The UK pharmaceutical market is low in price and slow in uptake, but “I would gladly trade price for uptake” to get to critical mass, says ABPI chief executive Stephen Whitehead.
We need to short-cut the understanding of what works and bring it more quickly into NHS organisations, added Mike Farrar, chief executive of the NHS Confederation, speaking with Mr Whitehead in London earlier this month at a first-of-a-kind meeting on innovation in the NHS, which was organised by the Confederation, the Association of the British Pharmaceutical Industry (ABPI) and the Association of British Healthcare Industries (ABHI).
The NHS is good at establishing proof of concept for innovations, but too often it fails to reach critical mass, and there is still a feeling that the real barrier to adopting innovations is getting the people on the ground to want to do it, said Mr Farrar.
This is not about incentives, it is about wanting to work to shorten the gap from proof of concept to critical mass, “clear away the white noise and bring proof-of-concept to the people,” said Mr Farrar. Innovation cannot be imposed on the NHS, but when the Service “owns” something, it really makes a difference, he added.
It is also about trying to short-cut the costs that industry incurs to sell into the NHS, he said. The pharmaceutical industry, which “does what it does for the good of people”, is a “kindred spirit” with the NHS, and they need to trust each other. “The only way you get trust is by giving trust,” he told the meeting.
Graham Reid, deputy branch head innovation at the Department of Health, reminded delegates that a central plank of NHS chief executive Sir David Nicholson’s recent review of innovation in the NHS is that, from April 2013, compliance with the delivery of high-impact innovations will become a pre-qualification for payments under the Commissioning for Quality and Innovation (CQUIN) framework. CQUIN enables commissioners in England to reward excellence by linking a proportion of healthcare providers’ income to the achievement of local quality improvement goals.
The innovation report is the outcome of a review process led by Sir Ian Carruthers, which included an open Call for Evidence. This received more than 300 submissions, and these confirmed to the review that the NHS is risk-averse, that barriers to innovation are persistent and that a architecture is need to support the uptake of innovation.
But there is no “silver bullet” solution – a number of approaches will be required and the true measures of their success will be the relationships which are formed and the partnerships created, said Mr Reid.
A strategic approach is necessary for getting innovations adopted faster throughout the NHS and moving them systematically into practice, noted Sally Chisholm, chief executive of the NHS Technology Adoption Centre (NTAC). For sustainability, the approach cannot be random – it must be systematic and sustained, she said. Health care professionals need to understand how a technology will fit into their area of the NHS – and manufacturers have to make time to work out if the system actually needs it – and its effects must be measurable. We need to understand what we are trying to change, and the technology’s cost-effectiveness and clinical outcomes, and it must be backed with comprehensive data to support its use.
A communication plans is also essential, to ensure that everyone understand the effects which implementation of the technology will have for them, she added.
The meeting was the first of a planned series of events, to include case studies showing best practice. Those presented at the first event were selected because they had all delivered demonstrable and replicable benefits under the Quality, Innovation, Productivity and Prevention (QIPP) agenda. Peter Ellingworth, chief executive of the ABHI, pointed out that many of the technologies showcased at the meeting would not be considered innovations because they are not brand-new; however, they are proven, he said.
