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Working Together For Patients Industry - NHS collaboration13/12/2006
Co-operation between the pharmaceutical industry and the NHS on improving health provision to patients is a bit like the curates egg in the Punch cartoon: it is good in parts. That may be acceptable for a young curate not wishing to offend his superior, but the Association of the British Pharmaceutical Industry (ABPI) believes we can do better.Indeed, it is important that we try to do so, since there is much that can be gained by patients and the NHS from co-operative working between the pharmaceutical industry, PCOs and the wider NHS. Companies wish to work with the NHS in appropriate ways to improve the healthcare available to patients. This can best be achieved by working collaboratively with NHS stakeholders: the custodians of, and gatekeepers to, health services. It goes without saying, however, that such ventures must always be conducted in a transparent and publicly accountable manner and the ABPIs Code of Practice lays down strict rules that must not be transgressed by the pharmaceutical industry.Improving uptake ratesImproving the rate of uptake of new, innovative, safe and cost-effective medicines to improve patient outcomes and generate fair commercial returns for pharmaceutical innovation are UK Government objectives that are endorsed by the ABPI. However, the adoption of new medicines in the UK continues to be slow by international standards: medicines launched during the past five years have only 17% of the UK market, which compares unfavourably with 27% in the USA and significantly higher percentages in countries such as Spain, Australia, Canada, Germany, France and Italy.It is important to keep it absolutely clear that pharmaceutical companies are businesses. They have to make sufficient profits to pay shareholders, raise capital and reinvest in research and development to discover new and better medicines. Profits come from the optimum sale and use of the medicines that they make, and to achieve this they need to work closely with stakeholders to ensure knowledge, awareness and appropriate use of products. However, the long-term nature of pharmaceutical research and development it takes 1012 years to develop a single new medicine means that companies have no interest in encouraging inappropriate prescribing of their products. At best, this would cause a gradual loss of confidence in the product; at worst, it might lead to actual harm to patients and subsequent damage to the reputation of doctors, the NHS, the pharmaceutical company and others. In short, the curates egg would become wholly bad. Only through the safe and appropriate use of medicines can confidence in medicines and the companies that research, develop and manufacture them be sustained and reward for long-term investment in pharmaceutical research and development be achieved. A partnership frameworkWays in which the pharmaceutical industry can work in co-operative ventures with the NHS in an open and transparent manner, to mutual benefit and in the interests of patients, are spelt out in an ABPI framework document agreed with the three principal organisations that represent NHS members and organisations: the National Association of Primary Care (NAPC), the NHS Alliance and the NHS Confederation.NHS and Pharmaceutical Industry Working Together for Patients also lists more than a dozen case histories that exemplify constructive ways in which the pharmaceutical industry and the NHS have co-operated on projects to the benefit of patients throughout the country. Not only does the framework provide safeguards and reassurance that such relationships are conducted to the highest ethical standards, but it also spells out the clear advantages that these ventures can bring. When the document was launched last year, Graham Kendall, Head of Commercial Relations for the NHS Confederation (which brings together the full range of organisations that make up the modern NHS across the UK) said: The modern NHS is changing rapidly with increased diversity in providers, we need to focus on how services work together. Partnership is key to making the system work for patients. The NHS Confederation is pleased to support this framework, which outlines innovative examples of how organisations are working together to deliver improved patient care. Eric McCullough, chief executive of NAPC (which represents practices, primary healthcare professionals and organisations, including PCTs and other bodies working in and with all healthcare providers outside of hospitals), said: Working in partnership makes sense for the patient, for the NHS and for the industry. The benefits can be huge and can result in truly modernised ways of delivering locally sensitive care, which holistically meets the needs of the individual. Partnership working provides an opportunity to do today what, alone, might not be possible tomorrow. Plurality of provision is now a major Government policy and reflects in part the leadership given by the pharmaceutical industry of Great Britain. Michael Sobanja, chief executive of the NHS Alliance (which represents most PCTs, including individual GPs, nurses and managers), said: Good patient care demands that the right medicines are available to the right patients at the right time. When the industry and the NHS work together in a transparent and ethical manner, then patients can only benefit. This publication demonstrates how that can be done to excellent effect. The guide stresses that all joint activities should be for the benefit of both individual patients and wider populations, and that any agreements between the industry and its NHS partners should be conducted in an open and transparent way. Other key provisions include protecting the interests of individual patients and ensuring that clinical aspects of care remain under NHS control. The examples of co-operative working given in the document range from implementing national policies or guidelines, such as those on schizophrenia and mental health, to providing a support strategy for flu campaigns. The document is freely available, either from the ABPI website at www.abpi.org.uk or from the ABPI at 12 Whitehall, London, SW1A 2DY, phone 020 7930 3477, e-mail publications@abpi.org.uk. A training programmeAnother example of how the industry can engage with the NHS on the ground is shown in the unique partnership developed between the Ashton, Leigh and Wigan PCT and the ABPI.A joint exercise to support the training and development of healthcare professionals working with the PCT, as well as undergraduate students from all healthcare disciplines, is at the heart of the Learning Development Programme jointly developed by this PCT and pharmaceutical companies working through the ABPI. The partnership shows a joint enthusiasm for and commitment to building opportunities to train staff at all levels to work locally in primary care. The Learning Development Programme is regarded by the PCT as vital to developing the skills of its existing workforce and bringing new recruitment into the borough. The PCT and pharmaceutical companies, working with the ABPI, have developed this programme to support further improvements in the management of long-term diseases in Wigan Borough. The aim is to support the training and development of undergraduate students from all disciplines, providing 150 placements for medical, nursing, dentistry and pharmacy students from Manchester University by 2007. The new programme began in February this year. Reaching outFollowing the success of this initiative, the ABPI is working with a specialist company, Pharma Partners, to expand its outreach programme by establishing similar partnerships in other areas specifically north, central and southern England. The object is to stimulate and initiate partnership projects between industry and PCTs in these areas.Some 22 PCTs that traditionally have resisted approaches from individual pharmaceutical companies have been approached. Meetings have so far been held with 17 of them, resulting in agreement from all of these to participate in the programme. The initiative is strongly welcomed by industry on the ground. Pharma Partners has been working to ascertain why the identified PCTs were reluctant to work with companies, and to identify their management, attitudes and priorities. The aim is to use what has been learnt from earlier exercises to improve the quality and quantity of interaction between the local NHS and the industry for the benefit of patients. Much of the problem has arisen from poor communication and poor understanding of each others motives and priorities, and the concept of a neutral approach is helping to overcome barriers. A shared visionThe history of joint working between the pharmaceutical industry and the NHS is patchy, with examples of excellent partnerships but also examples of mistrust, ideological differences and unfortunate behaviour. Trust is all-important in partnerships, and to have trust necessitates a sharing of values and principles. We must develop mutual trust within the framework of transparent agreements, so that real benefits can be realised by the NHS, by pharmaceutical companies and by patients. In this way, the curates egg will be good for all.
Martin Anderson is Director of NHS Policy and Partnerships at the Association of the British Pharmaceutical Industry (ABPI) and can be contacted on manderson@abpi.org.uk article covers the key elements of Martins presentation at the autumn PSMG meeting. For details of future PSMG meetings, please visit www.psmg.info or contact secretary@psmg.info |
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