Do you work beyond the molecule?

After the current lockdown period, as we return to work, what is your approach going to be to support the NHS agenda of unmanagable workload, linked to a reduced workforce and requiring an innovative approach? How do you plan to move beyond your molecule, device or technology to deliver something remarkable within the disease or therapeutic area you work in?

As we move post Covid-19, we anticipate that many of the changes made to the way patients access services within the NHS in respect of online, telephone and video consultations to stay in place; the rapid acceptance by patients of this change being one of the few positives to take from the response to the pandemic. We also anticipate the new ways of integrated working between General Practice, Primary Care Networks, Community Services and Hospitals, who all link into Social Care and the wider local Integrated Care Systems, surviving; another positive to take from the current situation.

This is going to require your approach to align meaning it’s likely to need you to offer a new solution that meets these new ways of working. That solution may well see you working beyond your molecule, device or appliance and instead focusing within a disease area to deliver innovative approaches that improve quality, reduce variety and deliver remarkable outcomes within the disease, rather than just the market sector that interests you.

Keep in mind our message throughout these articles that you need to positively impact both the workforce and the workload, and this should drive you way beyond the molecule in your thinking.

Within our work, our focus is always on getting the right patient in the right place at the right time, with the right clinical staff and with the right resources available to deliver the care required. This forces us to think about whole systems and complete end to end pathways rather than specific market segments.

This approach also ensures we focus on being value-based, with a focus on outcomes over inputs. It ensures we are not just cost-driven, looking only at the acquisition cost of the drug, device or appliance, but rather we are focused on the complete pathway acquisition costs, which are usually driven by the people costs. It is often the case that costs are driven by contacts: the more times a patient is seen the higher the pathway costs and conversely the fewer times they are seen the lower the pathway costs.

In taking that approach we often find ourselves working with completely different ways to that which has gone before, primarily because we focus on positively impacting the workload and workforce.

By way of example, we were recently involved in a redesign where 80% of all hospital admissions were driven by code Z911 – non-compliance with medication. By using inexpensive oral medication, it fuelled significant numbers of non-elective admissions to secondary care, along with an unmanageable workload. The redesign focused on the non-compliance resulting in the new pathway moving to use injectable medicines at 10 times the cost: over ￡200 a month. We therefore put a firm measurement in place on a monthly basis to review the reduced outpatient attendance, reduced admissions, reduced bed days and reduced contact with the system, the savings from that funded the medicine cost. Had we focused simply on the price of the drug the project would never have progressed. The results are remarkable.

There are many more examples of this kind of approach in action within our work; in every instance we worked beyond the molecule to deliver something remarkable within the disease area. It is therefore possible for any company to take the same approach.

Scott McKenzie is an independent management consultant supporting the Pharma, Med Tech and Device Companies better engage and access the NHS. Scott works within the NHS with GP Practices, GP Federations, Primary Care Networks of 30k-50k to structure them correctly to then deliver high quality patient outcomes with financially viable solutions. For more information on how we can support you please contact Frances on 0845 388 0302 or email [email protected]