When we have a fixed mindset, it can be hard to see the benefits of a different approach. It can be difficult to prove the success of something that you’ve never tried before.
With the NHS, the most obvious pathways to market access are not necessarily the most successful. Just as sales teams trying to find a way into the NHS can sometimes struggle, I get pushback from my clients – until I can find a valid way to illustrate my point.
Just this week, I met a chief executive in the pharma industry. Four weeks earlier, I’d delivered a presentation to his leadership team in which I’d tried to make clear that dealing with a Place footprint was always likely to be more successful than focusing on Integrated Care Systems, and their Integrated Care Boards.
But he wanted convincing. He thought his focus needed to be on the 42 Integrated Care Systems (ICS). Get one decision from the ICS and everything will then happen off the back of that. He wanted more evidence and reassurance that what he’d always believed was the best way to sell to the NHS was not necessarily the most effective way. So I gave it to him.
One size doesn’t fit all
A place footprint is usually a local authority boundary. So if you look at somewhere like Coventry and Warwickshire, there are four place footprints:
- South Warwick
- North Warwick
Coventry and Warwickshire is therefore one ICS, around a million patients and four place footprints. The main benefit of operating at place level can be really well illustrated with this ICS.
If the integrated care board decides it wants to turn left, each of those four place footprints can decide how it wants to turn left. That means they can all deliver projects and service change in different ways to meet the needs of their patient population and still get the right outcome.
So that proves that the expectation of working where one decision is made and everybody does the same thing to make that change happen, simply isn’t the reality.
In order to illustrate what I was talking about, I highlighted a project I’m working on where we are converting NICE guidance into a proposal to the Place commissioner for a Local Enhanced Service to implement this change. So it was a small incentive, driven by myself working with this GP federation, which aimed to encourage engagement from practices.
I also advised the pharmaceutical company client that this was a really good opportunity to significantly improve patient outcomes which, over time, will improve patient outcomes, reduce unnecessary appointments, referrals and admissions.
Why bypassing the integrated care system is advantageous for market access teams
We were also able to argue that we’re tackling quite significant health inequalities because improving patient outcomes tackles that disparity between the best outcome they can achieve and where they are currently pre implementing the NICE guidance. This made it a really solid project.
But I was challenged on why I didn’t take it to the Integrated Care System – instead choosing to take it to the place footprint for this particular GP federation. Incidentally, the federation thought it was a brilliant idea and have asked me on their behalf to develop the business case for it.
We then had a very initial conversation with the commissioner who admitted they were “sympathetic”. They recognised the NICE guidance, knew this was coming down the track at them and actually thought the outline idea of turning it into a Local Enhanced Service was a really good one they could potentially support.
When asked about costs, I estimated between £50,000 and £60,000, which they were confident they could find to get this implemented. We now have a meeting with the Director of Primary Care for the Integrated Care Board to discuss how to pilot this in one place footprint, before rolling out to others.
That’s how I was able to convince my pharma client that dealing with the place footprint is better than dealing with the system as a whole. Once we have it right in one “place” they then take it to the ICB and scale system wide. This is a scale the NHS can deliver at, whereas there is little or no evidence of ICS taking a wholesale approach across the ICS to change projects.
Don’t put the cart before the horse
I’ve talked before about Tom Poland’s excellent book, Leadsology. In it he makes the point that a common mistake people make is putting the tactics before the strategy. He encourages working with your ideal client – something I try to do all the time.
And it’s something all Pharma, MedTech and Appliance companies should do on a regular basis – define what your ideal client looks like. Then establish the transformation and the value you can bring that the client would ideally want.
The NHS, for example, would want you to reduce workload. They’ve got too much work for not enough people. So they are much more willing to innovate and work in different ways to solve that. So what could you do that will play on that agenda?
Beyond that, you need to work with the brand and marketing teams to work out what your ideal client needs to hear in order to get you through the door.
Also, if you’re talking to general practice, a hospital, community services or a mental health trust, ask yourself where else your messages might land, how else might you grab people’s attention? Walking through the door to see them is great but what about landing some of your messages on LinkedIn and Twitter?
That’s what I’m doing with industry at the moment – helping them identify the ideal client, working out the transformation we’re going to deliver, working out the message we need to learn to get through the door and then establishing what tools we should use to spread that message. We start in one “place” and then expand to ICS/ICB. If you want to know more about my approach, feel free to reach out to me on Linked In.
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.