The NHS continues to operate under extraordinary pressure. Capacity remains stretched, workforce shortages persist, and the system is still recovering from the long tail of COVID. Every decision, clinical or commercial, is made within this reality.
And yet, many pharma strategies are still built as if selling is a transaction between a company and an individual clinician. As if more data, more messages, greater coverage and higher frequency will somehow cut through.
They rarely do.
Based on nearly four decades working across healthcare, first in the NHS and later in pharma, here are five shifts I believe pharma leaders must make if they genuinely want to align with how the NHS thinks, decides and prioritises care.
1. From selling to doctors, to serving a system
The NHS is not B2C. It is a complex system with layers of decision making, constraints and trade-offs. Prescribing is an outcome, not the starting point. When strategies focus solely on influencing individuals, they miss the forces shaping what is actually possible.
2. From evidence in isolation, to evidence in context
Many organisations still equate impact with noise. More calls. More messages. More pages. More frequency. The result is often well-intentioned activity that adds cognitive load rather than clarity. Detail aids become dictionaries of clinical data, much of it disconnected from the realities clinicians are facing in practice.
Comparisons to placebo may satisfy regulatory requirements, but they rarely reflect real-world decision making. Clinicians are not choosing between something and nothing. They are choosing between trusted options, within existing pathways, under significant time and capacity pressure.
3. From influencing individuals, to understanding decision architecture
Tariffs, contracts, formularies, service specifications, community pharmacy frameworks, and workforce availability shape decisions far more than most brand plans account for. Ignoring these pressures does not make them irrelevant. Understanding them changes everything.
4. From competitor focus, to problem focus
Too often, strategy is driven by what competitors are doing. But the real competition is frequently not another medicine. It is time, prioritisation, staffing, and the need to rationalise care when demand outstrips capacity.
5. From product value, to system value
Sometimes the NHS does not need another innovation. It needs support with service redesign, pathway optimisation, or new ways of delivering care that help teams do more with less, sustainably and responsibly, including with consideration for environmental impact.
After forty years in healthcare, I feel a responsibility to say this clearly. The NHS does not need more noise. It needs fewer, better conversations.
Too much time is still wasted on misaligned messages, poorly timed engagement, and solutions that do not reflect the reality clinicians and payers are operating within.
That is why, this quarter, I am opening a small number of Strategic MOT conversations.
These are not sales discussions or workshops. This one-to-one strategic diagnosis will help you:
✔️Sense check brand alignment with NHS realities
✔️Identify the biggest barriers to traction
✔️Clarify where to focus time, energy and investment
This intent sits at the heart of our purpose at Cheemia, unleashing human potential to create a healthier world, starting here in the UK.
If you are a pharma leader working with the NHS and this resonates, message me. Sometimes clarity begins with a conversation.
Mehrnaz
