As government plans revamp of purchasing systems, experts warn trusts need to change
The NHS will fail to secure the cash savings and service improvements that could be achieved through enhanced procurement processes unless trusts join forces and increase purchasing expertise, experts are warning.
Next month the Department of Health (DH) will publish a new procurement strategy for the NHS that will be formally adopted before the end of the year. This aims to address the key issues highlighted in two recent critical reports from the National Audit Office (NAO) and the Public Accounts Committee (PAC). Both claimed that opportunities for efficiencies were being missed because of the current procurement processes used by NHS trusts.
It is agreed that procurement as a function is a key driver in delivering not just savings, but improved patient care and outcomes
But experts are warning that any approach will fail unless organisations accept that they do not have the necessary expertise and will need to break down boundaries and work together. This will be even harder as the Government’s reforms create more competition and division within the marketplace.
Speaking at a recent Public Service Events conference on health service purchasing, Beth Loudon, NHS procurement programme lead for the Department of Health’s procurement, investment and commercial division, said: “It is agreed that procurement as a function is a key driver in delivering not just savings, but improved patient care and outcomes and that NHS trusts will need to take action now to start making improvements at a local level on understanding and improving their procurement performance and becoming more transparent in how they do business and how they spend money.
“The solutions lie in a combination of evolutionary and revolutionary approaches; local, regional and national actions; and process and cultural changes.”
The NAO predicts that collaborations between trusts could amount to savings of more than £500m. Spokesman, Amyas Morse, said: “At least 10% of hospitals’ spending on consumables could be saved if trusts got together to buy products in a more collaborative way.
NHS trusts will need to take action now to start making improvements at a local level on understanding and improving their procurement performance and becoming more transparent in how they do business and how they spend money
“In the new NHS of constrained budgets, trust chief executives should consider procurement as a strategic priority. Given the scale of savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices.”
But the report warned that increased accountability could be difficult to achieve when there is little or no central control over foundation trusts. And a lack of expertise within the trusts themselves means few have the drive or knowledge to take action.
The solutions lie in a combination of evolutionary and revolutionary approaches; local, regional and national actions; and process and cultural changes
As part of a project exploring the impact of collaborative procurement, a QIPP workstream was set up involving 10 health bodies: Aintree University Hospital NHS Foundation Trust, Central Manchester University Hospitals NHS Foundation Trust, East Lancashire Hospitals NHS Trust, Royal Bolton Hospital NHS Foundation Trust, Salford Royal NHS Foundation Trust, St Helens & Knowsley Teaching Hospitals NHS Foundation Trust, Tameside Hospital NHS Foundation Trust, Trafford Healthcare NHS Trust, University Hospitals of South Manchester NHS Foundation Trust, and Wrightington, Wigan and Leigh NHS Foundation Trust.
While this has helped to build the evidence base for the impact of joint procurement processes, it has also highlighted the problems that threaten to stand in the way of the Government’s anticipated improvements.
Given the scale of savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices
Focusing on key procurement areas including orthopaedic surgery, audiology, and sutures, the project found that, on the positive side, clinicians appear to understand the challenge and have a major contribution to make. But it added that the overall commitment to collaboration between trusts is fragile and that the building blocks for change are not in place in many organisations. It also found that some trusts do not understand the procurement challenges or opportunities and a number of teams do not have the procurement expertise required to drive improvements. It added that, in some trusts, despite the growing evidence, procurement remains near the bottom of the list of priorities.
The DH’s plan is expected to provide some guidance for trusts, but the Government is also targeting the supply sector as part of its efforts to drive improvements.
The Cabinet Office’s head of domestic procurement, Ed Green, has revealed a five-point plan to improve transparency regarding NHS spending. It pledges to:
For more on the conference, click here