15 - Data - Wilmington Healthcare

As the NHS faces a second wave of COVID-19, it must continue to manage diverse cohorts of patients who are being impacted by the pandemic, from those who face long waits for planned care to those at particular risk of contracting the virus.

Care pathways have dramatically changed in recent months to try to mitigate the risk of coronavirus for different patient cohorts, and this has seen some services moving out of hospitals and into patients’ homes.

To capitalise on innovations and continue to drive improvements, as part of the Reset, the NHS needs to understand how new patient pathways are performing and how COVID-19 is impacting on its services regionally.

Data is key to achieving these goals and, in this article, we will explore how pharma can use it to help the NHS devise preventative, population-based solutions.

The pandemic has brought big changes in the way that patients are managed, with more care being delivered in patients’ homes and fewer people accessing the NHS via traditional routes. This, in turn, is seeing more patients being treated by multidisciplinary teams in the community rather than by specialists in hospitals.

The NHS needs to be very data driven in order to map these changes and understand local populations and what they need. However, tracking patients and understanding where they are in pathways is challenging, particularly given the speed and scale of the change that has occurred this year.

There is, therefore, a big role for pharma in helping the NHS to map the changes that have occurred as a result of the pandemic, from the new staff responsible for managing patients to how this is being achieved and whether patient outcomes are changing as a result.

There are a number of different data sets that can help pharma to track patients through the system. Hospital Episode Statistics (HES) data, which contains details of all admissions, outpatient appointments and A&E visits to NHS hospitals in England, is a good place to start in understanding patient flows in secondary care and how they have changed as a result of the pandemic.

The type of information available includes reasons for a hospital visit, treatments given, or procedures carried out, and whether admission was required. Pharma can also see how this data compares to previous years across different specialties to better understand how COVID-19 has affected them.

Prescribing data is key to understanding what is occurring more widely within the healthcare system based on the type of drugs that are being prescribed and where this is happening within the NHS. So, for example, it could confirm whether high cost drugs are still being prescribed in hospitals, or if this is now being done in primary care.

The data can also provide useful insights on who is managing treatment. So, for instance, is it being managed by multidisciplinary teams in primary care rather than specialists? And who are the key players in the multidisciplinary teams?

Pharma can also use this data to find out where treatment is being administered. This is particularly insightful in terms of determining the number and type of patients requiring homecare services, and therefore homecare drugs, which could, in turn, be leading to a change in the way that drugs are administered.

Prescribing data can also be used to identify who is monitoring the outcomes of drug regimens. Being able to find out the results of treatments is, of course, key particularly where new drug regimens have been introduced to enable homecare services, such as the use of subcutaneous or oral drugs in place of hospital delivered infusion services.

If a pharma company was able to ascertain that its homecare drugs were delivering good results, the data would not only enable it to make a case for the continued use of these products for current patients, it could also be used to show how these products might help the NHS to clear the backlog, by treating more patients at home so they do not have to wait for hospital appointments.

In addition to tracking patients through specific pathways, it is vital to know about hospital capacity, particularly with regards to COVID-19, as this will have a huge impact on the way care is managed from the number of inpatient beds available to the volume and type of services being delivered.

Key data that can be gathered in this regard includes patient flows and admission rates for COVID-19 in different hospitals from the start of the pandemic through to the present time. This can be broken down to determine how COVID-19 has impacted patients in a given therapy area, or sub-specialty on a month by month basis, compared to previous years.

Armed with this type of data, pharma could, for example, present homecare as a valuable solution for regions that have a high COVID burden and are unable to treat many patients in hospitals. The proposition could be backed up by a package of support for pathway changes that could include education and information for HCPs.

Disease prevention is, of course, a critical priority for the NHS and there is much that industry can do to risk stratify patients during the pandemic and help the NHS develop new preventative strategies to manage them.

For example, pharma can gather valuable insights into the potential complications and readmission risks faced by patients who have had coronavirus. This can help to form the basis for a range of preventative solutions with regards to products and how and where patients should be treated.

Industry can also gauge the number of patients who are likely to be delaying seeking help from the NHS during the pandemic, by comparing current hospital data based on the same months in the previous year. This information could be used to assess the risk of these patients developing more severe complications or overwhelming hospital services at a later date.

Tackling the elective care backlog is, of course, a huge challenge for the NHS, and there is much that pharma can do to help the NHS manage patients while they wait for surgery or other treatment. Industry can also monitor hospital capacity to determine where patients could be brought back into the system.

In terms of patient management, industry could, for example, identify and risk stratify patients who are highly likely to develop further complications while waiting for treatment and devise ways to safely manage them in the most appropriate setting.

So, a company specialising in pain management, for instance, could risk stratify older people facing long waits for hip or knee replacements, who may need extended, different and perhaps more intense pain management regimens, and devise appropriate treatment plans.

Conversely, by tracking COVID-related activity within hospitals, pharma could find out if the number of patients accessing certain services has decreased and whether there is capacity to resume them. If this is the case, it could create an opportunity for a company with a hospital-based infusion service to develop a case for resuming it.

The NHS must capitalise on the positive changes that have been made in service design and delivery as a result of the pandemic and continue to innovate if it is to tackle the challenges posed by COVID-19. However, it needs a wealth of population-based data to inform its decision-making.

There is a key role for pharma to play here in using data and information to help the NHS track patients through new pathways, understand where they are working well and how improvements can be made. There is also much that industry can do to help the NHS monitor the impact of COVID-19 on a regional basis and risk stratify patients who are being impacted by it.

Indeed, there has never been a greater need, or opportunity for pharma to work in partnership with the NHS on service design and delivery. By gathering and analysing data, pharma can develop truly customer-centric strategies that will help the NHS transform care pathways and rise to the challenges that lie ahead in these unprecedented times.

Oli Hudson is content director at Wilmington Healthcare. For information on Wilmington Healthcare, visit www.wilmingtonhealthcare.com

Data – the key to reshaping patient pathways