The ABPI sets out to deliver tailored support and advice to healthcare providers on the medicines its member companies produce. Kevin Blakemore, NHS Partnerships Manager at the Association of the British Pharmaceutical Industry, discusses the advantage of partnerships in healthcare.
The pharmaceutical industry has experienced tremendous change and, as part of that evolution, forming successful partnerships in healthcare has become integral to our way of working. The NHS delivers outstanding care to patients – utilising the innovative medicines the pharmaceutical industry produces – so it makes perfect sense for us to work together, ensuring the best possible outcomes for patients. There are some points, however, to consider when embarking on ‘joint working’ ventures – these partnerships must be managed and guided to ensure that the process is efficient, seamless and offers patients maximum benefit.
Often these partnerships can result in patients spending less time in secondary care settings, and can deliver significant savings. Patients benefit most when those with a stake in their care work effectively, enthusiastically and efficiently together.
Joint working describes situations where, for the benefit of patients, NHS and industry, organisations pool skills, experiences and resources for the joint development and implementation of patient centred projects and a shared commitment to creating a streamlined, joined-up care pathway, where patients are kept at the heart.
Joint working has already benefited thousands of patients across the UK and to help achieve greater outcomes, the Association of the British Pharmaceutical Industry (ABPI) has developed the ‘NHS Partnerships Team’. My dedicated team work with healthcare providers up and down the country, providing specialist advice and support, while facilitating successful working relationships.
The NHS Partnerships team is made up of eight individuals, each responsible for a different area of England. Their knowledge and expertise includes experience of working within the pharmaceutical industry and the NHS. They also bring their knowledge of innovative and effective medicines created by the industry, and this can be utilised for the benefit of patients. The central focus of the team is improving the healthcare environment in order to increase access to and uptake of innovative products. The team consists of Diana Vegh, Karen Thomas, Carol Blount, Harriet Lewis, Andy Riley, Mike Ringe, Angela Logun and myself.
Diana Vegh started her career in the pharmaceutical industry within regulatory affairs in AstraZeneca, working in scientific roles of increasing seniority. She then moved to the NHS where she held senior positions in the Strategic Health Authority, two PCTs and a Foundation Trust in the South West.
Diana returned to industry in a commercial capacity at UCB Pharma, working in market access for products. She has extensive networks across the industry and the NHS, and a wealth of practical, positive experience.
Karen Thomas – a recent addition to the NHS Partnerships Team – has extensive experience of working in the pharmaceutical industry, and for the past 12 years Karen has worked for Bristol Myers Squibb, where her roles spanned finances, sales, commercial and market access, covering several therapeutic disease areas. Karen joined the ABPI in November 2012 as the Regional Partnership Manager for London.
Harriet Lewis has been a pharmacist for over 20 years. She has worked in a wide range of healthcare sectors including industry, community, hospital and primary care. Before joining the ABPI, Harriet’s most recent role was Associate Director for Medicines Advice with the National Institute for Health and Clinical Excellence (NICE). Harriet has led on a number of NHS support programmes, including local formularies, local decision making, controlled drugs, accountable officers and ‘specials’. She has authored several key documents for NPC and NICE. Harriet is the Regional Partnership Manager for the North.
Most recent additions to the team are Andy Riley and Mike Ringe. Andy joins us as the ABPI Regional NHS Partnership Manager for Midlands and East. He qualified as a pharmacist in 1987 and has held posts in hospitals, community pharmacies and health authorities in London, the North West and the West Midlands. Mike joins us as the ABPI Group Therapy Manager directly from the NHS, and previously held the position of Chief Operating Officer at Luton Clinical Commissioning Group.
My role is the NHS Partnerships Manager and I manage the team. Previously, I have worked in the pharmaceutical industry for over 25 years – at UCB and GlaxoSmithKline (GSK) – and I have been responsible for developing national level methodologies and frameworks to support patient and market access programmes.
Bonded by blood
The ABPI recently undertook a joint working project at a hospital trust in the North of England looking at epistaxis – one of the most common ENT emergencies in England, with over 27,000 patients presented to secondary care between 2008 and 2011. In 2009/10 the trust admitted 250 patients presenting the condition, with the average length of stay at over two days, costing a minimum of £400 per patient per day.
Like many other hospitals, the trust had limited specialist ENT experience in their emergency departments, and as a consequence nasal packing was frequently used as a first line treatment – even for small volume bleeding – when a more conservative or targeted approach would have been safe and effective. There was a clear opportunity here for the patient pathway to be revised and a different approach taken.
Through the ABPI, a joint working project was instigated between a local pharmaceutical company and the trust. They jointly agreed – through a joint working agreement – to truly address the challenges within the current treatment regime and completely redesign the service. Consequently, it addressed the training requirements within A&E and junior doctors.
The new treatment pathway encouraged clinicians to identify the bleeding point, if possible, and in cases of continued bleeding, to consider the use of a product manufactured by the local company – thereby avoiding unnecessary hospital admissions. The company and trust continued to work in partnership to develop training materials in order to develop the new treatment pathway and introduce the use of the medicine where possible.
This venture resulted in a number of positive outcomes, which included a reduction in hospital stays, improving productivity and cost savings. But most importantly, when compared with the three preceding years, the audit of the venture showed that the total number of bed days due to epistaxis, was reduced by 30 per cent and length of stay was reduced by 21 per cent. Additionally, staff were motivated to consider an alternative to immediate nasal packing/admission, which also resulted in a reduction in the length of stay.
QIPP while ahead
Working with the Department of Health and the NHS, we have developed a toolkit on successful joint working. Joint working is a relatively new concept for many, but has already shown tangible benefits to patients, the NHS and industry. For example:
East Lincolnshire Primary Care Trust (PCT) reduced hospital admissions for Chronic Obstructive Pulmonary Disease (COPD) by 23%, through working with three companies to target and screen patients, train clinicians and set up specific COPD clinics.
In Ashton Leigh and Wigan the PCT is tackling low life expectancy, high rates of heart disease and diabetes by working with industry on a ‘Find and Treat’ strategy.
The innovative approach to patient care adopted by that trust was aligned with the Quality, Innovation, Productivity and Prevention (QIPP) programme. QIPP is an NHS initiative to improve the quality of care it delivers, while at the same time making savings that can be reinvested into the service. It engages with staff from across the NHS, at local and regional level, and is supported by QIPP plans and work streams that provide guidance and tools.
The NHS also works with a range of partners to deliver QIPP, one of which is the pharmaceutical industry. Apart from supplying medicines that improve the quality of patients’ lives and outcomes, the industry can contribute business skills and expertise, as well as extensive knowledge of the therapy areas relevant to its medicines.
Joint working is the foundation for creating, developing and implementing innovative healthcare solutions which can lead to better health outcomes. We believe this is the way forward in healthcare and both the NHS and industry must seek out more opportunities to work together.