Procurement and Supply Chain Technology in the NHS – Are You a Pessimist or Optimist?

Hot Topic

Our hot topic this month is procurement in the UK health service. As we said here, it is a huge topic, and we’re going to have some insight from senior practitioners in the sector soon. But first, a bit of personal musing about technology generally and procurement technology more specifically.

The NHS has hardly been a shining example of technology strategy or implementation generally. The National Programme for IT (NPfIT) in the NHS was the largest IT programme ever attempted in the public sector, and may well be in the Guinness Book of Records as the biggest waste of money ever. (There is a very good case history here on NPfIT from Cambridge University, if you’re interested. Its conclusions contain this gem: “In short, there’s not yet any failsafe way of stopping a new senior minister with a strong personality, a big mandate, campaign promises, short deadlines, and no experience of major IT systems from sweeping all before them and initiating yet another disaster.”)

Since then, there are precious few examples of successful national IT health initiatives. As Roy Lilley said recently in his daily newsletter;

"The ubiquitous web making life easier.  Everywhere. Everywhere except the NHS ... There is pretty well nothing I can't Google, find out or research. Everything except anything useful to do with the NHS. I want the NHS in my pocket, on my phone, like I have the rest of the world's knowledge".

The way we use IT in our daily lives has improved so much in recent years, yet the technology capabilities we take for granted every day do not seem to have percolated into the NHS as yet.

Few top-down projects appear to have worked – perhaps the NHS is just too big, too complex, too diverse for that approach to be successful. Yet, to be optimistic, at some stage, technology will revolutionise healthcare, in many ways, and that must include in the procurement space. It is simply inconceivable that as technology changes ever other part of our lives, business and personal, that somehow it will not touch the NHS. Even if progress is slow, it will come.

But I wonder whether it is going to be a “bottom-up”, viral process rather than a big bang, top-down? I believe that is how and where we will see some positive developments. That’s one of the reasons I am just a little cautious about much of the Department of Health driven GS1 work; it’s not the concept so much as a mistrust of another centrally driven programme. I’m more optimistic about some of the projects we’re beginning to see at local level, where individual Trusts or small groups of Trusts are coming up with new idea, solutions and ways of using technology.

If you look at the work BravoSolution has done with a group of Trusts – some of the most impressive I’ve seen in this field – it was not even a top-down, national DH contract for basic spend analytics, let alone the linking of that data to health outcome information, which is what is proving so useful and transformative. Successful IT has developed as Trusts see the benefits and learn from each other. I’m hopeful that we will see other examples following, whether it is in supply chain and logistics, ordering, sourcing, risk management, data and performance management ...

There is plenty of scope for improvement, and it will eventually happen. The only questions are when; who will lead and drive it internally in the NHS and which solution providers will ultimately come through with the winning products that really will help the NHS.

Voices (2)

  1. Mark Lainchbury:

    Slightly off topic, but from your HSJ round table comments

    Peter Smith, managing director – Spend Matters
    “I would identify by acclamation the 20 best procurement directors in the system, and give each of them five or six less good trusts and say, ‘Sort them out as well, please.’”

    Not a criticism of the idea, but just wondering if it was “off the cuff” or something you have been kicking around for a while ?

    1: How would you motivate them to accept this challenge? Rather than just set up a consultancy.
    2. You can be a great procurement director, working in a poor Trust, getting modest results & vice versa. (Bit like inner city schools perhaps!)
    3. Most notable success stories in the NHS have needed capital, a good team & economies of scale. Would this translate to “less good” Trusts.
    4. How would the existing “less good” manager (and team) be expected to react, to a constant stream of ” In L**ds, we do it like this” ?
    5. So “acclamation” identifies the best, how do we identify the “less good” ?. Certainly the Atlas didn’t help.
    6. Isn’t this ( bringing in outside expertise ) what Trusts’s already attempt every few years with KPMG, PWC, E&Y,G&K etc.etc

    May well work at a board level though, get a Mourinho for a week – every 4 months, to try to stir some passion and share what can be achieved?

    1. Peter Smith:

      Mark
      It was off the cuff! Let me think further about your points which are very valid. But really I stick to my one fundamental thought – I really believe there are some excellent procurement leaders in health. I know it would not be easy, but these are people who would be managing billions of £ of spend in the private sector, as CPOs, but they might have £200-400M in a Trust I guess in most cases. I sort of feel that these are people who could take on more … and of course if they are as good as I think they are, they wouldn’t just do the “in L***s we do it like this” thing! You’ve got me thinking though, perhaps this is a topic for a serious debate somewhere!

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