medtechbusiness blog

Medtech’s answer to Bob Dylan (“You just kinda wasted my precious time”) continues his series of rants against things in business that don’t add value, are not cost-effective, waste time and money, and generally take you down a road of fail.

My post-festive return to work was ruined by an e-mail that punctured my New Year optimism in an instant. The subject matter was fairly innocuous – but the closing sentence contained words that made my heart sink: “I think we need a meeting about this.” New year, same old crap. In the past ten years I’ve wasted more of my life in unproductive internal meetings than ITV has wasted on celebrity reality drivel. But at least I’m a Celebrity only lasts for three weeks. Bad meetings seem to last an eternity.

My previous employer took the meetings culture to new levels of ineptitude. The boss had clearly spent his career crafting a template from which he rarely strayed. First you’d get the e-mail (or worse still, the phone call, meaning there would be no record of it) stating the need to have a meeting. It would always conclude with the phrase “I’ll work up an agenda” – which he’d then not do. We’d spend about ten days doing what the management textbook politely terms ‘fannying around’ trying to agree a convenient date, which was often a good fortnight away to allow for priority deadlines (i.e. real work). Then, 24 hours before the meeting, I’d be summoned to the Meeting Before the Meeting – where we’d get together to see if we could remember why the meeting had been called in the first place. This delightful precursor to the main event would often last two hours, during which we’d pretty much have the meeting we were due to have the next day, but without key attendees – meaning we’d need to duplicate the conversation on the morrow.

The meeting itself would, of course, be delayed. Hopes would arise that it might be cancelled – or be squeezed in at the end of the day to make it a short, punchy and, dare I say it, worthwhile event. But these hopes were forlorn. There would be no escape. The eventual meeting would meander aimlessly, without an agenda, for over three hours. To enhance this, it would take place in a tiny, windowless room that within 20 minutes would become perfumed with Eau de BO. If we were lucky, there might be an argument to liven up the proceedings – it’s always more entertaining when someone loses the plot. But the most I ever lost was the will to live.

As the meeting yawned to its close, my boss would come to his one significant Action Point: enlisting some unfortunate to write up the minutes and e-mail them to him the next day. Meeting over, everyone would disperse… but I’d have to stay behind for the Meeting After the Meeting – the debrief session where we’d basically repeat what had been said in the previous three hours. Which would also be a replica of what had been discussed the day before, but without the bonus of group body odour. The likely final outcome would be the suggestion that, to progress, we’d need to set up another meeting.

One school of thought says that if you consistently find yourself in unproductive meetings, the answer may well be to look in the mirror. Sure, we all have a responsibility to ensure that we contribute effectively – but my feeling is that bad meetings can become institutional. They sap you of your passion, and sap a company of valuable time and resources.

The textbook says meetings are a necessary evil – and I’m resigned to the fact that they’re here to stay. But a better world is possible. If you want to facilitate successful meetings, clarity is the key. Attendees need to be clear about the purpose of the meeting, have an agreed (and fairly short) agenda distributed well in advance, and have definite start and finish times that everyone sticks to. And they should conclude with agreed outcomes that reflect the objectives outlined at the beginning.

Over Christmas, I read a blog that urged employees to ‘declare war’ on bad meetings in 2010. “Your company will thank you for it,” it said. That sounds like a good idea to me. In fact, I think I might call a meeting to discuss it with my colleagues. If everyone could just check their diaries and e-mail me with some convenient dates…

For many of us, the yearly appraisal is a trial rather than a positive event. But does it have to be that way? Gillian Morgan of Apodi Ltd looks at the pitfalls and the potential of appraisals.

How many of us actually look forward to our appraisal? Substitute if you wish the terms performance review, year-end review or performance appraisal for appraisal: they all mean much the same thing.

Do we relish the prospect of sitting with our boss, reviewing our work for the year? Do we anticipate a recognition of success and congratulations on good work done? Is your boss really looking forward to meeting with you and discussing your work? Do you look forward to your appraisal meeting like you look forward to your birthday?

My guess is probably not – but this is a real shame, especially when you consider how many hours are spent ‘doing appraisals’. It’s a big event that happens only once a year, so why does it often bring no satisfaction?

Why appraisals matter

Let’s consider the reasons why appraisals or performance reviews exist.

Appraisals are essential for the effective management and evaluation of staff. They help to develop individuals and improve organisational performance. They enable the effective management and monitoring of standards, agreement of expectations and objectives, and delegation of responsibilities and tasks.

Appraisals provide a formal, recorded, regular review of an individual’s performance, assessing it against objectives and standards for the trading year agreed at the previous appraisal meeting. They typically feed into company annual pay and grading reviews. They establish individual training needs and development plans, and enable organisational training analysis and planning.

Appraisals are times to say Well done and Thank you after good performance. They are important for staff motivation, attitude and behaviour development, communicating and aligning individual and organisational aims, and fostering positive relationships between management and staff. They are essential for career and succession planning – for individuals, key roles and the organisation as a whole.

Performance appraisals, whatever form they take and whatever name they assume, are therefore vital for managing the performance of people and organisations.

Breaking the silence

So why do managers and appraisees commonly dislike appraisals and try to avoid them?

To most people, the appraisal process is daunting and time-consuming. It’s not just the time spent in the meeting but the paperwork preparation and thinking time beforehand that takes time on both sides. The process is often seen as a difficult administrative chore, and one that can also be emotionally challenging. If you are expecting some level of disagreement about performance, you are likely to be stressed about the process.

Why are problems often anticipated? It may well be that the annual appraisal is the only time all year that the two people concerned have sat down together for a meaningful one-to-one discussion about the individual’s performance. It is easy, when the chips are down and workload is high, just to discuss immediate priorities and put off talking about underlying problems. So when the year-end comes along, both parties have their own view of where the appraisee is in terms of their performance – but their views and opinions have been unvoiced over the course of the year.

It may be that some agreed objectives have become more ambiguous, due to a change in circumstances or environment. They may even be no longer valid or realistic. There may be many reasons why things have changed over the last 12 months – but if the boss and appraisee have not talked about it, the forthcoming appraisal meeting may be difficult for both parties: neither knows what the other thinks, neither is sure of the other’s perceptions.

Appraisals that are dreaded and/or stressful defeat the whole purpose of reviewing performance in a constructive way, where the successes are recognised and the areas of underachievement reviewed, with plans being made to remedy any skill gaps. So if the main issue with appraisals is often a lack of sureness on both sides about what will be said and how it will be received, what is the remedy?

Meeting of minds

The remedy is in the age-old principle that ‘appraisals should contain no surprises’. The boss should meet each of the team members individually and regularly for one-to-one discussions throughout the year, reviewing the appraisal documentation and the objectives set. These should be meaningful regular discussions: quality time to discuss objectives, work, career, aims, progress, development – and then, if you get on with your boss, the other ‘stuff’ such as our hopes and dreams, interests and life outside work. Such discussions help to form bonds and make the workplace a happier one.

These discussions, which combine formal and informal aspects, make appraisals so much easier because the participants then know and trust each other, and are aware of each other’s views. There are no unpleasant surprises. All of which reduces the stress and uncertainty around the appraisal process.

Here are a few appraisal tips for appraisees:

• Don’t put off discussions – if you do, problems grow.

• Don’t wait for the annual appraisal to sit down and talk – especially if you seem to be drifting from expected performance levels, or you think things have changed and your objectives are not as relevant.

• Don’t leave everything to your boss to instigate – take the lead by asking for some review time.

• Prepare your facts and figures and think about your career development. This is your chance to say what you want and have it on record.

Here are a few appraisal tips for managers:

• Make time to sit with your staff over the year and get to know them, finding out about their work life and home life.

• If you rarely sit down and talk with staff, or your staff are not used to talking with you, then set about relaxing the atmosphere and improving relationships.

• Make sure you recognise good performance, both formally and informally.

• Remember appraisals are meant to be motivational – if you are dreading them, how well will you be able to appreciate and motivate your team?

Know your rights

What if it does go wrong? What if you feel your boss has bullied you and is recording information that is unfair or incorrect? This can happen. A colleague of mine tells of how one particular director in the company they worked for lost 12 staff in 8 years by using appraisals as a way to force resignations. The director appeared to be using the appraisal system to accelerate natural wastage and reduce redundancy costs. An extreme example perhaps, but there are situations where appraisals go unexpectedly badly for the employee. What is the best way to handle this?

In the first instance, if the meeting is not gong to plan and you feel that’s unfair, don’t sign any documentation at the end of the meeting. It is important to tell the appraiser that you don’t feel the process is fair and try to resolve the situation in the meeting. If this doesn’t work, it would be wise to ask to reconvene when both you and your boss have had a little more time to reflect and gather appropriate information. If there is still no progress, it may be time to use a formal grievance process, or to go to your line manager’s boss to get this resolved. Check your HR processes and ask to speak informally with the HR manager for your area. It goes without saying that the best thing for all parties is to resolve the problem informally if possible.

For both employee and employer, good communication is the key to successful appraisals. All parties should sit down together and talk as often as they can – and then the actual formal appraisals will be far more natural, easy and productive. By ‘productive’ I mean that they recognise good performance and support people who are underachieving in a fair way.

The current economic climate makes the appraisal process still more important. Without objective measures of performance that allow frequent review, how can companies compete with others and keep their best staff? Performance that is sliding behind plan is a lot easier to remedy at 95% of target than 75% of target. Staff achieving excellent results will inevitably be visible to competitors, so recognition for these top performers through effective review is important for keeping them and their skills.

Seize the day

Are you looking forward to your next appraisal? Be honest with yourself – and if there is any negativity, be honest about why. Think now about what can you do to make sure the meeting is as useful as possible. Remember that your future, as an employee, is in your hands. Be proactive, drive the agenda forward and communicate… it could just be that year-end appraisals this time around are the highlight of the year.

Go on, buck the trend. Have a great appraisal: treat it like a birthday, use it as a chance to celebrate, a day to plan your next career steps, a day when you and your boss agree what investment into your development the company will make next year – and what you will achieve within the organisation.

Gillian Morgan is Director of Resourcing and Development at Apodi Ltd. Gillian started her career as a representative with GSK, progressed to several second line management roles and then led operational departments for two major contract sales organisations, with responsibility for sales teams and internal service departments.

Apodi Ltd is a leading provider of outsourced solutions, including resourcing and HR services, to the healthcare and pharmaceutical industry.

It is easy, when workload is high, just to discuss immediate priorities and put off talking about underlying problems. So when the year-end comes along, both parties have their own view of where the appraisee is in terms of their performance – but their views have been unvoiced over the course of the year.

Millennium Gloucester Hotel, London, 24 November 2007

The past year saw the Association for British Healthcare Industries (ABHI) gain a higher profile among health policy-makers than ever before, through its advisory role in the new Office for Life Sciences (OLS) and its function as secretariat of the Ministerial Medical Technology Strategy Group (MMTSG), which provides the strategic direction for joint working by industry and Government.

Two major drivers affected UK healthcare policy development in 2009: the innovation agenda as defined by Lord Darzi’s Next Stage Review, and the impact of the economic recession on the NHS. This year’s ABHI UK Market Conference took ‘The future business environment’ as its theme, and attempted to define the relationship between these two drivers and to draw a road map for the medtech industry within the changing UK health system.

Opening session of ABHI UK Market Conference

Getting down to business

The Conference was chaired by Sir Chris O’Donnell, past CEO of Smith & Nephew and joint chair of the Healthcare Industries Task Force. He drew attention to the range of professions represented by the 300 delegates: the medtech industry, the DH, the NHS and a wide variety of agencies and consultancies. This, he noted, reflected the trend towards cross-sector dialogue and partnership working.

ABHI’s Chief Executive, Peter Ellingworth, discussed the positioning of medtech in relation to UK healthcare. Crucially, he argued, medtech is focused on helping to spread healthcare across community and clinical environments, as well as improving patient safety and health service efficiency. This means it can play a key role in helping the NHS make major efficiency savings in the coming years. Improving the uptake of innovative technologies, Ellingworth stressed, is a process of give and take: the industry must provide the quality and kind of evidence needed to support uptake, and the NHS must develop an efficient uptake and utilisation process.

Jim Easton, NHS National Director for Improvement and Efficiency, discussed the challenges facing the NHS and industry. He noted that the NHS does not have “a particularly strong track record” when it comes to saving money by driving up quality. Part of the solution, he said, lies in moving care “upstream” to reduce the need for critical care. Achieving that requires active adoption of new technologies by trusts working together to implement community-based healthcare systems. In turn, industry needs to develop technologies that can “deliver service change on the ground” to improve both quality and efficiency. For companies that can provide effective solutions, he said, “the opportunities are enormous”.

Mike Farrar, Chief Executive of the NHS North West SHA, looked at how medtech can work in partnership with the NHS to generate innovative healthcare delivery. He emphasised the need to move from the rhetoric of innovation to the practical reality. Discussing the reasons for slow and failed adoption, he criticised short-termism (on both sides) and the absence of a B2B culture. There is a clear need for SHAs to promote innovations that improve healthcare provision. Farrar pointed to the emergence of a new “regional innovation architecture” with the power to draw in new technologies. He called on industry to engage actively with SHAs in redesigning services, and concluded: “I’m optimistic because you invited me to speak here.”

Mike Farrar

Breaking the barriers

Earl Howe, Shadow Minister for Health, outlined the Conservative Party’s priorities for the NHS in a presentation that reflected the convergence of the major parties in health policy. He praised the work of the OLS, which he described as “potentially the most significant development of the last 20 years”, in addressing the problem of slow NHS adoption. Changes in the working of NICE, he argued, would help to improve the uptake of new technologies.

Marg Parton, CEO of the NHS Technology Adoption Centre (NTAC), reported on the Centre’s progress in two years of trying “to identify and overcome the adoption barriers for innovative technologies within the NHS”. She identified problems with the reimbursement process in particular. The industry, she stressed, needs to address issues of clinical utility (such as service change and training) early in product development. An integrated adoption pathway remains some way off, she concluded: if the goal resembles a motorway network, the current reality is more like an archipelago.

John Warrington, Deputy Director, Department of Health, Procurement, Investment & Commercial, discussed the recent progress in the uptake of medtech by the NHS. The development of regional commercial support units for commissioning, he said, promises to give medtech an “intelligent client” in each SHA. He pointed to the recent HCAI Innovation Programme, which used hospitals to showcase new infection control technologies, as an example of successful partnership working.

Lord Darzi

The bigger picture

Following a lunchtime network-fest to make Spiderman jealous, the Conference resumed with a presentation from Andrew Dillon CBE, Chief Executive of NICE, on the Institute’s new medtech evaluation pathway. Its purpose, he explained, is to support more organised and effective engagement between medtech and the NHS: it improves NICE’s capacity to evaluate devices and diagnostics, and also gives support to medtech R&D.

Michael Wallace, Director, Health Economics & Reimbursement, Johnson & Johnson Medical Devices & Diagnostics, gave an industry perspective on the new medtech evaluation pathway. It offers a significant opportunity for industry to engage with a faster and more medtech-friendly appraisal process, he said, but issues around funding and adoption still need to be resolved. The industry needs to respond with the right evidence to help NICE assess the system impact and health benefits of each technology in the context of use.

The growing recognition by Government of the importance of medtech for the UK economy was shown by an eloquent presentation from Lord Drayson, Minister for Science and Education. As a qualified engineer and the driving force behind the OLS, Lord Drayson is a key link between politics and industry. He described the OLS as having brought together industry and the public sector “in a way that I’d never seen”. The core principle of the OLS Blueprint, he said, is making the NHS an innovation champion. Its wider goal is to win global market share and investment for the UK life sciences. He went on to answer delegate questions on such issues as late payment (see our report on page xx) and support for export sales.

Andrew Haldenby, Director of the ‘think tank’ Reform, examined the role of the private sector in NHS service redesign. By contributing actively to the redesign of care pathways, he argued, industry can lead the shift of healthcare towards an integrated community-based model. It can also help to make NHS commissioning more effective. This partnership approach is critical, he said, if the NHS is to meet the challenges of the recession.

A networking session

Trouble ahead

A final ABHI panel discussion spelt out the key issues facing medtech in its dealings with the NHS. Are the positive messages from the NHS leadership getting through at the ground level of purchasing and commissioning? Will the new medtech evaluation pathway make a real difference to NICE’s traditionally slow and cautious approach? Finally, is medtech ready to help the NHS go through the difficult years ahead by delivering consistent messages and practices? At the very least, the panel agreed, the industry had shown a clear “willingness to engage”.

Chris O’Donnell noted that SMEs are likely to bear the brunt of the NHS funding crisis, and that the NHS needs to develop a strategy of “intelligent demand” rather than “supplier bashing”. Peter Ellingworth pointed to the capacity of the OLS to mediate between industry and Government: “We need to work in a more co-ordinated way to get our points across.” The role of industry trade associations (and of Medilink and related agencies) in empowering medtech companies has never been more vital.

Last words

Following this event, Peter Ellingworth commented to Medtech Business:

“The ABHI events programme focuses on delivering value to our members by bringing together key industry figures and Government officials, with a focus on informing our members and building strong relationships that are beneficial to both industry and the NHS. The UK Market Conference is our largest event, and I was pleased to that we were able to host key officials from the Department of Health and the Government. I look forward to delivering a series of similarly informative events throughout 2010.

“We are glad to have Great Ormond Street Hospital partnering us for this event. As a global leader in treating sick children and teaching and training of children’s specialists, we are proud to work closely with them. ABHI’s partnership with Great Ormond Street Hospital is a great example of how industry and healthcare professionals can work together to focus on the delivery of efficient and effective care.”

Düsseldorf, Germany, 18–21 November 2009

Medical imaging, home healthcare and device connectivity were among the key themes of MEDICA 2009. The 40th anniversary of the world’s largest medical trade fair drew a record 138,000 trade visitors from over 100 countries to view and discuss the innovative technologies on display. More than 16,000 visited ComPaMED, the three-day show dedicated to supplies for medical manufacturing.

45% of the visitors came from outside Germany – especially from the Asian and Arab countries that offer growth markets for medtech. 4,324 exhibitors from around 60 nations offered a clearly segmented line-up of new products, systems and services for the entire patient pathway, from the home to the hospital.

Wilhelm Niedergöker, Managing Director at Messe Düsseldorf, said: “The short innovation cycle in this industry is a crucial success factor of the world’s number one event for the sector – MEDICA. The most exciting innovations are presented here year after year.”

New developments in diagnostic imaging, home healthcare and telemedicine drew much attention, reflecting the growing focus on efficiency, patient safety and preventative treatment. They included a new generation of ultrasound devices designed for the diagnosis of nerve diseases, and new heart monitoring systems that are incorporated in clothing.

The MEDICA Congress included an international continuous medical education module in English for the first time. Integral diagnostics, cancer treatments, patient monitoring in intensive care and cardiac surgery were focal themes.

ComPaMED 2009 ran in parallel with MEDICA from 18–20 November. 518 exhibitors from 35 nations demonstrated supplies for medical manufacturing, ranging from components and individual assemblies to nanotechnology applications and solutions for custom manufacturing. A key theme of the ComPaMED forum was high-technology components for processing medical products.

 
MEDICA 2009 at Messe Düsseldorf

Get yourself connected

New solutions for connectivity between medical devices and systems played a major part in this year’s MEDICA trade fair. Two examples were:

• GE Healthcare is driving an interpretation of e-health in terms of health information systems that connect healthcare providers across a region. The UK-based company presented its new e-health solution to enable digital networks: the Centricity Imaging Portal. This web-based portal can retrieve historical patient data from different hospital systems such as HIS, RIS and PACS, enabling radiologists to diagnose and report independent of location, time and institution.

In order to promote the exchange of clinical expertise worldwide, GE Healthcare is delivering global solutions enabled by its German e-health technology partner ICW. The key project is an application helping to centrally manage and distribute medical documents, enabling experts from different institutions to gain access to patient data.

GE Healthcare also promoted its new digital imaging solutions for mammography and cardiology, aimed to meet the challenges of modern healthcare environments. The Centricity RIS/PACS system provides advanced clinical tools and 3-D technology in order to help clinicians evaluate huge sets of data.

“Our Centricity RIS/PACS is web-based and offers an extremely fast streaming technology, which enables the system to run in region-wide and multi-hospital environments even under low bandwidth conditions,” said Jürgen Reyinger, Vice President and General Manager at GE Healthcare IT for Europe, Middle East and Africa. “This supports cost-effective image exchange projects throughout several care providers and vendors. At the same time, fast access to vital patient information is leading to more timely and safe diagnoses for patients.”

• Welch Allyn, a global manufacturer of frontline medical devices and solutions, showcased its new suite of core diagnostics products that feature next-generation electronic connectivity. The company offered an interactive booth experience, with touch-screen kiosks and Mobile Clinical Assistant tablets, adding a high-tech dimension to the demonstrations.

Julie Shimer, Welch Allyn’s President and CEO, said the company’s new showcase was a response to the growing demand for device connectivity within healthcare delivery. “We are designing products that offer greater efficiency and more connectivity options to help shape the future of healthcare delivery beyond traditional approaches to connect, manage, and share patient information.”

The company showcased its new Green Series Medical Exam Lights, some of the first medical exam lights in the world to feature energy-efficient light-emitting diodes (LEDs). The range of four light systems are designed for use in a variety of healthcare settings: GP consultations, specialist examinations, outpatient checks and hospital-based procedures.

Welch Allyn also previewed a new, lightweight electrocardiograph (ECG) that is connectivity-ready and offers the speed and power of a fully-featured ECG in a compact, portable size. It can administer patient tests at the touch of a button, and can interface with Welch Allyn’s CardioPerfect Workstation Software to connect to an electronic patient record or health information system.

Biosign stand at MEDICA 2009

Saving lives with technology

A range of innovative products that stop bleeding in serious wounds was showcased at MEDICA by Crewe-based UK company MedTrade.

Celox controls moderate to severe bleeding from arterial or high-flow sites within seconds of application by attracting red blood cells to its surface and forming a strong gel plug that seals the wound. Since its introduction to the US market in 2006, Celox has been proven to rapidly and reliably stop major bleeding.

Craig Hardy, CEO of MedTrade, said before the event: “One of my greatest pleasures is hearing of the times when Celox have saved lives. It is now fantastic to be able to display the Celox range at MEDICA. We are hoping it will offer us the perfect opportunity to meet with international distributors and showcase our products to people from around the world.”

The Yorkshire Pavilion at MEDICA 2009

The Yorkshire Pavilion

An example of a regional medtech trade initiative at MEDICA 2009 was the Yorkshire Pavilion, co-sponsored by industry specialists Medilink Yorkshire & Humber and regional development agency Yorkshire Forward.

The Pavilion featured 10 companies: Biosign, Brenmoor, METRC, Paxman Coolers, Platts and Nisbett, Surgical Innovations, Tissuemed, Trio Healthcare, Tomorrow Options and Zilico.

“Healthcare innovation is one of the region’s rapidly emerging industries and these companies, through their innovation, have earned the chance to fly the flag for Yorkshire and Humber across the world,” said Jim Farmery, Assistant Director for Business at Yorkshire Forward. “Their success should act as a catalyst for further investment in the region and encourage the progress of other businesses in the sector.”

Paul Brennan of Brenmoor, which designs and manufactures printed wristbands to prevent patient identification errors, said: “MEDICA was incredible for us. We met a number of potential new partners from around the world who we are hoping to do business with over the coming year. MEDICA gave us great exposure and as a result we can take our product to new global markets next year.”

Some of the innovative Yorkshire products on display included:

• Zilico’s hand-held device for accurate detection of cervical cancer, which removes several weeks of waiting for a diagnosis.

• The scalp cooler from Paxman Coolers, which gives cancer patients a better chance of retaining their hair while undergoing chemotherapy.

• Biosign’s new range of silver-coated anti-microbial signs, which kill 99.99% of bacteria including MRSA.

• Platts & Nisbett’s specialist bespoke surgical instrument service, based on an in-house manufacturing capability.

• The LogiFlex, a flexible laparoscopic device from Surgical Innovations that has been described as an ‘innovative cost-effective solution’ by surgeons.

Lord Darzi visits the British Pavilion at ComPaMED

The components of success

Another regional medtech initiative was the British Pavilion at ComPaMED 2009, where nine UK component manufacturers secured an estimated £1 million of export sales. Run by industry specialists Medilink West Midlands and backed by UKTI and Advantage West Midlands, the British Pavilion included product and brochure display support for 20 companies.

Tony Davis, CEO of MedilinkWM, said: “Attended by an international audience of OEMs, this is a very targeted show, which is why it has proved so profitable and has led to such significant sales leads. At a time when many manufacturers have been hit hard by the weakness of the UK economy, £1million of sales is well worth travelling to Germany for!

“Normally this type of show would be out of the reach for UK SMEs, or at the very least would require significant investment. This kind of sales success just proves how valuable it can be to invest in marketing to overseas audiences, and I hope other manufacturers can see the return they could hope for by taking advantage of a shared, sponsored stand.”

The British Pavilion was visited by NHS innovation champion Lord Darzi, who spoke with each of the represented companies and invited them to his after-show reception. The UK’s Commercial Officers, representatives of British industry overseas, also visited the stand to talk with the exhibitors.

“No other show delivers this quality of leads from around the world, and it’s incredibly valuable for an SME to be able to reach so many influential people in one place,” said Caroline Herdman, Medical Division Manager of silicone supplier Primasil Silicones. “ComPaMED is a unique chance for Primasil Silicones to be seen on an international platform and to meet with the UK’s Commercial Officers. They have been able to provide essential market information that we can use to drive export sales.”

Precision component manufacturer Interplex showcased its range of complex metal parts and assemblies. Bruce Christie, Managing Director of Interplex, observed: “ComPaMED has exceeded our expectations, smashing our anticipated sales targets for the event.”

David Nichols, Director of the Translation People, preferred supplier of medical document translation services to Optima Health and several NHS Trusts, said: “As an SME, the format of the British Pavilion made it possible for us to maintain a consistent, professional presence at the show. Our staff were able to attend appointments and give visitors to the stand extra attention, using MedilinkWM’s highly professional staff to represent us on our pod.

“We had some really useful meetings with UK officials, which I know will develop into strong commercial opportunities. ComPaMED really is the world’s meeting place for medical devices and technologies.”

Rob Holder is Marketing Director of Activa Healthcare, a fast-growing wound care company based in Burton-on-Trent. Activa is a market leader in compression therapies.

What are your main priorities as Marketing Director of Activa Healthcare? How do you divide your time?

The strategic direction of the business is my main priority and so most of my efforts are aimed at getting feedback from the team and customers. As part of the Lohmann & Rauscher Group, we have to look at wider objectives and consider where the business is currently and where we’d like to be in the next five or ten years, particularly with new products, product innovation and staff development. My team is also responsible for the training and clinical service to customers, so a lot of my efforts go into supporting them so that they continue to provide these elements to the highest of standards.

How has Activa gained its recent successes, including the Queen’s Award for Enterprise 2008?

We’ve always had a strong and innovative programme of new product development. Healthcare in the UK is constantly changing, so it’s important that we work very closely with our customers and make sure we provide them with the right products – that area of business is easily overlooked, as it’s very easy to get wrapped up in your own product ideas without keeping an eye on what the customers want.

Ultimately, you can have the best products and the best marketing strategy – but without motivated staff who truly believe in what they’re doing, you won’t get very far. We’re very proud to have come fourth this year and sixth last year in the Times Top 100 Best Small Companies to Work For list, and we’ve worked closely with our employees to develop the right level of motivation and a winning attitude.

We’re also proud of the fact that close to 80% of the organisation is customer-facing. Whether the customers are external (clinicians) or internal (suppliers), we work very closely with them. For clinicians, we have regular training courses and a clinical services team who work with KOLs to develop new ideas and monitor the marketplace. Our priority is to make sure the company responds accordingly, so it’s a multifaceted approach.

How is Activa’s marketing strategy meeting the challenges of the UK wound care market?

There are pressures on the healthcare system in the UK, particularly in terms of limited resources, which means that they’re looking for good value from companies, so it’s important for us to ensure that we offer that level of value.

We provide a lot of customer support; we do a lot of clinical work, case studies and so on, to make sure that we can justify the claims we make and people can see value there. We also work very closely with the NHS buyers and the drug tariff to make sure the products aren’t overpriced.

Activa also strives to add additional value; we have over 40 trainers who provide training and education to clinicians, either at university level or at the workface in the clinical environment – for example, the development of their measuring skills with hosiery or their wound care skills. The critical thing is to listen and respond to the changes – and that’s never easy; maintaining the best products and the best service is critical in achieving our goals.

Activa’s marketing materials are distinctive in appearance. How important is design to your marketing approach?

We’ve worked with the same design company, Magic Box Creative, in Borehamwood, for 11 years now. As an organisation we’re happy not to take ourselves too seriously. In business it’s easy to get too wrapped up in things to an extent where creativity is stifled. We’ve always said as a business that the critical thing is to have fun, and if you’re not having fun then there’s something wrong. So when we look at creative design, we will often change on a regular basis. Corporate branding is very important, but so is being fun and innovative.

At the moment, we have a product called Suprasorb X that contains a new antimicrobial called PHMB. Two other companies have products that include PHMB, but our view is that Suprasorb X has the edge – so we call it the X Factor. Most companies would stick to the traditional healthcare approach: this is who we are and what we do, take it or leave it. But we thought having a bit of fun with the marketing, while at the same time recognising that we’re dealing with a serious area of healthcare, would help to drive the brand forward.

It’s always a balance in life. You can go too far one way and appear too conservative, or go too far the other way and not appear credible. Our design agency, like us, is responsive and creative in its thinking. That works for our customers too. I used to be a nurse, and many of us at Activa have a healthcare background. Health professionals are very empathetic by nature, as well as being scientifically informed; they’re very responsive to the human side. I think it’s important to humanise what we do.

New NHS policy documents from the Government and the Opposition indicate the ground on which the 2010 election battle over this crucial domestic issue will be fought.

Both Labour and Conservative parties emphasise the importance of preventative and community healthcare in meeting the financial and clinical challenges of the coming years, in which healthcare needs are predicted to increase while the NHS budget will be subject to severe constraints.

However, Labour’s policy document gives more weight to the provision of specific services that can achieve this goal, whereas the Conservative policy document gives more weight to decentralisation and an increased role for private health providers.

Labour promises a leaner NHS

NHS strategy from the Department of Health places emphasis on improving quality and productivity through ongoing service reforms.

According to NHS 2010-2015: from good to great. Preventative, people-centred, productive, published in December, the key priorities for managing the impending NHS budget cutbacks are protecting patients, supporting clinical staff, shifting resources to the frontline and cutting back bureaucracy.

The measures outlined include:

• A new payment system that links hospital income to patient satisfaction, rising to 10% of payments over time.

• Dedicated one-to-one carers for patients with cancer or serious long-term conditions.

• Plans to offer frontline staff an employment guarantee in return for flexibility, mobility and pay restraint.

• More freedom for successful hospitals to expand their services into the community, including GP centres.

• Personal care plans and health budgets, enabling patients to choose how and where they will be treated.

• A legal right to an 18-week waiting time for treatment after GP referral (two weeks for cancer patients).

• A legal right for everyone aged 40–74 to an NHS Health Check every five years to assess their risk of heart disease, stroke, diabetes and kidney disease.

Health Secretary Andy Burnham said: “For the NHS to become truly great, it must become more preventative and people-centred. This means top quality care is our goal and patient safety our top priority. Quality care is not always about spending more money, but about spending it in the right places. Moving care from hospitals into homes and communities is better for patients and more efficient.”

Burnham also stated that “where there is underperformance and the NHS is an incumbent provider, we will give the NHS the first opportunity to improve to the level of the best” – but that this did not mean “freezing out the independent sector”. The strategy underlines the importance of partnership between the NHS and the private sector.

Tories promise a decentralised NHS

The Conservative Party has pledged to scrap NHS process targets, open up the NHS further to independent sector providers, and enable patients to choose their own providers at all levels of healthcare.

The Conservative ‘Reform Plan for the NHS’, the first chapter of its Draft Manifesto 2010, places emphasis on decentralisation. It consolidates a number of policy statements made in late 2009 – and echoes a number of Labour commitments, including the conversion of all hospital trusts to Foundation Trusts. The document’s assertion “We can’t go on with an NHS that puts targets before patients” was a key theme of Lord Darzi’s Next Stage Review.

The key statement for the medtech industry is: “To give patients even more choice, we will open up the NHS to include new independent and voluntary sector providers – if they can deliver a service that patients want, to a high standard and within the NHS tariff, then they should be allowed to do so. To make sure all providers have the right incentives to succeed, we will implement a ‘payment by results’ system throughout the NHS.”

While this commitment challenges the recent claim by Health Secretary Andy Burham that the Government will view the NHS as the “preferred provider” of healthcare, the approach is closely allied to the current Labour policy of keeping ISTCs within the NHS tariff system and avoiding advance payments for work not carried out.

The Conservatives’ plans for public health reflect their commitment to decentralisation. They intend “to provide separate public health funding to local authorities, which will be accountable for – and paid according to – how successful they are in improving their local communities’ health.”

In addition, they intend to “give patients with chronic illnesses or a long-term condition access to a single budget that combines their health and social care funding which they can tailor to their own needs”. This is, in fact, a programme being piloted by the current Government.

The Conservatives say little about how they will deal with the impact of the anticipated funding restrictions, except that they will make the NHS more “efficient”. In this, again, the ‘Reform Plan’ echoes the Government’s strategy document.

Conclusion

The stated commitments of the two leading parties regarding the NHS are strikingly similar. The differences are more in emphasis and rhetorical impact than in actual policy. However, they may point to greater differences that will emerge in the detailed policy-making of the government following the 2010 General Election.

The ABHI Code of Business Practice was launched in 2009, but many medtech sales and marketing professionals – and their customers – are still getting used to it. Compliance specialist Steve Gray looks at how the Code guides your business route.

For some time, pharmaceutical company employees have looked at their colleagues in the medical technologies industry with a bemused envy. As the pharmaceutical industry’s Code of Practice became ever stricter, there did not seem to be a visible comparator for medical device companies – and stories about tickets to rugby games and golf matches continued to circulate.

Now that has changed. Our major industry associations, ABHI and BIVDA, have launched their own Codes of Practice.

For some in the healthcare industry, the bells of fear and horror will now toll. Having heard the dreadful tales of SOPs and form-filling emanating from pharma, knees will shake at the thought of healthcare being subjected to the same pressures. Others will welcome the clarity that the Code will bring to their professional activities.

This article is the first in a series that will examine the ABHI Code, its reason for being and its implications in working practice.

Why it matters

Why do we need a Code? We seem to have done perfectly well as an industry up to now without one. What’s changed?

The short answer is: quite a lot. The public demands increasingly high standards from government employees – the MPs’ expenses scandal being the highest-profile example in recent months. Who would have thought, just a year ago, that the public would demand curbs on the bonuses paid to city traders?

Industry associations in a very wide range of business sectors are developing and implementing professional codes of conduct. Even football players and nightclub bouncers have codes of conduct.

The public is outraged when hospitals are unclean, patients have poor experiences in hospital and public safety is placed at risk. The NHS is facing increasing cost pressures, and the public perception that healthcare companies spend inappropriate sums on hospitality and promotion has become one of the drivers of change. Given the role of medical technologies in diagnosing and treating human illnesses and frailties, it is important that we act in a manner that inspires confidence in our products and companies. There is also a need for a common framework to ensure that all medtech companies are judged according to the same standards.

Setting a standard

The Association of British Healthcare Industries (ABHI) Code of Business Practice was introduced in February 2009. Awareness of the Code is still growing, and its profile will increase over the coming months and years until we will forget that there was ever a time we operated without it. The British In Vitro Diagnostics Association (BIVDA) has introduced its own Code of Conduct along similar lines.

The introduction to the ABHI Code states that members recognise their obligation to comply with “applicable laws and regulations” and to adhere to ethical standards because they know that compliance can enhance the reputation of the industry. In fact, the maintenance of high standards is seen as a “critical step” in the industry’s being seen to contribute credibly to the well-being of patients.

The ABHI Code defines minimum standards that it expects members to achieve. In practice, company policies are likely to go further than the Code itself requires, especially if the company is subject to US laws such as the Foreign Corrupt Practices Act (FCPA).

Readers who are familiar with the Eucomed Code of Practice will recognise much of the ABHI Code, because the UK association was integral to the development of the European standards. In effect, there will be similar standards in every country in Europe. And many of the principles are common to a variety of codes across the life sciences sector.

Playing by the rules

The ABHI Code incorporates eight key policies:

• Quality and regulatory compliance

• Interactions with healthcare professionals

• Advertising and promotion

• Unlawful payments and practices

• Competition/antitrust and procurement laws

• Export controls and sanctions

• Environmental issues

• Data privacy.

These core policies are underpinned by a ninth: Compliance and enforcement. The ABHI is serious about ensuring that its members comply with the Code (see below).

In general, the Code requires members to produce, supply and promote medical devices and related services in accordance with existing regulations and good ethical practices. For example, it says about data privacy: Members should ensure that patient data and other types of confidential or personal data be maintained and used in accordance with applicable legal requirements.

The detailed requirements of data privacy in the UK are defined and policed by the Information Commissioner’s Office, which gives advice regarding compliance with the Data Protection Act. The ABHI Code does not need to go into the details regarding data privacy – but it makes it clear that the ABHI expects its members to members to follow the law.

Two areas of ABHI policy are covered in some depth within the Code: interactions with healthcare professionals and competition law. We will cover the details of these in a future article. Regarding competition law, it is sufficient for now to note that ABHI members should not share competitive information with each other.

Brief but clear guidelines

Colleagues who have worked in both the pharma and medtech industries will recognise similarities between the ABHI and ABPI Codes regarding interactions with healthcare professionals. For example, speakers at educational meetings will now have to be formally contracted for the services they provide. ABHI members must not provide lavish hospitality, or use anything other than reasoned argument and product demonstration to influence their customers. Lunches in five-star hotels, golf days and favouring grant applications from good customers are definitely not approved!

In general, the ABHI Code is very focused in its requirements and is less onerous than its pharmaceutical cousin. However, there are a few areas where it is actually stricter – for example, donations and grants cannot be paid to an individual HCP. (An individual HCP can apply for a grant, but the cash transfer must be between the healthcare company and the Trust the HCP works for.) This is to prevent any misunderstanding that might arise if a representative were giving a cheque to an HCP.

The ABHI Code highlights the need for good quality promotional material. It summarises this in three sentences: Members should ensure that all promotional presentations, including product claims and comparisons, are accurate, balanced, fair, objective and unambiguous. They should be justified by appropriate evidence. Statements should not mislead the intended audience.

There is no requirement for formal certification of promotional material by nominated head office signatories, or the onerous review procedures so common in pharmaceutical offices. The ABHI Code expresses in those three sentences, what the ABPI code takes two and a half pages to say.

But do not be mislead by the brevity. The ABHI is serious about the need for members to comply with the Code – indeed, compliance is mandatory. There is a defined complaints procedure and a formal Complaints Panel to rule on disputes. Companies will need to prove their compliance with the Code if a complaint arises.

Enforcing compliance

The sanctions that the Complaints Panel can impose on a company include:

• Reprimand.

• Imposition of a requirement that the offender take specific actions to ensure compliance with the Code.

• Inspection and audit by a third party, at the offender’s expense, of the offender’s systems for compliance.

• Requiring the offender to recover items given in connection with the promotion of products.

• To issue a customer communication regarding future corrective practice (in effect, an apology to customers).

• Requiring the offender to publish or otherwise disseminate corrective or explanatory information or statements (in effect, a public apology).

• Withdrawal of a ‘compliance’ logo or equivalent industry accreditation or certification.

• Publication of any decisions or sanctions imposed in such manner or media as may be specified (a public release indicating the offender’s bad practice, or an actual public reprimand).

• Suspension from membership of the Association for such time period as may be specified, and readmission on such terms as may be specified.

• Expulsion from membership of the Association.

Many of these sanctions rely on the threat of public embarrassment to drive compliance. That may not sound like much, but it’s the kind of thing that breaks CEO careers! Examples of cases and rulings from the pharmaceutical industry have long been visible on its ruling body’s website (www.pmcpa.org.uk). A quick read of these cases gives an impression of the issues that the medtech industry may face should the ABHI adopt similar behaviour-monitoring approaches.

Of course, many of the requirements of the Code are enshrined in law – or at least are designed to keep companies on the right side of the law. As was mentioned above, companies with a US presence will be particularly aware of the implications of failing to maintain standards. There are circumstances in which the actions of a company anywhere in the world can lead to fines (and even jail sentences) for its US division. European law enforcement agencies provide considerable assistance to the US when FCPA cases are investigated.

Code read

Of course, the Code is ultimately in our best interests. As the ABHI says, the industry prides itself on making “a significant contribution to the safety and well-being of patients and the improvement of healthcare systems.” It would be irresponsible to undermine the positive impact of our products and services by allowing our customers to develop a negative view of our behaviour.

By publicly declaring and pursuing high standards, we can create and maintain a positive environment in which our customers are more receptive to information that will help them to make informed purchasing decisions.

We are at the start of a new era in public scrutiny. The Code will help us to stay in the spotlight for the right reasons.

Steve Gray is an experienced compliance specialist. His company produces training materials, workbooks and distance learning courses designed specifically for companies and sales teams working with the ABHI Code of Practice. For more information, visit www.stevengrayconsulting.co.uk.

We are at the start of a new era in public scrutiny. The Code will help us to stay in the spotlight for the right reasons.