Fenin en colaboración con el departamento comercial UK Trade and Investment, de la Embajada británica en Madrid, han organizado un foro empresarial dirigido al sector de tecnología sanitaria, con el objetivo de evaluar los sistemas de compras de los sistemas sanitarios de España y Reino Unido (NHS), y conocer las oportunidades de negocio que el NHS representa para empresas españolas de tecnología sanitaria.

1. OPPORTUNITIES IN THE NHS –
NOW AND THE NEXT FIVE YEARS
Frances Pennell-Buck

2. AGENDA
2
• What is the National Health Service?
• Current situation in the NHS
• NHS England Five Year Forward View
• Innovation and opportunities in the NHS and
beyond

3. THE NHS IS A NATIONAL TREASURE
• Survey by Channel 4 – a TV station (2012):
What makes you proud to be British:
1. Our history
2. The NHS
3. Our armed forces
4. Royalty
• NHS Constitution:
The NHS belongs to the people.
3

4. HISTORY OF THE NHS
• Founded in 1948 –
“Good healthcare should be available to all with access
based on clinical need, not the ability to pay”
• Today’s Constitution of the NHS:
“The NHS belongs to the people. It provides a
comprehensive service, available to all, irrespective of
gender, race, disability, age, sexual orientation, religion
or belief, gender assignment, pregnancy and maternity,
or marital civil partnership status”
4

5. PRINCIPLES OF THE CONSTITUTION OF THE
NHS
1. The NHS provides a comprehensive service available to all
2. Access to NHS services is based on clinical need, not on an
individual’s ability to pay
3. The NHS aspires to the highest standards of excellence and
professionalism
4. The NHS aspires to put patients at the heart of everything it
does
5. The NHS works across organisational boundaries and in
partnership with other organisations in the interest of patients,
local communities and the wider population
6. The NHS is committed to providing best value for the taxpayer’s
money and the most effective, fair and sustainable use of finite
resources
7. The NHS is accountable to the public, communities and patients
that it serves
5

6. WHAT MAKES UP THE NHS?
“ The NHS is an integrated system of organisations and
services bound together by the principles and values
reflected in the Constitution”
•NHS in Scotland, Wales and Northern Ireland
•NHS in England
•1.6 million employees (in top 5 of world’s largest
workforces)
The NHS is the largest single publicly funded health
provider in the world
6

7. BREAKDOWN OF “THE NHS”
NHS Scotland -
£12bn – 5.3 m
people
159,748
employees
14 NHS Boards
NHS England
£115 bn – 53 million
people
1.3 million emps
NHS Northern Ireland
£2 bn – 4.5 m people
62,603 employees
Health and Social Care Board
5 Health and social care trusts
5 local commissioning groups
NHS Wales
£7bn – 3.5 m people
7 Local health
boards
84,817 employees
2015-16

8. MORE STATISTICS – NHS ENGLAND
• 247 Trusts – Hospitals, mental health, ambulance
services
• 209 Clinical Commissioning Groups (CCGs)
• 8 Commissioning Support Units
• Registered professionals (January 2015)
– General practitioners (family doctors) – 40,236
– Nurses – 351,446
– Ambulance staff – 18,576
– Hospital and Community Health Service medical and
dental staff – 111,963
The NHS treats over 1 million patients every 36 hours 8

9. THE RECENT TRANSITION IN THE NHS IN
ENGLAND
“The Health and Social Care Act 2010 will deliver more
power to clinicians, it will put patients at the heart of the
NHS, and it will reduce the costs of bureaucracy. We now
have an opportunity to secure clinical leadership to deliver
improving quality and outcomes; better results for patients
is our objective.”
Clinical leadership has never been greater:
75 Clinical Reference Groups
12 Clinical Senates
209 Clinical Commissioning Groups (CCGs)
15 Academic Health Science Networks (AHSNs)

10. A new commissioning system
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11. HOW DOES THE MONEY FLOW?
HM Treasury
Department
of Health
Centrally Managed
Projects and Services
Arms Length Body
Funding
Public Health
Spending
NHS
England
(£98.5 bn)
Nationally
commissioned
services
Clinical
Commissioning
Groups (£67 bn)
Locally
commissioned
services

12. THE ROLE – AND BUDGETS – OF CLINICAL
COMMISSIONING GROUPS (CCGS)
•Urgent and emergency care
•Elective hospital care
•Community health services
•Maternity and newborn
•Mental health and learning
disabilities
CCGs have 65% of overall budget to “commission” (buy)
services from providers for:

13. CURRENT ROUTES TO THE NHS MARKET
Collaboration with existing supplier(s) – research projects/trials
Direct to NHS Trusts – hospitals, clinical commissioning groups,
commissioning support units and NHS England for specialised areas
NHS Supply Chain – more for commodities/quick turnaround products
Collaborative Purchasing Agreements - eg London Procurement
Programme
National Framework contracts – government-run esp for contracts
under £10,000
Tenders - Official Journal (OJEU) for contracts over £113,000

14. 2015/16 NHS OUTCOMES FRAMEWORK
Domain 1 Preventing people from dying prematurely
Domain 2 Enhancing quality of life for people with
long-term conditions
Domain 3 Helping people to recover from episodes of
ill health or following injury
Domain 4 Ensuring that people have a positive
experience of care
Domain 5 Treating and caring for people in a safe
environment; and protecting them
from avoidable harm.
68 indicators to measure performance at a national level

15. CHALLENGES FACING THE NHS
• Ageing population
– Dementia
• Increase in long term conditions – account for 70% of health service
budget
• Changes in expectations – “treat me NOW” – 22 million visits to
A&E a year
• Technology transforming our ability to predict, diagnose and treat
disease
• NHS hasn’t changed organisation of care since inception
(boundaries between hospitals and primary care, health and social
care)

16. BIG PROBLEM!
Current model of care unsustainable –
MISMATCH BETWEEN RESOURCES AND
PATIENT NEEDS OF NEARLY £30 BILLION A YEAR
BY 2020/21
ACTION NEEDED TO:
– Reduce demand
– Increase efficiency
– Manage funding

17. NHS ENGLAND - FIVE YEAR FORWARD VIEW
Opportunity to change future of
healthcare:
•Radical upgrade in prevention and
public health
•Greater control of own care when
patients need health services
•Breaking down the barriers
•More local control of health services

18. GETTING SERIOUS ABOUT PREVENTION
Priorities:
•Tackle obesity
•Reduce smoking and harmful drinking
•Ensure children get the best start in life
•Reduce risk of dementia through tackling lifestyle risks
•Keeping people in employment (sickness absence costs £22 bn pa)
•Empowering patients to take control of their own health, especially
long term conditions

19. WHAT WILL THE FUTURE LOOK LIKE?
• Need to manage systems – networks of care – not
just organisations
• Out of hospital care needs to be much greater
• Services to be integrated around the patient
(mental health, physical health, social care)

20. NEW CARE MODELS
• Multispeciality Community Providers (MCPs) – will become the
focal point for wider range of care needed by their patients
• Primary and Acute Care Systems (PACS) – single organisations to
provide GP and hospital services, together with mental health and
community care services
• Urgent and emergency care networks
• Viable smaller hospitals
• Specialised care – eg stroke, cancer
• Modern maternity services
• Enhanced health in care homes

21. INNOVATION IS KEY TO THE FUTURE OF THE
NHS
Although 86% of adults use the internet, only 2% report
using it to contact their family doctor
•Comprehensive transparency of performance data
•NHS accredited health apps
•Interoperable electronic health records
•GP appointments and electronic prescribing to be available to all
•Patient data to be used in research (able to opt out)
•Increase use of technology eg smart phones by staff and patients

22. HEALTH INNOVATION TO BE ACCELERATED
Despite history of innovation (vaccines, modern nursing, hip
replacements, IVF, CT scanners, DNA double helix), not so good at
adopting or implementing innovation. NHS England will:
•Support the work of the National Institute for Health Research (NIHR)
•Develop collection and use of health outcomes data
•Work with NICE to expand work on devices and equipment
•Combine different technologies to transform care delivery eg monitor
elderly patients with heart disease to keep them at home
Digital health will play a big part in transformation of
service delivery

23. NHS – ATTITUDE TO INNOVATION
The NHS will become one of the best places in the world to test
innovations that require staff, technology and funding all to align in a
health system, with universal coverage serving a large and diverse
population.
NHS England will:
•Develop a few “test bed” sites with the AHSNs
•Work with NIHR and the Department of Health to expand NHS
operational research
•Get involved with the development of health and care “new town”
developments
AHSNs will have a key role to adoption of innovation in
NHS

24. CONCLUSIONS
• The NHS is a national treasure – the majority of services remain
free at the point of access.
• There is no single “NHS” but several hundred organisations brought
together under a single set of values
• Just building up from the most radical transformation in its history
but more needs to be done
• Facing critical factors, especially ever-increasing demand on its
service
• Five Year Forward View sets out plan to address issues
• Innovation key to sustainability of the NHS

25. THANK YOU
ANY QUESTIONS?
Frances Pennell-Buck
Frances.pennell-buck@uktispecialist.com
Tel: +44(0)7711 191 828