New opportunity – Clinical Therapeutics Specialist – Orphan products – Northern UK/ Southern UK/ Ireland – Excellent reward package – 4724

Clinical Therapeutics Specialist – Orphan Product – New product launch opportunity.

Three territories:-

1. Northern England & Scotland

2. Southern England & Wales

3. Ireland

As a medical sales professional launching a new entity in to the market is one of the most thrilling and challenging career landmarks. For our client, there is just one chance to bring their new product to market; hence we are in search of an elite salesperson who can establish a breakthrough treatment in key centres across your territories. You must:
– Thrive in a fast-paced working environment
– Be able to work with your internal and external stakeholders to drive through results
– Understand the market dynamics, particularly around funding and use of Orphan status products
– Have sound planning skills with strong commercial judgement
– Be motivated by the ultimate goal of improving patients’ lives

Critical to your success will be the ability to remove any barriers to usage of the specialist product so as all relevant patients who would benefit have access to the drug. You would need to;
– Develop and execute specific account plans
– Communicate disease and product knowledge effectively
– Create a long-term ‘partnership’ and value propositions with all key stakeholders

This is a high profile sales role requiring a range of transferable skills and knowledge; it is likely you can demonstrate the following:
– A proven track record of sales success in your pharmaceutical/biotech career to date
– Experience of selling in a highly specialist market (Orphan products, other high cost:low volume areas)
– An understanding of the healthcare regulatory environment
– Excellence in selling skills, account management and networking
– Prior product launch experience will be an advantage
– Degree level education
– Valid UK driving license (max 6 pts)
You will need to able to cover your territory effectively so a willingness to travel/stay overnight, as the business requires, is a must.

The successful person will be joining a new sales team and be at the forefront of future growth plans for this ambitious company. On offer is a top end basic salary plus an extensive benefits package.
To be considered for this exciting vacancy please send your CV to administrator@2020selection.co.uk or call our specialist team on 0845 026 2020.

http://ping.fm/mJhe3

NHS Patient Safety – Medication

How can Pharmaceutical Companies contribute to improving NHS Patient Safety?

They can demonstrate ‘added value’ , for example, by either offering products which contribute directly to making the administration of medicines safer by helping to reduce:-

• Making the drug up to the wrong strength
• Using the wrong diluent
• Microbial or other forms of contamination
• Labelling errors
• Administration by the incorrect route by clearer design/packaging of the product

The products which are commonly offered as part of a compounding service include:-

• Cytotoxics
• Antibiotics
• Inotropes
• Potassium solutions
• TPN
• Unlicensed medicines

In addition, the provision of non-promotional training/educational services to healthcare professionals in the form of Continuing Professional Development events and nurse advisor teams helps to educate NHS staff on how to administer medicines more

• Confidently
• Accurately
• Competently

The Department of Health (DH) has issued the following list of ‘Never Events’ for 2012-13. The list is circulated to a wide range of NHS managers, clinicians and healthcare professional allied to medicine.

The document authors are the DH’s Patient Safety and Investigations unit. The purpose of the document is to highlight certain events which are deemed to be very serious risks to the standard of care to patients, but most importantly avoidable.

The document forms part of the wider DH’s Patient Safety Agenda policy and should be read in conjunction with the NHS Standards Contract for organisations providing services to the NHS

1. Wrong site surgery
2. Wrong implant/prosthesis
3. Retained foreign object post-operation
4. Wrongly prepared high-risk injectable medication
5. Maladministration of potassium-containing solutions
6. Wrong route administration of chemotherapy
7. Wrong route administration of oral/enteral treatment
8. Intravenous administration of epidural medication
9. Maladministration of Insulin
10. Overdose of midazolam during conscious sedation
11. Opioid overdose of an opioid-naïve patient
12. Inappropriate administration of daily oral methotrexate
13. Suicide using non-collapsible rails
14. Escape of a transferred prisoner
15. Falls from unrestricted windows
16. Entrapment in bedrails
17. Transfusion of ABO-incompatible blood components
18. Transplantation of ABO incompatible organs as a result of error
19. Misplaced naso- or oro-gastric tubes
20. Wrong gas administered
21. Failure to monitor and respond to oxygen saturation
22. Air embolism
23. Misidentification of patients
24. Severe scalding of patients
25. Maternal death due to post partum haemorrhage after elective Caesarean  section

Source: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_132352.pdf

You can read the whole document if you wish, but the indicators within the specific areas where the Pharmaceutical Industry has opportunities to work in conjunction with the NHS includes:-

1. Wrongly prepared high-risk injectable medication

• Death or severe harm as a result of a wrongly prepared high-risk injectable       medication.
• High-risk injectable medicines are identified using the NPSA’s risk assessment tool1. A list of high-risk medicines has been prepared by the NHS Aseptic Pharmacy Services Group using this tool2. Organisations should have their own list of high-risk medications for the purposes of the “never event” policy, which may vary from the NHS Aseptic Pharmacy Services Group list, depending on local circumstances.
• A high risk injectable medicine is considered wrongly prepared if it was not; o prepared in accordance with the manufacturer’s Specification of Product Characteristics;

1 NPSA High Risk Medication Risk Assessment Tool, 2007, available at

http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60097&type=full&servicet ype=Attachment

2 Pharmaceutical Aseptic Services Group. Example risk assessment of injectable medicines. 2007. Available at http://www.civas.co.uk/

• This event excludes any incidents that are covered by other “never events”.
• Where death or severe harm cannot be attributed to incorrect preparation, treat as a Serious Untoward Incident.

5. Maladministration of potassium-containing solutions

• Death or severe harm as a result of maladministration of a potassium-containing solution.

Maladministration refers to;

• selection of strong potassium solution instead of intended other medication,
• wrong route administration, for example a solution intended for central venous catheter administration given peripherally,
• infusion at a rate greater than intended.

Setting: All healthcare settings.

Guidance: – Patient safety alert – Potassium chloride concentrate solutions, 2002 (updated 2003), available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59882

6. Wrong route administration of chemotherapy

Intravenous or other chemotherapy (for example, vincristine) that is correctly prescribed but administered via the wrong route (usually into the intrathecal space).

 

Setting: All healthcare premises.

Guidance: – HSC2008/001: Updated national guidance on the safe administration of intrathecal chemotherapy, available at http://www.dh.gov.uk/en/publicationsandstatistics/lettersandcirculars/healthservicecirculars/dh_ 086870 – Rapid Response Report NPSA/2008/RRR004 using vinca alkaloid minibags (adult/adolescent units), available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59890

7. Wrong route administration of oral/enteral treatment

Death or severe harm as a result of oral/enteral medication, feed or flush administered by any parenteral route.

Setting: All healthcare settings.

Guidance: – Patient Safety Alert NPSA/2007/19 – Promoting safer measurement and administration of liquid medicines via oral and other enteral routes, 2007, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59808

8. Death or severe harm as a result of intravenous administration of epidural medication.

• A broader “never event” covering intravenous administration of intrathecal medication or The “never events” list 2012/13 9 intrathecal administration of intravenous medication is intended once the deadlines for Patient Safety Alert 004A and B actions have passed.

 Setting: All healthcare premises.

Guidance: – Patient Safety Alert NPSA/2007/21, Safer practice with epidural injections and infusions, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59807 – Safer spinal (intrathecal), epidural and regional devices – Parts A and B, available at http://www.nrls.npsa.nhs.uk/resources/?EntryId45=65259

9. Maladministration of Insulin

Death or severe harm as a result of maladministration of insulin by a health professional. Maladministration in this instance refers to when a health professional

• uses any abbreviation for the words ‘unit’ or ‘units’ when prescribing insulin in writing,
• issues an unclear or misinterpreted verbal instruction to a colleague,
• fails to use a specific insulin administration device e.g. an insulin syringe or insulin pen to draw up or administer insulin, or
• fails to give insulin when correctly prescribed.

Setting: All healthcare settings.

Guidance: – Rapid response report – Safer administration of insulin, 2010, available at http://www.nrls.npsa.nhs.uk/alerts/?entryid45=74287 – NHS Diabetes – Safe use of insulin, 2010, available at http://www.diabetes.nhs.uk/safe_use_of_insulin/ – NHSIII Toolkit – Think Glucose, 2008, available at http://www.institute.nhs.uk/thinkglucose – NHS Diabetes guidance – The Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus, 2010, available at http://www.diabetes.nhs.uk/document.php?o=1037

19. Misplaced naso- or oro-gastric tubes

Death or severe harm as a result of a naso- or oro-gastric tube being misplaced in the respiratory tract.

Setting: All healthcare premises.

Guidance: – Patient safety alert – Reducing harm caused by misplaced nasogastric feeding tubes, 2005, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59794 – Patient safety alert – Reducing harm caused by misplaced naso and orogastric feeding tubes in babies under the care of neonatal units, 2005, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59798&q=0%c2%acnasogastric%c2%ac

Please visit the20:20Selection website if you have found this article helpful, as we regularly update the articles in our Factsheet section

http://www.2020selection.co.uk

Are you eligible? Having your documents ready for your job search.

Embarking on a search for a new job can be daunting however like all things in life it can go more smoothly with forward planning. This short article is aimed at ensuring you have the relevant factual information at hand. This is important as agencies (like20:20 Selection Ltd) and importantly employers do need to check your legal, employment and academic documentation. Hence if you have all this in order, then when it comes to you being made that perfect job offer the contract/job offer letter is likely to be with you more quickly.

 

The following checklist should help you with your preparation:

• Passport & Visa (if applicable) – an employer can be fined for employing individuals who are not eligible to work in theUK

• Driving Licence – you will need the paper and photo card parts. For field based positions you will need a validUKdriving licence with no more than 6 penalty points. It is important you make clear declarations about your driving history when asked as employers will check this with the DVLA.

If you have a nonUKlicence holder and need to convert your licence the following link will give you some guidance:

http://www.direct.gov.uk/en/Motoring/DriverLicensing/DrivingInGbOnAForeignLicence/DG_4022562

• A recent payslip. This will validated your current basic salary and your National Insurance number. If you are in receipt of other monthly benefits such as a car allowance this will also be verified on the payslip.
• ABPI certificate – if you have sat and passed the examination you will need to produce your certificate if you are offered employment with a pharmaceutical company. If you have misplaced this, the following link may help

https://extranet.abpi.org.uk/web/abpi/exams.nsf/pages/duplicate_certificate_request

• Highest education certificates (degree, nursing, A levels etc)
• For nursing roles you will need your current NMC PIN number and date of expiry. Plus you will also be asked about the date of your last CRB check however your new employer will need to undertake a fresh check.
• For sales positions you should also put together your ‘Brag File’ or portfolio of successes which should include Sales Data, other performance against KPIs, recent appraisal documents; in fact anything that you can use to sell you and differentiate you in the marketplace.

 

If you are not facing redundancy, timing your job search is also something to consider. For example,

• We do come across people who may be tied in to car schemes. You are advised to carefully calculate the costs involved to you in walking away from your current agreement, as not all employers offer car opt-out schemes.
• If you are going to jeopardise any bonus/incentive payments pay by leaving before a certain date.
• If you have significant holiday commitments it is important you flag these. A job offer may be subject to you attending a training course on a specific date for a fixed time, however discussing these with your Recruitment Consultant early in the process may mean this can be negotiated. Also remember that holiday entitlement will be prorated depending at what stage of the leave year you commence work.

 

At 20:20Selection, we are here to help and guide our candidate along the process. Our specialist team can be contacted on 0845 026 2020 from08:30 – 18:00weekdays.

MABS / CYTOKINE MODULATORS / ANIT- TNF AGENTS AND MORE

A medication ending with the stem ‘mab’ indicates that it is a monoclonal antibody. This is the internationally recognised nomenclature for the naming of monoclonal antibodies. 

Nomenclature has become somewhat confusing though as the BNF includes ‘mabs’ under the heading of cytokine modulators and anti-lymphocyte monoclonal antibodies in several chapters.

 Monoclonal antibody production for medical use was first discovered by Milstein and Kohler in 1975, but it was confined mainly to diagnostics until Vilcek and Li approached Centacor (now part of Johnson & Johnson) to help them produce ‘mabs’ against TNFα.

Tumour necrosis factor-alpha (TNFα) is a cytokine (an immunomodulating agent) produced by monocytes and macrophages, two types of white blood cells. It mediates the immune response by increasing the transport of white blood cells to sites of inflammation, and through additional molecular mechanisms which initiate and amplify inflammation. Inhibition of its action by ‘mabs’ reduces the inflammatory response which is especially useful for treating autoimmune diseases.

The ‘mab’ that Vilcek and Li discovered become known as Infliximab (Remicade) and it became an important treatment for severe Crohn’s disease, including the fistulating variety. It has subsequently been used to treat other auto-immune system  diseases such as psoriasis and rheumatoid arthritis. Infliximab became known as ‘Kwik Fiximab’ in medical circles due to it’s clinical success in treating otherwise unresposive patients.

There are two types of TNF receptors: those found embedded in white blood cells that respond to TNF by releasing other cytokines, and soluble TNF receptors which are used to deactivate TNF and blunt the immune response. In addition, TNF receptors are found on the surface of virtually all nucleated cells. Red blood cells, which are not nucleated, do not contain TNF receptors on their surface.

A ‘mab’ neutralises the biological activity of TNFα by binding with high affinity to the soluble (free floating in the blood) and transmembrane (located on the outer membranes of T cells and similar immune cells) forms of TNFα and inhibits or prevents the effective binding of TNFα with its receptors. Infliximab and adalimumab (another TNF antagonist) are in the subclass of “anti-TNF antibodies” (they are in the form of naturally occurring antibodies), and are capable of neutralising all forms (extracellular, transmembrane, and receptor-bound) of TNFα. Etanercept, a third TNF antagonist, is not a ’mab’ and it is in a different subclass (receptor-construct fusion protein), and, because of its modified form, cannot neutralize receptor-bound TNFα. Etanercept is sometimes referred to as a ‘non-biologial’ agent to distinguish it further from the ‘mabs’ Additionally, the anti-TNF antibodies adalimumab and infliximab have the capability of lysing cells involved in the inflammatory process, whereas the receptor fusion protein apparently lacks this capability. Although the clinical significance of these differences have not been absolutely proven, they may account for the differential actions of these drugs in both efficacy and side effects.

Infliximab has high specificity for TNFα, and does not neutralise TNF beta (TNFβ, also called lymphotoxin α), an unrelated cytokine that uses different receptors from TNFα. Biological activities that are attributed to TNFα include: induction of proinflammatory cytokines such as interleukin (IL) 1 and IL 6, enhancement of leukocyte movement or migration from the blood vessels into the tissues by increasing the permeability of endothelial layer of blood vessels; and increasing the release of adhesion molecules.

A range of newer agents which act against these other cytokines have subsequently been developed.

Tha table below summarises the anti- TNF mabs available in the UK currently. None-mab anti-TNF agents are also included for comparison

MOLECULE	BRAND	CLASS	DERIVATION	INDICATION	NICEAPPROVED
Adalimumab	Humira (Abbott)	Anti-TNFα	Recombinant human ‘mab’ From hamster ovary	RA PJIA PA AS CD P	Yes No Yes Yes Yes Yes
Alemtuzumab	MabCampath (Genzyme)	Anti-lymphocyte	Recombinant human ‘mab’ from hamster ovary	CLL	Yes
Certolizumab Pegol	Cimzia (UCB Pharma)	Anti-TNFα	Recombinant human ‘mab’ From E Coli	RA	Yes
Golimumab	Simponi (Schering-Plough)	Anti-TNFα	Recombinant human ‘mab’ from murine cell line	RA PA AS	No No No
Infliximab	Remicade (Schering-Plough)	Anti-TNFα	Recombinant human ‘mab’	RA CD UC AS PA P	Yes Yes Yes Yes Yes Yes
Ofatumumab	Arzerra (GSK)	Anti-lymphocyte	Recombinant human ‘mab’ from murine cell line	CLL	No
Rituximab	MabThera (Roche)	Anti-TNFα	Recombinant human ‘mab’ from hamster ovary	RA CLL NHL	Yes Yes Yes
Tocilizumab	RoActemra (Roche)	Anti-IL-6	Recombinant human ‘mab’ from hamster ovary	RA	Yes
Ustekinumab	Stelara (Janssen-Cilag)	Anti-IL-12/23	Recombinant human ‘mab’ from murine cell line	P	Yes
Abatacept	Orencia (Bristol-Myers Squibb)	T-cell modulator	Fused protein formed by recombinantDNAtechnology	RA PJIA	Yes No
Anakinra	Kineret (Swedish Orphan)	Anti-IL-1	Recombinant human ‘mab’ From E Coli	RA	No
Etanercept	Enbrel (Wyeth)	Anti-TNFα (soluble receptor specific)	Fused protein formed by recombinantDNAtechnology from hamster ovary	RA PJIA PA AS P	Yes Yes Yes Yes Yes

 

KEY

RA = Rheumatoid arthritis

PJIA = Polyarticular juvenile idiopathic arthritis

PA = Psoriatic arthritis

AS = Ankylosing spondylitis

CD = Crohn’s disease

P = Psoriasis

CLL= Chronic lymphocytic leukaemia

NHL= Non-Hodgkin’s lymphoma

NICEapproval status correct as of May 2011. Please refer to NICEwebsite for latest guidance http://www.nice.org.uk/

Sources:NICE, manufacturers Summaries of Product Characteristics, and BNF vol 61

VALUE BASED PRICING (VBP) – How the NHS will purchase drugs

 The government intends to reform the way in which drugs purchased by the NHS are priced by the end of 2013. It aims to ensure that drug costs more fully reflect clinical benefit and to improve patient access to new treatments. At present the prices are determined by the Pharmaceutical Price Regulatory Scheme (PPRS). These prices are usually reviewed at 5 yearly intervals. Pharmaceutical companies are relatively free to set the price of a newly launched product (assuming it is accepted for use by NICE, the Scottich Medicines Consortium or the All Wales Medicines Strategy Group in the first instance). The PPRS then reviews these prices so that the profits that are made from the sale of drugs to the NHS are not considered to be excessive.

The Office of Fair Trading argues that drug prices should reflect their clinical benefits and current policy wastes NHS resources. The pharmaceutical industry welcomes the concept of value-based pricing, but is concerned about the impact on profits which are needed to make research viable. The Office of Fair Trading (OFT) estimates that up to 25% of world pharmaceuticals sales reference UK prices to some extent. Companies are thus particularly sensitive about any agreement that reduces the UK list price of a drug as this can have a knock-on effect on the profits made on sales elsewhere in the world.

Successive price cuts and exchange rate movements mean that UK prices are currently amongst the lowest in Europe. This has led to parallel-exporting (the opposite of the practice of parallel-importing cheaper non-English language versions of the same branded product from the EEU to the UK) of UK branded medicines to the EEU, by wholesalers, pharmacies and NHS trusts for commercial gain which has led to severe shortages of many popularly prescribed medicines in the UK.

Under the new system of value-based pricing, the Government would apply weightings to the benefits provided by new branded medicines, which would imply a range of price thresholds reflecting the maximum they are prepared to pay for medicines. These thresholds or maximum prices would be adjusted to reflect a broader range of relevant factors that are not fully taken into account by the current sytem of using Quality Adjusted Life Years (QALYs) by NICE so they could be used to calculate the full value of a new product.

The Government proposes that the price threshold structure is determined as follows:

• there would be a basic threshold, reflecting the benefits displaced elsewhere in the NHS when funds are allocated to new medicines
• there would be higher thresholds for medicines that tackle diseases where there is greater “burden of illness”: the more the medicine is focused on diseases with unmet need or which are particularly severe, the higher the threshold
• there would be higher thresholds for medicines that can demonstrate greater therapeutic innovation and improvements compared with other products
•  there would be higher thresholds for medicines that can demonstrate wider societal benefits.

 

Designing the new system to be both stable and transparent would allow companies to predict well in advance how prospective products may fare, and to focus their research efforts on the treatments that society values most. Companies would be informed of these weightings – allowing them to orient their research and development investments appropriately. This may well draw to a close the ‘me too’ concept of launching ‘newer versions’ of drugs which treat similar conditions with little demonstrable benefit over the original.

Thus, a new product would be launched, then reviewed by the Government to access its impact on patient health and the others factors discussed above, and the price to the NHS adjusted accordingly over a period of time.

The work of NICE as a provider authoritative advice and information would continue, but the decision as to whether a new medicine will be used in clinical practice will ultimately be made by the clinicians themselves.

VBP models are already implemented in many European countries including Germany, Sweden, France, Spain and Italy.

What I Wish I’d known As A Hiring Manager……….

It’s been almost a year since I joined 20:20 Selection Ltd as a Recruitment Consultant; and as we approach the shortest day and start the wind down for Christmas, I feel that it’s a good time to reflect on what I’ve learned over the last twelve months.

Firstly, I’ve realised that in the world of recruitment there isn’t a wind down for Christmas at all! In fact, at 20:20 Selection Limited we are still flat out busy, working on new vacancies as well as existing ones, for our clients who want jobs offered and filled over the next two weeks, in time for ITC’s on 4^th January. I had naively thought that we would be starting on the mince pies and sherry by now, but in fact I suspect that the Season’s merriments won’t begin until 4pm on Friday 24^th December.

When I was a hiring manager, both as a Regional Business Manager, and as a National Manager, I thought I knew quite a bit about recruitment. I thought I knew how to spot an outstanding candidate from an average one. I thought I knew how to really dig down deep to get to know the ‘face behind the mask’, so that I could recruit the best of the best; the gem who would fit into the team quickly and would add value from day one.

What I’ve now realised, is just how little I actually knew about recruitment when I was a hiring manager.

If only I’d known that:

• An awful lot of work goes on behind the scenes, long before a manager receives CV’s to review.

 

• For every strong potential candidate, the best agencies reject another hundred CV’s from the ‘Average Joe’.

 

• The recruitment industry is incredibly competitive, with most clients now choosing a multi agency Preferred Supplier List.

 

• Achieving exclusivity with a client, is worth it’s weight in gold, as it gives the agency the luxury of time to really match the best candidates to every role, and to deliver all the KPI’s, without being pulled into the ‘bun fight’ of trying to speak to candidates about a job first before the other agencies get to them.

 

• Candidate loyalty only comes from delivering outstanding service. If people are registered with too many recruitment agencies, it is actually much more difficult to find them a job.

 

• Not all agencies are ethical and professional, and some still work on a volume principle, sending far too many CV’s out for a vacancy, rather than only selecting candidate’s who really fit the brief.

 

• We’re all fishing from the same candidate pool, and only the most skilled and experienced recruitment consultants know which bait to use to attract the most suitable, highest calibre people.

 

• The world of recruitment is full of highs and lows. Nothing beats the feeling of placing a candidate in their perfect job. Equally, nothing matches the heart sink feeling when your super prepped candidate gets down to the last two, and gets beaten by a whisker.

 

• It is extremely hard work, energy draining and soul destroying at times. It is also the most fulfilling, satisfying, people focused job I’ve ever done.

 

• The role of the recruitment consultant is the ultimate selling role. You need to sell to clients to win the business in the first place, sell the job and the company culture to candidates and to sell candidates’ to hiring managers to encourage them to shortlist your people.

 

• The term KAM is overused, and means so many different things to different companies and different people.

 

• The pharmaceutical market place is very still unstable. Candidates seem to have very high expectations about their employability, and so a key part of the recruitment consultant’s job is to manage expectations and to really explore motivation in a very competitive environment.

 

• As more and more companies choose to install electronic CV logging systems, it becomes increasingly difficult to ‘sell’ the candidates into hiring managers. Therefore, it is even more critical for a candidate’s CV to be absolutely outstanding, to differentiate them from the rest of the crowd, and to be as clear and as achievement focused as it can possibly be.

 

So, one year ends and another is just around the corner. I have learned a huge amount over the last 12 months, both about my job as a Recruitment Consultant, and also about myself, my own motivation and what makes me smile. I’d forgotten the buzz that is to be had from working in the toughest sales arenas, and I’d forgotten just how much I still want to win and to succeed. Every day is different, every day is action packed, and every day I live on my wits, and I’m ready to deal with anything that comes my way. I’m looking forward to the Christmas break, but I’m also optimistic and hopeful that 2011 will be a very fruitful year for 20:20 Selection Limited and for our selected candidates.

by Sam Harrison

Health White Paper

LANSLEY’S HEALTH REFORMS

Tuesday 13^th July 2010

The new Health Minister announced the White Paper that lays out the future of the NHS over the course of this parliament (which is now a guaranteed 5 years).  He described this as a ‘blueprint’ for Health Policy up to the next General Election.  The main aim is to cut £20bn from the Health Budget over the next 4 years.  One of the main issues is the end of the current PCTs, which means that GPs will have direct control of the commissioning of services.  NHS Management costs are set to reduce by 45% as a part of this reduction.

This is considered by many to be the most radical NHS White Paper to date, and is expected to be well received by the Conservative back benches.  As for the Lib Dems, they had the abolition of StHAs as part of their 2010 manifesto, so this should sit well with them also.

Lansley said ‘the provision of healthcare service will be led by patients and professionals and not by politicians’.

The basics of the White Paper are set out below:

 More power to GPs

The most contentious issues will be the compulsory devolvement of huge commissioning powers to GP and GP Consortia and the abolition of Primary Care Trusts (PCTs). None of this was proposed by the Conservatives when they were in opposition.  These decisions emerged after the General Election. There is concern that a large number of GPs do not want to take on commissioning functions, and in fact are ill-equipped to do so.

It is interesting therefore to note that the British Medical Association has welcomed today’s announcement.

More power to patients

The Government is going to launch HealthWatch England, a new ‘consumer champion’, which will sit within the Care Quality Commission (CQC). The White Paper provides an ethos for structural change; the NHS must be patient led and choices must be led by those at the frontline of delivering those services to patients, i.e. clinicians. On a national level, it will be able to propose CQC investigations of poor service. This organisation will help to strengthen the patient voice and ensure that patient feedback is heard at a local level. Patients will not only have power over the choice of GP they would like to attend (regardless of where they live), but will also have power over who has sight of their patient record.

Abolition of Primary Care Trusts (PCTs)

The complete removal of PCTs, instead of simply reducing their numbers, came as a big surprise when compared to the proposals contained in the Conservative manifesto from January 2010. However, it is in keeping with current measures when you look at the plan to reduce admin costs by 45%.  Some form of supervisory role is of course required, particularly in respect of GPs and other primary care services, and it is a role which Monitor (the body currently responsible for the regulation of Foundation Trusts) may find challenging.   

Abolition of Strategic Health Authorities (SHAs)

SHAs will be abolished as early as  2012. Their functions will be taken over by Monitor. Monitors’ remit will extend to establish it as the key economic regulator in healthcare.

Foundation Trusts

All NHS Trusts will become or be part of a Foundation Trust and this will be the preferred governance model for the health service. Trusts will be given more freedom to innovate to improve patient care. NHS staff will have the opportunity – where appropriate – to manage these organisations as ‘the largest social enterprise sector in the world’.

NHS Commissioning Board

A review of existing quangos is due to report in the autumn but the White Paper makes provision for a number of new bodies which will help implement this new, patient led vision of the NHS. The most vital is the NHS Commissioning Board which will act to ensure quality in commissioning and be responsible for commissioning certain services, such as community pharmacy, which GPs cannot commission. It will also be responsible for increasing patient choice through helping patients manage their personal health budgets. The intention is for this body to be fully operational in April 2012. The underpinning concept is to reduce the number of quangos but those that do exist will be interlinked and more accessible to patients.

Value based pricing

The White Paper confirms that the Government intends to move to value based pricing when the current Pharmaceutical Price Regulation Scheme (PPRS) runs out at the end of 2013. A reference is made to the Cancer Drugs Fund, which will operate from April 2011, but no further details are provided.

NICE

In a further strengthening of its powers, NICE will be in charge of developing new quality standards for all the main pathways of care. The paper estimates that NICE will develop up to 150 new quality standards over the next five years. This will position NICE as the key quality regulator building on Lord Darzi’s work on quality improvements, under the previous Government.

 Scrapping targets

As mentioned in the NHS Operating Framework, targets with ‘no clinical justification’ will be scrapped (although not as many as were discussed in Opposition). There is a concession that some targets do work but the paper is not clear on which ones and a consultation is promised on new measureables.

Long Term Care

A Commission will be set up to look into long-term care from the Department of Health. This is in keeping with the move to strip away the Department’s NHS functions and replace them with longer term social care objectives.

Consultation

A number of consultation papers will be published in the near future, getting stakeholder views on policies including; commissioning for patients, freeing providers and economic regulation, the NHS outcomes framework, the framework for transition. This process will be an important part of the transition to the new system as will the proper management of the financial risk.

Legislation

Primary legislation will be required to make many of the proposed changes in the White Paper. The Health Bill announced in the Queen’s Speech provides for many of these reforms and is due to be introduced in late 2010. The main legislative reforms in the Bill will include: Making improvement in outcomes central to the NHS; Reforming NICE;  creating the independent NHS Commissioning Board; creating a framework for a comprehensive system of GP consortia; establishing HealthWatch; reforming the Foundation Trust model; developing Monitor’s role and reducing the number of arms length bodies in health. The Department of Health is taking comments on implementing all the changes in the Health Bill, which must be submitted by 5 October 2010. We can therefore deduce that the Health Bill will not be laid before Parliament before this date.  

The Health Bill will also support the creation of a new Public Health Service, which will streamline existing health improvement and protection bodies. Another White Paper, this time on public health will be published later this year. In addition, the public health budget will be ring-fenced and local Directors of Public Health will be responsible for health improvement funds allocated according to local need.

Sources: white paper and Mr Lansleys press release.

Pharmaceutical Sales – A spark of interest

Having embarked on a career as a medical representative in 1987, I still reflect on the route that led me to the pharmaceutical industry.  Being a Pharmaceutical Sales Representative doesn’t often appear in the list of careers that we aspire to as teenagers hence it is invariably something people come across coincidently.  For me I spent five years in a hospital Biochemistry Dept completing post graduate studies and developing a strong clinical understanding of various diseases and illnesses.  It was here I met Sales Representatives selling laboratory diagnostics and equipment which sparked an interest in sales (I have to admit to being initially impressed by the suit, car and perceived flexibility of their job).  In fact what did appeal to me about a sales role was the inherent challenges working towards targets and ultimately being rewarded (bonus) and recognised for exceeding goals (working in the NHS could not fulfil that need) as well as selling products which genuinely make a difference to people’s lives.

Hence I started buying the New Scientist and Daily Telegraph; there was no internet job searching in those days! Quite quickly I secured two interviews for Laboratory Territory Manager positions before seeing an advertisement for Trainee Medical Representatives with a major pharmaceutical company.

Have to confess at that stage that pharmaceuticals was a bit of a mystery to me, but my Dad said that company was great (blue-chip), and there was a number to call to apply.  Two interviews later, including being flown to head office, I was offered a GP/Hospital Representative position.

Looking back I do wonder how I got that job as these days we expect entry level candidates to know so much more about the day to day practicalities of the role, the NHS and how the business works.  Clearly the company were looking for the basic ingredients which they could then train, develop and mould to reflect their values and culture in the eyes of their customers;  GP, Nurses, Pharmacists, Consultants, Registrars, SHO etc.

Over twenty years later in a different NHS landscape I still believe this to be true so what are some of those basics;

Personal Qualities – An inner drive, self-starter, the ability to work on your own initiative, enthusiasm, can-do attitude, tenacity, the ability to problem solve, good interpersonal skills, the willingness as well as aptitude to learn.

Clinical Foundation – This means an interest in medicine, the ability to learn and apply technical information.  You will need to communicate this knowledge to customers of all levels.  ‘A’ level standard Biology should help with ABPI. 

Business & Selling Skills – Understand you are there to increase sales; it is a sales job & not a promotional or educational position.  Have a consultative selling style, i.e. probe to understand the customer needs and agenda before offering solutions. Key Account Management & Networking Skills. Understanding local NHS politics, targets, agenda and how these may impact on your business.

Clearly a lot of clinical and business skills can be taught as long as you have the right positive attitude. In summary I would describe the role of a Medical Sales Representative, whether that be GP, GP/Hospital, Hospital or Generics as the opportunity to run your own local business.

I have enjoyed a varied, challenging and satisfying career in the pharmaceutical industry. I also know others, who embarked on their career at the same time, who have had similar experiences and taken their careers in to different functions in the industry including: Marketing, Senior Sales Management, Training, Consultancy as well as others who are now Senior Representatives such as Hospital Specialist Representative or Healthcare Development Manager.

If this sparks an interest in you fantastic!  To discuss your background and transferable skills then contact 20:20 Selection Ltd on 0845 026 2020 or visit www.2020selection.co.uk . We have current opportunities Nationwide with hot-spots in London, Kent, Sussex, Essex, Somerset, Wiltshire, East Anglia.

Key Account Manager Roles – Catching a KAM

Many articles have been written about the best way to engage with our customers in the NHS. How best to partner with this new breed, made up of payers, commissioners, and medicines management gurus. How best to tap into their agenda. In fact, many careers have been built on telling us just how to sell to our customers, and an awful lot of consultancy fees have been paid to experts so that we can all be scared to death about this ‘new’ customer group who we are told work hidden away, been firmly shut doors in an increasingly complex and confusing NHS maze.

In my simple world view, yes, of course we do need to speak the same language as our customers, but we also need to ensure that we are getting the balance right, to ensure that our customer partnerships are mutually beneficial. We need to be truly customer focused, but we also need to achieve the win:win equilibrium, to avoid promising the world in value added services for very little commercial return.

Over the last few years, Key Account Management has been the new pharma industry term that seems to be bandied about on a daily basis. It is used often and widely and it seems to mean different things to different people in different companies. Every hiring manager seems to be looking for the elusive KAM. Does it mean a hospital representative? Does it mean an NHS Liaison Manager? Is it a bit of both? Or is it just a very good salesperson with the right attitude, the right skills and the common sense to convince key influential customers to sit round a table, to weigh up the pros and cons, and to agree on decisions that will help them to achieve their desired outcomes, but that will also grow product sales for their company?

In many ways, Key Account Management is a philosophy; a way of thinking, rather than some magical process. Account plans and systems can of course help to keep business on track, but they cannot be the golden ticket on their own. People still, and always will, buy from people.  Outstanding KAM’s need to be outstandingly talented sales people. In the ‘good old’ days, when sales people were autonomous, and they had full accountability for their results, the successful ones managed their own business and they managed it well. Naturally, they identified and involved all key stakeholders, naturally they engaged with clinicians, and non clinicians alike, and naturally they engaged the people who ultimately held the purse strings. They were unblocking the clinical and funding barriers that KAM’s and Market Access Manager’s do today, whilst always remembering to sell.

This breed are driven, competitive, innovative, competitive, hardworking, flexible responders to change and above all, as superb net workers and communicators, they can be relied upon to consistently achieve results.

At 20:20 Selection Limited, we know that recruitment agencies are mainly fishing from the same pond. The skill we use to catch the KAM’s is to recognise the specific species, and to know which bait to use.

Interview Guidance

Interview Guidance

PRIOR TO the Interview

Research

• Look committed and find out as much as possible about the company.

 

• Visit their web site for more information on the company.

 

• Find out who will your competitors be and as much as possible about the market/customers you will be selling to 

 

Job Description

• Make sure you are fully aware what the role is you are being interviewed for.  Your consultant at 20:20 Selection Ltd will have fully briefed you on this. 

 

• Be confident that you are technically qualified to do the job.  We would not have spoken to you about the role if we didn’t think your profile matched the client’s criteria!

 

• Have examples from your previous roles to demonstrate your ability to do this job and evidence in your brag file to back this up

 

FOR THE INTERVIEW

Personal Presentation

• Look your smartest and show your most professional side during the interview. A company is more likely to employ someone who is well presented and who will therefore best represent their company to customers. 

 

Punctuality

• Arrive to start the interview on time (be early if possible)

 

• Obtain clear directions for the location of the interview and plan your journey, allowing plenty of time to arrive.

 

INTERVIEW DO’S

• Introduce yourself courteously (first impressions last!)

 

• Express yourself clearly.

 

• Show tact, manners, courtesy, and maturity at every opportunity.

 

• Be confident and maintain poise. The ability to handle your nerves during the interview will come across as confidence in your ability to handle the job.

 

• Be prepared to show how your experience would benefit the company.

 

• Ask questions concerning the company or products and the position for which you are being interviewed for. An interviewer will be impressed by an eager and inquisitive mind. You will also be able to demonstrate that you can contribute to the company or industry if you show an interest in its products and/or services.

 

• Take time to think and construct your answers to questions to avoid rushing into a vague and senseless reply.
• Demonstrate that you are sufficiently motivated to get the job done well and that you will fit in with the company’s organisational structure and the team in which you will work.

 

• Show willingness to start at the bottom and work up.

 

• Anticipate questions you’re likely to be asked and have answers prepared in advance. Uncertainty and disorganisation show the interviewer that you are unprepared and unclear what your goals are.

 

• Be assertive without being aggressive (ensure you close – remember you are a sales person & ‘you’ are your product)

 

• Thank the interviewer for their time

 

Interview Don’ts

• Be late for the interview. Tardiness is a sign of irresponsibility or disorganisation and the employer could take it as what to expect in the future.

 

• Arrive unprepared for the interview.

 

• Say unfavourable things about previous employers.

 

• Make excuses for failings.

 

• Give vague responses to questions.

 

• Show lack of career planning – no goals or purpose could convey the impression you’re merely shopping around or only want the job for a short time.

 

• Show too much concern about rapid advancement.

 

• Overemphasise money. Your interviewing goal is to sell yourself to the interviewer and to get an offer of employment. Salary discussion is secondary.

 

• Show any reservations you may have about the role/company. You can always turn down second interviews and job offers after you have had time to appraise your concerns in the cold light of day.

 

• Express strong prejudices or any personal intolerance.

 

• Leave your mobile phone on during the interview.

 

These are general tips that can be applied to any interview situation.  Part of the service we offer at 20:20 Selection Ltd is to help you prepare for specific client interviews.  We have key account managers specifically working with clients & members of the team who come from a pharmaceutical sales management background so you will get personalised expert advice relating to your interview!  To find out more about 20:20 Selection Ltd visit www.2020selection.co.uk