NHS reluctance to work with pharma must be addressed

The life sciences industry has been getting a good deal of attention from politicians and policymakers lately. This is no surprise with a new government firmly focused on its missions to drive economic growth and create an NHS “fit for the future”. If, as is hoped, the life sciences sector is going to play a pivotal role in delivering these missions then the NHS and industry need to find ways to work effectively in partnership.

This is not a new concept. Life sciences companies have a long history of working with the NHS on research and providing it with goods and services. There are also well-established routes for partnerships focused on getting recommended treatments into practice and improving clinical care, including collaborative working projects which involve pharmaceutical companies and NHS organisations formally pooling skills, expertise and/or resources to deliver a specific project.

The King’s Fund has published a new report examining examples of these partnerships. The research, commissioned by the Association of the British Pharmaceutical Industry and independently conducted and produced by The King’s Fund, explores what partnerships involve, the value they can bring for patients and services, and the approaches and guard-rails needed to ensure they operate ethically and transparently.

We found that, at their best, industry partnerships can be powerful catalysts for improvements in care, bringing the NHS access to resources to pump-prime change, and to a depth and breadth of skills and expertise within these often large, global companies. Among the examples we studied was the Hep C U Later programme.

This ambitious five-year partnership between the NHS Addictions Provider Alliance and Gilead Sciences drove testing and treatment for hepatitis C via community drug and alcohol services (whose services work with many of those most at risk from hepatitis C). More than 40,000 tests were taken over the course of the programme with many more people successfully treated and cured as a result.

But despite these and many other positive examples, the full potential of partnerships between the NHS and life sciences industry to improve patient care is not being realised.

Our work revealed barriers around openness and trust including reservations among many in the NHS about working with pharmaceutical companies. These need to be addressed head-on to achieve meaningful collaboration, including by following existing guidance to mitigate risks and guard against conflicts of interest, and ensuring full transparency about what partnerships involve.

We found issues around access to and experience of industry partnerships, with routes to partnership often relying on existing relationships and networks, meaning opportunities for collaboration are not available equally to all parts of the NHS

We also identified issues around the current leadership and oversight of industry partnerships. Although there are firm requirements in place around collaborative working and extensive guidance and resources to support it, we were struck by the extent to which these are currently led by industry. More could be done to create a genuine sense of co-ownership, with greater leadership and oversight from NHS England and the Department of Health and Social Care, particularly given their stated ambitions for closer collaboration with industry.

Finally, we found issues around access to and experience of industry partnerships, with routes to partnership often relying on existing relationships and networks, meaning opportunities for collaboration are not available equally to all parts of the NHS.

Steps could be taken to support wider access to partnerships, including by building routes for industry involvement into national programmes where this could help deliver programme priorities, and to facilitate learning and experience from successful industry partnerships to be shared.

Industry partnerships are not a panacea and are certainly not without challenges. But in the context of an NHS desperately in need of transformation but often lacking the resource and headspace to make it, it is timely to consider the role they can play in supporting improvements to patient care, and to do so with a meaningful understanding of what it takes to partner successfully. In the words of one of the NHS clinicians we interviewed:

“It is really important because ultimately, in an environment which is stretched resource- and demand-wise, and particularly in the area we work in where you’re working with people who are often really disadvantaged, I’m trying to ensure that we facilitate the best access to care for them, which gives them the best opportunity of being well. That means we have an absolute responsibility to try and lever those resources and assets which might be available to benefit them. We shouldn’t let our ideologies get in the way of that.”

To meet the scale of current challenges and build a sustainable health and care system for the future, the NHS will need to draw on the assets and contributions of all its partners, including in the life sciences industry. We are calling on NHS and industry bodies to help enable this by creating a supportive context and putting in place practical support at local and national levels to address key issues around openness and trust, access and experience, and leadership and oversight of NHS-industry partnerships.

This should form part of a broader, ambitious approach to collaboration between the NHS and life sciences industry that looks to deepen links and understanding between the sectors to tackle the challenges of today and shape innovations in health and care for the future.