the £100bn customer; doing business with the nhs
TRANSCRIPT
Frank RatcliffSenior Project ManagerWessex [email protected]
“The £100 Billion Customer; Doing Business with the NHS”.
Frank RatcliffBill GillespieWessex Academic Health Science Network
Contents:
Follow the Money; existing structure of the NHS; Frank Ratcliff
Current pressures and changes; how the NHS is evolving; Bill Gillespie
Simple Selling Strategies; Frank Ratcliff
Not really £100bn.
NHS alone is £120bn.
LaingBuisson Healthcare Market Review, 28th edition, 2015
Total UK is ~£165bn.
19>6£120bn
£72bn
50%-80%->90%£3.9bn
£?
Bill’s story…..
NHS 2-3000 patientsContract with CCG
NHS
QualityOutcomesFramework
QOF; “a stich in time saves nine?”
DiabetesAsthmaCOPDStrokeDementiaHeart disease+16
Register / PrevalenceTreatment to targetAnnual reviewsPrevent illness
www.gpcontract.co.uk
Points make prizes…..
£?HRGHSCIC/NHS Digital/SUS/HESTariffInvoiceCCG pays Hospital (NHS?)XS bed-days?30 day re-admissions?
Bill’s story…..
Bill’s story…..
£?
£23,250?
Southern Health NHS Trust
Agency contract
CCG;Stop people getting illPreventionKeep poorly people out of hospitalFrequent Fliers personal care plansIntermediate care teamsDiagnose + prevent
Acute;Early dischargeReduced cost pathwaysNo 30 day re-admissionsAvoid fines (RTT)/infection
GPs;Not enough of themNot enough timeLeague tablesTick boxesEducation
Council;Public Health National Living Wage?NI riseCouncil tax rises capped.
Care Agency;Handing back contracts?
Families;Want to keep Bill at homeAgency fee £300/weekCare Home £1500/week
Patient Outcomes
VFM;Timescales
Product
Commercial return
Decisions decisions.EVIDENCE
A word about NICE…(National Institute for Health and Care Excellence)
Guidelines
Technology Appraisals
Interventional Procedures Guidance
Medical Technology Guidance
Diagnostics Guidance
Highly specialised technologies guidance
Necessary, but not sufficient.Lots of rules, no police.
NICE is changing too…..Fee for service; TAsOffice for Market Access
NHS Supply chain (DHL) + NHS Shared Business Services (Virtual Stock)
Barcodes / GS1 / Scan 4 Safety
Procurement
Estates
Specialised commissioning
Some lose ends…..
Help !!??!!
AHSNs - push
Health Innovation ProgrammeHealth Innovation SurgeryHealth Innovation ForumFunding Support ServiceInvestor Showcase
NHS – Pull
AHSNsDirectors of transformation/innovationNIAAccelerated access reviewInnovation Tariffs
National and Regional PrioritiesLEPSUKTIDept International TradeCouncilsSBRI Healthcare
Summary;
NHS is complex, and big.
Everyone cares about the patient, but……
Understand the organisations, money flow and drivers.
Help is out there.
NHS is changing……
Bill GillespieWessex AHSN Chief Executive Officer
What’s happening in the NHS?
From this… …to this
Moving away from….
Commissioner/provider split
Primacy of Foundation Trust/Trust Governance
Domination of Payment by Results financial system
Disaggregated provider landscape – acute +
primary care
Sub-optimal scale for specialised servicesSharp separation between commissioner
& provider performance management
Failure to join up and
exploit data across settings of
care
Predominantly reactive model
of care
… and moving to this….
Blurring of commissioner/provider
boundary eg prime contractor roles, vanguards, ACO-type
models
Emerging system governance- STPs, SROs, system control
totals
New financial models – outcome-based eg “Year of
Care”, Innovation Tariffs
Consolidation of providers- hospital chains, place-based
integration, GP federations
Consolidation of specialised hospital
servicesJoined up data and population
segmentation and risk stratification
Service models driven by data
insights, inc patient-generated data –
agnostic on setting of care
Increase in user-led service design supported by ease of capturing patient-generated
data. Self-management a critical theme
National/regional performance management
of system aligned to direction of travel
A spectrum of proportionate evaluation recognising pace oftechnological advances?????
Predictive, preventive care models
Evolution not revolution
From this… …to this
The implications for industryPositives
• Greater NHS system working removes some key barriers to adoption• STPs• Vanguards
• Greater willingness to explore different financial models• Does the model incentivise the right
behaviours – prevention, self-management, pro-active management of conditions, patient resilience?
• Does the model make it easier for commissioner eg convergence of pharma + medtech?
• Data seen as an asset – products which support population segmentation, risk stratification and pro-active management will be attractive
• Products supporting workforce productivity, including “virtual multidisciplinary teams” will be attractive
• Products which resonate with the “lived experience” of patients/carers – eg multiple morbidities of an ageing population
• Provider consolidation may make it easier to do business at scale
Challenges
• The system is in transition - this will take years• Caldecott 3 and increasing fears over cyber-security
may inhibit use of data for population health management (what is secondary use?)
• System changes and level of operational pressure may preoccupy managers and boards
• Providers need to acknowledge and be responsive to “digital divide”, “harder to reach groups”. The NHS values equity
• The system can be highly ambivalent towards piecemeal, incremental improvements versus wholesale, pathway change
• Disruptive innovation may resisted by some powerful groups within the system
Frank RatcliffSimple Selling Strategies.
Simple Selling Strategies.
Frank Ratcliff
My experience?
Your experience…..
Best and worst BUYING experience;WHY?• process, not product.• what was good….left you
recommending to others• what left you annoyed /
frustrated?
Simple Selling Strategies.
1. Be prepared2. Find the need3. Fill the need (or walk!)4. Objections5. Close – next steps.
Great…thanks for your help!
I feel like I’ve just been sold to! X
Sales models…..
1)Be prepared. • Who are you going to see?• What’s their role?
board minutes; “declarations of interest”• What’s are you aiming to achieve?• What do you need to ask?• What key facts do you need to say?• What do you need to take?
Do your research;• Google• www.gpcontact.co.uk• HES data• https://fingertips.phe.org.uk/• https://www.whatdotheyknow.com/
…be prepared.
• Introduce yourself, the company AND;• “The Benefit Statement”• Why should they listen?• Practice….practice….practice!
I’d like to explore whether we can reduce
your XYZ costs…
I think I can help you increase your income from
ABC
I think you had ZZ hospital acquired infections last year, and I’d like to talk about how
we could help reduce that number.
Tell-sell = no-sell
2) Aim to help - Find the need!Understand their role, and levers
Commodities/competitive market;• How is their current supplier?• Frequency?• Volume?• Quality?• Reliability?• Price?
“We have an IT product that will help keep people out of hospital. We’ve spoken to all our local hospitals, and no one is interested”.
What are your priorities at the
moment?
Are you happy with how things currently
are, or could anything be better?
Un-recognised needs;• Open questions….
• scale• frequency• value• desire
3) Fill the need.
Once you’ve understood, or agreed their problem……
Can your product help?
If it can’t, then politely walk away.
If it can, then explain features AND Benefits.
My device has this button/switch/menu/camera/
etc……
Which means that for you, the costs go down, the quality goes up, things
happens faster etc…
5) Objections – a gift
• Listen• Acknowledge• Check• Respond• Check• Close
“Yes, but….” Opportunity to learn customer’s;• Understanding• Buying process• Timescales• Budgets• Quality thresholds • ETC!
PRACTICEPRACTICEPRACTICEPRACTICEPRACTICEPRACTICE
!!???WTF??
4) CloseWhat are your thoughts?What’s the next step?How do we move this forward?Could you introduce me to…Could I have a copy of that document?Summarise actions……
Summary;
• Be prepared• Have a plan for the call• Aim to help• Listen• Practice
Questions?