Delegates at the first ABPI Regional Interest Group London meeting on 13 June heard from a panel of NHS and industry speakers and took part in interactive sessions that honed their understanding of Joint Working.
Stephen Fensome, regional business manager Almirall is chairing the London Regional Interest Group (RIG) and said: "We leave our competitive behaviours at the door for this group. Our aim is to see an increased number of joint working projects with NHS London that drive an improvement in trust between the NHS and industry."
He used a rugby analogy saying that the four Nations teams come together every four years as the Lions and although they are natural competitors, they do well because the share a common goal.
So far, the group has been mapping key stakeholders and hearing from customers about the future NHS, with some fantastic national and regional insight. They have also been talking with the AHSNs.
"At the heart of everything the RIG is doing is the trust piece," Stephen explained. "We want to measure our success through an increased number of joint working projects with NHS London and its partners and through evaluating those to demonstrate improved trust."
Karen Thomas is the ABPI Regional Partnership Manager for London. She explained that the group is absolutely not intended to promote a particular company or therapy area or to improve market share. "We are looking to identify opportunities that maybe an individual member might not see and to understand and overcome barriers to access using the ABPI's seven-step partnership model."
The group's activities are funded by the ABPI, which also provides the secretariat. Karen concluded: "Our vision is that industry is an integral part of the NHS solution to deliver better patient outcomes. Critically, the ABPI Regional groups are just one of many avenues to joint working with healthcare providers and certainly not the only one."
Meeting Chair Jonathan Mason talked about medicines optimisation: "Why do we need new terminology?", he asked.
"There are savings to be made, but we need to look at medicines in a different way – as an investment and not a cost pressure," he explained. "Just looking for savings on the prescribing budget is not good for any of us."
He went on to explain just why medicines optimisation is so important. Innovation health and wealth is partly about using medicines better through investment in healthcare and the faster adoption of new technologies across the system. The management and mortality associated with cardiovascular disease has been dramatically improved over the past 20 years through medicines such as statins, PPIs have revolutionised the care of peptic ulcers and HIV is becoming a long term condition with anti retrovirals. We are now looking at older people possibly living through two to three cancers when in the past the first would have killed them.
"However, if patients do not take their medicines correctly, they won't get the outcomes they or we expect, he warned . He recommended that the audience read the Waste Medicines Report
for a better understanding and pointed to a role for joint working in his concluding comments: "Medicines optimisation requires a three-way partnership with the patient at the centre and the industry and NHS working together to get the return on investment that we all want from medicines."
The London Procurement Partnership gave insight on their workings, with Tim Root commenting: "I have always believed in seeing and engaging with pharma and for me the key drivers are around getting the value proposition right from everyone's point of view and about transparency and honesty."
He acknowledged that each party will have its own agenda, and emphasised how important it is that these are tabled at an early stage of discussions.
Giving a brief overview of the work of the LPP, Tim explained that its remit is far wider than medicines and includes IT, estates, staffing and agency. He described the changes in commissioning and observed that if anything tensions are in some ways increasing between centralised control and the influence of NHS England and local decision-making.
Where medicines are concerned, he said that they look for clinical- as much as cost-effectiveness and equity of access. Tim also flagged the possibility that NHS England may move to contracting certain high cost medicines directly with industry with major implications for transparency on pricing, benchmarking and value judgements.
His college Jasbinder Khambh, talked through the process of commissioning which involves discussion with local stakeholders in the context of national work programmes and NICE and, where possible, medicines optimisation. She highlighted how the LLP is still working to improve engagement with GP and community pharmacy colleagues and said that that this could be an area of opportunity for industry joint working as could correlating data with outcomes.
UCL Partners' Amanda Begley talked through the AHSN perspective and placed great emphasis on the need to overcome delayed adoption and missed opportunities, to improve patient outcomes through collaboration and a ‘bottom up approach'. She explained that UCL has a dual agenda to improve patient outcomes, but also to consider the wealth agenda and how research and developments can contribute to UK Plc. She also explained the challenges and opportunities that the AHSN faces as it works from discovery, through first-in-man and the translational pathway to trials, and then delivery into scale and described some of its programmes.
Concluding, Amanda said: "You have to start with what matters first – the patients. Then it is all about values, relationships, co-creation alignment and outcomes. Getting everyone, including industry around the table to improve patient outcomes."
The last morning session provided insight into the soon-to-launch Specialised Services Commissioning Innovation Fund (SSCIF). Designed to overcome the repetition that the former 10 specialised commissioning groups created, the SSCIF, known as ‘CIF', will provide one centralised point with which to evaluate mechanisms that have some ‘but not definite' evidence.
Bernie Stocks, NHS England described how projects can be submitted via a simple three stage process that starts on the internet and that evaluation will be rapid – typically ranging from 6-18 months, where other mechanisms can be three to five years. The key she warned, will be to have all stakeholders, including a lead clinician on board if the project makes it through to phase three.
Andrew Jones, senior medical science manager, Bristol-Myers Squibb who has been on secondment to SSCIF explained in more detail. Anyone can access the innovation fund, whether multinational, one man band or a nurse at bedside who wants to change the way things are done.
"Is it another hurdle for industry? I truly don't think it is," Andrew said. "This is about generating evidence and translating efficacy data into robust evidence."
Following a lively workshop session around what is joint working and how to go about it, Karen Thomas closed the meeting: "We have a commonality," she said. "Joint working can achieve high quality care for all, for now and future generations."
Jonathan Mason BSc MSc MPhil DIC DUniv FRPharmS
Clinical Adviser (Medicines), NHS England: London Region
Jonathan is Clinical Adviser (Medicines) at NHS England: London Region, and Operations Director for the Commonwealth Pharmacists Association. Jonathan is a member of the Prime Minister’s Challenge on Dementia Champion Group, a member of the Malnutrition Task Force, and chair of the NICE Good Practice Guidance Development Group on Patient Group Directions. Jonathan is the former National Clinical Director for Primary Care and Community Pharmacy at the Department of Health, and former Pharmacy Lead for the Dementia Calls to Action at the NHS Institute for Innovation and Improvement.
Jonathan champions the development of medicines optimisation services which best meet the needs of patients and the public. Jonathan is passionate about the role of community pharmacy in improving the use of medicines and promoting and supporting healthy lifestyles.
Jonathan has a wealth of experience in pharmacy practice including working in hospital and community pharmacy, laboratory-based research into drug metabolism and pharmacokinetics, academia and medicines regulation. He has been working in primary care pharmacy since 1998.
Follow Jonathan on Twitter @jonathanmason
Regional Business Manager, Almirall; Chair, ABPI Regional Industry Group London
Stephen has held commercial roles in the pharmaceutical industry for 19 years; holding a number of positions in business operations, management and marketing. For the last 10 years, he has been working in account management roles, working on ensuring successful placement of products into local health economies and in delivering partnership programs which support local NHS organisations. He shares a passion for ensuring companies demonstrate trust with its partners and is keen to utilise vehicles such as the Regional Industry Group to develop long-term sustainable projects between the pharmaceutical industry and the emerging NHS.
Pharmacy & Medicines Use & Procurement Lead for Primary Care, NHS London Procurement Partnership
Jasbinder has extensive experience in varied roles within the NHS over the last 14 years both as a senior pharmacist and a senior manager. Prior to her current position as the Pharmaceutical lead for primary care for the London Procurement Partnership, Jas held various posts within NHS City and Hackney. Her previous roles have helped her to adapt to the changing environment of the NHS with experience in working across organisational boundaries and with various stakeholders across a number of interfaces. She has a particular interest in the current healthcare agenda including QIPP.
Jas is a registered pharmacist and independent prescriber, with excellent clinical knowledge and experience spanning both primary and secondary care organisations of the NHS as well as partnership working with various stakeholders including external organisations.
Key achievements to date include: leading, developing and implementing strategies across London to achieve the aims of the QIPP agenda in order to make significant efficiency savings; establishing one of the first area prescribing committees across primary and secondary care which has been recognised as a model of best practice by the NPC; launching one of the first successful joint formularies between primary and secondary care to improve the quality of prescribing; and providing leadership, as well as coordinating the review, for the strategy for primary care substance misuse services facilitating the development of services in line with the National Treatment Agency’s Models of Care framework.
Director of Innovation and Implementation, UCL Partners AHSN
Dr Amanda Begley has 14 years experience of co-designing and implementing change programmes across a variety of NHS settings, having worked as a clinical psychologist, a commissioner and manager of provider services across primary, community and secondary care. More recently Amanda worked as Head of Innovation at NHS London, Strategic Health Authority. Amanda is currently Director of Innovation and Implementation at UCL Partners, Academic Health Science Partnership and is on secondment part-time as a Fellow at GlaxoSmithKline.
At UCLP, Amanda is focused on mobilising UCLP Academic Health Science Network to serve a 6million population, writing the national guidelines for Clinical Commissioning Groups on their duty to promote innovation on behalf of Innovation Health and Wealth, and building expertise within UCLP around the uptake and diffusion of innovation. As a GSK Fellow, Amanda supports the generation of collaborative solutions between GSK and the NHS to achieve even greater outcomes for patients, and focuses particularly on collaboration with AHSNs.
Senior Medical Science Manager, Bristol-Myers Squibb
Andrew works in the Medical department of BMS and is responsible for supporting the appropriate and safe use of BMS medicines that are marketed or in clinical development.
In addition, Andrew had recently spent 14 months working full time with the Department of Health, assisting in the implementation of various actions that were specified in Innovation Health and Wealth: Accelerating Adoption and Diffusion in the NHS. More specifically, Andrew was heavily involved in the development of the Specialised Services Commissioning Innovation Fund (SSCIF).
Andrew has worked in the pharmaceutical industry for 12 years in multiple roles within Clinical Development and Medical Affairs and understands the challenges faced by all aspects of the industry. A graduate in genetics (BSC Hons), Andrew spent time in academia, researching targeted prostate cancer treatments before joining the industry.
Associate Director, Innovation Adoption, Specialised Services, NHS England
Bernie is responsible for supporting the delivery of NHS England’s commitment to improving innovation in specialised services, including the establishment of a potential new fund for specialised services. Bernie recently designed a transformation plan and secured a £3million budget across primary and secondary care to improve the care experience, outcomes and cost effectiveness of services for the Frail Older Person in Nottingham and the south of Nottinghamshire.
Previously Head of Innovation and Improvement at NHS East Midlands for three years, Bernie successfully delivered the SHA’s Innovation and Improvement agenda, was the SHA’s contract and relationship manager for the National Institute for Innovation and Improvement, Programme Director for the successful implementation of innovative technologies adoption (iTAPP) in the East Midlands and led the delivery of the Leading Large Scale Change - Clinical Leader’s Network development programme for 100 clinicians over three years.
Qualifications: MBA, Diploma in Marketing, Post Graduate Certificate in Clinical Leadership, Ba (Hons) Business, Harvard Local Organising and Action social movement training.
Bernie is a Member of the NHS Institute’s Improvement Faculty and was previously a member of the national iTAPP Programme Board and the Open University’s Steering Group Member: Open University Innovation Adoption Group. Before joining the NHS in 1993, Bernie worked in the private sector for six years. Roles included PR, marketing, direct marketing, management consultancy; production planning and university placements were in the retail, steel, newspaper and electricity industries.