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All things Pharma

The new NHS stakeholder map

Paul Midgley, of Wilmington Healthcare, looks at the new NHS stakeholder map and explores the latest changes in NHS structure, which were outlined in a recent webinar run by the company’s Digital Learning Academy

Amid the COVID-19 pandemic, NHS service transformation has been continuing apace in line with the NHS Long Term Plan’s vision of integrated care, and this is radically changing pharma’s customer base.

In this article, we explore the latest developments which are explained in more detail in a webinar, entitled: The new NHS stakeholder map; who are the customers now? The event was run by Wilmington Healthcare’s Digital Learning Academy – the leading online learning platform for the life sciences industry.

Statutory bodies

There is speculation that Clinical Commissioning Groups (CCGs) will disappear in the next set of reforms and that, by April 2021, they will have been entirely replaced by ICSs. If this happens, ICSs will become the statutory bodies responsible for commissioning, working alongside wider system partners such as social care and housing.

In the 18 areas where ICSs are up and running, and in other places where they operate in shadow form, many CCG staff are already effectively working in ICSs. Key contacts for pharma in ICSs and CCGs include programme managers for specific disease areas and clinical leads, in addition to staff working in medicines management and medicines optimisation. Locality managers and Primary Care Network development managers in ICSs are also important.

Drug budgets are held by the finance director in the ICS. Pharma has a role to play in facilitating engagement between the finance director, medicines management, transformation teams and clinical leads, when trying to sell costly, but innovative treatments, that could save money by delivering whole system benefits.

Integrated care providers/partnerships (ICPs)

There are two definitions of ICPs. Firstly, there are the Integrated Care Providers (ICPs) working to an NHS England ICP contract which enable commissioners to award a single contract to a provider who is responsible for the integrated provision of general practice, as well as wider NHS services and potentially local authority ones too. These contracts already exist in some areas; but they will not be fully rolled out until ICSs become statutory bodies and all relevant organisations can legally share one budget.

Elsewhere, in places like Nottinghamshire, ICPs have been established under the name of Integrated Care Partnerships and these are seeing provider partners, including primary care, secondary care, social care and the private sector, working together. This type of ICP uses the term ‘partnership’ rather than ‘provider’ because it is not currently a single legal entity working to a single, shared contract.

The ICP style of working is likely to result in more joined up pathways for people with chronic conditions, particularly those highlighted in the NHS Long Term Plan. There are opportunities for pharma to help here by developing propositions informed by best practice methodologies.

Primary Care Networks (PCNs)

1259 Primary Care Networks (PCNs) were introduced last year and serve, in most cases, 30,000-50,000 people each. They enable groups of GP practices to collaborate locally with community services, social care and other health and care service providers. PCNs are also partners in every ICP.

PCNs are assuming three new responsibilities this year. These are enhanced health in care homes, conducting medicines optimisation and medication reviews and ensuring rapid diagnosis of cancer.

Key contacts for pharma in PCNs include the clinical director and lead manager, as well as the PCN leads from individual GP practices. The GP Practice Managers’ Forums are also key influencers in every PCN.

Academic Health Science Networks (AHSNs)

AHSNs are working on a joint campaign with the NHS Confederation and the Health Foundation to help with NHS Reset, which aims to drive improvements post-pandemic. This is seeing AHSNs helping CCGs and ICSs evaluate what has been working well and where improvements could be made. They have also been helping to ensure the uptake of digital services.

Prescribing bodies

Area prescribing committees are still in operation. Currently they are CCG committees, but they will likely evolve into ICS committees and be one per footprint. PCNs may also have their own mini pathways for the delivery of certain services but their pharmacists will still work to the local formulary and the guidelines of area prescribing committees.


The NHS stakeholder map is in a state of flux as the move towards integrated care continues. Once it is complete, CCGs are likely to disappear completely and ICSs, ICPs and PCNs will assume a more prominent role. Pharma needs to map these changes on a local and national level, and consider how a therapy, service or pathway will be viewed, not only by traditional NHS contacts, but the wider organisations that are getting involved, and consider the impact on commercial strategies and brand plans.

Wilmington Healthcare’s Digital Learning Academy keeps pharma abreast of all the latest changes in NHS structure with regularly updated content and online training courses. It also provides information and training on ABPI and compliance, KAM and specific therapy areas.

For details on the Digital Learning Academy, visit http://ow.ly/hWcE30r4NJO

To register to listen to the webinar on-demand, visit http://ow.ly/vrRr30r4NKC

Paul Midgley is Director of NHS Insight at Wilmington Healthcare. For information on Wilmington Healthcare, visit www.wilmingtonhealthcare.com

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