As we move into an uncertain 2022, Wilmington Healthcare’s Oli Hudson picks out three underlying themes that are likely to influence the way industry works with the NHS in the next 12 months.
Industry has shown itself to be extraordinarily resilient and adaptable over another gruelling 12 months – and it will surely need to be again in 2022 as a number of factors, not least the emergence of new COVID variants, combine to make the commercial and operational environment within healthcare as challenging as it has ever been.
Of course, if the last two years have shown anything, it’s that making bold predictions about the direction of health policy can be an extremely perilous business, so here are a few observations about the key trends affecting the NHS landscape now – and where they might take us in 2022.
- The reform story will continue beyond April 2022
Firstly, the political context is likely to throw up further surprises as the Health Bill makes its way through Parliament. We also have a new Health Secretary looking to make his mark, pledging a year of ‘reform and recovery’ for health and care. Both suggest that further substantial policy changes may be on the cards.
While backbench unrest has not yet materially affected the legislation, we’ve already seen significant Commons rebellions on amendments around workforce planning and social care, and we can expect these arguments to continue as the bill is scrutinised by the House of Lords ahead of Royal Assent in the spring. At this point – all being well – Integrated Care Systems (ICSs) will become statutory entities and can continue getting on with the important job of planning and delivering effective health services for their populations.
Except this may not be the end of the reform story. Firstly, because the recent NHS operational planning guidance indicates that the timescale for any new statutory arrangements to take effect will now slip three months (partly in recognition of pandemic pressures), with a new target date of 1 July 2022.
And secondly, because of the Health Secretary’s reported interest in a more radical approach to integrating health and care. An Integration White Paper is expected at some point in 2022 and various media briefings have intimated that this may include measures that would involve ICSs and local authorities pooling their budgets as a way of driving through greater integration in practice.
For pharma, there’s already been much to ponder as the structural reforms reshape its customer landscape and establish ICSs as the dominant unit of business within the NHS. A further package of reforms, predicated on sharing budgets between ICSs and LAs, would add even greater complexity in how the power dynamics and decision-making will work within the NHS.
Either way, considerable variation will continue to exist across the country in terms of how things work in practice. It may be a slight exaggeration to say pharma will be dealing with 42 different varieties of NHS this year, but local intelligence and context will be key to making sense of a broad spectrum of working practices across the NHS landscape.
- A provider sector on a knife-edge
A second critical environmental factor is the parlous state of NHS provider organisations and what this means for industry’s opportunity to work collaboratively with key customer accounts.
Few commercial organisations can fail to grasp the enormity of what its NHS customers are faced with at present. Even so, the recent State of the Provider Sector report by NHS Providers is particularly stark in the way it lays bare the high levels of unease within the trust leadership community about what the future holds.
The report finds that 84% of trust leaders are worried about their hospitals having the capacity meet demand for services. The vast majority (87%) also say they’re extremely concerned about the impact of seasonal pressures over winter while nearly every trust leader (94%) has said they are concerned about the current level of burnout across their workforce.
Omicron, while seemingly not causing the high levels of severe illness that were first feared, has nonetheless compounded pre-existing operational and staffing pressures on health services, with a number of NHS Trusts declaring ‘critical incidents’ over Christmas and into the new year due to staff shortages. An extremely challenging few months lie ahead for the NHS.
It all means that 2022 will see pharmaceutical companies seeking to promote their offer to a customer base that’s physically exhausted, wracked by ongoing operational pressures and wholly dedicated to the task of maintaining core services and making in-roads into a ballooning elective waiting list that is now fast approaching six million.
It’s therefore never been more important for industry to develop an intelligent and informed approach to engaging their customers. Time will be an ever more precious commodity for healthcare professionals in 2022, and pharma will need to make sure, firstly, that every contact counts in terms of aligning its offer to their needs and preferences, and secondly, that it engages in a way that recognises the human realities of what frontline clinicians are having to contend with.
- A golden period for innovation and invention?
But here’s the good news. One of the positive effects of all the upheaval within the NHS has been an increasing appetite for doing things differently – the 2022/23 NHS planning guidance reinforces the idea that innovative ways of working will continue to be vital in future years.
The recent HSJ Awards celebrate the fact that despite the considerable headwinds against it, the NHS around the country is still doing extraordinary things, which together offer a tantalising glimpse of how the reformed structure of the NHS could yet improve the way it delivers for its patients and populations.
For example, the provider collaborative of the year award, which was won by an ‘ambassador’ programme established in the North West to improve diagnosis of atrial fibrillation, shows the capacity for collective action across multiple organisations and agencies to deliver better outcomes across a population.
Similarly, one of the HSJ Value award-winners, the Form an Orderly (Digital) Queue! initiative from Great Ormond Street reflects the appetite within the NHS to embed digital solutions as a first line response to critical operational challenges – in this case, enriching the Trust’s electronic patient record (EPR) system capabilities to triage and manage patients awaiting care more effectively.
Meanwhile, the scale of integrated working by organisations within the Cambridgeshire and Peterborough footprint underlines how a shared, system-wide approach to designing processes and pathways could improve the efficiency and effectiveness of services for patients with respiratory and cardiovascular conditions and diabetes.
These awards reflect the tenacity and dedication of health professionals and their many partners in triumphing over the adversities faced by the NHS frontline. They show that even in the face of (and sometimes because of) these stark operational challenges, the NHS is open to reimagining the way it does things.
For all its tribulations, 2022 will continue to be a time for bold ideas and big partnerships across the health landscape, and the ingenuity, knowledge and power of the pharmaceutical sector will play an important part in the story to come.