Health Service Focus

Time to empower procurement professionals in the NHS

Helen Lisle (pictured), associate director of procurement at County Durham & Darlington NHS Foundation Trust, discusses the interim report from Lord Carter of Coles on NHS efficiencies and the need to empower procurement professionals in the sector.

Lord Carter of Coles’ interim review into the operational productivity of NHS providers suggests that the NHS could save up to £5bn a year by 2019-20 through efficiency measures alone, especially in procurement.

The report, based on data collected from a cohort of 22 trusts, identified that £2bn could be delivered by improving workflow and containing workforce costs, and a further £3bn could be saved by improving hospital pharmacy and medicines optimisation, estates and procurement management by adopting best practices and modern systems.

Lord Carter believes the quickest way to solve the problem of “poor procurement data on prices and volumes” is to accelerate the implementation of a “single NHS electronic catalogue”, which he has been working on.

NHE has since caught up with one NHS foundation trust that has spent many years creating regionally – through the County Durham Procurement Consortium – what Lord Carter is asking for nationally.

Helen Lisle, associate director of procurement at County Durham & Darlington NHS Foundation Trust (CDDFT), who is also chair of the Health Care Supply Association, said it was good to have an objective and independent examination from outside of the NHS. “Where trusts become focused upon looking inwards, they can become insular and miss opportunities to learn and develop from others,” she told us.

She added that while Lord Carter’s report identifies a number of elements that cannot be argued with, “from a procurement point of view it doesn’t identify much, if anything, we didn’t already know”.

People already knew that spend data was patchy across the system and that there hasn’t been an agreed national approach to deliver clean data. “This was supported by the fact that from the data collected from across the 22 trusts within the cohort, only 18% could be matched,” said Lisle. “There will be a number of reasons for this, ranging from the lack of catalogued spend through to the inconsistency of how spend is catalogued across trusts.”

CDDFT has a centralised procurement team that supports all aspects of non-pay spend, with the exception of pharmaceuticals, managed by the trust pharmacy department.

“The team provides a full procurement service, from strategic procurement planning and advice right through to the delivery of a materials management service at ward level,” she said.

Over recent years, CDDFT, with support from eProcurement provider Wax Digital, has been able to link 90% of the volume of its purchase orders to eCatalogues.

Lisle told NHE the Department of Health’s eProcurement strategy goes some way into directing standardisation with the introduction of PEPPOL and GS1, which NHE has reported on in great depth recently.

“But we are some way off, across the country, achieving that,” she said, adding that it will be “interesting” to see how trusts have developed their initial plans to meet the requirements for the eProcurement strategy. The original submission date was March, then extended to 30 June.

Discussing the importance of inventory management within trusts, which Lord Carter also raised, Lisle said the need to be able to track products from purchase to patient is critical and well-documented. “What is the point of investing in robust contracting approaches to drive efficiency at the front if you have little control at the back-end?” asked Lisle, referring to inventory management. She added that unless the right controls are in place then a potential for savings is lost through “maverick” spending, over-ordering and out-of-date stock going in the bin.

On top of this, Lisle welcomes the recommendation on the introduction of something similar to the US Sunshine Act, which requires suppliers and clinicians to disclose their commercial relationships.

However, Lisle would like to further understand how it would be facilitated. “I do wonder where the cost of facilitating such an Act would lie,” she said. “If accreditation/registration is costly to the supplier, we would be very naïve to think that cost is not going to be transferred through to trusts somehow.”

Lisle said she is concerned about the inconsistency of messages coming from the centre, and the amount of money and time required to enact Lord Carter’s recommendations. “It actually takes quite a lot of investment, capacity and having the right people with the correct skillset to achieve the outcomes,” she said. “In the NHS I worry that we don’t have the ability to retain and attract the best procurement practitioners.”

She thinks it is time for the NHS as a whole and individual trust boards to accept their responsibility to invest and empower procurement professionals.