Oli Hudson, content director at Wilmington Healthcare, considers the tumultuous challenges the NHS is facing and how medtech can respond.
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NHS
“This is the worst I’ve ever seen in my career,” said Prof Martin Marshall, head of the Royal College of GPs council.
The Health Service Journal’s editor Alastair McLellan agrees. “This is the worst – except for next year which will be even worse.”
The statistics speak for themselves: 7 million people are now waiting for treatment – up from 6.8 million in July and the highest on record.
The treatment backlog – already considerable before COVID, fiercely challenging since it – is still with us; and with NHS staff resigning in record numbers, leaving understaffed wards and bottlenecks in everything from diagnostics to discharge, it’s hardly likely to improve any time soon.
Furthermore, the NHS faces crisis-level issues in workforce – with staff vacancies at 132,139; and finance – with two in three ICSs are reporting deficits against their year-to-date financial plans. Because of inflation, any extra funding it does manage to squeeze out of the government will be swallowed up before it has a chance to improve anything.
This is without even mentioning the services’ struggles to adopt the integration agenda – which in many other years would be the number one issue of focus – or the need to fulfil net zero obligations. And with current energy prices coupled with multi-year running costs, sustainability is not just a matter of carbon footprint reduction, but an existential driver.
Medtech now finds in the NHS a truly desperate customer. So, what can it do to help? How should it amend its engagement strategy, and what kind of value proposition should it be offering?
There is by now a well-understood series of value hooks that medtech can apply to product – anything that saves staff time, with the current workforce crisis, has an advantage. Anything that can produce cash-releasing savings will too. Products that reduce theatre time, ward time, length of stay or improve speed of recovery in the community are all important of course too, with the backlog as it is.
But another way of approaching this is to see how the NHS itself is attempting to haul itself through and aligning your business proposition directly with that. Here are three points of consideration for the industry going forward.
Collaboration
When they were originally announced as part of the 2019 Long-Term Plan, provider collaboratives were primarily seen as a way to promote integration and futureproof care delivery by making the most of the local staff and resources available to the local population.
We are already beginning to see how the NHS is reorganising itself on local lines – legally it has been divided into 42 systems, with provider collaboratives bonding trusts together within each. COVID-19 has made everyday collaboration mainstream, not to mention expedient. The subsequent upheaval has only made this more so.
The numbers here are important. There are approximately 115 provider collaboratives in England, at various stages of development from emerging to more mature, but 26 of them are acute collaboratives – that means secondary care trusts, coming together to share staff, resources and, not least, procurement functions.
And 28 of these are mixed provider collaboratives, meaning such trusts are collaborating with primary, community and care trusts to the same degree. That means there are some 54 core medtech accounts out there working in this way.
At a recent NHS SCIE webinar, discussion covered the purpose of these provider collaboratives. Aside from elective care backlog and COVID-19 recovery, those collaboratives surveyed said that their primary purposes were to improve clinical pathways, especially cancer and urgent care – and joining up procurement functions. All of this will be done in the name of service survival.
Collaboration may be one way out of the crisis – and medtech should take heed that these new stakeholders will be an important part of the landscape and a model going forward. The value proposition should be aimed at such collaboratives to show how devices and the pathways they enable can deliver efficiencies, better outcomes and patient benefits across their wider footprint.
Sustainability
We know that the next round of category towers to take over procurement next year will “embed sustainability into its DNA” – and any supplier should take heed that this will be a key component of successful tenders and entry to framework agreements.
The NHS has come to the realisation that net zero has not just environmental benefits, but financial and social ones too.
Thus, net zero value propositions are no longer nice-to-have but imperative. Since April all NHS procurements have included a minimum 10% net zero and social value weighting.
From April 2023, for all contracts above £5 million, the NHS will require suppliers to publish a carbon reduction plan for their UK carbon emissions as a minimum, and from April 2024, it will extend the requirement for a carbon reduction plan to cover all procurements.
NHS Supply Chain states: “The landscape for Procurement and Supply Chain has changed, creating a need for a broader range of priorities in our decision making. This includes total cost, environmental impact, supply chain resilience, social value, quality, flexibility, and availability. This broader focus requires a different approach in how we develop, and add new, capabilities but also how we ask our suppliers to operate.”
Localism
It’s difficult to make firm predictions in today’s febrile political climate, but one trend that seems to be supported by NHSE and system leaders (plus the current chancellor – who at time of writing – is Jeremy Hunt) is the need for fewer top-down targets and more locally driven initiatives, which will mean that different areas have different priorities, different delivery mechanisms, and different overall aims.
It's essential for medtech to tap into this localism and increase local account knowledge as to what each system (or collaborative) is going for. Each will have their own population health drivers, their own funding constraints that they will address with differing contractual and incentive arrangements, and their own challenges to address health inequalities in their area - which for example could focus on older populations, relevant ethnicities or deprived patients.
And each of these groups has their own needs, so for example companies dealing with orthopaedics or ophthalmology would be wise to consider how systems’ plans for older patients cover these therapy areas and are revising pathways.
By adopting these three areas into the value proposition medtech can go a long way to helping address the NHS’s needs on its own terms.
Wilmington Healthcare holds extensive data on provider collaboratives and other organisations in the new NHS landscape. Our consultancy team is available to help your company refine its value proposition in the light of the needs of the NHS. Please feel free to contact us at info@wilmingtonhealthcare.com or visit our consultancy webpage.
