LLP Conference – Some Positive Signs for NHS Procurement

Last Friday there was a real buzz around the NHS London Procurement Partnership conference which went by the snappy title "Savings and improvement for the NHS by the NHS through collaboration to deliver better patient case". Held at the Barbican, it was standing room only as around 100 procurement folk crammed into a strange shaped room to hear about the Carter Report implementation, agency staff issues, collaborative procurement (and a bit from me too).

There was some fascinating discussion about the agency cap (for temporary medical staff) although it felt like a somewhat complacent view from NHS Improvement - "it's all going very well" when in fact we are seeing some real system problems - such as the worst figures in A&E for years. Some real analysis of whether the cap is at least in part to blame for that is perhaps needed? We may come back to that in a further post.

But there were many positives too, as the LLP seems to have a real momentum now. Even in that contentious agency area, it has led some effective collaborative action in London. And in a totally different field, that of PFI contracts, the value of a structured and professional approach to re-negotiating contracts that many assumed were untouchable has been demonstrated.  One Trust has saved £5 million by a data and market information-driven approach to negotiation of FM costs, part of the PFI deal.

The most encouraging session was from Professor Tim Briggs, who has led a national initiative around Orthopaedics and is now "National Director for Clinical Quality and Efficiency for the NHS".  He is an eminent surgeon and a very straight talking, direct and impressive chap. He talked about the issues around "variation" - different clinicians and hospitals using different equipment and devices. That leads to vast differences in cost and indeed outcomes, and there are few good reasons why this is the case other than clinician custom and practice. Briggs has visited 240 hospitals in his role - "I've heard all the excuses, I've had all the bulls**t" he said.

But this is not simply about reducing prices or aggregating volume. The work is also looking at clinical performance and outcomes, and some of the most shocking numbers he quoted related to post-op infection rates in different Trusts. Spreading best practice, using the best and best value implants and devices, reducing the number of doctors and sites doing very small numbers of a particular operation - all this will save large sums of money and improve clinical performance.

We will certainly come back to a more detailed report of that presentation. There was also some discussion of the future operating model and the "what replaces NHS Supply Chain" debate. That is becoming clearer and again is something we will cover in the future. On the Carter implementation issue, that is now the responsibility of the new NHS Improvement organisation. There are still some outstanding questions about resource and skills in NHSI to execute that, but clearly things are happening, and we should see a national price benchmarking solution in action by the summer, for instance.

So all in all, there are obviously still huge challenges for the NHS and NHS procurement, but the LLP event was generally encouraging; lots to do, lots of issues, but it does appear that progress is being made. Finally, more senior procurement people in the sector than ever are simply talking to each other, which must be good.

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