Pf Magazine March 2019 by E4H Ltd

SPECIAL EDITION

Partnership

WORKING “ Joint working projects will support patients to have a better NHS experience and improve their disease outcomes” Page 10

MARCH 2019

How to add true value Technology enabled healthcare NHS engagement reimagined PHARMAFIELD.CO.UK

CO M I N G U P I N TH E N E X T

PF MAG A Z I N E S PECIAL E D ITI O N:

PATIENT CENTRICITY PATI E NT- C E NTR E D H E A LTH C A R E I S H E R E TO S TAY, A N D IT H A S TH E P OTE NTI A L TO C H A N G E TH E WAY P H A R M A D O E S B U S I N E S S A N D H OW H E A LTH C A R E I S D E L I V E R E D.

TH I S I S S U E W I L L I N C LU D E :

Upskilling sales teams Involving patients in medicines development Ethical and effective patient involvement Creating value-added models Understanding the patient experience Customising solutions for local health economies.

M A K E YO U R VO I C E HEARD

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We are looking for key opinion leaders and influencers in pharma to provide industry intelligence for the Pf Special Edition on Patient Centricity in July.

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HEAD OF CONTENT

Hello.

elcome to March’s Pf Special Edition; this month we’re covering partnership working. As with so many things in life, they’re better when you do them together, and the examples of joint working featured in these pages show just how working in collaboration can make all the difference to patients – by improving and saving lives. Partnership working takes many different forms, and in this issue, we look at a range of collaborations, from those between pharma and the NHS, academia, digital health, genomics data, patient care, and collaborations which are addressing skills shortages. All of these partnerships have a shared common goal – to bring together the expertise of healthcare and industry to develop projects and innovative solutions with patients’ wellbeing at the centre of everything. As one of our authors, David Southern, once put it: “Joint working is about getting the right patient to the right place, where they can receive the right treatment.” At a time when the pharmaceutical industry is faced with the challenge of improving health outcomes while staying within the tight financial constraints of NHS budgets, collaboration is needed more than ever. But barriers do exist; whether these are technical, legal or cultural obstacles. Different ways of ‘doing things’, for example when the risk-averse pharma industry meets the risk-taking culture of technology, can leave the parties with a potential impasse. But this is where the learnings that open up a world of possibilities lie; in recognising the merit of these differing dynamics, organisations can work together to derive real value from taking a fresh approach. This month, we also look at how the second Life Sciences Sector Deal is creating a thriving environment for partnerships of many forms, and how industry leaders are investing in the future of healthcare and drug discovery; how reimagining NHS engagement can lead to the development of sustainable models of care, and how nurturing an inclusive approach helps involved parties to work together in new ways to deliver better care to more patients. Because, ultimately, that’s what it’s all about. We hope you enjoy this issue – if you would like to have your say on anything you’ve read, get in touch at hello@pharmafield.co.uk.

Emma Morriss emma.morriss@pharmafield.co.uk SPECIAL EDITIONS EDITOR

Amy Schofield amy@pharmafield.co.uk CREATIVE DIRECTOR

Emma Warfield emma@pharmafield.co.uk GRAPHIC DESIGNER

Olivia Cummins olivia@pharmafield.co.uk COMMERCIAL DIRECTOR

Hazel Lodge hazel@pharmafield.co.uk DIGITAL MARKETING EXECUTIVE

Emma Hedges emma.hedges@pharmafield.co.uk NEWS DESK

Hannah Alderton newsdesk@pharmafield.co.uk FINANCIAL CONTROLLER

Fiona Beard finance@e4h.co.uk Pf AWARDS

Melanie Hamer melanie@e4h.co.uk PUBLISHER

Karl Hamer karl@e4h.co.uk HEAD OFFICE

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M AG A ZI N E | M A RCH 2019 | 1

March HAVE YOUR SAY: If you’d like to share an idea for a feature or collaborate with us on a captivating advertorial, please get in touch. GET IN TOUCH: hello@pharmafield.co.uk

Contributors

@pharmafield

DR STEVE ARLINGTON Steve has worked in the pharmaceutical and diagnostics industry for over 40 years and became President of The Pistoia Alliance in 2015. In his career, Steve has grown two global consultancies into billion-dollar businesses and launched a biotech company. It’s academic, page 20. CRAIG BRADLEY Craig is Product & Business Lead for Internal Medicine across the UK and Ireland, Takeda. He has worked for Takeda, through the 2019 acquisition of Shire Pharmaceuticals, since July 2006 within a variety of sales, marketing and market access roles. Craig is currently responsible for the Internal Medicine Franchise. A rare opportunity, page 28.

2 | PH A R M A FI EL D.CO. U K

@pharmajobsuk

Pf Magazine

commercial organisations − creating opportunities for collaboration both nationally and globally. Delivering the future of genomics, page 6.

YOSHIKO COOK Yoshiko is Head of Strategy and Business Planning, North Europe, IQVIA, and is responsible for driving forward-thinking and strategic initiatives both internally and externally. She joined IMS Health in 2006 and has held a number of roles across thought leadership, change management, internal business planning, product/offering development and marketing. Delivering the future of genomics, page 6.

PROFESSOR JOANNE HACKETT Joanne is the Chief Commercial Officer (CCO) at Genomics England and Lead Member of the Business and Investment Committee. As CCO, Joanne is responsible for Genomics England’s industry engagement strategy by developing, managing and accelerating relationships with

CHRISTOPHER MCKENNA Chris is Global Head of Professional Services & Consulting at Clarivate Analytics. He has over 25 years’ experience serving global life science, chemicals and energy, and consumer products markets. He is responsible for strategy, new innovation development, go to market, customer delivery, and financial performance at Clarivate Analytics. He is also a Participating Member on the Pistoia Alliance Advisory Board. It’s academic, page 20. ANTONIS PAPASOLOMONTOS Antonis is Corporate Affairs and Policy Lead, Government Affairs, AbbVie UK. He supports the external affairs activities of the company on topics relating to medicines reimbursement, healthcare reform and therapy area policy. Antonis has over 10 years’ experience in external facing roles across healthcare, life sciences and within the UK Parliament. True value, page 8.

HEATHER PARKIN Heather is Strategic Partnerships and Initiatives Lead at Roche Products Limited. She is an experienced industry professional, having held a number of sales, training and market development roles in pharmaceutical companies, and has also worked in the NHS leading the review, redesign and implementation of an integrated COPD service within a PCT. A sustainable ecosystem, page 16.

JAMES ROACH James is an experienced NHS director who has held roles in hospitals, clinical commissioning groups and in joint roles with social care. He runs Conclusio Limited, developing innovative solutions in health and care systems in the UK and China. Feeding better outcomes, page 12.

In this issue LEE SIMMS Lee is Account Lead, Internal Medicine, Takeda. He has 20 years of experience in the pharmaceutical industry, working for five different companies in a variety of therapy areas. Lee has worked in a number of different roles, however he has always specialised in and focused on top account management performance. He also has five years’ experience running his own healthcare service business in the private sector. A rare opportunity, page 28. DAVID SOUTHERN As Managing Director of Spirit Access, David enables industry to describe the value that they add to the healthcare sector, the NHS and patients, through innovative solutions based on data analysis and simulation to evaluate the impact of change on health services. Thinking beyond the pill, page 4.

INTELLIGENCE

IN PRACTICE

Thinking beyond the pill: Pharma’s pathway to sustainable models of care

A healthier future for our NHS: Delivering sustainable innovation

DAVID SOUTHERN

MARK TOMS

10 12

The future of genomics: Exploiting data for precision medicine

Feeding better outcomes: The pilot programme delivering care differently

YOSHIKO COOK & JOANNE HACKETT

JAMES ROACH

True value: Driving value-based decision-making ANTONIS PAPASOLOMONTOS

A rare opportunity: Building trust and confidence with the NHS LEE SIMMS & CRAIG BRADLEY

Preventing AF-related strokes: The partnership behind the webinar saving lives AMY SCHOFIELD

Positive impact: Pf Joint Working Award Winners’ Q&A RUTH CHRISTER & JONATHAN WALKER

DARREN SPEVICK Darren Spevick is the Managing Partner and Founder of Eventum Partners – a leading provider of executive recruitment to the life sciences and health technology sectors since 2013, and Chair of the EMIG Digital Health Special Interest Group. A long engagement, page 24. MARK TOMS Mark Toms is Medical Director and Chief Scientific Officer, Novartis UK. Building a healthier future for our NHS, page 10. HELEN WELLER Helen is Recruitment Consultant at CHASE. She is a successful recruiter with 18 years of pharmaceutical and healthcare sales and marketing resourcing experience. Helen is responsible for all recruitment in South London, Surrey, Sussex, Kent and Hampshire. Partnering for career success, page 23.

INSIGHT

A sustainable ecosystem: Strategic partnerships could transform the NHS

Partnering for success: Collaborating with the Primary Care Women’s Health Forum

HEATHER PARKIN

AMY SCHOFIELD

It’s academic: Pharma and academia partner for biologics R&D DR STEVE ARLINGTON & CHRISTOPHER MCKENNA

Plugging the gap: Addressing the skills shortage through collaboration AMY SCHOFIELD

DIGITAL

A long engagement: Is collaboration the key to digital health success? DARREN SPEVICK

36 Directory

COLLABORATIVE ENGAGEMENT

Thinking

BEYOND THE PILL

E WORDS BY

David Southern

4 | P H A R M A FI EL D.CO.U K

xisting commercial models of UK pharmaceutical companies need to change. NHS organisations have a clearly defined mandate to get the best value out of medicines and reduce unwarranted variation in care. In addition, the Efficiency Plan outlined in the NHS Five Year Forward View (FYFV) calls on NHS organisations to minimise avoidable demand and improve patient flow in acute care. However, recent research shows that NHS spending on medicines is growing at a faster rate than the total NHS budget, potentially threatening patient access to innovative treatments in the process. Clearly, despite sector-wide efforts to strengthen market access capabilities and demonstrate value, pharma has not yet designed the optimal approach. Thankfully, it takes only a small – albeit semantic – change of focus beyond demonstrating product value for companies to help providers address wider efficiency challenges and, in the process, unlock meaningful value. The key is to reimagine NHS engagement. The development of sustainable models of care is not about products – it is about pathways. The most successful companies will be those who think beyond the pill and take a pathway-led approach to designing services that meet their customers’ needs. The question is: how?

Despite rhetoric around service redesign and efforts to carve out new ways of working with customers, the unavoidable fact is that companies too often revert to the traditional default of product-based detailing, an engagement model that is misaligned with today’s stakeholder needs. It’s understandable; companies boast great innovations that can alleviate disease and transform lives – why wouldn’t they place them at the heart of their engagement strategies? Unfortunately, this ‘solution sell’ is built on a narrow definition of value that doesn’t resonate with all stakeholders along the care pathway. Companies need to understand what value means to every and all stakeholders. That definition will vary depending on who you are talking to and where they sit within the pathway. Companies must therefore map these stakeholders, identify their needs and understand what constitutes value in their environment. Moreover, they must use this understanding to develop dynamic stakeholder engagement strategies that address value in multiple ways – at the same time – to drive meaningful outcomes. While the rationale for pathway change is well understood, how to execute it is not. The key is to mirror the work of NHS commissioners and establish a dispassionate, patient-centred view of the pathway. This is fundamental and should be the starting point for all thinking: establishing a baseline of current performance, what success looks like and how it can be measured. Put simply, the patient pathway is a map of time and resources that patients consume when receiving treatment for their condition. It can be visualised as a flow diagram that illustrates the different activities at every touchpoint along the pathway. In most diseases, the optimal ways to treat patients are well established, with organisations like the National Institute for Health and Care Excellence and the Royal Colleges recommending standardised pathways of care. However, the dynamics of healthcare mean there are always gaps between gold standard pathways and the reality at the local level. Variation in resources and population needs, along with complex socio-economic factors and regional drivers, mean that companies need to look beyond NICE guidelines to design pathways that respond to these local needs in a three-stage process.

INTELLIGENCE

Taking a fresh look at NHS engagement is where success in meeting customers’ needs lies. But how?

STAGE 1

STAGE 2

STAGE 3

The first step is to develop a granular, end-to-end understanding of the patient pathway in your disease area to identify problems and opportunities. This primarily requires engaging with all the stakeholders along the pathway – not just the usual suspects. For example, recent work to redesign cataract services in Leicestershire was built around insight not only from ophthalmology consultants, clinicians and service managers but also theatre nurses, porters and receptionists. What’s more, it involved patients, pharmaceutical and device companies too. To be effective, stakeholder mapping must be open, collaborative and comprehensive. It must also be evidence-based. Developing the business case for pathway change requires establishing a robust benchmark of present-day performance and using that data to model new pathways. The industry can draw on huge datasets to understand and prove the patient pathway. For example, International Classification of Diseases and OPCS codes show the diseases and treatments assigned to individual patients in secondary care, whilst Healthcare Resource Groups show the treatment costs to the NHS. Primary care data is also crucial. GPs record diagnosis and activity using Read codes, though this can be harder to access. The challenge is to identify and integrate data from all these separate coding systems to develop a detailed picture of the current pathway.

The next step is to use intelligence captured in the mapping phase to develop simulations for new pathways that minimise waste and inefficiency. Ideally, companies should be thinking about this during Phase 3 development. An effective simulation will demonstrate how a remodelled pathway can drive positive change. However, it should focus on delivering value to the patient – rather than the institution delivering the pathway. Unlike institutions – which, as we’ve seen with primary care trusts, strategic health authorities and now accountable care systems, fluctuate with policy – patient pathways are stable and provide common ground for all stakeholders. Simulations must be built using currencies that provide value to all these stakeholders, with everything converging around the patient.

The final step – implementation – is crucial. Passive behaviours are the single largest component of failure. Change does not happen automatically. Pharmaceutical companies should be prepared to provide management capacity throughout the change process. This begins with developing and proving the business case for change and should evolve to support stakeholders through the communication and implementation phases. The development and management of a structured project plan is essential. A good implementation plan will detail the systems, resources and processes required in the new pathway – and connect actions and responsibilities with appropriate stakeholders. It will be underpinned by a commonly understood purpose and clearly defined metrics. Collaboration is the key to success; joint working is about pursuing shared goals, openly and transparently. For pharma, this may also mean collaborating with independent partners that can help bridge the gap between industry, NHS stakeholders and patients. The best partners will have experience in NHS commissioning and service redesign – as well as robust simulations that evidence high-value pathway change. However you approach it, the message is simple: to unlock meaningful value, pharma must shift its focus from product-led detailing to pathwayled models of engagement. Ultimately, success is all about the pathway, not about the pill. David Southern is Managing Director, Spirit Access. Go to www.spirit-healthcare.co.uk

Gain end-to-end understanding

Simulate demonstrable patient value

Collaboration is the key to success; joint working is about pursuing shared goals, openly and transparently

Implementation through collaboration

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Delivering the future of genomics

How is the use of genomics data enhancing our medical understanding and what does this mean for the future of precision medicine? WORDS BY

Yoshiko Cook and Joanne Hackett

6 | P H A R M A FI EL D.CO.U K

INTELLIGENCE

enomics is one of the fastest growing branches of medical science, and is already driving a paradigm shift in how we research a disease, as well as diagnose and treat illness. Fifteen years on from the first complete sequencing of a human genome, there is a growing number of medicines moving through approval processes for treatment based on a person’s genomics. The data gathered and held on non-identified patients is getting larger, more varied, and more precise. We increasingly know more than ever about the science behind a disease, the impact of treatment and the development of therapies for specific individual characteristics. For example, in diseases such as sickle cell anaemia, the gene has been identified so that treatment can be targeted for optimal outcomes. In many diseases however, the variant gene that causes illness has not yet been identified. Genomic medicine works by mapping an individual’s DNA and comparing it to a database of DNA to identify the genes which may be causing the disease. Considering that there are 3.2 billion pairs of letters in an individual genome, identifying the single variant which causes disease can be challenging. The addition of genomics data to our scientific and medical understanding forms a critical step on our journey towards precision medicine – with the potential to transform clinical research and healthcare delivery. COMBINING EXPERTISE

In October 2018, IQVIA and Genomics England announced a collaboration to launch the first Real-World research platform with integrated clinical and genomic data - non-identifiable as to an individual – bringing together the genomics data, expertise and network of Genomics England with the healthcare data management, technology and industry engagement from IQVIA.

Authorised researchers will be able to run studies to enable faster and more efficient drug research as well as the development of robust evidence to support treatment value and be a catalyst in the direction towards personalised medicine. Together, the collaboration will develop the technology platform that will connect clinical and nonidentified genomics data that will enable researchers – both academic and commercial – to conduct a wide range of research including: association studies of genomics and observable traits, comparative efficacy and safety trials, and burden-of-illness and discovery analytics using the de-identified data in a secure environment that protects patients’ privacy. Life sciences companies that use IQVIA’s leading clinical and observational research will be able to provide genomic testing to patients in parallel or as part of their clinical programs. ACCELERATING DIAGNOSIS

There are currently over 7000 known rare diseases, with approximately 250 approved drugs for treatment based on a person’s genomics, and yet it still takes on average 4.8 years to accurately diagnose a patient. A better understanding of the genetic drivers of diseases will help to accelerate patient diagnosis and the right treatment. As an example, within nephronophthisis (NPHP) it can be hard to identify patients. Using the rich data within Genomics England, 12 previously undiagnosed patients with homozygous NPHP1 deletions were found. Ultimately by finding these patients, the healthcare system can better treat the patients; through linking to clinical data the disease history can be analysed and research used to develop future treatments for this condition. In another example, a molecule for the treatment of pancreatic cancer has been granted FDA Orphan Drug Designation and is currently being trialled in patients across the UK – this has not only speeded up the molecule’s progression through testing, but reduced trial costs by 30-50% due to better targeting of patients.

The addition of genomics data to our scientific and medical understanding forms a critical step on our journey towards precision medicine

The deeper insights about patient populations and faster ability to understand the value of patient treatments has the real potential for analytical and scientific advances. The IQVIA and Genomics England alliance will enable research to advance precision medicine and patients’ access to novel therapies – getting the right drugs to the right patients, at the right time. UNLOCKING INNOVATION

We believe that the linkage of nonidentified genomics with non-identified clinical and other health data will be a centrepoint of healthcare innovation. However, it will not be possible to unlock the potential of this science without appropriate access to the data that the science generates. Both IQVIA and Genomics England were proud to take part in the second Life Sciences Sector Deal released in December, and continue to support the UK Government and the industry’s aim to ensure life sciences’ potential is realised through collaborations such as these. Customisable, searchable and flexible databases are the future of the development of this sector of life sciences, and the collaboration between IQVIA and Genomics England to make this dataset available is a significant step forward. Through medical researchers having access to this data, it will have a role in accelerating the development of medicines to treat disease and ultimately, improve human wellbeing. Professor Joanne Hackett is the Chief Commercial Officer at Genomics England and lead member of the Business and Investment Committee. Yoshiko Cook is Head of Strategy and Business Planning, North Europe, IQVIA. Go to www.genomicsengland.co.uk and www.iqvia.com

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Decisions with Value The NHS is facing complex challenges every day; with only finite resource available it must rethink its approach to value.

Value is securing the greatest improvement in health outcomes possible within the fixed budget of the NHS IT IS NOT…

minimising costs by cutting resource or budget, often at the expense of health outcomes

ACHIEVING REAL VALUE IN THE NHS REQUIRES A WHOLE SYSTEM APPROACH

Everyday healthcare decision-making should consider: Personal value1 for the individual Delivering outcomes of most importance to a patient

Allocative value1 for the population Delivering outcomes across a group of people

Technical value1 for the system Delivering quantity, safety, quality and outcomes from allocated resource

True value How AbbVie’s ‘Decisions with Value’ initiative brought healthcare experts together to tackle the challenge of improving health outcomes while making savings. WORDS BY

Antonis Papasolomontos

8 | P H A R M A FI EL D.CO.U K

ver recent years the NHS has faced complex challenges to remain sustainable – adapting to deal with an ageing patient population and tightening financial controls, whilst also making productivity and efficiency savings. AbbVie recognised the challenge that this presented having seen frequent examples of how pressure to realise efficiencies had led to a concept of ‘value’ in NHS services commonly being approached in terms of cutting costs, instead of securing the greatest improvement in outcomes within the NHS budget available. The Decisions with Value initiative began in 2017 with the aim of helping those working within the NHS to achieve the greatest improvement in health outcomes possible, within the fixed budget or resources available. The work remains highly relevant as the NHS Long Term Plan sharpens the value imperative further, containing as it does a number of interdependent aims to ultimately secure more efficient services, enhancing impact on patient and clinical care, whilst maintaining financial discipline.

MAKING VALUE-BASED DECISIONS

AbbVie brought together experts from across academia, healthcare policy and the NHS, all with front-line knowledge on the concept of value, to firstly investigate how it is understood and perceived within the NHS. The resulting report, ‘Kick-starting Value in the NHS’, focused on the implementation of value-based decision-making in a healthcare setting, which considers a broader set of metrics than simply cost of acquisition alone to deliver valuable health outcomes. The experts sought to facilitate an understanding of ‘whole system value’ and support a more holistic view of healthcare that avoids the pitfalls of silo thinking – in particular, how different roles within the NHS can fit with others to make more sustainable value-based decisions. Three practical guides for providers, commissioners and clinicians identified the barriers and challenges that often hinder the achievement of value (such as a single-minded focus on cost of acquisition); highlighted successful case studies of innovative local initiatives, and signposted NHS validated tools to support implementation of value-based decisions locally and at scale across regions.

INTELLIGENCE

The challenges

MAXIMISING VALUE CAN BE DIFFICULT AND THERE ARE MANY BARRIERS

Short-term budgeting System fragmentation Unrealistic targets and priorities However, embedding it in everyday practice will help lay the groundwork for the longerterm change required within the NHS.

Decisions with Value guides provide practical advice and tools to support adoption of value-based decision-making for: COMMISSIONERS

• Managing conflicting priorities between departments and organisations • O vercoming perceived lack of information on outcomes or costs data • A ligning contracts to the achievement of health outcomes over activities PROVIDERS

• Collaborating with clinical colleagues • Securing investment in value • Designing effective patient pathways CLINICIANS

• Identifying patient challenges • Securing the clinical voice in leadership decisions • Developing a business case template to implement value change

One of the greatest challenges is uniform adoption of approaches across the NHS. Speaking to front-line staff in the NHS I was struck by how difficult it can be, for a doctor or nurse trying to make positive change in the way they care for patients, to get visibility on how that change fits into the wider needs of the healthcare system or get buy-in from other parts of the NHS. Integration continues to be a key driver to reform healthcare delivery but people needed help in articulating their plans to commissioners and providers, or vice versa, to deliver an improved, sustainable system-wide service. That’s where the guides come in, giving examples of how it has been done elsewhere to try and remove unwarranted regional variation so that next time healthcare staff want to improve out of hospital care in a long-term condition, for example, they have a resource at their fingertips to make that happen. In addition to materials, facilitating face-to-face interactions was key to further embed the value concept across the NHS, fostering networking and the sharing of best practice. • Decisions with Value Roundtable meetings discussed how to ensure that the principles of whole-system value are taken into account with pathway design and optimisation and reducing variation (as per NHS Right Care principles) in gastroenterology, helping to bring to life the concept in a specific therapy area. This led to a special report ‘Taking the Value-Based Agenda Forward: The Five Essential Components of Value-Based Approaches to Health and Care’. • Commissioner and Provider Roundtable meetings at Clinical Pharmacy Congress and the Commissioning Show tasked participants with sharing and delivering their own case studies about value-based decision-making locally. Those attendees are now networked and sharing progress. AbbVie formally partnered with NHS Confederation (NHSC) and the Healthcare Financial Management Association (HFMA), to reach NHS commissioners, providers and finance leaders. In each of the devolved nations, Decisions with Value was exhibited at NHS conferences in Scotland, Wales and Northern Ireland. The Decisions with Value initiative has delivered tangible outcomes. Whether discussing whole system value at an exhibition in Belfast and Cardiff, or a roundtable discussion in London it was clear how much interest there is in the concept. Getting these things right is more complicated than it seems, but we know that healthcare teams have taken the insights back into their regional and local service discussions. We’ve also seen pathways being redesigned to reduce hospital demand across inflammatory bowel disease services in different parts of England. And we have discussions ongoing about how to embed these principles in long term condition management in other areas to trial the approaches in a practical setting. Value, when properly implemented across organisations and whole systems, can deliver improved clinical and financial outcomes, alongside achieving better patient experience – all critical if the NHS is to remain sustainable for years to come. Antonis Papasolomontos is Corporate Affairs and Policy Lead at AbbVie UK. Go to www.abbvie.co.uk/decisionswithvalue References: 1. NHS Confederation (2015) The ’triple value agenda’ must be our focus this century. Available at: https://www.nhsconfed.org/blog/2015/05/the-triple-value-agenda-should-be-our-focus-for-this-century [Accessed May 2017]. 2. Wagner et al. Med Care. 1995 Aug;33(8):765-70. Available at www.ncbi.nlm.nih.gov/pubmed/7543638 3. Williams, S. et al. (2012) IMPRESS Guide to the relative value of COPD interventions, British Thoracic Society Reports, 4(2). Available at: http://www.academia.edu/26043328/ISSN_2040-2023_British_Thoracic_Society_ Reports_Vol_4_Issue_2_2012_IMPRESS_Guide_to_the_relative_value_of_COPD_interventions [Accessed May 2017]. 4. NHS Institute for Innovation and Improvement (2012) Quality and Service Improvement Tools. Available at: https://webarchive.nationalarchives.gov.uk/20121201160701/http://www.institute.nhs.uk/quality_and_service_ improvement_tools/quality_and_service_improvement_tools/ [Accessed May 2017].

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CASE STUDY.

Building a healthier future for our NHS WORDS BY

Mark Toms

In a resource-scarce and budgetstrained environment, Joint Working Projects between the NHS and the pharmaceutical industry are helping to meet the healthcare challenges of the 21st century. How?

10 | P H A R M A FI EL D.CO.U K

t was during a routine meeting at NHS Lothian in 2014 that an idea was conceived for a new Joint Working Project (JWP) that would profoundly change the way people with cancer in the UK are treated. The Novartis Oncology team and Mira Farquharson, a consultant at the Western General Hospital in NHS Lothian, were mapping the patient journey in myeloproliferative neoplasms (MPNs), a rare type of blood cancer. Together they identified a number of pressure points in service delivery and soon realised the current situation was unsustainable. Increasing incidence of cancer diagnoses, an ageing population, and the development of more personalised and targeted cancer therapies meant that more healthcare professionalsâ&#x20AC;&#x2122; time was required to meet patientsâ&#x20AC;&#x2122; needs. More people were surviving cancer, but the service was working at full capacity and was unlikely to cope with future demand.

IN PR ACTICE

THE SERVICE MODEL

LEVERAGING DATA SCIENCE AND DIGITAL

Against the backdrop of a new NHS Scotland Cancer Strategy Plan, Novartis and the NHS Board worked in partnership over time to develop and pilot a new patient care pathway. As part of the JWP, they funded a MPN clinical nurse specialist who could offer patients telephone and outpatient clinics and manage patients who were clinically stable and did not have complex needs. The nurse-led service covered education, lifestyle advice, support, guidance and assessment throughout the patient’s journey. It was a huge success – 94% of patients said the NHS Board’s service had improved since the clinical nurse specialist joined. Crucially, the new model released 800 consultant appointments each year, freeing up consultant time to manage more difficult MPN cases. At the conclusion of the two-year pilot, evidence that the new pathway worked – and even gave the NHS Board cost-savings – was so robust, the Board continued the investment into a permanent clinical nurse specialist. A second JWP has now started in NHS Fife which was built on the learnings from NHS Lothian. Dr Kerri Davidson, Consultant Haematologist, Victoria Hospital, Fife, said: “Without the enthusiasm, support and efficiency of the Novartis team, we would never have got this MPN service development off the ground.”

It’s not just unlocking new skill sets within teams that Novartis is focusing on within JWPs. Within the 50+ NHS-Novartis Oncology collaborations, several are using data science to better patient outcomes. At the Christie NHS Foundation Trust in Manchester, the team knew that despite overall improvements in the outcomes of patients with breast cancer in the UK, significant differences remained in the presentation and management of the disease. A JWP with Novartis was implemented to analyse patients’ experiences of the breast cancer service at the Christie in real-time. Patients were asked to capture their thoughts and feelings as they received care using the app uMotif. It is hoped that the project will improve the speed of decision-making and treatment initiation (a key priority within the Cancer Strategy Plan) and be more responsive to patient needs.

A PARADIGM SHIFT

This type of JWP, where Novartis Oncology supports NHS organisations to utilise skills within the existing team to create new care pathways, has been rolled out across the UK and in services for breast cancer, neuroendocrine tumours (NETs), MPNs and rare cancers. Typically, Novartis and the Trust with whom they partner offer nurses or pharmacists the opportunity to train to become prescribers and undertake a clinical examination which enables them to take responsibility for a group of patients themselves. Since 2014, over 30 projects of this kind have been initiated and more are in the pipeline. Although consultant oncologists have traditionally been at the heart of cancer care delivery, a more inclusive approach validated through this type of JWP shows that a multidisciplinary team of doctors, nurses, pharmacists and others can work together in new ways to deliver better care to more patients. TRANSPARENCY AND TRUST

JWPs can take multiple forms, but all projects are designed to identify and adopt sustainable innovation that will deliver benefits to patients, the NHS and industry. The strict governance structure of JWPs demands that identified milestones have to be reached before funding from either partner can be released. Detailed benchmarking and evaluation means that although projects are highly localised, they aim to establish best-practice models that can be adopted more broadly across the health service.

COLLABORATING BEYOND CANCER

JWPs are embedded in Novartis UK’s DNA – we are proud to be a leading industry investor in JWPs in the UK and, outside of oncology, our partnerships span multiple therapeutic areas including cardiology, rheumatology, neurology, dermatology and ophthalmology. Preliminary outcomes from an ongoing JWP focused on heart failure (HF), also in NHS Lothian, reported in January 2018, show a new hospital-based specialist HF service is already reducing mortality rates, ensuring more patients receive the specialist and follow-up care they need and readmission rates are lowering. At the start of the project, an audit conducted by the Novartis-NHS JWP team showed patients were frequently not being seen by a HF specialist prior to discharge from hospital, which was reflected in higher-than-desirable readmission rates. Following the implementation of the new service, an estimated 91% of patients are now receiving input from a specialist during hospital stays versus less than 50% previously. Novartis is proud of its collaborations with the NHS – we believe we have a responsibility to create a healthier and more sustainable NHS. By working in close collaboration, sharing knowledge and experience with transparency, JWPs will support patients to have a better NHS experience and improve their disease outcomes. We have come a long way since 2014, but the results speak for themselves. As we face increased demands for care, JWPs offer a powerful new model of service delivery that will help to meet society’s new and unrelenting healthcare pressures. Mark Toms is Medical Director and Chief Scientific Officer, Novartis UK. Go to www.novartis.co.uk

M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2019 | 11

A partnership to improve outcomes for malnourished older patients has had a positive impact on this vulnerable and often marginalised group.

Feeding better outcomes

THE CHALLENGES TACKLING THE CRISIS

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There is no ignoring the significant challenges facing the NHS. Rising demand is stretching the limits of health and social care providers and there now exists a higher than manageable number of older, sicker, people with more complex conditions, living in the community. In common with most systems nationally, it is often the most vulnerable in society who disproportionately experience the impact of these pressures. Malnourished, dehydrated elderly people are the most vulnerable and disadvantaged cohort across health and social care systems. Urgent action is needed to address this. There have been numerous efforts to address nutrition and hydration challenges through policy and service development. However, this has not always translated into necessary service change on the ground or resonated with the practitioner on the operational front line. However, the 10 Point Plan pilot programme – a partnership between healthcare professionals, whole systems and a range of provider organisations and other healthcare organisations – demonstrates what is possible with energy, focus, commitment and, above all, a willingness to think and deliver care differently. The aim is to transition the older person to full independence as quickly as possible, transferring them home from hospital as soon as they are medically fit, with core rehabilitation and support provided by an integrated health and social care team in a home setting. This Programme demonstrates that there is a place for industry and partnership working, enabling that transition from supplier to partner.

THE 10 POINT PLAN Ten steps to a commissioned care pathway for frail older people

Understand the challenge through case reviews ° Spotlight failures and breakdown of care at the interface

MAXIMISING EFFICIENCY

Malnutrition is estimated to cost the public purse £19.6 billion in England alone; this is 15% of overall health and social care expenditure.1 It is estimated that £5,000 could be saved per patient through better nutrition management. The provision of nutritional support to 85% of patients at medium and high risk of malnutrition could lead to a cost saving of between £325,000 and £432,000 per 100,000 people.2 This is not just a health crisis, but a social and economic one too, which has the potential to disproportionately harm our most vulnerable citizens, negatively impacting our health and social care sector and society as a whole. A paradigm shift is required in the way that policy makers, commissioners, providers and professionals think and operate.

IN PR ACTICE

Create regional and sector champions

Grasp the key challenges

Reset the workface

Sanctions

° Clinical and operations

° Prioritise main disease areas ° Apply financial targets

° Targets to encourage compliance ° Sanction for non-compliance

Involve the sectors

Increase awareness

° Role of the prescribing dietitian in the multi disciplinary team – and pharmacists ° Elevate role of voluntary sector as prompters ° Opportunity to educate/retain

° Industry, NHS, healthcare professionals, third sector ° Opportunity to cost pathways (eg opportunity cost, avoidable cost, cost of management in own home versus hospital) ° Opportunity to run pathways (eg B2B industry/care providers) ° New products ° Risk shares and lead accountable provider (LAP) ° Voluntary sector and the ‘brefriender and carer’ ° Incentives – evaluate products in a different way? ° Key specialist expertise

° Mandate nutritional health check ° Screening on admission ° Signposting to key groups (eg dietitians, pharmacists)

Change point of care ° Don’t rely on one point of entry to system ° Joint reviews: dietitians and community pharmacists ° Include voluntary sector and the unpaid cover ° Don’t neglect GPs either

The goal of the 10 Point Plan was to create a multi-organisational, pan-sector comprehensive care pathway for frail older people, recognised and applied by all. Bringing together the acute hospitals, community care, social care, third sectors and industry, it is hoped that the plan will be endorsed by key stakeholders and rolled out in clinical commissioning groups up and down the country. The organisations involved in the 10 Point Plan pilot programme have shown what is possible through partnership working, thereby enabling that ‘supplier to partner’ transition. 1 Elia, M, (on behalf of the Malnutrition Action Group of BAPEN and the National Institute for Health Research Southampton Biomedical Research Centre), The cost of malnutrition in England and potential cost savings from nutritional interventions, 2015 2. Forgotten not fixed - A blueprint to tackle the increasing burden of malnutrition in England - published by BSNA , Feb 2018

Minimum standards required ° Ensure NICE CG32 and QS24 are recognised and implemented ° Ensure MUST and malnutrition pathway is followed ° Mandate oral nutritional supplements in certain situations ° Create specific timelines and milestones for patient monitoring and review ° Create risk profiling guidance/ set of common sense indicators

10.

Pilot the new pathway in one or more CCGs

To test the concept, the plan was piloted in Kent, Essex and the South-West (Wiltshire and Gloucester) over an eight-month period from April to November 2017. The organisations gave their time for free and willingly and positively engaged in the pilots as they recognised the value of this approach not just within their own settings, but nationally.

INDUSTRY INVOLVEMENT

By understanding fully the local environment, challenges and opportunities you can do things differently

WORDS BY

James Roach

An unrestricted grant was directed by the British Specialist Nutritional Association (BSNA), the voice of the specialist nutrition industry in the UK, representing the manufacturers of high-quality foods designed to meet the needs of people with very special nutritional requirements. The BSNA and its members were keen to support the programme in an unrestricted way and consider system-wide innovative ways to address the impact of medical malnutrition and ensure the issues associated with malnutrition are recognised by key decision makers on a regional and national basis. Without the support, insight, expertise and flexibility of the BSNA and its industry, this would never have been achieved.

M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2019 | 13

MOVING THE PLAN OFF THE PAGE PILOT STAGE APPROACHES

The aim was to engage a range of patient organisations to ensure that the patient and carer view was at the heart of all activity

DIV AL IDU S

Agile Purpose REAL CHALLENGES, PRACTICAL SOLUTIONS

Relationships Understanding

The aim of the 10 Point Plan was to develop a practical service improvement guide for the health and care sector to ensure an increased understanding of the challenges generated by insufficient focus on malnutrition and dehydration, and provide the evidence and tools by which patient experience can be enhanced.

Community base Caseworkers Strength based M CO MU NI TY

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THE 10 POINT PLAN PILOT PROGRAMME HAS LEFT A CLEAR LEGACY OF CHANGE AND IMPROVEMENT. SOME EXAMPLES OF ITS ACHIEVEMENTS ACROSS REGIONS INCLUDE:

• Engaged with providers who collectively provide health and social care services for a population in excess of 1.5 million. • Uniquely pulled together acute hospitals, community services, primary care (GPs and pharmacists), nursing and residential care, domiciliary care, voluntary, independent and private sector, patients and relatives into a connected service pilot. • Engaged directly with individual nursing and residential homes and also consulted with organisations representing 125 nursing and residential homes. • Engaged with over 250 front-line professionals (covering a range of disciplines). • P ut in place a range of new service initiatives in areas such as assessment, training, technology and integrated working. • Demonstrated through action and example what is possible in developing new approaches and practices. • Engaged a range of patient organisations to ensure that the patient and carer view was at the heart of all activity. • Left a strong legacy for change and improvement locally, nationally and, perhaps more importantly, on a personal level for the individual practitioner.

THE LEGACY

THE HOW

IN PR ACTICE

AN INDUSTRY PERSPECTIVE

Key to the pilot programme’s success has been the active involvement of health and care professionals, voluntary sector, trade, the public, subject matter experts, service directors and leaders. It’s critical we engage, inspire and motivate those at the sharp end of care delivery so they feel empowered to change things for the better for the patients they serve.

M CO MU NI TY

Exploration Conversations Relationships Collaboration Connection Trust

Adam Brown, National CCG Sales Manager for Fresenius Kabi Ltd, a member of the BSNA: “We wanted to see how the current service could be changed to improve what is being provided for patients in an area. By understanding what was needed we could then work with the NHS to support change. The impact on market access is positive as it shows that by doing things differently you can make a difference in an area. It is ‘grown-up’ working, being open and transparent without hidden agendas. By doing this it means that we can work towards a common goal with the right patient receiving the best products. Industry brings value in a number of different ways. This is not about financial value. It is time and expertise from a company in terms of data, knowledge and skills. By understanding fully the local environment, challenges and opportunities you can do things differently. It was about the NHS as customers and benefits for the patients.” NEXT STEPS

• The full report and its key recommendations will be launched nationally in March 2019 • A range of engagement events • All documents and supporting resources will be made publicly available.

Platform

DIV AL IDU S

James Roach is Director of Conclusio Limited. The author extends his sincere thanks to all those involved.

WILTSHIRE AND GLOUCESTER

ESSEX

KENT

• Community matrons and district nurses receive annual training led by specialists on nutrition and hydration for patients on an End of Life Pathway. • All patients receiving domiciliary care as part of the Urgent Care at Home Service run by Medvivo are now being screened for malnutrition and dehydration within 48 hours of being discharged home. • Screening questionnaires now form part of the triage process for NHS 111 and out of hours services.

• The presence of the Patients Association Nutrition Checklist has encouraged GPs to undertake an assessment for risk of malnutrition through the annual health check process for the over 65s. • Community pharmacy-led screening for malnutrition and signposting, advice and support given. • Intention to align more dietitian input and capacity to established integrated teams.

• Module on identifying malnutrition and dehydration now a mandated part of all staff inductions. • Public health-led prevention programmes focused on malnutrition and dehydration. • Launched the ideal comprehensive care pathway for the frail older people which has been developed as part of the 10 Point Plan.

Adopting and scaling the innovation generated as part of the 10 Point Plan programme is absolutely critical and working in partnership with organisations such as the Allied Health Science Networks (AHSN), NHS Right Care, and NHS Improvement will help to achieve this. Clear benefits will be gained if professionals from across the system work together to develop a common plan and a common solution.

M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2019 | 15

CASE STUDY.

A sustainable ecosystem How can we create a world-class system of care which fulfils the ambitions of the NHS Long Term Plan? Working together holds the key. WORDS BY

Heather Parkin

e are at a pivotal moment in healthcare history. An unprecedented convergence of medical knowledge, technology and data science is revolutionising patient care. Rocheâ&#x20AC;&#x2122;s vision is to ensure that the screening, diagnosis, treatment and even prevention of diseases will more quickly and effectively transform the lives of people everywhere â&#x20AC;&#x201C; ensuring the right treatment for the right patient at the right time. We believe that advancements in medicines and technology will ultimately offer a route to modernising the NHS and improving patient care, yet we recognise that the current pace of change inevitably places pressure on our complex health system. The NHS is facing considerable challenges as it looks to create a modern healthcare system that supports our ageing population, and the rise in chronic diseases. These demands are being addressed at a time when the NHS is coping with unprecedented financial and human resource challenges.

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INSIGHT

ROCHE AND NHS JOINT WORKING PROJECTS TO DATE HAVE STRIVED TO REALISING POTENTIAL

A FOCUS ON VALUE

It is widely accepted that nothing short of a re-envisioning of the NHS will be required to realise the true potential of these advances and create a system of care that sets an example to the world. This is an ambition that has been laid out in the NHS Long Term Plan. Such a significant change will critically require strong partnership between industry and the NHS to ensure UK patients can benefit and together we can create a sustainable healthcare ecosystem. As a result, strategic partnerships are now a core element of our business at Roche, allowing us to work with likeminded NHS innovators who want to drive transformational change through personalised healthcare, patient selfcare and commercial innovation. Our commitment ensures we can always deliver access to our ground-breaking analytics, scientific rigour, medical technology and expertise in innovative contracting in the long-term, and not just for one-off projects. A long term, shared vision is enabling us to work together with the NHS on projects which have multiple work streams and aims to deliver world class systems of care.

Working with one forward thinking NHS system on models that put patients at the centre and adopting new models of care, we have been able to set out an ambitious programme of work which includes improved pathways of care, the development of a tumour board and improved access to clinical trials. In addition, we have been working together with forward thinking clinicians and managers to define criteria for setting up an outcomesbased contracting framework for cancer treatments. The aim of this is to create a contracting mechanism that moves the focus toward the value that a patient and the NHS receives and changes the focus towards incentivising the best possible outcomes. If the pilot is successful we would look to scale this across the country. To date, we have prioritised suitable outcome measures, identified the data infrastructure which would be required to support such a contract, and identified a suitable product. The outcomes measures that have been identified are focused on those that really matter to improving clinical outcomes, patient outcomes and increasing system efficiency. The next stage in the process requires an in-depth understanding of the commissioning process and funding flows. Partnership working can lead to increased patient benefits â&#x20AC;&#x201C; better access to quality healthcare services and better healthcare outcomes. Heather Parkin is Strategic Partnerships and Initiatives Lead, Roche Products Limited. Go to www.roche.co.uk

The current pace of change inevitably places pressure on our complex health system

Improve quality throughout a patientâ&#x20AC;&#x2122;s healthcare pathway

Implement alternative models of care to increase patient access to care

Support redesign of disease management services

Better use of data to measure healthcare outcomes and reduce inequalities

Enable NHS spending to translate into better healthcare outcomes

Share good clinical practice across the NHS.

M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2019 | 17

And the Pf Awards 2019 winners are... Congratulations to all finalists and Pf Award winners. Follow the event on social media and look out for the highlights in the April issue of Pf Magazine. For full coverage of the night, subscribe to receive the special Pf Awards 2019 Post Awards Brochure at www.pharmafield.com/subscribe

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GOLD SPONSORS

S I LV E R S P O N S O R S

SPONSORS

Itâ&#x20AC;&#x2122;s academic As R&D across genetic and cellular therapies progresses, how important is the role of innovation in the world of academia to exploiting the full potential of biologics? WORDS BY

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Dr Steve Arlington & Christopher McKenna

INSIGHT

Figure 1.

METHODOLOGY

A cultural shift is needed from industry to really get behind collaboration

Top 30 institutions or companies that issued patents for the first time for new biologics for calendar year 2015 inclusive through May 2018. COMPANY OR INSTITUTION

BIOLOGICS PATENTS

University of California

183

F Hoffmann-La Roche AG; Hoffmann-La Roche Inc

112

F Hoffmann-La Roche AG; Genentech Inc

t the end of 2018, The Pistoia Alliance and one of its members, Clarivate Analytics, undertook research to develop the Life Sciences Innovation Report. Developed with inputs from executives at GSK, AbbVie, Cancer Research UK and Diavics, we sought to uncover the top five trends for the life sciences sector in 2019. The report highlighted a range of topics, including multi-disciplinary innovation, the implementation of new technologies, new approaches to research, the digitisation of R&D and healthcare, and academic contributions to biologics R&D. In this article, we will look more closely at one of these trends – the contribution of academia to biologics R&D, and how the industry can better collaborate with academic counterparts. Biologics is an area likely to see considerable growth in 2019; the market is predicted to grow from $254.9bn in 2017 to $580.5bn by 2026. The key to realising this potential though – as with all successful life science endeavours – is collaboration. As R&D across genetic and cellular therapies (for example CAR-T cells, stem cells, siRNA, and CRISPRCas9) advances, innovations in academia will be essential in realising the therapeutic potential of biologics. Although there is a long history of productive work between scientists in academia and pharmaceutical companies, there are barriers in place that don’t always make it easy – whether these are technical, legal or cultural. These barriers hamper collaboration, but to progress biologics research in the future, industry and academia must work together to overcome these hurdles. BIOLOGICS RESEARCH TODAY

Our report found that of the top 30 institutions patenting biologics (see Figure 1), the majority are non-commercial, with universities making up a third of the list alone. One reason for this is that academic research, indeed basic research, is where most of the insights into disease cause originate. As that knowledge becomes available, academia is quick to exploit an increasing understanding of genetic, cellular and protein engineering to intervene in those disease processes and to test new therapeutic approaches. While traditional pharmaceutical companies also have the scientific prowess to test new therapeutic approaches based on novel disease insights, pharma is optimised for scaling up therapeutic production and manufacturing of large batches of the same formulation for all patients.

109

Regeneron Biopharmaceuticals Inc

Johns Hopkins University

MedImmune LLC

Novartis AG

Stanford University

Bristol-Myers Squibb Co

National Institutes of Health; US Department of Health and Human Services

Harvard University

Agency for Science Technology and Research

Samsung Electronics Co Ltd

Memorial Sloan Kettering Cancer Center

Texas A&M University System

Dana-Farber Cancer Institute Inc

Massachusetts General Hospital

Massachusetts Institute of Technology

University of Pennsylvania

Janssen Biotech Inc

Mayo Clinic Foundation

Amgen Inc

SNU R&DB Foundation

Chugai Biopharmaceutical Co Ltd

University of Washington

University of Massachusetts

Duke University

AbbVie Inc

University of Wisconsin-Madison

UCL Business PLC

Pfizer Inc

Source: Cortellis, from Clarivate Analytics.

M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2019 | 21

INSIGHT

Figure 2.

THERAPEUTIC CATEGORIES Biologics therapeutic categories by investigational drug count, Life Science Innovation Report, December 2018 Humanised Monoclonal Antibodies Human Monoclonal Antibodies Gene Therapy (Adeno-Associated Virus Vector) Bispecific Antibodies Murine Monoclonal Antibodies Monoclonal Antibodies Gene Therapy Antibody-Drug Conjugates Stem Cell Therapy Cell Therapy 0

100

200

300

400

s CAR-T and other cellular therapies advance, a different paradigm emerges – the raw ingredients (for example T cells) start with the patient, are modified in a lab, and delivered back to the patient as therapy. This new form of cell-based supply chain is a completely new form of treatment paradigm, more aligned to an academic research hospital than large pharmaceutical manufacturing and supply chain. Additionally, the field of biologics and its associated disciplines are more varied, making academia a perfect proving ground for biologics R&D. This is illustrated by the breadth of the top 10 biologics therapeutic categories (see Figure 2). Commercial pharmaceutical companies are built to exploit knowledge of the molecular basis of a disease, while academia is typically where that knowledge originates in the first place. However, with biological therapies this process is flipped on its head, and knowledge discovered in an academic lab or research hospital can be exploited directly with investigational tools, at a small scale for individual patients. With this approach, massive R&D infrastructure isn’t necessary (i.e. lead discovery, optimisation, and formulation development). But one area where big pharma can help is by using its networks and know-how to get new innovations to market quicker. One project in this vein is Merck (MSD) and InnoCore’s recent partnership to develop a new drug delivery platform for biologics to bring therapies to market faster by increasing compliance.

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500

600

700

800

A CULTURAL SHIFT

To make this kind of industry-academia collaboration possible, several obstacles currently hindering collaboration between pharma and academia must be overcome. One of the biggest is the wide variance in data formats, something that needs to be addressed to increase the interoperability of data. Another factor is that although there are incentives in place, and the benefits of collaboration are clear from other examples, a cultural shift is needed from industry to really get behind collaboration. One of the most deep-rooted problems is the fear from both pharma and academia of sharing data, and entrenched positions from legal and regulatory advisers which often result in an unwillingness to collaborate. The establishment of programmes like National Institutes of Health’s Data Commons, a cloud-based platform that promotes the sharing of biomedical research data from government-funded grants, and the creation of resources like database of Genotypes and Phenotypes (dbGaP), is a move in the right direction. Improving ontologies and data sharing standards will accelerate the adoption of these resources. However, as academia and private industry have inherently different goals – typically, academics are looking to publish papers on new findings, while private groups want to efficiently discover new therapies – this shouldn’t be a concern. Big pharma should nurture collaborations so both parties benefit, furthering progress in the field of biologics and fulfilling unmet needs. Today, no single company has the resources or knowledge to meet all their goals alone. The Pistoia Alliance’s mission is to work with members to enable data sharing in a precompetitive environment and ensure companies feel safe while doing so. Throughout 2019, and working with members like Clarivate Analytics, the Pistoia Alliance will continue to develop projects in the areas its members are most interested to further life science innovation. Dr Steve Arlington is President of The Pistoia Alliance and Christopher McKenna is Global Head of Life Sciences Professional Services & Consulting at Clarivate Analytics. Go to www.pistoiaalliance.org and www.clarivate.com

A DV ERTO R I A L

f you’ve been doing the same job for a while or you feel like you need a change but you’re just not sure what to do about it, then you’re not alone! Many of the candidates who approach CHASE feel the same way. This feeling could be related to a clear, specific issue that’s bothering you or simply just a voice in the back of your mind asking recurring questions about how much satisfaction you’re getting from your work. Whatever the catalyst, it means you’re feeling unsettled in your role. Whenever CHASE has these types of discussions, our consultants get to know candidates as individuals and will explore what they really want out of a job. This could be future career opportunities, a more varied role, a specific therapy area or a better work:life balance. Luckily the pharmaceutical and healthcare sectors offer lots of choice and wonderful career opportunities. In short, these industries are more than pretty good – they’re great!

Our best advice for the vast majority of candidates is to start by reflecting on how you’d like to move forward. Speak to those who you trust and who know you the best. Spend time thinking about it – be honest with yourself. Also speak to someone who does this for a living – for example, one of the CHASE consultant team! You’ll find that talking this through with a variety of people will be a massive help, and it may even lead you to a place where you decide that you’re actually okay where you are. Sometimes we forget to stop to appreciate what we have. However, if you decide that pastures new are for you, speak to your chosen consultant and work with them to craft a plan to find something new and fresh. Whatever your situation there will be something for you to seriously consider. At CHASE our team of experienced consultants will help you make the best possible decisions over the course of your career. We love seeing our candidates thrive and progress their careers. As we celebrate our 21st birthday year, we have many, many examples of candidates who have turned to us at various points in their career for advice, support and assistance. Whatever your career stage or level of seniority, find your trusted advisors – you won’t regret it. Helen Weller is Recruitment Consultant at CHASE. If you’d like to speak to your local CHASE consultant please do get in touch: 0131 553 6644 | connect@chasepeople.com www.chasepeople.com

“The pharmaceutical and healthcare sectors offer lots of choice and wonderful career opportunities”

PARTNERING FOR CAREER SUCCESS

We’ve got a fantastic range of Sales, Marketing & Nursing roles across our Pharmaceutical & Healthcare clients. Please get in touch today to find out what we can do for you. chasepeople.com 0131 553 6644 connect@chasepeople.com

Not sure what role is next? Find your trusted advisors. CHASE’s Helen Weller shows you how. M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2019 | 2 3

O WORDS BY

Darren Spevick

A long engagement Can pharma and the NHS equal the fast pace of change necessary to fully embrace technological innovation?

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ver the last few years, slowly but surely, the pharmaceutical industry has been waking up to the changing world and engaging with technology providers. Why is this? Technology is viewed by many as the enabler of change â&#x20AC;&#x201C; change that could decrease the time for drug development; improve the early diagnosis of conditions; increase patient adherence; collect real world evidence to demonstrate outcomes and value; enable the delivery of healthcare solutionsâ&#x20AC;Śand so on. Many pharmaceutical companies have struggled with how to engage with this new technology and we have seen some different business models employed from creating innovation teams or incubators and others looking to find the right partner and collaboration. Some examples of collaboration include Otsuka and Proteus, Novartis and Google, IBM Watson and Novo Nordisk, Sanofi and Verily, GSK and Propellor Health, Sanofi and Science 37, to name but a few.

D I G I TA L

THE RISK FACTOR

NHS INVOLVEMENT

There are some challenges when pharmaceutical companies and tech firms try to collaborate, as their ‘normal’ worlds are often poles apart. For instance – pharma is traditionally conservative, relatively slow moving and highly regulated; whereas technology firms are traditionally high risk, fast moving and often less regulated, so when the two are brought together, there is likely to be some tension. Risk is an interesting dynamic in this equation. Recently, I presented an overview of digital health to the UK leadership team of a top five pharmaceutical company. Their general manager pointed out to his team that their company and the pharmaceutical industry as a whole would often risk £1bn+ in developing a new drug which may fail, yet seemed overly worried and cautious about investing £500k to £1m in a digital health technology. It is all a matter of mindset and a recognition that this was outside of their comfort zone. Given the dynamics of the different industries, I think it is fair to say that a technology company is unlikely to want to become a pharmaceutical company, and vice versa, but there is a convergence and the lines will become blurred over time. As a result, we are seeing more collaboration, recognising that each party brings something valuable to the table.

An interesting shift we have also seen in the last 12 months has been for the NHS to get far more involved, actively wanting to become more digital and making it a little bit easier for technology firms to test their products in the real world. This is because the NHS sees the potential benefits to patients and the decrease in costs that technology could enable. For example, the NHS has recently collaborated with several technology firms to deliver technology enabled services including Babylon, Oviva and Medopad. In a recent interview with Forbes, Vas Narasimhan, Chief Executive Officer of Novartis AG, openly talks about the challenges of bringing technology into pharma, and whilst there is a lot of hype, a lot of potential, and a lot of conferences and events talking about artificial intelligence, data, digital etc in pharma, we must remember that this is an emerging landscape and it is still early days in terms of seeing some real tangible results. However, the fact that the pharmaceutical industry finally seems more serious about ‘going beyond the pill’ has to be a good thing for the industry and patients alike. I fully expect that over the next few years we will start to see the positive results of collaborations between technology companies, the NHS and the pharmaceutical industry in delivering technology-enabled healthcare that has a real benefit on improving all of our lives, so watch this space. Darren Spevick is Managing Partner of Eventum Partners and Chair EMIG Digital Health Group. Go to www.eventumpartners.com

This is an emerging landscape and it is still early days in terms of seeing some real tangible results

M AG A ZI N E S P EC I A L ED I T I O N | M A R C H 2019 | 2 5

PARTNERING FOR SUCCESS:

The Primary Care Women’s Health Forum presents many opportunities for partnerships that improve women’s health.

he Primary Care Women’s Health Forum (PCWHF) was originally created to address the specific needs of healthcare professionals (HCPs) caring for millions of women in primary care in the UK today. It operated as a successful general networking and best practice group for a number of years before becoming incorporated as a community interest company (CIC, a special form of non-charitable limited company, which exists primarily to benefit a community or pursue a social purpose, rather than to make a profit for shareholders) in 2013. Relaunched in 2018, with a new website, membership offering, exclusive specialist resources and news, the PCWHF has access to a network of around 10,000 HCPs with a special interest in women’s health, all working at the forefront of primary care.

2 6 | P H A R M A FI EL D.CO.U K

IN PR ACTICE

THE BENEFITS OF PARTNERSHIP

Partnering with the PCWHF on women’s health projects gives pharmaceutical companies and healthcare organisations the opportunity to increase their chances of success, by providing access to a significant group of HCPs with a wealth of specialist knowledge, expertise and connections within the area of women’s health. The Forum does not endorse products but will support initiatives that improve HCP education, standards and patient treatments. The PCWHF attracts a wide range of membership from multiple disciplines, to promote and progress standards in women’s health, and is widely recognised and respected as a credible consultation body for women’s health issues.

The PCWHF attracts a wide range of membership from multiple disciplines, to promote and progress standards in women’s health

WORDS BY

Amy Schofield

THE PCWHF:

• P resents an opportunity for peer support and exchange of views through its website, and national, regional and local educational events. Its annual conference attracts over 100 delegates. • Is a trusted information source for female patients. • P rovides opportunities to support and develop evidence-based practice through pathway development; clinical guideline development; continuous quality improvement. • Is a place for continuous sharing of best practice in relation to national, regional and local developments in women’s health issues. • Is an advocate of, and prominent voice in, support for HCPs working in women’s health. PCWHF’s exclusive resources are created by its Executive Committee and Members, who know exactly what information busy primary care HCPs are looking for, and exactly how they like to consume it. For example, in January 2019, The Menopause Doctor, Dr Louise Newson, created an HRT Prescribing Guide which has been downloaded almost 5000 times. Other specialist resources include: ‘10 Top Tips for Intrauterine Contraception Guidance’, and ‘10 Top Tips for Recognising and Supporting Women with Ovarian Cancer’, which take the form of handy, easy reference guides for busy HCPs.

WORKING IN PARTNERSHIP TO DEVELOP BEST PRACTICE

In recognition of the fact that there are many myths associated with intrauterine contraception (IUC), the PCWHF created ‘10 Top Tips for Intrauterine Contraception (IUC) Guidance’ for HCPs, with grant funding from Bayer. Easy to refer to, it looks at the role that healthcare professionals have in helping women to consider and choose their preferred contraceptive option, while addressing potential concerns regarding IUC use. The tips have also been produced as a poster which can be used in conjunction with the resource. Both have been made freely available to download from the PCWHF website for any interested HCPs, and have been designed to be easily digestible and shared amongst primary care colleagues interacting with women on a daily basis.

Educational programme The PCWHF has a dedicated educational programme aimed at HCPs with industry supported exhibitions. New for 2019, the ‘Her life, her health’ series of events across England follows a woman’s health through the four stages of life. Starting with the early years, moving through her fertile years, onto a woman’s renaissance years and finishing in her golden years, HCPs hear live consultations and critically analyse what is discussed. ‘Her life, her health’ uses national guidelines to construct concise and relevant clinical consultations looking at the evidence around different treatment options and using interactive teaching methods to test each HCP’s knowledge. Speakers are leading women’s health experts including PCWHF Chair and Royal College of GPs Clinical Champion for Women's Health, Dr Anne Connolly. The educational programme also includes a range of podcasts and exclusive ‘Ask the Experts’ webinars for HCPs. If you specialise in women’s health and would like to support HCP education to enable women to make informed choices about the care they receive, PCWHF can help you to reach those professionals who focus on the health of women. Contact submissions@pcwhf.co.uk or call 01462 476120. Go to www.pcwhf.co.uk

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INTELLIGENCE

A rare opportunity

Partnership, whether local or strategic, must add value in order to be successful, especially in the rare disease space. Lee Simms & Craig Bradley WORDS BY

2 8 | P H A R M A FI EL D.CO.U K

artnership working between pharmaceutical companies and the NHS in the UK can be undertaken at many different levels. What we know about partnerships with the NHS is that they must add value in developing healthcare delivery and improving outcomes to ultimately benefit patients, whilst enabling the NHS to meet the requirements of its mandate and operate within its financial resources. Over the last few years there’s been a real shift in pharma to delivering innovative medicines in the UK for patients with rare diseases, with partnerships a reality on many different levels – from the strategic level where there is a great opportunity for pharma to meet considerable unmet clinical needs in markets with very limited treatment options, through to the local level where for field-based pharma teams there can be series of different challenges regarding partnership around access/funding/implementation of treatments as there is a much smaller base of key healthcare professionals to engage.

THE PATIENT JOURNEY

Within the rare disease space specifically, diagnosis, treatment and management requires the highest level of partnership working to remove unnecessary barriers. Optimising the patient journey is paramount: the patient’s experience from their first contact with the NHS through to reaching a diagnosis and onto managing their condition and ongoing care. By understanding the patient pathway in granular detail, we can pinpoint the value points of the pathway that can be improved to create value for the patient, the NHS and pharma. And in getting partnerships right and delivery of quality outcomes, there is the added benefit of building trust and confidence with the NHS. Within rare disease, the smaller number of NHS centres commissioned to treat specific conditions provides greater opportunities for closer collaboration and partnership working. Dr Jonathan Hind BMedSci, BM, BS, FRCPCH, Consultant in Paediatric Hepatology, Intestinal Rehabilitation and Transplantation, at King’s College Hospital, London, and SecretaryTreasurer Elect of the Intestinal Rehabilitation and Transplant Association, describes how collaborative working between the NHS and industry can facilitate better understanding about rare diseases and how they can be best treated, whilst industry’s support for education and training programmes can enable health and social care professionals to better identify rare diseases to help deliver faster diagnosis and access to treatment pathways for patients. “I have had a very positive working relationship working with Lee and Craig from Takeda, via legacy Shire. They always work in a collaborative fashion to help patients and to facilitate education on rare conditions. This has helped facilitate patients to get the care they need easily. The education aspect has enabled front-line staff to access educational opportunities they otherwise wouldn’t be able to,” he says. “I have also been able to talk to the wider team, which I hope was positive for those who don’t get to see the stories of the real-life patients behind the medications they work on.” Positive partnership working between the NHS and pharma can be synergistic and should lead to the delivery of enhanced patient care, improved outcomes for patients including increased access to innovative treatments, and positive working relationships. Lee Simms is Account Lead, Internal Medicine, Takeda. Craig Bradley is Product & Business Lead for Internal Medicine across the UK & Ireland, Takeda. Go to www.takeda.com

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PLUGGING THE How can collaboration help to fill the skills shortage gap to ensure that the UK can compete in the global future of life sciences?

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he Topol Review * of digital training needs for the NHS was published in February 2019, and according to the review, cross-sector collaboration is vital to the future success of medicines development. But this can only be achieved if there is enough scientific talent coming up through the ranks to cement the UK’s place in the global health marketplace – and collaboration could be key to addressing the problem. The future depends on a sufficient number of students studying the science, technology, engineering and mathematics (STEM) subjects that are vital to facilitate the discovery of the advanced technologies and treatments that will shape the future success of the UK’s pharmaceutical and biotechnology sectors and cement the part that the UK plays on a global scale. The ABPI recently warned that the UK is falling behind Europe in nurturing the students who could fill these highly-skilled scientific roles. If the situation is not addressed as a matter of urgency, a skills shortage could result as talented people move to other parts of the world. Despite the number of UK undergraduates studying STEM subjects increasing by 16% over the last decade (compared to an overall increase across all subjects of 13%), undergraduate numbers for EU students increased by 52% and non-EU students (worldwide) increased by 63%**. The figures around the skills gap came from the ABPI’s latest biennial survey of member pharmaceutical companies, and analysed the challenges of recruiting suitably qualified and experienced staff. Writing the foreword to the skills gap analysis, the ABPI’s Chief Scientific Officer,

Professor Carole Longson, said that the UK’s current position as a leading global hub in life sciences is in large part driven by ‘the quality of our UK workforce with outstanding skills and talents in companies, universities and, of course, the NHS’. The Topol Review addresses the importance of this cross-sector collaboration, which author Eric Topol, a cardiologist, geneticist, and digital medicine expert, says is vital for the future of the health service. He adds that our workforce must adapt its skill set to the rapidly evolving technologies coming down the line. Although it focused solely on the biopharmaceutical industry, the ABPI report also identified genomics as a crucial priority and a swiftly evolving field, as far as industry skills needs lie. The use of genomics is the force behind a new age of medicines discovery and offers a host of benefits to patients’ health. Other areas of need identified in the report and in the Topol Review were: • i nformatics • computational disciplines • i mmunology • clinical pharmacology • core training in genomic literacy • career pathways for bioinformaticians • expansion of undergraduate capacity in genomics • bioinformatics • data science. Together these reports highlight the need for a substantial increase in availability of crossdisciplinary talent to feed the needs of a world where increasingly patients are better informed and take more ownership of their care. *https://topol.hee.nhs.uk/ **https://www.abpi.org.uk/media-centre/news/2019/ january/addressing-skills-shortages-critical-to-thefuture-of-uk-science/

INSIGHT

GAP

FUTURE READY To help build a workforce able to research, develop and manufacture the medicines of tomorrow, the ABPI made the following recommendations:

Clinical pharmacology should be on the Home Office shortage occupation list, and for the list to be reviewed more regularly so we can react to shortages more quickly (as part of the Clinical Pharmacology Skills Alliance (CPSA)).

Progress in meeting these challenges will be most effectively addressed through collaboration across industry, NHS and academia

WORDS BY

Amy Schofield

Create the standards for a new high-level Clinical Pharmacology Scientist apprenticeship together with the CPSA, which has now been approved for development by the Institute of Apprenticeships (as part of the CPSA).

Align and work with organisations including the British Science Association to encourage more young people into STEM subjects at university and helping support a new government-funded competition for young people.

The ABPI also committed to ‘convene key partners in healthcare and industry to identify opportunities to improve support focused on research and innovation for medics throughout their training and career, e.g. developing ABPI’s careers resource into a new joint portal that will support, amongst others, medical students with their career’. Alex Felthouse, Science Industry Partnership (SIP) Board member and Managing Director of Eisai Manufacturing Ltd, said: “The Science Industry Partnership is delighted to welcome the ABPI’s updated Skills Survey report, providing the sector with further evidence on skills, as it prepares for a future outside the EU. The SIP looks forward to collaborating with the ABPI and the BioIndustry Association, to responding with a ground-breaking Life Sciences 2030 Skills Strategy.” The second Life Sciences Industrial Strategy Sector Deal made commitments to working with Health Education England to align industry’s support for work on medical careers with the Topol Review, and the ABPI says that it is now ready to begin taking the work forward. “The UK has the potential to be a worldleader in healthcare technology and in medicines and vaccines research and development,” says Andrew Croydon, Director of Skills and Education Policy at the ABPI. “This is an exciting area of science and we want young people in the UK to be equipped to lead this work, alongside other countries such as Germany, France and China, who are all making strides in developing advanced treatments and technologies for patients. “It is logical that progress in meeting these challenges will be most effectively addressed through collaboration across industry, NHS and academia.” Go to www.abpi.org.uk

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The work means patients with previously unknown AF can be detected and treated to prevent a stroke

WORDS BY

Amy Schofield

Preventing AF-related strokes The ‘Podiatry and Atrial Fibrillation – Save a life, stop a stroke’ webinar was created to improve the detection and management of atrial fibrillation, and it’s already saving lives. 32 | P H A R M A FI EL D.CO.U K

three-month pilot foot pulse-checking project aimed at increasing the diagnosis of atrial fibrillation (AF) and created by a partnership of NHS bodies and industry, successfully identified a number of patients with previously undiagnosed AF. Conducted by County Durham and Darlington NHS Foundation Trust, the work is part of a wider AF Programme run by the Academic Health Science Network for the North East and North Cumbria (AHSN NENC) in conjunction with the Northern England Clinical Networks. It aims to reduce the number of strokes and deaths in the region by treating AF as early as possible. As part of this work, medical education and events company E4H, in partnership with the AHSN, London Clinical Network, voluntary sector and NHS England, created a series of educational webinars, ‘Podiatry and Atrial Fibrillation – Save a life, stop a stroke’, to which 407 people tuned in. Martin Fox FFPM RCPS (Glasg), FCPM, Vascular Specialist Podiatrist, chaired the webinar, accompanied by speaker, Advanced Podiatrist Linda Hicks. During the Q&A they were joined by Kate Mackay, Atrial Fibrillation Programme Lead at the AHSN NENC and Co-ordinator, Northern Diabetes Footcare Network. OPTIMISING TREATMENT

Kate Mackay led and developed a programme of projects to ensure those with undetected AF are found and to optimise treatment of patients with known AF, with the aim of reducing AF-related stroke and mortality.

IN PR ACTICE

PREVENTION MEANS PROTECTION

DIABETES

DOUBLES THE RISK OF A STROKE

1 in 20

PATIENTS WITH UNTREATED AF

WILL HAVE A STROKE

Kate developed a multi-professional AF Steering Group representative of the AHSN’s geographical footprint, consisting of local leaders from within the AF community including the NHS, third sector and commercial partners. The pilot work involved podiatrists checking patients that were having a diabetes foot check. It was initiated through existing relationships between Kate and Linda Hicks, Advanced Podiatrist, Podiatry Department, County Durham and Darlington NHS Foundation Trust. Kate was looking for ways to detect patients with an irregular pulse, particularly where patients are already being seen by a healthcare professional, while Linda was aware that patients with diabetes are at greater risk of cardiovascular disease. Both knew that patients attending for their diabetes annual review have their feet checked, and this included a check on their foot pulses. Podiatrists are not usually listening to a pulse for regularity, so with a bit of extra training the podiatry team started to listen for regularity and referred any patients with an irregular pulse, and not known to have AF, to their GP for a 12-Lead ECG to confirm or refute a diagnosis of AF. Both Kate and Linda also sit on the Northern Diabetes Footcare Network and this enabled the spread and adoption of the work, post-pilot, to other podiatry teams in the North East and North Cumbria area. The work has not been onerous for podiatrists or GPs and means patients with previously unknown AF can be detected and treated to prevent a stroke.

Anecdotally, South Tees Arrhythmia Team contacted Kate to tell her that every patient in one of their morning clinics had been referred via a podiatrist, and five of the six patients were found to have AF. The work continues to be adapted with the majority of areas in the North East and North Cumbria now adopting this work. CASE STUDY

Linda Hicks shares this case study of a patient: A 57-year-old male was diagnosed with Type 2 diabetes in June 2017. He also has hypertension which he is on medication for. As part of the annual review, the patient was seen by the foot care technician in the GP surgery. His pedal pulses were manually palpated and the quality and regularity was checked using a hand held Doppler. The technician noted an irregularity when checking his left dorsalis pedis. She liaised with the practice nurse who arranged a 12-lead ECG there and then. The GP reviewed the result and diagnosed AF. The patient was started on warfarin the following day. Had the patient not been diagnosed with AF he could have potentially suffered a devastating stoke which could have left him with a life changing disability or could have been fatal. Had he been driving his lorry and had a stroke, the potential damage to him and other road users could have been devastating. The benefit of the foot checks being carried out in the GP practice shows how quickly a potential diagnosis can be made, and treatment commenced straight away.

A LIFE SAVED

Registered Podiatrist Clair Sparkes runs a podiatry practice in the New Forest. Following her attendance at the webinar, Clair immediately made sure that she Doppler’d every patient. While almost every patient knew of their AF status, one didn’t. “His nocturnal leg pain alerted me to a problem and although the GP was unable to detect it, the ECG did!” says Clair. “I am very grateful to you for hosting this webinar.” The anonymous patient wrote to Clair to thank her: ‘It has now been confirmed that I do have an atrial fibrillation and I have been prescribed some medication immediately. Obviously this is bad news, but I have to thank you very much. ‘This problem has only been found because of your attentive listening to my symptoms, your knowledge and understanding, and your prompt action. I very much appreciate that your exemplary standard of professionalism has resulted in the discovery of a very serious condition which requires urgent treatment. ‘I’m only beginning to realise what this means. I wouldn’t have the chance I now have without you. ‘Thank you Clair.’ Go to www.ahsn-nenc.org.uk and www.events4healthcare.com/ preventing -af-related-strokes 1. The Stroke Association, quoting The Lancet and SSNAP 2. The Stroke Association quoting Annals of Medicine

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INTERVIEW BY Amy Schofield

POSITIVE IMPACT The winners of the Joint Working Pf Award 2018, Senior Coloplast Care Nurse Ruth Christer and NHS Partnership Manager, Coloplast, Jonathan Walker, on the positive patient outcomes that come from working together.

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ongratulations on your Pf Award win, how did it feel when your name was announced? RC: I was stunned into silence; literally lost for words! JW: It came as a real surprise given the quality of entrants within our category so I was delighted when our names were read out. What does winning the Pf Award mean to you? RC: It is a huge honour, especially as it is such a prestigious award. In fact, I donâ&#x20AC;&#x2122;t think I realised how prestigious it was until after we had won! JW: It is an honour to win such a prestigious Pf Award and have our project recognised. We set out a few years ago with an idea of gaps within the patient pathways and have developed this service to address those gaps and provide patients living with a stoma with access to specialist nurse reviews in their GP Practices. It sounds simple, but weâ&#x20AC;&#x2122;ve had to navigate a number of challenges and ensure that what we do day-to-day provides patients with the very best experiences and outcomes. Our success within the initial project in partnership with NHS Northumberland CCG has resulted in over 4000 patients across 30 CCGs benefitting from our model of care.

IN PR ACTICE

 Bayer’s Reena Cholera,

lives, providing them with access to clinical reviews and specialist advice. This helps to improve clinical outcomes and quality of life. It also provides me with immense job satisfaction knowing that this really does make a difference to patients. JW: We regularly see patients who have not had a specialist nurse review for 10-15 years and have consequently lived with sore skin and leakage for years, accepting that that’s just the way things are now. We’ve seen patients who have needed to take two spare pairs of clothes to work due to leakage, and following a review with Ruth have left the house for the first time in 25 years forgetting they were even wearing their stoma bag.

sponsors of the Pf Award, Jonathan Walker, Ruth Christer and host of the Pf Awards 2018 Dinner, Hal Cruttenden

What this project has taught me is that by working together we can be stronger

How did your path to pharma begin and what have been your career milestones to date? RC: I worked for 22 years in the NHS before joining Coloplast in 2015, and I would have to say that winning this Pf Award is one of my career milestones. JW: I’ve always been fascinated by biology and science, what can go wrong and finding solutions to fix things. My path to pharma was also inspired by my Uncle Ray, who used to work in the industry and highlighted that this was a career that was interesting and rewarding with scope to develop and challenge. I think the people I’ve worked with over the years have been the most significant highlight, such as Emma Carling (I believe she is still at Ashfield), who had faith that someone who’d worked in retail had sufficient potential to take a punt.

Tell us more about your joint working initiative. RC: The Stoma Partnership Programme continues to develop and is now being developed for continence care. Jonathan and I are seen as the pioneers and are often called upon to give advice regarding the implementation of this project in other areas of the business and how to encourage other stakeholders to participate. JW: We continue to learn from our existing projects to make them more efficient and improve outcomes and have taken our key learnings to develop services that will help patients using catheters to address their own clinical challenges such as UTIs and antimicrobial resistance, in line with the NHS agenda. What positive effects have you seen in patient outcomes? RC: The Stoma Partnership Programme has a positive impact on patients’

What can be done to improve delivery of the NHS’s Long Term Plan? RC: Collaboration with stakeholders is crucial. There needs to be open, honest dialogue – pharma is often perceived as a threat to the NHS and there is always speculation and suspicion about commercial gain. What this project has taught me is that by working together we can be stronger and this needs to be developed as part of the Long Term Plan; being transparent and delivering outcomes which not only demonstrate commercial gain but most importantly improved clinical outcomes and patient satisfaction. JW: One of the challenges we continue to face is the age-old scepticism from NHS of industry. The more we can do to be open and honest that there is a commercial benefit for our expertise and services the better. It’s been a key learning for me in this partnership working and I am acutely aware of the need for compliance and confidentiality, but as an industry we can be over cautious and stifle entrepreneurial thinking and ideas. What motivates you? RC: I am motivated by the knowledge that what I do has a positive impact on patients’ lives. When I see a patient in clinic who hasn’t seen a Stoma Nurse for 25 years and has been struggling with loss of confidence and low self-esteem due to an ill-fitting stoma appliance, I can change that by listening, assessing and finding the right appliance for the patient’s needs. It can be life-changing for the patient and makes me feel like I’ve got the best job in the world! JW: It’s not everyone who gets to say they’ve landed their dream job, but something I can! I am privileged to work as a small part of a much wider team and business that all go to work every day knowing that we are making a positive impact on patients living with intimate healthcare needs. Go to www.coloplast.co.uk and www.pfawards.co.uk

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Pf Magazine March 2019

Articles inside

Delivering the future of genomics