Sue Thomas, Paul Midgley and Steve How, of Wilmington Healthcare, explain how pharma can work with the NHS to transform services
Most NHS care pathways have remained largely unchanged for many years, with recent updates simply being ‘bolted on’ to existing services and pathways, without any fundamental alteration to the underlying framework.
However, following the publication of the Five Year Forward View in October 2014, NHS vanguards have been a force for change, leading the way in starting to redefine patient pathways and trialling new ways of working in both primary and secondary care.
Their comparatively revolutionary approach is being further expounded by Sustainability and Transformation Partnerships (STPs), which have been tasked with identifying and delivering savings, and increasing efficiency within 44 individual geographical areas.
This place-based approach to care, that is being adopted by the NHS, creates a pressing need for granular-level data on issues such as the burden of specific diseases both regionally and locally, as well as nationally.
In this article, we will explore the current situation regarding the NHS and access to data, its need for commercial assistance in obtaining and analysing that information, and how pharma can capitalise on this need and provide a ‘case for change’ within an STP to a CCG or NHS Trust.
How is the NHS using data?
NHS organisations cannot make significant improvements to their services without a detailed knowledge and understanding of how they are currently performing, and where problems and inefficiencies exist.
Although industries ranging from retail to insurance have been successfully harnessing big data for years to improve products and services, the NHS has struggled to capitalise on complex data.
For example, critical data on admissions, outpatient appointments and A&E attendances at NHS hospitals have been available via Public Health Observatories and other sources for some time, and complemented by data on specific diseases in recent years. However, commissioners have struggled to access it in order to plan and commission new pathways, and have been further hampered by the fact that primary and secondary care data sets have not been linked. Where they are taking advantage of data, it is likely to be in priority disease areas only.
Consequently, many NHS organisations do not know how patients are utilising their services and why. Similarly, they do not know where improvements and cost savings could be made by, for example, treating recurrent infections in patients suffering from diseases such as multiple sclerosis at primary care level to keep them out of hospital. As a result, they cannot benchmark their services against other parts of the health service either.
How can pharma help?
With the NHS struggling to afford to capture, procure and analyse its own data, there is a huge opportunity for pharma to help shape the way that NHS services are delivered by gathering this data themselves, analysing it and sharing the findings with CCGs, NHS Trusts and new emerging organisations.
At Wilmington Healthcare, we draw on a variety of sources from NHS Digital, such as Hospital Episode Statistics (HES), alongside interviews with stakeholders, such as vanguards, CCGs and patients, to gather insight on trends, gaps or inefficiencies in patient care in a variety of priority and nonpriority disease areas.
These insights can be used to highlight the burden of disease; identify variations in patient outcomes and provide evidence for change in therapeutic areas. They can also help the NHS gain a clear understanding of the impact that pathways have on patients’ experiences and outcomes, and highlight areas of best practice and opportunities for improved efficiencies.
Thanks to advanced data mining capabilities, information can be analysed at a granular level to give a local and regional picture, as well as a national one. This also means that the actual causes for hospital admissions can be highlighted and followed over time, rather than simply shown in ‘headline numbers’.
Where there is a clear benefit to health and social care outcomes, such data can be used by pharma to engage peer-to-peer with Trusts/CCGs and inform an initial ‘case for change’ for a particular patient pathway, which can then lead to a detailed business case developed by a multidisciplinary group.
For example, one pharma company has supported development of a disease insight report in partnership with a charity to highlight a cross-sectional analysis of hospital data. This revealed reasons for emergency hospital admissions – which can now be tackled at a national level but the data also highlighted that the majority of non-elective admissions (which were thought to be high) were in actual fact due to an uptake of disease-modifying therapy.
Another pharma company has supported development of an England-wide report to be used by an All Party Parliamentary Group (APPG). These reports have been used effectively to influence service design, health policy and improve patient outcomes.
As new data sources become available following the amalgamation of health and social care within STPs, Wilmington Healthcare will work with pharma and the NHS to follow wider and more complex patient journeys that may, for example, go from a GP to community services to hospital and then social care.
As the NHS undergoes one of the most fundamental organisational changes in its history in a bid to save billions of pounds and improve efficiency, the need for data to identify anomalies, unwarranted variation and trends in patient treatment pathways has never been greater. However, the cost of buying and analysing such data is a major barrier to the NHS.
Consequently, there is a real opportunity for pharma to help shape NHS services by gathering data around relevant disease areas and identifying where it can help to improve patient outcomes and save money. Having access to this kind of data can give pharma the edge by enabling it to approach a cashstrapped NHS with solutions rather than problems. And as the examples in this article show, this can bring clear benefits to all, including patients.