Marker by Robin Cook (Pan, £6.99 pb)

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If you are young, fit, healthy and checking in for minor surgery, then we suggest that you don’t reach for this latest Robin Cook offering just before you go to theatre!

A series of unexplained deaths of seemingly young and healthy individuals in quick succession following unremarkable minor surgical procedures forms the basis of this novel, which is set in the USA and has medical examiners (and lovers!) Dr. Laurie Montgomery and Dr. Jack Stapleton in the starring roles. As the story unfolds and the body count rises, Laurie begins to suspect foul play. She very quickly decides that a serial killer is on the loose – but hunting for clues is met with resistance from sceptical colleagues and Jack alike. Their personal relationship also comes under increasing strain, as Jack fails to commit to family life and Laurie feels her biological clock is ticking away.

The book starts off rather slowly, but stick with it – it soon gathers pace and, with the suspense building towards the end, becomes increasingly hard to put down. The finale is great and should give food for thought to anyone with a clinical or scientific mind.

Throughout the book, the medical terminology and procedures ring true – no doubt a legacy of Cook’s own training as a doctor. Cutting-edge laboratory techniques, contemporary ethical issues and corporate greed are all in evidence – all cleverly crafted, and some insights hidden until the final pages are turned. Frightening stuff indeed… but could it happen over here… indeed, is it happening now?

Tina Young is a Director at Kirkham Young, a specialist recruitment agency dedicated to the commercial healthcare sales market.

On Target special book offer

Pan Macmillan is offering a free copy of Marker by Robin Cook to the first 5 On Target readers who answer this question correctly: What types of body tissue might be joined together by a ligament?
Please send your answer to joel.lane@healthpublishing.co.uk.

The Four Kinds of Salesople by Chuck Mache (Wiley, £12.99 hb)

This book is a kind of novel: it uses narrative to present a view on what makes for success in sales. Four characters are used to illustrate Mache’s ‘four kinds’ of sales person: the Performer, the Professional, the Caretaker and the Searcher. Two of these individuals are relatively good at their jobs; two are not. All four have reached a point of crisis in their working lives where a change in attitude is necessary to prevent career meltdown. Each of them runs into a mysterious gas station attendant, and is placed in a situation where they have to reconsider their approach to life... Despite its subtitle (‘How and why they excel – and how you can too’), this book is not intended to help sales people develop their professional skills. It doesn’t examine key skill sets such as people management, persuasion or negotiation. However, sales managers, HR managers and recruiters may find it a provocative and stimulating read – and for any sales professional who has lost motivation or confidence and feels unable to move forward, this book could provide valuable food for thought. The Four Kinds of Sales People is not a formal guide or textbook. Like many works of popular psychology, it’s very much a personal view. There are not necessarily only four kinds of sales people, and spotting personality types is not a short cut to assessment of sales ability. But if you don’t expect too much from it, this book can deliver both fun and insight. And no, the gas station attendant doesn’t grow wings at the end. Manjit Johal is Sales Manager at Health Sector Publishing, and is a former medical sales representative.

On Target special offer winners: free copies of Bullshit Bingo by Graham Edmonds were won by Ivan Jones, Allan Mackintosh and Kevin Bage. Will it be you next time?

 

 

 

Driving a hard bargain

Never mind the healthcare, where’s the health car? Terry Bartlett of Inchcape Fleet Solutions offers some guidelines on choosing the right company car for field sales.

With more than 6,700 makes and models of new car on sale in the UK, drivers face the most bewildering company car choice ever. Among the record number of vehicles available, it is difficult to identify a ‘bad car’. What’s more:

• Manufacturers are producing an ever-increasing number of niche models for new market sectors, such as sports activity vehicles and grand tourers.
• Many car makers are attempting to produce cars across every sector of the market. For example, the 4X4 sector used to be dominated by a handful of specialists, but now almost every car maker has an offroader – some, such as BMW, in more than one market sector.
• When corporate social responsibility is factored in, it is not simply a choice between petrol and diesel: there are now hybrid (petrol/electric) cars from three manufacturers – Honda, Lexus and Toyota.

Selecting a company car can be a minefield. More businesses than ever before are turning to fleet industry experts to help them source the right vehicle for the job.

Born to run

Ensuring the vehicle is ‘fit for purpose’ is perhaps the number one priority for any fleet decision-maker and driver. With sales and marketing professionals in the medical devices sector clocking up thousands of miles a year and transporting valuable goods, a number of issues spring to mind:

• fuel efficiency – perhaps a diesel car
• driver comfort – air conditioning, maximum movement of steering wheel and driver’s seat
• security – immobilisers and ability to hide goods from prying eyes
• boot space for transporting goods
• Bluetooth compatibility to facilitate mobile phone use
• satellite navigation to assist with journey planning, appointment schedules and congestion.

Performance is also vital. High-mileage sales representatives are unlikely to thank their boss or fleet manager for putting them behind the wheel of a so-called ‘city car’. Automatic transmissions should also be considered.

This is not an exhaustive list: it is merely intended to show that choosing the ‘right’ company car is not a 10-second task.

The price you pay

All the factors mentioned above will impact on vehicle cost. But cost runs far deeper than simply the ‘on-the-road price’ of a car. There are two separate cost issues: cost to the company and cost to the driver.

For the driver, the issues are simpler. Typically, drivers will look for the ‘most for the least cost’ in terms of benefit-in-kind tax, while taking into account their job requirements and personal lifestyle. In addition, if the employee pays for fuel used privately, vehicle economy is likely to be a major choice criterion for the individual.

For the company, cost issues are more complex. Most businesses now base their company car choice lists on ‘wholelife’ costs: a calculation made by a fleet management specialist of how much the company car will cost to run on a monthly basis, taking into account every factor involved in keeping that car on the road over a specific period (the benchmark period is three years).

Just because one car has a lower list price than another does not mean that it will be cheaper to run. And where cost issues for the driver and the company are in conflict, this will need to be resolved.

Other factors to take into account for the cost equation include corporate cash flow implications, on or off balance sheet issues, corporation tax and VAT implications. Again, it is little wonder that compiling choice lists requires professional expertise.

Meanwhile, methods of funding – outright purchase, contract hire, contract purchase etc – should be reviewed at least annually to ensure that the chosen routes are the most cost-effective and administratively efficient for the company, as Government and European Commission-inspired fiscal and legislative changes may change the situation. Changes in a company’s business circumstances may also make a funding review necessary.

Between a third and a quarter of all road traffic crashes involve someone who was at work. That means between 800 and 1060 deaths a year. It is therefore vital when specifying a car that its safety features and ability to withstand crashes is taken into account.

Streets of fire

In recent years, two further issues have grown to dominate fleet industry headlines: occupational road risk management and fleet-related environmental concerns. Both fall under the banner of corporate social responsibility.

Driving on business is the most dangerous task most employees will undertake during their working life, according to official figures. The Government and the police are working together with other agencies, such as the Health and Safety Executive, to encourage all organisations to implement best practice occupational road risk management programmes.

Last year, according to Department for Transport figures, 3172 people were killed and 255,232 people injured on Britain’s roads. It is estimated that between a third and a quarter of all road traffic crashes involve someone who was at work at the time. That means between 800 and 1060 deaths a year, compared with 241 fatal injuries in the ‘traditional workplace’. The percentage of occupational drivers injured is similar.

It is therefore vital when specifying a car that its safety features and ability to withstand crashes are taken into account.

The European New Car Assessment Programme was established a decade ago to crash-test new cars and rate their ability to protect occupants, children and pedestrians in a road crash. Vehicle ratings can be accessed at www.euroncap.com, and we would recommend that drivers choose a four or five star occupant safety rated car.

ABS brakes are now mandatory on all new cars, and the number of new models with airbags continues to grow. However, for maximum safety we would recommend electronic stability control. This is designed to prevent skidding, and is now fitted as standard to around half of the new cars on sale in the UK.

Another key factor is whiplash prevention. Thousands of drivers suffer whiplash injuries each year, resulting in many needing time off work. The insurance industry has tested hundreds of cars to assess their ability to protect against whiplash; rating details can be found at www.thatcham.org.

With many healthcare sales and marketing professionals likely to park vehicles in tight spaces, parking sensors (along with a reverse parking camera and screen) may be considered an important feature to prevent dents and scrapes. Lane departure warning systems are also beginning to appear in new models.

Finally, most businesses are striving to reduce their carbon footprint. Selecting the vehicles with the lowest CO2 emission figures should be a key priority. Typically, a low CO2 figure means a high MPG figure; and with fuel usage the second biggest vehicle cost factor after depreciation, this should not be ignored. For drivers, a low CO2 figure also reduces benefit-in-kind tax.

Drive all night

As can be seen from the above, choosing the ‘right’ car for a medtech sales professional is both an art and science. This article has not even touched on some issues, such as insurance, service, maintenance and repair costs – though these are all taken care of in wholelife cost calculations – and the importance of company car ‘badge power’ for recruiting, retaining and motivating staff.

So out of the more than 6,700 makes and models in the showrooms, which is the most suitable? Well, that depends…

Terry Bartlett is Managing Director of Inchcape Fleet Solutions, which operates more than 56,000 vehicles in the UK and is one of the country’s leading leasing and fleet management companies. For further information, visit www.ifs.inchcape.co.uk, telephone 0870 191 4444 or e-mail info@ifs.inchcape.co.uk.

 

 

 

A piece of the action

Medical devices are active technologies, and selling them calls for a strategy that actively engages the customer. Andy Beech of OTD discusses the power of action-based call objectives.

Imagine there are 99 sales representatives and account managers from the medical technologies industry lined up in order of their sales skills, from lowest to highest. You have to join that line. Where would you put yourself? Confidence and belief in yourself and your products are essential for a really successful career. Confidence becomes even more powerful when coupled with a realistic awareness of your own abilities and a desire to improve.

So now you are standing in a line of 100. What is your desire to move up that line and leapfrog the competition? If your desire is low, then over time people will start to overtake you. By doing nothing different, you will be slipping down the line. Doing nothing is doing something!

We have worked with thousands of sales people and hundreds of sales managers over the years – and while everyone’s strengths and development areas are different, there is one core skill that if developed further is most likely to make you the one moving up the line. It is a simple skill, but if used well and consistently it will have a significant impact on your business. What is it?

Ready to go

To begin with, how long should we spend preparing for a customer call or meeting? Of course it depends on the situation. You need as long as it takes in order to consider and write down the following:

• What problems may our customer have that we can provide solutions for? Why do they have these problems? What is likely to be important for them?
• If we have seen this customer before, what is their preferred communication style? What excites and inspires them? How might I need to adapt my style to connect with them more effectively?
• What would be good outcomes from the contact from the customer’s point of view? Why would these be helpful to the customer?
• Why am I seeing this customer? What specifically would be good, better and best outcomes for me and my company? (These should be actions that your customer is going to take, there and then or once you’ve left depending on the situation. Keep them short and action-based.)
• What resources do I need to take with me into the call?
• What state of mind am I in? (Give yourself a score out of 100.)
• What state of mind do I need to be in?

Don’t waste your breath

Let’s consider a case history. Tony was a sales manager for a company making ventilators for use in hospital care. Competition was tough, and there were few clinical differences between the competing brands. Differentiation was based on service levels and discount levels.

Tony had recently taken over a new geography. On his first field visit with sales representative Chris, Tony asked him what he wanted to achieve in the next call. “To find out when they are due to upgrade their ventilators and show them the benefits of our new model,” he said. Chris was an expert when it came to product knowledge, and he took great pride in being knowledgeable about his customers. He spoke enthusiastically about the world-class service and potential discount structure. They came out of the call without an order.

For the rest of the calls that morning, the objective was the same as before. So was the result. But when measured against the actual call objective, Chris was being successful! He knew exactly when the customers were likely to purchase new equipment, and his customers knew about the features and benefits of the new model.

After lunch, they agreed to try a new approach. For the next call, the objective was “To gain a commitment to purchase their model of ventilator the next time they were considering adding or upgrading their equipment.” They spent a few moments closing their eyes and imagining what real success would sound like and look like, then went in. They came out with an agreement that the customer would undertake a full trial of their product starting next month, with a view to purchasing three of them in six months’ time.

Over the next six months, Chris continued to have clear action-based call objectives. His sales performance went from the bottom of the sales league table to mid-way, a huge improvement.

You get what you wish for, so make your wishes good ones.

You get what you wish for, so make your wishes good ones. How clear are you on the customer actions that will move your business in the right direction?

Make it happen

In a complex account where there are multiple influencers, decision-makers and gatekeepers and the sales cycle is lengthy, this principle becomes even more important. How clear are you on the customer actions that will move your business in the right direction? Your customer or call objective should be:

• in line with your account plans
• imagined by you and then written down
• action(s) that your customer commits to taking by an agreed date.

Let’s consider a few actual customer call objectives that we have heard from account managers and sales people in our development programs and on field visits. Tick the ones that pass the customer action test.

Let’s consider a few actual customer call objectives that we have heard from account managers and sales people in our development programs and on field visits. Tick the ones that pass the customer action test.

1. To find out what products they are currently using. 2. To get them to agree to a call back/ another appointment. 3. For them to be committed to writing product usage guidelines and circulating these to the relevant departments by the end of the month. 4. Customer will sign an order for a year’s supply of X at a discount of 5% or lower. 5. Customer to be committed to speaking to a specific colleague about their good experiences of using your product by the end of the week. 6. To get the customer to agree to a product demonstration within the next month. 7. To inspire them to agree to undertake a two-month trial of your product, making a full assessment at the end of the trial period. 8. The customer will put in a proposal by the end of the month to the relevant committee, recommending that they purchase your product. 9. I don’t need an objective, as it’s just a courtesy call to build the relationship and see how they are getting on with our product. 10. (Insert your next customer contact objective here.)

Do they pass the test?
1. Knowledge is important, but it is not action.
2. There is no customer action here.
3. Yes.
4. Yes.
5. Yes. Can you be sure it will happen?
6. No. What do you want them to do?
7. Yes. You will need to flesh out the details.
8. Yes. Can you see it before it is submitted?
9. We have actually heard this one!
10. You tell me.

Where will you be standing in the line by the end of the year?

Andy Beech is a Director of OTD, a company that provides bespoke learning and development solutions to the healthcare industry. Its motto is ‘Inspire & Grow’. Andy can be contacted on 0845 224 1775. For more details, visit www.otd.uk.com.

 

 

Michelson strengthens management team CANCER IMAGING TECHNOLOGY company Michelson Diagnostics Ltd has strengthened its management team by recruiting experts in healthcare marketing and strategic finance. Katy Draper joins as Head of Marketing. Katy is a Chartered Marketer, and a former On Target contributor. Her career began in sales and marketing with Bristol Myers Squibb, where she was responsible for the wound care brand Granuflex. With Salts Healthcare, she promoted brands in stoma, orthotics, dispensing appliance contractor and breast care markets across the world. Katy has also set up Marketing Medicine, a specialist medical marketing agency that works across the spectrum of healthcare businesses. Tom Flynn joins as Finance Director. After working for Thorn EMI as a Corporate Strategist, Tom helped to set up a strategy consultancy advising companies on business development and market innovation. In 2001, he undertook a two-year strategic project for the NHS, piloting innovative working in six acute trusts. He has joined MDL with the aim of complementing the skills of its strong founder management team. Based in London, Michelson Diagnostics Ltd is a leading manufacturer and developer of Optical Coherence Tomography medical imaging equipment.

Advance for child healthcare HEALTHCARE RECRUITMENT company Advance Recruitment is supporting Action for Sick Children. Director Nick Langley has confirmed that, as well as making monthly contributions, Advance will donate a percentage of all fees earned in December and January to this worthy cause. Action for Sick Children is the UK’s leading children’s healthcare charity, formed to help seriously ill children receive the best possible standard of care. It provides information and advice for children and carers, and campaigns for child-friendly services and clear public information.

Kirkham Young’s gifts for Oxfam SPECIALIST HEALTHCARE AND SCIENTIFIC RECRUITMENT company Kirkham Young is supporting overseas development charity Oxfam by sending its customers corporate Christmas gifts with a difference. “Choosing a broad selection of gifts from Oxfam Unwrapped, including chickens, goats, trees, school dinners and even health workers and safe water, was great fun and enables Kirkham Young as a company to support poor communities around the world in a very direct way,” said Director Sam Kirkham. “We hope that clients will appreciate these more unusual corporate gifts, and not be too disappointed the customary bottle of wine has been ousted!” Fellow Director Tina Young added: “We were delighted to support Oxfam in this ingenious scheme, providing desperatelyneeded help to people across the globe. Specialising in medical and scientific sales, marketing and technical support roles, in some cases we were able to match the gift to the company’s specialist area – hopefully making it all the more appropriate!”

New STARs in the sky HEALTHCARE RECRUITMENT company STAR Medical has created four new roles to strengthen and support its team. As the STAR team continues to expand in response to new recruitment partnership opportunities, a new Sales Force Co-ordinator role has been created. Emily Button will be looking after all of STAR’s externally-based employees, such as field-based Regional Account Managers and contract representatives. After just five months as a STAR Resourcer, Gemma Head has made a rapid step to the role of Recruitment Consultant for the South West, Scotland and Northern Ireland. New Resourcer Tom Legrand is assisting Regional Account Manager Helena Epplestone in looking after clients and candidates in the Midlands. David Alexander’s new role of sales support will provide essential administrative support and additional candidate care to the STAR team.

Ethicon’s top newcomers TWO SALES PROFESSIONALS placed and trained by Pareto Law have won 2007 Sales Newcomer of the Year awards at Ethicon Endo-Surgery’s UK Sales Awards, held in Cardiff. Deborah Blanks and Magda Szymanska have achieved 100% of their sales targets since joining Ethicon Endo-Surgery. The Newcomer of the Year awards recognise individuals who have made a significant contribution to the company’s business performance in their first year. Deborah joined Ethicon Endo’s Harmonic Division as Territory Manager for Staffordshire, Cheshire and North Wales in February 2006. Magda joined the company’s Endo-Mechanical Division in May 2006 as Territory Manager for the South Coast region. Deborah and Magda work on a range of customer accounts, visiting operating theatres to promote and demonstrate Ethicon Endo’s medical devices. They also provide training workshops for surgeons and nurses. Deborah said: “It is a great honour for me to receive such recognition in my first year. The support I receive from across Ethicon Endo-Surgery, combined with the skills and training provided by Pareto, have been invaluable in helping me achieve my targets.” Ethicon Endo-Surgery, a division of Johnson & Johnson Medical Ltd, develops and markets advanced medical devices for surgical procedures. Pareto Law is a leading graduate assessment, placement and training company.

IRONMAN success for Helix DICK AND CLARE DONOVAN, the Directors of specialist healthcare and laboratory science recruitment company Helix Recruitment, have completed the demanding IRONMAN triathlon in Florida to raise funds for WaterAid. In our June issue, we reported the Helix duo’s intention to complete two IRONMAN triathlons this year. These are long-distance events comprising a 3.8km swim, a 180km bike ride and a marathon run (42km). Sadly, the hot and humid conditions in Austria in June resulted in Clare suffering serious exhaustion and Dick not reaching his target of completion within 13 hours. The Florida triathlon in November began with nearly 2500 athletes on the white sands of Panama City Beach. This time, Helix’s ambitions were realised. Dick finished in under 12 hours, a remarkable personal best, while Clare finished in under 13 hours. The ‘Pirate’ tops they wore are team kit for those who have taken part in IRONMAN for three or more years. The ‘Pirates’ offer training tips and mentoring for newcomers to the triathlon. Next stop, IRONMAN France in June 2008! If you would like to know more about sponsoring or participating in the triathlon, please call Dick or Clare at Helix Recruitment on 01323 445464. WaterAid is a charity dedicated to the provision of safe domestic water, sanitation and hygiene education worldwide.

Advo celebrates double success

THE ADVO GROUP, a healthcare intermediary that advises businesses on staff healthcare, has won two industry awards. Advo’s online health insurance management system Clarity enabled the company to win the ‘Best E-business 2007’ prize at the Cover Excellence Awards. The awards were presented by celebrity Gyles Brandreth in a ceremony at the Plaisterers’ Hall, London.

Advo was also named ‘Best Group PMI (private medical insurance) Intermediary 2007’ at the annual Health Insurance Awards. Managing Director Paula Aitken was presented with the award during a ceremony at the Grosvenor House Hotel, London.

Larry Bulmer, Chief Executive of Advo Group, says: “The principle of the Advo Group is to offer all clients exemplary levels of service, and these industry accolades prove that the attitude, training and acumen of the group and its staff are achieving our aim. However, we will not be resting on our laurels.”

Based in Maidstone, Advo specialises in advising small and medium-sized enterprises (SMEs) on their private healthcare requirements. The Clarity system helps clients to manage their healthcare schemes online.

 

 

 

The Other Side 16:

Interview with a Clinical Procurement Specialist

Ian Poxon is a Clinical Procurement Specialist at Nottingham University Hospitals NHS Trust, and is Chair of the National Network of Clinical Procurement Specialists. On Target talked to him about the new landscape of NHS purchasing for secondary care.

1. How would you define ‘procurement’?

The obtaining of products and services for an institution, attempting to get value for money.

2. How does your role bring together clinical and financial priorities?

The two don’t always go together. There are a lot of pressures coming through from central government: initiatives on infection control etc. And we have to be mindful of clinical need: it’s not just about buying the cheapest option. As with purchasing a company car, you don’t want the Trabant and can’t afford the Rolls Royce, so you go for a Rover or a BMW. You try to get a balance, to get the best deal possible for the organisation.

To support clinicians, we need to get an understanding of the financial processes and implications, as well as clinical needs and the product. Many people think purchasing in the NHS is a bit like going to Sainsbury’s and they can pick what they want off the shelves, but it’s not like that. More and more Trusts are saying “We need a corporate way of doing this,” rather than letting it devolve to individual budgets or deciding earlier which products to use.

3. What are the key features of the new NHS procurement structure where medical technologies are concerned?

We’re not totally joined up on this at the moment. The Hubs that have been formed are working in slightly different ways. We are targeted by the DH to work with companies developing technologies and help them get through to the marketplace. It’s not very straightforward at times.

A lot of companies don’t understand the way the NHS and procurement work, and don’t understand the needs of clinicians and how to take their innovation to the end user. Then we have the silo budget mentality of the NHS, where money is put into certain pots and then can’t be moved. From a Trust perspective we are targeted on moving new technology forward, but we are mindful of the financial constraints that NHS Trusts operate under.

As for the new Collaborative Procurement Hubs – we’re paying for them to help us purchase in a better way by aggregating volumes and getting better prices, but again it’s about making sure that the links are there down to the customer and the patient. The Hubs are targeted on innovation and being progressive, but if we don’t have the communication channels in place it’s difficult to move forward.

4. What positive opportunities does the new purchasing landscape offer to medtech companies?

It gives them a contact point. One problem they’ve had in the past has been not having enough points of contact to bring new products to. They’re getting nearer to the end user than before: we’re still not close to the end user, but we’re trying to give them the opportunity.

The DH has set up new bodies, like the Innovation Hub at Warwick University, to look at development. The work of HITF supposedly helps us to do that: it gives us a channel to bring new technologies to the fore. The Innovation Hubs will be working with CP Hubs, who in turn work with individual Trusts, aiming for change and communication to help move products forward.

Tied in with that, the Centre for Evidence- Based Purchasing has moved from working alone to working within NHS PASA. It can look at products across various routes, trying to see whether they should be moved forward into the NHS faster, and to provide the evidence to do that.

5. What are the potential pitfalls of trying to sell medical technologies to the new purchasers?

Communication again – getting the information to the right people. The new purchasers are still distant from the end users, because they are covering such a large geographical area. Companies should never miss out the Trust procurement department: the interface between the hospital patients and the purchasing side is there, not ten miles up the road at the CP Hub. You can sell the idea to a CP Hub, but will individual Trusts follow what it says? Each Trust, though paying for the Hub’s services, has its own budgets to manage and its own problems to face on a daily basis. You do need to see the Hub, but also people at individual Trust levels.

A lot of medtech companies think once they have designed a product it’s just going to be snapped out of their hands. They don’t understand the beast of the NHS! The days of targeting individual consultants are going. Now the Hubs get information out to the Trusts, where it is evaluated again and passed on to the clinicians.

Companies should never miss out the Trust procurement department: the interface between the hospital patients and the purchasing side is there, not ten miles up the road at the CP Hub. Each Trust, though paying for the Hub’s services, has its own budgets to manage and its own problems to face on a daily basis.

6. If you had to condense your advice to the medtech industry into a single message, what would that be?

Let’s all work together. We all have a part to play in this. We need these medical technologies, but we need to know they ‘do what it says on the tin’. We need independent research, clearly presented as such. We don’t like the American way of thrusting things down our throats. We also want companies engaged in innovation to talk to Trusts about what they are doing in their locality, as we are targeted by the DH to support local businesses.

We want to work with companies to use products to the best effect. They have to bring not just the product, but the training and support to go with it. It’s no use just coming as a company with the MD as salesman and saying “Yes, I can sell you this, it’s dirt cheap.” Because of the legal implications of using medical technology, we need to ensure that staff are fully on board and fully educated in using any new product.

 

 

NHS private sector ADDENBROOKE’S HOSPITAL in Cambridge has begun treating cancer patients with the TomoTherapy® Hi-Art® radiotherapy system. Addenbrooke’s, run by Cambridge University Hospitals NHS Foundation Trust, is the first NHS-affiliated hospital to install a TomoTherapy system. Its Oncology Centre treats more than 4,000 new patients a year. The Hi-Art system uses a CT scanner-based design to deliver image-guided, intensity-modulated radiation therapy (IMRT) from all angles. The system facilitates dose escalation while reducing radiation exposure to healthy tissue. “We are honoured to work with Addenbrooke’s and the Trust to make TomoTherapy technology available to NHS cancer patients in the UK,” said Beth Klein, Vice President of Global Sales for TomoTherapy. “The Hi-Art system’s CT-guided, helical IMRT deliveries represent a significant advance in radiotherapy,” said Dr. Neil Burnet, a clinical oncologist at Addenbrooke’s. “With this one device, we can image the patient’s tumour and surrounding anatomy immediately before each daily treatment. Then we can deliver highly-conformal radiation to the target from 360 degrees, enabling us to treat complex or intricate shapes, or multiple target lesions, with a single set-up.” TomoTherapy Inc. launched its Hi-Art treatment system in May 2007. For more details, visit www.TomoTherapy.com.	PleuraSeal™ assists lung healing COVIDIEN LTD has been buoyed by the European launch of its new surgical lung sealant system. The PleuraSeal Lung Sealant System is intended for use during thoracic procedures to assist the closure of pleural air leaks. Air leaks are a common complication during thoracic surgery that increase patient length of stay and risk of infection. PleuraSeal uses a unique hydrogel technology to provide an airtight seal that is effective during the operation and throughout the critical lung healing period. “Our investment and efforts to develop and commercialise new biosynthetic technologies aim to address unmet clinical needs and to improve patient outcomes,” said Scott Flora, President, Surgical Devices, Covidien. “We believe that this highly innovative synthetic sealant will be adopted quickly by any surgeon unsatisfied with the options available today.” Dr. Paul De Leyn, Professor of Thoracic Surgery at the University Hospitals Leuven Gasthuisberg in Belgium, said: “An easy-to-use and effective thoracic lung sealant to address complications in thoracic procedures will be very welcomed by the surgical community. We have been impressed by the performance characteristics of PleuraSeal and are pleased to be associated with the clinical study.” Covidien is a leading global healthcare company. For more details, visit www.covidien.com.
Wireless detector for digital X-rays SIEMENS MEDICAL SOLUTIONS last month unveiled a new digital X-ray unit with a wireless detector. The Ysio wi-D unit, which offers increased flexibility in imaging, greater patient comfort and reduced examination times, was launched at Medica 2007. X-ray detectors for digital imaging are normally integrated into the examination table. The Ysio wi-D allows the detector to be positioned directly underneath or next to the patient. Exposures that are difficult or impossible to take using an integrated detector, such as lateral exposures of the hip, can now be taken easily. Patients can be X-rayed on a gurney or in a wheelchair without requiring transfer to the table. The wireless detector, which transmits image data to the diagnostic workstation via WLAN, can be used as flexibly as a cassette in analogue X-ray systems while offering the advantages of digital imaging. The detector supplies images of excellent quality within seconds of exposure. The Ysio wi-D also assists in streamlining routine work. The system can be operated by a remote control and moved automatically to different positions at the push of a button. Siemens Medical Solutions is one of the world’s largest healthcare product suppliers. For more information, visit www.siemens.co.uk/medical.
New surgical scanner is built to last An ultrasound surgical scanner that works as an integrated part of the operating room has been launched by B-K Medical. The Pro Focus OR ultrasound system is designed to be a permanent part of the operating room (OR). Surgeons can access its ultrasound capabilities during surgery quickly and easily, aiding decision-making and patient management. Being off the floor, the Pro Focus OR affords staff greater freedom of movement within the sterile area. The scanner’s monitor and control panel are mounted on flexible arms. The system also reduces cleaning and preparation time. The Pro Focus OR is compatible with the full range of dedicated surgical transducers, including the new 8814 and 8815 systems. Michael Brock, B-K Medical’s President, said: “The Pro Focus OR is designed for the professionals and the OR of the future. With this system, we are not only able to offer hospitals and clinics the most advanced, dedicated surgical ultrasound system on the market today, but also a cost-effective way to configure and streamline their operating rooms.” B-K Medical, a wholly-owned subsidiary of Analogic Corporation, specialises in developing and producing diagnostic ultrasound equipment. For more information, visit www.bkmed.com.	Salitas gives patients a leg up UK COMPANY SALITAS has developed an innovative leg support system, designed to reduce the risk of back injuries to healthcare staff. The Salitas Leg Support System, launched at Medica 2007, reduces the muscle stress associated with lifting and holding a patient’s leg. It also supports hip movement while reducing the risk of hyperextension at the knee joint, pressure sores on the heel and DVT. The system’s suspension stand is mobile and can support other loads, such as the positioning of drips and monitors above or close to the patient. Also launched at Medica was the Salitas Plaster Room Suspension System, designed to improve patient comfort and reduce the risk of back injuries to staff while applying a cast to a lower limb. Richard Wilson, Managing Director of Salitas, said: “We’re delighted to be exhibiting at Medica 2007 our cutting-edge range of products designed to improve treatment and aid recovery, for which we are hoping to source new distributors. As well as greatly improving patient care, a key benefit of the products is the ability to prevent healthcare professionals suffering from back problems.” Salitas is based in Knaresborough, West Yorkshire. For more details, visit www.salitas.co.uk.
SunTech Medical launches ‘new product category’ BLOOD PRESSURE TECHNOLOGY specialist SunTech Medical has introduced a device that bridges the gap between manual blood pressure gauges and vital signs monitors. The new SunTech 247™ Diagnostic Station is described by the company as “a whole new product category”. The new device combines an automated monitor with a manual mode that allows for stethoscope readings of blood pressure. The modular design allows the addition of temperature and SpO2 modules. Don Wildmon, SunTech Medical’s VP of Sales, said: “The SunTech 247 Diagnostic Station establishes a whole new product category in medical devices. Clinicians really like the modular design that allows them to start out with a blood pressure device and later to upgrade to other vital signs parameters as needed.” Dayn McBee, CEO of SunTech Medical, commented: “As the adoption of healthcare information technology increases, the need to upgrade from manual to digital instruments becomes increasingly strong. We are striving to fill the need for more affordable, flexible and expandable technology in order to decrease the cost of healthcare and to provide greater ease of use to the clinician.” SunTech Medical’s European operation is based in Eynsham, Oxfordshire. For more details, visit www.SunTechMed.com.

 

 

Medica 2007: a global market

More than 280 UK companies descended on Germany to take part in Medica, the world’s largest healthcare trade fair, held in Dusseldorf from 14–17 November 2007. The leading global exhibition for the medical devices sector, Medica attracted more than 130,000 visitors. A total of almost 4,800 exhibitors from 65 nations – a record figure in the history of the event – presented innovative products and services for the healthcare of the future.

The main topics of the accompanying congress were the electronic health card, telemedicine and new media. Presentations on Wednesday, November 14, focused on the electronic health card and professional ID cards. On Thursday, the focus was telediagnostics and its new developments: ultrasound, gene analysis, imaging and endoscopy. On Friday, there was a debate on doctors and telemedicine. Saturday’s presentations focused on information transfer.

Products on display

The Medica 2007 exhibition was structured into product groups presenting the entire range of products, systems and services for hospital and outpatient care, including medical devices, diagnostics, physiotherapy, consumables, IT applications and facility management.

A major aspect of the exhibition was current innovations for medical imaging and IT developments in the field of electronic patient records and medical data networks. Another key aspect was products used by patients in the community, including remote monitoring and diagnostic applications.

Running concurrently with Medica was CompaMED, High Tech Solutions for Medical Technology, a trade fair for components, parts and raw materials for medical manufacturing. CompaMED is also experiencing an upswing: the number of exhibitors has risen by 45% since 2006. The exhibition showcased a range of high-tech solutions for use in the medtech industry.

ABHI and UKTI

This year the Association of British Healthcare Industries (ABHI), supported by UK Trade & Investment, took a pavilion of more than 90 innovative medical companies who are at the forefront of product technology development and services worldwide.

Minister of State for Trade and Investment Lord Jones of Birmingham said: “It is well known that the UK punches well above its weight in the Medical sector. We are a leader in developing cutting-edge healthcare products for the world market. Every year at Medica, small innovative companies can join forces with the major players to present a showcase on a scale unrivalled worldwide.”

John Wilkinson, Director General of the ABHI said: “UK medical technology companies are highly respected within the global Medical community as world leaders in innovation and quality. For many small and medium-sized UK companies this exhibition is an integral part of their export strategy, providing an essential gateway to new markets. ABHI is proud to be taking a leading role in organising the participation of many of these groundbreaking UK companies.”

In association with ABHI, UK Trade & Investment has organised a directory of UK exhibitors at MEDICA, detailing every company and their products and services. This can be found online at www.uklifesciences.co.uk/Medica.

Some of the exhibiting companies were:

• AFOS (NSE) Ltd, exhibiting its extensive range of laboratory, mortuary and operating theatre equipment.
• Malem Medical, exhibiting its range of Enuresis Alarms to combat bedwetting.
• Inditherm Medical, showing revolutionary patient warming systems using its patented flexible polymer technology.
• P3 Medical Limited – launching the new Papworth Bivent double lumen tracheal tube to assist safe lung isolation.
• Infutech Ltd – launch of unique needle safe subcutaneous infusion system.
• Fertility Focus – exhibiting the Fertiloscope, a unique minimally invasive instrument for the early diagnosis and immediate corrective surgery of certain abnormalities that can cause female infertility.
• Exmoor – launching the innovative new product Epidrum, which gives a signal to the anaesthetist when they are in a position to introduce the catheter and feed in the anaesthetic.
• Bedfont Scientific Limited – launching two new state-of-the-art touch screen technology monitors that address infection control issues.
• Hydro Physio – launching the new Focus treadmill, which utilises the properties of water to assist rehabilitation.

Medtech from the Midlands

West Midland manufacturers were well-represented at Medica 2007. The regional membership organisation Medilink West Midlands secured two stands at the show, providing a cost-effective sales opportunity for companies wanting to reach global customers.

The stand at Medica showcased 15 companies’ products, generating interest and sales leads. The MedilinkWM team gathered nearly 150 sales leads that will be available to member companies.

“Exhibiting at Medica is an absolute must for Warwick Sasco,” said Darby Booth, Managing Director of the medical plastics company. “We meet with existing distributors and find new contacts in our target markets. Working with Medilink and ABHI is ideal for UK companies.”

Healthcare from Yorkshire and Humber

Member companies of Medilink Yorkshire and Humber saw commercial opportunities opening up at Medica 2007.

Chris Truman, Managing Director of Hydro Physio (see above), said: “Medica was a great opportunity for us to meet with our current distributors – from areas such as Greece, Korea and Australia – and to source new ones. We also saw a high level of interest from end users such as physiotherapists and rehabilitation specialists.”

Also showcased at Medica 2007 was an innovative leg support system created by Salitas (see our Product News section). Richard Wilson, Managing Director of Salitas, said: “Medica allowed us to meet potential distributors from areas across the globe, including India, France, Ireland and Saudi Arabia. It was also a great platform for us to forge excellent network links with fellow exhibitors.”

Medica 2007 also saw Ulsys exhibit a pressure monitor that increases the accuracy of leg ulcer treatment. Mick Karol, Managing Director of Ulsys, said: “Our innovation saw interest from distributors and manufacturers in areas such as Holland, Australia, Hong Kong and the UK.”

M.A.S. Medical showcased its ‘Visual Therapy’ nature images for the clinical environment. John Coe, Director of M.A.S. Medical, said: “As well as interest in our nature images, Medica brought us companies looking for us to distribute their radiology products from areas such as North America, France and Spain.”

An innovative case that allows patients to carry home peritoneal dialysis kits was exhibited by CP Cases. Edward Sloper, Marketing Director of CP Cases, said: “Medica was a key show for us to exhibit our range of bags and cases, which play a significant role in improving the delivery of medical products.”

Vernacare was at Medica to exhibit its infection control solutions. Greg Cranfield, Export Director of Vernacare, said: “Medica was a great opportunity for us to meet with our existing distributors and our new Swedish distributor, and to create partnerships in new locations across the world.”

 

NHS private sector schemes fail ‘value’ test SIX PLANNED SCHEMES to franchise NHS services to private sector companies have been scrapped as failing to demonstrate good prospective value. An existing NHS private sector project to deliver mobile diagnostics has been cancelled due to insufficient use. The Government has approved 10 new NHS private sector projects, however, and Health Secretary Alan Johnson denies any change in the NHS reform policy. The projects that will not go ahead are: North East Yorkshire and North Lincolnshire Referral Assessment Diagnostics and Treatment Service; North East Diagnostics; South East Diagnostics; Norfolk, Suffolk and Cambridge Electives; Cumbria and Lancashire Clinical Assessment and Treatment Services; and Lymington in the Hampshire and Isle of Wight Electives. The DH will also terminate Care UK’s mobile diagnostic service for the West Midlands, which was launched in June to provide 200,000 diagnostic procedures per year. Mr Johnson said the service had “unacceptably low rates of use”. He added: “The reduction in the overall size of the procurement does not represent a change in policy. New providers have been instrumental in helping the NHS slash waiting times.” Mr Johnson also announced the approval of 10 new NHS private sector schemes. Richard Jones, chairman of the NHS Partners Network, commented: “We are naturally disappointed that the scale of the next stage of this programme is going to be smaller than originally planned.”	Creating a wound care brand BRAND DEVELOPMENT AGENCY Brand Create has been hired by global medtech company KCI (Kinetic Concepts Inc.) to create an international ad campaign for its new wound care products. Brand Create’s campaign, aimed at healthcare professionals, will reposition KCI’s Vacuum Assisted Closure® Therapy technology in the marketplace as an across-the-board treatment for acute and non-acute wounds. Within this brand, two next-generation products to be launched by KCI are InfoV.A.C.® (for the hospital) and ActiV.A.C.® (for the home and transition from hospital to home). The hospitalto- home transition market is an increasingly important one. Brand Create’s ads will appear in healthcare and general journals over 2007/2008. The campaign has four strands: effective therapy, healthcare economics, hospital-to-home transition and user-friendly technology. In the hospital-to-home transition strand, a series of images show patients in normal home settings – for example, working in the garden. “The advertising concept arose from meeting some recovered patients and getting to understand that a hard-to-heal wound really messes about with quality of life, not just for the patient but for friends and family,” said Michael Dumigan, Managing Director of Brand Create. London-based Brand Create is part of the Core-Create Group. For more information, visit www.brandcreate.com.
Olympus snaps up Gyrus Group OLYMPUS, THE JAPANESE digital camera group, has purchased UK medical devices company Gyrus Group for £935 million. The deal establishes Olympus as a leading player in the global medical technology market, and reflects the growing interest of Japanese imaging businesses in the medical devices market. The new combined business, Olympus said, will be a medical devices specialist. The company is already the world’s leading maker of endoscopes, with a 70% global market share. Gyrus is based in Cardiff, and specialises in radio-frequency devices used for visualisation in keyhole surgical procedures. The deal still requires approval from Gyrus shareholders, and from antitrust authorities in the UK and the US. Brian Steer, chairman of Gyrus, said that there were clear synergies between the two companies that, combined with the substantial premium price, presented an “outstanding opportunity” for shareholders. “The market for minimally invasive surgical systems is seeing double-digit growth annually and is very promising for the future,’’ said Tsuyoshi Kikukawa, President of Olympus.
A goal worth scoring A SUPPLIER OF SCANNERS for sports professionals is among the winners of the 2007 Medilink West Midlands Medical Technology Awards. The award ceremony, held at the Council House in Birmingham, recognised five of the region’s 1300 medical technology enterprises for their outstanding business accomplishments. The Start-up award was won by Aston Academy of Life Sciences Day Hospital, which provides musculo- skeletal scanning facilities to Premiership footballers and Olympic athletes. Eco-Logic UK, which supplies one-touch and touch-free controls for basins and baths, won the Best Growth in Sector prize. E-Medix, a surgical instrument company, won the prize for Export Achievement. The world’s second largest manufacturer of stairlifts, Minivator, won the Innovation award. Surgical training company Wetlab won the prize for Partnership With the NHS. Stand-up comic and GP Dr Phil Hammond, who presented the awards, emphasised the power of innovation to change people’s thinking. MedilinkWM’s Communications Director, Michelle Dalton, said: “These awards are an excellent chance to celebrate the huge variety of skills, expertise and experience in this sector.” The winners now go on to compete with other regional winners for the Medilink National Medical Technology Awards, to be announced at MEDTECH UK in February 2008.	Johnson & Johnson integrates its parts JOHNSON & JOHNSON (J&J) is to create three new units in order to accelerate business growth and extend its commercial scope. J&J subsidiaries concerned with medical devices and diagnostics will be integrated into two groups targeting the surgery and longterm conditions markets respectively. A new Office of Strategy and Growth will highlight growth opportunities in new areas for the company. The J&J Surgical Care Group will focus on technologies and services in the surgical area. The Comprehensive Care Group will develop portfolios to treat long-term conditions such as diabetes. William C. Weldon, J&J’s Chairman and CEO, explained: “Much of the change in healthcare reflects the coming together of parts of the system that were at one time separate. The very solutions that the healthcare system most needs – those coming from the convergence of science, technology and services – are the ones we are most capable of providing.” The J&J franchises making up the Surgical Care Group will include Ethicon, Ethicon Endo-Surgery and DePuy. Ethicon’s current Chairman, Sherilyn S. McCoy, will become Worldwide Chairman, Surgical Care. The subsidiaries making up the Comprehesive Care Group will include Diabetes, Cordis and Ortho-Clinical Diagnostics. Donald M. Casey, Jr., currently Chairman for the Diabetes franchise that includes LifeScan and Animas, will become Worldwide Chairman, Comprehensive Care. These changes will become effective on January 1, 2008.
Spire Healthcare reaches for the sky SPIRE HEALTHCARE has been unveiled as the new independent healthcare group formed from the sale of BUPA Hospitals to private equity company Cinven. Spire Hospital signs have gone up outside the 25 UK hospitals previously owned by the BUPA Group. In addition to private and insured patients, NHS patients can now be treated at Spire Hospitals through the Government’s Choose and Book scheme. Spire’s Chief Executive, Clare Hollingsworth, said: “Becoming a standalone private healthcare company, separate from BUPA, will give us greater freedom to develop our business and offer more services to more people. “We deliberately chose the name ‘Healthcare’ rather than ‘Hospitals’ because we don’t want to limit our ambition. The long-term trend is for more care to be delivered outside of the conventional hospital setting, and while our priority will be to develop our existing facilities we will also look at new ways of delivering quality healthcare services. She concluded: “Over the last 25 years we have built up a great reputation among our customers, so we hope that everyone will see that although our brand name has changed, our commitment to deliver excellent service and clinical expertise has not.”
Minister for Competitiveness visits Eschmann Equipment THE MINISTER OF STATE for Competitiveness has praised the UK medtech industry’s substantial contribution to the economy during a visit to Eschmann Equipment in Lancing, West Sussex. Stephen Timms, who is responsible for enterprise, growth and business investment, viewed Eschmann technologies such as the new range of Little Sister™ sterilisers and the successful T-Series operating table system, and applauded the innovation of the sector as a whole: “It is always a great pleasure to visit a British manufacturing business thriving on the world stage whilst continuing to innovate and invest in what I know is a very competitive healthcare market. Innovation in medical technology is a UK success story, and the Government is working closely with the sector to ensure it continues to make a substantial contribution to the UK economy.” Mr Timms was accompanied by John Wilkinson, Director General of the Association of British Healthcare Industries (ABHI), who said: “Eschmann are a great example of a successful UK small to medium-sized medical technology company, producing high-quality products which improve outcomes for patients and contributing to the UK economy.” Based in Lancing, West Sussex, Eschmann Equipment is a leading manufacturer of operating tables, theatre equipment and infection control systems.	Getinge acquires surgery businesses GETINGE HAS PURCHASED THE CARDIAC SURGERY and Vascular Surgery divisions of Boston Scientific in the USA for $750 million. This acquisition will enable Getinge to become the global market leader in cardiac surgery products by marketing the acquired brands outside the USA. The cardiac surgery market is an important niche within the market for cardiovascular diseases, and is growing by 8–10% per year. Boston Scientific purchased the cardiac surgery business from Guidant in 2006, and acquired the vascular surgery business in 1995. The cardiac surgery division has market-leading products for endoscopic vessel harvesting, anastomosis, surgical ablation and other procedures. The vascular surgery division has built up a very strong position in the treatment of aortic and thoracic aneurysms. Getinge views the acquisition as a basis for expansion in the global market for medical devices, equipment and instruments for cardiac surgery. By marketing both divisions’ products outside the USA, it expects to greatly increase their market share. Johan Malmquist, President and CEO of Getinge AB, said: “The acquisition of these high-quality, market-leading businesses creates a unique platform upon which to take further steps toward building a global, market-leading presence in cardiac surgery.”
Mobilis wins BHTA award THE MOBILIS HEALTHCARE GROUP has won the British Healthcare Trades Association (BHTA) award for outstanding customer service. Nottingham Rehab Supplies, Pride Mobility Products and Optelec won awards for their assistive technologies at the same event. Mobilis was presented with the trophy for its service excellence to physiotherapy, podiatry, occupational therapy and sports healthcare professionals at the BHTA’s Annual Awards Dinner at Central Hall, Westminster. Broadcaster Angela Rippon presented the award to Ian Eaves, who commented: “This award is a fitting tribute to all the Mobilis staff who, over the last 18 months, have worked tirelessly to implement the installation of a major new IT and logistics system, a key enabler to maintaining the loyalty and goodwill of our customers.” Based in Oldham, the Mobilis Healthcare Group is the preferred supplier to the RFU and official partner to RFU community rugby. The same ceremony saw the 2007 BHTA Independent Living Design Awards, recognising innovation in assistive technology. First prize went to the 2 in 1 Bed Rail from Nottingham Rehab Supplies, designed for use in a domestic setting. Second prize went to the Airgo Navigator from Pride Mobility Products, a four-wheel walker that converts to a chair. Third prize went to the Compact + pocket video magnifier from Optelec. Sue Norris, head of the NHS PASA Centre for Evidence-Based Purchasing and chair of the judges, said: “We felt that the three prizewinners had made subtle but significant improvements to the safety and quality of life for the users of their products.”

 

 

Ready for independents

Recent NHS reforms have established the independent sector as an important part of the UK healthcare system. Thoreya Swage explains the diverse roles of these new providers, and asks: is the healthcare industry ready to meet the unknown?

The days of the local NHS hospital being the only choice available for patients requiring a hip or a knee operation are long over. Indeed, the days of NHS hospitals being the only healthcare provider around are also over. The supply-side reform of the English healthcare system has brought new players into the market, and these players are growing in influence. They are the independent sector healthcare providers.

The Government’s stated aim in increasing the number of different types of healthcare provider is to stimulate change in clinical practice, improve access to care and deliver improvements in clinical services. Change can be achieved through ‘planting’ new organisations within a local health economy and then seeing the ripple effect of innovative or efficient practice passing through the other healthcare bodies in the locality.

These objectives are reinforced by the policy of Patient Choice or Free Choice: the Government wants the NHS to offer more convenient and personalised care that takes into account the preferences of patients as to where and when they would like to be treated. By 2008, patients will be allowed to go to any provider of their own choice for their treatment. The choice of provider can be from an NHS Trust, a Foundation Trust or an independent sector organisation so long as it meets NHS standards and costs.

Giving patients choice increases the chance that a more responsive, high-quality health service tailored to the individual will be provided. The independent sector has an essential role in providing this wider choice for patients.

An independent history

The involvement of the independent sector in the UK health system is not recent. Since the inception of the NHS sixty years ago, General Practitioners have worked as independent contractors who provide their services mostly, but not exclusively, to the NHS. Similarly, dentists who work from their own surgeries are independent businesses, as are high street chemists and opticians.

The independent sector is also a significant provider of mental health care (e.g. eating disorder services), social care (e.g. nursing homes) and palliative care (hospices), and has been used as a means to tackle long waiting lists for elective surgery.

The ISTC programme

Back in the nineties, the NHS practised ‘spot purchasing’: it went to independent hospitals to buy extra capacity in order to shorten waiting lists. These agreements were not efficient, however, as the NHS usually had to pay more than the standard reference costs for procedures and co-ordination for follow-up care between the NHS and the independent sector was poor. The use of independent healthcare was therefore limited at that time.

The involvement of the independent sector was given a major boost by the Government’s reform programme for the NHS: the independent sector was challenged to drive innovation, ensure contestability and deliver the additional capacity that the NHS could not.

The independent sector treatment programme was announced by the Government in 2002 in an effort to stimulate a reduction in the long waiting times for elective surgery that patients were experiencing. The independent sector treatment centres (ISTCs) are private healthcare companies that deliver care funded by the NHS and free at the point of delivery to NHS patients.

The first ISTC was opened in 2003. By late 2007 there were 23 centres across the whole of England, covering elective procedures including hip and knee replacements, cataract surgery and general surgery. Other initiatives in the ISTC programme include six commuter walk-in centres and diagnostic services providing imaging, MRI, echocardiography, ultrasound and endoscopy.

The ISTCs have provided to date nearly three-quarters of a million episodes of care.

Reaching out

A further development has occurred to support patient choice: the extended choice network (ECN). This is a system whereby independent providers have applied and been approved to provide care. There are currently some 100 providers on this ‘list’, and more are being added as the NHS moves closer to the 2008 Free Choice target.
The involvement of the independent sector in the NHS continues to expand through various developments, including:

• the ‘Fairness in Primary Care’ procurement, whereby providers are invited to tender to provide GP services in nine PCTs that are under-doctored
• the ‘Framework for Procuring External Support for Commissioners’ programme, which aims to provide commissioning support to PCTs
• the provision of medical oxygen to patients’ homes
• the growth of commercial home care delivery services – these enable patients to receive medical treatment such as stoma or HIV care or ambulatory dialysis equipment without having to go to outpatient clinics
• the development of decontamination services for the sterilisation of surgical instruments.

The introduction of a multiplicity of providers, including the independent sector, means that the NHS is no longer the sole significant buyer for the medtech industry. There are other customers with whom relationships need to be built and commercial deals need to be set up.

A new healthcare market

All of these changes add up to a new emerging healthcare market that requires closer examination by the medtech industry.

The introduction of a multiplicity of providers, including the independent sector, means that the NHS is no longer the sole significant buyer for the medtech industry.
There are other customers with whom relationships need to be built and commercial deals need to be set up.

Introducing new players into the healthcare market has resulted in the development of new services in many areas of medicine and surgery. This means that new care pathways have been developed within a local health economy.

The drive to innovate has led to new technologies and equipment being used to help implement evidence-based clinical care. For example, the average length of stay for inpatients at ISTCs is less than 50% of that within the NHS (4.4 days compared to 11–12 days), theatre utilisation is 33% higher than in comparable NHS trusts, and re-admission rates are much lower.

All of this adds up to greater clinical productivity, and therefore an increase in the use of medical equipment and supplies.

A testing ground for medtech

The emergence of ISTCs has implications for the NHS market. Some ISTC staff also work in the NHS; this provides an opportunity to influence the NHS indirectly, when staff can see how effective a piece of equipment or technology is when used in the ISTC setting.

This effect has stimulated changes in NHS clinical practice, where previously the uptake of new technologies was slow.

The independent healthcare companies setting up ISTCs or other services require information on medical devices and related equipment, as more often than not they will be establishing new facilities. This provides an opportunity for medtech representatives to form relationships with these new providers and discuss their products.

The independent sector provides a whole new customer base for training. Many of the ISTC staff are not conversant with the local healthcare systems, having worked abroad, and do not understand how the NHS works.

The local healthcare economy may not be very accepting of them. By providing joint training opportunities between an ISTC and its local NHS Trust, whether in clinical or management areas, medtech companies could facilitate the building of relationships between them and thereby help to improve the continuity and quality of patient care.

Another group of independent providers worth getting to know are those currently going through the process of being chosen to provide commissioning support to PCTs. You need to find out who these providers are and what services they will be required to commission. The key approach here is to demonstrate that your medtech products are evidence-based and have the potential to improve patient outcomes.

Medtech companies may also be in a position to get involved in service redesign, particularly if the products facilitate the transition of services from secondary care to the community.

The clear message is that medtech companies should review their relationship with the independent sector in all its forms, and consider how to develop good and robust relationships with these new players in the healthcare market.

Off the shelf

Private healthcare providers have a different challenge to face in the healthcare market of the future. The days when strictly private healthcare was the only alternative to the NHS for the affluent are gone.

In the past, the main advantage of private healthcare over the NHS was shorter waiting times and greater convenience for the patient. The Government target of a maximum of 18 weeks from GP referral (including diagnostic tests) to hospital treatment by the end of 2008 and the policy of Free Choice have eroded this advantage.

Although no more centrally-driven procurement programmes involving the independent sector are planned, the emphasis is shifting to the local procurement of services by PCTs and practice-based commissioning groups. NHS commissioners are required to demonstrate effective commissioning, using commercially-based contracts that provide a level playing field for any provider (whether NHS or independent) that wishes to offer services.

For the patient, this means an opportunity to choose the provider that best suits their needs, using criteria such as quality and convenience as well as (or instead of) waiting time. The effect is rather like the way a supermarket can compete with more ‘upmarket’ stores for customers by stocking the same brands at lower prices. The NHS customer will now have a wider range of healthcare brands to choose from.

Independents’ day

The involvement of the independent sector in the UK healthcare system is not a simple process. It has a number of different facets, presenting the medtech industry with different market opportunities and challenges. The clear message is that medtech companies should review their relationship with the independent sector in all its forms, and consider how to develop good and robust relationships with these new players in the healthcare market.


Dr Thoreya Swage is the Clinical Lead for new projects at the Commercial Directorate at the DH, with a responsibility to transfer the clinical knowledge and experience acquired from the Independent Sector Treatment Programme to the wider NHS. She has worked in the NHS both as clinician (psychiatry) and as senior manager, including Executive Director for a Health Authority, in various NHS organisations covering acute as well as primary care. She can be contacted at t.swage@btinternet.com.