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King's Fund, London 29 March 2006 Some key issues and critical success factors for 2006 Alan Jones

King's Fund, London 29 March 2006 Some key issues and critical success factors for 2006 Alan Jones. PEST & SWOT. Key issues. CSFs. Sos & APs. Business Planning. On the boil in England in 2006/7. New pharmacist’s contract Non- medical prescribing Managing long-term conditions

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King's Fund, London 29 March 2006 Some key issues and critical success factors for 2006 Alan Jones

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  1. King's Fund, London 29 March 2006 Some key issues and critical success factors for 2006 Alan Jones

  2. PEST & SWOT Key issues CSFs Sos & APs Business Planning

  3. On the boil in England in 2006/7 • New pharmacist’s contract • Non- medical prescribing • Managing long-term conditions • OHOCOS • GMS for 2006/7 • Health of the public • PCT/SHA mergers • New national standards • Practice-based commissioning • Public sector procurement • Health consumerism v patient ‘obligations’ • Payment by results • Extending roles • NHS foundation trusts • Connecting for health • Health + social care • Patient Choice • Vertical integration • New NICE • Private Providers • Agenda for Change • Last of the NSFs

  4. PEST • Assessment for improvement: the annual health check • Commissioning a patient-led NHS • Health reform in England: update and next steps • The NHS in England: the operating framework for 2006/7 • Practice based commissioning: achieving universal coverage • Our Health, our care, our say: a new direction for community services

  5. Assessment for Improvement: the annual health check • Second Domain - clinical and cost EffectivenessDomain Outcome: “Patients achieve health care benefits that meet their individual needs through health care decisions and services based on what assessed research evidence has shown provides effective clinical outcomes”. • Core standard C5: Healthcare organisations ensure that they conform to NICE technology appraisals and, where it is available take into account nationally agreed guidance when planning and delivering treatment and care

  6. Commissioning a patient-led NHS • Appeared last summer while a lot of folk away! • About strengthening PCT commissioning, but…. • PCTs to halve numbers by October 2006 • SHAs to reconfigure • PCTs to divest of provider role by 2008 • Caused a lot of anger……

  7. A PCT CEO view….. “What has made people gasp is the timing of ‘Commissioning a patient-led NHS’ and the order and speed of its implementation….The rapid prescriptive timetable for implementation ignores a number of key issues, which unless addressed properly will drag the system into chaos.” Lise Llewellyn, Brent PCT CEO September 2005

  8. Health reform in England: update and next steps • A new ‘vision statement’…. • Review of both demand-side & supply-side reforms • Plus ‘transactional’ & system management ones….. • Spells out the new ‘rules’…. • Signals 14 other policy frameworks to come…. • Annexe C a ‘must-read’…..

  9. The NHS in England: operating framework for 2006/7 • Interesting ‘language’ with lots of ‘musts’…. • Restates the priority priorities…. • Examines commissioning in more detail • Looks at the provider role • Spells out changes to PbR and the tariff • Details guidance on system management & regulation • Annexes are again ‘must-reads’…..

  10. Practice based commissioning: achieving universal coverage • A one year DES in GMS • A ‘must-do’….. • The WP ‘oyster grit’……. • Note prescribing is in here too…. • Early wins and top tips • Major opportunities re business case prep • See PCC newsletters and www.npdt.org

  11. Our Health, Our Say Our Care • Services to be moved out of hospitals….. • Polyclinics are good…. • Joined up health & social care • Increasing GP provision in deprived areas • LTC, self care & EPP • Disease prevention & health promotion • Health literacy and ‘information prescriptions’ • PbC as a major driver but no new monies

  12. Some implications • Back to the future – Optimal, etc • Impact on hospital teams? • Enhanced roles of nurses and pharmacists • Dealing with ‘social enterprise’ units • Dealing with big ‘corporates’ • Major opportunity for ‘support’ initiatives

  13. SWOT • Weakness – Innovex report & stakeholder engagement • Threat – ABPI Code of Practice & ‘loss’ of KOLs?

  14. An era of secondary care • Innovex EU report, October 2005 • Suggests companies now focussing on acute care • Funny this as UK NHS moving in the opposite way… • But does suggest a need to regroup on customers • Confuses decision makers and influencers • Stakeholder relationships need improvement – YES!

  15. A wake up call for Industry? “…the industry is in danger of not keeping up with the pace of NHS change. The new emphasis on a systematic approach to care has largely left pharmaceutical companies flat-footed…” Dr. David Colin-Thome, National Primary Care Director Pharmatimes “The pharma industry is a hostage to history. Most healthcare systems are in the process of modernisation, change, realignment and refocusing. The pharma industry seems blissfully unaware that anything has changed…” Roy Lilley, Pharmaceutical Marketing “The traditional ‘three product detail’ is out of step with what the NHS requires, and that to continue to achieve success we have had to radically change our model in the new healthcare environment.” Andy Davis, Managing Director, Takeda UK

  16. Some KIs • How can we make sure that we are correctly aligned? • How can we ensure that we are (more) customer focussed? • How can we ‘walk the talk’? • How do we effectively upskill our sales force (s)? • How can we engage more ‘strategically’ & appropriately? • How can we help the NHS better understand the Industry? • How do we deal with the ‘baggage’….? • How do we best avail ourselves of the opportunities?

  17. Some CSFs • We must make sure that any new (re)alignment is fit-for-purpose • We must make more effort to be (really) customer focussed • We must say what we mean, and mean what we say • We must ensure appropriate skill sets are in place • We just have to engage more ‘strategically’ & appropriately • We must make sure NHS customer understand Industry R&D • We have to be able to deal with customer ‘baggage’…. • We must capture some/all of the available opportunities

  18. Waking up?...... “Many of the major players are now examining their marketing and salesforce structures, whilst others have already done so and made changes. MSD, Novartis, Pfizer, Sanofi-Aventis and Wyeth, to name but a few, are taking a deep look at their sales and marketing strategies amid a rapidly changing healthcare environment..” John Lidstone, PharmaTimes, February 2006 “…We have now developed a cutting-edge key account business model that integrates all of our activities around local PCOs whilst allowing us to constantly adapt our approach to the evolving needs of a decentralising NHS…. So it’s goodbye to yesterday’s rigid marketing and limited value-added offerings for customers and hello to a tailor-made, localised marketing mix that meets the needs of every customer across the UK…” Huw Tippett, Novartis Pharmafield, January 2006

  19. But complacency must go….. “The pharmaceutical industry is currently experiencing a sharply worsening climate…..In this environment, there is no room for complacency… a new industry dynamic is required… The pharmaceutical sector must learn its lessons and keep pace with developments in healthcare ….We all need to take a fresh and honest analysis of our ways of working and decide whether they enhance or erode the reputation of our industry. If it is the latter, we must act decisively for change. The reputation of the industry may be taking a battery – but its restoration is in our hands.” Richard Barker, ABPI Director General European Pharmaceutical Review, Issue 2, 2005

  20. Changing mindsets “In a way, it’s rediscovering the essence of marketing, which I believe the industry needs to do in many cases. Marketing is really about understanding the underlying means and driving forces of your customers and stakeholders, and positioning yourself and your products to meet them. It is a different mindset from simply seeing healthcare prescribers as sales targets… Pharma should reshape its sales and marketing business around the needs of governments and healthcare providers. This requires us to understand and be sensitive to their problems.” Richard Barker, ABPI Director General 12th Annual Economist Pharmaceuticals Conference, 2006

  21. Customer Consultants “....It is those pharmaceutical companies that identify the relevant KOLs and, critically, deliver the right message that combines product efficacy with health service value, that will forge a strong position with the NHS.” PharmaField “..a refocusing on the customer though a sustainable selling model is required where representatives take on more of a partnership, advisory and consultancy role will not only better meet customers’ needs but also go a long way towards boosting the industry’s declining image.” Lal Ashby, Commercial Director, Serono UK European Pharmaceutical Executive, March 2006

  22. The view of the RCN “The marketing community…should not assume that communication techniques used for doctors will work for nurses….The industry must learn to engage with nurses in the way they want to be engaged with…..Nurses will also need to develop their understanding of the pharmaceutical industry…” Molly Courtney Pharmaceutical Marketing

  23. Into 2006 • Stormy waters ahead for the NHS… • Privatisation, Herceptin, OOHs, flu jabs, smoking… • Plurality, contestability & choice…. • Flush with cash; short of money… £90bn in 2006/7 • The reconfiguration of primary care….. • Is a rationing debate beginning?.... • Stormy waters ahead for the industry?…

  24. Some conclusions • The ‘mould’ is now set to 2008 > 2012 • Mr. Brown is a-coming….. • The ‘iceberg’ of risk • A fragmenting NHS?.. • More ‘market turmoil’ is inevitable • Patient choice could unleash powerful forces • Industry to engage more ‘strategically’? • Dealing with the ‘baggage’…. • Companies need to continue to adapt • But opportunities abound!......

  25. A closing thought…. “…doctors are on the receiving end of a new, secret language now infecting the whole NHS….buzzwords are bandied around but when anyone is brave enough to ask what they mean no-one is quite sure. Answers usually contain the word ‘framework’ and we’re all left none the wiser…” Dr. Phil Hammond “…A lot of the pain and anger from doctors is because they don’t understand how the system works and why it works like it does….Learning more about how the NHS functions as an organisation and how decisions are made can be key to improving the ability to influence...” Prof. Jenny Simpson, BAMM

  26. Wellard’s Health Care Managers’ Forum 2006

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