The Pharmaceutical
Journal Vol 267 No 7157 p81-82
July 21, 2001
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The Pharmaceutical
Journal Vol 267 No 7157 p81-82 |
How to win bids and influence future pharmacy services in your locality |
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Winning bids for funding pharmacy services is a skill that pharmacists need to develop. Clare Bellingham discusses the important issues to consider |
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Pharmacists are faced with a new prospect: bidding for funding for pharmacy services. Since the National Plan for Pharmacy announced a change in the way pharmacy services will be provided, pharmacists have been getting used to the idea of bidding. And the expected reduction in the global sum will result in a financial necessity for pharmacists to deliver services. Some pharmacists have already gained funding for services, like those who have just become medicine management pilots, but others are feeling intimidated by the prospect. Over the next few years, preparing bids is likely to become second-nature to pharmacists. In the meantime, this feature aims to show pharmacists the principles of applying for bids in order to gain the top prize: funding. This feature describes some of the advice on preparing bids given to over 60 pharmacists who attended a conference earlier this month organised by Hemant Patel, local pharmaceutical committees secretary, north east London. This report is based on advice given by Jo Holland, freelance consultant, Dr Chris Watts, director of public health, Barking and Havering Health Authority, and Dr Darrin Baines, director of medM.
Bids can be submitted to a number of organisations including primary care trusts, health authorities and pharmaceutical companies. The key steps in writing a compelling bid are:
When writing a bid, the prioritisation criteria (see Panel below) can provide a useful outline structure.
Establishing a need The most important part of preparing to submit a bid is identifying a local need for the service. If the service is not needed, a bid will certainly be rejected, so all bids should be supported by evidence that demonstrates that need. “If pharmacists want to develop bids, they should contact their LPC secretary first,” said Hemant Patel. “Pharmacists may have the right ideas but need input from someone who knows about the local plans and the LPC secretary will have contacts and resources to help.” One way to demonstrate need is to provide the service as a pilot. Tim O’Donoghue, pharmacist, Green Light Pharmacy, London, described how his pharmacy had run a pilot of educational classes for the local Bengali community on diabetes and asthma management before submitting a successful bid for funding. However, pharmacists have concerns about providing services free of charge because a value needs to be placed on the service. Mr O’Donoghue said that this problem could be overcome by providing the service free for a limited time, as a sample, and then withdrawing it. In his case, the community then asked for it back, he said. Local health needs assessments can be used to identify gaps in care pathways where pharmacists can provide services. Health needs assessments can also be used to provide supporting evidence for a service. A health needs assessment reviews the health issues either affecting a population or being affected by a programme. It aims to improve health and reduce health inequalities through identifying priorities for change, and then planning action to make the changes happen. In a health needs assessment, the following questions are asked:
In addition, pharmacists preparing a bid should consider when the service is needed — now, or are there other more immediate priorities? If there is room for flexibility, this should be included in the bid so that if no funding is available immediately, it can be considered for the following year’s budget. Other points to include in a bid A bid should make clear whether the service is targeted at a particular population or is opportunistic. Inequity, per se, is unacceptable. However, if equity of outcomes is desired, then access may need to favour one patient group. The bid should recommend a course of action with a detailed plan of timings, costings and a review process. Performance indicators, ie, what will be achieved in six months or a year, should be included based on the timescales that the organisation is considering. It is also important to decide whether the bid is for a pilot or full-scale implementation of a service. The wider consequences of the service should be described even if the bid is only for a pilot. Pharmacists should decide whether the bid will involve working in partnership, multi-agency or solo. Organisations look favourably on being well-networked and even if the bid is for solo provision of a service, it is useful to get a local general practice to endorse the bid to demonstrate this. Any changes that are needed (eg, structural changes, behavioural changes, staff recruitment), machinery costs (initial costs, maintenance and replacement costs) and staffing costs (all implications not just basic salary), should all be included in a bid. Importantly, an executive summary of the bid should be written and submitted with the full, detailed bid. Being faced with a long document to read can put decision-makers off. Further points are listed here. Resources Before submitting a bid, pharmacists should find out what resources are available and what the expected size of bids is (if a bid is too much it will be thrown out regardless of its content). It is also important to find out whether funding will be recurring, or only a one-off payment is available, and/or there are any specified constraints, such as activities that funding is for and who can apply for funding. “It often comes down to this simplistic way of thinking: can we afford to do it, can we afford not to do it?” Ms Holland said. Another way to approach funding is to consider whether existing resources can be used differently or whether there are new resources available, eg, money allocated as a result of the National Service Framework for Coronary Heart Disease or the Cancer Plan. Choosing an area where there is limited evidence for an intervention is less likely to gain resources. Health authority budgets are divided under separate headings. If the bid fails to fall under one of the budget headings it is likely to be turned down. The timing of submitting a bid is also important. The best times are either in April, when new finances are available, at the end of the year, when health authorities want to get rid of the reserves of the current year’s budget, or 12 months in advance to get the service on the agenda for the following year’s budget. Pharmacists should start planning soon if they wish to submit a bid by the end of this year. Decision criteria Pharmacists submitting a bid should find out the criteria for the organisation’s decision process. If there is no explicit decision process then looking at examples of previous decisions to identify patterns can be useful. In addition, it is a good idea to make contact with the lead in the particular area the bid is for, and the person who has most influence (eg, a finance director), in advance of submitting the bid. Marketing pharmacy services The key to marketing success is “selling the right product to the right people at the right time”, said Dr Baines. In order to market pharmacy services, you have to decide who you are, create your own products and find a niche. “Add value to what you are rather than trying to invent something new,” he added. Many services that pharmacists currently provide can be repackaged and sold to the NHS in a value-added way. For example, supply of methadone can be turned into a “methadone service”. Market segmentation should be used in preparing bids. This involves breaking patients into groups according to their physical and emotional needs. Services can then be sold on this basis, eg, a service for older patients based around the NSF for older people. Making the service a product To be marketable, pharmacy services need to be packaged as products. “The service has to be packaged so that it can be seen and felt, and so that it meets the needs of the purchaser. This is all the National Plan is about: turning a service into a product,” said Dr Baines. Pharmacists provide lots of services to patients but, once provided, they disappear and no one can prove that they have been delivered. There are lots of examples of services, from giving advice to medicines management, that pharmacists do already but cannot prove it. The answer is in documentation: document the services and put in performance indicators to form a product that can be sold. Pharmacy services should be packaged as products so that they are:
Pricing and selling services “Pharmacy services should be sold on value not costs,” said Dr Baines. The value is different for different people, eg, to the PCT the value may be reaching a health improvement and modernisation plan (HIMP) target, but for a patient it is more likely to be getting advice. Therefore, pharmacists need to find out what the value is and to whom, and how to recognise the value. Then the service value can be sold to both the NHS and to patients. The key messages in pricing are:
Conclusion Applying for funding for bids is an ongoing process. It can take a long time, and lots of failed attempts. Not only that, but the population’s needs change. Even after gaining funding for a successful bid, pharmacists need to start assessing needs for the next service and begin negotiations all over again.
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Clare Bellingham is on the staff of The Pharmaceutical Journal |