How Pharma, MedTech and Device firms can help drive patients toward an early diagnosis

Patients missing opportunities for an early diagnosis have been a bugbear for the NHS for years now – and it’s an issue they are very much aware of.

There’s actually two problems here – either the tests aren’t available when the patient visits their GP, or the tests are in a hospital setting, and the patient has to wait months to be seen.

This paper highlights the issue from a formal perspective, trying to encourage integrated care boards working with their hospital boards and general practices to build the capacity and the capability needed to provide spirometry, FeNO testing and NT-proBNP tests.

These tests achieve quicker diagnoses for patients suspected of chronic obstructive pulmonary disease, asthma or heart failure.

Early and correct diagnosis and treatment are key

The paper talks about simple interventions that could be deployed as hub and spoke models in primary care.

It advises general practice providers of respiratory diagnostics, pathology labs and the integrated care boards to get together and work out how they could provide a GP direct access pathway for adult patients with symptoms indicative of those three disease areas.

As those who follow me will know, one of the things I highlight regularly is that early and correct diagnosis, leading to early and direct treatment, will improve the patient outcome and reduce unnecessary appointments, referrals and non-elective admissions.

So I heartily agree with what this document is recommending. We have to remember that the NHS is drowning in workload, it does not have the workforce to meet the demand it is currently faced with – and that’s not just general practice, it’s everywhere.

There’s a need and a desire now to innovate and work in different ways.

No one should be expected to work for free

Unfunded work is a potential pitfall here. In spirometry particularly, some practices are ju,st expected to do those tests without any payment which isn’t going to work and it’s why you can end up with a patchwork quilt of service across the areas where they’ve gone down that route.

Some practices will do it because they see it as good for the patient, other practices won’t do it because they see it as bad for the practice. Doing unfunded work can mean paid work doesn’t get done – and that just doesn’t make any sense. Work like this has to be properly commissioned.

I’ve been involved several times over many years in business cases around spirometry where my NHS clients have established services, many of which are still in place today, and in every instance what we focused on was delivering a high quality, standardised approach without any unwarranted variation.

In those cases, the right patient is seen in the right place at the right time by the right healthcare professional who has the skills and the resources required to deliver the care.

That has often meant training, educating, upskilling and accrediting people to be able to deliver the service and that’s why we need the right resources to pay for and deliver the work.

Heart testing figures paint a bleak picture

This paper also discusses echocardiograms. They are linked to the NT-proBNP testing, which it recommends should be used as a triage for echocardiography.

I’m aware through my own work with cardiology diagnostics that many patients are referred for an echocardiogram without having had a NT-proBNP test because they’re not routinely available in general practice.

So patients with suspected heart failure are just referred away for an echo and the document makes clear that shouldn’t be happening. They’ve also had feedback from many echo services making it clear a significant proportion of suspected heart failure patients are referred without having the NT-proBNP test.

I had a look at the waiting numbers for echoes on February 19 and it was showing 160,919 people waiting for an echocardiogram. That won’t include those who have regular screening echoes every two or three years because of their condition.

So that’s an awful lot of people stuck in treatment backlogs, and it’s not uncommon to find people waiting more than a year for an echo.

Use good examples as pilot schemes in other areas

Another document was recently published called Progress on Cardiovascular Disease and I’m going to look at it in more detail on a later article. But it shows that cardiology waiting lists have tripled since 2012 – that’s a higher increase than NHS waiting lists overall.

So there’s clearly a problem in this area – but within every problem lies an opportunity. And that’s where Pharma, MedTech and Device companies can come in and get involved.

In all of this turmoil, there are pockets of brilliance and companies are likely to know where there are spirometry services and NT-proBNP testing up and running. These good examples can be pulled out and used at small scale as pilots in other areas.

Read my blog here on grabbing the attention of NHS decision-makers

Offer to get involved on the project management side

Work with the willing and use the document to prove to services that there’s a problem. If you’re not getting co-operation from the integrated care boards, create your own project, start with one practice or one primary care network or even a GP federation that covers a whole place footprint and demonstrate the art of the possible.

This is one area where the industry could easily be involved on the project management side, supporting the project as part of the delivery team.

For those who want to scope, I recommend no more than two sides of A4 as a project outline. So before you go writing a 30-40 page business case, get the commitment up front based on a simple document that outlines:

1.      The problem you are setting out to solve.

2.      What you are going to do.

3.      How you are going to do it.

4.      Probably most importantly – who is responsible, and for what, within this project. Named individuals or practices, networks, GP federations, hospital trusts, pathology labs or integrated care boards.

5.      What outcome you expect to deliver.

6.      How you will measure and evaluate to show that outcome.

7.      What contingency you have got for the things you don’t know today that will pop up as the project is delivered.

8.      What the cost of delivery is going to be. That involves working out every step of the pathway, who is responsible for it and looking at that hourly rate to build a picture of the costs.

With a pilot like this, write it up as a case study, show the art of the possible to the integrated care boards to help secure their buy-in.

How should Pharma, MedTech and Device market access teams deal with objections to an NHS sales pitch?

The document is well worth a read, there’s lots of information in there to help industry with a project – in fact, here’s the link again.

If anyone has any questions on this topic, please don’t hesitate to ask me.

Scott McKenzie helps pharmaceutical, medical technology and appliance firms get their products and services in front of the right NHS decision makers. He helped to land no fewer than 53 new projects with the NHS in 2023 alone and has now developed a 12-month masterclass that gets straight to the heart of the challenges of selling to the NHS.  If you want to get your products fully embedded into treatment pathways, Scott can help. Get unprecedented access to key customer insights, proven tools, resources and strategies plus 1-2-1 coaching and decision-maker introductions to finally get your project over the line. Find out more here.