Guerrilla Negotiation Techniques by Alan McCarthy (RDC, £300 from www.rdc-uk.com) This 37-minute DVD doesn’t waste a second. Alan McCarthy, an experienced strategic management consultant, goes straight into explaining his 10 rules and 5 phases of ‘guerrilla’ negotiation. As he says at the outset, negotiating is not selling. The ‘win-win’ deal, an ideal of selling, is the only successful outcome of negotiation. Talking to a small workshop audience, McCarthy gives dramatic examples of his principles. He nails the term ‘ono’ as an example of ‘negotiating with yourself’. He explains the dangers of the ‘salami’ (the breaking down of a deal into separate parts) with sarcastic wit. His energy and no-bullshit style are infectious. And his image of a good proposal as a jellyfish – flexible, but holding together under pressure – will lodge in your head more effectively than any amount of dry jargon. McCarthy uses plain language to put across a savvy and subtle understanding of how to negotiate better deals – and how to see possible coercion before it reaches the table. A survival kit for those making deals under pressure, this DVD is relevant to anyone conducting sales meetings at a level where negotiation is needed. Because, as McCarthy says, you only negotiate when you have to. On Target special DVD offer RDC is offering a free copy of Guerrilla Negotiation Techniques by Alan McCarthy to the first 3 On Target readers who can answer this question correctly: How does Alan define negotiation? Alan’s article on pages 16–17 will help you answer this question (and many others). Send your answer to joel.lane@healthpublishing.co.uk now!

Kiss Me Softly, Amy Turtle by Paul McDonald (Tindal Street Press, pb, £7.99) Possibly the funniest novel ever about hospital care – and a considerably more gritty and relevant picture of the NHS than Doctor in Love – this hard-hitting comic thriller from Black Country writer Paul McDonald comes without anaesthetic. If you want something to read while waiting for a sales meeting, or perhaps something to lift your spirits after a frustrating day of hospital visits, this book is just what you need. Providing, of course, that you are not too squeamish or sexually innocent to cope with the author’s revelations. Kiss Me Softly, Amy Turtle deals with the experiences of a Walsall journalist, Dave McVane, who is admitted to a local hospital with severe abdominal pains. After a bizarrely comic triage process, he finds himself in a pre-surgery ward alongside a crew of no-hopers, addicts and psychos. And that’s just the staff. This hospital has the highest mortality rate in the region – as McVane knows well, having highlighted the fact many times in his outspoken column for the Walsall Reflector. As McVane’s paranoia spirals, he begins to relive episodes from his colourful past. But who is he really in danger from: the surgeons, his forgotten enemies, or himself? For the medtech sales professional, this book offers some provocative thoughts on the similarities between medical devices and S&M gadgets. For the crime fiction enthusiast, it offers a sly parody of the noir genre. For anyone with a sense of humour and an interest in the NHS, it will provide hours of enjoyment and a few severe episodes of uncontrollable laughter. Recommended (but not by NICE). On Target special book offer! Tindal Street Press are offering a free copy of Kiss Me Softly, Amy Turtle by Paul McDonald to the first 10 On Target readers who can answer this question accurately: What does a triage nurse do? Send your answer to joel.lane@healthpublishing.co.uk. Avoid disappointment – do it now!

One for the road... What do you listen to while driving, on the train, or in a hotel room? What music provides the soundtrack for your working life? Send us a list of your top 5 CDs for the road, and we’ll compile a chart of what On Target readers are listening to. Your CD list could be new releases or old faves – as long as it’s not ‘Lady in Red’, let us know about it. Send your list to the e-mail address above. Keep listening, and keep selling!

 

New General Manager for Baxter Healthcare BAXTER HEALTHCARE LTD has announced Harry Keenan as its new General Manager for the UK. Harry Keenan has spent 24 years with Baxter, where he has held strategic planning and sales and marketing positions of increasing responsibility in Belgium, UK and Ireland. His most recent position is General Manager Greece, Ireland and Portugal, based in Dublin. “Harry is well-known throughout Baxter from previous roles, and also because of the continuous strong performance of our Irish business,” said Peter Nicklin, President Europe. “It is because of Harry’s experience and track record of success that he has been appointed this position. He is a great asset to our business and we wish him every success in his new role.” Harry said: “I’m delighted to be appointed as the General Manager for the UK. We have a great team in the UK, a strong business momentum and exciting opportunities ahead.” Baxter Healthcare Ltd is the primary domestic operating subsidiary of Baxter International Inc. The company specialises in the treatment of complex medical conditions through medical devices, pharmaceuticals and biotechnology.	Toumaz joins Continua Health Alliance WIRELESS HEALTHCARE COMPANY Toumaz Technology has joined the Continua Health Alliance, an industry group that promotes interoperability across emerging technology-based healthcare systems. As a full member, Toumaz will gain early access to Continua guidelines and test processes to enable the development of interoperable products and services. Toumaz recently joined the Alliance’s Technical Working Group and has participated in a number of discussions centred around its Sensium™ system, a new ultra-low power wireless infrastructure system for health and lifestyle monitoring applications. “Toumaz’s vision of proactive, cost-effective personal connected healthcare is shared by the members of the Continua Alliance,” said Keith Errey, Toumaz Technology’s co-founder and COO. “As the provider of a key enabling technology in the emerging personal telehealth ecosystem, it is obviously vital for Toumaz to take a role in this important organisation and support it in its aim – to deliver highly integrated systems that work together to improve the quality of people’s lives.” The Continua Health Alliance is a collaborative open industry alliance made up of technology, medical device and healthcare industry leaders. Members include Cisco, GE, IBM, Intel, Kaiser Permanente, Medtronic, Motorola, Oracle, Panasonic, Philips, Partners Healthcare, Samsung, Sharp and Welch Allyn.
IRONMAN and iron woman DICK AND CLARE DONOVAN, the Directors of Helix Recruitment, are aiming to raise £1000 for WaterAid – the hard way. At 7am on Sunday July 8th, they will join more than 2000 competitors at Klagenfurt for the IRONMAN Austria triathlon (see www.ironmanaustria.com). IRONMAN triathlons are gruelling long-distance events comprising a 3.8km swim, a 180km bike ride and a full marathon (42km). Training for this achievement involves long weekly runs and shorter daily ones, five-hour bicycle rides, and swim training in open (unheated) water. Having completed the Switzerland IRONMAN event in 2005, Dick is aiming for an even better time (under 13 hours) this year. Clare, attempting the event for the first time, is aiming to fulfil the IRONMAN mantra that just finishing is a victory! You can monitor their progress via www.ironmanlive.com. Not content with one triathlon in 2007, they have booked another assault on the event at IRONMAN Florida in November – sharks willing (the swim is in the Gulf of Mexico). You can show your support by sponsoring them on behalf of WaterAid at www.justgiving.com/dickandclare. WaterAid is dedicated to the provision of safe domestic water, sanitation and hygiene education worldwide. Helix Recruitment offers a specialist recruitment service to the laboratory and healthcare products marketplace.
Smith & Nephew appoints new Chief Executive SIR CHRISTOPHER O’DONNELL will retire as chief executive of medical devices company Smith & Nephew at the end of June. He will be replaced by David Illingworth, who has been Chief Operating Officer since February 2006 and headed up Smith & Nephew’s orthopaedics division prior to that. Sir Christopher joined Smith & Nephew in 1988 and has been Chief Executive since 1997. Since 2003 he has jointly chaired the UK government/industry Healthcare Industries Task Force. David Illingworth (53) has 28 years’ experience in the medical technology industry, including 15 years with GE Medical. He has led companies in the areas of diagnostic imaging, respiratory devices and urological products, as well as heading up a technology incubator company. John Buchanan, Smith & Nephew’s Chairman, thanked Sir Christopher: “During his ten years as Chief Executive, Chris O’Donnell has transformed Smith & Nephew into a focused global leader in medical devices and created substantial shareholder value.” He added: “We are delighted to announce the promotion of David Illingworth to Chief Executive. His extensive medical technology experience with GE Medical and other leading medtech companies, coupled with the strong business performance he has demonstrated as President of our Orthopaedics businesses, and latterly as Chief Operating Officer, show he has the leadership qualities needed to continue the development of Smith & Nephew as an outstanding medical device company.” Smith & Nephew is the biggest medical device manufacturer in Europe. Its product range includes knee and hip replacements and dressings for acute wounds.
Owen Mumford opens new manufacturing facility MEDICAL DEVICE COMPANY OWEN MUMFORD has opened an extended manufacturing facility in Chipping Norton. The opening was presented by the Rt. Hon. David Cameron, MP, Leader of the Conservative Party. Forty million drug delivery devices will be produced at the new facility, and over 100 new jobs will be created. Owen Mumford is a family-owned company with over 50 years’ experience in the design, development and manufacture of medical devices used by healthcare professionals and patients worldwide. Its Cotswold division in Chipping Norton manufactures automatic injection devices. The recent growth in the management of long-term conditions by patients who self-inject medication, using bespoke autoinjector and pen technology, has led to increasing demand for the medical devices produced by Owen Mumford, whose branded products are purchased by hospitals, clinics and pharmacies. Adam Mumford, Managing Director of Owen Mumford, commented: “As a successful and growing business, this expanded site will enable us to produce more new products and greater volumes, to meet the increased demand from patients, healthcare professionals and pharmaceutical and diagnostic partners.”

 

 

Meeting local needs in renal care

On Target profiles Bexhill Satellite Dialysis Unit, where the medical technology industry and the NHS are working together to meet patient needs in the community.

Interviewer:
Tina Young, Director at Kirkham Young.
Interviewees:
Lisa Matthews, Unit Manager at Bexhill Dialysis Centre; Ken Richardson, Business Manager at Dialysis Products Southern, Fresenius Medical Care.

Tell me about the dialysis unit at Bexhill Hospital.

Lisa: The unit has been open for 15 years and is attached to Brighton & Sussex University Hospitals NHS Trust. There are two satellite units – one at Worthing and this one at Bexhill. Bexhill is nurse-led, which means there are no doctors on site. Before the satellite unit opened it was a ‘minimal care unit’ – patients whose homes were not big enough for them to dialyse there came to the unit. Prior to the unit opening, patients had to travel to St George’s Hospital in Tooting, London.

Currently there are two shifts, one in the morning and the other in the afternoon. We look after 50 patients in any one week at 16 dialysis workstations – this is due to expand to 55 by the end of 2007, and 64 plus one holiday patient by the end of 2008.

What does having a local satellite dialysis unit mean for your patients? Lisa: The biggest advantage is not having to travel far. A smaller team of ambulance transfer staff are needed; patients can drive themselves in or can use public transport. The patients can dialyse in a familiar, relaxed ‘family’ environment, and social groups have developed with patients looking out for each other. The three days per week away from home is made more tolerable by these long-term relationships.

Typically a patient may arrive at 7.30am and be on the machine for four hours. It looks very relaxing on the surface, but in this time 80–100 litres of blood is filtered at 300ml/minute – it’s a bit like ‘running a marathon from the inside out’, and leaves patients feeling very tired!

How have changes in the NHS impacted on your unit?

Lisa: Over the years I have been running the unit, I have developed strong managerial and financial skills in addition to clinical nursing. Purchasing of disposables is relatively straightforward, coming as part of a contract with the company, but capital purchase of equipment is a completely different ball game.

There is currently no financial plan for the purchase of new machines – three out of the five new Fresenius machines were bought via the Bexhill Hospital League of Friends, and all five new machines currently on order will also be funded this way. I have to give a high-level presentation to the League of Friends with our consultant and the lead renal consultant, lead renal nurse and chief technician.

With the financial deficits faced by Trusts, everyone has to do their bit to reduce costs. We work in partnership with companies such as Fresenius to come up with creative purchasing schemes such as cost per therapy funding, whereby new units are equipped with machines and the cost spread over a number of years with slightly increased consumable costs.

How are decisions about purchasing equipment made on the unit?

Lisa: The lead renal nurse, unit manager, lead consultant, service/procurement manager and chief technician are all involved. The unit has a mix of machines, but we have found the modern Fresenius equipment offers us the greatest flexibility.

Ken: It is important that companies constantly innovate – as machines need replacing, newer models need to evolve in order for the company to compete.

What do you gain from visits from company business managers like Ken?

Lisa: Up-to-date information on company products and services, as well as advice on all the support services the company offers. Ken: Training is vital – machines would come in for pre-tender trial for two weeks and key personnel are taught how to use the equipment.

“We work in partnership with companies such as Fresenius to come up with creative purchasing schemes such as cost per therapy funding, whereby new units are equipped with machines and the cost spread over a number of years with slightly increased consumable costs.” – Lisa Matthews, Unit Manager, Bexhill Dialysis Centre.

If they are successful, the company nurse specialists return post-tender to do more training – there is a legal obligation on the company to ensure that all staff using the machines have been fully trained and are competent to use the equipment.

How do you see the service developing over the years?

Lisa: 10 years ago the dialysis population at the centre was 80% elderly. Nowadays it is split fairly evenly across all ages, but numbers are still growing.

And the future?

Ken: Future developments might include technology to miniaturise an artificial kidney, but we don’t have the technology at present. The kidney is such a complex organ, even growing one in a lab seems a very long way away.

Lisa: For the foreseeable future, dialysis and the hope of transplantation is the only way for renal failure patients to survive.

Fresenius Medical Care is the world's largest integrated provider of products and services for individuals with chronic kidney failure. Through its network of 2,194 dialysis clinics, Fresenius provides dialysis treatment to 169,216 patients worldwide. Its UK operation is based in Sutton in Ashfield, Nottinghamshire. For more information, visit www.fmc-ag.com.

Kirkham Young is a highly specialist medical sales recruitment agency dedicated to the commercial healthcare sales market.

 

 

UK launch of knee implant for women ORTHOPAEDIC DEVICE COMPANY Zimmer has released the first bespoke knee implant for women in the UK. The Zimmer Gender SolutionsTM knee implant is made to fit the shape of women’s knees, offering a better fit with more natural movement than a traditional ‘unisex’ knee implant. Three main features of the Gender Solutions knee reflect the typical shape of a female knee: a thinner profile than a traditional knee implant; a contoured shape to prevent the implant from overhanging the bone (see diagram); and an adaptation to the hip and knee alignment found in women. The implant is available in five sizes for either knee, allowing surgeons to give women a ‘personalised’ knee implant. The Gender Solutions knee is being introduced in the UK by six consultant orthopaedic surgeons, including Mr Howard Ware of Chase Farm Hospital NHS Trust. Mr Ware said: “The Zimmer Gender Solutions knee implant is an advancement in orthopaedics. It is a step forward for female patients and will allow a better range of motion, because it is tailored to closely fit the female anatomy.” The Gender Solutions knee will be rolled out across the UK over the next year. With more than 35,000 knee replacements carried out on women in England and Wales in 2006, it is set to benefit many patients. For more information, visit www.zimmer.co.uk.	Remote ECG monitoring in prison a success HMP WAKEFIELD has reported the success of its pioneering outsourced ECG monitoring service, which has delivered considerable cost savings and improved public safety by providing expert cardiology reporting onsite for prisoners. Since introducing the remote cardiac monitoring service from Broomwell HealthWatch 12 months ago, the high-security prison has been able to monitor and treat more patients within the prison. The on-site healthcare team carries out a simple 12-lead ECG test and transmits the data to Broomwell’s monitoring centre, where expert cardiac staff provide round-the-clock advice on patient care. Brian Almand, clinical manager at HMP Wakefield, said: “By eliminating unnecessary hospital visits for ECG examination, we’ve not only improved public safety, but also achieved significant cost savings. Having access to rapid, expert cardiac advice has also improved clinical outcomes by supporting more informed referrals, enabling us to provide the highest level of patient care while effectively managing risk.” Prisoners presenting with cardiac problems were previously referred to the local A&E department, or a GP visited the prison. The remote cardiac monitoring service enables the prison to use resources more effectively and reduce risk, while improving clinical outcomes. For more information, visit www.broomwellhealthwatch.com.
B-K Medical provides a better view B-K MEDICAL HAS LAUNCHED its new 8848 transducer for prostate brachytherapy and pelvic floor scanning in women. The 8848, together with the B-K Medical Pro Focus scanner, is designed to provide the best image quality in its class. The 8848 enables a clear and detailed image of the prostate, which in turn allows for greater ease of use and accuracy in volume studies and source-dose planning for brachytherapy. The 8848 is also a key component of B-K Medical’s pelvic floor ultrasound system: it allows a dynamic examination of the pelvic floor region, enabling the physician to see the positions of organs. Images and video clips can be saved to a USB stick or CD. Michael Brock, President of B-K Medical, said: “The 8848 is the result of our continuous pioneering in this field and in emerging applications such as pelvic floor scanning. Whatever their application, our customers can count on seeing what they need to when using the 8848 during examinations.” B-K Medical, a wholly-owned subsidiary of Analogic Corporation, specialises in the development and production of diagnostic ultrasound equipment. Based in Denmark, it has a subsidiary sales company in the UK. For more information, visit www.bkmed.com.
Biodegradable implant receives CE Mark ORTHOPAEDIC MEDICAL IMPLANT COMPANY INION has received the CE Mark from the British Standards Institution for its CPS/OTPS FreedomPlate™, a biodegradable device for fixation of bone fractures and osteotomies. The Inion CPS/OTPS FreedomPlate system has been cleared for the fixation of a wide range of bones, including those in the arm, leg, skull and ankle, in the presence of appropriate support such as a plaster cast. The implants are made of the Inion Optima™ biodegradable polymer blend, which degrade safely in the body within two to four years. Chris Lee, CEO of Inion, said: “This is an important new product launch for Inion as it means we can now market the Inion OTPS™ line for all orthopaedic trauma indications, including for ankle fractures, in the USA and in Europe.” Inion has an office and an R&D facility in the UK and head office, R&D and production facilities in Tampere, Finland. The company specialises in developing and commercialising biodegradable and bioactive implants to enhance bone healing following trauma or reconstructive surgery. For more information, visit www.inion.com.	BloodTrack SuiteTM wins major computing awards A WIRELESS BLOOD TRACKING SYSTEM from Olympus UK has won the top prize at the prestigious Government Computing Awards for Innovation 2007, and also the award for best project in the ‘Government to Citizen’ award category. Both awards were presented to the John Radcliffe Hospital in Oxford for the Olympus BloodTrack Suite, which uses handheld devices to identify and track blood transfusion units. The BloodTrack systems provide a simple interface that allows all clinical staff to manage and transport blood products in the clinical environment. The system was installed by the John Radcliffe Hospital as a response to the EU Blood Safety & Quality Regulations 2005, which mean that all EU hospitals must have systems in place to provide a comprehensive audit trail of blood units. Piers Devereux, Managing Director of Olympus UK, said: “We welcome this recognition of the real benefits that the BloodTrack Suite brings to hospitals and patients. It also results from a successful partnership between Olympus, Oxford Radcliffe Hospitals NHS Trust and the National Blood Service. Together we have been able to develop a state-of-the-art patient safety system.” The Olympus BloodTrack system offers significant cost savings. ORH Project Manager Barbara Cripps said: “The system reduces the blood transfusion process from 131 minutes to just 81 minutes. This equates to staff time savings of £17.44 for each transfusion. When the system is implemented across the Trust, this will equate to time savings of around £523,200.” For more information, see www.olympus.co.uk.
Birmingham hospital chooses Xograph for dental imaging UK MEDICAL IMAGING SPECIALIST XOGRAPH Healthcare has installed a Planmeca Proline XC Dental X-ray System at Birmingham Heartlands Hospital, part of the Heart of England NHS Foundation Trust. Planmeca Proline XC radiographic examinations are rapid and easy to perform. The system offers clear and sharp clinical radiographs, achieved by the unit’s focal layer following the shape of the dental arch and jaw. It also eliminates shadows and ghost images, increasing the diagnostic value of the image and reducing the need for retakes. “The Planmeca Proline XC is a great new addition to the department. It is easy to use and delivers a superior level of image quality,” said Laurence Skermer, Superintendent Radiographer at Birmingham Heartlands Hospital. Xograph Healthcare is a leading independent supplier of medical imaging systems to the UK. Based in Tetbury, Gloucestershire, Xograph also has a Scottish office in Stirling. For more information, see www.xograph.com.

 

The Other Side 11:

 

Interview with an Anaesthetist

Dr Jasmeet Soar is a Consultant in Anaesthetist and Intensive Care Medicine at Southmead Hospital, North Bristol NHS Trust. On Target talked to him about purchasing equipment in this key specialist area of secondary care.

1. What types of healthcare products do you purchase? What factors influence your purchasing decisions?

Over the past eight years I have been involved in the purchase of anaesthetic machines, patient monitoring equipment for operating theatres, recovery areas and the ICU, intensive care unit ventilators, defibrillators and infusion pumps and a variety of other devices.

Anaesthetists use a lot of different devices in their everyday work, and like most doctors always want the latest piece of new kit. The biggest factor that decides whether a piece of equipment is purchased is the cost. Those funding the cost prefer to buy the cheapest option that is clinically acceptable. Those using the equipment usually want to buy the one that is clinically the best for their patients. A happy balance needs to be struck.

It is vital that new devices are trialled, a range of opinions is sought, and a formal procurement process is used to purchase equipment. After all, in the NHS we are spending taxpayers’ money. Usually if the pot of money has been identified, a good procurement process will enable purchasers to buy more items of equipment than was originally planned.

In my experience of sitting on equipment committees, anaesthetists are fairly savvy when it comes to equipment compared with other doctors. They work hands-on with a wide range of equipment and devices on a daily basis in a number of settings. Understanding how equipment and devices work are a key part of anaesthetic examinations. Indeed, I would not be keen on buying something if I were not familiar with the principles of how it worked. It also has to be fairly intuitive in terms of which buttons to press or knobs to turn to make it work.

Equipment is usually purchased either through haphazard replacement as things break down or as part of a planned replacement programme. At North Bristol, we have a planned replacement programme based on knowing when current items will reach the end of their useful lifespan. The planned approach seems to ensure the best deals in terms of costs and servicing.

Purchasing of innovative equipment is always a big problem. Usually there is little in the way of good evidence and a lack of NICE approval or a Health Technology Assessment to support its use. These items usually only get in if there is a consultant with persuasive powers championing their cause. If they are purchased, the funding often comes from charitable sources.

Ideally, when we buy something we want to standardise to one particular type of equipment (e.g. anaesthetic machine, monitor). This means that training is easier and staff are familiar with using it. Having a hotch-potch of equipment that carries out the same function is not safe in my view.

2. What aspects of medical device sales and marketing do you find helpful? What aspects do you find unhelpful?

I find it useful to meet company sales representatives face to face to find out about the equipment. The biggest problem is usually agreeing on a time to meet. Sales representatives seem to have larger and larger patches, so some have travelled a long

way to see me. I often find it embarrassing when I end up being late because my list has overrun, or I can only give them a very short amount of my time.

I usually do not like it when representatives turn up unannounced to see me. A greater use of e-mail to send information on products would be useful for me, as it would enable me to tell the representative whether it was worth their time seeing me or not.

One of my biggest bugbears is compatibility between equipment in anaesthesia and in intensive care.

3. Is there anything in particular that sales and marketing professionals could do to meet your needs better?

In my experience, very few of the manufacturers ever provide as much support as they promised once you have purchased equipment from them.

4. What impact has the challenge of infection control had on your approach to purchasing?

The biggest impact of infection issues has been that more and more items have become single-use. For example, we now have disposable laryngoscope blades. Also, non-single use items have to be traceable, i.e. we need to know which piece of kit (e.g. laryngeal mask airway) was used on which patient. Single-use items are often not as good as the original multi-use item that they replace.

5. How are current changes in hospital practice affecting your medical equipment needs?

Procurement in many areas has now moved to groups of hospitals. Hospitals pooling together to buy equipment and devices should, in theory, cut costs. The downside is that individual clinicians have less say in what they get to use. This is happening more and more, especially for devices such as intravenous cannulae and syringes.

NICE guidelines about the use of ultrasound for central venous access have increased the use of ultrasound by anaesthetists in both theatre and ICU. As anaesthetists have become more expert in the use of ultrasound and start using it for other indications, e.g. nerve blocks or cardiac echocardiography, the demand for better ultrasound machines has increased.

 

 

 

Hi-Tech Healthcare Week

(21–27 May 2007)

The Department of Health held a Hi-Tech Healthcare Week from 21–27 May 2007 to showcase medtech innovation. The DH asked leading healthcare experts to highlight innovations from the past decade that have brought major benefits to patients.

1. Following a cardiac arrest, there are only a few minutes in which defibrillation can succeed. Heart Tsar Roger Boyle said: “Speed is vital. The quicker the shock is given, the greater the chance of success. Community defibrillators have so far saved the lives of at least 93 people.” Boyle also noted the value of telehealth devices in remote monitoring of heart rhythm and ECG.

2. Ambulatory chemotherapy has enabled some cancer patients to remain active outside hospital during treatment. Cancer Tsar Mike Richards said: “Backpacks to replace drips have been life-changing for cancer patients with bone tumours. These patients would normally spend at least four days in a hospital bed while receiving chemotherapy. The backpacks also free up valuable hospital beds.”

3. Renal Tsar Donal O’Donoghue said: “A new type of ‘blood washing’ has transformed the lives of thousands of people with kidney disease. Plasma exchange with immunoabsorption is a technique where high levels of potentially harmful antibodies are removed from the plasma.” This treatment has enabled many patients to receive a kidney transplant.

4. A pneumatic boot used by people with diabetic foot sores deflects pressure. Diabetes Tsar Sue Roberts said: “Normally, a foot ulcer could mean months resting the foot at home. The boot means that people with diabetes who have a foot ulcer have the freedom to continue with their daily lives.”

5. Older People’s Tsar Ian Philp said: “Telecare helps people with social care needs to stay independent by bringing that care directly to the user in their home. A practical example of this is a sensor placed under a mattress, programmed to switch the lights on if an older person gets out of bed in the middle of the night.”

6. Professor Sir Ara Darzi, National Advisor on Surgery, drew attention to the contribution made by keyhole and laser surgical techniques. He also highlighted the Da Vinci system, a robot the surgeon can operate while viewing a 3-D image of the surgical field.

7. Dr Sheila Shribman, National Clinical Director for Children, Young People and Maternity Services, highlighted three devices. Portable ventilators have enabled many children to be treated at home. Breath-activated inhalers offer greater ease of use. Doppler blood pressure recorders enable nurses to measure blood pressure in babies by holding a probe against the skin.

ABHI Director General John Wilkinson welcomed the showcase: “Encouraging technological innovation in medical treatments is essential in order to improve the treatment patients receive from the NHS, and to save vital time and resources.”

 

 

 

Madeleine’s uncle is medical rep

The sad disappearance of Madeleine McCann from a Portugese holiday resort has undoubtedly touched the hearts of the national and international communities. But the disturbing story also has a connection with the medical representative community. Madeleine’s uncle, 48-year old John McCann, is a medical representative for AstraZeneca. AZ has granted John indefinite leave as he plays a central role in the international campaign to find Madeleine. Pf wishes to take this opportunity to extend its thoughts and sympathies to the McCann family, and, as does the rest of its loyal readership, prays for the safe return of Madeleine. For further details of the McCann’s campaign, please visit www.findmadeleine.com .

 

 

 

Reforming the NHS:

A culture of choice

As the NHS is challenged to provide greater patient choice, a new commissioning culture is emerging. What does this mean for the healthcare sales professional? Chris Ross reports.

We all know the NHS is changing – but do we know how it is changing and, crucially, how it affects us? This month, On Target begins a four-part series looking into the Government’s reform agenda.

The vision for change was laid out in the DH’s 2005 publication Creating a Patient-Led NHS, which outlined four strands of reform: demand-side, supply-side, transaction and system-management reform. Our new series Reforming the NHS takes a detailed look at these four areas. We start with demand-side reform.

Restructuring the system

The wider reforms are designed to create a business-focused health service. The NHS is in deficit, hospitals are full, the population is living longer and the healthcare budget cannot withstand the pressures. What’s more, the single-supplier service that is the NHS, founded on a principle of ‘free for all at the point of need’, was not built with such a situation in mind.

The Government wants to introduce competition into the market to improve quality, drive down costs and provide choice for healthcare consumers. Central to these aims is the introduction of the traditional supply and demand model of economics that dominates other business sectors, but has always been absent in healthcare. Previously, if a service needed commissioning, it would be commissioned to the local hospital. The desire to move away from this model has heralded a wave of policies under the umbrella of ‘demand-side reform’. Demand-side reform focuses on giving patients a stronger voice in deciding what healthcare services they need, and input into how these services are delivered. Patients will be offered a choice of service provider, such as an independent treatment centre, a community or practice-based service and a foundation hospital. The local hospital, stimulated by the competition, may well be able to offer a more efficient service. In a sense, local hospitals will now be competing for patients. The benefit for the patients will, hopefully, be speedier and thus more effective treatment.

So demand-side reform is about establishing the philosophy that patients should have a choice in the way they access healthcare services, and creating a framework that enables choices to occur. This philosophy is supported by supply-side reform, which we will look at next month.

For demand-side reform to succeed, the process of commissioning services in the NHS needs a radical overhaul. As such, the reforms have also set about implementing a robust framework for an improved commissioning function.

Think nationally, act locally

Many of the headline initiatives of demand-side reform have already taken place. Last year, the NHS was reshaped to provide a platform for implementing change. The boundaries of the Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs) were redefined, creating bigger but fewer bodies to govern the system. The purpose of this restructure was to strengthen the commissioning functions of PCTs and, in the process, to give them the support and infrastructure necessary for them to design services that could deliver local healthcare priorities. These enlarged PCTs are much stronger commissioning bodies, covering larger patient populations.

Demand-side reform also introduced a policy with which we are all familiar: practicebased commissioning (PBC). PBC enhances the commissioning function at the local level within PCTs and satisfies the patient choice element of demand-side reform.

Through PBC, PCTs can listen to patients’ requirements and design services that meet their needs. PBC adds the vital ‘patient voice’ to the commissioning process. The DH expects PBC to become an important mechanism through which the number of hospital referrals can be reduced and replaced by an increased provision of healthcare services nearer patients’ homes. Budgets will be delegated to practice level, but PCTs will retain strategic responsibility for the commissioning process. .

A new commissioning culture: responding to demand

Alongside this, demand-side reform is precipitating a new culture of commissioning. Traditionally, commissioning has always been undertaken by virtue of block contracts, awarded almost entirely to the local hospital.

Commissioners purchased services that delivered a given number of outpatient appointments, leading to an output-led service. For example, a commissioner might buy a service that guaranteed 100 cataract operations, i.e. 100 pre-agreed outputs.

In the new NHS environment, commissioning will be outcome-based. A commissioner cannot award a bulk contract to a local hospital based on volume because, given the role of patient choice and the anticipated range of service providers, the volume cannot be guaranteed. Instead, commissioners will ask service providers to guarantee outcomes. This cultural shift empowers the purchaser and commits the provider to agreed levels of quality and tangible results. Together with PBC, this creates a market that is able to respond to demand.

The impact on the sales professional

What does all this mean for the field force? Well, it signals the emergence of a new customer group for the sales professional: the NHS Commissioners. Also operating under a range of other titles such as Modernisation Directors, Directors of Strategy and Directors of Service Provision, their importance cannot be underestimated.

Commissioners will make key decisions about how money is spent on service provision. Since the services they commission necessarily involve products, decisions made by commissioners will undoubtedly affect how medical technologies are used. Consequently, sales professionals need to develop a different set of messages to address commissioners, based on an understanding of their priorities and how specific products help them achieve their objectives in the NHS environment.

A commissioner has a range of objectives, the most fundamental of which is to improve health outcomes in a cost-effective manner. The opportunity for the sales professional is to identify how to persuade the commissioner to change a service in a way that delivers a cost saving and improves health outcomes.

Defining clinical pathways

Professor Sir Michael Rawlins, Chairman of NICE, has identified hysterectomies as an area where devices can help to redesign a service. In a recent interview with On Target, he pointed out that some devices reduce the need for major surgery: “For example, for women with heavy periods, there are ways of destroying the lining of the womb that don’t involve having a hysterectomy. The NHS does 50,000 hysterectomies a year.

Women stay in hospital for a week and end up heavily scarred. There are now implantable devices which burn the endometrium and destroy it. These can be done as a day case with no surgery, and women don’t end up scarred.”

Medical technology can to help save the NHS money by changing care pathways while delivering improved health outcomes. The challenge is to identify where your product can make a difference and help to provide choice.

Clearly, medical technology can help to save the NHS money by changing care pathways while delivering improved health outcomes. The challenge is to identify where your product can make a difference and help to provide choice.

The key questions are:

• Can your product be delivered as part of a community-based service?
• Will it have a positive impact on waiting lists?
• Will it enable secondary care patients to be discharged earlier?
• Does it prevent people going into hospital?
• Can you wrap up your product in a package of care that will help a commissioner meet a target?

The bottom line

In the spirit of outcome-based commissioning, hardline purchasers will be business-orientated and driven by achieving their ultimate objective: health gain. The modern commissioner is not concerned with who provides a specific service, but seeks assurances that it will be provided to an agreed specification and deliver agreed outcomes. If your product can become a part of such a service, the opportunities for growth will be vast.