NHS Environment & engaging with the NHS in 2007

(Published March 2007)

Michael Sobanja, NHS Alliance Chief Executive and a Director of Health Direction, takes a look at the NHS Environment in 2007 providing useful insight for all those engaging with the NHS

In England probably the key news is around money, practice based commissioning and the pressure on medicines management and the pharmaceutical industry, and perhaps these are all interrelated.

The financial picture is confused, on one hand the NHS is heading for a massive overspend in a number of local health economies, but on the other, the centre now predicts a small surplus for the NHS as a whole. This can be accounted for by recognising that reserves, top slices and other accounting “tricks” will be used to balance the books. Whilst the Secretary of State seems to indicate that growth after 2007/8 will be in excess of 3% (Patricia Hewitt was taking part in a question and answer session on the 10 Downing Street website) this is not as good as it looks as NHS inflation is running at around 3.9% currently – leaving a significant deficit at this level of funding.

Coping with this level of financial stringency means that PBC has to work – good service design means good financial management and David Nicholson, the new chief executive of the NHS recently tried to demonstrate that the most efficient can also be high quality. Few will be completely convinced.

All of which means that the pressures on prescribing and medicines management is unlikely to go away, and may intensify. Developments to the performance matrix will now target other medicines than just statins, and there is unprecedented pressure to get clinicians to “toe the line” in prescribing. Link this to the review of NICE and the just released OFT report on the PPRs means the squeeze on pharmaceutical companies is tightening and may be orchestrated across a number of areas.

The Scottish, Welsh and Northern Ireland news demonstrates how different life is in the UK NHS components – now and increasingly independent and different as devolution develops. The abolition of prescription charges in Wales, no overspends in Scotland, and the more traditional agenda in Northern Ireland mean that the only viable UK strategy for pharmaceutical companies is to have local approaches at both country and local health economy level.

Meanwhile we have conservative policy announced – more of same, but harder, faster and better. When will the NHS have room to breath and consolidate? When it does, perhaps the pressure on the industry to reflect will lessen. In the meantime, the changes are biting hard and look to continue in the future.

Pharmaceutical Marketing Supplement - A guide to NHS Reforms

We hope you will forgive a plug for these supplements which run for five months starting with the first insert in the February Edition of Pharmaceutical Marketing. There are lots of thought provoking articles (including ones from Mike Sobanja). If you haven't seen them, then email us and we will send you pdf copies of the February and March supplements.