Rumours are growing that the QIPP brand, as it is known, is to be discontinued because NHS organisations have struggled to understand the essence of change based on quality, innovation, productivity and prevention, PharmaTimes Magazine has learnt.
Driven by the ‘Nicholson Challenge’ – where the NHS must make £20 billion worth of efficiency savings by 2015 – the quality, innovation, productivity and prevention agenda was introduced in late 2009 to make the NHS fit for purpose in the 21 Century.
However, QIPP has come under fire for being hijacked as a cost-cutting machine, largely targeting the drugs bill for short-term savings rather than looking at long-term healthcare savings and efficiency through medicines optimisation. The Department of Health has continually denied these claims despite evidence to the contrary, including reports that primary care trusts are blacklisting certain drugs to cut costs.
PharmaTimes Magazine has been told work is now in progress to discontinue the QIPP brand, where the concept of medicines management will be scrapped and replaced with a focus on whole system change and a shake-up of patient care pathways. The spirit of QIPP is expected to remain, but it will be incorporated into “transformation” under Jim Easton, with “medicines optimisation” under Keith Ridge. These will operate alongside the 26 Innovation Health and Wealth Task and Finish Groups, which have been implemented as one of the recommendations in the Innovation, Health and Wealth report.
When contacted by PharmaTimes Magazine, the Department of Health denied the claims, but while information has been patchy, the change in Jim Easton’s job title from national director of improvement and efficiency at the DH to national director of transformation, NHS Commissioning Board is suggestive of the shake-up, PharmaTimes Magazine has been told by sources.
Indeed, Easton recently announced the formation of an improvement board, under the NHS Commissioning Board, as part of a wider strategy to maximise efficiency in the NHS, and in a recent interview with the Health Service Journal he admitted QIPP was being re-labelled as funding cuts by some NHS organisations.
“There are people who report [locally] that QIPP is being increasingly seen as just a label applied to what would once have been described as cost improvement plans, and that the focus on deeper change and focus on quality is less marked,” he told the HSJ.
“We need to understand why that is and go forward. It is not endemic or dominant, but we’re not going to ignore it.” He added there was a fear that deeper service redesign would not occur.
PharmaTimes Magazine was unable to get hold of Jim Easton for comment, but in an interview with the Magazine, Michael Sobanja, policy dIrector at the NHS Alliance, said changing the brand alone would not be enough to change behaviour and “win the hearts and minds of those at the sharp end of the innovation”.
“QIPP, I believe, was launched with the best of intentions to harness innovation and improvement in a harsh financial environment. It suffered from being perceived as being a cost-cutting programme as opposed to responding to the challenge of doing things differently, improving outcomes, patient experience and increasing cost effectiveness. Changing the brand alone won’t change this; it needs a more developmental, bottom-up approach and a commitment of support, not dictation from the centre.”
Sobanja said “the shift to medicines optimisation was too little too late” and that medicines needed to be managed as an investment not a cost.
Change to the system is expected over the next six to eight months, PharmaTimes Magazine believes.