Procurement in UK hospitals – must be a good QIPP there

Appalling puns aside....I spoke recently to one of the people who is heavily involved with the Department of Health's QIPP  programme (quality, innovation, productivity and prevention) which includes a procurement workstream.  The focus is very much on improving hospital procurement, which the recent NAO report criticised for lack of co-ordination and standardisation, rather than commissioning of health services.

The programme has a number of items on their procurement agenda. They recognise that Hospital Trusts are increasingly independent of the centre, and as all become Foundation Trusts over the next couple of years, that is only going to become more pronounced. So progress will have to be made through winning 'hearts and minds' rather than dictat.  Becuase of this, a lot of the focus is on communicating with CEOs and CFOs, as they are in most hospitals significantly more powerful than the CPO (if such a creature exists, which is unusual).

So the review of prices provided to Trusts (featured here in Supply Management), and which showed major variations, was one element of this, and another, perhaps even more interesting, was a 'diagnostic' (available here) aimed at the top  managers which QIPP also circulated.

It asks 25 relatively simple questions, the answers to which should give the C-Suite management in a hospital a good idea of how strong their procurement is, and what they might do about any shortfalls. For example, the first question is:

"You have procurement representation on the board and procurement issues and risks are given board time monthly". The multiple choice responses are "always / amost always / sometimes / rarely".

It is in effect a very cut-down version of the OGC procurement capability reviews, but it is very thoughfully positioned and I suspect many CEOs, not just in hospitals, could benefit from doing something like this.

The QIPP team are also looking at introducing common product coding, which would enable easier comparison of prices and more standardisation. Of course, the fact that the centre cannot dictate is frustrating; for instance, you can imagine how beneficial it would be if every hospital used a single spend analysis platform. But they don't; Spikes Cavell, @UK,  BravoSolution, Rosslyn... all (and no doubt others as well) have spend analytics business inthe sector but there is no standard or national approach.  Something along the lines of a 'Spotlight on Spend' for hospitals would be great.

The QIPP team are also providing guidance on procurement sustainability issues, and looking to work with the 'innovation' programme which as you might expect looks at innovative ways in which better health outcomes and better value can be obtained.

So there's a lot to be positive about, and everything the team are working on seems sensible.  If the diagnostic is used it could have a very positive effect on procurement in hospitals - although that is a big 'if' given the myriad priorities facing Trust CEOs.  And tomorrow we'll take a look at some of the barriers to progress in the sector, what QIPP is doing to overcome then, and what more may need to be done.

Voices (2)

  1. Flog:

    Ops Peter – that question “You have procurement representation on the board and procurement issues and risks are given board time monthly” causes me to get on my ‘soap box’ (again)! How can that question be answered in a single statement? Maybe on the odd occasion, but certainly not frequently. I would suggest that the ‘always’ and ‘almost always’ statements would be the most infrequent. If the questions are being automatically scored by the system behind the input screen, how can the outcome be reliable? To get any level of sensible response, this should be 3 sepatate statements each dealing with a single point e.g.

    Q You have procurement representation on the board
    Response options: Yes or No

    Q At the Board meetings, procurement issues are given board time monthly
    Response options: Yes always, Yes sometimes, Yes rarely, No, N/A

    Q At the Board meetings, procurement risks are given board time monthly
    Response options: Yes always, Yes sometimes, Yes rarely, No, N/A

    These multiple questions with a single range of responses, usually Yes / No, within the likes of PQQ really get my blood pressure up, and at my age and BMI ….

    Automated systems, need simple, single issue questions!! I remember years ago trying to complete a mandatory online questionnaire about procurement in my organisation within its public sector area where things were ‘getting better’. The question was “The organisation has an approved procurement policy that is consistently applied” Yes / No. How was I to answer? Yes we had a policy, but was is consistently applied, sometimes. So, what did I respond – Yes (because saying we didn’t have a policy was greater sin that bending the truth about its application). No doubt, many other respondents answered in the same way, because as a sector it appeared that we were doing well (ok better) as the majority had ‘an approved procurement policy that was being consistently applied’.

    Rant over!!

  2. Rob:

    Let’s see (and hear) what the NHS CEO, and the PAC, had to say about all of this….

    http://www.parliamentlive.tv/Main/Player.aspx?meetingId=7948

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