Health Service Focus

National collaboration in medicine procurement

Howard Stokoe, principal pharmacist at the Commercial Medicines Unit (CMU) at the Department of Health, spoke to NHE about maintaining a collaborative approach to procurement and supply.

The Commercial Medicines Unit (CMU) is part of the Department of Health’s procurement division, which focuses on strategic management of medicines for use in secondary care.

NHE talked to principal pharmacist Howard Stokoe about maintaining a system that works in a maelstrom of change, and how information is the key to successful medicine management.

He said: “Patients need medicines that are safe and supplied and administered with the minimum amount of risk. The overriding objective in the way we source medicines is that they are available to treat patients when they are required. They must also be appropriately selected, safely administered and safely used.”

One of the key factors behind effective contracting is the information available concerning every order placed by the NHS with the supplier. This means that success and value for money can be very easily measured, Stokoe said.

“The CMU aims to ensure the NHS is conducting business in a modern way, as efficiencies must be found right across the public sector. In the NHS, we are fortunate that information is centrally collected; this means everybody can monitor it to see how it’s changing and performing. Our strategy is well aligned with some of the best medicine procurement strategies in the world.”

Maintaining current systems

Despite significant upheaval throughout the NHS, the strategic framework used to manage contracts for supply of medicines will remain largely the same.

Stokoe explained: “Our strategy for medicines procurement is recognised as working by the majority of the NHS. The NHS is changing and even though national commissioning is coming in, our current arrangements are remaining in place. It would be counterproductive in the short term to change. The new stakeholders will be able to review the existing structure and evaluate the need for change in the future.”

Stokoe described the good relationships and communication between SHAs, PCTs and the acute trusts, adding that this type of relationship would have to be achieved with the new commissioners before effective communication is established.

“The CCGs are still forming so we don’t yet have a network of communication in place,” he said. “Those relationships will start to emerge as we get more clarity on how they’re going to work and develop. When they are in place, the communication will flow.”

The best deal

Change may be counterproductive in the middle of a full-scale reform – but it may not be a matter of choice for specific trusts who are struggling to manage their finances, and looking for areas to cut.

Stokoe said that while it was obviously an issue for individual trusts, a collaborative national approach was the best way to achieve the greatest value for money.

He pointed out: “A collaborative national approach to medicines procurement is the best way to achieve the greatest value for money. Some NHS trusts often think they can do better on their own, but a collaborative approach is the best way to negotiate with suppliers.

“It leads to better relationships and dialogue with them, it avoids duplication and means suppliers can do business with the NHS in a consistent way. Doing business in different ways just adds to their costs.”

Collaboration and coordination

It was this collaboration that could be used throughout the NHS to drive improvements and consistently secure the best deal, he added.

“We have very strong collaboration held together by systems and information. This is key in the relationship with the CMU as the contracting authority: it’s a nationally coordinated approach, but locally delivered.

“This means it is not CMU making the decisions, as it’s the NHS spending the money. It works for everybody – the suppliers, the patients and the taxpayers.”

Maximising collaboration could also be used to balance the risk of creating a monopoly in the supply of a certain type of medicine, which could potentially damage patient health, as well as allowing prices to rocket.

“Our contracting model ensures we distribute business between a minimum number of suppliers – this is a more intelligent way to conduct business,” Stokoe concluded.

“It’s really important that we manage that properly. There’s a real performance issue here. It’s about having confidence in your suppliers and building good relationships with your suppliers.”

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