Countywide Supplies is part of the Atos Medical Group. Atos Medical is a global company founded in 1986 in the south of Sweden. It has a direct presence in many countries, including the United Kingdom.
Atos Medical develops, manufactures and distributes products for laryngectomy and tracheostomy rehabilitation. The laryngectomy product range is known as Provox and the tracheostomy product line as ProTrach.
At the beginning of 2015, Atos Medical acquired Countrywide Supplies Ltd (CWS), and the companies now operate within the UK as a single legal entity.
The merger of the two companies was thoroughly investigated by the Competition & Markets Authority (CMA). The conclusion of the CMA investigation was that the merger has not resulted, or may not be expected to result, in a significant lessening of competition (SLC).
A full report of the CMA investigation is available at http://tiny.cc/atosmedical.
It is common within the UK market for manufacturers to own and operate prescription and home delivery services. In fact, nearly all of the Dispensing Appliance Contractor (DAC) licenses are owned by trans-national medical device companies. This practice enables the manufacturer to provide products that are available on prescription, directly to consumers at a local level – improving efficiency and the level of service which benefits the user.
Atos Medical pursues a strategy of empowering its end-user.
At all levels of the company staff are continually encouraged to put them at the centre of everything that they do. This strategy of empowering end-users permeates every part of the company and its activities.
Like any successful medical company, Atos Medical invests a significant amount its profits back into research and development.
Services including community events, nurse visits, and order reminder calls, texts, or emails, are all designed to connect with its customers directly and ultimately improve the end-users’ compliance with the prescribed treatment, which is of benefit to the patient and the clinician.
Countrywide Supplies (CWS) is what the NHS terms a Dispensing Appliance Contractor (DAC). This means that it distributes prescriptions in a similar way to a high street pharmacy.
And like a pharmacy, CWS has to conform to strict standards and regulations which govern the way it operates, and, crucially, the way it protects sensitive patient data.
In practical terms, being a DAC means that as well as dispensing appliances it is obliged to support self-care, promote healthy lifestyles, exhibit clinical governance and advise on the utilisation, storage, and disposal of appliances.
CWS is contracted to provide advanced services as an NHS contractor. Part of this means there is an expectation that CWS will give all of their customers the opportunity to have an appliance usage review (AUR) should they wish.
CWS specialises in servicing head and neck patients.
Countrywide Supplies (CWS) offers appliance usage reviews (AURs) which are carried out by qualified nurses. This can take place in a pharmacy or at the patient’s home and is designed to improve their knowledge of the appliances they have been prescribed.
Nurses and other staff who directly support customers undergo intensive and continual training to ensure that they can provide the best service available.
As well as establishing how the appliance works, AURs also educate the patient in how the appliance can be used most effectively, how it should be stored safely and its ultimate disposal.
The performance of AURs is strictly controlled and CWS nurses are prohibited from promoting Atos Medical products. The AUR covers the appliances that the patient has been prescribed. Any changes to appliances used must be directed by the relevant hospital team. The CWS nurse will not change any product without prior agreement from the hospital. In cases where the end user has been discharged back to the care of their GP, the nurse will work with the GP to establish the most suitable product.
Initially, the Countrywide Supplies (CWS) nurse will visit the ENT/Head & Neck team, to explain what its services are and discuss whether it is something that the hospital team would find helpful to their patients.
Once a trust or hospital has indicated to be interested in this service for their patients, further details are discussed and agreed. This verbal agreement is confirmed via email, and if required a ‘shared care’ agreement or honorary contract is put in place.
The agreement is adapted to the hospital preferences and needs, and covers for example, which patients will be offered the service and who will contact them.
The CWS nursing service intends to collaborate with the local MDT. For example, the CWS nurse will always inform the responsible clinician of the nurse visits planned, send a copy of the AUR form for the visit, and offer regular reviews with the MDT or responsible clinician.
It is a requirement that CWS nurses all have prior experience in this area. Prior to seeing any patients, the nurse undertakes a three-week induction programme which includes face-to-face training as well as online training, including the Imperial College Head and Neck course. Each nurse is fully qualified and registered, has an active PIN and has enhanced DBS clearance. Prior to seeing patients independently, the nurse shadows the established nursing team.
The nurses also undertake regular continuing professional development (CPD) and clinical supervision.
The CWS customer care team undergoes a two week intensive initial training and induction before they speak to patients, as well as continuing clinical and product training by qualified Healthcare Professionals (HCPs).
Despite CWS investment in training for its staff, as well as rigorous policies and procedures, occasional errors or mistakes can happen and CWS wants to hear about them right away.
If CWS receives complaints or concerns it will immediately review and take action where appropriate.
Countrywide Supplies (CWS) has a firm commitment to patient privacy and ensuring that it uses patient information only as necessary and for a clear legal purpose.
CWS relationship with patients is underpinned by its absolute requirement for patient consent and, where appropriate, ensuring that clinicians have consented to transfer patients’ information.
In practical terms, this means both a local consent and a CWS consent are obtained from every patient.
As with any company, CWS is legally required to obtain the consent of the patient before collecting and using their personal information.
This means that CWS explains to patients what it will use their information for and ask their permission to do so. CWS will also make patients aware that they can change their mind and withdraw consent at any time.
CWS has a rigorous process in place for gaining consent and ensuring that everyone in the company understands and adheres to this process.
CWS believes in a personal level of care, which means that each patient decides on how the company will provide services to them. For instance, how they like to be contacted, whether they will receive news on products and services and how often they would like to receive reminders to order the products that they need.
All UK-based Atos Medical and Countrywide Supplies staff are employed by the same company, which is Countrywide Supplies Ltd (CWS). Patient data is only shared between employees, and only when absolutely necessary; it is not transferred between different organisations.
In compliance with the seven Caldicott principles, information sharing is strictly monitored by the CWS-registered Caldicott Guardian to ensure that not only does CWS operate lawfully but ethically as well.
The Atos Medical Group has access to anonymised patient data which is only used for data analysis purposes.
The supply of any medical service must be underpinned by a need to protect patient confidentiality and CWS is fully compliant to Level III of the Information Governance (IG) requirements as defined in the NHS guidelines.
CWS employees carry out regular IG updates as well as data protection training.
Whilst not required by law, CWS has chosen to undertake registration with the CQC to emphasise its commitment to providing a safe, ethical and quality service.
As a manufacturer and distributor of medical devices, the Atos Medical Group also complies with all relevant regulations.
Countrywide Supplies (CWS) only promotes products and services to customers that have indicated that they are interested in receiving such information and have given their consent. The customer will only receive marketing information about products that are relevant to their condition and current product usage, and about services that are relevant and available to them.
Examples of marketing information include newsletters, emails, brochures and flyers about products and services. Marketing materials going out to patients usually include a phrase to check suitability with their clinician where relevant e.g. ‘as always, talk to your clinician about which products are right for you’.
In addition, CWS representatives will always aim to check with the clinician or prescriber when a patient requests new products or samples that require assessment of appropriateness.
CWS will always aim to inform clinicians about new products first.
Countrywide Supplies (CWS) provides the appliances that are on the patient’s prescription. It is CWS’s process that if a patient wishes to change their product, or sample a new product; they should first discuss this with the responsible clinician or prescriber. When the patient requests a product or sample that requires assessment of appropriateness, the CWS representative will discuss the request directly with the clinician or prescriber, on behalf of the patient.
Countrywide Supplies (CWS) is committed to offering both the patient and the clinician the opportunity to access all products available on prescription from all suppliers, with an emphasis on the patient’s individual needs. CWS holds a large inventory of products from all major suppliers and aims to deliver any appliance to the patient within 24 hours of receiving the prescription.
All products dispensed by CWS that are prescribed for each patient, are on the Drug Tariff and are brand specific on the prescription. If a patient would like to try a new product, CWS will check suitability and discuss with the responsible clinician or prescriber when an assessment of appropriateness is required.
If a product is unavailable, CWS can provide an alternative but again will check with the responsible clinician or prescriber unless it concerns an accessory where the difference between brands or products is negligible and an assessment is not required.
In support of their user-driven innovation strategy, Atos Medical commissioned an anthropological study together with Red Associates.
In addition to identifying user needs requiring product innovation, this work revealed a large number of unfulfilled user needs that can be met with services and education. For example, people with a laryngectomy would like to feel more knowledgeable about their changed anatomy and increase their product literacy.
As a result of this, the Atos Medical Group has initiated community events for people with a laryngectomy and their spouse and/or caregiver. The events are designed to be small (approximately 4-6 per event), educational and informative, and encourage engaging discussions around key topics such as ‘staying active’ or ‘better sleep’. They are also local and informal to ensure attendees can access the venues easily and meet other users in the local community. The events are usually held in venues outside of the hospital environment allowing users to feel relaxed and have a sense of normality. In some cases the events are held at a hospital.
In some areas in the UK these community events have been inadvertently initiated without informing the clinical community, and clinicians may have been unaware of the anthropological study results that have led to these events. Atos Medical has taken steps to rectify this and Atos Medical’s preference is to collaborate with clinicians where possible.
These community events are open to all people with a laryngectomy, regardless of their service provider or product used.
Atos Medical encourages clinicians to be involved with these events and although clinic time may not always permit attendance, clinicians are always welcome to attend. Similarly, Atos Medical would like to collaborate more with the clinical community and our Managing Director Corina Van As Brooks is keen to continue to engage with the NHS clinical community.
If you have any questions or concerns in relation to Countrywide Supplies (CWS) please contact your local CWS and Atos Medical representative or email firstname.lastname@example.org.