Comment

The roadmap to successful clinical information system procurement

Tom Slater, assistant director of provider procurement for NHS Shared Business Services, reports on a recent forum on clinical information systems.

NHS organisations have a real opportunity to achieve greater productivity savings through investment in information and digital technology when they take over responsibility for end-to-end clinical systems management once the CSC Local Service Provider (LSP) programme ends in July 2016.

This was one of the clear messages during a recent forum organised by NHS Shared Business Services (NHS SBS) jointly with the Health and Social Care Information Centre (HSCIC) as part of their ongoing working relationship to provide trusts with appropriate support.

With the ending of LSP contracts looming closer, the forum shared with delegates the best approach they could take when procuring clinical information systems and how the framework that NHS SBS introduced earlier this year would provide a suitable exit route.

While work to support trusts exiting from the LSP contracts is challenging and complex, good progress is being made as a result of strong joint working relationships between providers, HSCIC and stakeholders such as NHS SBS.

One of the stand-out points was the potential contribution that providers could make towards the £22bn NHS productivity challenge, as highlighted by the King’s Fund, by focusing on improving their digital maturity.

While there is currently a varied picture across the NHS as to how much digital technology is exploited within individual organisations, the overriding message was that increased efficiency and quality benefits were in the offing if each organisation aimed for greater maturity.

NHS organisations need to consider all the financial, clinical and operational implications when procuring clinical information systems so it is critical that they procure the right technology, on the right contract, with the right service and at the right cost.

Another equally important consideration is the need for each organisation to assess its own capabilities to manage programmes and ongoing services. Here it’s important to put in place the right leadership to drive forward change management, benefit realisation and adjust working practices to optimise clinical pathways.

A vital first step before any procurement is set in motion is actually to take time out to think, answering key questions such as: ‘What is the best possible outcome of a procurement?’

Similarly, it will pay to look carefully at how the organisation’s typical buying behaviour can affect the pre-engagement stage and the outcome of the procurement.

This is because there are several behavioural paths that organisations need to think about – some veer towards outcomes leading to supplier opportunism, while others lean towards feasible foresight, whereby they look ahead, uncover potential hurdles and work out the mechanisms that enable them to steer clear of potential contractual hazards.

By answering these initial vital questions and scrutinising previous behaviours, organisations will be able to focus exactly on what it is they need, and learn from the past in order to achieve a better outcome.

When embarking on the procurement path, NHS SBS’s clinical information systems framework provides crucial guidance and support, including the provision of templates that help keeps each stage on-track and relevant to the needs of the purchaser.

Finally, NHS SBS advocates a seven-stage strategy for procuring and phasing-in clinical information systems:

1. Clinical engagement

Engage with all stakeholders right from the start and maintain this engagement throughout the planning and implementation phases.

2. Mobilisation & governance

Establish the leadership and a cross-discipline team that will instil and maintain the governance needed on the project.

3. Procurement requirements

Engage with stakeholders to enable a clear mapping of the requirements.

4. Sourcing strategy

Talk to suppliers early in the process to understand the market and the benefits of each system. This will then enable a procurement strategy and business case to be developed.

5. Procurement

Prepare the tender and evaluate the submissions. Focusing on the ‘know your needs’ requirement will ensure you have a clear focus on the right specification, tender questions and demonstrations you require from suppliers. Templates in the NHS SBS clinical information systems framework facilitate this.

6. Implementation

Plan carefully for the integration, testing and piloting of the system, including establishing a robust communications and training programme, and a method of extracting data to evaluate the system’s performance.

7. Supplier management

Once a system is up and running, it is still important to manage the supplier, evaluating the system performance and the maintenance, support and change management that is provided.