Andrew Harrison, Hanover Communications - Fight NHS cuts in pharma

The industry needs to help the NHS avoid cutting branded medicines and products.

You have heard it a hundred times. The NHS has to save £20bn. And you know the NHS must change - more community-based services, fewer hospital admissions, shorter hospital stays and the rest.

But what if the NHS doesn't change? Simply put, the cost-cutting focus on suppliers such as pharma and medical technology will intensify. And how much deeper can you and your brands dig to fund the NHS? Not a lot, I suspect.

The challenge for industry and communications is to help the NHS make that change. To minimise the impact of crude cost-cutting, industry needs to redouble its efforts to help transform the NHS locally, and to align itself and its products more clearly with the NHS's goals. Throughout this, strong and targeted market access communications from national to local level is essential to entrench brands and products as solutions in the change agenda, not burdensome costs on top of it.

Effective change needs leadership. At the time of writing (the morning after the election) the prospect of decisive political leadership looked slim. Political uncertainty will not inspire paternalistic NHS managers to redesign local services, but even if a workable coalition has emerged, a poll of parliamentary candidates showed over 75 per cent made pledges to oppose NHS service changes.

Any coalition or minority government will be more beholden to backbenchers, meaning MPs can hamstring efforts for local reform and reduce the political 'cover' NHS managers may normally receive from the Department of Health. Add to this the Conservative pledge to oppose 'forced' local changes, and the Liberal Democrat pledges to integrate PCTs with local councils to form elected Local Health Boards. These plans could leave the NHS again taking its eye off the ball of creating better services.

All this makes local service change more difficult, and raises the likelihood that the NHS will look for easier savings elsewhere. That is where the industry comes in. Worryingly, in the same survey of parliamentary candidates, 70 per cent chose a ban on all branded medicines where generics are available as their first choice of method to find NHS savings. There are plenty of other areas ripe for savings - the multi-billion-pound NHS pension scheme for example - but the election result reduces the ability and appetite to tackle contentious issues.

The NHS is, of course, already using and developing mechanisms to find savings from industry budgets at a local and national level. And the slowdown in NHS funding has not even started yet. Many commentators say we are just in the foothills of the savings agenda.

If industry wants brands and products to be saved from the worst of the savings agenda, it must do it itself. The NHS is slow and reluctant to adopt new practices, but complaining will not help. Industry must work harder to help the NHS make the right changes.

There are many good examples of industry/NHS partnerships delivering service redesign but these are too often on a small scale. Industry must increase its efforts to identify positive connections between products and the NHS's goals (not always the same as clinical and patient goals, sadly) and seek ways to co-operate and even jointly deliver services. Many companies are doing this. Partnerships and outsourcing are common in medtech.

Market access-based communications is central to spread ideas and uptake locally; to build understanding of good practice and develop systemic approaches with national policy, NHS and political leaders; and to continue growth of third party support. The NHS is diverse and driven by different but common forces. Companies are changing to develop integrated approaches. Your agency should too.


- Who is the most effective third-party advocate you have worked with?

Michael Livingston of cholesterol charity HEART UK. He is a respected and passionate advocate of patient and clinical perspectives, now taking his successful UK approach internationally.

- What did you learn from the swine flu episode?

A sad reminder of reputation issues. After such a brilliant case study of industry responding to patient need through rapid vaccine development, the media lapped up conspiracy stories of the industry 'manipulating' the World Health Organization.

- Andrew Harrison is a director at Hanover Communications.

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