Innovation and R&D are key to improving patient outcomes and they must be placed at the core of NHS architecture, but the Service currently still views the pharmaceutical industry as "selling products and adding to costs," according to Sir Ian Carruthers, head of the government's Innnovation Review Team.

However, speaking at a recent meeting in Parliament, Sir Ian also told pharmaceutical companies that they need to think more in terms of working in partnership with the NHS "rather than sending in the sales force." He asked industry delegates: "when will you seize the opportunity? We need your disruptive contribution to help NHS reform, but too few companies are coming forward."

Despite the huge challenges being faced by the NHS, new medicines are still regarded too often within the Service as an expensive problem rather than part of the solution.  Regional committees make decisions not for the long-term benefits to patients but for short-term budget savings, speakers told the meeting, which was held to mark the 10th anniversary of the European Medicines Group (EMG).

The pharmaceutical industry is being asked to demonstrate the value of its products, but to a system that doesn't fully understand or appreciate it, said Matthew Speers, managing director for UK and Ireland at UCB Pharma. "What we in the industry want is for our medicines to be considered as part of the patient pathway, and not in a separate silo," said Mr Speers, who chairs the EMG, which was set up to enable its members, 16 research-based drugmakers headquartered in continental Europe, to provide their perspective on UK health policy.  

The differences in medicines use across general practice nationwide is stark, Professor Steve Field, chairman of the NHS Future Forum, told delegates. Many medicines are not being prescribed properly and adherence to National Institute for Health and Clinical Excellence (NICE) guidance is varied, but the importance of national-level approval will mean NICE having a big impact over the next five years, he said.

We are on the cusp of radical change in primary care, and we will need the flexibility to experiment and allow failure, innovate and take ideas from other countries. Disruptive innovations come in under the radar, and change will be driven by a mix of technology and need, said Prof Field.

Overcoming the UK's low and slow uptake of innovative treatments will require a major cultural change within the NHS  - "and we in the industry will have to be patient," said Mr Speers. Conservative MP Stephen Dorrell, who chairs the House of Commons Health Select Committee, pointed out that the NHS often believes that it can embrace disruptive innovation without changing itself, but Prof Field stated that putting patients at the centre of the system will mean increased roles for GPs and nurses, and also for pharmacists - "they are better at managing medicines than we are, and it is about how drugs are being taken," he said. 

And as for "pointy-headed specialists - we'll need less of them," said Prof Field. 

Medicines optimisation is the way forward but this cannot mean denying patients in one Primary Care Trust (PCT) a treatment that is available to those in the next one, said Sir Ian, who was speaking shortly before the Innovation Review was published. "We have denied treatments on the grounds of affordability too often," he added.