With the release of the NHS White Paper, we caught up with Star OUTiCO Market Access Multi-Channel Account Manager, Steve Meadows, to hear his thoughts on what the NHS reshuffle means for those in customer-facing roles going forward.
Hi Steve, you’ve gone through the NHS White Paper from top to bottom. Could you kick off by introducing yourself please?
Sure. My experience within pharmaceutical market access goes back a few years. I started in the industry in 1984 with my first role as a GP Representative. Since then, I’ve been working to build successful relationships between the NHS and pharma industry, and secure pre-NICE funding and universal patient access for multiple high-cost drugs.
I have a real passion for healthcare informatics and the NHS policy environment and use my experience of these to ensure innovative opportunities are understood by everyone – experts and non-experts alike. For example, I was able to deliver significant savings to CCGs through innovative board level engagement of branded generic asthma inhalers in those CCGs that traditionally don’t engage with the industry.
Last year I was really proud to win the award for ‘Digitally Enabled Representative’ at the Pf Awards during a time that was difficult for everyone.
As a Market Access representative, what do you think the initial challenges will be for representatives when Integrated Care Systems (ICSs), are implemented?
The change won’t be the overnight CCG mergers that we’re seeing now – most ICSs will have just one CCG. For example, the three CCGs that were in Leicester have now become one.
The real change will come when ICSs become statutory bodies – meaning they can employ people and hold a budget – which is where the White Paper comes in. Expected to be passed in May, it’s the legal authority for ICSs to change services and how they are structured, and to do so without a mandatory tendering process.
The real challenge for the representative is not identifying those NHS Managers that are making decisions on the Primary and Secondary services your indicated patients are accessing, but one of access.
Outside of Healthcare Professionals and Medicines Management, the service managers are looking for representatives who have access to NHS service information that can demonstrate the impact on activity, costs and outcomes, and I mean service outcomes here, that treat the patient with a client’s product.
In an NHS awash with data, the representative who has access to data tools that turn that raw data into meaningful information about the service in which their product is accessed, is far more likely to be granted access.
The availability of insights (service activity / cost data), to discuss the Primary and Secondary services that patients access is important.
- Primary Service – The service which diagnoses and manages the condition for which your product / service/ device is indicated.
- Secondary Service – Other services that manage and create co-morbidities that patients being treated with your product / service / device might have to access, e.g., Mental Health, Social Care and Community Care.
Armed with valuable insights enables you to add value when discussing:
- the state of the service now
- how the service will look due to the service impact of patients being treated with a client’s product
- how that future service is helping to deliver national NHS Priorities (Integrated Care Plan), locally for the commissioner of that service
What are the needs of the position that are driving the needs of the NHS Manager?
Do you see the combining of previously siloed budgets as a positive thing for pharma clients?
Definitely as a positive from an ICS point of view.
Take a hypothetical disease altering rheumatoid arthritis product:
- It’s the most expensive in-class with comparable clinical data
- The company has unique data that shows that patients taking it have the following Primary and Secondary service impacts:
- Reduction in non-elective admissions
- Reduction in patients seeking a Mental Health referral
- Improved joint function improves mobility, making the patient more independent, leading to a reduction in the need for Social Care support, or the need for a care home
- Rheumatology charities report reduced registrations with them
If the only budget that was counted was Medicines Management, then the price would prevent the product being used because Medicines Management is not performance-managed on the other measured service data, such as Mental Health and Social Care, and is therefore not relevant to Medicines Management.
From an Integrated Care point of view, the product is overwhelmingly favourable as its price is offset by positive impacts across multiple Secondary Service budgets, such as Rheumatology Service Commissioning, Mental Health, Social Care and Voluntary Services.
There’s going to be quite a shake-up of roles. How can representatives ensure that their client brands continue to get in front of the right people?
From experience, every time the NHS reorganises, the number of truly ‘new’ people is small as many NHS managers transition to similar roles in the new organisations, usually with different titles.
The key is to map the patient pathway and the managers that commission the services in which your product is used in the new organisational structure. A by-product of this is that customers that you have built relationships with can end up in roles that are no longer relevant to your area of interest, forcing you to develop new customer relationships.
From an education point of view, how important is it for you – and all Market Access representatives – to recognise connections between services within Integrated Care Providers?
Critical. As part of the ICS plan it will be optimising how a service is delivered over the ICS geography. Providers (mainly Secondary Care hospitals), will be optimising how a service is delivered over the geography of the ICS. This will render the days of working individual hospitals in isolation difficult.
Also, a Provider is now any organisation that provides patient services. Mental Health and Social Care may be Secondary services for your patients, but if you can develop meaningful service impact data that shows how the treatment of a patient with your product can have Secondary service benefits, this will increase your chance of having your product adopted across all the ICS.
Don’t forget that this integrated care across an ICS will be hard for the NHS. Organisations that only worked together in the remotest of senses previously are now working cheek by jowl with each other, and now have to work from a shared budget. This is the hard bit.
An overspend by one organisation means other organisations will have to make equivalent savings. This should be carefully thought about when considering how a product impacts its Primary and Secondary services.
Map the patient pathway and the managers that commission the services in which your product is used in the new organisational structure.
Finally, what’s the main piece of advice that you’d give to other sales representatives who want to ensure they’re continuing to improve outcomes for their client brands?
I think it’s just three things:
- Understand the NHS environment on your territory and the Primary and Secondary services that patients indicated for your product access.
- Talking about the service impacts that the effect of your product on the patient has will ensure access to the mangers of those services.
- Communicate this widely within your company so they can understand and provide you with the right market access tools to maximise the chances of a positive outcome when you access those NHS Service Managers.
Is your company facing challenges when it comes to engaging with the right customers?
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