Start your NHS pitch by talking about inequality

As we know, there are certain groups of people in society who are more likely to experience inequality in healthcare services. This is true both in terms of access to the help they need and the health outcomes they ultimately achieve.

There’s a really good article on this topic here – it’s all about how NHS trusts can tackle inequalities in mortality, both in primary prevention and secondary prevention.

The inequality is more apparent among ethnic minority groups and those living in deprived areas, with a big overlap between the two.

With that in mind, how can the Pharma, MedTech and Device companies plug into the secondary prevention agenda?

Read my blog here on how taking a different approach will make you more memorable to NHS decision-makers

The two types of prevention

Addressing inequality is a great way to start any conversation with the NHS. Those conversations can drive the hospital to look at the work they do when they have a patient in their care – making every contact count, which is a major NHS priority – and also how they might link out into primary care.

As I’m sure you all know, there are two types of prevention:

· Primary prevention – this focuses on improving the population’s health, preventing illness and disease and also tackling the health inequalities that some communities experience.

· Secondary prevention – this focuses on catching the causes of ill health as early as possible to prevent or reduce the chances of them leading to more serious conditions.

It’s worth noting that the primary and secondary prevention agenda has been a focus for NHS England since its inception in 2013.

Case study: the Newcastle fracture liaison service

I am regularly asked to work on prevention projects within the NHS and I can go all the way back to 2008/09 to one of the best secondary prevention projects I’ve ever worked with in Newcastle upon Tyne.

They developed a fracture liaison service to review patients who were aged 50 and over with a history of low-trauma fractures. Initially, they concentrated on those with hip and wrist fractures.

From the initial audit, they identified two very distinct groups, just under 2,000 patients who were in nursing and residential homes and about 1,500 patients who had a previous history of fracture.

The aim of the project was to provide a really efficient and cost-effective service which included a direct referral process for patients to have a DEXA scan to assess their bone mineral density and identify those at greatest risk of fracture. Those people then went on to have treatment.

It also made sure that anyone identified as being at low risk and, therefore not requiring drug therapy was not overtreated.

Working in this way ensured patients were screened, diagnosed and treated in a cost-effective manner to give the best possible outcome. The project followed both local and national guidelines from NICE and NOGG (National Osteoporosis Guideline Group) at all times.

All patients had their treatments monitored, which enabled the project team to make alterations to therapy as appropriate.

It remains one of the most successful secondary prevention projects I’ve ever been involved with because it really did deliver a fantastic outcome for the patients. One of the key measurements was the number of hip fractures in the community, and you could clearly see a reduction in those as the years progressed.

Only a third of hip fracture patients make a full recovery

One of my NHS customers down in the South West wants to do a primary prevention project to screen for those at risk of falls and fractures. That would be a primary prevention population health project and it would be really interesting to see if we could screen, diagnose and treat people at risk of having a fall or a fracture and actually stop it from happening.

We’ve got to remember – with hip fracture particularly – the statistics show that roughly one third of people will die as a result of their hip fracture, one third of them will recover but not get their full mobility back, and only a third of people recover to where they were before.

Hip fractures are expensive to the NHS, and they’re expensive to the patient in terms of not getting a great outcome. It’s a really good example of where a secondary prevention programme could work, but you’ve also got the thought process of what a primary prevention programme might look like.

Success comes from strong partnerships

From a Pharma, MedTech and Device company perspective, effective prevention programmes rely on partnerships between the different system players – hospital trusts, mental health trusts, community services, general practice, and the voluntary sector – maybe not all of them, but definitely some of them.

Most of them will benefit from the new technology and digital innovations that are appearing, but operational pressures are still the main thing to bear in mind – anything you go to the NHS with needs to have the workforce to deliver it.

Sometimes you might need to do some data gathering right at the beginning of the project to verify precisely what you’re about to do.

A major problem – as highlighted in the article – is that health inequalities are not seen as the core business of the NHS. That means they are not regularly focused on, funding and resources to tackle them often slips through the net or becomes piecemeal, so we don’t get the outcome we’re looking for.

New strategy will provide even more opportunities

As I’ve written about before, zooming in on what you can support the NHS with is absolutely key for Pharma, MedTech and Device companies.

The NHS is in the process of completing the major conditions strategy, which is due for publication in the spring and will outline the government’s commitment to the prevention and management of long term conditions.

This is a topic we will definitely return to because I am certain that strategy is going to be focused on tackling health inequalities and the biggest inequalities are seen in those with long-term conditions.

Scott McKenzie helps pharmaceutical, medical technology, and appliance 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 Scott can help. Scott has doubled revenue for his clients and is happy to share these processes with you too. Schedule a call today.