The majority of the NHS’s imports come from overseas businesses, and rising import costs post- Brexit pose a significant threat to purchasing budgets. Around £5.7bn per year (or around 4% or the NHS’s overall budget) is currently being spent on the procurement of supplies and medical equipment.
This means that there are huge potential savings to be made by streamlining current procurement procedures in order to ensure maximum efficiency. [9] For example, falls have been estimated to cost the NHS around £2bn per year, but a new technology introduced to the Salford Royal Foundation Trust has the potential to reduce patient falls by up to 57%. Light therapy sleep masks have also been introduced in select practices to tackle the progressive blindness caused by diabetes and macular degeneration, and it is claimed that these technologies alone could save the NHS up to £1bn per year.
This is would be enough to cover the earnings of an extra 16,000 junior doctors. The benefits to both patients and the NHS as a whole from such initiatives could be enormous. [10] The procurement process at present is complex, fragmented, and in drastic need of reform. Even once a product has been approved, procurements teams must convince every hospital to adopt it one by one, something smaller businesses cannot easily afford to do.
The main goal of hospital procurement staff is reduce their individual purchasing prices, rather than concentrating on strategies that reduce costs for their organisation as a whole. The disunited purchasing structure of the NHS has meant that the adoption of new technologies has turned into a ‘postcode lottery’. [11]
It is vital moving forward that the focus of solving the challenges of NHS procurement moves towards establishing a national standard for product pricing and reducing product variation. This will allow major savings to be made through aggregation.
Several initiative has already been established to achieve these aims;
– The Nationally Contracted Products (NCP) programme has produced a list of products recommended for purchase by NHS organisations. By stimulating overall demand, this will reduce total purchasing costs and allow for greater saving. It is estimated that the purchase cost of couch roles alone could be reduced by up to 15% using this method.
– The High Cost Tariff Excluded Devices programme aims to centralise procurement of high-tech devices to achieve greater pricing transparency.
– The Trusted Customer Company programme allows senior procurement experts to develop closer working relationships with the NHS supply chain, combining efforts to optimise strategy for priority product categories.
– The independent NHS Clinicians Evaluation Team conducts centralised product evaluation and selects products for use in NHS organisations, reducing the need for local evaluation activities. [12]
This work could and should be done by a single, centralised body, with the responsibility of receiving, processing and evaluating product initiatives submitted to it. This organisation could then assess which technologies should be applied regionally or nationally and in which departments, and be able to mandate the uptake of some and strongly recommend the uptake of others. [13]
“Renew is interested in championing precision public health and precision medicine. Data driven innovation, amalgamating knowledge and with the emphasis on smarter systems is just one arm of our NHS policy. Centralising procurement has significant benefits and savings and whilst the work so far has been impressive there is a need for a more coherent approach.”