Integrated care systems: What are the implications for the life-sciences industry?

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Many of our life-science clients are asking about engagement with local health-system leaders. Particularly, where to focus, when to engage and how to partner. Some have instructed their field teams to go and have a dialogue with senior NHS leaders, although the benefits to the NHS are often unclear. Other clients are watching this evolution and trying to understand the impact and implications to their business.

Let’s see if we can start to help with answers to some of these questions.

What will the impact of integrated care systems be on the industry?

The latest meeting papers for the NHS England and NHS Improvement Board Meeting in Common (24 May 2018) describe the next steps on aligning the work of NHS England and NHS Improvement and the importance of “moving from fragmentation to coherence”. The paper also recognises the restrictions of the 2012 Health and Social Care Act but states that this should not ‘stand in the way of enhanced joint working’.

This is a significant step by the leadership of the NHS in England and demonstrates a commitment to a joint and common purpose at a national level. With it comes renewed emphasis on developing integrated care systems (ICS) at a regional and local level.

Local or place-based ICS involve primary, secondary and community care working together with a commitment to deliver better services and balance the system. With pooled and capitated budgets, integrated organisations will be driven to contain cost and manage demand.

ICS will want to redesign local services and agree outcomes in response to the financial challenge being faced. The first step is to assess system-wide pathways of care – the opportunity for prevention and early intervention and the available treatment options – in order to standardise the local pathway and realise the desired patient and system-wide outcomes.

The opportunity for the industry is in ensuring its products demonstrate real value to local systems and can be targeted within customised pathways to address local needs and priorities.

What to say?

In this context, ICS leaders will be interested in a strategic conversation with the industry focused on how to improve local disease management.

Life-science companies should be aware that the NHS is advanced in its identification of system and pathway enablers e.g. workforce, digital, patient involvement in decision-making, patient safety, service quality etc. In this setting a product-specific approach will not be welcome and may damage the relationship with the industry.

For many companies a disease management approach needs thinking through with careful consideration given to working with other suppliers to present a joined up solution across a care pathway.

However, there are some companies that are further ahead in their understanding of the care pathway and how it can be optimised using a range of interventions and treatments. For them the challenge is to get in front of the right people and a need to think carefully about what it will take to develop a trusted partnership with the NHS.

Where to focus?

Given imperfect national policy and the absence of legislative change, ICS are driven by local leaders and are evolving inconsistently. Therefore, the organisational form for each ICS will look different. Ranging from loose alliances, to partnerships that retain individual autonomy but agree to collaborate, to a completely integrated system.

The extent to which the ICS takes responsibility for specialised services will also vary depending on factors like the size of the population footprint, the availability of a major trauma centre and their appetite for risk.

Identifying the NHS change-drivers, analysing the local priorities and commercial opportunity and deciding which ICS to target are all key to a company’s decision on where to engage.

When to engage?

Linked to decisions about where to focus is the issue of the timing of the approach. In some instances, the local NHS is already open for conversations like the ones described. In other areas, companies need to adopt a ‘watchful waiting’ approach to monitor the pace of change and have the ability to respond rapidly when an opportunity arises.

In conclusion, the NHS faces substantial challenges and recognises that it won’t be able to make the journey to improved patient and service outcomes on its own. In response to this clear customer need, industry leaders will start to take the initiative by identifying opportunities to partner to deliver solutions that are of interest to the NHS. They will recognise the importance of delivering value to the local ICS and may need to look beyond their organisations to provide innovative solutions.

If you want to understand the impact of ICS on your company strategy and objectives, get in touch on info@visions4health.com