What’s going on

by Admin 2. June 2006 00:47
 

 

Your guide to the current NHS ‘revolution’ – and how the new landscape of healthcare commissioning and provision will affect your business.

For those of us who work in (or are linked to) healthcare sales, the ongoing saga of change in the NHS can almost become background noise – after all, there have been numerous changes in the past, but they haven’t really changed what we do. This time, however, things are very different. The NHS in England is undergoing wholesale, coordinated reform, which – particularly in the hospital sector – will change what your customers do and how they do it.

If you don’t understand how your main customers and their operating environment are changing, you run the risk of not optimising your approach and resources – or worse still, of getting left behind and losing out while your competitors move ahead. To help you along the way, here is a quick review of some of the major Government policies and environmental factors that will affect your NHS customers in the coming year. These are interesting times for the NHS in England: we’ve seen unprecedented levels of investment, but also unprecedented financial deficits at the end of the financial year (March 2006). Organisations are being restructured – again – and there’s been a wholesale overhaul of the way finances flow within the system. The new National Tariff for 2006–7 has been withdrawn and then reissued, and to cap it all Sir Nigel Crisp has recently ‘retired’.

The change programme has been constant for a number of years now – but 2005–6 must have felt like a bit of a roller-coaster for those working within the NHS, and there are more upheavals to come as we move into 2006–7.

The financial environment

Cost pressures on the system continue, and the financial stakes are high. Elevated funding runs out in 2008. The NHS must move from (substantial) deficit in 2005–6 to ‘surplus’ by the end of 2006–7.

As a result there is both national-level and local-level scrutiny of cost-effectiveness, including the viability of continuing funding for a number of high-profile national programmes, more effective procurement (e.g. via the Supply Chain Excellence Programme) and the inevitable focus on prescribing costs.

As part of the plan to get things back on track financially, commissioners and providers of services will receive different levels of ‘uplift’ in their finances this coming year. Commissioners come off relatively well, at an average of just over 9%. Acute Trusts, on the other hand, will receive much less: just 1.5% increase on the 2005–6 National Tariff after various deductions, which means that most will be moving backwards since pay increases alone would mean the need for a 2% increase in charges.

Even though investment in the NHS is at record levels, the cost pressures continue: the possibility of funding Herceptin and other NICE fast-tracked medicines, plus all the other hopes for new product launches, new service developments and licence extensions, means that expectations will inevitably outweigh resources.

Payment by Results

Payment by Results (PbR) has been rumbling along in the background for a number of years now, but 2005–6 was really the year when most people began to sit up and take notice. By the time we entered the new NHS financial year in April, PbR had really kicked in: the DH anticipates that up to £20 billion of services will be covered by the system this year, as compared to £9 million the previous year.

With PbR, acute trusts provide services against a fixed cost from commissioners. From a commissioner’s perspective, every patient who enters the hospital as an in-patient, out-patient or emergency incurs a cost. Because of the financial climate (particularly where Trusts are in deficit), providers may be more inclined to scrutinise their costs and review the effectiveness of procedures, including the prescribing and use of medical devices; this may pose either opportunities or threats to the suppliers of the devices. Similarly, commissioners will be trying to limit their own costs by avoiding uneccessary referrals and ‘unplanned’ admissions in order to manage their own finances. From a Trust’s perspective, this may mean reduced activity and therefore reduced income.

This policy hasn’t had a smooth ride: we’ve seen a lot of backtracking as the NHS really got to grips with its implications. At the time of writing, the new National Tariff for 2006–7 had just been withdrawn due to “underlying errors in the calculation of the Tariff”. This has been a blow to both commissioners and providers, who have spent valuable time planning services to be purchased and delivered. It will inevitably result in further financial disruption – with possible consequences for suppliers to the acute sector, depending on the extent to which service costs have to be recalculated.

Reconfiguration, plurality and patient choice

The NHS is once again going through major organisational change: the Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs) are being reconfigured. It has now been announced that the number of SHAs will drop from 28 to 10 (see diagram), and that the number of PCTs will drop from 303 to 152. The new SHA configuration will come into force in July 2006, and the new PCT configuration in October.

To date, much of the emphasis from the DH has been on strengthening providers via the introduction of Foundation Trusts and increased competition from the independent sector. There are currently 32 Foundation Trusts, with an anticipated increase to 65–80 by March 2007. Independent sector treatment centres (ISTCs) are set to increase from 18 to 24 by March 2007.

Under the ‘plurality of provision’ policy, more new providers – the commercial sector and the ‘third sector’ – will come into the mix, meaning that increasingly NHS patients will be treated outside traditional NHS organisations. This obviously has implications for suppliers to the NHS, as their customer base will change.

‘Patient choice’ is also a key feature of the new NHS. Patients are currently offered a choice of at least four hospitals for their treatment. This will be extended to include any NHS Foundation Trust, any nationally procured ISTC and any centrally-accredited independent sector provider.

How will the patient of the future make choices? Many will still rely on their GP or primary healthcare professional; but for some, hospital results and information from patient organisations will inform their choice. Again, this may be relevant to those who supply the NHS: do your products help hospitals to differentiate themselves and offer a quality service within the confines of the National Tariff? If so, do you have the evidence to support this?

strategic health authority configurations





























Commissioning and primary care

Commissioning is currently defined by the DH as the process which determines how the health and healthcare budget is used”. They have identified that the commissioning function needs strengthening: much of the emphasis to date has been on providers in the acute sector, but the emphasis is now shifting to commissioning and the development of primary care.

As part of implementing Commissioning a Patient Led NHS, the DH has worked to redefine commissioning – including specialised commissioning and practice-based commissioning. There is currently a Ministerial Review of specialised commissioning arrangements, and during the summer the DH will issue guidance on commissioning (including a commissioning framework).

The recently published White Paper on primary and community care (Our health, our care, our say, 30th January 2006) sets out four main goals:

1. Better prevention services with earlier intervention.
2. More choice and a louder voice for patients.
3. Tackling inequalities and improving access to community services. 4. More support for people with longterm needs.


From the viewpoint of an acute sector provider, there is an emphasis on shifting the provision of services into the primary/community care setting: the target is 5% of activity in the next 10 years. Strategies to achieve this include:

•Implementation of Practice-based commissioning.
•More care outside hospitals (including in the home). The DH will be working with the Royal Colleges to develop clinically safe care pathways within primary care for dermatology, ENT medicine, general surgery, orthopaedics, urology and gynaecology.
•Allowing different providers to compete for services – particularly in primary care. This is already becoming a reality: UnitedHealth, a giant US health corporation, is taking over two NHS practices in North-East Derbyshire, no doubt with more to follow.

Practice-based commissioning (PBC) is a very exciting (and confusing!) development that brings huge changes to decision-makers and influencers alike. Under PBC, practices and/or groups of practices can apply to hold all or part of their population’s commissioning budget. Although it remains voluntary, the target for take-up of PBC is 100% of practices by the end of 2006.

Inevitably, as PBC, PbR and the measures outlined in the new White Paper kick in, the configuration of some services will change, with more scrutiny on referral to and treatment in the acute sector (as this comes with a fixed price tag), and new models of delivery in the primary/community care setting (often at a price below the hospital tariff). Just because a service has traditionally been delivered in hospital, that doesn’t mean it will continue to do so.

The road ahead

The new NHS presents suppliers of healthcare products with new opportunities and challenges. You will need to keep your eye on how the services are changing, and which acute sector services or aspects of a service might be delivered elsewhere (by an NHS provider, a commercial provider or a ‘third sector’ provider) – and conversely, which acute trusts are looking to provide primary care services. Only by keeping track of what’s going on can the healthcare industry successfully offer new solutions to public needs.

On Target - What Is Going On



































Anita Baylis is a freelance management consultant specialising in NHS purchaser and policy issues. She can be contacted on anita@healthcomm.org.uk

 

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Interview with a Theatre Manager

by Admin 2. June 2006 00:45
 

The Other Side1:

Interview with a Theatre Manager

Our series of interviews with NHS professionals starts with Eddie Merrick, Eye Theatre Manager at the Royal Bournemouth Hospital.

What types of healthcare products do you purchase?

I am the Manager of an Ophthalmic Theatre Suite of two specialised Theatres (increasing to three Ophthalmic Theatres in April ’06). No other speciality uses our Ophthalmic Suite, thus allowing us total management and control of this area, which eliminates problems relating to finance, space and cross-infection with other specialities. I have total control over the budget for this area, including staffing, consumables and equipment. Most of the items purchased are very specialised to Ophthalmology, consequently very expensive. The various types of healthcare products break down into three specialist areas: Anaesthetics, Surgery and Specialist Surgical Procedures.

How often do you meet representatives selling medical devices and related products?

Representatives from all different companies in the healthcare industry are made to feel welcome, and are a necessity for the smooth running and organisation of the Operating Suite in the Eye Theatres. Most representatives telephone me or my Personnel Secretary for an appointment. In critical areas of supply, some representatives are able to come direct to the Theatre Suite and be seen by the appropriate person as soon as possible without a prior appointment. Here at the Royal Bournemouth Hospital, there is no overall policy towards visits from representatives; however, a diary is kept by the Personnel Secretary where companies are required to make appointments. At the busiest times, up to six representatives can be seen over a period of one week – some with an appointment and some without.

I particularly like, and find very advantageous, the knowledge and professionalism that most representatives show.

Where a trial of any product or equipment is ongoing a representative will be allowed onsite at any time, and be made to feel an essential part of the ongoing process of support and discussion within the Eye Theatre Unit where the item’s suitability is being assessed and evaluated. Often a representative will make more than one visit in a week. If a particular requirement is ongoing this does not infringe on the running of the Theatres, and quite frequently is to the Unit’s advantage.

Where there is a need for wider involvement (i.e. other areas and departments of the Trust), representatives – no matter how frequent or infrequent their visits – would have in the first instance to be directed to the Trust Procurement Department. Not all areas have the same flexibility and the same perception of such visits, for reasons best known to themselves.

Depending on the frequency of visits and the technical expertise needed, the Procurement Department would normally vet the representative/company and would not inform the appropriate department of their visit. Eye Theatres do not tolerate this approach: we ask all companies, without exception, to speak directly to us.

What do you like about representative visits? What do you dislike?

Representative visits are viewed by this department as an essential part of the smooth running and service provided to our patients. I particularly like, and find very advantageous, the knowledge and professionalism that most representatives show. The following are particularly beneficial:

• Keeping up to date with our account.
• Providing liaison if there are any problems.
• Helping if any product requires discussion or further information.
• Informing us about R&D, new products, changes in company procedure or organisation, or any change in a product’s material or design.
• Building a trusting relationship between company and Theatres.
• Combined training and sponsorship of the healthcare provider.

Within the healthcare industry there are rules, not just one’s own opinions, to take into account when discussing dislikes about representative visits. The following are not acceptable:

• Representatives who are unprofessional and discourteous towards other representatives/ companies.
• Representatives who are late, or do not turn up for appointments, without undue reason/notification.
• Being over-zealous towards staff in a manner that is deemed unprofessional, i.e. rudeness/provocative comments.
• Lack of concern over customer care (i.e. continuity) and lack of trust in their customers and colleagues.
• Representatives who telephone after a long period of absence (a year or more) and have the same expectations as a colleague who visits on a regular basis.
• Over-optimism or untruthfulness regarding product quality and delivery.

What do you look for from the healthcare industry? Are you sometimes disappointed?

Having expectations of the industry can sometimes be a minefield, whatever the speciality. There is a vast array of companies selling, producing and marketing different kinds of equipment and medical products. When making an analysis of any company, my priorities would be reliability, cost and quality of product.

Over the past few years, the healthcare industry has developed a very strong public relations force to troubleshoot and pass on information to the customer. Due to the complexity of healthcare products and the vastness of the industry, I see this as a major requirement for the future. I would look for a strong and knowledgeable representative, coupled with a strong PR team, to give me the service and support that I find essential as a customer.

I would look for a strong and knowledgeable representative, coupled with a strong PR team, to give me the service and support that I find essential as a customer.

There are companies within the industry whose supply chain one finds it disappointing to be part of, because the exclusiveness of the product offers little choice to the provider. Generally, one tends to build a more trusting relationship with the smaller type of company in this speciality: they are usually more competitive and customer-conscious, trustworthy and reliable – which cannot always be said of the larger companies.

My impression is that a vast amount of work is going into developing customer service. However, I feel the service is still disappointing, and in most aspects there is room for improvement.

How do you see the relationship between the healthcare industry and the NHS changing in the immediate future?

Relationships between the healthcare industry and the NHS will see very few major changes in the immediate future, due to the relatively unstable political climate the NHS finds itself in today. Major developments that one can foresee are primarily related to cost, not care.

The major change that I can see affecting relationships is disposable products being marketed and supplied at a much-increased cost by the healthcare industry, having a quadruple effect on the NHS budget. This is not always done with complete honesty, thus causing mistrust in the customer. The detrimental effect of this on the industry is already becoming apparent – with the result that companies are beginning to take these points into consideration and improve their customer care.

Summing up, I see the relationship between the healthcare industry and the NHS changing through companies becoming more trustworthy, cost-conscious and reliable, and improving their after-sale service to the customer.

 

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Try something different

by Admin 2. June 2006 00:44

 

 

The healthcare industry depends on innovation – but how can sales professionals be innovative? The answer, Gerry Duffy explains, lies in the principles of key account selling.

Throughout 2005, Sainsbury’s ran a series of TV advertisements featuring the ‘wunderkind’ Jamie Oliver. The advertisements showed people sleepwalking as they shopped, drifting through stores, oblivious to the majority of the offerings on the shelves and purchasing only the same items they had bought last time and the time before that. Oliver invited us to wake up and ‘try something different’.

The success of this message was due to the fact that many of us could immediately see the truth in it. The imagery was uncomfortably close to a reality that we recognised only too well: it aptly depicted our normal shopping behaviours.

The old adage that ‘familiarity breeds contempt’ is alive and well and lurking in a shopping aisle near you. As soon as we get our hands on a shopping trolley, we drop into ‘snooze mode’. Actually, many of us drive in a similar fashion – but that’s another, and altogether scarier, story. This ‘sleepwalking’ behaviour is apparent in all walks of life.

How often do you purchase a commodity or service and are left feeling good about the experience? Not often, I bet. All too often, the assistant or sales person is simply going through the motions. As we buy, so too do we sell.

Familiar details

Anyone who has had the privilege of watching salespeople at work will be familiar with the ‘selling by script’ affliction. Call after call, one witnesses the same opening lines, the same questions and – worst of all – the same close. It is truly as if they were talking in their sleep.

One observer has suggested that ‘repeating similar actions, or behaviours, all the while expecting a different outcome’ is a definition of insanity. It follows that many salespeople are experiencing a form of insanity – which is matched only by doctors’ ability to absorb this insanity without protest. While this approach will occasionally produce a serendipitous success, it will routinely fail as markets become ever more sophisticated and customer needs ever more complex.

Purchasing decisions are today, more often than not, team decisions with many participants, each pursuing a different agenda. The layers of decision makers extending through PCOs/PCTs, Strategic Health Authorities, Department of Health etc demand a structured key account approach to selling that can stretch the ability of even the most professional salespeople.

Mapping the stakeholder chain

Salespeople need to acknowledge that they must now sell to meet both the needs of the customer and the needs of the organisation – and that usually these will be different. For example, a clinician may be wholly convinced of the benefits offered by a particular ‘piece of kit’, but the purchasing decision may also have to address cost vs. economic benefits, lease vs. purchase, service and ongoing maintenance requirements, technician/operator training and costs, site requirements… etc…etc. The clinician may have scant regard for ongoing maintenance requirements, but this aspect may be a high priority for the finance director – who, after all, holds the cheque-book!

Meeting the needs of all the stakeholders requires a considerable investment in intelligence gathering – before you even begin to sell. Indeed, you will have to make a judgement call at some point. Do you decide you have enough information to proceed, confident that you can make a short-term gain – or do you invest further time in developing your strategy so as to create a long-term partnership with greater potential returns over time? It’s your call, and one you can only make based on a full understanding of the account.

Having mapped out the stakeholder chain, you will begin to see the shape of the organisational structure you are dealing with. You will have developed an understanding of the decision makers and influencers at various points along the chain, and all of this intelligence will come together as you develop your strategic and tactical plans.

Win-win, not win-lose

Be careful at this point. Some salespeople will seek to find weaknesses in the organisation that they can exploit. They may indeed achieve some early success with this approach, but rarely does it produce anything other than a short-term win followed by a longer-term disaster.

The essence of truly professional key account selling lies in the creation of partnerships that deliver business goals for both the customer organisation and the supplier organisation consistently in the long term. This is only achieved when the needs of both organisations are wholly understood.

Be prepared

“So when do I get to sell?” I hear you cry. Only when you’re ready. Remember the axiom Measure twice – cut once.

Frequently, progress within an account will grind to a halt. You will kick yourself when you discover that the reason for this impasse is something you missed in your planning cycle. Perhaps an individual assured you he was the organisation’s decision maker, but when it came to the crunch he confessed that he would have to take the proposal to the rest of the team for approval.

A ‘glitch’ such as that can mean months of additional account working before you see a return on your investment. Take nothing for granted, and build in checking mechanisms at every stage.

The human factor

If account selling were only about understanding the account structure, how simple it would be! When we add people to the mix, things get complicated.

Anyone who has had the privilege of watching salespeople at work will be familiar with the ‘selling by script’ … It is truly as if they were talking in their sleep.

Each stakeholder in the account will have personal responsibility for one or more aspects of the organisation’s needs. You must understand how each individual’s personal needs may affect his/her organisational need.

For example, a finance director may need – organisationally – to balance the books, but the personal impetus to deliver this organisational requirement could be a strong internal drive to gain recognition from a peer group.

Understanding these personal ‘drivers’ is critical, as they generally expose the ‘need behind the need’ – which is usually a more powerful driver than the expressed organisational need. For example, a finance director and a ward nurse may be officially driven by the same need when making a decision about purchasing capital equipment: the need to balance cost with clinical benefit. But the unspoken priorities may be different: the finance director may be motivated primarily by the approval of the other directors, while the ward nurse may be motivated primarily by the approval (and recovery) of patients. Easy really, isn’t it? Why, you could almost do it in your sleep. Ooops!

The spice of life

While some people can build careers on ‘selling by rote’, this style will simply not deliver in a key account environment. But who wants to sleepwalk through life? Key account management may demand inordinate amounts of time for planning and preparation, but the thrill of succeeding in this environment is second to none! So try something different with every customer.

And, you may be wondering, did Jamie Oliver rouse the shoppers to ‘try something different’? Well, in one advertisement he suggested sprinkling nutmeg over traditional spaghetti bolognaise. In the week that followed, Sainsbury’s had to scour the world for additional supplies of nutmeg, and ordered two years’ worth of stock (around nine tons) to fulfil customer demand.
What difference will you make today?

Gerry Duffy is Managing Director of White Water Rapid Solutions Ltd. He can be contacted by e-mail on gerry.duffy@wwrs.fsnet.co.uk or by phone on 0151 920 0166 or 07830 155994. For more details of White Water Rapid Solutions, visit their website at www.whitewaterrapidsolutions.co.uk

 

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Healthcare technologies in the UK

by Admin 2. June 2006 00:39
 

 

Healthcare technologies in the UK

On Target interviews John Wilkinson, Director-General of the Association of the British Healthcare Industry (ABHI)

What is the role of the ABHI in the UK healthcare products industry?

ABHI is the voice of the UK Medical Technology Industry and has a membership that comprises manufacturers of medical devices, equipment and consumables, as well as service companies, distributors, professional groups (such as architects and lawyers) and other suppliers to the medical community.

As the most representative and largest healthcare trade association in the UK, the ABHI is best placed to represent the industry’s interests on critical issues affecting the UK market to key audiences. To be the loudest and the strongest voice is essential when representing membership interests. ABHI has strong relationships with a number of professional associations, other trade associations, NHS organisations, patient groups and healthcare professionals. These relationships come into their own when ABHI works towards the achievement of a goal, and broad stakeholder representation is needed to effect change.

How do healthcare companies benefit from membership of the ABHI?

As well as the macro benefits the ABHI delivers to the healthcare industry through influencing government policy and legislation, regulations and standards, and key groups and agencies, companies also benefit individually from ABHI membership.

ABHI members profit from networking at ABHI meetings, conferences and other events. We provide information on business development and competitiveness and give members exposure to UK and international business opportunities. We support companies in their exporting activities by helping them access new sources of funding. We regularly host international trade missions to target markets, and host a British pavilion at the major worldwide exhibitions.

ABHI members can participate in our Special Interest Sections: industry working groups that concentrate on promoting the interests of specific healthcare products or policy areas. The Association also helps individual companies to navigate the Government and regulatory environment when they have specific problems.

What are the key industry or NHS issues that the ABHI is currently seeking to address?

Through our Policy Groups and Special Interest Sections, ABHI tackles a wide range of horizontal and vertical industry issues. For example, the Research and Innovation Policy Group looks at all the issues within this par- Instruments Special Interest Section will look at all issues related to this product type. Of course, all our members are crucially affected by the vagaries of their biggest customer, the NHS. The recent pressure from Government to cut costs in the face of the NHS financial deficit has been felt sharply throughout the industry. In times of financial trouble the NHS looks to industry to share the burden, and it is able to use its position as virtually the sole buyer of medical technology in the UK to drive down prices. The NHS Purchasing and Supply Agency (PASA) and the Commercial Directorate are charged with setting costcutting targets and introducing procurement initiatives to help trusts slash their deficits. While the medical technology industry may look like fair game from a Whitehall perspective, the well-being of the industry is intrinsically linked to that of patients. If healthcare companies can no longer afford to fund research and development, or if they go under, this damages the UK healthcare system as a whole. It is the ABHI’s task to put these arguments across to the decision-makers in Government.

The ABHI is also at the centre of initiatives to encourage the creation of high valueadded jobs in the UK, and firmly believes that medical technology is a critical sector for the future of the UK economy. In this context we are very active in championing the cause of small and medium-sized businesses, as they are the source of so much radical innovation in patient care.

What do you see as the main challenges faced by UK healthcare companies at this time? Do major corporations and small to medium-sized enterprises (SMEs) face the same kind of challenges?

SMEs and major corporations are mutually dependent at a strategic level, though they may often tussle with each other on a day-today basis as all competitors in a vibrant market will. The vast majority of ground-breaking innovations come from the small business sector, and are often then incorporated into large corporations at a later stage. The large corporations are very good at quality and cost improvement, global marketing and steady incremental technology improvement.

All companies operating in the market are looking for innovative customers who value new technology for what it can offer the patient and the system. The UK remains “a late slow adopter” of technology, as Sir Derek Wanless said in his report on the state of the NHS, and changing that situation remains the biggest challenge for companies large and small. It is for that reason that the Association and Government are engaged in the Healthcare Industries Task Force (HITF), which reported in 2004 and is in the middle of implementation.

The ABHI firmly believes that medical technology is a critical sector for the future of the UK economy.

In an innovation-averse environment the small companies introducing new technologies obviously suffer badly, as they cannot build a business base in the UK and often have to go overseas for early sales. This increases risk by escalating costs, and often acts as a deterrent for investors who ask why they cannot see the technology in use in the home market of the company. Large corporations suffer in the longer term, as they increasingly look elsewhere to develop and launch new products. All of this means later access to life-saving technologies for patients in the UK and a reduced incentive for companies to invest in research, development and manufacturing in the UK.

How will current changes in NHS resourcing and procurement affect the healthcare industry? What are the positive aspects of these changes? What are the dangers?

The trend towards more centralised procurement in the NHS, with the increase in national contracts, is creating problems for the small and medium-sized businesses (or SMEs) that typify the medical technology sector. These companies do not have the capacity to tender for contracts on a national scale and are being driven out of the marketplace.

This leaves the market to just a few large suppliers. However, the larger companies are also under pressure from the dramatic price cuts the NHS is using these contracts to introduce. Many of these cuts are arbitrarily introduced and not sustainable in the long term.

The more choice and responsibility are placed in the hands of the patients, the more information they need; and undoubtedly, the industry is one of the key sources of that information.

The danger is that UK companies will be either driven out of business or forced to concentrate on selling to other countries (something that is already happening). The real loser in all this will be the patient as the NHS purchases older equipment to try and save in the short term, leading to patients not receiving the best possible treatments. This also removes the incentives for innovation, meaning a lack of investment in research and development for the future. The irony is that driving companies out of the marketplace means that the competitiveness of the sector is reduced, which will lead to higher prices in the longer term. Also, the use of older equipment actually increases the costs of healthcare, as it leads to longer hospital stays and reduced efficiency.

To what extent does the increased emphasis on homecare and patient choice mean that the market for medical technologies is becoming more consumer-driven? How should the industry respond to this?

There is undoubtedly a very sensible shift in emphasis from managing patients in expensive hospital environments to more treatment at home. This benefits the patients, the system and the economy as a whole. In parallel with this is the inevitable increase in the need for patients to manage themselves more effectively as they become less packages going through a hospital system and more responsible for their own care. The more choice and responsibility are placed in the hands of the patients, the more information they need to exercise the choice and take an active role in their own care. All of this means that reliable information needs to be available; and undoubtedly, the industry is one of the key sources of that information.

To deliver this in an efficacious way the industry will need to look at raising standards to the level of the best in class, and I believe that regulatory systems will be introduced to support this either on a voluntary basis or, if there are significant examples of poor practice, via externally enforced regulation.

How are current changes in public healthcare need affecting the UK medical technologies market?

We are at the very earliest stages of reform of public health, and there remains a significant reluctance to employ technologies designed to help manage patients in their homes.

Hopefully, the planned shift of the balance of resources towards community care will encourage a strong stimulus to the use of appropriate technology, and the temptation to just throw people at the problems will be resisted.

On Target - Healthcare technologies in UK

How will the impact of new technology change the healthcare industry over the next few years?

The pace of technological change in healthcare is accelerating all of the time, and individual companies will have to be even more alert and responsive than they have been in the past. The incremental changes that characterised the industry for most of the last century are giving way to disruptive changes that have a radical effect on both the cost and the effectiveness of care. For example, managing colon cancer has moved from late open and radical surgery, through more effective in vitro and in vivo diagnostics, to management via endoscopy. Not far away are virtual colonoscopy, where tumour cells are illuminated via bio-markers, and very targeted surgical interventions at an early stage of disease development. The cost and outcomes impact of such massive innovative changes is huge, and will be replicated in many other areas of clinical care as computing, biochemistry and engineering converge in ways that just a few years ago would have seemed unimaginable.

What are the commercial prospects for innovation in the UK medical technologies field?

The UK is still a net exporter of medical technology, and this situation is built on a legacy of top-class medicine, engineering and science. HITF is all about ensuring that the legacy is not squandered, and that we increase the productivity of research and development and translation of that legacy into businesses that can benefit the economy as a whole. Getting the market and research environment right is critical to making the UK a springboard for businesses. Failure to do so will see an overall decline in medical research (as industry is a key contributor) and a migration of jobs overseas. I am optimistic that we can get the virtual circle operating.

How do you see the structure of the healthcare industry evolving? Does the future belong to large corporations or to diverse and specialised SMEs?

Neither. The market has been and will remain dynamic, with innovative small fry populating the emerging end and large multinationals consolidating at the more mature end of the business cycle.

Occasionally the consolidations don’t work and break up into new configurations, but essentially I do not see industry structure changing too dramatically though individual companies will continue to change status as sectors evolve. Small non-innovative SMEs will continue to be under greater pressure than most as economies of scale become increasingly an issue. They will have to generate some very specific local service value in order to continue to exist in the face of large broad-line suppliers.

How will the ABHI provide support to the industry in a changing environment?

The ABHI will continue to inform members ahead of changes, so helping them to adapt.

We will continue to endeavour to be valued stakeholders when policy is being developed, so moving from reactive to proactive in policy development. We will continue to explain to Government and other stakeholders why medical technology is fundamentally different from pharmaceuticals and needs to be understood for effective policy to be developed.

We will continue to explain to Government and other stakeholders why medical technology is fundamentally different from pharmaceuticals and needs to be understood for effective policy to be developed.

Most important, we will continue to work to ensure that technology is part of the solution for the NHS rather than part of the problem.

What should sales and marketing –professionals in the healthcare sector be most worried about? What should they be most encouraged and motivated by?

Sales and marketing professionals should be most worried about threats to the unique and valued relationship that they have with clinicians, as buyers are increasingly trying to manage them out of the hospital in some cases. The level of professionalism demonstrated by sales and marketing people can substantially influence this tendency. Highly ethical and knowledgeable professionals will continue to be welcomed for their ability to inform, train and support customers. The opposite is, of course, the case for those who do not operate to the most exacting standards.

The Association of the British Healthcare Industry
The ABHI has been representing the medical systems industry for more than ten years, providing the lead and expertise on general and specialist healthcare issues for the industry. A key factor in the Association’s success is the active participation of member companies. If you are looking for a trade association to represent your interests in both the UK and European Medical Devices industry, please contact enquiries@abhi.org.uk or tel: 020 7787 3061.


There is still a huge paucity of training in the NHS, and I believe that the role of sales and marketing organisations will continue to be crucial to the NHS if it is to accelerate new technology adoption. I believe that there is, through the HITF process, a growing opportunity to get buyers, managers and clinicians constructively engaged in the procurement of products that offer best value rather than lowest price; and the message about redesigning clinical pathways and processes around opportunities afforded by new technologies will get through more broadly.

The role for professional sales and marketing teams is pivotal in project-managing these interactions and ensuring that sales are followed by training and effective support for change management. The pace of change will increase, and that creates opportunities for those who wish to take them.

ABHI Logo John Wilkinson is Director-General of the ABHI. More information about the ABHI is available on their website at www.abhi.org.uk

 

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Health is wealth: the vital role of medical technology

by Admin 2. June 2006 00:37
 

 

Health is wealth:

the vital role of medical technology

European healthcare policy-makers’ obsession with cost-containment could be an expensive mistake. On Target Editor Chris Ross looks at how investment in medtech could provide the solution by delivering wealth through health.

Improving public health must become an economic priority, says Dr Drago Cerchiari, the Chairman of Eucomed. Without long-term investment in health, healthcare and social costs will continue to rise and the European economy will suffer.

Drawing parallels with a former EU Health Commissioner’s famous “Health is Wealth” speech in 2003, Cerchiari warns that Europe should look at “what health puts into the economy and what illness takes out”.

The money or the medtech

Cerchiari’s words come at a time when the healthcare industry finds itself under increasing pressure to contain costs. And nowhere is this focus sharper than in the medical technology environment. Yet, far from being the root of the financial problem, medtech may well be the answer to economists’ prayers.

Achieving this depends on a cultural shift in perception, thinking and understanding. The medical device and IVD (in vitro diagnostics) sectors, while different in many aspects, are complementary in their aim to improve patient care. Their leading European associations, Eucomed and EDMA respectively, have joined forces to inform and educate policymakers and stakeholders about how early awareness of the specific benefits of medical technologies can reduce the need for later medical intervention.

The medical device and IVD sectors currently have over 10,000 products available in Europe alone – and yet, according to EDMA President Jean-François de Lavison, awareness of them remains low. “When we mention healthcare products, most people think of the pills and potions they buy at the local chemist’s,” he said. “Yet when you walk into a hospital, or a doctor’s practice, medical technology is everywhere.

Much of it is very familiar: orthopaedic shoes, contact lenses, blood tests, pregnancy tests, infectious diseases tests and cardiac markers, for example.”

The fashion to ration

Despite their widespread use and value, medical devices and technologies currently suffer as a result of the increasing obsession with cutting healthcare spending. Such rationing of healthcare is leading to discrimination in patient access to innovative medical treatments. At the same time, new methods of rationing – such as the centralised procurement of medical technology – are having a negative impact on innovation.

Pressure to keep healthcare budgets under control has led to widespread reprocessing of single-use medical devices – which, Eucomed says, is dangerous and counter-productive.

“Many hospitals attempt to clean devices or outsource the job to reprocessing companies. They assume that this can save money. This assumption is incorrect,” says Dr Cerchiari. “A single-use medical device is designed to be used once then disposed of. If reused, there are potentially severe consequences for patient safety. These are: infection, injury, diagnostic errors and ineffective care. These consequences have a cost. The cost of repeat surgery. The cost of repeated diagnostic tests. The cost of hospitalacquired infection. The cost of patient incapacity, pain and suffering.” The trend towards cost-containment in health is, says EDMA, misplaced. Health should be seen as a driver of economic growth. So how can medical devices and IVDs play a part in this growth, and in the process facilitate a shift in cultural thinking away from healthcare rationing? Investment in diagnosis will, says de Lavison, provide economic benefits by reducing overall healthcare expenditures. “Finance ministers should work hand in hand with health ministries. Together they should consider the positive economic impact of investing in medical technologies.”

Taking control of health

The increasing longevity of the patient population has, of course, impacted on the costs of managing public health. However, according to EDMA, there is evidence that investing in population health brings substantial benefits to the economy. For example, researchers at Oxford University have recently estimated that cardiovascular disease costs the EU €169 billion annually, with Germany and the UK along accounting for 54% of this. Productivity losses represent 21% of costs, and informal care 17%.

“Cardiovascular disease represents an average annual healthcare cost of €230 per EU citizen. It is the leading cause of sickness and premature death, killing 2 million people every year in the EU. Healthier lifestyles, early diagnosis and better access to innovative treatments can help to reduce the burden on society of cardiovascular disease.”

Medical devices undeniably have a major role to play in the treatment of cardiovascular disease. Interventional cardiology, including coronary angiography, coronary stents and the management of arrhythmia and stroke, provide excellent examples of the contribution made by medical technology to patient care. In its 2004 review of the sector, Eucomed highlights a continuous trend of innovation in the development of procedures in these areas, pointing out that advanced techniques used in minimally invasive surgery help to avoid complicated procedures and reduce the length of stay in hospital. Diabetes is another therapy area where medical technology can play a major role.

According to EDMA, diabetes accounts for between 5% and 10% of a nation’s health budget, with over 194 million people suffering from the disease worldwide. “If nothing is done to slow the epidemic, the number will exceed 333 million by 2025. Diabetes patients suffer from an increased risk of cardiovascular disease, kidney failure, blindness and amputation. Combined with the promotion of healthy lifestyles, the use of innovative medical technology, such as blood glucose self-tests, can considerably reduce the impact of this illness.”

Recent studies demonstrate that intensive control of glucose levels can reduce the risk of new eye disease by 76% and the risk of early kidney disease by 54%. Similarly, it can reduce the risk of nerve damage by 60% and the prospect of heart disease by 56%. “In vitro testing is the basis for better decisions in health care,” says de Lavison.

Now’s the time

Persuading purchasers to invest in medical technology remains a significant challenge for the sector. Over the coming months, On Target will highlight the benefits of such technologies and the vital roles they have to play in improving public health. Like its close sibling, the pharmaceutical industry, the medical product industry is among the most innovative sectors in the UK. Next month, we take a close look at the European market.

Who are EDMA and Eucomed?
EDMA (European Diagnostic Manufacturers Association) represents the interests of the In Vitro Diagnostic (IVD) industry in Europe. EDMA’s membership is composed of 21 National Associations and 14 corporate members, dedicated to the manufacturing of biological and chemical reagents, automated machines and devices that are used for the medical analyses of body fluids. EDMA’s mission is to raise awareness of the value of in vitro testing, to support an appropriate regulatory system, to work towards a realistic economic environment for health care in Europe, and to be an effective voice in globalisation. For further information, visit www.edma-ivd.be/


Eucomed is the voice of the medical technology industry in Europe. Eucomed represents 4,500 designers, manufacturers and suppliers of medical technologies used in the diagnosis, prevention, treatment and amelioration of disease and disability. Eucomed members include national trade and pan-European product associations and internationally active manufacturers of all types of medical technology. The mission of Eucomed is to improve patient and clinician access to modern, innovative and reliable medical technology. For further information, visit www.eucomed.com

 

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Are you good enough to be one of our future leaders?

by Admin 1. June 2006 05:00

Procter & Gamble Pharmaceuticals Management Development Programme

Imagine working for a world renowned, multi-national blue-chip company that recognises your ambition, talent and potential. A company where the exceptional performance you deliver is rewarded with accelerated career development, aggressive salary management, unusual levels of job satisfaction and the reassurance that your career really is going places. In a recent survey conducted by High Fliers Research, Procter & Gamble was The Graduate Employer of Choice for Sales. In addition P&G ranks no.9 in the Times Top 100 Graduate Employers 2006.
We are offering an exciting opportunity to join the Pharmaceuticals division of Procter & Gamble. We are looking to hire highly successful individuals who, based on their passion for winning and ability to continually deliver exceptional results , will become the senior managers of our future.

The Company

At P&G we believe our people are our number one asset. Our tradition is rooted in the principles of personal integrity, respect for the individual, and doing what's right for the long term. It is the strength of our people that has enabled us to become a global success story with one of the largest and strongest portfolios of trusted, quality brands; Pampers, Olay and Pringles to name but a few.


Focus on Pharmaceuticals

  • One of the fastest growing divisions within P&G
  • Market leaders in the treatment of Osteoporosis and Inflammatory Bowel Disease
  • Pharmaceuticals has the fastest brand to reach one billion dollar status in P&G
  • Strong product pipeline with an imminent, first to market product launch in the category of womens health
  • Helping improve the lives of millions of patients across the world.

The Management Development Programme (MDP)

We need ambitious, talented and driven people to ensure we continue to out-think, outplay and out-invent our competitors in all we do. Our ‘promote from within’ ethos means that we must hire, train, develop and coach top talent to lead our organisation to future success. The MDP is a unique opportunity to accelerate your development and fast track your career within the Pharma Industry. You will benefit from:
  • Continued investment in your personal development through a first class, structured training programme
  • Challenging development and real responsibility from day one
  • Varied assignments and opportunities to build on your strengths and broaden your skill-set
  • Being highly rewarded and recognised for your strong performance and results

How does it work?

Starting as a territory manager working in the field you will be accountable for delivering your sales volume and market share goals by working innovatively to influence your NHS customers. The rate of career development and the duration of your assignments will be dependent upon your ability to exceed your sales targets and demonstrate proven performance in role. Having managed your own territory you will then have the breadth and depth to excel in your next assignment. From this initial grounding you will then move through a number of developmental roles to build on your strengths and skill set. The principle stays the same though – you must excel within each role as you climb the career ladder.

Are you what we are looking for?

  • An ambitious and commercial high flier you have a proven track record of achievements in your field.
  • Positive and proactive, you are hungry for progression and know that you are the best at whatever you apply yourself to.
  • Excelling in a sales role, you are confident in your own abilities and know that you have the potential to go all the way to the top, with the right organisation.
  • Perhaps you are currently on a Management/Graduate Development programme but despite your excellent results, don’t seem to be getting anywhere fast.
  • Passionately committed to your career goals and you have the flexibility to pursue them

What else is important?

To be accepted on to the ‘Management Development Programme’ you must be totally mobile within the UK and be ready and willing to relocate as opportunities arise. You will be educated to degree standard (minimum 2:1) and will have a full driving licence.

What do you need to be successful?

In order to benefit from one of the most challenging and rewarding ‘Management Development Programmes’ in the industry you will need to demonstrate that;

  • You consistently exceed expectations through exceptional personal leadership
  • Positive and proactive, you are hungry for progression and know that you are the best at whatever you apply yourself to.
  • You can get results through selling and influencing
  • You possess excellent communication and inter-personal skills
  • You can inspire others and bring them round to your way of thinking
  • You are a self starter that is driven by achieving the end result

“If you associate with what you have just read and are brimming with enthusiasm and a passion to learn then don’t miss out on this top flight opportunity”.


To register your interest in our Management Development Programme please call our exclusive consultants at STAR Medical on: 0870 2422025 or email: P&G@starmedical.co.uk Closing date for applications 7th July 2006.

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The IT Factor:

by Admin 1. June 2006 05:00
The IT Factor

 

The IT Factor:

how honest is your ETMS reporting?


By Chris Ross, Editor, Pharmaceutical Field

Virtually all modern-day representatives have access to an ETMS. Yet despite its almost total uptake across the industry, honest and accurate use of it among sales professionals remains the exception rather than the rule. As Pf’s 2005–6 survey shows, you can take a horse to water, but you cannot make IT sink in.

THIS YEAR’S Pf Company Perception, Motivation and Satisfaction Survey, conducted independently by the Royal Statistical Society, proved conclusively that pharma is embedded in the e-age. While electronic territory management systems (ETMS) have been in existence for well over a decade, it is perhaps only in the last few years that they have become a major part of the representative’s toolkit, with the paper-based operations of some of the more traditional companies almost totally extinct. The Pf study showed that 95% of survey respondents had access to an ETMS of some description, whether laptop, PDA or desktop. However, it would appear that the full benefits of the technology are yet to be realised by representatives. Large numbers seemingly view ETMS as Big Brother-like surveillance designed simply to monitor their performances. Despite being equipped with such valuable tools, usage levels among the field force remains lower than the industry’s ROI gurus would like. Perhaps even more worrying is the fact that fewer than half of the survey’s respondents claim to report their findings accurately 100% of the time. Only 45% of the sample claimed to be totally honest in four major areas where they are called upon to report their visits: the number of customers seen face to face, the number of customers sold to at meetings, the number of products sold and the delivery of key messages for every product sold. A quarter of respondents the admitted that they ‘sometimes’ or, worse still, ‘never’ provided honest reports of their visits.

Table 1 – Accuracy of reporting
Respondents were asked to indicate how accurately they recorded information in four key parameters. Were they always, mostly, sometimes or never accurate?













The repercussions for sales force metrics are significant: how can current sales force strategies be measured and improved if the information gathered and inputted in the field cannot consistently be trusted as accurate?


Likewise, usage among representatives remains sporadic. Respondents were asked to reveal how frequently they used ETMS to file a post-call report, and also how often they set appropriate pre-call objectives on ETMS. Across the board, only 45% of respondents said that they always filed post-call reports, while 13% admitted that they never bothered. In the area of pre-call objective setting, the figures were even worse: only 26% always set their objectives on ETMS, only a marginally higher figure than the 20% who said they never did.

Table 2 – Frequency of reporting
Respondents were asked how often they filed appropriate post-call reports and set pre-call objectives on ETMS.














The IT girls As in previous years, fractionally more women completed the survey than their male counterparts (53% vs. 47%). However, this relative willingness to provide information is not wholly reflected when it comes to filing call reports. Survey analysis reveals that while women are marginally more honest in the accuracy of their reporting, there is no discernable difference between men and women in their overall usage of ETMS.

Table 3 – The Battle of the Sexes (part i): Reporting accuracy















Table 4 – The Battle of the Sexes (part ii): Frequency of reporting














Midlife crisis? Another interesting comparison can be made between the use of ETMS among older, more experienced representatives and younger users. The most commonly represented age band in the survey was, as in all previous Pf studies, the 25–34 band. Analysis of the ETMS behaviour of those beneath the age of 34 and those over the age of 45 actually dispels the myth that the younger generation is more accepting of technology. Though still low, usage in these two groups is largely very similar in the area of pre-call objective setting on ETMS. The under-34s appear more willing to submit post-call reports, though the figure of 51% who always file reports is hardly a ringing endorsement for the age group.
In terms of honesty, the younger group holds a clear edge over its more experienced peers in one of the key parameters: 69% of the under-34s claim that they always accurately report the number of face-to-face visits they have, which is well above the survey average (50%). With 57% of the over- 45s also stating that they always report face-to-face customers accurately, it is clear that the mid-range age band of 35–44 are underperforming in this area. Critically, however, performance in the other three parameters remains disappointing across all age bands.



Table 5 – The Generation Game (part i): Accuracy of reporting














Table 6 – The Generation Game (part ii): Frequency of reporting














The industry has, over many years, earned a reputation for being a late adopter of technology. While this may be the case, the Pf survey clearly shows that ETMS or similar systems are a core part of representatives’ weaponry. However, the study also demonstrates that there is still some way to go before medical professionals see beyond simple ‘monitoring’ and recognise the true value of the technologies at their disposal. As articles elsewhere in this issue show, CRM and ETMS can make a significant and positive difference to a customer call. Success depends on two IT factors: greater use of the technologies available and more honest call reporting. IT could make the difference between success and failure.

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Reaching doctors through the Internet

by Admin 1. June 2006 05:00

A new report from Datamonitor shows that drug representatives must embrace new technology to avoid missing sales opportunities.


IN A MARKET where the days of the blockbuster-selling primary care drug appear to be numbered, the days of pharmaceutical sales representatives having the time to visit physicians and provide them with drug samples are also running out. In a recent survey conducted by independent market analyst Datamonitor, 71% of surveyed physicians report that the availability of sample packets from drug companies impacts their prescribing decisions. However, 38% of the same physicians report that they do not receive enough samples through traditional methods of sample delivery, and 22% complain that the supply of drug samples is too unpredictable in general.
Sales representatives must now employ Internet technology to ensure the efficient distribution of samples to physicians, and must also take on the role of educators in their changing and dynamic relationship with their customers.

New playing field

Today’s pharmaceutical sales representative faces several challenges. Many drugs will lose patent protection within the next five years. This, combined with the dry product pipelines, means that representatives are increasingly faced with selling branded drugs for which there are cheaper generic alternatives.
As the age of primary care blockbusters draws to a close, pharmaceutical companies are moving to focus a greater percentage of their R&D budgets on developing specialty drugs for smaller patient populations. Intense competition within a limited number of highly-profitable specialty drug markets means it is even more important than before for medical sales representatives to gain access to key physicians and non-physician prescribers, says Datamonitor eHealth analyst Kimberly O’Malley. “These challenges are surmountable, but they will require a restructuring of the traditional sales and marketing model. Future sales and marketing teams will be forced to do more, like launch patient- as well as physician-targeted campaigns in both domestic and foreign markets, on smaller budgets. “While eHealth applications, such as eDetailing and eSampling, are not complete solutions to overcoming current challenges within the market, strategic implementation of Internet-enabled services has the potential to positively impact sales force efficiency and effectiveness.”

Getting through to customers

In addition, beyond the traditional detailing and sampling roles, the pharmaceutical sales force can bolster a company’s other physician-facing online efforts by taking on the role of educators. Many prescribers continue to depend on representatives as a primary source of information on both new drugs and new clinical data for existing therapies.
Datamonitor has found that approximately half of the surveyed physicians in the EU and the US have accessed a pharmaceutical sales representative as a source of medical information during the past week. O’Malley comments: “The problem is that very few sales representatives have adequate face time with key prescribers. Gaining access to physicians is difficult because even those physicians who would like to spend more time with a sales representative often do not have the time to do so during their work day.”
Furthermore, sales representatives generally fail to make the most of the little time they have with prescribers. This is one of the key reasons why Datamonitor observes that representatives are losing influence to patients in the prescribing process. The trend towards consumerism means that the prescribing decisions of the physicians surveyed are just as likely to be affected by patient requests for specific medications as by visits from sales representatives.

Harnessing available technology

Medical representatives can use Internet-enabled services to improve their influence and efficacy by supplementing traditional sales and marketing practices with eHealth applications such as eSampling. There are three ways in which eSampling can be used as a supplement to traditional, representative- based methods of drug sampling:
1. The physician orders samples online, usually through a third-party Web portal. The samples are then delivered by post to the physician’s practice.
2. Instead of ordering a specific number of samples, the physician prints out a single sample voucher from the Internet. The voucher can be given to a patient during a consultation, together with a prescription; the two are then redeemed at the patient’s local pharmacy.
3. The patient downloads a voucher from the Internet and presents it to the doctor for approval. More than the other methods of eSampling, this approach allows patient requests to influence the physician’s prescribing behaviour. However, it is not permitted by law in most countries other than the U.S.
Although 29% of surveyed physicians state that in-person delivery of drug samples by a sales representative is their preferred method of sample delivery, electronic sampling provides pharmaceutical companies with a cost-effective means of reaching physicians who have routinely been under-covered by representatives.

Benefit all round

The improvement of services to physicians means that patients are better served, since patients are more likely to fill a prescription if their physician has samples on hand. Recent Datamonitor surveys find that only 54% of surveyed consumers will always fill a prescription regardless of whether they receive a sample, voucher or coupon. The remainder, surprisingly, are most likely to fill a prescription only in the presence of a cost-saving supplement provided by the physician.
Drug sampling is a critical, but increasingly difficult, aspect of pharmaceutical sales and marketing. Like detailing, it is a central part of the relationship between the sales representative and the doctor. However, the efficient delivery of drug samples suffers as doctors cut the amount of time they spend with representatives. O’Malley says: “eSampling allows sales representatives to respond more accurately to physicians’ demands. Over time it also allows reps to anticipate when a need is about to arise based on collected metrics, such as the timing of past sample requests.
“Armed with this knowledge, pharmaceutical sales representatives can expand their roles outside of the traditional detailing and sampling responsibilities. [They] can be used to bolster a company’s other physicianfacing online efforts, by taking on the role of educators.” As well as guaranteeing that physicians receive both the information they need about a drug and the samples they need to start patients on the therapy, the sales force can prepare physicians to field questions posed by patients. “In particular, an overview of the messages patients receive through TV and magazine ads, as well as through company-sponsored websites, should be shared with physicians.
“In this way, physicians can begin to be integrated into the multi-channel marketing mix that their patients have come to know, and in this way can better support patient requests and queries.”

Net profits

Datamonitor’s report Optimising Sales Force Effectiveness: Using eHealth Applications to Improve the Quality of Physician Interactions explores how pharmaceutical companies can use eHealth applications to improve drug representatives’ access to key prescribers, with particular emphasis on eDetailing and eSampling.

Ms Kimberly O’Malley, Datamonitor eHealth analyst and report author, is available for comment. Datamonitor plc is a premium business information company specialising in industry analysis. We help our clients, 5000 of the world’s leading companies, to address complex strategic issues. Through our proprietary databases and wealth of expertise, we provide clients with unbiased expert analysis and in-depth forecasts for six industry sectors: Automotive, Consumer Markets, Energy, Financial Services, Healthcare and Technology. Datamonitor maintains its headquarters in London and has regional offices in New York, San Francisco, Sydney, Tokyo, Frankfurt, Shanghai and Hong Kong. See www.datamonitor.com for further details.

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Divided loyalties: a mixed response to PCT restructuring

by Admin 1. June 2006 05:00

With almost half of PCTs to be merged out of existence in October, the customer landscape for the medical representative has again changed. Pf’s Assistant Editor Diana Spencer takes a look at local and national reactions to the news.

 

ALMOST HALF of the Primary Care Trusts (PCTs) in England will disappear in October 2006, following a major reorganisation by Health Secretary Patricia Hewitt. The Department of Health says the changes are designed to provide services shaped around the needs of patients, and will deliver value for money for taxpayers. But some critics claim the move is ill-timed and will not deliver anticipated cost-savings, while others accuse the Government of ‘reinventing the wheel’.
The restructure, which brings about a shift in focus from hospitals to community-based care, will see the number of PCTs drop from 303 to 152. It represents the final part of the ‘Commissioning a Patient-Led NHS’ consultation, which ended in March.

Benefits of the reorganisation

The new ‘supertrusts’ have been designed to coincide more accurately with local authority boundaries, with the intention of building a closer working relationship with social services, and giving patients better access to GPs. Perhaps more significantly, Hewitt has announced that she expects to see annual savings of £250 million as a result of the changes. “The new PCTs will be better organised to commission services that best suit the needs of their local population,” she said. “These changes will also put more power into the hands of GPs and other frontline NHS staff and give them a greater say in how services can be delivered around the needs of their patients.”
But not everyone is so optimistic. Niall Dickson, Chief Executive of the charitable foundation The King’s Fund, said: “We remain unconvinced that a complete reorganisation of the health service at such a crucial time is the right thing to do. However, the move to reduce the number of health organisations was inevitable and is a sensible move for the long term.” While Dickson conceded that the changes should lead to a strengthening of management within PCTs, and welcomed the decision to match PCT and local authority boundaries, he remained sceptical that the move will have the economic impact the Government expects: “The big question is whether or not these structural changes will deliver the £250 million of cost savings that the government has promised.”
The NHS Alliance, which represents over 90% of PCTs in the UK, said that the announcement brought a welcome end to months of conjecture and instability. Its Chairman, Dr Michael Dixon, warned that there was much to do before the changes took effect. “What matters now is that there is smooth hand-over to the new PCTs and that individual PCT staff members are treated fairly and reasonably. That is essential if we are not to lose momentum in implementing practice-based commissioning and other NHS reforms. The new PCTs will have to hit the ground running in October, so the next few months are critical,” he said. “Most importantly, they have to build relationships of trust with their local clinicians. That is not going to be easy for those that cover large geographic areas. Strategic clinical leadership is the key.”

Commitment to local interest

The reorganisation of PCTs will have a major impact on sales professionals working at the coal-face. So what kind of reaction to the changes can representatives expect from healthcare practitioners up and down the country?
The Health Secretary says that the changes to the PCT structure were carried out according to the best interests of the local people who will be affected. “I have spent a great deal of time considering local views and concerns about the reconfiguration and have not been afraid to respond to these concerns in my final decision. These changes make it clear that there is not a blueprint for PCTs across the country and the final decisions reflect a range of views and will deliver the best for patients in all parts of the country.” In some cases this has been successful, and there are many examples of localities that have welcomed change (or the lack of it). PCTs such as Darlington, Hartlepool, Middlesbrough, Stockton & Redcar and Cleveland were successful in retaining their independence, while others were inexplicably merged out of existence. Bassetlaw locals were relieved, after extensive petitioning to remain independent, to hear that their PCT would not be merged with the new Notts County PCT. Louise Newcombe, Chief Executive of Bassetlaw PCT, told Worksop Today: “This is an excellent example of how local people’s views have been taken into account and made a real difference.”
Changes were also endorsed in Essex, where the decision was made to reduce the county’s PCTs from 13 to five rather than the two favoured

 

by health chiefs. Harlow MP Bill Rammell was delighted with the decision: “Harlow and Epping Forest PCTs have been very effective in delivering health services for my constituents. I wanted their achievements to be carried over into a new West Essex PCT through joint working. I’m pleased that the Government has backed my view and that of the overwhelming majority of the public in Essex.”

“Bureaucratic monstrosities”

However, there are other instances where local opinion seems to have been completely ignored. There was a bad reaction to plans to merge the South Huddersfield, Huddersfield Central and North Kirklees PCTs into one organisation. Disappointed with the merge, Kirklees Conservative leader Clr Robert Light told the Huddersfield Daily Examiner: “Health services should be localised to ensure people get a fair deal, but instead all we get is bureaucratic monstrosities.”
Harborough MP Edward Garnier also shared the fears of his constituents that their PCT would lose its local focus through a merger with the Melton and South Leicestershire PCTs. He commented that the NHS has now been returned to a similar structure to that before 1997, telling Harborough Today: “The Government has reinvented the wheel several times since then but now we are back to where the Conservative Government left off.”
Elsewhere, the locals of Middleton are not unhappy about the proposed merger of Heywood & Middleton and Rochdale PCTs – but rather about the fact that, after extensive argument to the contrary, the new PCT is to be named ‘Rochdale’ PCT. Government officials, concerned for local interest, feel that Middleton has been ‘trampled upon’ by an ‘NHS Juggernaut’. The Greater Manchester SHA has defended its decision on the grounds that the new PCT will match the boundaries of Rochdale Metropolitan Borough Council.

Strategic Health Authorities

Changes have also been recently made to the number of Strategic Health Authorities (SHAs), which will fall from 28 to 10. The new SHAs, which the Government says will be more strategic and deliver stronger commissioning functions, come into effect next month. The DH said the changes to the SHA structure would strengthen the architecture of the local NHS, and save money by streamlining management and administration so that more resources can be dedicated to patient care. In addition, it said, the configuration will “cut out unnecessary bureaucracy by bringing together administration services and reducing the duplication of administration, human resource functions, accounts and hospital contract negotiation teams”.

Too much pressure?

The number of jobs under threat due to the wholesale reorganisation remains unclear, though cuts seem inevitable as Trusts battle to lower administrative costs. This is an obvious concern for many local PCTs. The changes will possibly have the greatest impact in places such as Norfolk, where PCT debts of up to 10.5 million mean that five PCTs will have to become one organisation.
Clearly, the restructuring programme will place all PCTs – particularly those that have retained their independence – under intense pressure to achieve financial stability before the changes come into effect in October.

 

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Innovex Representative

by Admin 1. June 2006 05:00

Paul Huntley of Innovex was named the Pharma Field Experienced Representative at the gala industry awards’ ceremony at the Royal Lancaster Hotel in London. As he presented the award to Paul, BBC Breakfast Television presenter Dermot Murnaghan described it as “the most prestigious award of the evening”. The award recognises Paul’s outstanding contribution within the industry as well as his commitment and dedication to providing the best possible service to his clients. It also pays testament to the quality of the ongoing training Paul has received at Innovex, to the strong support networks within the company and to Innovex’s culture of encouraging people to develop their careers.


An ardent scuba diver and motor biker, Paul is married to Helen and the couple have a five-year-old son, Ethan, and a rescued, ex-racing greyhound called Buddy.They live in Plymouth, an ideal base for Paul to indulge his love of Devon, and of the sea.

A Night To Remember

The calibre of the people working at Innovex was confirmed at the Pf Awards’ night. Out of a record-breaking 500 entries to this year’s awards, Innovex had an incredible 33 finalists, six top three finalists and two outright award winners. In addition, it was the only Contract Sales Organisation to win awards that evening, underlining its position as market leader.

Paul shares the experience with us …
Before the ceremony, I hadn’t really given much thought to the possibility that I might be in with a chance of winning. I’m relatively new to the industry and although I always give 110 per cent to my career, it’s difficult to compare yourself with other people when you aren’t working directly beside them. I was thrilled to have been nominated by my Regional Business Manager, and whatever the eventual outcome, that made me feel very proud and valued. I gave the final assessment day my best shot - this involved taking part in a role-play and a business simulation.
On the night of the awards, the atmosphere was excellent. I was sitting with my colleagues having a great time when, suddenly, my picture was up on the huge screen. I realised I’d won the award! I was quite overwhelmed – I had this beaming smile on my face as I went up to collect my award. It was the proudest moment of my career, made all the better as I’d won in the face of such strong competition from big industry players.

” We had an outstanding number of nominations proving that this award was far from being a lightning strike out of a clear blue sky ”

I know I couldn't have done it without the backing of my team, in particular my Regional Business Manager who was so pleased she was in tears when I brought the award back to our table! You can’t put a value on the kind of support she gives me. Her advice and guidance mean I never feel I’m out there on my own.
That was a brilliant night, but the celebrations didn’t stop there. I was also guest of honour at the ‘Innovex Oscars’, a superb awards’ event which followed a two-day managers’ meeting at the Radisson Edwardian Heathrow. In front of all the field managers and colleagues from head office, Alison Clough, the Managing Director, invited me on to the stage for a standing ovation.

The Road To Success

I joined Innovex in November 2003. I chose a Contract Sales Organisation because of the variety it offers and I chose Innovex because it’s the market leader.
Innovex doesn’t just take on graduates; it also attracts people coming from other companies and other sectors looking to develop their careers. As a sales organisation, it offers unparalleled opportunities and it was perfect for me.
The career transition was painless. I had previously worked in financial services and this had given me experience of technical sales and working to targets. Prior to this, I had set up drug and alcohol treatment programmes and this had given me insight into the NHS. I had also gained training and presentation skills whilst setting up these programmes. There was still a steep learning curve on joining pharma, but the more experienced Innovex representatives were very happy to show me the ropes.

” The energy of this company and the commitment and quality of its people are irresistible! ”


The Innovex Experience

The last two and a half years have been amazingly diverse and interesting! I’ve sold in a huge range of therapy areas from wound care to oncology, cardiology to fungal nail infections … and I’ve had the chance to work with and learn from GPs, district nurses, practice nurses, pharmacists and hospital consultants.
The training has been first class and, I have to say, this has been one of the major contributory factors to my success. Innovex invests heavily in its people and prioritises their development and welfare, which is why people who have worked for this company never lose their loyalty to it.
Nowhere else develops people as well, positioning them to win industry ‘Oscars’ of this kind.
Beyond the basic training, there are a number of courses every Innovex representative takes including a fantastic course in style and sales techniques, courses on NHS knowledge, presentation skills, business planning and much more.
Add to that the commitment of a dedicated field manager giving ‘on the job’ coaching and working with you on your own personal development plan – what more could you ask for?
There’s also a great sense of team spirit and you get loads of support – and it’s always great fun as well. Another thing about Innovex is how well they understand the importance of the individual.The company abounds with nice personal touches which make you really feel at home – such as a card from the Managing Director on your birthday, the company’s five and ten year awards and the Employee Appreciation Day. I don’t think you’d get that attention to the individual in many other places these days!

What Next?

Despite having won this industry accolade, I have absolutely no intention of resting on my laurels.
With this experience behind me, I am eager to see what I would be able to achieve as a Regional Business Manager.
I greatly enjoyed developing and supporting people in my previous career and would love to do that at Innovex.
Fast and furious change is part and parcel of the Innovex experience – the pace of change at Innovex not only accelerates and extends your individual learning and development, it also continually throws up new opportunities for enthusiastic, competent people. It’s a great place to be!

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