The increasing demands placed on the UK healthcare system, along with a challenging financial environment, has led the Department of Health to explore new ways to ensure the NHS continues to deliver a world class service to patients. A part of this has been an emphasis placed on joint working initiatives between the NHS and the pharmaceutical industry.
Both the Department of Health and the ABPI have developed guidance outlining joint working best practice but at Opus we wanted to look beyond that. We wanted to know from those people in the NHS who are actively involved in these projects what constitutes a good or a bad experience, and the reasons for this.
We conducted over 10 hours of in-depth interviews with a range of NHS stakeholders including medical directors, heads of pharmacy, consultants and NHS managers. From this we were able to gain a better understanding of how to effectively initiate and deliver joint working projects in a secondary care setting.
Closer working
The first thing we wanted to know was whether people within the NHS see a need to get involved in joint working projects and work more closely with the pharmaceutical industry. The overwhelming answer was “yes”, although the extent to which people were prepared to engage in them differed greatly.
The reason for this willingness was predominantly down to finance. The “financial situation is dire” remarked one interviewee, with another describing themselves as a “reluctant convert” due to the economic environment.
The “changing needs and technology” within medicines was also cited as a reason for a closer working relationship between the NHS and the pharmaceutical industry.
A changing relationship
Once we’d established people’s willingness to engage in joint working projects, we then looked at how to foster an environment more conducive to creating such opportunities.
On a macro level interviewees highlighted a need to change pharma’s relationship with the NHS if they were to create the right environment for joint working. As one person we interviewed put it “pharma needs to embrace the idea of working in partnership with the NHS”. This is neither a quick, nor simple thing to do, but others pointed out that the reality is that the NHS is looking to pharma to move away from the old “buyer/seller relationship”.
Interestingly the medical devices industry was cited in interviews as an example of a good working relationship. Understandably the need for aftersales support is much greater when you have invested in a significant piece of equipment. That said, the relationships they create and the value they deliver by supporting the customer beyond simply the transaction itself was clearly an important part of their business model.
Other respondents pointed out that the NHS is moving away from a “transactional business model” and the pharmaceutical industry needs to do the same. Most businesses, whatever sector they are in, are now looking to create an ongoing dialogue with their customers but not everyone in the pharma industry can claim to be doing the same. As one person we spoke to said, what was important was to have “a company that is out to support me as a clinician”.
Be transparent
The need to be open from the outset as to why you are engaging in a joint working initiative and what you seek to gain from it is vital to setting up and delivering a successful project.
At the end of a joint working event we were supporting, a medical director, who had been involved in the project from the start, stood up to make an unplanned speech. She thanked the pharmaceutical company involved and said she had been reluctant to participate in the project at the outset as she feared there may have been a “hidden agenda”. This wasn’t based on anything that had happened when the project was set up, but simply her own perception of how the pharmaceutical industry has previously done business. She was pleased to see that this wasn’t the case and her experience had been a very positive one.
This is a common fear. The nature of the commercial relationship that exists between the NHS and the pharmaceutical industry is a complicated one, with a chequered history. It is therefore understandable that someone within the NHS entering into a joint working project would be nervous that an ulterior motive exists.
The reality is that if a pharma company is engaging in a joint working project with the NHS then it is likely to have a vested interest in the outcome of that project. It is therefore important to be honest about any interest from the outset. Be clear as to why you are entering into the arrangement and what you/your company are looking to achieve.
From the interviews we conducted, it is clear that many people within the NHS are aware that pharmaceutical companies don’t enter into such activities without a specific objective in mind. That may be because they are actively involved in a particular disease area or they simply want to improve their relationship with the person involved, for example.
What is important is that you are transparent as to why you are open to providing support. The NHS person can then decide whether to go ahead with the project or not. In our experience being open from the outset helps to put people at ease, as they understand why you are offering your support.
Know yourself
It is impossible to offer support if you don’t know what it is you can offer or what support is needed. As one interviewee put it, you need to be able to “understand your own offering and understand the agenda of the customer and be able to make them match”.
People are aware that pharma has a “different set of skills” which can be of benefit to the NHS. Understanding what those skills are, where they can be of benefit and then making your customer aware of them, seems an obvious part of any joint working process but it was clear from the people we spoke to that these things don’t always happen.
Environments for success
We have spoken to a number of people within the pharma industry who are sceptical about the benefits of joint working. On further investigation this largely seems to stem from involvement in projects that have ground to a halt for one reason or another. Lots of positive noises about great collaboration turning to silence before the project reaches anywhere near completion.
Similar frustrations were voiced from the NHS side as well. Interviewees complained about people within the pharma industry simply not doing what they said they would, acting unprofessionally or under-delivering. As one person put it, “It’s disappointing when the promise is greater than what is delivered”.
It is important that you create the right template for success in the first place. Be clear about intended outcomes, understand the time and resource that your NHS counterpart can offer, commit to a plan of working and stick to it. Finally, build in plenty of evaluation so that success can be demonstrated internally on both sides.
Must try harder
There is clearly a shift in attitude within the NHS towards more joint working, albeit a move largely driven by the current financial climate. Although there is some great work being undertaken by pharma companies to deliver joint working projects, more could be done to create the right environment for these opportunities to arise, to ensure such projects are a worthwhile experience for all involved and ultimately make a difference to the lives of patients.
Andrew Knill is the director of specialist health communications consultancy Opus. You can receive a free copy of its joint working report ‘Working in Partnership with the NHS’ by emailing
andrew.knill@opuscomms.com
