The Department for Health and Social Care recently published the White Paper Integration and innovation: working together to improve health and social care for all, laying out legislative proposals for a health and care bill for England.
The paper sets out a system that integrates and builds upon the high levels of collaboration between health and social care, which developed out of the Covid crisis, stripping out bureaucracy and allowing formerly disparate parts of the NHS to work better together.
All of which creates a problem for the pharmaceutical, medical technology and device industries – how can you understand and engage with such a massive policy shift? And where do you fit into this ever-changing landscape?
What the White Paper proposes
The two broad aims of the bill are the removal of boundaries between different parts of the NHS so they can work together easier and, more crucially, to create a much stronger collaboration between the NHS and local government.
The legislation will enshrine Integrated Care Systems (ICS) in legislation in England. This will comprise an ICS Health and Care Partnership, bringing together the NHS, local government and partners, and an ICS NHS Body. The ICS NHS body will be responsible for the day-to-day running of the ICS, while the Health and Care Partnership will develop systems to support integration and a plan to address public health and social care needs.
This emphasis on collaboration is a pointed move away from the previous focus on competition. A step in this direction should give the NHS and its partners flexibility to deliver joined-up care to the increasing number of people who rely on multiple services.
Examples of how a renewed focus away from the competition will look include better collaboration between providers (ambulance, hospitals and mental health services) across larger geographic footprints and between partners across local authority areas in the health, care services, public health and voluntary sectors.
- Overcome competing objectives and separate funding flows
- Mean that decisions are taken closer to the communities they serve
- Target the delivery of better outcomes
- Address health inequalities and unequal access to services
- Aim to deliver high-quality care with joined-up, efficient services
This model also increases accountability and should enhance public confidence. By working with local authorities to develop assurance frameworks for social care, we should be able to expect improved patient experiences.
There will be a single system budget and a new duty compelling providers to have regard to the system’s financial objectives. This is designed to ensure both providers and ICS NHS bodies are mutually invested in achieving financial control at every level.
Time for industry to focus on place
The legislation aims to avoid a one-size-fits-all approach and leaves many decisions to local systems and leaders. This is appropriate given the great variation across England in terms of history, demography and local health challenges.
The pharma and med-tech industries will need to quickly get to grips with the three levels at which they can work: system, network and, in particular, place. The big risk for the industry is that there is currently not enough focus on place.
While there are 42 Integrated Care Systems across England, there will still be 343 local authorities. Working at that scale in terms of place-based care will be essential as services are likely to vary from one ‘place’ to another. The development of place-based partnerships will be left to local determination, building on existing successful arrangements.
The purpose of the system
I constantly hear a strong focus on ‘system’ and its four major purposes:
- Improving population health and healthcare
- Tackling unequal outcomes and access
- Enhancing productivity and value for money
- Helping the NHS to support broader social and economic development.
But most within the industry do not understand the importance of ‘place’, which could mean missing out on lucrative relationships when so many budgets are being delegated to that level.
This bill represents a significant opportunity for industry – but only when an organisation truly get to grips with the people, processes and language, it involves.
Scott McKenzie helps pharmaceutical, medical technology, and device firms increase revenue by getting their products and services in front of the right NHS decision-makers. If you want to get your products fully embedded into treatment pathways, we can help you. We’ve doubled revenue for our clients and can share these processes with you too. Download your free guide: Click here.
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