NHS Southern Derbyshire CCG is to hold a series of events where people with diabetes can discuss their condition with fellow diabetics.

The Diabetes Conversation Cafe will open its doors at three different locations across the region to allow patients to discuss the help they need to manage their condition with clinicians.

Vanessa Vale, Long Term Conditions Manager at the CCG, said the events would reveal the “patterns and insights that will give us a much deeper understanding of the real issues that affect people living with diabetes.”

There are around 27,000 people in Southern Derbyshire with diabetes. That figure is expected to rise to around 35,000 by 2030. Between 2010-2012, hospital related admissions cost the NHS nearly £2 million.

“As diabetes affects a range of different groups we are encouraging people of all ages to attend the events so that we can learn from a range of experience,” said Vanessa Vale.

“Patients are at the heart of everything we do and it’s important that our diabetes patients benefit from a patient-centered service that is designed specifically around their needs. This is an ideal opportunity for patients to influence our next steps and help us to make good services even better.”

The events are planned for 10 June in Belper, 12 June in Mickleover and 19 June in Swadlincote. Reservations can be made at 01332 868727 or by email vanessa.vale@southernderbyshireccg.nhs.uk.

Want more local CCG stories? Visit pfdiscovery.com.

A pilot physiotherapy scheme by NHS Newcastle West CCG has helped saved thousands of pounds and reduced unnecessary hospital visits.

Commissioners introduced private appointments in GP surgeries for basic cases and established a call referral management centre to decide how patients are treated before being referred.

The two-year project allowed more serious cases to be transferred to secondary care physiotherapy services at Newcastle Hospitals NHS Foundation Trust whilst reducing demand.

The CCG established a partnership in 2010 with private therapy company Connect Physical Health to bring services closer to patients’ homes.

Patients who had minor requirements saw a physio or specialist at a primary care setting and were also given access to a one-to-one advice line to receive guidance at home.

Patient feedback from the pilot scheme revealed that 96% of patients said the standard of care they received was “excellent or very good” and 97% of doctors agreed the service was better than when it was first introduced in 2010.

Commissioners have estimated that if the scheme was introduced across CCGs in England it could make savings for each group of around £220,000.

The Government’s controversial shake up of the NHS resulted in more than 10,000 workers being made redundant, new official figures show.

Information in the DH’s people tracker report showed that 2,394 redundancies were made in 2012-13, 2,100 in the year before that and an estimated 5,600 throughout 2010-2011. An additional 3,841 left the NHS on their own accord.

Initial estimations by the DH in January 2011 expected around 16,000 redundancies and a further 3,600 staff to leave the health service during the reforms.

These figures have since been acknowledged by the DH as uncertain but the report hailed a “successful people transition process while minimising redundancies and maximising the retention of essential skills.”

The report adds there may be more redundancies to come from commissioning groups as a result of reorganisation.

However, further job losses were avoided as 34,204 jobs from organisations such as strategic health authorities and primary care trusts were moved to new bodies, such as NHS England.

NHS Hambleton, Richmondshire and Whitby CCG has started a new scheme to tackle the expected demand in healthcare services from elderly residents.

Commissioners estimate that by 2021 the number of people aged 65 and over within the local population will have increased by nearly a third (30%).

The scheme, Fit 4 the future, will focus on four main areas: staying healthy, long-term conditions, dementia and end of life care.

Dr Mark Hodgson, a governing body member, said the CCG wanted to hear from patients about “what they want from local healthcare and how we can work together to design future services.”

A series of meetings will be held by commissioners where people can attend and give their experiences of care, outline what they require from the NHS and discuss what’s important to them.

The CCG hopes it will then be better prepared for the expected increase in demand for health and social care as the elderly population increases.

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The chair of the Royal College of General Practitioners (RCGP) has hit back at claims by Health Secretary Jeremy Hunt that doctors are to blame for the increased pressure put on A&E services.

Dr Clare Gerada (pictured) issued a statement claiming Mr Hunt was wrong to blame GPs for a lack of out-of-hours provision and said doctors were being used as a “scapegoat” by the Health Secretary.

She said it is “not acceptable” to point the finger of blame at GPs for rising levels of A&E use and there is “no evidence” to prove this increase is down to the 2004 GP contract – as some ministers have claimed.

Hunt first made the accusation in the House of Commons when he was discussing the 2004 GP contract introduced under the former Labour government. A DH spokesperson subsequently insisted the Health Secretary was “clearly not blaming GPs.”

However, Hunt reiterated that doctors were to blame during a speech at Age UK where he outlined plans to “rethink the role of primary care” and said that “inaccessible primary care” had resulted in increased pressure on A&E services.

Dr Gerard insists “it is not true that the rise in demand on A&E services is due to a reduction in out-of-hours provision by GPs” and that there are “numerous reasons why our colleagues working in A&E departments are under pressure.”

She highlighted a shortage of consultants and a lack of integration between community and social care which has caused a “myriad of problems, including unnecessary admissions.”

The chair added that assumptions that the NHS “starts and ends with hospitals” should be ended and called upon the Health Secretary to consider the wider picture before pointing the finger of blame. “We are one NHS with patients accessing different services at different times,” she said.

“These are tough times for us all and one of the issues Mr Hunt should be addressing is the shortage of 10,000+ GPs across all services, not just out-of-hours. As a national health service we should all be working together with Government to improve patient care, not blaming GPs for perceived ‘inadequacies’ in patient care.”

NICE has not recommended Novartis’ Jakavi (ruxolitinib) in final draft guidance for the treatment of disease-related splenomegaly or symptoms in adults with myelofibrosis.

An independent appraisal committee concluded the treatment is clinically effective but raised concerns around the manufacturer’s economic model and many of its assumptions.

Sir Andrew Dillon, NICE Chief Executive, said the regulator had to be sure treatments are clinically and cost effective otherwise “money has to be diverted from elsewhere” to fund such drugs in the NHS.

The guidance states that Jakavi is not recommended for the treatment of disease-related cases of an enlarged spleen or its symptoms in adults with primary myelofibrosis, post polycythaemia vera myelofibrosis or post essential thrombocythaemia myelofibrosis.

Myelofibrosis is a rare type of blood cancer in which the bone marrow produces too many cells too rapidly. This affects the bone marrow making it less able to create cells. Other organs, such as the liver and spleen, then compensate for this by producing additional cells. The spleen, as it begins to create cells, becomes enlarged.

NICE noted that Jakavi was clinically effective in reducing the size of the spleen in these cases and related symptoms. However, it could not be considered a cost-effective option of NHS resources when compared with existing treatments.

The committee found there were “fundamental issues” with the structure of the economic model supplied by Novartis. It concluded that the associated assumptions made increased the uncertainty of the cost-effectiveness ratio (ICER) for the treatment and that rectifying this would actually increase the ICER.

Final guidance is now expected in June 2013.

Asthma treatment Xolair (omalizumab) has been recommended by NICE in final guidance as an option for treating adults, adolescents and children with severe or persistent allergic forms of the condition.

Xolair has been recommended in people aged 6 years and older as an add-on to optimised standard therapy for patients who require continuous or frequent treatment with oral corticosteroids.

However, the treatment can only be used by the NHS if Novartis Pharmaceuticals UK provides the treatment under the terms of an agreed patient access scheme to lower its price.

The treatment has a UK marketing authorisation as an add-on therapy to standard care to improve asthma with severe persistent allergic asthma. Currently, it is only prescribed to those whose condition remains poorly controlled, despite receiving standard therapy options.

Professor Carole Longson, Health Technology Evaluation Centre Director at NICE, commented: “NICE is pleased to recommend omalizumab, with the agreed patient access scheme submitted by the manufacturer, as an effective add-on therapy for adults, adolescents and children with severe, persistent allergic asthma, which can have a significant effect on a person’s life.”

The great and the good of planet pharma converged on the Lancaster Hotel in London for, quite simply, the greatest award ceremony in the galaxy (that’s unbiased journalism, right there, folks!) John Pinching reflects on a delightful evening.

During 13 glorious years the Pf Awards has been an increasingly-important fixture on the pharma industry’s hectic calendar. It’s a chance to reflect on the high points of the last 12 months, reward the supreme efforts of pharma’s finest and meet up with vaguely recognisable faces on the dance floor!   This year’s shindig was perhaps the most exciting so far with new categories, inspirational performances and, in Ed Byrne, a compelling host.

The evening got underway with the dulcet Black Country tones of Melanie Hamer who – in her capacity as Events Director for Pf Awards and a Director of Events 4 Healthcare – has overseen every ceremony to date. She was keen to point out how the Pf Awards have evolved in accordance with the demands of the industry, and why they continue to set a benchmark for the most passionate people in the business.

It was my very first Pf Awards and I was most honoured when asked to present the award for best company (the most notoriously unpronounceable organisation in the history of pharma, naturally). The night before I had dreamt that my pilgrimage to the stage was greeted with a chorus of abuse, but in reality the crowd were consummately professional and, as a result, the words ‘Boehringer Ingelheim’ tripped off the tongue effortlessly!

As the names of other winners resonated around the venue, it was very clear from the spectacularly wild celebrations that these endorsements are treasured acknowledgments of a job well done.

Now enjoy our photo album which commits those unforgettable moments to the hallowed pages of the very magazine that gave the awards their name.

Adding a Pf Award to the mantelpiece will be used to inspire several companies as they aim to reach even greater heights. Here’s how one of the winners will be celebrating.

Lundbeck: Working in partnership

The Pf 2013 Joint Working award was won by Jo Livingston, Lundbeck’s Parkinson’s disease specialist.

Jo Livingston worked with partners in primary and secondary care across the Sunderland NHS to develop an integrated care pathway for local people suffering from Parkinson’s disease. An account of the project’s goals and outcomes appeared in an HSP Partnership in Practice supplement in 2012.

A medium-sized pharmaceutical company, Lundbeck specialises in treatments for mental health and neurological disorders. The company has devised a strategy for 2013 that builds on the stability the organisation has achieved and focuses on its three main pillars of strength: delivering excellent results, giving value to customers and being a great place to work. The company’s strategic priorities are complemented by its four operating principles: to be ambitious and take action; to own the future; to be better for less; and to create results together.

In recent years, Lundbeck UK has focused strongly on working in partnership with the NHS to improve the care of people with Alzheimer’s disease and Parkinson’s disease. Jo Livingston’s project is a good example. According to Andrew Jackson, Sales & Marketing Manager for Azilect, there are two reasons for this strategic focus: “The changing NHS and the relationship that the pharmaceutical industry has with it means we need to work jointly, rather than simply promoting drugs. Services for neurological disorders are very varied across the UK, so it’s important that we partner with the NHS to make them better for mutual benefit.”

What made Jo Livingston’s project stand out among the finalists? “It was a true partnership project,” Jackson explains. “She got buy-in from various stakeholders within the NHS and she worked in partnership with them, which is rare. We’ve evolved over time to a model where we’re jointly sharing projects, as opposed to the traditional model where pharma gives money and the NHS goes and does something.”

While joint working is a team achievement, that doesn’t mean good leadership isn’t crucial. Jackson comments: “Clinicians and stakeholders in the NHS are very, very busy, and for the project to actually be seen through and implemented correctly, Jo needed to be the one who was spearheading that and who was driving the meetings, their content and their output, to get towards the end result.”

As well as winning in the Joint Working category, Lundbeck had five other finalists in the Pf Awards 2013. Jackson puts that success in context: “Eighteen months ago Lundbeck restructured to align to the changing needs of the NHS. We developed a team of regional account directors to tailor Lundbeck’s offering to the needs of the local health economy.” That dynamic response to NHS reform has boosted their reputation both with customers and within the industry.

This month Brigadier Pinching shares a surprisingly palatable civil service coffee with the Department of Health’s NHS/big pharma relationship expert, Naima Khondkar.

I love Elephant and Castle. If you are in any doubt about where you are, just outside the station, there is large sculpture of... an elephant and a castle. Oxford Circus, King’s Cross and Cockfosters have clearly missed out on a neat trick. Anyway, I digress, for I was in central London on important business – to chat with Naima about how the private and public sector could make their marriage work. Having spent six years in curious governmental buildings, this was my territory. Bring on the future!

Hi Naima, what’s your story?

At the Department of Health I work in the Medicines, Pharmacy and Industry Group. The head is Giles Denham and he has a number of teams which sit under him. One looks after the pricing environment – which is very topical right now because of the negotiations – while the pharmacy team takes care of community and pharmacy issues. Another concentrates on prescription policy, and I’m in the industry sponsorship team.

How do you guys roll?

We’re almost account managers for the pharmaceutical industry, within government, and also the first port of call on health policy issues concerning research-based pharma companies, including global outfits that have locations in the UK. There’s a very high-level of strategic engagement, driven by the Ministerial Industry Strategy Group, which combines global heads of pharma, from as far afield as Japan and America, and ministers from health, business, the treasury and UKTI (UK Trade and Investment). The discussions are a great way to highlight how government policy can help partnerships. Our minister, Earl Howe, is a particularly engaging contributor, while ‘No 10’ frequently sends along a representative, indicating how serious the Government is about forming cohesive inter-sector partnerships.

How has the concept of joint working progressed?

Over the last few years we have carefully considered how to fundamentally improve the relationship between industry and the NHS, and a lot of this consideration has been carried out in conjunction with colleagues at the ABPI. There is still a lot of mistrust on both sides, however, and that is one of the greatest challenges reform needs to overcome. The NHS has the perception of pharma as being a big bad wolf, just above the arms and tobacco industries in terms of popularity! For some reason people have a big problem with the pharmaceutical industry making any kind of money. Sometimes I think the level of suspicion is unjustified, but then again, I don’t think pharma do themselves many favours sometimes. It’s important to be open and honest about these things! Equally, the NHS can sometimes be over-sensitive – they don’t like to be told by other people how to do their job.

What needs to change?

There needs to be a shift in how people on both sides view one another and they must learn to wipe the slate clean. Bad relationships can date back to minor incidents that happened 25 years ago, when a young, naive rep went into a meeting with a box of doughnuts to help flog a new product. Something as trivial as this may have resulted in a door being shut. Whereas now NHS representatives need to re-engage, open doors and think about the broader benefits of working together with the pharmaceutical industry towards joint goals. It’s really important that both sides build allegiances and forget past animosities. Ultimately this will benefit everyone.

Do the ‘different’ motivations of the public and private sector make gelling difficult?

There is an incorrect perception that, because pharma makes money, someone else has lost. We must remember that if people have their lives extended due to better treatment then NHS, industry and wider society has won. Recently Helen Bevan, NHS Director for Transformation, said both industries have been very target driven in the last 15 years and, consequently, the humanity factor has eroded. Healthcare professionals on the frontline have been too busy with waiting lists and reductions, while sales reps have been under enormous pressure to shift products and been too focussed on sales. Patient cases have become about performance measurement rather than health outcome, or quality of experience. Clearly there needs to be a radical change in priorities.

What can big pharma do to engender trust?

Their approach can be ill-informed sometimes. Often they think they know the NHS, but actually they need to fully appreciate the complexities of what is an ever-evolving beast. Companies need to consider who they make responsible to forge vital connections and forming sustainable relationships. They regularly send an under-qualified person, who might have the enthusiasm, but not the authority. With joint working one of the big issues has been compliance and, often, the pharma representative at the table can’t actually make a decision about whether a company can work in a certain way. This is one of the areas we are really trying to help with.

How should they alter their approach?

If pharma goes in simply looking for a market share increase, they’ll get figured out straight away. Representatives of the big companies need to prove that they genuinely want to improve a health economy or health outcome, before profits. These are the aspects that make the whole system better, and ultimately everyone wins. The CCGs want more people appropriately treated and that means less hospital admissions and, in turn, more financial resources will be available for commissioning. In this respect pharma needs to look at the bigger picture. Remember, every service that the NHS uses is a business – from nurses to bed sheets – but because of the fractious history, the NHS is suspicious about pharma making money. When they do engage the NHS needs to feel like pharma is an integrated and credible part of the solution, as opposed to a procured service. It’s a fine balancing act.

What are the priorities when it comes to galvanising joint working?

Since joint working was outlined as part of NHS reform we have been keen to establish how it can be improved. A policy working group in 2007 carried out some market research and they came up with some recommendations. The two major areas of focus, on our side, were the issuing of guidance – clear definitions of how the NHS works - and the language that should be used. This is a refreshingly concise 11 page document. We also addressed the practical side by combining with the ABPI to launch the, ‘Joint Working tool kit’. It’s an interactive quick-start guide, which includes exactly what the NHS’s definition of joint working is, essential templates and a versatile project management tool. Above all, it avoids jargon and allows people to understand what is required straight away. This has been endorsed by NICE, the NHS Alliance and Confederation among others. We will be looking again at how we can update these documents and make them more practical in the ‘new world’ and also partnering with industry [through the ABPI] and the NHS to review and revitalise both these tools.

Are you optimistic about fruitful partnerships?

Joint working will continue to be an important focus and a part of my day job. QiPP came and went, so we had to hold fire for a while, but now Innovation Health and Wealth (IHW) has provided a restructure, we are pretty sure of what is happening; six months ago we sat down and established that the shift of power is moving to CCGs. Now individual CCGs. Director of Partnerships, Ivan Ellul is particularly keen on localised, dynamic relationships and Mike Farrar is also a champion. Ian Carruthers is the NHS England lead for IHW and is also keen to encourage this type of engagement.

Do you feel that the tide is turning already?

I’m resolutely positive about changes within the NHS. I’ve had heated discussions with clinicians and pharma about joint working, because a lot of them see it as more rhetoric. Some companies, however, are hugely proactive and want to be pioneers of change. GSK are a good example. They’ve shifted their entire salesforce to encourage new ways of working with NHS counterparts. Their leader, Andrew Witty, is passionate about successfully transforming approaches and he’s someone you can believe in, because GSK have freed up patents, conformed to the ‘alltrials’ ideology and shared data. This has filtered down to the way they engage with the NHS and the company have been very smart, as they realise it’s about increasing the whole market. If a healthcare pathway improves it will produce better diagnosis, and better diagnosis means more appropriate and timely use of medicines.

Well said, thanks Naima!

Contrary to long-standing opinion, new research has found that younger employees value job satisfaction over financial reward. Jessica Pryce-Jones examines why this change of thinking has evolved.

In uncertain economic times, the need to retain and nurture key existing talent is a priority. Organisations do not want to invest both time and energy into training key employees to discover that the benefits will be realised by another company.

This issue is particularly relevant when applied to ‘Generation Y’ employees: the demographic cohort born after the early 1980s and before early 2000s. This 20-to-30- something workforce has heavily influenced the socially networked, multi-channel society and is the management class of the future. However, they demonstrate a new-found job mobility which, from an employer’s perspective, is a ticking time-bomb of potential cost and disruption to their business.

The need to foster and retain employees is not an entirely foreign concept to the pharmaceutical industry. Nevertheless, a more concerted effort is needed. A recent RSA survey of 400 life science executives discovered that, while over 90% identified talent management as a key priority, only a quarter (26%) had an active strategy in place for retaining talent. More than two-thirds (68%) had no clear leadership succession plan at all.

Forward thinking

New research by the iOpener Institute for People and Performance, which analysed responses from more than 30,000 professionals in Europe, US, Australia, India, China and Africa, has shown the digital friendly Generation Y values job fulfilment over financial reward. Whilst pay levels still matter to this demographic – individuals are not prepared to be under-paid for their work – there is no significant correlation between increased levels of pay and greater talent retention.

The research analysis also looked at the correlation between job fulfilment and the likelihood of moving jobs. Job fulfilment was measured by the extent to which people stated that they ‘love their job’. Here, a very strong correlation emerged, definitively showing that a fulfilling job is what keeps the Gen Y employee on board, not simply throwing money at them. A single point of increase in job fulfilment brings down the intention to leave by 0.8 points. Statistically speaking, job fulfilment or, rather a lack of it, explains almost 60% of the variance in a Gen Y employee’s desire to leave. This suggests that Gen Y is not inherently interested in jumping ship for the sake of a bigger pay packet. Instead, Gen Y is simply not prepared to stay in jobs that make them unhappy.

This point is of particular importance to the pharmaceutical sector. Whilst pay levels are, on average, 20% higher than other manufacturing sectors, analysis of the iOpener database, which includes information from workers across a range of industries, reveals some areas of job fulfilment where pharma is specifically underperforming. Happiness and well-being are not ambiguous ideas. They can be finely measured by assessing the identifiable key components of happiness at work – positive factors such as recognition, respect and time on task, as well as negative indicators such as the likelihood of leaving or having sick days off.

Take, for example, contribution, which is one of the most important factors that influences happiness at work. Contribution is a two-way concept. It is not only about what the employee puts in but also what they get out of working. Therefore, as well as feeling that they are achieving goals and contributing to the working of the organisation, the employee also needs to be given feedback, respect and appreciation in return. By analysing the responses of employees in the pharmaceutical sector, we can see that they display 4% less contribution than the average across other industries.

New approach

The strategic direction that an employer is pursuing particularly applies to the working beliefs of Generation Y. iOpener research found a correlation between the trust that Gen Y employees have in their leaders’ vision and their intention to leave the organisation. In short, the more Gen Y believes in the leadership’s corporate strategy, the less likely they are to leave.

This last point should not go unnoticed in the context of the pharmaceutical sector where scandals have weighed heavily on the industry over the past few years. The most notable of which was the $3 billion fine against GSK – the largest fine ever imposed to a pharmaceutical company by the US Department of Justice. Indeed, GSK are not alone – the total cost of industry fines is more $20bn in last two decades. These episodes have damaged the sector’s reputation, not just amongst the public but also within current and potential employees.

Deficiencies aside, it is also important to recognise where the pharmaceutical industry is performing well. For example, employees report feeling that their job has a positive impact on the world – 22% more than average across all sectors – and that what they’re doing is worthwhile, 14% higher than average.

Different mindset

Organisations are quickly recognising that Generation Y is distinct from the previous generations, especially in terms of job mobility. No organisation wants to invest in the next generation of talent if that investment is compromised by job mobility. While this recognition is shared by the pharmaceutical industry, few companies have strategies in place to retain talent.

Gen Y employees need to feel a sense of job fulfilment and this can be finely measured by analysing the components of happiness at work. Research, based on the analysis of thousands of responses obtained by iOpener, clearly demonstrates that simply throwing money at Generation Y will not be enough to retain them.

After analysing employees across the pharmaceutical industry as a whole, it’s clear that whilst employees feel that their jobs have a greater sense of purpose and meaning, feelings that they are contributing to the working of their organisation are low. These are factors to be taken into consideration as pharmaceutical companies formulate talent retention strategies which will contribute to their growth and ultimately, to the success of the sector as a whole.

Jessica Pryce-Jones is joint founder and partner of the iOpener institute for People & Performance which examines the factors that contribute to resilience and how it can be maintained.