This issue will run and run, and Darzi mentions it 16 times. The most deprived patients are most likely to present as a cancer emergency. General emergency presentations are 68 per cent higher in the most deprived. The most deprived are more than twice as likely to die of heart failure than the least deprived.

Darzi says: “A strong voice for patients and local communities would promote more responsive services, while making it easier for the NHS to fulfil its promises to promote population health and to narrow health inequalities. The NHS could look to make data more publicly available by local authority area.” What can pharma do here?

Pharma can interrogate variation in system-level utilisation of different interventions in oncology. Who exactly is using what, and what difference does that make?

Morbidity, mortality, quality of life, patient-reported outcomes; these are all factors that can differ depending on whether the medicines, the diagnostics, the pathways and the overall service are working as they should.

There’s a stark difference in survival times between the UK and other countries – are the way pathways are set up contributing to this?

What difference does system-level use of different combinations of therapies make to those metrics Darzi looks at?

Cancer waiting times, too – monitoring performance of cancer referrals across a range of cancer types – is ripe for re-investigation, to be able to highlight need and establish best practice.

Some areas do things better – this is NHS fact. It’s empowering for pharma to be able to help spread this news and to shine a light on how it’s done to those systems that are struggling with your patients and your pathways.

Looking at referral to treatment (RTT) times for your condition, and comparing one system with another, can help to show where blockages are and where the local NHS might need to support to identify and mitigate against them.

You can analyse the changing waiting lists across a wide range of services, determine which services are succeeding and why.

Outpatient KPIs – analysing variation in outpatient services such as DNA rates, referral source, waiting times and first: follow-up ratios, are also worthy of investigation to establish obstacles and drags.

Or you can use commissioning maps and data to track the provision of services across newly formed commissioning boundaries – offering insight on how evidence-based changes in that provision lead to better outcomes.

Everyone knows that the NHS’s biggest problem at the moment is capacity and occupancy, with thousands of patients in hospitals that don’t need to be there, and many millions of patients on waiting lists.

In this climate, looking at the number of patients in your disease area that are ‘A&E Frequent Flyers’ is a reliable way in to concerned commissioners.

You can assess the impact of patients experiencing multiple A&E attendances on A&E performance, and establish how better patient management, faster diagnosis or care closer to home could beneficially affect these numbers.

You might also want to examine Mental Health Service data – to understand the pressures from referrals into the mental health service.

What concomitant costs does your pathway have here, for example from diabetes patients, who, lacking the right management, begin to suffer MH comorbidities?
You can also analyse bed occupancy rates specific to certain diagnoses/ procedures across hospital sites – can these be improved upon with better patient management?

Improved diagnostics are absolutely crucial for a number of areas – to establish patients on pathway at the earliest possible stage, so the chance of treatment working is optimised.

Also, to be able to stratify and prioritise the most pressing diagnoses within the backlog and to have a realistic estimate of the number of patients you’re going to need to treat and establish budget impact and staffing models.

Furthermore, there is a need to understand the nuance between different diagnoses within the same condition, to be able to place patients on the right clinical and pharmacological pathway, to reduce the chance of misdiagnosis and sending patients on the wrong pathway, and to ensure underserved or deprived patients groups are being diagnosed with the right level of timeliness and accuracy.

Absolutely all of these factors are key to success for a new launch or indication, and doubly so if companion diagnostics to biotech are in play.

For many of our clients at HSJ Advisory, working with the NHS to improve diagnostics in their chosen clinical field is a key goal they ask for help with.

Fortunately, these days there are sophisticated tools at your disposal. You can opt for diagnostic imaging data set dashboards, which can benchmark diagnostic service performance for a wide range of imaging and procedures and is extraordinarily useful in pinpointing where blockages are.

You can cross-reference diagnostic performance with outcomes, cost and patient throughput; and you can use all this data to show how important enhanced diagnosis will be to the performance of the overall NHS pathway.

Oli Hudson is Content Director at HSJ. Go to hsjmarketingintelligence.co.uk