By Claire Munro, founder and director of Dovetail
“Joint working is vital to the future of the NHS, and should be included in junior doctors’ training,” according to Professor David Nutt of Imperial College London, speaking at a recent Dovetail round table meeting.
The ABPI and Department of Health defined how companies and the NHS can pool skills, experience and resources to plan and deliver patient-centred projects. Working alongside their clinical stakeholders means that – in theory at least – companies are able to reach commercial and strategic goals while improving patient outcomes and experience at the same time; the results end up being more than the sum of their parts.
The reality, however, is often disappointing and many joint working initiatives fail to deliver. Sometimes the results are lopsided, producing better outcomes for one party than the other. One clinician cited a project that had delivered a strong commercial result but did little for patients, while some industry representatives thought
that joint working was usually more beneficial to the NHS or patients than to themselves.
At the round table we asked the group to list the problems they’ve encountered from the separate perspectives of industry and healthcare. There was a striking similarity. Key among these common issues are:
- A lack of time, capacity and resources to invest in setting up projects properly
- A lack of the right skills or capabilities to plan and manage joint working effectively
- Poor communication
- Misaligned objectives
- Bureaucracy and fear of reputational damage. Given all these issues, why put the effort into collaboration? For industry, joint working gives
the chance to understand the real challenges clinicians face and learn in real time, compared to waiting years for a conference paper from an investigator-initiated study, for example, or a report from a hands-off project funded by a grant.
Being an equal member of a steering group allows dialogue, while ongoing working relationships strengthen networks and help to build trust. Collaboration gives industry access to invaluable strategic insights, and with better understanding of their NHS customers and stakeholders, companies are better able to align corporate objectives with the public health agenda, and develop effective programmes to support it.
Clinicians, meanwhile, recognise that collaborating with industry enables them to deliver projects they otherwise wouldn’t be able to. Importantly, it’s not just about money: they also value the opportunity to work alongside talented people with different skills and perspectives in a collaborative learning environment.
So how do we ensure that joint working really works? The consensus from our experts chimes with Dovetail’s own experience from delivering over 20 collaborative projects. To begin with, we need to make sure that joint working is the best solution for the problem we’re trying to solve. Don’t do it just because it’s seen as trendy if a grant would be more appropriate. Time and energy need to be invested in setting up the project. The set-up phase should include taking a holistic view and looking to understand the challenges and perspectives of all the partners. Bear in mind that pharma industry contracting can be very functional, and there’s a need for a human-to-human element; having an open and honest conversation is important in building trust.
It’s essential to align objectives and find the sweet spot where the work will meet patient, NHS and commercial needs. None of these should be shoehorned in, and if they’re not balanced and transparent, the chances of success are reduced. The patient benefit needs to be clear, and should act as the ‘moral compass’ for the work. Goals need to be realistic and achievable. A small project with modest ambitions can be transformative for patients if well executed, whereas big projects that never get off the ground can’t actually change anything.
There is a capability gap on both sides, and this needs to be addressed if the NHS, industry and patients are to reap the potential benefits of collaboration. Staff turnover means that corporate knowledge and know-how can be lost over time, so training resources should be developed to help teams develop and share best practice.
Our experts reflected that the healthcare landscape has evolved since Moving Beyond Sponsorship was published by the ABPI and Department of Health, and agreed that an updated and simplified toolkit would be very helpful.
It’s clear that there is an appetite for collaboration, but also a real need for better skills training, shared learning resources and support with processes in order to unlock the potential to deliver real and lasting benefit
to patients, the NHS and companies.
