The NHS isn’t waiting for official guidance – and neither should Pharma

The NHS Operational Planning Guidance for 2024/25 sets the NHS delivery plans for the financial year. It’s normally published before Christmas – but we still haven’t seen it.

This is primarily, we’re told because the Treasury refused to sign it off. That, we are being told, is linked to the disruption caused by the NHS strikes, which the Government and NHS England both blame for big financial deficits. However, the deficits were there long before the strikes, which appear to be being used as a cover.

It’s only the second time in 15 years the guidance has emerged after Christmas, and it leaves Pharma, MedTech and Devices companies with an obvious problem – how are they supposed to work with the NHS when they don’t know what the priorities are?

Negotiations stalled by strikes

Some of this links back to November last year, which saw a re-planning exercise targeted at dealing with the large deficits which are being blamed on the industrial action – financial gaps the Government refused to plug, but those deficits have been around for a long time.

After that exercise, Integrated Care Boards (ICBs) and NHS Providers were given clarity on the funding situation and the actions they were required to take over the remainder of 2023/24 to try to manage those financial pressures.

My understanding is that issuing that guidance derailed the negotiations on 2024/25 (which remain ongoing), and that’s why we’ve not got the operational planning document which would normally be with us that week before Christmas.

With negotiations still in play, my guess is they’ll be working to agree the outcomes and priorities for 2024/25. So we wait.

No fundamental changes are likely

But what they did tell everyone in a letter on December 22 – and this provides real insight – is that the ICBs have been advised not to wait for the official guidance before starting to plan for next year. They’ve already published the financial allocations for 2024/25, which were exactly as expected, remaining consistent with what they’ve had historically.

That includes the payment approach used to support elective recovery, which was the big focus post-pandemic – getting elective services back up and running fully.

It’s obvious to me that ICBs will be asked to achieve financial balance. That has been a recurring theme in my advice to the Pharma, MedTech and Device companies I work with since late last year.

We first got wind of it in October, it then became the focus of the replanning exercise in November, and it remains the number one goal for the ICBs – deliver financial balance by March 31 2024.

I suspect there will be some financial juggling to show that financial balance has been achieved because there are some significant deficits out there among the 42 ICBs.

And the published recovery plans that we had during the year around urgent and emergency care, primary care access and elective and cancer care – they won’t fundamentally change and the interim letter confirms that.

Tackling waiting times remains top of the list

The key requirements from the previous year’s operational guidance were to maintain and then increase urgent and emergency care capacity. That was firmly established last year.

There will also be a requirement to complete the agreed investment plans to increase diagnostic and elective activity. Of course, that’s targeted at reducing the very long waiting times we’ve got at the moment for patients.

All of this means the NHS is being asked to maximise the return on investment that is being made in primary care around improving access. That was part of the Network Contract Directed Enhanced Service (DES) for 2023/24, which included a capacity and access payment designed to make PCNs deliver increased capacity and access throughout 2023/24.

You can read all about the financial allocations here.

The requirements also include the networks being asked to start to use the new Pharmacy First service, and there should be ways into that for Pharma, MedTech and Device companies.

Those that work with me have already been using the capacity and access payment to help invest in projects to improve the patient outcome and reduce the net workload into general practice, and we’ve used that money in some really creative ways to build a workforce for them.

Plenty of entry points for Pharma, MedTech and Devices firms

So while we haven’t got the planning guidance for the next financial year, we do know ICBs are being asked to work on the basis that they shouldn’t wait for the document, they’ve got all the information they need, and initial planning returns will still be expected by the end of February.

There’s also a number of other documents that were published alongside the Christmas letter and which give Pharma, MedTech and Devices teams ideas about the direction of travel for the NHS over the next financial year:

So we didn’t quite get what we expected, but actually, there isn’t going to be a huge change from last year. There’s a massive challenge to find financial balance amid big budget holes that are really going to create problems for the ICBs between now and March 31.

But there are good opportunities for the Pharma, MedTech and Devices companies to show the impact they can have to significantly improve the patient outcome and therefore, reduce unnecessary appointments, referrals and admissions.

As soon as we’ve got the guidance, I’ll refresh this advice and will update everyone as soon as I possibly can.

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.