P 41

Ymchwiliad i’r Adolygiad Blaenoriaethau ar gyfer y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon

Inquiry into the Priorities for the Health, Social Care and Sport Committee

Ymateb gan: AbbVie

Response from: AbbVie

Health, Social Care and Sport Committee
National Assembly for Wales
Pierhead Street
Cardiff
CF99 1NA

Email: SeneddHealth@Assembly.Wales

Consultation on the Forward Work Programme of the Health Committee 2016/17

AbbVie is a global, research-based biopharmaceutical company formed in 2013 following separation from Abbott Laboratories. The company's mission is to use its expertise, dedicated people and unique approach to innovation to develop and market advanced therapies that address some of the world's most complex and serious diseases. For further information on the company and its people, portfolio and commitments, please visit www.abbvie.com.

AbbVie welcomes the opportunity to contribute to the Committee’s forward work programme during the Fifth Assembly.  As well as considering legislation, the Committee has a key role in scrutinizing spending plans and policy matters set out by the Welsh Government.  In our submission, we have focused on three key areas:

• A review of the impact of the Prudent Healthcare approach to health policy in Wales in order to assess the effectiveness of the policy and how the principles of prudent healthcare are being applied in practice to the benefit of patient care. 

• We share the Committee’s interest in looking at the progress made towards effective integration of care, in particular whether closer working has improved patient pathways.

• We have also highlighted an opportunity for the Committee to play a key role in scrutinizing  plans to introduce a new treatment fund – making sure it is sustainable and delivers access to innovative medicines in Wales.

Prudent Healthcare

In 2014, Professor Mark Drakeford, Minister for Health and Social Services, defined Prudent Healthcare as “Healthcare that fits the needs and circumstances of patients and actively avoids wasteful care that is not to the patient’s benefit.”

The Welsh Government established principles of prudent healthcare which are centred around involving patients in decisions about their care; prioritizing care for those with the greatest need; to do only what is needed, and to do no harm; to adopt evidence based practice and reduce inappropriate variation.

With almost half of the total Welsh budget allocated to NHS spending there is increasing pressure to reduce costs and achieve efficiencies within the service to ensure sustainability in the long term.

Given that this policy drives decision making in the NHS it is important for the Committee to consider and understand the impact it is having on the day to day running of the NHS and to determine whether the principles of prudent healthcare are driving positive change in the Welsh NHS.

AbbVie supports the principles of Prudent Healthcare and believe that there is an opportunity for all of those involved in the delivery of healthcare services in the NHS to contribute to developing new and sustainable ways of supporting people living with illness to achieve better outcomes and which help to make limited NHS resources go further.

AbbVie has established a UK-wide Sustainable Healthcare programme and has identified three key areas for opportunities to improve the sustainability of healthcare services, which we believe could form the focus of a Committee Inquiry:

· Embedding a person-centred approach, which considers the individual rather than a siloed focus on their condition(s)

· Using technology to improve the delivery of services and care closer to home and equipping individuals to self-manage

· Helping individuals to navigate the healthcare system and manage their condition with confidence. For example, AbbVie is supporting the development of a new, shared decision-making (SDM) tool, led by Professor Debbie Cohen at Cardiff University. The SDM tool has been designed to aid and improve conversations and decisions about health and work between patients and their healthcare professionals.

In September AbbVie in partnership with NHS Public Health Wales, will be hosting a conference on Prudent Healthcare to consider how Wales is getting it right in terms of Sustainable Healthcare.

Integration of Health and Social Care services

AbbVie would support an inquiry into progress made towards the implementation of the “Framework for delivering integrated health and social care for older people with complex needs”, particularly to consider opportunities and challenges for closer working between health, local authorities and the third sector in Wales.  It would also be useful to consider whether this closer working has delivered improvements to patient care pathways from initial referral to specialist services through to discharge and the provision of care at home.

Within this context, the Committee may also wish to consider is how the NHS defines and recognises ‘value’ in terms of the decisions that are made regarding treatment choice and the model of care. Managers across the NHS face a number of competing demands and pressures however in some cases the financial pressures and structural limitations constrain their ability to make long term decisions that may require upfront costs but which have potential to deliver savings in the long-term.  In other cases, the benefits of investing in particular preventative strategies or investing in medicines or technologies may fall on the shoulders of one part of the service at a particular point in the patient pathway with the benefits of such investment, through reduced admissions and financial savings, accruing to other parts of the service responsible, but there is no mechanism to support this type of activity.

One example would be the management of long-term conditions such as rheumatoid arthritis or gastroenterology and the value that can be achieved across a whole patient pathway by patient support programmes that seek to provide bespoke support to patients receiving medicines in a way which is most impactful to them. This can reduce the amount of hospital appointments required for routine medicine administration which, alongside patient benefits, frees up hospital resource. It can also support adherence to medication reducing complications and costs that can arise from a patient failing to take their medicine. However, these wider benefits and value points that occur across the patient pathway are not always easily accounted for by the prescribing service.

Integration offers an opportunity to simplify the system to remove the barriers between primary, community and hospital based care as well as between the NHS and social care services, to achieve best value across a whole pathway. AbbVie believes in addition to these structural changes tools that encourage a wider assessment of value may be beneficial.

New Treatment Fund

The First Minister set out a commitment to work on a new NHS treatment fund within the first 100 days of his government and, on the 30^th of August 2016, the Welsh Government issued a media statement which reported that within the first 100 days, they had:

“Committed £80m to establish a New Treatment Fund and to independently review patient funding requests – this is a significant step forward in ensuring treatment for life-limiting and life-threatening diseases are immediately and consistently available across Wales. The independent review panel has been agreed and we fully expect the fund to be in operational in December”.

It would be appropriate and welcome for the Committee to be actively involved in the development of this fund and to monitor its implementation. 

An inquiry into this policy should take into account the funding, alignment with existing HTA processes and learn from experiences in other parts of the UK.

The Committee may wish to investigate the plans in detail to ensure that a clear budgetary mechanism is established to provide sufficient and sustainable funding for access to medicines. 

Aligning the fund to the AWMSG and NICE health technology appraisal process would ensure that there is clarity on how this fund can be accessed. 

Introducing a new treatment fund in Wales should support the policy of Prudent Healthcare where patients have access to the clinically and cost effective medicines they need.

AbbVie believes that all partners in the health service have a role to play in delivering new patient pathways that support patients to manage their conditions and remain at home with minimal need for hospital-based care.  In Wales, this work is underpinned by the Prudent Healthcare principles.  As stated previously, AbbVie is hosting a conference in September in partnership with NHS Public Health Wales to look more closely at how Wales is progressing this policy and members of the Committee should have received invitations to attend this event.

I would be happy to provide more detail on any of the information provided in this submission and, should the Committee proceed inquiries into any of these issues, AbbVie would be happy to provide more detailed evidence to the Committee.

Yours sincerely,

Gail Grant

AbbVie Government Affairs Manager

E: XXXXXXXXXXXXXXXXXXXX

M: XXXXXXXXXXX