Making sense of the Five Year Forward View

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Parallel Learning’s second webinar addresses how pharma can support the NHS in how care is delivered.

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The performance of the NHS is firmly under the microscope, as increasing demand amplifies the already intense pressure on services.

The second Parallel Learning webinar focussed on the NHS’s Five Year Forward View (5YFV) – the comprehensive strategy for the future of the NHS in England – asking what progress has been made. Originally published in October 2014, can the 5YFV deliver sustainable care, and how can pharma work with the NHS to deliver it?


The opportunities

Guest speaker Paul Maubach presented delegates with an overview of the 5YFV, along with the key opportunities and challenges he sees arising from it. The original vision of the 5YFV was to address the quality, care and efficiency gaps across the NHS.

Paul pinpointed where the biggest opportunities will arise from new care models and working differently. These included moving towards a more outcomes-based way of working, which began 15 years ago with the advent of payment by results.

In today’s population, however, at least one third of people are living with one long-term condition or more, while rising cohorts have multiple complex needs, which require complex care co-ordination.

“The game-changing shift that we are looking at now is moving away from payment by results, to an arrangement which genuinely incentivises outcomes for patients and populations,” said Paul. “This has the potential to be one of the biggest drivers for change.”


The challenges

Paul set out the biggest challenges to the delivery of new care models. Notably, the complexities of governance and statutory responsibilities; the stress of managing change; bringing organisations together and cuts in social care and public health services.

Paul proposed that for the 5YFV to work, the successful systems and organisations of the future will be ones that create a partnership way of working that supports staff in the community with patients and the public. This would require a different culture which works with people in their own homes and communities.

Chair Michael Sobanja pointed out that patients should expect the same level of service and outcomes wherever they are geographically. Paul responded by saying that there is a need for common dialogue with the public about which outcomes are the most important.

“More work is needed around a shared vision; what are the standards we expect, and what are the standards that our public would expect? There could be some real benefit in national debate and dialogue to establish clear national standards.”


What can pharma do?

Given that such a large proportion of the population is now living with chronic conditions and multiple complex health needs, Michael asked Paul his view on what the pharmaceutical industry can do to support or work with the NHS.

“One of the fantastic things about the pharma industry is that drugs are one of the most disruptive technologies we have, for example, where the introduction of new drugs results in a substantial change in the way care is delivered. The reason that more of us are living longer with a long-term condition is because of the success of the pharmaceutical industry in providing drugs that enable us to stably manage those conditions.”

Paul pointed out the importance of pharma’s role in the delivery of a more efficient NHS. “The pharmaceutical industry has a tremendous amount to offer the NHS. Spending on prescribing is significant, so it is a substantial part of our resource and our options for intervention.”

The webinar moved on to what the NHS might expect from the pharmaceutical industry, and how the NHS can better understand the potential of medicines to support people with their long–term conditions. According to Paul, the risk of these patients’ use of higher cost secondary health services reduces with the use of the ‘right drugs at the right time’, which could result in a reduction of need for more complex and costly care.

“One of the things that the pharma industry is very good at is the evidence base. For the right compliance, the right conditions management, really enabling us to reduce avoidable demand elsewhere,” Paul said.

Paul explained how it all comes down to the individual and empowering them to better manage their own health and wellbeing. “There is a lot more that the pharma industry could do to work with the NHS in establishing common standards that we should be working towards. We need to ask how we more proactively support individuals to self–manage. If we’re going to have more sustainable care, we need to be able to do more to support the individual.”  

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