What does the latest tranche of CCG mergers mean for pharma? Oli Hudson explores the mergers, the role of pharma and the integrated care agenda.
Pharma’s stakeholder map is set to change once again, bringing new territory planning challenges, following NHS England’s decision to allow 74 clinical commissioning groups (CCGs) to merge in April to establish 18 new ones.
The new mergers will see the total number of these organisations fall from 191 to 135, with significant variation in the number of CCGs involved in different mergers and the population sizes they will cover.
For example, Kent and Medway Sustainability and Transformation Partnership is merging all of its eight CCGs into one with a population of 1,846,478; while the new Northamptonshire CCG will be formed by merging just two CCGs and will have a population of 730,650.
Integrated care and pharma
The latest tranche of CCG mergers is a significant milestone in the journey towards integrated care, as the NHS moves decisively towards the NHS Long Term Plan’s vision of ‘typically’ just one CCG per Integrated Care System (ICS) area.
This collaborative approach will help to deliver a 20% reduction in operational costs, including administration, enabling savings to be ploughed back into frontline services.
Pharma’s account planners will have to consider the needs of a wider population within a CCG area and the NHS’s move towards managing healthcare at a system level, with pooled budgets and collaborative working practices.
This requires a holistic, whole system approach from pharma as CCGs come under pressure to help make savings across whole patient pathways.
New roles and responsibilities
Historically, CCGs have been responsible for planning and purchasing healthcare locally. However, as they reduce in number, but become larger in size, they will take on a more strategic role.
In line with this, they will be instrumental in helping the NHS to introduce place-based care and to ensure that providers are doing the right thing for their local population. They are also expected to formally take on other roles and work from NHS England, which could include specialised commissioning.
The extent to which formularies will be affected by the mergers is unclear. For example, all the Lincolnshire CCGs are merging but they already use one formulary. However, it will be important for pharma to track variation between CCGs.
As the NHS moves towards larger CCGs with pooled resources and budgets, it will be vital for pharma to determine how money flows within these organisations and where it will be spent. This will also demand a tailored approach as there will be considerable variation between different localities as new territories emerge with new budgets and new decision-making units.
Ultimately, pharma is working with a very different type of health economy now and this is being set in stone by CCG mergers, which will be key to delivering many aspects of integrated care.
Oli Hudson is Content Director at Wilmington Healthcare. For information on Wilmington Healthcare visit www.wilmingtonhealthcare.com