It was more than 10 years ago
that I conducted a small survey-based study into the NHS / pharmaceutical
industry collaborative working landscape (click here for more information). Since then, I have maintained a close
interest in collaboration and collaborative working. More recently, I have
explored Collective Intelligence (the Nesta definition of which is, “something
that is created when people work together, often with the help of technology,
to mobilise a wider range of information, ideas, and insights to address a
challenge”) and collaborative working in foresight. You can read articles on
both these topics by following the links.
So I was curious about how
many of the research conclusions I drew then (on the landscape for
collaboration between the NHS and pharma) remain true today across business
more generally.
Context
Over many years, much has been
written in the health press, by the DoH and ABPI about collaborative working.
Most commentary has involved statements of intent or policy and descriptions of
a number of collaborative working initiatives that are repeatedly held up as
exemplars of collaboration in the health sector. Helpful as these examples are,
they focus mainly on the structures, outcomes, and organisational arrangements
that support collaborative working.
But how do practitioners of
collaborative working—those individuals in industry and the NHS that are
currently engaged in joint working initiatives—experience collaboration and how
much success do they enjoy? What does the future hold for collaboration and
what needs to happen in order for collaborative working to be widely and
successfully adopted?
Addressing these questions
raises a number of issues that are pertinent to how the industry and NHS will
progress the collaborative working agenda.
Collaborative Working
Practitioners’ Experience
About half of all respondents
reported positive experiences and success from collaborative working, but other
experiences are variable with mixed success. It has been said that the NHS has
yet to fully grasp the concept of equity and mutuality, sometimes seeing the
industry as a source of funding. A lack of understanding about the NHS’ needs
and particularly a lack of any clear effort from some industry members to
understand it, leads to frustration on the part of their NHS colleagues.
Given this backdrop, it is no
real surprise that the attrition rate for converting ideas into implemented
projects can be high.
The ability to partner
successfully can be situational and a factor of both organisations’
collaborative working culture. Where NHS organisations and pharmaceutical
companies are able to jointly work on a patient-focussed issue and its solution
is expected to deliver benefits to both parties, experiences become positive
and can act as a catalyst for further collaboration.
Competence in collaborative
working is critical. But there is broad acceptance that the process of
connecting to form relationships, contracting to set clear goals and
guidelines, collaborating to deliver the objectives in the agreed manner, and
closing to review success and agree next steps is still new but competence is
increasing with experience.
Despite the largely positive
perspective provided by industry colleagues, some scepticism about the
industry’s willingness to fundamentally change its business model remains.
Making reference to a number of company re-organisations, a respondent
remarked, “we have seen commitment (to collaborative working) via the
structures that pharmaceutical companies have put in place but there is still a
question-mark whether fundamental change is really happening.”
Hurdles to Collaborative
Working
Attitude to collaboration at
the organisational level is seen as the most significant hurdle by both
industry and NHS colleagues. The
overwhelming sense is that collaborations generally succeed because of the
commitment of individuals rather than an institutionalised approach to
collaborative working by their organisation. "Partnership isn't someone's
job it's just part of one”. This leads to a supplementary question: “Is the partnership
role main-stream or just a bit-part?" Change has to start at the top:
“Senior pharmaceutical folk (directors) have got to get out and meet with their
customers," as one industry respondent put it.
A change in
priorities—particularly as the industry tries to cut its cloth according to its
means—can be disruptive to ongoing collaborative initiatives. NHS or pharma
company re-structuring—often an operational fact of life—can lead to colleagues
taking on new roles, often in different organisations leaving a particular
initiative lacking the required leadership, knowledge, and drive to see the
work through to an optimal conclusion.
Some NHS participants still
lack an understanding of what the industry is offering. “It is not always clear
what pharma has to offer, what they want in return and how they want us to work
with them,” said one respondent. As such, assessment and qualification –
understanding the potential business value of a collaborative initiative and
partner – can be challenging.
In some cases, entrenched
views about the “other side” remain. “Some pharma companies are only really
interested in selling drugs," remarked one NHS colleague. But then again
an industry respondent said: “The NHS still expects to get things for free from
pharma.”
Motivation to Collaborate
There are two different
perspectives when it comes to the motivation for collaborative working: a
business perspective – by working with customers and other stakeholders,
benefits will be realised and shared which will help both parties achieve their
business objectives; and a strong personal perspective – a desire to add value
and invest personally in the relationship and the expected outcomes from
collaborative working.
Evidence suggests that when
colleagues engage in personal development activities on collaborative working,
they quickly build their newly acquired skills into their practice. Individual
relationships can be further enhanced by the reputation of the colleague’s
company, re-enforcing the importance of a positive corporate attitude.
Colleagues from both sectors
demonstrated their commitment to a collaborative approach. “What would motivate
me to collaborate with industry is the ability to procure a package of products
and services from a company,” was one NHS perspective. “As a partner, the
industry can become an inclusive part of the care delivery process.”
There was equal enthusiasm
from industry colleagues. “Collaboration can be a very productive way of
working, and one that reflects my personal values. This is a proper way of
working,” said one account manager. “Shared challenges, need and a desire to work
together can lead to great collaborations.”
Recognising Value
Critically, value must be
delivered to all parties if collaborative working is to be universally
successful. There are varied perspectives of what defines value across both
sectors; including reputation, commercial and financial success, relationship
development, and access to information and capabilities. Mismatches in what is
perceived as value by the industry and NHS can be particularly damaging when
emerging during collaboration.
The following key themes
emerge when seeking to determine how the value of collaborative working is
recognised:
- Planning for partnership –
understanding the idea, assessing the investment required, and the desired
outcomes;
- Measuring success – identifying
success factors and metrics; and
- Risk / benefit analysis.
The NHS is looking for the
tangible benefits of collaboration. The achievement of mutually agreed targets
and shared goals are often linked to efficiency, improving care pathways, and
eliminating hospitalisation through appropriate drug intervention. Access to
and adoption of pharma’s skills and competencies are seen as critical for the
NHS’ ongoing development. Collaborative working is seen as an ideal way to
acquire these skills and competencies.
For the industry,
"Identifying a shared view with our customers on important health
challenges that relate directly to our product portfolio,” is critical. The
view was also expressed that, "Collaborative working in my organisation is
seen as a strategic activity and so we plan for RoI over a longer period.”
Evolution of Collaborative
Working Practice
Just under half of all
respondents expected to be involved in more collaborative working over the
following 12 to 18 months. A similar number gave a qualified “maybe” citing
their personal capacity to participate or that supply and demand for
collaborative working between companies and local NHS organisations was already
about right.
It was also felt that a
pharmaceutical company’s ability and willingness to collaborate effectively
would increasingly be a differentiator. Colleagues in both sectors, however,
thought that skills, capabilities, and attitudes need to be addressed in their
own as well as their stakeholder’s organisations, to improve collaborative
working.
A number of NHS colleagues
expressed a desire to be involved in more collaborative working and when asked
if a company’s ability and willingness to collaborate would become a
differentiator, one NHS colleague said, “Definitely, definitely, definitely
yes." But it will require, "brave leaders on both sides," he
added.
Industry respondents feel that
competence in collaborative working will or may have a positive impact on how
pharmaceutical companies are regarded by NHS organisations. “Our approach to
working collaboratively should position the company as first port of call for
customers when they want above-product support,” said one account manager.
What Needs to Happen to
Improve Collaborative Working Practice?
In describing the actions
required to improve collaborative working in their own and their stakeholders’
organisations, three themes emerged in respondents’ feedback: corporate
attitude to collaborative working; communication to promote collaborative
working and capability development in collaborative working.
There is work to do to ensure
that colleagues across the organisation—not just in the client/customer/partner
facing roles—have a greater understanding of the collaborative working process,
the aims and objective of collaborating, and an appreciation of the partner’s
agenda. Investment in improving skills and capabilities in collaborative
working is critical and includes the collaboration process, assessment and
qualification of collaboration opportunities and consulting skills.
As the external environment
changes, organisation across sectors are required to review business models and
approaches to remain successful and valid.
This might require historically based pre-conceptions of partnering
sectors behind them. A genuine and sustainable commitment to moving away from the
traditional business model can only work if both parties engage and experience
the benefit of joining forces and sharing skills. Building trust is a crucial
element here and will require consistent messages and demonstrable
collaborative behaviours are exhibited to re-enforce commitment to collaborative
working.
A commitment to the resourcing
required, an understanding of both parties (in any given partnership), and
clarity about wants and offers are a critical component of the contracting to
partner as well as components of developing trust. Deep frustration can emerge
when the division of resources applied varies from what was agreed. Partnership
is not a quick fix, so the parties need to be aware of, and be able to
demonstrate their long-term commitment to achieving the desired outcomes.
A Final Thought
Perhaps seeking to answer the
questions posed through this work will encourage collaborative working
practitioners and other colleagues to pose questions to each other and their
potential partners. It is only through a process of ongoing dialogue that both
parties will be able to make informed choices about the relationships they want
to have with their stakeholders, and what they need to do to make them
successful.
Questions:
- How pertinent are these
observations about the collaboration between the NHS and pharma sectors to your
business environment in 2020?
- How have your perspectives on
collaboration and collaborative working changed or not in the current covid-19
pandemic?
- What role might collaboration
play in re-energising your enterprise post-pandemic?
- Given the increasing
uncertainty we face through the pandemic, how might collaborative working
support the development and implementation of sustainable business strategy?
To download a free copy of the
full report click here or you can email Steve for a copy and more information.
Image Credit: John Hain /
https://pixabay.com/illustrations/mind-peace-peace-of-mind-unity-2176566
