PCAM Presentation

8/6/2019 PCAM Presentation

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Primary care account

management

November 2008


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What is account management?


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Definitions of account management

Account management is an attitude where many different skills and in-depth account

knowledge are utilised combined with tenacious behaviour

Key skills for successful account management

Planning Relationship Problem

building solving

Marketing Negotiating Opportunity

creating

Organisation Communicating Presenting

Selling


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Key areas of knowledge for account management

The benefits of successful key account management include:

keeping out yourcompetitors

a focus on long-term planning

a mutually beneficial business relationship increased business growth

Focus Flexibility

Diplomacy

Tenacity

Independent

training Team

player

Opportunity

seeker


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Becoming a partner of choice

Customer perception has a huge impact

A true partner ofchoice will focus upon the customer's agenda

Account managers should be customer-focused

How can I add

more value for mycustomers?


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Customers have three maintypes of need:

organisational needs

personal needs

clinical needs

Becoming a partner of choice

Questions to consider:

How often do we take time to discover ourcustomer's perceptions of us and discover theiragenda?

How often do we find ourselves in win: win scenarios versus win: lose or lose: win?

What questions will help you to uncover the customer's agenda and therefore their real

needs?

Customer needs

Maslow's hierarchy of needs theory

Customers buy on their emotional/personal needs

Must identify the most important needs Often the focus is on customers clinical needs

without exploring the others


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Becoming partner of choice

Level 1 Me too, is seen by customers as someone who is selling a product which

they perceive to be the same as everyone else, there seems to be no differentiation

so cost is their main decision criteria. There is no customer loyalty.

Level 2 The salesperson is seen as someone with a product with some benefits above

other suppliers. Cost is still a driving force and customer loyalty is low. The sales person hasmore of an emphasis on benefit selling.

Level 3 The sales consultant is seen as some one who will help the customer achieve their

objectives. Here, cost is no longer the driving force and customer loyalty increases. The sales

consultant sets their account objectives to mirror the customer's objectives. They understand the

customer's priorities, challenges and needs.

Level 4 The partner ofchoice is seen as part of the team, an insider. They offer strategic advice whilst still selling theirproduct. Price is no longer a huge threat as customer loyalty is at a high. They have a huge network within the account andknow when things are going to happen before they do. They constantly discover new opportunities in the account, understand

the decision making process, and win new business. They work at a higher level, understanding the organisational priorities,needs and challenges in addition to those of the individual key customers.


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Differences between key account management, account

management and account selling

The pharmaceutical industry uses many different labels when defining an

account approach:

y account selling

- short-term goals- large accounts or business units

y account management

- long-term business relationship

- multi-levelcontra

ct

y key account management

- accounts are prioritised


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Identifying key accounts

A key account offers long-term potential. If you are required to prioritise youraccounts, ask yourself the following questions:

Is this account a high revenueproducer?

Are they looking

for industry

partnership?

Are there

opportunities to

increase sales?

Is it a strategically important

account, ie, one with highnational or regional influence or are they key opinion leaders inyour disease area?


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Why is account management important?

Proactively manage our future business

Identify customers that will help achieve objectives

Gain entry to new customers

Increase loyalty and allocate resources

The wider network may include customers not seen before, for example:

finance directors,

customers within the primary care trust

bed managers


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Influence versus usage

It is important to understand the customer's level of influence versus theirusage of a product

Often time is spent with key customers who have high influence yet theirusage is low

High users with less wider influence would be the GPs and increasingly,

nurses and pharmacists Time management is important


In accounts where you have formulary inclusion in both primary and secondary care, what actions

are you taking?

Who are you seeing?

Are you relying on one or two customers to influence the level of prescribing in the account?

What else could you do to drive your business in this account?

Product on PCT formulary GPs/pharmacists/nurses High usage/ low influence

Product not on PCT formulary Secondary care referral High influence/ low usage


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Discovering opportunities

Uncovering opportunities

Asking about the customer's long-term and short-term priorities andchallenges could uncover an area where you can work together inpartnership

Understanding who influences a

customer's de

cision-making opens up theinfluencing network

What are the PCT and trust long-term objectives?

What do they need to help achieve those objectives?

What is the customer's perception of you and yourcompany?

What are your strengths, weaknesses, opportunities and threats?

Sales figures, how are they tracking? What are yourcompetitors doing? Are

you responding appropriately? Past successes/ failures, what have you learned? What will you stop, start

and continue doing?

Who are the key decision-makers and who influences them?


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SWOT analysis

Each of the four areas should be considered in terms of what is beinganalysed.

Strengths

Internal characteristics,

behaviours, aspects ofperformance etc. that

you consider to be

strong.

Weaknesses

Internal characteristics,

behaviours, aspects ofperformance etc. that you

consider to be weak.

OpportunitiesExternal events, changes,

happenings etc. which may

provide positive

opportunities for growth or

improvement.

Th

reatsExternal events, changes,

happenings etc. which

could be detrimental to any

aspect of the area being

analysed.


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Planning and prioritisation

It is recommended that an account development plan is put into place for each

account.

The three steps to completing a successful account plan are:

Set account

objectives

what by when

Key strategies

and tactics

how to achieve

the objective,

by who and by

when

Write the key

account

development plan

in an easy to

follow format


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Setting goals and objectives

Account objectives will differ for each account

Objectives are SMART

Use the following outcome planner to check whether the objective you have

written will enable you to achieve your ultimate goal:

1. Outcome

2. Run it like a video

3. Can you own it?

4. Is it appropriate?

5. Positive by-products6. What is the cost?

7. Time frames

8. Ecology

9. How will you achieve it?


Consider your most important

account. What is your account

objective? Now run through the

well formed outcome planner.

Is your outcome the same or

do you need to change it?


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Planning and prioritisation Information gathering

When working in a primary care arena we need to know who is who, whichcustomers are important to our business and where to find them.

Need to know how to:

- access our target customers

- find out if they are prescribers

- if they are, what they prescribe in theirarea of medicine together with who the

other key influencers and decision-

makers are

Examples of information required:

the decision-makers

the influencers; positive and negative who is involved in decision-making

within the local health economy?

customers perception of you, your

company and the account SWOT

analysis

the customer's needs; organisational,

personal and clinical

the customer's priorities andchallenges in the short, medium to

long-term

the customer's perceptions of

competitors


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Tactical plans: the how

In order to grow market share orcash growth many different actions can betaken based upon the opportunities uncovered or already available in theaccount.

These could include:

formulary/guideline inclusion or review

departmental protocols

secondary care guidelines

shared care guidelines

speaker meetings

departmental meetings

selling one on one


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Resource required

Account management is not about working harder it is about working

smarter

Often there are internal resources available that could be utilised more

thoroughly and consistently

Internal resources may include:

Marketing

Medical

Medical information

Colleagues

Managers

Representatives

NHS liaison

Budget


What are the internal

resources that you could

utilise in your most

important account?


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The big picture

PEC board

PEC chairman

Chief executive

Director of finance

Social services representative Director of public health

Executive nurse

Clinical governance lead

Prescribing lead

Pharmacy advisers

PCT board

Lay chair

The lay members

The chief executive

Director of finance

Director of public health


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PCTs

Within a primary care organisation are many sub-committees such asprescribing, cardiovascular disease, diabetes and clinical governance.

When putting an account togetherconsider the important questions eg:

Who is on what committee?

What level of influence does each of these committees have on the rest of thePCT?

What is the level of influence each of these committees has beyond theconfines of the PCT?

Who within the PCT does it have most influence with?

What relevance does this information have to helping me achieving myobjective?

What must I be doing?


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PCT funding

PCTs

81 per cent of NHS funding

100 per cent of the expendable budget

Four distinct areas must be funded:

1. commissioning of hospital, mental health and learning

disability services2. primary care infrastructure

3. providing community services

4. running and management costs


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Drugs and therapeutics committees

Role of drugs and therapeutics committees (DTCs) - spanning both

secondary and primary care:

develop and/or approve hospital, clinical directorate and nursing

medicine policies

monitor drug budget develop and/or approve cost containment measures

advise the trust of the impact of new drugs

seek funding for new drugs

advise pur chaser of impact of new drugs

seek funding from purchaser for new drugs

develop and/or approve joint/shared care prescribing protocolswith primary care

develop and/or approve patient information

develop and/or approve prescribing documents (primary and

secondary care)

monitor medication errors


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Working together

Although different stakeholders within accounts have individual agendas,

drivers and targets, there is also significant overlap in their agendas.


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Formularies

What are formularies and guidelines for?

1) Administrative reasons: this leads to rationalised purchasing and simplifiesdispensing

2) Clinical reasons: the fewer the number of products, the more familiar ea

chone will be to doctors, nurses and pharmacists, which lessens the likelihood

of mistakes in prescribing, dispensing and administering the drugs

3) Medical reasons: for example, restricting the use of antibiotics so as tominimise the development of resistance. This tends to be an area whereformulary/guideline recommendations are quite strictly applied

4) Cost containment: formularies/guidelines may ensure that it is more difficultfor newer, more expensive products to be used in accounts. The keyinfluencers can limit cost within a given therapy area.


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Advantages to formulary/guideline inclusion

In some therapy areas the formulary is used more as a guideline.

The simple guide to gaining PCT formulary inclusion:

1. Obtain a copy of the formulary

2. Find out how often the area prescribing and medicines management committee/ DTC sit

3. Project plan

4. Find out what the procedure is for getting a product considered for discussion at APC and

DTC level

5. Who is on these committees?

6. Plan your campaign

7. Uncover what criteria the committee will use to make a decision

8. Before the meeting, provide your supporters with written evidence to help them back your

product

9. If you are successful, find out why and if you're not find out what needs to be done next time


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What if your product is not on formulary?

Guidelines help achieve standardised care and promote evidence-basedmedicine

Guidelines are often produced by the members of the primary caremedicine management group or area prescribing committee using the bestavailable evidence at the time

Shared care guidelines are aimed at both primary and secondary careprescribers

80 per cent of prescribing will fall within the guidelines


In which of your accounts do you need to gain formulary status? Have you a written project plan with milestones and timelines

on how you will do this?

In those accounts where you have formulary status do you

know when it is up for review?

What are the obstacles to you achieving your goal?

When guidelines are issued does the PCT name your product?


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Shared care guidelines

The NHS Management Executive issued its guidance on prescribing at the

hospital/GP interface through an executive letter EL (91) 127: responsibility

for prescribing between hospitals and GPs.

The NHS Executive has asked for:

'Responsibility for prescribing between

hospitals and GPs so that where a

consultant considers a patient's

condition is stable, he may seek the

agreement of the GP to share the care'.

EL (94) 72: purchasing and prescribingfurther stated that where GPs accept

prescribing responsibility, they should

have all the information and support

that they need to prescribe and monitor

their patients.

Shared care guidelines willnormally include:

indication

general guidance

background

secondary care responsibilities primary care responsibilities

contact details


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Patient pathways

'The patient pathway is the route that a patient will take from their

first contact with an NHS member of staff (usually their GP),

through referral, to the completion of their treatment. It also covers

the period from entry into a hospital or a treatment centre, until the

patient leaves. You can think of it as a timeline, on which every event

relating to treatment can be entered. Events such as consultations,

diagnosis, treatment, medication, diet, assessment, teaching and

preparing for discharge from the hospital can all be mapped on this

timeline.

The pathway gives an outline of what is likely to happen on the

patient's journey and can be used both for patient information and for

planning services as a template pathway can be created for common

services and operations.'

What is a patient pathway?

The Department of Health website definition is:


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Politics

Local delivery plans

Local delivery plans are three-year programmes to improve the healthstatus and healthcare of a local population. They have to reflect nationalpriorities.

Local delivery plans cover:

1. the most important health needs of the

population

2. the main healthcare requirements of local people

3. the range and location of services and the

investment required

Hospitals and primary care

There is much talk these days of the primary-secondary care

interface; this encompasses what types of specialty can be

performed, and which types ofclinician can work in each setting.


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Influencing

Roles within the decision

There are generally six types ofcustomer in an account:

1. Decision-makers make the final commitment to the outcome you areseeking

2. Influencers (+)can positively influen

ce the de

cision3. Influencers (-) can negatively influence the decision. They may use

competitor products

4. User prescribes the products and will work with the decision

5. Specialist will be engaged by the decision-maker to advise orcover themore technical area's in the decision

6. Ally with someone who you have a great relationship with, who helps you

discover new opportunities and will give a heads up on the account. Theymay have no influence on the decision you seek


Consider your key account:

what decisions do you need to be made

who is involved in that decision?

what are their roles and what is your strategy with each of these people?


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Influencing tactics

There are many techniques we can use to influence. We can use more thanone in any given situation:

build rapport with yourcustomer by matching and mirroring body

language, voice tone, speed and volume

create empathy

logical structured argument

asking a favour; done well, people find it hard to say no

create a compelling futureimagine if

using others who have a greater relationship with the customer

negotiate if I do x will you do y?

appealing to ego or need for recognition

using third party references to appeal to their sense of affiliation, eg, Dr X

at the PCT was saying it has saved him lots of time


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Questions?

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