals (part 1)

Today we asked ourselves, given the current changes in the NHS, what are the two most important questions we are asked least often by clients?…

1) “Have you got clarity on how provider collaboratives will map out, and how they might relate to formularies, guidelines and pathways of care?”

We expect the introduction of provider collaboratives to have a significant impact.

And for the second question… Check out our post from the 10th December.

Top questions asked by UK market access professionals (part 2)

We know you’ve been waiting with bated breath for our second key question! (For those who missed yesterday’s advent post, we challenged ourselves to pick two questions on the changing NHS environment that are key but are asked least often by our clients). Our second question is…

2) “What is the variation in per capita funding between each ICS, and what might that mean?”

The ICSs that are in the Recovery Support Programme are all lowly capitated.

The major variation in per capita funding explains other things too, but is little-recognised in market access plans.

Population health management

Population health management comes up time and again in our webinars. Why are we so excited about population health management?

It offers an opportunity for systems to use data and insights to design services that reflect its population’s characteristics, demographics and health needs.

This should result in more targeted patient care, improved outcomes and reduced health inequalities.

Variety in prescribing

Variety is inevitable and it doesn’t help to see it as “postcode prescribing”.

Our clients are searching for consistency when, as we have said before, this is the first ever NHS change predicated on difference.

Value propositions and all market access activity have to embrace this variety as an opportunity.

Services in Camden, Barnsley, Newlyn or Keswick are meant to be different. Equal quality and equal in other standards but very, very different in detail.

Integrated Care System budgets

We often advise clients to ‘follow the money’.

The new Integrated Care System budgets will continue to be based on a weighted capitation formula. We estimate that this will bring up to 30% variation in funding per capita.

Budgets delegated to Place could have even larger variation.

So, where does that leave segmentation of accounts and targeted promotion?

The introduction of integration

This is an era of “acceptance”. We increasingly hear the changes to integrated care positioned as a “soft launch”, with multiple uses of the term “acceptance”, in recognition that few Integrated Care Systems are ready for a shift to integrated working from April 2022.

This nomenclature is a convenient euphemism for people and ways of working simply being unready.

So, expect further delays and compromises to the proposed aligned or blended payment systems.

Conversations with NHS decision-makers

First conversation? – What rules do you follow when reaching out to NHS decision-makers?

NHS leaders of advanced new organisations all say the same. Commercial approaches are typically move directly to third or fourth base.

Instead, an approach needs to start by establishing rapport, mutual understanding and a relationship.

Much harder in the days of social distancing, perhaps, but people need to work out the new ways of working.

A simple truth but a glance in an NHS email inbox shows a very different picture.

New NHS structures

Mapping and navigating the new NHS structures: the position on formularies is still uncertain, but some kind of coterminous link to Place seems to be common.

One ICS example we heard this week is that one Place will remain with its single APC but its neighbouring Place may see four formulary committees forming a new Place-sized APC.

Where such change happens, how will you level-up or level-down your guidance?

Messages for your Value Proposition (1 of 2)

Are you hitting the right buttons with your Value Proposition? Two quotes have really stood out for us from our recent conversations with our NHS associates.

From a hospital operational manager:

“If a drug or device can get our length of stay reduced by half an hour, then I am interested.”

And the second quote?… We will reveal all in tomorrow’s NHS Whispers Advent Calendar post.

Messages for your Value Proposition (2 of 2)

Does your Value Proposition hit the right buttons? Two quotes have really stood out for us from our recent conversations with our NHS associates.

We shared the first yesterday. The second is from a PCN Clinical Director:

“Show me something that means an HCA can do it rather than a GP or Practice Nurse and you have my undivided attention”

Lessons for NHS England from the devolved nations

A Christmas suggested read for the dedicated! The NHS in England is moving towards ways of working that the devolved nations have had for years. But, there is so little focus on England learning from those nations… Until now.

This December the Nuffield Trust has published a research report: ‘Integrating Health and Social Care – A Comparison of policy and progress across the four countries of the UK’.

This excellent publication is a goldmine of information and ideas from a highly-respected source.

Customer language: NHS acronyms

It’s so important to mirror your customer’s language. With the NHS, this sadly means its acronyms. The most common NHS acronyms not understood this year are ARRS, PIFU, ERF and HVLC.

Do you know them? Are you using them? And are you linking them to your value proposition?

  • ARRS = Additional Roles Reimbursement Scheme
  • PIFU = Patient initiated follow up
  • ERF = Elective Recovery Fund
  • HVLC = High Volume Low Complexity

Population health management and NHS engagement

Population health management is a major opportunity for NHS engagement. Life expectancy in many areas is falling, as evidenced here. This is a tragic trend and one that predates COVID.

Just one example of a reason behind this comes from County Durham reporting an increase in smoking rates among pregnant women.

The potential in community services

It’s Cinderella season… and we’re not talking of panto. When will we see the right focus on community services?

Community services have the potential to be a catalyst and enabler of pathways. Yet this service is neglected and staffed by an ageing and demoralised workforce with creaking infrastructure and massively increased workload.

In London and elsewhere the peripatetic services increasingly rely on agency and locum staff in clinical areas that depend so much on continuity.

Could Pharma play the role of fairy godmother to help community services reach its potential? Is this an area where industry can add value in 2022?

New NHS Oligarchs

The integrated care changes increasingly suggest real power is moving to the largest acute hospitals. Super Trusts and Provider Collaboratives could be the real definers of care as providers take on de facto and actual commissioning roles.

We have heard the Shelford Group mentioned more in the last month than in the previous 3 years. So, where does that group sit in your brand or territory plan, and how have you segmented the coming oligarchs?

Thank you to all those working in the NHS

With the NHS facing unprecedent challenges this Christmas, we send our good wishes to all those working in health and social care.

We’d like to particularly wish our 80+ NHS Associates a very Merry Christmas and a Happy and Healthy New Year in 2022. We have been humbled by their shared experiences this year regardless of their role or organisation. From major hospitals and GP practices through to care homes and ambulance services, from CEO to practice nurse, and from finance staff to pharmacists. We never, ever, take their commitment for granted. It breaks our heart to hear the toll it has taken on them.

The NHS, our country’s finest creation.

For more insights into the NHS and UK market access environment follow our NHS Whispers page on LinkedIn.