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Driving savings in procurement

Jennie Brice-Boutard writing on behalf of NHS Supply Chain explains how strong clinical engagement, dedicated resource and a close procurement partnership helped Gloucestershire Hospitals NHS FT deliver over £600,000 savings.

With increased pressure on budgets and maintaining high standards of care, individual departments within trusts are finding themselves in new territory in procurement that will inevitably require a change of approach. 

By working in collaboration with trusts to help maximise their procurement budgets, NHS Supply Chain has shown that challenging the status quo can, and will, deliver considerable savings. 

Identifying the right contract area, engaging with clinical teams and having the necessary support are all key factors that helped Gloucestershire Hospitals NHS FT save over £600,000 on orthopaedics without compromising quality or patient care. 

The challenge 

Gloucestershire Hospitals is a large acute hospital trust providing high-quality acute elective and specialist care for a population of more than 612,000 across two hospital sites. Like many other NHS providers, it is experiencing unprecedented financial pressures as it continues to protect frontline staff and deliver high-quality care for patients. 

Delivering year-on-year efficiencies from non-pay budgets is essential, with high spend areas like theatres being closely monitored and challenged to demonstrate they are delivering good value for money. 

Given the complexity within theatres, especially within musculoskeletal, it was imperative for the trust to select the right contract area and procurement partner, which would require full clinical engagement across the entire trust. 

The trust’s objective was to realise 10% savings in orthopaedics, whilst ensuring surgeons continued to use top ODEP (Orthopaedic Data Evaluation Panel) rated implants, and ensuring patient safety and outcomes remained unaffected. 

Deborah De Wit, general manager of Theatres, Anaesthetics, Critical Care & Pain at Gloucestershire Hospitals NHS FT, said: “We had to be realistic. What we were looking to potentially do would require a significant clinical change for several consultants, which would require training.” 

Solution 

Strong clinical engagement, dedicated resource and a close procurement partnership with NHS Supply Chain saw the trust beat its objective to deliver more than £600,000 savings, equating to over 17% annual savings. Here’s how they did it: 

• Identification of the right contract area with the potential to deliver the required savings: hip and knee
• Recruitment of a dedicated Specialist Project Lead with procurement expertise reporting to theatres team, providing greater transparency, visibility and support to the surgical teams involved
• Stakeholder mapping to understand who needed to be involved and when
• Developing a Clinical Reference Group, to ensure the required clinical input was secured. This included lead surgeons and the orthopaedic directorate as well as the stock control manager; general manager of Theatres, Anaesthetics, Critical Care & Pain; consultant orthopaedic surgeon – Hip Lead; and consultant orthopaedic surgeon – Knee Lead
• Working collaboratively with NHS Supply Chain gave the trust the flexibility, within an existing national framework, to support their strategy on supply. The trust also benefitted from the expertise of a senior services manager and full trading team to formulate the correct approach and strategy, to maximise saving potential whilst minimising risk
• Review of data and savings arrangements. Understanding the full scope of savings possibilities was vital. Paul Dennis, senior services manager at NHS Supply Chain, and Michele Woods, the trust’s stock control manager, reviewed the breadth of saving arrangements available to the trust, highlighting what would be involved, the degree of difficulty and savings impact
• Engaging the suppliers via three-way detailed briefing meetings
• Going to the market and issuing pricing exercises
• Presenting findings back to surgical teams to ensure joint understanding
• Making the decision to award – the final decision being made by the Surgical Board
• Ongoing support. Once the savings had been identified, to actually ensure they were delivered, NHS Supply Chain committed ongoing contract management support for the life of the contract 

Michelle Woods, stock control manager at Gloucestershire Hospitals NHS FT, said: “NHS Supply Chain’s industry experience and proven success in achieving savings for trusts was vital, assisting us to formulate a strategy and understand the risks and benefits associated with each potential saving option.” 

For both hips and knees, the overwhelming opinion of the surgeons was that the best financial deal would be achieved by moving to a sole supplier. The greatest savings would be possible by moving to the one company, with the risks of doing so discussed and scoped in great depth. The final decision was made by the Surgical Board following input and discussion with all stakeholders, including the submission of additionally requested information and risk assessment. 

Useful insights 

Upfront stakeholder mapping and agreement can be useful. For instance, establishing who needs to be involved, when and at the right time. This secures and maximises support and everyone’s efforts. Getting everyone to agree priorities within a first collaborative meeting is also crucial. 

Also appointing a stock control manager to oversee the project was invaluable from early detailed analysis through to project implementation. Without this post the theatre management team would not have been able to dedicate sufficient time and achieve successful implementation.