Oli Hudson, content director at Wilmington Healthcare, looks ahead to some crucial challenges for the NHS – and Industry.
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‘A year of reform’, is what health secretary Sajid Javid has said of 2022 – and while sometimes this kind of language can be overdone by politicians wanting to make waves, if anything this time it’s something of an understatement.
For some substantial shifts are indeed afoot – in the form of the passing of the Health and Care Act, a new NHS payment system, the follow-on from December’s Planning Guidance with its ten priorities, the publication of system level five-year plans, and a new GP contract.
Each of these will bring its own kind of reform to the NHS. In this article I’ll look at three of the most important in turn and assess what it means for Industry stakeholder mapping, planning and engagement.
The Health and Care Act
Currently stuck at the parliamentary committee stage, the Health and Care Bill is set to become law in the first half of 2022.
By 1 July (and not now 1 April as originally intended), it will establish a new landscape for the NHS in statute – so bodies currently operating in shadow form, such as Integrated Care Systems, each covering 1-2 million patients, will take over full local operational control. CCGs will quietly disappear.
ICSs – which we now know will have an ICB (board) and an ICP (partnership) element - will have significant control over budget, with payment for acute services already in their remit via contracting; over the next two years, responsibility for primary and specialist services will be added to that.
At local level, groupings of hospitals and other providers will officially be formed into provider collaboratives – which will work at both system and place level – and place-based partnerships, which will operate at place and likely include vertical integration of social care, primary care and community care providers.
All of these organisations will have to be stakeholder-mapped by medtech – and the decision-making units within them for financial, clinical, procurement and operational changes understood.
Clinical leadership is expected in these bodies – meaning clinicians will be responsible for transforming pathways and services and should be treated as vital contacts for medtech partners seeking to redesign how patients are treated.
The NHS Payment System
For 2022/23 there will be a new financial framework that puts a renewed focus on efficiency and productivity improvement and sees a return of local ownership for financial flows.
Developed to mesh with the new integrated landscape and contractual basis for payment, the system will have a fixed or block element intended to help providers negotiate their way out of the backlog, and variable elements to improve levels of activity and efficiency.
The fixed element will be based on funding an agreed level of activity and reflecting plans for 2022/23. The variable element will be to support elective activity and to reflect achievement of best practice tariff (BPT) and CQUIN criteria. So, anything that can help support elective activity may have a competitive advantage.
The latest consultation on the payment system also says NICE approved, commissioner-funded items introduced within the year are excluded from the fixed element – and that innovative products covered by the medtech funding mandate would be paid for outside of it, although funding for implementing them should be included within it. This means more local negotiation over new device funding.
Medtech should examine the proposals for the new system carefully – there may be opportunities for introducing new products based on how providers have agreed payments with their respective system, and via leveraging the greater freedom systems have to introduce new pathways and services via the system-based, population health-focused funding envelope.
The NHS Planning Guidance
Released on Christmas Eve 2021, the Planning Guidance gives the NHS 10 priorities to focus on this year.
These priorities are: Investing in workforce, responding to COVID, addressing the acute care backlog, improving urgent and emergency care responsiveness, improving access to primary care, improving mental health services, developing population health management, exploiting digital technologies, making the most effective use of resources, and establishing Integrated Care Boards(ICSs) and collaborative system working.
Some of these should form part of the general environmental analysis of medtech; for example, workforce is a critical issue with some 99,000 NHS staff vacancies and ongoing absences from covid and will be a central factor in most NHS managers’ minds. This, along with addressing the elective care backlog, affords opportunities for medtech companies that can help ease the pressure on staff via new interventions and treatments.
Others will involve more tactical developments – such as ensuring tech is compatible with NHS digital systems, and an awareness of the importance of new digital devices and monitoring in establishing new pathways.
Still others, such as population health management, could require medtech to adopt a different way of promoting the value of treatments, for example on their long-term impact on population health within the whole system – itself a big factor in the emerging focus on value-based procurement.
The Planning Guidance also repeatedly addressed health inequalities, and improving access to healthcare services for deprived populations. This will be key going forward, and Industry has a part to play in uncovering and making the case for treating patient groups that could benefit from healthcare innovations.
Conclusion
Medtech has a lot to take in – these really are quite substantial reforms, and this year could prove disruptive. However, along with developments in value-based procurement and backlog management, several opportunities present themselves to companies that can align with the NHS’ immediate needs and strategic requirements this year.
Devices, tech, diagnostics and consumables that allow the NHS to increase its efficiency, capacity and activity will be at a premium – and a knowledge of the emerging actors prepared to work in new ways, in new organisational set-ups, with new pathways and treatments – will afford many openings for engagement and partnership.
Wilmington Healthcare provides market leading data, insight and intelligence across the healthcare community. Read our latest white paper – Looking Ahead 2022: Challenges and Opportunities for the NHS and Industry here, or find out more about how we can support your NHS partnerships, visit wilmingtonhealthcare.com.
