The concept of maintaining a “stiff upper lip”—not showing any emotion—is something that many people think characterises the British. It is an antiquated stereotype that has left us with a reputation for being reserved and reluctant to express our feelings.
This attitude mars many of our interactions, making us more likely to withhold important information than share it with those that can help us, occasionally to the detriment of our own health and wellbeing.
In a healthcare scenario, we’re likely to be more concerned with whether or not we’re bothering a GP, than to ‘trouble’ them with our ailments; and even when we do go and see them, we are still too timid with our doctors. This is a view shared by Professor David Haslam, Chair of the National Institute for Health and Care Excellence (NICE). Professor Haslam believes patients are missing out partly because they are not pushy enough with their GPs. He suggests we should be more like Americans, who are less deferential when they see a doctor and go in armed with research about their conditions and its treatment.
What does this mean for our industry, which is committed to improving access and usage of innovative new medicines for patients? Well, legally you can ask for any medicine once it has been recommended by NICE to treat a condition. If your GP or specialist thinks it is appropriate to prescribe it, your local Clinical Commissioning Groups (CCG) must fund it. The problem, according to a recent survey conducted by The Patients Association is that nearly 80 per cent of patients don’t know this, and have never heard of the NHS Constitution.
And it isn’t just patients, the NHS also needs to change its behaviour. A growing population with an extending lifespan, fuelled by advances in knowledge, science and technology and ever-increasing expectations from the public it serves, are only some of the increasing burdens the NHS is facing. It now needs to do things differently and radically transform the way it delivers core services. Innovation is the way to meet these challenges and, in partnership with industry, a commitment to make a constant supply of new medicines, devices and technology available to patients.
The ABPI called for the creation of the Innovation Health and Wealth (IHW) agenda, which sets out a plan for spreading innovation throughout the NHS, and sets an objective for the Department of Health (DH) and NHS England (NHSE) to improve overall outcomes for patients through access to effective medicines. The ambition is for an NHS committed to innovation, demonstrated both in its support for research and its rapid adoption and distribution of transformative medicines, services and clinical practice.
In January 2014, two years after publication of the IHW agenda, the ABPI and three other leading healthcare trade associations undertook a review of the Strategy for UK Life Sciences, which sits alongside the IHW agenda and includes a host of policies and initiatives to support the UK as a global centre of excellence. There was cause to celebrate some improvements and successes over the past two years since the strategy was launched. For instance, we welcomed the setting up of new Academic Health and Science Networks that strengthen collaboration between industry, researchers and clinicians.
However, implementation of other government commitments have not been consistent and, in some cases, have yet to deliver anything close to their stated ambition. For example, while we are pleased that the NHS Innovation Scorecard has been produced, it has yet to become a useful and powerful tool that allows the public to easily see and highlight local NHS variations in access to new medicines. Another example is the aligning of incentives within the NHS to improve and streamline patient access to innovative treatments, for instance, by breaking down “budget silos”. A misalignment of incentives can have detrimental effects for the patient. If we can surmount these kinds of challenges and create a holistic approach, we can start to truly put the doctor and patient in the driving seat of treatment decisions based on medical need and the best available treatments.
If one provider is reluctant to purchase a service or treatment, it will result in money having to come from another health service provider’s budget, which takes longer and costs more. A holistic approach that puts doctors and patients in the lead and allows them to make the best treatment decisions based on medical need is necessary. It is clear that more work needs to be done to deliver the ambitions of the IHW agenda in the NHS.
Another policy driver for change is the 2014 Pharmaceutical Price Regulation Scheme (PPRS), which will underwrite growth in the NHS medicines bill for the next five years and has the potential to support more appropriate access and usage of innovative medicines without over-emphasis on cost containment.
To ensure the most is made of the PPRS, there has to be a change in behaviour by the NHS and patients: Britain need to loosen its “stiff upper lip” and demand more from GPs and the NHS must supply health professionals with the new medicines demanded by a better informed public. Our industry must play its part too, and the ABPI is currently in discussion with both the DH and NHS England on how best to ensure that the scheme delivers better access to innovative medicines for patients. We are committed to working with the NHS to achieve this.