Akeso&Co recognised as a Leading UK Management Consultancy in Healthcare & Life Sciences by the Financial Times

Akeso&Co have been awarded ‘recommended’ status in the Healthcare & Life Sciences sector of the Financial Times’ UK’s Leading Management Consultants 2019 survey. We received “a significant number of recommendations from peers and clients” and thank our clients that contributed to this success. As a team we are delighted to be included on the list for the first time and are pleased to be recognised for the value we continue to deliver for our clients. We look forward to building on this success across the healthcare and life sciences sector.

The full report is available at https://www.ft.com/reports/uk-leading-management-consultants

Medicines Shortages: The Real Underlying Issues

Our conversations with NHS Chief Pharmacists around their top challenges and issues almost inevitably end up on the topic of medicines shortages. It is, therefore, interesting to see this topic hit the headlines today: “Pharmacists warn of a surge in shortage of common medicines” (link to BBC News article here). As with many news headlines written at the moment, it is implied that this is an impact of the uncertainty surrounding Brexit. However, in reality, shortages are a daily issue for all NHS organisations, which are managed admirably by teams of Pharmacists and Pharmacy Technicians in NHS Trusts across the country, constrained by resources and limited supply chain tools.

In our experience a typical NHS Trust utilises 1 team member (one Trust as high as 2.5 team members) managing shortages, which represents at least £4m in workforce costs and many more times that figure in purchasing alternatives.

To prepare for a potential no-deal Brexit, manufacturers and suppliers have been requested to increase inventories by at least 6 weeks in order to mitigate the impact of any supply disruptions in the short term, whilst Trusts have been asked to operate as normal. This is a crude and expensive approach (six weeks’ worth of medicines stock for the NHS is valued at £2.0bn) to mitigate importation delays but may be successful in the short term, providing all entities in the supply chain act homogeneously.  Organisations naturally take independent decisions in their own interest and in the case of NHS Trusts in the interest of their patients. This can result in unintended, but significant consequence when the supply of lifesaving medicines fluctuates.

Stockpiling alone will not address the underlying challenges faced by Pharmacists, which existed long before any no-deal planning.  The attention on the medicine’s supply chain and specifically shortages going into a period of uncertainty gives the NHS the opportunity to seek out best practice in supply and demand planning. While it is a cliché to reference other sectors when referring to the NHS, we are consistently asked how FMCG, retail and automotive plan, forecast and manage their supply chains and strongly believe there are learnings that are relevant to the supply of £17bn worth of medicines to the NHS.

Data exists and while utilising it to make relevant supply chain decisions is easier said than done, there is huge value potential; both in terms of direct costs and managing supply risks such as shortages. Longer term demand forecasts can be provided to suppliers, who in return could share data on their supply chain performance. This would enable a clearer view on any potential shortages and the adoption of tactics to mitigate this risk earlier than it can be achieved today. The willingness to share data will be dependent on the length of contracts and level of commitment, and so this should be considered carefully when procuring medicines.

There is also a need for improved technology to enable this big data to be aggregated and matched quickly and efficiently, and in line with the Scan4Safety objectives to use common identifiers. The same medicine can have a different description and identifier in every organisation which makes mapping spend to actual activities a hugely manual task.

These steps are by no means easy to implement, and as such the system should consider the capacity and capability required to meet this challenge combining Pharmacists and Supply Chain expertise and underpinned with best in class tools.

With or without a Brexit deal, medicines shortages will continue to be a problem and the root causes should be given the focus they deserve.

Reducing the cost of Diabetes Care through centre-led standardisation and sourcing of Blood Glucose Monitoring products

Following a 30% growth in England over the previous five years, Diabetes medicines spend exceeded £1bn in the financial year 2017/18. Almost 20% of the £1bn spend was on ‘Diagnostic and monitoring’ devices, which mainly consists of Test Strips for Blood Glucose Monitors used in self-monitoring by patients.

Our research and client experience indicates that NHS England could save between £28m and £52m (17% to 32%) per year on Self-Monitoring Blood Glucose Test Strips.

Read the full article.

The NHS genomic service could transform medicine

Akeso&Co have enjoyed working with the NHS genomics service through our Diagnostics, Pathology & Therapy Services and Technologies to develop a competitive approach for the strategic sourcing of genomics consumables.

Read the full article.

Consultancy.uk: NHS selects 107 consultancies for Management Consultancy Framework

Akeso&Co is among a group of 107 management consulting firms the NHS has selected to assist the institution’s complex strategic, organsiation and transformational changes over the next five years. As well as the world’s largest professional services and strategy consulting firms, the list also features a number of boutique and healthcare specialists. 

Read the full article.

Health Service Journal: Purchasing chief promises ‘route to innovation’ for suppliers

Akeso&Co is tasked with delivering savings from purchasing “diagnostic equipment and associated consumables” for the NHS, after winning a £9m contract from the Department of Health and Social Care in January. Managing director Chris Robson told HSJ one of his main priorities during the next five years is to make it easier for the NHS to access innovative products and services.

Read the full article.

Leveraging the value of innovation & disruptive technology in healthcare

Leveraging the value of innovation and disruptive technology in healthcare

The term ‘disruptive’ often has negative connotations, but when it comes to innovative technology in healthcare, it is overwhelmingly positive. Initiatives such as Scan4Safety (using barcode technology to identify patients and products) are helping improve patient safety and Near Patient Testing (or Point of Care Testing) technologies are helping deliver care quicker and closer to patient homes.

While there is little doubt the British health and social care system will see considerable operational and clinical gains from the implementation of much needed emerging innovation, it still has a long way to go to be considered a leading user of technology and to reap the benefits it can provide.

In this article, we look at some of the ways in which health and social care organisations can make incremental leaps in efficiency with the latest technological innovations, some of which are available today, and some of which are close on the horizon.

The role of technology in integrating health and social care

UK hospitals are now seeing unprecedented demand for beds. At the start of the 2017/18 winter, one in five hospitals ran out of bed space, with some trusts officially declaring they had reached 100% occupancy 99 times in just two weeks[1].  And the average daily bed occupancy of general and acute beds has increased from 89.8% to 91.4% over the past five years[2].

The bed capacity problem is well known and multi-faceted, two of the key driving factors are:

  1. The UK population is increasing and getting older. By 2046, it is estimated that 24.7% of the UK population will be over 65, compared to 18% in 2016[3].
  2. More patients with long-term conditions are increasing the complexity of patient care requirements, e.g. the number of patients with diabetes has increased from 6% to 6.7% over the past five years alone[4].

Another well-established cause of reaching maximum bed capacity is not being able to discharge patients who are medically fit but require extra social support and not being able to discharge patients who require some ongoing monitoring. Technology can assist this process in several ways:

  • Remote monitoring & medicine – by using telemonitoring technology, patients who are generally well but require ongoing monitoring can return to their home in the knowledge that should their health decline, or should a problem emerge, their clinical team will be automatically alerted. This would enable earlier discharge, freeing up capacity, but allowing a quick response if the patient’s health deteriorates. Telemonitoring and telemedicine are now advancing rapidly. One such solution is Kardia ECG, which is able to record a high standard cardiac rhythm using a small and relatively inexpensive pad which links to a standard smartphone. With the application of special algorithms, amongst other benefits, the software can assess for arrhythmia, and keep a close watch on patients with atrial fibrillation – even detecting this early.
  • Integrating data – there are many programmes at governmental level looking at how technology can help make health and social care work together more efficiently. At present, there is a persistent lack of data integration between the two sides, but rather than waiting for a national strategy, it is possible to achieve better integration with existing technology. By using existing data integration engine software, data analytics tools, and bed capacity management solutions (which are used by some NHS trusts to gain a real-time view of hospital bed capacity) in health and social care settings, it could be possible to have an overview of capacity across the regional health and social care system. Using such an approach would also offer social care providers a picture of the discharge needs of hospitals, allowing them to plan accordingly.

Doing more with fewer clinical resources

One of the consistent themes of the latest disruptive technologies in healthcare is undoubtedly maximising the use of available data.  In the past, data has resided in silos, unable to be harnessed in ways now possible as data becomes increasingly integrated. By correctly analysing large datasets, patterns emerge which can point to large cost savings and efficiencies, perhaps with minor or inexpensive changes; otherwise known as ‘low hanging fruit’.  It may even be possible to use predictive analysis to proactively alert operational managers to problems that are yet to occur.  The challenge is seeing through the noise of the data to find the nuggets of gold.

Machine learning is also extremely powerful and has the potential to transform data analytics and clinical care.  One way in which machine learning can be used is to augment the ability of clinicians to find disease in patients. Using algorithms, new software solutions can now rapidly analyse patient diagnostic images to find clinical signs of illness.

Large potential improvement in operational efficiency may be realised by using in-home devices to capture data on patient progress following surgery, thereby ensuring close monitoring, and crucially negating the need for face follow up appointments. Having such larger volumes of patient data (as opposed to data collected purely in clinic) will provide a much more accurate view of how the patient has healed, and at a much lower cost.

Personalised medicine

We are entering a world of personalised medicine, in which therapies, medication and interventions are bespoke to our unique genetic makeup, medical history, environment, and personal characteristics. Large-scale initiatives such as the 100,000 Genomes Project, in which 100,000 complete human genomes will be sequenced by the end of 2018[5], will enable the recommendation of treatments that are optimised for an individuals’ genetic profile. This will lead to many improvements and efficiencies including earlier detection of disease, improved health outcomes, less need to repeat or try new treatments due to ineffective drugs, less time in hospital, fewer drugs needed, and less time required by clinicians.

In the future, with the aid of handheld DNA scanners, a patient’s entire DNA profile will be uploaded, and illnesses or markers of future disease picked up before the patient is even aware. Such technology certainly raises ethical and moral questions, but the potential for re-engineering our model of care from one that is reactive to proactive is considerable.

Personalised medicine will also go a long way to assisting health and care commissioners, and managers understand the ever-growing clinical complexity of patients’ clinical and medication needs and how to most effectively allocate scarce resources.

How can we help?

Akeso & Company offer unrivalled experience and expertise in the areas of Healthcare and Life Sciences operations.  We were appointed as the Category Tower operator for Diagnostic technology and associated Consumables in the NHS Supply Chain Future Operating Model (CT8) in January 2018.

Through continuous market horizon scanning, Akeso has a broad and comprehensive understanding of the latest innovations and disruptive new technologies which have the potential to deliver transformative value to the UK health and care system.

We work with healthcare comissioners, healthcare providers and technology suppliers, and take an end-to-end view of the clinical pathway to fully understand the potential of an innovation or technology to improve clinical outcomes, reduce risk and bring about operational / cost efficiency.

For more information, please call on 020 3011 1381,or email ct8@akesoco.com

 

[1] https://www.independent.co.uk/news/health/nhs-hospital-trusts-bed-shortage-capacity-run-out-room-winter-christmas-a8110481.html

[2] Overnight Bed Availability and Occupancy Data. NHS England

[3] UK Population Data. Office of National Statistics

[4] Disease and Risk Factor Prevalence Data. Public Health England

[5] https://www.england.nhs.uk/healthcare-science/personalisedmedicine/genomics/

Health Service Journal: Nine trusts plan pharma network to save £17m

Akeso&Co have helped to deliver a pioneering collaboration project between nine acute trusts in West Yorkshire on a pharmaceutical network that could achieve efficiency savings estimated at more than £17m. Akeso&Co supported the opportunity assessment, solution design and outline business case to deliver forecasted one-off savings of £4.5m by creating a central medicines store, and further operational savings of £13m through the proposed operating model.

Read the full article.

Akeso & Company joins the MCA

The Management Consultancies Association is delighted to announce that Akeso & Company is the latest management consulting firm to join the Association.

Specialising in the field of Healthcare and Life Sciences, Akeso & Company is an independent management consultancy offering experience and expertise in Procurement, Supply Chain and Healthcare Operations, delivering high value and lasting outcomes for their clients.

Read the full Press Release.

BBC Radio 4: Could weaker pound cost the NHS?

Worst case scenario

In the Health Service Journal in July, management consultant Chris Robson, who works with NHS trusts on purchasing, predicted the cost could be up to £900m.

When we talk this month, he says things have not changed much, around a billion pounds per year, he says.

But he is keen to stress that is a “worst case scenario” and highly dependent on long-term currency movements.

He hopes the actual figure will not be anything near that and he says much can be done to avoid this cost; there are large savings and efficiencies to be made – but there might also be quite a lot of “running to stay still”.

Read the full article or listen to the podcast from 32:30.