NHS purchasers urged to step out of their offices and get on the frontline
Procurement expert claims lack of expertise in NHS trusts is thwarting value-for-money purchasing
A healthcare expert has called for NHS procurement managers to get out of their offices and get into theatres and onto wards in an effort to save the billions of pounds currently wasted every year on poor purchasing practices.
Richard McIntosh, UK managing director of procurement consultancy, Inverto, spoke out after the company’s work with Mid Essex Hospital Services NHS Trust helped to save more than £300,000 in just three months on the purchase of hip products alone.
He told BBH in an interview this week: “There is a huge amount of financial pressure on the NHS in the current climate and trusts need to make significant cost improvements year on year.
Fundamentally, you must have good procurement people on the ground to see where savings are possible, work with clinicians and managers and make the savings happen. It is this that is missing in some trusts
“There are three tiers of NHS procurement. Firstly, the Government Procurement Service, providing pan-government procurement frameworks; then there are regional NHS procurement hubs; and then the procurement departments in each trust. Where I see the biggest gap currently is at this trust level. Fundamentally, you must have good procurement people on the ground to see where savings are possible, work with clinicians and managers and make the savings happen. It is this that is missing in some trusts.”
This on-the-ground expertise is crucial to help determine where the opportunities for savings lie. However, many experienced healthcare purchasers have left the health service over the past 18 months as part of the revamp of the NHS and the eradication of primary care trusts.
McIntosh said this has left a large skills gap, but also means there is potential to make savings.
“For many categories of spend, there will not be a single solution that would for all trusts, as each trust’s requirements may be different and the solution that gives the best value for money will be different,” he added. “And they can’t do this without experts.
“Good procurement comes from good processes, detailed market knowledge and, most importantly, from stakeholder engagement. It can’t be done by managers in back offices. It has to be done by people who are on the frontline, spending time with estates and facilities managers, clinicians and heads of nursing to understand their requirements and match this to the market and in the most cost-effective commercial way.
Good procurement comes from good processes, detailed market knowledge and, most importantly, from stakeholder engagement. It can’t be done by managers in back offices. It has to be done by people who are on the frontline
“By speaking to clinicians you get an idea of what they require and what they want. For example, you might be getting a really good price for a hip replacement device, but the screws used to hold it in place are expensive. When considering areas where you can reduce spend you need to look at the whole picture.”
Inverto has been working with procurement managers at Mid Essex Hospital Services NHS Trust, looking at all non-salary spending across the board. This covers everything from big CT scanners to office supplies and medical consumables.
As a result, the trust has saved 28% on hip products, with final savings across the wider orthopaedics speciality forecast at around £500,000.
The results clearly demonstrate the power of clinical engagement and what can be achieved when you combine specialist procurement expertise, clinical and commercial expertise and the backing of the trust board
To drive the efficiencies, Inverto put together a cross-functional commercial and clinical team, which reported directly to the clinical director, chief financial officer and chief operating officer.
Bill Martin, one of the trust’s consultant orthopaedic surgeons and lead clinician on the procurement panel, said: “The initial worry that financial pressures would lead us towards accepting substandard implants or major inventory changes has not been borne out and it was reassuring to be involved in the process as a surgeon.”
McIntosh added: “Using our product and market knowledge we were able to work with the trust to supply accurate cost modelling and scenarios too the clinicians for them to base their decisions on. The results clearly demonstrate the power of clinical engagement and what can be achieved when you combine specialist procurement expertise, clinical and commercial expertise and the backing of the trust board.”
