The topic was more than timely. Only hours prior to the event, the government published its eagerly anticipated Integration white paper, seeking to clarify exactly how integrated care will improve the patient experience and bring better value to the taxpayer. The white paper follows the publication of the Elective Care Recovery Plan published on Tuesday, which sets out the NHS plan for bringing down the elective care backlog and addressing the longstanding issue of waiting times, both of which have been exacerbated following Covid-19.<\/p>\n
In the context of these flagship health policy proposals from government, this session was quickly brought into sharp political focus. \u201cWhat we need to do through integrated care systems (ICSs) is learn lessons of recent history and apply them to develop more joined up integrated care \u2013 this is as important for UK life sciences as it is for health providers,\u201d reflected PPP Executive Chair, Stephen Dorrell.<\/p>\n
While this end goal has never been in question, the exact role of ICSs, and by extension ICS leadership, in delivering this joined approach has often been subject to debate. Dr Penny Dash, Chair of NW London ICS and Co-Chair of the Cambridge Health Network, likened the role of an ICS to one of the key facilitator of joined up care rather than a direct provider of it. \u201cWhile we [ICS leadership] have control over funding, we do not have direct control over the health service provider portfolio, nor do we have commissioning control and we cannot simply move contracts around the system,\u201d she said. The key benefit of ICS frameworks, she insisted, was to convene key parts of the system and build a robust population health strategy.<\/p>\n
\u201cWe are rapidly moving towards borough-based partnerships (accounting for some 300,000 people in a locality). We want to see those services delivered much more at scale, with much better ability to coordinate and deliver a population health approach.\u201d<\/p>\n
Matthias Winker, Head of Strategy at Oxfordshire and Berkshire West ICS, also stressed the importance of ICSs acting as conveners of care transformation. \u201cOur function as a facilitator is crucial, we are introducing a \u2018learning culture\u2019 by bringing different capabilities from different organisations to the table. This is particularly relevant when discussing commissioning skills, provider capabilities and local authority expertise.\u201d<\/p>\n
A new model of coordinating care also signals profound changes to the relationship between pharmacy and the wider healthcare sector. Brian Smith, Chief Pharmacist, Applied Insights, Access & Value, UK at IQVIA, stressed that ICSs have the potential to alter focus from measuring inputs to focusing on outputs. \u201cCommunity pharmacists, for example, are remunerated on the number of prescriptions they dispense rather the value they provide \u2013 this dynamic has to change to bring community pharmacy further into system wide healthcare provision.\u201d<\/p>\n
Industry should be and will be round the same table as colleagues in the ICS landscape – playing an important part in delivering innovation<\/p><\/blockquote>\n
The agenda to join up health and care service provision wherever possible runs parallel to developing the UK into a life science powerhouse. ICS frameworks present new opportunities to enhance access to care, develop transparency and choice, and ensure that innovative treatments reach the people who need them \u2013 the patients.<\/p>\n
Also speaking was Dr Ben Bridgewater, a former Professor of Cardiac Surgery at South Manchester NHS and now CEO of Health Innovation Manchester – an academic health science and innovation system, at the forefront of transforming the health and wellbeing of Greater Manchester\u2019s 2.8 million citizens.<\/p>\n
Reflecting on the opportunities for advancing health and care innovation, Dr Bridgewater said, \u201cThere is an extraordinary and exciting opportunity in ICS development to build momentum for those innovations and exciting projects and move as quickly as we can from the same old statutory functions. We must seize the opportunity.\u201d<\/p>\n
Building on this positive tone was Russell Abberley, General Manager, UK & Ireland for Amgen and Chair of the American Pharmaceutical Group (APG). Insisting that the pint glass was \u201chalf full\u201d when it comes to UK life sciences innovation, Mr Abberley outlined his excitement over the prospect of industry, \u201cbuilding a stronger partnership\u201d with the health and care sectors. \u201cIndustry should be and will be round the same table as colleagues in the ICS landscape – playing an important part in delivering innovation and data to solve issues around workforce and diagnostics and moving patients through the systems.<\/p>\n
\u201cI think we [industry] can play a really important part in communicating the value proposition of the solutions: the data, the technology, the medicines, the diagnostics, whether it be to solve some of the challenges around workforce and diagnostics and moving patients out into primary care or out back into the community.”<\/p>\n
Mr Abberley went on to stress that the longer-term challenges are around health inequalities, driving uptake and access to treatments, as well as delivering treatments for patients in locality.<\/p>\n
\nThe voice of the patient<\/h3>\n
It is not about having the patient directly in the room, it’s about ensuring the system represents their voice<\/p><\/blockquote>\n
An increasingly important part of the integrated care debate has been the concept of building care around the patient – putting the patient in control of their own care and ensuring the system works for them. These themes were affirmed in the recent Integration White Paper, which placed particular emphasis on the value of \u201cpersonalised medicine\u201d. However, if providers truly want to develop personalised medicine, then they will need to take opportunities to better understand the people receiving it.<\/p>\n
The extent to which patients should be included as an active participant in system transformation has proven to be a challenging and interesting debate and speakers on the day did not shy away from this discussion. Dr Bridgewater pointed to the inclusion of the voluntary sector as an important and necessary step to securing the patient voice in system transformation.<\/p>\n
While certainly conscious of the fact that the people sitting at an ICB meeting may not be best placed to help patients understand how to live a healthier life, Dr Penny Dash played down the idea of direct patient involvement in transformation processes. She argued that if providers consider the idea of the patient \u2018voice\u2019 too literally, it could end up encompassing an entire ICS population (in Ms Dash\u2019s case that would include the 2.2 million residents of NW London ICS).<\/p>\n
\u201cIt is not about having the patient directly in the room, it’s about ensuring the system represents their voice, understands their needs and challenges and [about] tackling population health and…addressing health inequalities.”<\/p>\n
Addressing health inequality is as important for life sciences as it is wider health and care \u2013 treatments and innovations brought into the ecosystem must not inadvertently exacerbate disparities through unequal access. As Dr Dash explained, \u201censuring equitable service uptake while addressing the perennial issues of obesity and smoking is the priority; this is a huge and complicated agenda but we can no longer have an environment where sections of the population are \u2018hard to reach.\u2019\u201d<\/p>\n
Dr Bridgewater argued that what is considered the concept of a patient \u2018voice\u2019 in healthcare might be referred to as \u2018customer centricity\u2019 in other sectors. \u201cSoftware companies understand the importance of user-centric design, but this concept has not always fed through to healthcare. Achieving this will require some co-creation with people who have lived experience of this issue \u2013 as well as ensuring collaboration with industry colleagues.\u201d<\/p>\n
\nDelivering innovation<\/h3>\n
If you do not open yourself up to power of industry you are missing a trick<\/p><\/blockquote>\n
Industry has a huge role to play in guiding system transformation. Ahead of ICSs taking up statutory footing in July, this webinar was a timely opportunity to dissect the debate and ensure that industry has a \u2018seat at the table\u2019.<\/p>\n
\u201cThere must be incentivisation for both sides of the equation,\u201d said Mr Matthias Winker, \u201ccommercial innovation has yet to truly mature for ICSs, however this could rapidly develop over the next few years \u2013 but we are still a long way off from where the life sciences sector is in terms of utilising commercial opportunities to encourage innovation adoption.\u201d<\/p>\n
Where pharma was once considered the \u2018dark side\u2019, there is now acknowledgement that its capacity for harnessing innovation presents a powerful opportunity to deliver lifesaving treatments to patients. Evidence in recent years of this shift in mindset can be seen with the Cancer Drugs Fund, presenting a faster means of appraising new drugs and treatments \u2013 harnessing industry innovation earlier. The ICS framework presents a unique opportunity to expand such opportunities.<\/p>\n
\u201cIf you do not open yourself up to power of industry you are missing a trick,\u201d said Dr Bridgewater who outlined the importance of the concept of \u2018agency\u2019 in encouraging innovation adoption. This concept has allowed Health Innovation Manchester to shift the dynamic in favour of innovation, allowing organisations to craft relationships and drive technology within the ICS structures.<\/p>\n
\nLife science innovation in an ICS future<\/h3>\n
Whatever happens over the next few years, the whole system must be engaged in this transformation process<\/p><\/blockquote>\n
\u201cWhile specific roles and duties of ICS leadership will change over time, it should become, and remain, the place where strategy is developed before handing to local providers for delivery,\u201d said Dr Dash, \u201cand developing strategic visions for innovation, as well as measuring and assessing its impact, is absolutely the role of the ICS.\u201d<\/p>\n
What most refer to as a care pathway, some in other sectors would consider an \u2018innovation supply chain\u2019, and this mindset should help turn the dial in favour of quicker innovation adoption. Ensuring this supply chain works requires making priority calls about what to do next, managing the benefit of innovation against the complexity of implementing it across the system.<\/p>\n
Whatever happens over the next few years, the whole system must be engaged in this transformation process. As Mr Dorrell concluded, \u201cthis process cannot simply be about which compound to use specifically while the rest of the system remains unchanged. Why even bother innovating if it is used in an unchanged health system?\u201d<\/p>\n
Evident from the outset of this webinar was that the principle of integration must extend far beyond linking service providers. ICSs have a special responsibility to ensure that the health and care ecosystem includes industry partners, harnessing their innovative potential while ensuring the \u2018voice\u2019 of the patient is a key consideration in the transformation process.<\/p>\n","protected":false},"excerpt":{"rendered":"
During a crucial period for UK health and care policy reform, Public Policy Projects and IQVIA convened over 500 healthcare stakeholders for a special online discussion to identify the challenges and opportunities for UK life sciences within a new future of integrated care.<\/p>\n","protected":false},"author":27,"featured_media":2705,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[37,25,27],"tags":[39],"acf":[],"_links":{"self":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/2701"}],"collection":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/users\/27"}],"replies":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/comments?post=2701"}],"version-history":[{"count":4,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/2701\/revisions"}],"predecessor-version":[{"id":3117,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/2701\/revisions\/3117"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/media\/2705"}],"wp:attachment":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/media?parent=2701"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/categories?post=2701"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/tags?post=2701"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}