On 4th February 2015, we held our second Market Access Seminar with Andrew White
, Change Programme Director at North West Commissioning Support Unit (see details below).
Market Access Seminar
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‘Medicines Optimisation: A Regional Perspective’Presented by Andrew White, currently Change Programme Director at North West Commissioning Support Unit (CSU).
Andrew White explained the role of the CSU is to support commissioners in the NHS in the delivery of safe, patient-centric care. The current realism of operating within the confines of deflation, in real terms, reflects itself in his use of Simon Stephens’ mantra; ‘Think like a patient, act like a tax-payer’.
The financial savings set for the NHS over the next five years, require unprecedented and “heroic efficiency” according to White. The integrated care model strived for by the NW health system, as he predicted, is the Trojan horse for much expanded care commissioning and management. Get it right and he believes it should/could be the way of the future for us all…
So what are commissioners’ aspirations and goals for the next five years and how can communicators better understand their priorities? Firstly, White outlined that a mind-set shift is required and the health and care system are working towards it. Prevention of ill health (public health) rightly takes a place in the attention of those with the purse strings, and should be for all of us. People need to be active and engaged in their own health and wellbeing subject to circumstances that allow them to do so. White explained that it is no longer acceptable for a clinical diagnosis to mean handing over responsibility to the NHS to ‘do treatment to us’ in order to make us better.
The role of the workplace in improving the health of the nation should be further explored. Personalised health technologies, like Fitbit®, and the forward-thinking organisations that have embraced the idea that good workforce health is a win-win investment – are riding the wave of transformation.
In addition, other key areas outlined included; understanding and valuing the role of support carers and volunteers, implementation of integrated and responsive care pathways, and investment in technology and genomics where long-term efficiencies may result. These types of changes, says White, are essential if the NHS is to be more efficient.
So how can commissioners drive down spending while driving up standards of patient care? He believes that excellent standards of data are absolutely vital - insight is often the catalyst for change. For example, benchmarking data, according to White, drives real improvement in standards. Optimising use of medicines and reducing wastage are also key areas to examine, “It’s a lot easier, politically and practically to reduce the costs of prescribing than it is to reduce staffing levels,” he added.
How has greater devolution affected the way medicines are used and managed at a regional level? ‘Devo Manc’ has already got significant traction. If the books are made to balance, it could soon take on a health budget of £5-6 billion to spend across 12 CCGs, with tremendous implications for the way health and social care is joined-up and delivered locally. White believes that a keen focus on medicines optimisation is likely to continue, and that the role of the Greater Manchester Medicines Management Group (GMMMG) is critical.
The GMMMG is responsive to the need for change; embracing the need to act swiftly in issuing local guidance and in the development of integrated, responsive, care pathways. As of this date, in addition to numerous other outputs, the GMMMG has eight sets of drug-related guidance and three integrated care pathways that have been rolled out across the region.
These new integrated care pathways demonstrate the mind-set shift in practice. Investment is made at key points in the pathway to prevent wastage and poor outcomes in others. Other notable benefits include that patients are clear on what they can expect from their care, and clinicians are clear on what services are commissioned and which medicines are funded. Key from a budget management perspective is that the full cost of patient care for a defined condition is woven together, making a meaningful difference to understanding of costs and planning.
White explained that the drugs budget is always under scrutiny. Until recently, it has regularly “come in under planned spending” – as blockbusters have come off patent resulting in vast savings. However the source of such savings is drying out. Big blockbusters have mostly come off- patent and biosimilars do not deliver nearly the same level of cost reductions.
White shared many more insights along with useful tips for communicators and companies working to create market access opportunities for treatments. One key piece of advice to all is to keep front of mind that, ‘commissioners buy outcomes, not molecules’.
He was warmly thanked for giving up his valuable time for the HCA - we hope to welcome him back in the future to see how his five-year vision is shaping up!