A Guide to Psychometric Testing

by Admin 1. June 2004 14:57





Over 70% of big companies often use psychometric tests in recruitment. We have all been tested and examined throughout school and beyond so we might ask why any of us need any more stress and what, if anything, are these new tests telling people about us?

What are Psychometric Tests?

The exams we took at school tested what we had learnt. Psychometric tests are different in that they look at a number of different things. They are instruments used to find out about individual differences. They might investigate our personalities, looking for factors that cause us to act the way we do and to predict future behaviour. They might also be used to try and find out how "good" we are at a certain task compared with other groups of people.

But often they look like quizzes in magazines

The difference between a good psychometric test and a quiz is what lies behind the test. In some cases this is over 100 years of theory and data gathered on thousands or even tens of thousands of people. In a good psychometric assessment, the 'questions' are presented in a precise way and complex statistical analysis is used to generate meaningful interpretations of the results.

So what do they measure?

Anything going on underneath the surface of an individual. Recruitment tests usually assess one of two areas:
  1. Old IQ tests claimed to give one number that expressed your intelligence. Nowadays you're liable to be assessed on specific areas: verbal, abstract, spatial and numerical intelligence. Jobs require different mixes of these: For example; people involved in structural engineering may tend to have a good ability to work with numbers and shapes.
  2. Personality: Good personality tests are tried out on thousands of people to build up profiles of the sorts of people who are successful in different jobs. There are never 'right' or 'wrong' answers in a personality test.

Will the test decide whether I get the job?

It really shouldn't. Good test users get training and know that tests should never be used on their own. Tests are used with interviews, references and other information to provide different parts of the jigsaw.

When will I be tested?

Sometimes they're used in conjunction with other information to shortlist candidates; sometimes they're used as part of a first interview, sometimes to generate questions for a further interview.

Should I cheat?

There is little point. Many of the best tests are constructed to spot people second-guessing what an employer wants. More importantly, getting a job you're not suited to will make you unhappy and probably lead to a short stay! Mind you, there's nothing wrong with practising. Ability tests are designed to get your best performance and there's evidence that the more relaxed you are with the format of tests, the better you'll perform.

What should I look out for?

You should take the test where you concentrate on it without disruptions. The administrator should be happy to explain anything you're not sure of. Check that the test looks good - it's not a photocopy or a cheap print out. Ask questions about the test; what it's for, how it's being used in the process. After testing, ask for feedback. This can be useful whether you get the job or not.

Should I be nervous?

A little bit of adrenaline helps. But there's no need to be worried. Strangely, research shows that a lot of people enjoy a well-run testing process because the feedback gives them more information about themselves.



Medtech Features

frontline managers

by Admin 1. June 2004 14:56


good managers hold the key to your sales force’s success.
Managers make a difference. At least they're supposed to. Yet even though senior executives seem to agree with this premise, they don't act as if it were true.

In fact, companies are often their own worst enemies when it comes to improving the quality of their sales organizations. Businesses frequently and significantly undervalue or misunderstand the key role that front-line managers play in driving productivity and in building a sustainable business model. It's no wonder that for the sales forces studied, average engagement levels hover at around 37%.

Too many sales organizations are operating well below their potential. If they paid greater attention to their front-line managers, their performance would improve substantially and rapidly.

Deeds don't match words

Almost every company believes that the quality of its managers directly affects its financial results. Still, it's often hard to match a company's words with its actions.

For example, in many organizations, training for front-line sales managers is woefully inadequate. Rookie managers are expected to transform themselves from sales rep to supervisor overnight. The little training that is offered usually revolves around learning the policies, procedures, and paperwork that the job demands.

What's more, the practice of promoting the wrong people into front-line manager roles is widespread. When companies promise that the way to climb the corporate ladder is to sell more than anyone else - in other words, when they confuse a talent for sales with a talent for managing people - they encourage the promotion of the wrong people. The best managerial candidates are not always the people who attain the highest sales. But sometimes, companies are so afraid of losing a great salesperson that they promote that person despite real concerns about how well he or she will perform as a manager. The consequences are usually disastrous. Not only do they end up losing a good salesperson, they often wind up with disengaged employees or an outright exodus of reps who must report to a less-than-ideal boss.

Yet another problem is that businesses - in the interest of "flattening" their organizations - have decimated the numbers of front-line sales managers, often without any real understanding of how this will affect employee engagement and productivity. We have seen "span of control" ratios climb from 7-8 representatives per sales manager to 15-20 reps per manager.

Suppose a company has 220 positions for its field sales force. Is it better off with 20 managers and 200 sales reps or with 10 managers and 210 sales reps? Most companies instinctively choose the latter, without doing much quantitative analysis. They really don't believe that the extra 10 managers will help drive productivity and profitability. Their attitude is, "Sales managers are a necessary evil, so let's have as few as possible."

In past years, we did see sales organizations with too many managers. Now we're more likely to find businesses with too few.

Some suggestions

Fortunately, these problems are fixable, and the solutions can provide a rapid improvement in organizational effectiveness.

First, let's reaffirm the basic notion that managers indeed make a difference - because they do. The quality of a sales organization is directly linked to the quality of its front-line managers. Those managers greatly influence turnover, productivity, and profitability, and= they help build a base of engaged customers. In many companies, they are crucial to achieving key corporate strategies and programs. Unless your company is continuously improving the quality of its front-line managers, it's unlikely that you're improving the quality of your sales organization.

Consequently, companies must pay special attention to the people they promote into those roles. Your sales team needs both great coaches (front-line managers) and great players. Some of the people you hire must have the potential to become great coaches. But besides their innate managerial talents, you also want your front-line managers to gain some practical experience selling your product line. This firsthand experience provides the best managers with an invaluable frame of reference that enables them to provide real help to their sales teams.

What this means in practical terms is that when recruiting entry-level talent, companies must always seek both great salespeople and great managers. But most businesses either look for one or the other; as a result, they end up with an unbalanced ratio. Either they hire too many people, promising ultimate (and often rapid) promotions into management ranks - or they hire too few. In the first instance, the company is left with dissatisfied reps who feel they're not getting promoted quickly enough; often, they'll leave the company out of sheer frustration. In the second case, the business has far too few qualified candidates to meet the needs of its succession plan; they lack bench strength.

Furthermore, in hiring potential managerial candidates, it's important to look beyond their narrow qualifications for the position. When the time comes, will they really accept a managerial position? Are they willing to relocate? Are they willing to travel extensively, if that's what the job requires? Pools of potential managers have a way of evaporating just when you need them. Senior executives must make sure those pools remain full.

Next, be sure that new managers receive the appropriate help in developing a management style that is most suited to their own talents and strengths. In general, companies don't invest enough resources in training and developing front-line managers. However scarce or abundant your own company's training resources are, you should be mindful of this fact: Your best return on the dollars you have available to spend will come from efforts directed toward those managers.

We have seen rapid improvement in the effectiveness of sales organizations in which managers are trained to do a better job at setting expectations, allocating resources, creating productive relationships with their salespeople, offering praise, and listening to opinions. Too many managers are unaware of how attention to these issues actually drives results.

Additionally, don't stop training and developing your long-term front-line managers. Sometimes these people get forgotten and overlooked simply because they aren't candidates for more senior positions. However, if you allow them to become disengaged in their jobs, it's unlikely that you'll find engaged sales reps working for them. Finally, remember that good managers are just that - good managers. They're not magicians, nor are they miracle workers.

When companies overload good managers with too many direct reports - when they stretch the span of control - those managers are no longer able to invest time and attention on their best salespeople. When the crucial bond between top reps and their managers suffers, those stars' engagement levels and productivity are likely to decline. Indeed, while cutting the ratio of managers-to-sales reps always looks good on paper, it seldom works out to be as financially beneficial as it seems.

If you want to improve the quality of your sales organization, start by improving the quality of your
front-line sales managers.



Medtech Features

mail matters

by Admin 1. June 2004 10:38



Those who learn to write effective sales letters reap their just rewards.

If only to stay in touch with customers and prospects, effective use of the written word is essential. Without it, the number of people who you can remain in touch with is severely limited. Properly prepared sales letters provide an efficient, low cost, and immediately available method for expanding your list of prospects. However, if your mailing campaign is slipshod and careless then it can have the opposite effect.

People who don’ t know you, will judge you by what you write. Poor sales letters generate more talk than good ones. Infamy is not an easy route to sales success.

According to hearsay, a mailing campaign should result in a 2% response rate. This is complete bunkum. Any marketing person will tell you that achieving 2% from a direct marketing campaign warrants celebration. Some sales letters do generate a high response, perhaps even five or ten percent. The vast majority struggle to inspire more than one in a thousand to reply. The big question that individuals, companies, and the media industry invest huge energy in answering is, what makes the difference?

For marketers, it is a never-ending quest because everything that works, sooner or later stops working. There is no need for despair. Sales people can achieve worthwhile success with sales letters by following a few simple rules and avoiding some rather dark pits.

Mailing Lists

Yes, let’s get back to basics. If you mail starving people an invitation to a free scoff, you will get a good response. People hate junk mail. You probably have a personal loathing of the nameless hordes that send you parts of dead trees every day. I sometimes wonder about the fiscal cost of the paper merry-go-round. Some one pays to send out paper. Someone pays to dispose of it. Recycled bits of it are given back to the paper suppliers who merrily resell it to the same people for another cycle. Yet when we happen to receive an offer that interests us, we are perfectly pleased to have got it!

The direct marketing consultants will tell you to spend your resources on the headline, and for a very good reason that we will discuss further on, however; if you don’ t first invest in making sure that you have an accurate and appropriate list, you will be wasting your time and money. Instead, why not believe the marketing claptrap about lists being clean. Some list brokers do clean their lists every six months. Despite their efforts, what you get can be very inaccurate. One survey that we conducted, based on our own email communications with customers, indicated that email lists become out of date at the rate of 4% a month. If this is representative of an unrefreshed mailing list, it may become virtually useless in less than a year.

Trade magazines will sell you use of there lists. If you receive any free subscriptions, you will have noticed that some publishers are constantly re validating the accuracy of their information and checking the interest of subscribers. Those that can only be obtained through a paid subscription may yield better results. Trade show lists seem like a good idea. At least people who attend an exhibition or conference have expressed a definite interest in its focus. Attend the exhibition whose list you are interested in and assess the value of it by observing the attendees.

There are two important issues. First, will the intended recipients see the message? Consider having a sample of the list, cleaned by telesales professionals or people in your own organisation. This will tell you whether or not you need to clean the whole list. Secondly, will the recipients be interested and able to take advantage of your offer or information? If you can run a test mailing on a small but representative section of the list, it will tell you all you need to know.

If the idea of cleaning a list and using precious time to test it seems expensive, identify the real cost of sending your mailing and getting disappointing results, or none at all. Apart from wasting the money, you will have wasted the time it took to organise and you will have damaged your standing with subordinates, peers, and seniors. Test small. If the test works, you can go ahead with confidence.


It all depends on the headline. If you don’ t get the readers attention with the headline, it doesn’ t matter if the rest of the copy is brilliant. The only purpose of the headline is to get the reader to read the first sentence. The only purpose of the first sentence is to get the reader to read the second sentence and so on. Eight seconds is the time it takes to read 25 words and, on average, eight seconds is all the time you have to get the attention of a senior executive. Test yourself when you are busy to check the truth of this statement. Next time you open the post when you are under time pressure, try to get a sense of the average length of time that you give each piece of sales mail.

The less the person whose attention you seek has to do, the easier it is to get their attention. If you have nothing to do, arrival of the post might be the high point of your day. Unfortunately, decision makers always seem to have more than enough to do. Spend 70% of your available copywriting time on the headline. If you can’t, hire a professional to do it.

His or her fees are an investment rather than a cost. When you have written your headline read it back. If your words reach out and grab you by the throat, create a buzz of excitement, and compel you to read on, assume you have been completely blinded by your own senses and time investment. Use the ‘stranger’ test. It is much more reliable than the ‘friend’ test. Put your headline in front of an appropriate stranger and gauge their reaction. It is much harder to find an appropriate stranger than an appropriate friend or peer, but well worth the effort. Why not do both? If your headline fails to inspire the reader to demand more, ditch it and start again. Leave out all trumpet blasts and chest banging. Don’t even mention your company name or the name of your product or service. It is a waste of precious words and will make whatever you write, read like a sales pitch. Instead, focus on its greatest benefit.

Put your headline in bold type, at a larger font size than the rest of the letter. Make it easy for people to find out what it’ s about.

If your headline has sparked interest, the next most likely step is for the reader to assess the message’s credibility. It is natural to consider who sent the message and why. The ethos of it, as Aristotle described it. Often, readers skip the letter and look to see who sent it. A perfect headline would also have the reader searching for instructions on what to do next. It is because of these reasons that a ‘PS’ is so effective. Your ‘PS’ can tell the reader about the next step. Right above the ‘PS’ is your signature. This is a good place to put your name, company name, telephone number, and email address.

Use the body of the letter to expand on the benefits of your proposition. Dynamic use of language is better. It uses fewer words, is easier to read, and conveys pace, even excitement. Use the active rather than passive voice and avoid using uncommon words or jargon.

Using words such as ‘you’ and ‘your’ , focuses attention on your issues, challenges and opportunities. Too much use of ‘I’ , ‘we’ , and ‘our’ diminishes interest. Sales letters are read for profit, not for pleasure so keep sentences brief and to the point.

People who don’t know you, will judge you by what you write. This sentence is worth repeating. Few can reliably proof read their own work. Engage the help of one or more people with an eye for detail. You might forgive the odd typing mistake, grammatical error, or miss spelling. Others won’t. Writing an article on this topic almost always provokes a corrective response from someone who has a keener eye for mistakes the my proof reader, and a better understanding of English grammar than I do.

Those in sales will have heard the old saying, ‘a sales letter can’ t be too long’ . In my opinion, you should take into account who you are sending it to. No doubt, some people like to while away the minutes, revelling in the craft of a clever copywriter. I believe that business decision makers will thank you for getting to the point. Keep your letter to one side of A4, or two at the most.

Response Mechanisms

How many times have you thrown up your hands in exasperation because a sales pitch failed to live up to its promise? Imagine your disappointment. The headline was fantastic. Almost instantly, as your eyes scan the paper, you know that this is exactly what you need right now. Your eyes leap all over the paper to find the contact response instructions. You find them and take immediate action and . . . The days stretch into weeks and nothing happens. There is no call back, no promised information, not even an acknowledgement of your interest. With utter disgust, you consign the original letter to the bin. Of course, this won’ t happen to any of your readers, will it.

Use a response tracking method to make sure that you know who responded to your letter. If you don’ t measure response, you will have no way to assess your letters effectiveness and no opportunity to make it more effective next time. Temporary 0800 numbers are inexpensive and national rate 0870 numbers cost nothing. You can set up a unique number for every letter. If this isn’t appropriate, add a unique reference to the letter so that when people call, you can identify how they found you. You could even use a fictitious name. It makes people feel more confident when they have a person to ask for and the name reveals the subject of the enquiry to the sales person. Fax back forms, reply paid cards, unique email addresses, and special web pages aid tracking and encourage response.

This is more important than you think. We have had business enquiries that resulted from campaigns up to eleven months old. I can think of a response that I made over a year after receiving the letter. Sometimes the message is right but the time is wrong. Then people often hang onto the information to use it later.

Nothing impresses like speed of response. It tells the customer that you are interested in their business and prepared to put yourself out for it. Technology makes it possible to respond in minutes. These days, anything more than two business days is rude. It communicates the idea that you don’t care about your marketing, the customer, or their business.

Success lies in planning and preparation. It has been said in so many different ways, and will be said in many more. It’ s the actions, your actions that will make the difference. Here is an anonymous quote that rings my bell, ‘The most practical, beautiful philosophy in the world won’t work – if you don’t’

Clive Miller

Questions and comments to Clive Miller

Telephone +44 (0)118 933 1357
www.salessense.co.uk for free ideas to increase business



Medtech Features

Life after PGEA

by Admin 1. June 2004 05:00

Planning your meetings in the new GMS world

Paul Midgley of Healthcare Partnership looks at the combined effects of the new practice-based GMS and PMS contracts, GP appraisal, revalidation and the greater use of skill mix on what type of educational meeting will meet the needs of the Pharma representative’s customers now PGEA has ended.

Background – the move from PGEA to PDP

The Postgraduate Education Allowance (PGEA) for GPs, introduced back in 1990 with the first GMS contract, failed to deliver consistent, high-quality continuing medical education leading to improved delivery of patient care. The spread between the best and the worst of the 10 000 practices in the United Kingdom is still wide. In a matter of minutes one can travel from paperless practices with integrated teams which have developed skill mix with triage, nurse practitioners heading a nursing team, healthcare assistants, and other in house enhanced services, to those where the prescribing is suspect and the consultations perfunctory, performed with the sole aids of prescription pads, sick notes, unchecked equipment and barely any use of IT. The new contracts aim to remedy this. How?

Goodbye PGEA, hello CPD

PGEA was scrapped on April 1st 2004 with the advent of the new GMS contract. CPD, in the guise of Personal (PDP) and Practice (PPDP) development plans, aims to bridge the gap between time spent learning and the practical application of what has been learnt. This move to CPD is a direct result of the former Chief Medical Officer Sir Kenneth Calman’s ‘Review of Continuing Professional Development in General Practice’ (1998) publication. This review added a surge of energy to the “corporate” rather than the “independent practitioner” vision of primary care that has now culminated in the new practice-based GMS and PMS contracts. Calman’s review was a response to the criticism that the postgraduate education allowance has been based on an educational model which is “didactic, uni-professional and top-down,” rarely involved the whole practice team, and showed little evidence of any “convincing benefits to patient care.” Calman’s doctrine became enshrined in the NHS Plan in 2000 – signalling a move away from PGEA to a system of PDPs as the way to manage doctors’ education and professional development, and PPDP to manage the organisational development of the practice unit.

PDP/PPDP – the new way of documenting Continuing Professional Development Personal and practice development plans are a hybrid approach which combine documented personal learning within an organisational development framework. Successful training and development interventions contain features that predispose to, enable, and reinforce changes that deliver information, rehearse behaviours, and provide reminders and feedback. Effective strategies also use contextual and motivational influences. You need look no further than the very effective systems employed within the Pharmaceutical Industry for training and developing employees to judge the relative efficacy of these methods. Personal and practice development plans call for the construction of learning portfolios for all the practice team (doctors, nurses, managerial and admin staff) which take account of the development needs of the practice or department as well as the individuals in it. The plans therefore combine a systems approach to change management, with self-directed learning holding the key to harness motivation and maximise the impact of time spent learning. PDP/PPDP represents a gradual shift away from individual to organisational performance as a proxy measure for quality. The involvement of patient feedback (encouraged by the Quality and Outcomes framework) will strengthen the process, ensure local responsiveness, and guard against the loss of personal care.

What elements are driving CPD in primary care under nGMS?

Quality and Outcomes Framework The new GMS contract encourages practices to seek patient involvement by incentivising the running of annual Patient Satisfaction Surveys, and getting patients involved in reviewing the results alongside the practice, by providing 70 points on the ‘Quality and Outcomes framework’. Practices will need help establishing ‘Patient Participation Groups’. There are a further 29 points for attending to a range of training issues, including PDPs for all nursing staff, appraisals for all staff, and regular Critical Event audit. All staff are also encouraged to regularly update basic life-support skills.

Practice Management Competency Framework Annex C to the new GMS contract is a framework for managing a practice effectively. It identifies 85 management tasks that every practice should perform, and grades each into definitions of administrative, managerial and strategic levels of activity. These tasks fall within 9 key areas of Practice operation and development, Risk management, Partnership issues, Patient and community services, finance, human resources, premises and equipment, IT and population care. Increasingly, practice managers will encourage the senior team members to benchmark themselves against each of these standards and put together a strategic development plan for the practice management team. Good facilitation of these sessions is essential and will be sought by practice teams. Practice manager groups are already holding training days on this topic – HCP run these too.

GP Appraisal, PDP and Revalidation Now appraisals for GPs have commenced (all GPs should have been appraised at least once by April 2004), the link between PDP, annual appraisal and ultimately revalidation (starting April 2005) becomes apparent (see diagram, and www.gmc.org.uk). The GP appraisal process results in a Personal Development Plan being agreed between appraiser and appraisee, so all GPs should now have a PDP. Many GPs have a learning objective around developing their IT skills, as these are central to doing well on the Quality Framework in the new contract, and practices are being encouraged to move away from paper-based records, in preparation for a patient hand-held record by 2010.

Appraisal and PDP - supporting GPs through Revalidation

Practice Professional Development Plans and the GMS Quality Framework A number of primary care focused ‘Think Tanks’ have advocated team-based development initiatives for a number of years, for example, the RCGP’s ‘Quality Team Development’ and the Kings Fund’s ‘Commitment to Quality’ audit. Many PMS practices have part of their contract incentive payments based around high quality organisational standards including producing an annual PPDP. So, what is the benefit of all this planning? Practices who construct development plans (PPDPs) have found significant benefits. Teamwork is improved as the plans (when constructed via a whole-team approach) represent a consensus view about how best to deliver the organisation’s priorities. Perhaps nurses should become responsible for immunisation procedures? Should warfarin and lithium monitoring services be available? Does the appointment system provide reasonable access? How easy is it to communicate with the practice by phone? As part of the PPDP process involved an audit of practice activities, HCP now uses the Quality and Outcomes Framework as a benchmarking tool as part of our PPDP workshop. This has the added benefit of identifying how to maximise QOF points and practice income. PPDPs become tools for measuring the achievement of priorities a form of stepwise practice reaccreditation. By linking the personal/professional development of individual practitioners to an organisational development strategy that recognises variable starting positions, professional and practice development plans could be the most effective lever for change in primary care yet devised (Note - they apply equally to doctors in secondary care). Next month: Who is driving PPDP and PDP and what are the difficulties and opportunities?

If you would like further information on the work of The Healthcare Partnership, and on the range of topical talks and skills development workshops we run for NHS professionals via our team of expert facilitators, then please call us on  0870 2413506  0870 2413506 or e-mail to enquiries@healthcarepartnership.com. Find out how we can help improve your access to key customers by providing PDP and PPDP development workshops, and support for their ongoing professional development through our extensive range of educational programmes specifically designed for the NHS.

Tags: ,


The Matrix

by Admin 1. June 2004 05:00

The CONCLUDING CHAPTER to this series of the NEW GMS CONTRACT distills key points for those representatives selling products within therapy areas

Conclusion: CONTRACT FACTS 46-50

46. Selling in Cancer: There are 2 objectives to cancer care in the new GMS – but they represent difficult tasks – produce a register of patients with cancer (noting that only skin cancers that are melanomas are to be included) and then review these patients within 6 months. The review is to include assessment, supportive patient needs and specific arrangements made with co-ordinating services with secondary care. They both provide 12 points (split equally) and it is difficult to state ‘what pharma companies’ can do for these tasks. Due to the overarching tasks for all cancers and the diverse nature for treating different cancers the actions required by GMS are generally specific! This means that pharma companies will probably focus on the cancer they are aiming to treat with marketing and subsequent energies focussing on issues such as outcomes, tolerability, quality of life and reduction in death. Broadly speaking cancer is very much in the limelight and incessant media coverage and public expectations lend this emotive disease area to significant political and documentary profile reporting. Secondary care, tertiary centres and specialist ‘beacons’ will remain the focus for pharma targeting. Of interest the concepts of ‘funding following patients’ is very important. One area pharma companies need to understand better is the approval of new cancer drugs within drugs and therapeutics remits. Bidding for new drugs will often become funding for a new business case depending on current services and new implications for the drug in question. In addition, around the country sits this dichotomy – specialist centres that patients with cancer can travel to get the best care – and the inevitability that many patients don’t want to travel and want their local consultant to provide care locally. Try moving a group of patients with cancer from a national beacon centre to their own locality where they and their families want treatment without the travel. The paperwork, funding arrangements and logistics is nothing short of verging on the impossible. Ask around…
47. Selling in Cardiovascular Medicine: Make hay. Because not only is the sun shining for those selling in this disease area, but cardiovascular disease is a priority for everyone. There are 121 points for secondary prevention alone with further points repeated for cardiovascular end-points within other diseases such as diabetes, hypertension, stroke and TIA. So with all these companies talking about the how their drug will help their GPs achieve their points – is anyone really offering anything original?
48. THINK POINT PF: Interesting in that it is very difficult to get all 121 points for cardiovascular disease but makes more sense in concentrating say on blood pressure - CHD 26 points + diabetes 20 points + stroke 7 points and hypertension 76 points !! By tar getting across diseases rather than down them, service investment pays off rather than trying to ‘tick all the boxes’ on a single disease (note BP target 150/90 except for diabetes which is 145/85 and also note that current payments for BP is capped at 70% - no doubt to be increased later.. The same principal could be said for cholesterol management - CHD 23 points + diabetes 9 points + stroke 7 points (note cholesterol targets of 5mmol/l and capped payments is again at 70% except for diabetes which is only 60% !! Few thoughts emerge – firstly capped payments means that the GP need not treat any more patients to target. If they do, they certainly don’t get more points or prizes. I have companies say to me that using their statin will get more patients to target. Interestingly the GP contract (at the moment) allows GPs to leave over 1/3 patients cholesterol levels uncontrolled and still achieve maximum points! The blood pressure caps are the same – 70%. It’s a bit like when pharma company representatives have their bonus capped at say 120%. Why try and achieve more sales if payments are capped? So has the government overlooked this? No. This is how they will turn the screws into general practice (see point 50)
49. The Prescribing Advisers: The pharmaceutical companies have finally realised that marketing their products to GPs whist essential requires additional attention to other professionals involved Conclusion: CONTRACT FACTS 46-50 OMAR ALI is the Formulary Development Pharmacist for Surrey and Sussex Healthcare NHS Trust and is a PCT Formulary Adviser to 2 PCTs. He is a lecturer on the MSc on Pharmacy Practice at Portsmouth University and is also an adviser to three Drugs and Therapeutics Committees in the South of England. Omar is a National Speaker in the UK (cardiovascular, diabetes, mental health) and is an Executive Board Member for the National Obesity Forum. He can be reached directly on ‘alipha@aol.com’ with prescribing. What has become an interesting dynamic is the relationship between the pharmaceutical industry, prescribing doctors and pharmaceutical/prescribing advisers. This has been covered in previous issues of PF but how does the new GMS relate to prescribing advisers? Much of the key lies in medicines management. Without a doubt the prescribing advisers will be involved in directive patient medication reviews, formulary and prescribing guidelines and new drug usage and restriction. There are even points for GPs to see us now! (A total of 42 points under medicines management covering activities such as meeting with the prescribing adviser at least annually, recording and documenting medication reviews, providing evidence of agreeing to and producing change in prescribing as agreed with the prescribing adviser and repeat prescribing). Many companies are struggling with a mismatch of ‘aiming for 1st line in the market and formulary inclusions’ and the subsequent ‘restrictions’ or even ‘blacklisting’ of certain products within individual PCOs by way of newsletters, incentives or simple control at the prescribing level. The way forward is a teetering balance for pharma companies. Try to liaise, involve and get on board the powers at be – or, at some point, plough ahead with a vigorous marketing campaign regardless of what may be coming from prescribing advisers per se. Either way, unless pharma companies have flexibility in their launch direction (remember there will always be a NICE guidance or an NSF or some directive) they will remain always trying to react to the climate/customer base and never feeling they are controlling it. This is the key to the future of pharmaceutical companies in today’s NHS.
50. Epilogue GMS contract: One of the most fascinating aspects of the GMS contract is not what is in the contract, but what is not in the contract! No dermatology! No gastroenterology? Why? What about those selling in these areas. Not easy. In fact the danger with GMS (or NICE or NSFs) is that it creates ‘trendy’ diseases which means there will always be non trendy ones. So if you suffer from reflux or eczema – there are no points in the GMS – there are no NSFs – will we be too busy to take these diseases seriously? Will there be reluctance to fund or prioritise these conditions compared to say heart disease or diabetes? Interesting questions. Furthermore – I made reference to the capping % - at first sight it seems ludicrous. It can’t be acceptable to just control the blood pressure of 70% of your patients and leave the rest! Well here’s the twist – quite literally… Follow this. Start the GMS idea of points means prizes. Give the carrot MPIG so no-one loses out and they all play ball. Set the minimum targets of 25% (to get the ball rolling). Leave capping at 60%-90% to allow for slack in the system. Then – as time goes by – turn the screws…. Minimum becomes 30%, then 35%. Maximum becomes 80%-100%. The goalposts move – but the money doesn’t change. Hence to get minimum payment this year needs 25%. Next year it may need 35%. Extra work. For the same payment. It’s a very clever way of how the government pushes the NHS to do more for less. Nothing new there then… That’s the Matrix for you.


OMAR ALI is the Formulary Development Pharmacist for Surrey and Sussex Healthcare NHS Trust and is a PCT Formulary Adviser to 2 PCTs. He is a lecturer on the MSc on Pharmacy Practice at Portsmouth University and is also an adviser to three Drugs and Therapeutics Committees in the South of England. Omar is a National Speaker in the UK (cardiovascular, diabetes, mental health) and is an Executive Board Member for the National Obesity Forum. He can be reached directly on ‘alipha@aol.com




by Admin 1. June 2004 05:00

Autism is a disorder that affects the way a person communicates with other people. Most (but not all) people with autism also have a learning disability. There are a number of related disorders known as autistic spectrum disorders. These include Asperger’s syndrome, which involves fewer or less disabling autism symptoms. About autism and Asperger’s Around 9 in a 1000 children aged four to five are affected by an autism spectrum disorder (ASD). Autism is rarer, affecting about 1 in 5,000 children. It is four times more common in boys than girls. An ASD is any disorder where autistic symptoms are present. Autism is thought to be caused by an abnormality in the development of the brain that occurs before, during or soon after birth. The exact cause is unknown, but doctors think that there may be a genetic factor, but no pattern of inheritance. Symptoms Symptoms of autism first appear in children in their first three years. In severe cases, autistic behaviour may be noticed soon after birth. There are three main types of symptoms. Children with autism, rather than ASD, usually have some symptoms from all of the groups. Social difficulties Generally, this group of symptoms can be described as difficulty getting on with other people. Children with ASD may:

  • rarely make full eye contact
  • not seek affection in the usual way, and resist being cuddled or kissed
  • be unable to play with their peers, and have difficulty making friends
  • not understand other people’s emotions
  • find it difficult to accept simple social rules, which can cause problems at school


- Children with autism may show very little or no interest in imaginative play. Instead they may show excessive interest in repetitive activities, such as lining up their toys or watching the washing machine drum rotate for an extended period of time.
- Games may remain exactly the same every day, and be the type of games usually played by younger children.
- Speech may be affected, with difficulty starting or keeping up conversations, and odd use of words.


- Children with autism may learn to sit up or walk later than most children.
- They may have odd mannerisms such as rocking back and forth, hand flapping, walking on tip-toes or head banging.
- Children with autism and Asperger’s syndrome tend to be clumsy and to struggle with games lessons at school.
- Obsessions may develop in older children and adolescents, such as excessive interest in timetables or lists, and in storing up trivial facts.
- Children with autism may be easily upset or angered if their daily routine is changed. Some are extremely sensitive to noise, and may be very disturbed by an unexpected noise from a vacuum cleaner or hairdryer.

Intelligence and autism Around 70% of people with autism have an IQ below 70 (the average IQ of the population is 100). This is classed as a learning disability. Some people with autism have normal or high intelligence. Many people with Asperger’s have normal or above average intelligence and can lead independent lives. Diagnosis and assessment Autism is usually diagnosed in childhood, when a parent may raise concerns about their child with a GP or health visitor. The most common age for diagnosis is between three and four years, though some children may not be diagnosed until the age of 12. Mild autism spectrum disorders, such as Asperger’s syndrome, are often not noticed until the child starts school because many aspects of their development are normal. At school their poor social skills are more noticeable and challenging behaviour may arise. There is no specific test for autism. Tests may be carried out to exclude other conditions (eg blood and hearing tests). Diagnosis is then based on observation of communication, behaviour and development. A number of health professionals, as well as the parents or carers are involved. If autism is suspected, the child will be assessed to identify specific needs. He or she may see a child psychiatrist (doctor specialising in children’s mental health), paediatrician, speech therapist, psychologist, and an educational expert such as a specialist teacher or educational psychologist. Each child should have an appointed key worker, such as a health visitor or school nurse, who knows about the assessment process and acts as a contact for the parent or carer. Treatment Treatments include special education, behavioural training, social skills training and, in some cases, medicines. Special education All children with autism need special education. This may be in a special school, or if symptoms are less severe, in a mainstream school with additional individual help. In general, autistic children do better if classroom activities are very structured. Behavioural therapies These may be provided by a clinical psychologist and can help a family cope with any behavioural problems associated with autism. Similar methods may be used at school where the child can be taught better ways to express themselves. Medicines Sometimes medication is used to reduce specific symptoms. For example, some drugs can be used in the short term to help relieve agitation, obsessional or hyperactive behaviour. However, these can have side-effects if used for a long time. For example, drugs to reduce hyperactivity can increase repetitive and obsessional behaviour. Other treatments There are various approaches available to help with communication, such as music therapy and picture symbols. However, there is only limited evidence that these treatments are effective. Some people claim that a hormone called secretin can help with the symptoms of autism. However, again there is no scientific evidence for this and the sideeffects have not been investigated fully. Help for carers Parents and carers need information, help and support too. This should be provided by the health professionals involved in the child’s care, but further advice is available from charities such as the National Autistic Society (see Further information, below). Respite breaks give the parent or carer a chance to rest while somebody else looks after the child. They may be provided by social services. Some families are also entitled to welfare such as disability living allowance.

Further Information
The National Autistic Society  0870 600 8585  0870 600 8585 http://www.nas.org.uk Contact a family  0808 808 3555  0808 808 3555 http://www.cafamily.org.uk
For consumer-friendly and reliable health information on over 200 conditions, treatments and living healthily, visit BUPA's website at: www.bupa.co.uk

Tags: ,



by Admin 1. June 2004 05:00

Patients involved in clinical trials benefit from their treatment, but recruiting more patients to take part is a challenge. This issue is highlighted in the ABPI’s newly-published report of its seminar Current Issues in Clinical Trials held at BMA House to explore issues related to clinical trials. “The scientific support for trials is solid and the subject of constant scrutiny and change. The ethical basis for volunteering is also well established. Participation on clinical trials has been shown to be generally beneficial for the patients involved, but the number of patients participating remains relatively low,” Dr Pablo Fernandez, senior vice president of Clinical Research Europe, PharmaNet, told the meeting. “Recruitment remains a challenge. There are various mechanisms for finding recruits, such as public information campaigns, raising patient group awareness of the availability of clinical trials, and publicity, for example, collaboration with patient groups, information leaflets in GP surgeries, press announcements and listing on the appropriate websites.” Dr Fernandez continued: “Once a patient has been recruited for a clinical trial, the regulatory requirements are strict and adhered to by all main countries around the world. They are set out in the International Conference on Harmonisation Good Clinical Practice guidelines and the World Medical Association Declaration of Helsinki.

When the trial is concluded all data has to be included in the analysis of results and in the final report. Reports of all trials are provided to the medicines agency - the MHRA in the UK, the EMEA for the EU. Subsequently, trial data are presented at scientific meetings and published, ensuring scientific scrutiny of the research methods and results, whether positive or negative. Robert Meadowcroft, Director of Policy, Research and Information at the Parkinson’s Disease Society, said that one reason why there was a low level of participation in trials was because people did not have the information on how to get involved. The Society occasionally had to advise people desperate to take part in trials before the trials were properly set up. “A lack of feedback to participants about trials is a frequent issue - they want to know what the end date is, where the results will be published, what the outcomes were etc. Expert patients who are better informed and more confident about their treatment are more likely to benefit from it. “People need to be more aware of the process and of the importance of clinical trials. That will mean they will have more questions for those who design the trials, but that is a welcome development. In summary, there is a need for more and better information and genuine consultation,” said Mr Meadowcroft. Copies of the seminar report are available from the ABPI Publications Department (price £10) on  020 7930 3477  020 7930 3477 ext. 1446 or e-mail publications@abpi.org.uk. The seminar report is also available on the website: www.abpi.org.uk

Guidelines on what company data should be made public during a NICE health technology appraisal have been agreed between the National Institute for Clinical Excellence and the Association of the British Pharmaceutical Industry. The agreed guidelines recognise the importance to both patients and to the quality of the NICE appraisal process of putting relevant information into the public domain to ensure the credibility, clarity and comprehensiveness of their guidance, while also acknowledging that the rights of owners of data should be respected. They set out principles and practical examples of what data should be made public and when.

Reviews of NICE by both the World Health Organisation and the House of Commons Health Select Committee have highlighted the need to limit confidentiality constraints on information supplied to NICE for technology appraisals. “This is a welcome agreement for both the industry and NICE,” said Vincent Lawton, President of the ABPI. “It reflects the accepted trend towards transparency, embodies industry effort to minimise what is labelled confidential, but also respects the industry’s legitimate right to maintain confidentiality where absolutely necessary.”

Andrew Dillon, chief executive of NICE, said: “These guidelines are helpful in achieving consistency of approach by companies now, and they are step towards our long term goal of achieving unrestricted access to all relevant data.” NICE’s new technology appraisal process and methods of technology appraisal documents now incorporate these guidelines.




Tag cloud


<<  April 2018  >>

View posts in large calendar

Month List