NHS partnerships with the pharmaceutical industry

1. NHS partnerships with the pharmaceutical industry Sandy Briddon Interim Network Director South Central PCTs Alliance

2. Scope of presentation • Policy and reform • Impact of reconfiguration of SHA & PCTs • Commissioning frameworks & care closer to home, PbC implementation • NHS South Central new thinking • NHS partnership with the industry

3. Completed The reform programme • Health reform in England: update and next steps (December 2005) • Our health, our care, our say (January 2006) • The NHS in England: operating framework (January 2006) • Health Reform in England : update and Commissioning Framework (July 2006) • Commissioning Framework for Health & Well-being • Focus: current policy development • System Management and Regulation • Incentives (including primary care contracting) • Quality Framework • Direction for patient Choice • Provider development

4. PCT re-configuration .................

5. PCT structures • Appointment process underway • Huge change agenda • Loss of organisational intelligence • New executive teams under pressure • New financial year days away ............

6. PCT agenda • Improving the health & well being of their populations with in the resources available ensuring value for the taxpayers £ • Deliver the efficiency targets 21% + • Managing the market through effective commissioning strategy • Maintain financial balance / surplus

7. The Commissioning Cycle

8. DH – Commissioning framework • DH commissioning framework (DH August 06) • patient-driven through choice, voice and competition; • commissioner-driven through contracting, contestability and service redesign; and • nationally-driven through standards, targets and regulatory approaches • PbC further endorsed

9. Money following the patients, rewarding the best and most efficient providers, giving others the incentive to improve (transactional reforms) More diverse providers, with more freedom to innovate and improve services (supply-side reforms) A framework of system management, regulation and decision making which guarantees safety and quality, fairness, equity and value for money (system management reforms) Commissioning is one element of a comprehensive health reform programme Commissioning Framework August 2006 Better care Better patient experience Better value for money More choice and a much stronger voice for patients (demand-side reforms)

10. PbC implementation • National variation v 100% coverage • Consortia v individual practices • New management skills in 1º care required • Relationships need to change • Understanding the commissioner – provider function • New partners ....................

11. New provider opportunities • GPs / practices / consortia are commissioners and providers of approved services • More choice for patients closer to home • GPSI and nurse practitioners accreditation • Pharmacists & opticians • Joint ventures with private providers

12. NHS South Central • Fitness for purpose PCT gaps identified • New ways of thinking being embedded • World class commissioning • Commercial department – “think tank” • Improved productivity, efficiency, care & resource utilisation • Lean thinking

13. South Central profile • South Central – spend • £4.6bn budget • £3bn payroll • £1.6bn non-pay and pharmaceutical spend • Largest categories (70% spend): • £470m primary pharmaceuticals • £227m purchased healthcare • £183m other miscellaneous • £163m secondary pharmaceuticals • £92m medical/surgical equipment • There is a very long tail • Spend – • 29% (£470m – primary pharma) DH PPRS and Drug Tariff • 14% NHS Supply Chain – to grow from around 5% • 17% PASA – secondary pharma and agency • 37% (balance) Hub and overall responsibility

14. NHS South Central Commercial Strategy • Why do we need a commercial strategy? • Integral part of delivering South Central’s objectives • NHS moving to market based model – commissioning and competition • NHS supply side restructuring – “Take Over Code” • Need a policy framework for commercial activity • More services delivered under contract • Need effective commissioning and procurement • Need to improve service quality and gain efficiencies • Fragmentation is a theme across South Central: • contracting • purchasing • shared services • Approaching problems commercially will ensure we get what we want, when we want it and at a price that we are willing to pay • We can use a commercial approach to: • influence style and behaviour – incentivise & reward • execute strategy and deliver health gain – transform

15. Partnership working • NHS & Industry must try and adopt a different mind set to enable closer relationships • Move away from funding projects / lunches to partnership working & sharing best practice • HDM need to identify consortia chairs, GPSIs and support key players needs • Share skills – marketing, horizon scanning • How important is the relationship with SHAs?

16. Summary • PCTs and PCOs will need to develop new skills to tackle commissioning agenda • GP consortia getting to grips with PbC • New partnerships including private sector & social enterprise • More commercial approach • Learning from large and experienced organisations