NHS Procurement – so who do we blame for the dodgy spend data?

The furore, in the procurement world at least, around the publication of NHS spend data last week has been considerable. And when you've got respected non-execs of major trusts writing to the Minister then we might assume this hasn't gone away as an issue yet.

The problems with the data were well described in the comments here and in our guest post yesterday. Basically, the data came just from one supplier to the NHS, which was the in-house supplier, NHS Supply Chain (run by DHL). So the Minister was criticising something that was a political construct in the first place, and is in theory totally under his control. So it did not consider where Trusts are buying from elsewhere, or the specification or quantity differences between items purchased. It also ignored anomalies like the stories we featured yesterday.

They are the sort of issues that the Minister doesn’t seem aware of, and of course the national press don’t give a damn about the actual facts if it looks like a good story. Even Colin Cram got the wrong side of the argument, being demolished by Tony White (procurement director at Sheffield Hospitals Trust, one of the innovators and leading lights in NHS procurement), after Cram’s piece on the Guardian website last week promoting his usual arguments for a national approach to everything.

We don't believe most procurement heads would complain about accurate data on performance being published. The act of publication is not what is being objected to here.  Rather, it is clear that the data in the Atlas does not reflect in any real way the procurement performance of trusts or even indicate areas for improvement. And disappointingly, it has damaged trust between the procurement professionals in the system and at least some elements in Department of Health. As one of our commentators said, it stands as a very poor example of change management, apart for anything else.

How did it happen though? The conspiracy theorists will say that the Tories want to sell off the NHS to the private sector, so rubbishing current performance is a good way of softening up public opinion prior to further privatisation. I don't buy that personally – after many years of being involved in some sense in public procurement, my philosophy is that if you're not sure whether something is conspiracy or cock-up, it is almost always cock-up.

Clearly, it wasn't Department of Health procurement people who suggested this data was published. Or, I suspect, NHS Supply Chain. Actually, I feel a little sorry for DHL who operate NHS Supply Chain, and the NHS Business Services Authority who manage that contract with DHL. I know some excellent people from both of those organisations (you know who you are...) They must have known that the data was flawed, and wouldn’t tell us anything about competence or procurement opportunities in Trusts.

So the Minister, Dan Poulter, was badly advised or showed major misjudgement himself. I wonder if he got carried away by the sexiness of the whole “Atlas” idea. Clever maps you can click locations on! Little coloured dots that indicate prices! Ranges and variations to make it all sound mathematical! To a busy Minister, might that have seduced him so that he didn't ask the really key questions that we should always ask when faced by data. Where has it come from? How reliable is it? What does it actually mean?

And if you haven't read our anonymous post from a practitioner yesterday, please do. It is all worth reading but the story about the Hertfordshire gloves purchase is a classic. I will be using it to illustrate the dangers of using data badly in presentations and at conferences until 2030 at least!

Voices (2)

  1. Bob Beveridge:

    Having championed transparency it seems Dan Poulter got carried away looking for a pre-summer break press release. The issue about NHS Supply Chain had been explained to him so there is really no excuse. I have followed up with his office but am told they are on holiday. Plus ca change….

  2. Secret Squirrel:

    “I wonder if he got carried away by the sexiness of the whole “Atlas” idea. Clever maps you can click locations on! Little coloured dots that indicate prices! Ranges and variations to make it all sound mathematical!”

    Did you not know that was what ‘digital’ is all about? Get with the hip kids at GDS, Peter! They can debate fonts for hours (https://gds.blog.gov.uk/2012/07/05/a-few-notes-on-typography/) , spend time producing videos (https://gds.blog.gov.uk/2013/07/12/this-week-at-gds-38/ as an example) and reskin gov.uk endlessly.

    More seriously, how are the DH procurement people not at fault here? Can anyone point to an action they have taken and actually driven through to delivery in the NHS? They seem to me to be a classical set of procurement strategy developers with no way for making the ‘strategy’ happen except through lip service actions.

    My view is that this is their shot at the ‘benchmarking’ part of the ‘strategy’. They didn’t have the data, but they said we will do it so they did what they could and never mind the fall-out.

    And could anyone tell me if any of the actions in the NHS procurement strategy have been delivered? Properly and to time?

    https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/226835/procurement_development_programme_for_NHS.pdf

    Genuinely interested as I would love my hypothesis to be proved wrong.

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