Account Management: how well suited are you or your teams to sell to the modern NHS?

How well is the industry adapting to an account management-led model? New data suggests a worrying skills gap amongst UK sales professionals.

Ah, it seems like only yesterday. The good old days… How to be a successful pharmaceutical sales person – call on doctor, talk about product. Doctor likes product, trusts company, likes you. Doctor prescribes product. Job done!

Perhaps a little over-simplified. However one thing is for sure: the times they are a-changing, or should that read, have changed. It is a brave new world out there and, naturally, we in the fast-moving, innovative, adaptable pharmaceutical industry have moved to a new approach – Account Management. The question is: has anything changed at the coalface?

To find out, the National Health Intelligence Service (NHIS) has commissioned an independent survey of the Sales & Account Management skills of the UK pharmaceutical industry. The survey’s objectives are fourfold, establishing individuals’ and sales teams’:
• capability to influence traditional and new customers
• skill level to work across a local health economy
• confidence working in the modern NHS
• propensity to work as account managers.

The ongoing survey will provide cross-company analysis to allow direct benchmarking of an organisation against the industry and selected competitors (minimum of five), plus time point progression.

So far, over 600 people have responded, with the figure growing daily as organisations become increasingly keen to determine how well their existing sales teams adapt to the new environment.

Answers to the survey’s 45 questions (www.nhis.info/survey) are captured and transformed into a needs analysis model based on nine key categories (Figure 1). Sub-cuts can be made by time in industry and primary job role. For the purposes of the article, three groups have been investigated, namely Key Account Managers & NHS Liaison, Hospital Specialist Representatives and GP/Hospital Representatives.

To encourage honesty the survey is anonymous. For each question the respondent is asked “To what extent….” and rates themselves from 1 (not at all) to 5 (to a full extent). Refer to Figure 3 for the full scale.

The results

A snapshot of the overall results (Figure 2) reveals the varying levels of performance for each of the three groups in the nine categories. Due to the relative nature of the survey it is valuable to look at the comparative areas of strength.

The self-perceived areas of least strength are:
1. Market Analysis, Account Strategy and Planning
2. Commercial Focus
3. Understanding NHS Customers.

The self-perceived areas of highest strength are:
1. Interpersonal Communication Skills
2. Teamwork & Partnership
3. Customer Focus.



These results may cause some anxiety at management level. The ability to work across a local health economy using an account-based approach requires the development of processes and a change in the skills of those implementing. Whilst the industry has started to invest resource in developing processes, the data show that little has changed in the perceived skills of those at the coalface. For example, the three key skill areas for selling using an account-based approach in the modern NHS are ‘Market Analysis, Account Strategy and Planning’, ‘Commercial Focus’ and ‘Understanding NHS Customers’. Unfortunately, these are identified as the three areas of least strength.

Thankfully, there is little problem communicating this, as the traditional stalwart strengths of the pharmaceutical representative, namely ‘Interpersonal Communication Skills’ and ‘Teamwork’, remain as strong as ever.

An interesting point to note is that ‘Partnership’ (with the NHS) is identified as an area of highest strength. For those readers who have scanned the document produced jointly by the Department of Health and the ABPI, ‘Developing Partnership Between Industry and the NHS in the UK’ (well worth a read), this is somewhat at odds with the customer’s perspective on the situation.

Looking deeper into the key findings for ‘Market Analysis, Account Strategy and Planning’, it is interesting to see the response to a selection of individual questions. In the example, employees from Company X (an anonymous real-life organisation) were asked to what extent ‘do they allocate resources to deliver best return on a sound business case?’ The results are compared against the industry benchmark (Profile) and selected competitor organisations (Company Selection). Alarmingly, over one third (35%) of those surveyed ‘never’ or ‘only to a small extent’ allocate resource to deliver a best return! (See Figure 3.) Severe concern to those holding the promotional budget purse strings, and it doesn’t bode well for allowing true budget-devolved account management.

The way forward

Clearly, this article has only scraped the surface in terms of analysing the data and forms the basis of ongoing work to monitor the change in skill mix. Already though a number of interesting questions are emerging:

Have sales personnel really started to evolve towards improved selling in the modern NHS? The data would suggest not, with the industry’s traditional status quo remaining the same. For example, eight years ago the Healthcare Partnership and NHIS undertook a similar survey, which concluded that ‘Interpersonal Skills’ and ‘Teamwork’ were the highest significant areas of perceived strength (Pf February 2000).

Are training, development and support for selling in the modern NHS vastly different from what has gone before? Whilst a small group of people in some organisations may have received elite training, it is our experience that for the vast majority little has changed.

As identified in the DH & ABPI Long Term Strategy report into partnership working, one of the biggest issues the NHS has with the industry is our lack of comprehension around their agenda. As most NHS organisations publish their agendas and consequential needs (albeit disguised in NHS language), this is simply not acceptable. However, the situation is understandable when sales people express that they feel least confident about ‘Understanding NHS customers’.

To change the behaviours for selling in the modern NHS, intensive and consistent training is now required. Without it, all the industry will do is spend more money on re-badging the existing model.

Are you (or the teams you manage) better than the industry average at moving towards improved selling in the modern NHS? On an individual level go to www.nhis.info/survey and complete the 45-question survey, keeping a copy of your score. In next month’s edition full results will be printed, allowing you to benchmark your areas of strength and weakness. If you would like to find out how you can benchmark your whole team and receive group results, contact ask@nhis.info.

Continuing her series on NHS commissioning, Thoreya Swage explains how the FESC is expected to regulate collaboration with the independent sector and fill the gaps in PCT commissioning expertise.

In an effort to improve the commissioning capacity of PCTs and practice-based commissioners, the government has decided that delegating this function to other (commercial) organisations would achieve this aim.

Following repeated NHS reorganisations and the adding of responsibilities over recent times, commissioning skills have become stretched and diluted as PCTs have had to focus their attention and resources elsewhere. This has sometimes resulted in gaps in commissioning expertise within PCTs.

When NHS commissioners have sought to buy services from independent sector companies they have traditionally done this by undertaking their own procurement. Each PCT has carried this out in its own way and there has been little consistency of approach. This has carried the risk of many different types of contracts with varying requirements, which may or may not have produced the outcomes originally intended.

This picture is further complicated by the fact that commissioning functions and activities are now devolved to practice-based commissioning groups, who themselves may or may not possess the appropriate skills.

Recognising this situation, the Department of Health has developed a national framework to support PCTs who want to use a range of commissioning skills and expertise from the independent sector to help them procure healthcare services for their populations. The Framework for External Support for Commissioners (FESC) is a national initiative that ensures that private companies offering such expertise provide this service in a consistent manner.

How is FESC structured?

FESC is structured in such a way so as to help PCTs commission a specific service or a range of services. The aim is to set a high and consistent standard for the commissioning of healthcare for NHS patients across the country and to reduce the risk of variability in the quality of services that have been procured in this manner.

Independent organisations wishing to offer their services in the commissioning of healthcare have had to go through a national procedure managed by the DH to be eligible to be on a list of approved suppliers to do so. PCTs can then seek the help of the successful companies in procuring healthcare for their local populations. Although the commissioning function can be delegated to these providers (if the PCTs wish to use them), the accountability for such a function remains firmly with the PCT.

What commissioning functions are covered by FESC?

The approved suppliers on the list will have specified which of the following four services (or service segments) they are able to offer under FESC:
These commissioning functions apply to the whole of healthcare (elective or planned as well as urgent or unplanned care) including primary, community and secondary care, mental health and ambulance services. The FESC suppliers may also be able to offer expertise in the commissioning of social care.

The key requirement of FESC is the ability to demonstrate not only commercial expertise but also appropriate clinical expertise and the framework sets out in detail the exact resource required to achieve each aspect of the service segments identified.

The FESC framework also reinforces the need to comply with national standards that apply to the NHS, for example, to ensure that the requirements in Standards for Better Health are followed; that other key DH policies, e.g. the operating framework, National Service Frameworks etc are taken into account and that the NICE recommendations are applied, where appropriate.

As we are dealing with taxpayers’ money there is a need for the suppliers to ensure best value and quality improvement in their proposals and subsequent commissioning. The payment for their services is arranged in such a way that the suppliers are required to take on some financial risk and also a share of the savings achieved through more effective procurement. If the expected savings do not materialise, then the share of the savings is reduced, thereby building in an incentive to improve performance.

How does FESC work?

The FESC provides a menu of expert services by a number of suppliers from which PCTs can choose and refine further to suit the needs of their local populations.

Once a PCT has decided to use FESC, suppliers are obliged to bid for all relevant commissioning services when requested and not avoid the PCTs that present particular challenges or where it is more of a problem to supply a service. This is to ensure effective competition on a national basis.

At the end of the procurement an External Support Services Agreement (ESSA) is drawn up with the successful supplier to ensure consistency of approach and the meeting of nationally set Operational Performance Indicators (OPIs) which are linked to NHS performance measures.

PCTs have the right to exclude any bidder at the ESSA procurement stage where there is a confl ict of interest between the proposed commissioning function and the provision of clinical services to the PCT’s local population.

FESC and the industry

FESC has opened the door for another new set of players to enter into the English health and social care market and, for the pharma industry, a chance to influence them.

The FESC suppliers that have opted to provide service redesign, demand management and patient and public involvement services, will have a direct role in developing health and social care for PCT populations. On the flip side, the suppliers will need to take on financial risk if their innovative ideas do not work.

It is in this situation that the industry can help through the demonstration of evidence-based interventions, the development of clinical pathways and protocols and redesign of services across different health and social care sectors.

The framework also emphasises the type and level of clinical expertise required in the various commissioning functions. The companies on the FESC list have very differing backgrounds and some may not necessarily have some of the expertise ‘in-house’. They will, however, have indicated how they would provide these roles and here is an opportunity to seek out new customers to promote key effective drug interventions and possibly work in partnership.

Of course PCTs can still go their own way and decide to undertake procurement independently of FESC, however, if the industry can strengthen the skills and effectiveness of the approved suppliers, the potential gains could be great for all.

Dr Thoreya Swage is the Clinical Lead for new projects at the Commercial Directorate at the DH, responsible for transfering the clinical knowledge and experience acquired from the Independent Sector Treatment Programme to the wider NHS. She has worked as both clinician (psychiatry) and senior manager in various NHS organisations. She can be contacted at t.swage@btinternet.com.

A necessary evil or a valued business relationship? New research has revealed how buyers from various industries view salespeople, and it isn’t pretty. Pf takes a look at the findings.

We have all seen him on TV, the pushy, smooth-talking suitclad salesman, confident in the belief that his sheer charisma and persuasive technique could convince anyone to purchase the latest shoddy and unnecessary item he is touting. He was a familiar figure in the Eighties, brief case and over-sized mobile phone in hand, ever ready to charm his next potential customer.

This was the perception of salespeople about twenty years ago, and most people would assume that this stereotype has long since become out-dated and irrelevant. However, recent research has suggested that this perception is still alive today and, like the mobile phone, the salesperson of the noughties is just slightly better presented and capable of more advanced applications, but ultimately performs the same function.

DDI’s 2007-2008 Global Sales Perceptions Report does not make comfortable reading for anyone involved in sales. It reveals a perception of salespeople as lacking knowledge and understanding, unwilling to listen and more interested in their own bonus than the customer’s needs.

This article will look at the conclusions of the report and ask whether they can be applied to the medical sales industry. Has pharma been successful in breaking down old stereotypes and revolutionising the image of sales?

The report

Business leadership consultancy Development Dimensions International (DDI) surveyed 2,705 people across six countries about how they feel about their interactions with sales professionals. Those surveyed were buyers or people who interact with salespeople and are involved in buying decisions, and represented a wide range of industries, job levels and age groups.

The research was designed to provide answers to the following questions:
• What qualities do buyers truly value in a salesperson?
• Have their expectations of salespeople changed?
• What value do salespeople add to buying organisations?
• Do buyers really want a trusted business advisor or just an ordertaker?

The overwhelming conclusions of the research were that buyers generally have a poor perception of salespeople, that their increasingly high expectations are not being met and that salespeople are not becoming business partners.

We spoke to some industry managers to find out if the same can be said of pharmaceutical industry salespeople.

A necessary evil

The most common perception across all countries was that sales is a ‘necessary evil’. A typical attitude amongst respondents was that salespeople are more interested in making money for themselves than in providing a service for the customer. One went as far as to say that they felt “conned and cheated” following interactions with salespeople.

Regrettably, it seems the stereotype of the ‘pushy’ salesperson is still a reality today, though there has been some improvement – 40% of UK buyers said that expertise has increased.

“There is still a long way to go,” comments Paul Hughes, Director of Strategic Accounts at DDI and co-author of the report. “Fortyone per cent of UK buyers said that expertise has stayed the same and 19% say it’s getting worse. At the same time, 44% of buyers have increased expectations of sales people. The gap between expectations and delivery is getting bigger.”

Although medical sales is not necessarily a victim to sales stereotypes to the extent of some other industries, the pharma sales professional has other prejudices to contend with on a daily basis. As Andy Holgate, Business Unit Director at Ashfield In2Focus explains: “The anti-industry PR is pretty significant in the UK, and the controversy created by recent reports of inconsistent disclosure of clinical trial outcomes will have shaped opinion, whilst totally outside the control of any UK salesperson. In some respects, the representative is starting from a negative stance with many HCPs (healthcare professionals), and this is one of the reasons for reduced access.”

Great expectations

Could it be that the perception of the sales industry is so low because buyers have higher expectations? There are several different areas where buyers seem to expecting more from salespeople. Firstly, the customer expects the salesperson to understand their business and what their needs are. Secondly, the customer expects the salesperson to listen and provide sound advice. Thirdly, the customer wants to create a ‘win-win’ situation, where a good compromise is reached and both parties benefit.

This more consultative approach to selling is nothing new to the pharmaceutical industry. Changes in the structure of both the NHS and the industry have meant that it is more important than ever that pharma sales professionals build relationships with their customers and are able to speak knowledgably on their therapy area. According to Paul Hughes, however, training the sales team is not enough, a sales organisation needs to have these three expectations at its core: “Sales organisations have to realise that some salespeople are going to make that transition more easily than others. It is crucial organisations first assess and select the people with the potential to deliver what buyers want from a modern sales force and then structure the sales teams so that the sales leaders can take the team in the right direction.”

Ian Wrathall, Head of Primary Care at AstraZeneca, agrees that the move to an account management approach is not going to happen overnight and will require more than just a change in sales force structure: “To move to a true account management approach takes a huge change in mindset. I believe it will take a while before the industry moves away from the old model-thinking such as share of voice and coverage and frequency.”

Changes in the NHS customerbase are also demanding more from representatives, as Ian went on to explain, “Decisionmaking has moved away from the individual GPs to local and regional bodies like PCTs and PBCs, hence the strong relationship a representative might have had with an individual GP has less leverage than it once did.”

Valued business partners?

Despite the fact that popular sales training programs today do focus on more consultative selling, UK sales professionals are failing to become the business partners they aim to be. Just 42% of UK respondents said that they consider their sales contacts as business partners, with only Australia scoring slightly lower out of the six countries. In contrast, 84% of German and 64% of French buyers feel they have this relationship with salespeople.

In keeping with these findings, there is some feeling within the industry that old mindsets and a lack of ‘customer orientation’ are preventing pharma sales professionals from being seen as trusted business advisors. Ian Wrathall explains: “The medical representative role in recent years has been driven by centralised brand strategies. This has led to a tick-box culture that measured the success of representatives by the number of times they could deliver key selling messages to individual target customers, irrespective of customer needs and environment.”

Nick Edwards, Head of Sales Excellence at Roche, expands on how the attitude of pharma needs to change: “We need to ‘help people to buy’, not ‘sell’ to them. All salespeople need a thorough understanding of their product and their customers so they can target and tailor their messages in the right way. Medical sales specialists need to have a longerterm approach to achieving a successful outcome versus a more consumer orientated ‘sign on the line now’, with a relationship built on trust between customers and sales people.”

One disadvantage with this type of selling, however, is that if a sales professional moves to another company the client relationship goes with them. Nick Edwards describes the attitude an organisation needs to have as a more joined-up ‘one company approach’. He suggests that accurate customer records will ensure that each sales contact will have knowledge of what has gone before. “In turn the customer feels valued and the relationship with the company is not only maintained but potentially enhanced,” he concludes.

“To move to a true account management approach takes a huge change in mindset” Ian Wrathall, Head of Primary Care, AstraZeneca

Most valued qualities

Respondents were asked which top three qualities they value most in a salesperson. UK respondents voted pricing/price negotiation, product or service advice and trust as the most valued qualities.

Trust, in particular, is an essential in the relationship between medical rep and HCP. However, the UK scored lowest in trust across all industries. When UK respondents were asked if they felt salespeople had their best interests at heart, just 13% said ‘definitely’. It would be impossible for the pharma industry to function without the trust of its customers, as Andy Holgate went on to explain: “Giving the wrong advice about dose, side effects and contraindications could have catastrophic effects, and therefore the pharmaceutical industry representative must always be conscious that their first duty is to that unknown patient that their medicine may be able to help.”

A never-ending mission

The pressures on pharmaceutical sales might be different to other sales industries, but the customer’s perception of the sales force is equally as important, if not more so. The challenges of selling to an ever-changing customer base and overcoming the perceptions generated by negative media coverage have forced the industry to re-evaluate its attitudes and approach.

Andy Holgate feels that this has resulted in a positive change: “I see far more realism from the industry about where companies position their brands, and far more understanding of the financial and rational environment GPs are operating within. This is a never-ending mission, but I would like to believe that overall HCPs would admit there has been a significant change in the way most companies operate.”

So has pharma been successful in changing the image of sales? To some extent. Although not many representatives could be described as experienced practitioners of the consultative selling advocated by DDI, this is certainly the approach that most companies aspire to and are moving towards. As the results of this report indicate, in just realising the need for change, pharma is a step closer than many other industries to achieving the mindset necessary for true account management selling.

Alan Jones reports on the Wellards Academy meeting for industry healthcare managers held last month at the King’s Fund in London.

As we begin the new NHS financial year, it is likely more turbulence lies ahead for both the NHS and the industry. An early look-see into the 2008/9 NHS year suggests tightening expenditure and calls for increased productivity. NHS Foundation Trusts will become mainstream and PCTs will be called to account as world class commissioners. For high-cost, low-volume services, specialised commissioners will be more active and early warning systems can be expected to be very focused in flagging up any new technologies in development in good time. The industry’s front line with the NHS in all these areas, the healthcare development manager (HDM), is now a key role and in recognition of this, the Wellard’s Academy hosts twice-yearly meetings for industry HDMs at the King’s Fund. This article reports on the latest meeting, held last month.

Building a new foundation

The meeting began with Malcolm Lowe-Lauri, Chief Executive of King’s College Hospital NHS Foundation Trust (NHSFT), who spoke on the changing managed market structure and outlined why Foundation Trusts were brought into place. This, he said, was to effect change through ‘supply-side deconstruction’ – the tentative deregulation of NHS hospitals at a time when other new players, such as the Independent Sector Treatment Centres, are entering the market.

“Specialised services are an important but often complex and costly part of the portfolio of services provided by the NHS. They account for about 10% of total PCT expenditure on hospital services and were reviewed by Sir David Carter in 2006”

So what are Foundation Trusts? Well, firstly, they are accountable not to the Department of Health but to an independent regulator, Monitor. They are allowed to keep their profits, have some borrowing powers and are more accountable to their local communities through a Board of Governors. So far, NHSFTs have performed well, albeit with some variation, particularly on the financial side. Most are in profit although some clusters of deficit remain. But NHSFTs have certainly looked for new solutions to old problems. There have already been some ‘consolidations’, such as the acquisition of Good Hope Hospital by Heart of England NHS Foundation Trust, while there is also current discussion in the Cambridgeshire health economy on a similar solution. NHSFTs pose a significant challenge for commissioners, as the NHS has historically been a supply-led environment. PCTs, said Lowe- Lauri, have been undersized and underpowered, and so NHSFTs may have an emerging leadership role.

Also in the mix are Academic Health Sciences Centres. This is because the current university hospital lacks scale and the pricing system for NHS services (Payment by Results) lags behind innovation. Tertiary hospitals have to compete globally for staff and academic funding streams are currently unstable. As such, we might see further consolidation to create mergers of hospital and university campuses.

Finally, Lowe-Lauri described novel partnerships to support service delivery and whether there might be a new role here for the private sector. Kings is actually currently in such discussions and, of course, as in all the various waves of reform over the last decade and more, innovators will innovate. So there could be possible investment opportunities for NHSFTs to get into primary care and even more mergers and acquisitions could be on the cards.

Asked if he would see industry representatives Lowe-Lauri said ‘probably not’, but some of his direct reports would likely be interested, though at a fairly high strategic level. He did make a plea to be made aware of any expensive technologies on the horizon! Two key issues for the industry are:
• Should HDMs account manage hospitals in the same way as they do PCTs?
• Should HDMs (and hospital specialists) treat NHSFTs any differently to non-NHSFTS, and if so what might this look like?

For more details on each of the 80 NHSFTs, please see www.monitor.nhsft.gov.uk.

Being world class

Dr Lise Llewellyn, Chief Executive of Berkshire East PCT, reflected on PCT commissioning. Dr Llewellyn described the recent history of PCT reorganisation, the fitness for purpose review and the DH’s vision of ‘world class commissioning’ – better health and wellbeing for all, better care for all and better value for all. PCTs will now have to demonstrate a range of eleven new competencies such as:
• engaging more effectively with the public
• collaborating more with clinicians
• fully assessing health needs
• securing procurement skills.

Dr Llewellyn described her ‘patch’ in this regard and compared Royal Windsor with Slough, where there are 140 languages spoken! All this is new ground for PCTs and though progress will not happen overnight, a new ‘assurance framework’ is being developed to address it. Refreshingly, she wondered about timelines: how long do PCTs have to reach world class commissioning status? She pointed out that US companies over here say that there are no world class commissioners anywhere in the world at the moment!

PCTs will be able to seek assistance by contracting out various bits of work to a range of private companies through a framework for external support of commissioning. These areas might include contracts negotiation and validation, engagement with the local community through social marketing, communication and business skills. Dr Llewellyn was keen to point out the opportunities here for pharmaceutical companies, and mentioned a couple of current examples such as health coaching and nurse support in respiratory disease.

Practice-based commissioning was explored, and it was pointed out that this was not an end in itself but more a lever for service redesign. Clinical engagement remains a problem and progress has been slow because of some cynicism amongst GPs. Again, Dr Llewellyn was keen to point out the opportunities here for companies. These are not about the promotion of products per se but about making explicit links to the benefits of appropriate medicines use – benefits such as the redesign of clinical pathways and freeing up other resources. There is also an opportunity around helping PCTs to get GPs to understand the benefits of service redesign and assistance with communication/marketing. When asked if she would see representatives, Dr Llewellyn said that she looked forward to such contact, albeit with a more strategic focus, rather than simply being ‘detailed’.

Being special

Karen Helliwell, Director of Specialised Services for the West Midlands Specialised Commissioning Group (SCG), offered a helpful review of current progress in this area. Specialised services are an important but often complex and costly part of the portfolio of services provided by the NHS. They account for about 10% of total PCT expenditure on hospital services, and were reviewed by Sir David Carter in 2006. His report recommended various changes, and these have largely now been implemented through the formation of 10 SCGs in England. In the West Midlands the SCG (hosted by Birmingham North and East PCT) controls a budget of £700m (bigger than some PCTs) and the Strategic Commissioning Group (which includes PCT Chief Executives) meets once a year to decide on resources.

But what actually are specialised services? A National Definition Set identifies some 35 services including many of interest to pharma (e.g. HIV, Renal). Generally speaking, such services are low-volume but high-cost and are provided in specialist centres covering populations of over one million and delegated by PCTs to the SCG. The Carter Review recommended a need for simpler commissioning structures and integration with other PCT collaborative functions (including PBC) and a new National Specialised Commissioning Group to give a more uniform approach across England.

So what are the challenges ahead? Ms Helliwell highlighted the rapid growth in new technologies belied by a finite (and static) level of resources. SCGs will therefore likely be at the centre of some difficult decisions around priority setting. In terms of the managed entry of new technologies, the proposed closer collaboration between the 10 SCGs might include possible HTAs where NICE does not get involved, for instance in the area of orphan drugs. Next steps for specialised commissioning will be:
• more robust need assessments for services
• the designation of specific providers for specialised services
• clearer clinical outcomes for the investment (and maybe some ‘decommissioning’)
• more openness and transparency in decision-making around getting information out to practice-based commissioners.

Ms Helliwell said that she would appreciate appropriate contact with the pharma industry, but said the timing of such contact would be critical as resources are allocated in January each year at the latest. Clearly there are new KOLs here for relevant companies.

“The NHSC’s purpose is the early identification of emerging new technologies, providing advanced notice to the DH and national policymaking bodies. As one of its customers is NICE, it is very important to the industry”

Over the horizon

Finally, Dr Claire Packer, Director of the National Horizon Scanning Centre (NHSC), now part of the National Institute for Health Research, looked at the important work of the NHSC. The NHSC’s purpose is the early identification of significant emerging new technologies, providing advanced notice to the English DH and national policy-making bodies. As one of its customers is NICE, the Centre is very important indeed to the industry.

Technologies are identified up to three years before launch, triaged, filtered and then prioritised in terms of any evaluation performed. The Centre would be particularly interested in any new drug on its way that could potentially significantly affect current treatment options and might require some planning for its introduction. For technologies that are monitored, there is consideration of clinical and cost effectiveness, as well as likely cost impact, but this is not a health technology assessment as such. The final publication is a Technology Briefing, and these are to be found on the Centre’s website. As there are now around 350 such briefings, you will undoubtedly find there a briefing on one of your drugs, especially if used in either cancer or coronary/ cardiovascular disease.

The NHSC will also be in contact with your company asking about your new pipeline drugs, being particularly interested in the timing of any application for licence and early details on marketing plans. And in terms of company relationships, Dr Packer said some are very constructive, others less so! In the successful ones there is one contact person with a good understanding of the process, able to pass requests to other relevant internal staff. More ‘difficult’ company relationships are where communications are poor, where there is no overall responsibility for information requests and provision and where confidentiality concerns seem paramount.

The NHSC has strong links with the National Prescribing Centre and UKMI, and its work has informed the recent NHS Cancer Strategy and the deliberations of the Health Select Committee Inquiry into NICE. The NHSC is also involved with the Ministerial Industry Strategy Group Longterm Leadership Strategy Partnership Working Group (out of which has come the recent guidance on joint working with the industry and the toolkit) in looking at ways of maximising the use of horizon-scanning information as an aid to local NHS planning. For more information visit www.pcpoh.bham.ac.uk/publichealth/horizon/.

In the second instalment of two-part series, Andy Preston looks at the top five responses he’s had to the question: “What are the top attributes of great salespeople?” This month, Andy focuses on the attributes that are more commonly associated with sales: confidence, self-motivation and enthusiasm.

Number 3 – Confidence

How important do you think confidence is for a salesperson? Well, I don’t think I’d say ‘everything’, but it’s pretty close. Confidence is important in a lot of different areas of selling – pitching, cold calling, closing, objection handling, even picking up the phone in the first place – confidence is pretty much everything in sales. Think back and I’m sure you can remember the voice tone of someone who sounded confident, and someone who sounded nervous and unsure. Which one would you buy from?

Confidence is one of the most important yet undervalued attributes of a great salesperson.

Think back to the last time you or one of your team was struggling or going through a ‘sales slump’ – where do you think your level of confidence was at those moments?

“Most average salespeople rely on things outside of themselves to motivate them – their manager, a ‘lucky’ sales call or email, a sales competition, a sunny day or a stroke of luck with a client”

Now I know there will be some people reading this who might say, “But how can I be expected to stay confident when things are going really badly?” It’s the transference of confidence to the other party that’s most important. My personal belief is that in sales situations where you are trying to persuade the prospective customer to buy products or services from you, confidence can be seen as ‘trust’. The customer will be asking themselves a number of questions when you meet them or talk to them over the phone, such as: “I wonder if this person and their company are any good?”, “I wonder if I can trust them and rely on them to look after my needs?” and “I wonder if they will do what they say they’re going to do?”

In most situations, especially if you are in field sales, to the customer you are the company. You might be the only contact and certainly are the main contact for them, so whether they buy from your company or not is down to you! If you seem confident and capable in what you do, then the customer will have more confidence and trust in you.

Number 4 – Self- Motivation

If you ask any salesperson whether they are motivated, they’ll usually reply “Of course I am!” However, if you follow it up with the question “How often?” you might get a few uncomfortable looks!

Motivation is another important aspect of selling and can dramatically affect the behaviour of an individual salesperson at any given moment. Most salespeople and companies say that motivation is important, yet fail to do much about it. They seem to think that motivation is something that is just there or it isn’t!

You’ll notice by the way, that the attribute I’ve listed above is not just ‘Motivation’ but ‘Self Motivation’. For me, the key is in the first part of the word! Most average salespeople rely on things outside of themselves to motivate them – their manager (and we know how dangerous that can be), a ‘lucky’ sales call or email, a sales competition, a sunny day or a stroke of luck with a client. Now that probably sounds ridiculous while you’re reading this, but if you were to take a closer look at yourself or members of your team right now, you’d see how often that is the case.

My belief is that motivation has to come from yourself, rather than hoping that something else is going to do it for you. Sales mangers have asked themselves the question for years: “How do I motivate my sales team?” Let’s look at one of the traditional options, the effect of sales competitions or special incentives, versus the salespeople motivating themselves.

Often, the motivation has to come from the salesperson wanting the cash incentives, vouchers, holidays or whatever the ‘incentive’ is that the company is hoping will motivate them to better performance.

However, this often fails to have the desired effect – for example, if the salesperson doesn’t believe that they can achieve the desired level in order to earn the incentive or bonus, or if they feel the competition is going to be won by someone else (as in the single winner incentives). In addition, very often sales competitions and incentives are set by management with no thought as to whether the ‘incentive’ is actually something that will inspire the team.

Remember – the top salespeople take charge of their own motivation and do whatever it takes to stay motivated, rather than whinge to everyone within earshot about what a bad day they’re having!

“In between sales meetings or after a bad phone call or email, make sure you mentally ‘re-set’ yourself and your passion and enthusiasm. This will help to ensure that the next person you meet or talk to gets the best viewpoint of your product or service, not a below par performance”

Number 5 – Passion and Enthusiasm

You’d be amazed how many salespeople I meet who aren’t passionate and enthusiastic about what their product or company does – or even themselves most of the time. Yet those same salespeople complain that their customers don’t seem interested in them and what they have to offer. Usually, when they go back to the office and their sales manager asks them “How did you get on at xyz appointment,” they’ll say something like “Oh, they aren’t ready to buy at the moment” or “They don’t have the budget”, or some similar excuse.

Bored, tired and dejected, those same salespeople trudge from appointment to appointment or sales call to sales call without ever stopping to think that they might be the cause of the client’s indifference!

If you want your clients to be passionate, enthusiastic and interested in what you have to offer, you have to be passionate, enthusiastic and interested first. This will come across when you talk about your product (voice tone is even more important when on the phone), when you are asked why it is a better choice than a competitor product (make sure you’re not directly knocking the competition) and in the crucial first few seconds of a sales interaction. This is an area that most salespeople ignore to their own cost!

So, are you consistently passionate, enthusiastic and interested when discussing your product or service? Do you still sound like that if you’re affected by the weather when you’re driving to the appointment? Traffic congestion? Parking issues? When you’re feeling tired? When you’ve just had a bad phone call or email? At the end of a long day? Lots of things can affect how passionate and enthusiastic we feel – but the more that you can lessen the extent, the better your sales will be.

Andy Preston is the founder of sales training and coaching company Outstanding Results, which provides help, guidance and support to the in-house sales teams of both large and small organisations.
Andy can be e-mailed at info@outstanding-results.co.uk

Key account management – many sales professionals claim they have moved to this type of selling, but have they been successful? Lorraine Willis of ACHiiVE asks whether the industry really has changed its business model.

For the first time in a while you sit down to reflect on your territory and your sales. It has been a frantic few months, the company has restructured and you have been given a new title, but what effect is all this going to have on your business?

You look at your sales figures for the last six months and see a flat line, despite all the hard work and effort and the promises from your customers – what is going on?

You have been selling and/or managing in the industry for a number of years and have seen increasingly many changes in that time but you have always managed to hold on to your sales through increased call contact and frequency on your key customers – so why isn’t that working any more?

“The business is no longer one of coverage and frequency – giving out a repetitive message or ‘providing information’ – but is about adaptable opportunistic business development”

We were working with a group of key account managers a couple of weeks ago when one recounted a typical story. He had taken a phone call from a consultant in one of his target hospitals, a call he had been waiting for anxiously for some days. The customer started the conversation with “do you want the good news or the bad?” The good news was that his drug had at last been accepted onto the hospital formulary – cause for celebration you think? The bad news was that the PCT had not approved its use and so no one was allowed to prescribe it. The PCT’s ultimate control was a shock to the KAM who had been working very hard to get the formulary inclusion and was looking forward to the subsequent increase in his sales. So, what’s going on here and why is this a typical situation in today’s NHS?

The ‘complex’ sale

There has been much written about the changes in the NHS and the consequent changes in the industry to meet the market needs. The priorities within the NHS are now focused on meeting the government’s strategic health provision targets, gripped within tightly controlled budgets allocated in the new contracts – similar to any other commercial organisation, you may say. Perhaps, but with healthcare provision, commissioning and drug prescribing going through major and evolving change you can no longer sell on the basis of having the most effective treatments, nor rely on success from persuading just say the clinicians and/or pharmacists that your product or service is superior. The whole thing has become dynamic and more complex and you need new skills and a more entrepreneurial style in order to achieve success.

What you face is the complex sale, a dynamic sale with more than one ‘customer’ involved in the decision-making process, and it is this complex sale that is at the heart of pharma account selling. The problem is how to sell effectively to a group of different customers with different priorities, often in different locations, some of whom may not obviously be part of this process but left unattended can cause a potential sale to stall or fail.

Many companies have embraced the ‘key account model’, trying to make the retail model fit the NHS. Key account working is not new to the pharmaceutical industry and the industry has tried for a number of years to reflect the practices established by key account managers in the retail world. Those principles may be sound in the retail environment but when it comes to selling your products and services in the NHS currently and in the future does it actually work?

New working practices

We recently had the opportunity to act as assessors for the Pf Awards and met a number of top performers from the industry. One of the tasks they were given was to present how the changes in the NHS have affected their role. Many of those who we assessed mentioned key account working as an important change to their working practices, yet interestingly when asked what this really meant they answered with the following:
• building relationships
• establishing customers’ real needs
• providing services and support
• gaining specific commitment to their products.

Where, I wondered, did this differ from selling per se?

Digging a little deeper it would appear that key account working in the NHS market means little more to most representatives, new and experienced alike, and even their managers, than selling effectively, and there is nothing wrong in that. But why do we need a new job title to do what we have always done? Unless, of course, we have not always done that in the past?

What I had perhaps expected to hear was that key account working is:
• a process
• about selling to groups
• about the whole company working as a team
• about seeking and creating business
• about being entrepreneurial
• about business responsibility and accountability.

A whole new strategy

Pharmaceutical account working IS different from the retail key account model. There is much more to pharmaceutical account development than is currently being provided in the myriad training packages and programmes being offered on key account development.

Pharma needs a new business model, one that employs more experienced business skills, one that reflects a wider range of competencies in addition to effective needs based selling. The whole selling team top to bottom needs to develop additional knowledge, skills and attitude sets supported by clear management strategies in order to achieve longterm success.

All too often we see companies not fully practicing real key account working or who have dipped their toes into it only to revert back to the comfort zone of contact and frequency as if activity alone holds the secret to success. The business is no longer one of coverage and frequency – giving out a repetitive message or ‘providing information’ – but is about adaptable opportunistic business development, selling effectively to groups of customers and working the dynamic as hard as possible.

So if you are wondering how you are going to maintain and develop your territory business in the future, it may be worth considering a different strategy, a different approach with different knowledge, skills and mindsets.

Lorraine Willis is the MD of ACHiiVE and has over 20 years experience in learning and development in the pharma industry. www.achiive.co.uk  +44 (0) 1962 793 131  +44 (0) 1962 793 131

Eighteen months after the successful launch of its product to prevent hospital-acquired infections, Enturia Ltd is expanding its team. Its partnership with VMC goes from strength to strength.

In November 2006 Enturia Ltd, a specialist Healthcare Company from the USA but new to the UK, launched its unique ChloraPrep® skin antisepsis system into the secondary care market. Today ChloraPrep® is an essential product used to prevent life threatening bloodstream infections such as MRSA. Eighteen months post launch ChloraPrep® is being used in over 70% of UK Hospital trusts.

The ChloraPrep® range of skin preparation products are unique in the infection control market and these products are significantly impacting the way healthcare professionals are preparing patients’ skin prior to invasive procedures. ChloraPrep® already has national endorsement from bodies such as the Department of Health, the Health Protection Agency and the National Blood Service. ChloraPrep® remains the only licensed 2% chlorhexidine and 70% alcohol patient preoperative skin prep on the market.

Within the last six months Enturia has launched four line extensions to the ChloraPrep® range and is now preparing to launch a further range specifically designed for major surgical procedures. This tremendous success story enables Enturia to move into a new growth phase with further team expansion.

The inception of this successful start-up in the UK goes back beyond November 2006, when Enturia selected The Vacancy Management Company as its partner of choice to recruit field-based Account Management and Clinical Teams. Enturia looked for a recruitment partner who shared its vision and values when establishing a flagship Healthcare Company in the UK. The initial strategy was to have contract field based sales and clinical teams as this gave flexibility to the newly formed organisation. Within a year of the launch these teams were then transferred onto Enturia permanent contracts. The Vacancy Management Company has continued to work closely with Enturia in the ongoing recruitment of Account Managers and Clinical personnel.

“The product is great to sell and the role allows me to partner with hospitals, delivering significant sales, training and medical expertise” Sue Fox, Account Manager

With full project management and assistance from The Vacancy Management Company, Enturia has built a very strong foundation in the UK and now has a multimillion pound turnover. Enturia has consistently exceeded its goals and much of this success has been down to recruiting the right people into the organisation.

Enturia’s guiding principles are Integrity, Respect, Leadership, Courage and Passion and it is living by these principles that has made the company successful with its products, customers and chosen partners.

Sue Fox, an Account Manager with Enturia, was one of the initial six to be recruited. Sue really feels her role with Enturia gives her the autonomy she requires to succeed. Whilst the product is great to sell, making a real difference across all wards and departments, Sue also believes her role allows her to partner with her hospitals in delivering significant sales, training and medical expertise.

The partnership between Enturia and The Vacancy Management Company continues today, as together they look to expand the team of Account Managers across the UK. If you want to be a part of this great future and wish to apply for one of these fabulous positions refer to The Vacancy Management Company advertisement for more details.