Readers’ comments – NHS procurement and the Advisory Board

We’ve had some very good debates amongst our “comments” in the last couple of weeks, with  excellent contributions from readers. So over the next few days I’m going to feature some of those discussions here and re-visit some of the most-read recent pieces.

Let’s start with one that didn’t get many comments, but the couple we had made me think we should follow up the discussion. " Sam Unkim" (no, not sure if that is his / her real name) provoked this with a  comment  in response to our write-up of the Advisory Board, who provide services to hospitals and other health bodies. They are carrying out spend analysis type work, as well as what we might call information  provision, community building and a certain amount of consulting support. Here is Unkim’s comment, pretty much in full;

 Let’s not forget, the NHS is supposed to have procurement hubs, capable of carrying out all of the functions above, and the QIPP work stream is tasked with these as well. Of course the Advisory Board is developing a benchmarking service. In effect they roll the PO data of each new NHS customer into their previous dataset. Hardly ground breaking stuff given each Trust has to pay for the privilege.

Have we NHS purchasing staff, been so alienated from each other (by artificial market competition) that the only way we can communicate is through membership of an American Consultancy “community”? And finally, all these kind of companies really offer is a chance for CEO’s and CFOs to starve their own internal staff of commitment and other resources, whilst they wait for the next magic short-cut to procurement savings.

I’m featuring this because Unkim makes some very good points. Of course private firms seek out opportunities and gaps in the market – but the question for me comes down to whether the UK system has the capability, and political desire, to provide the sort of services that private sector firms like the Advisory Board are now offering.

I agree that in an ideal world, the public sector in health would be doing more from the centre to drive better procurement itslef – we have said that before. But it doesn’t look likely to me that this is going to happen as hospitals are becoming ever more independent and central resources reduce, despite the best efforts of some very good people in the central Department of Health. We mentioned previously that the resource that went into the procurement related QIPP effort was high in quality, but low in quantity.

So do we think the sort of things suppliers are doing are worthwhile? I’d argue they are, and whilst we might prefer to see some of the services provided internally by the public sector, we should be pragmatic about that, and accept that maybe it will have to be the private sector driving some of this.

Final Furlong chipped in as well. (I’ve tidied up his / her slightly garbled comment, obviously written after a hard day on the gallops).

Hubs, and the like don’t do this. They can’t afford it. There is plenty of benchmarking being undertaken and no-one is doing it for free. Data in the AB model is regularly updated (I am told).

Yes, NHS buyers could and would communicate with each other but no solution, aside from email, exists (yet). NHS must deliver £1billion+ in procurement savings  - so why are you surprised that CEOs and CFOs are doing everything they can to target product savings rather than people?

There is another approach though that might be a “third way”. The Department of Health could, for instance, contract with a third party to provide spend analytics across the whole network. Not only would they receive significant economies of scale from the provider, they would then in the centre be able to access (in time) a complete spend picture across the system.

Expensive? Yes, but as Unkim points out, hospitals are spending considerable amounts now with organisations such as Advisory Board and other software / solutions providers. And imagine the benefits if we could have a truly national picture of spend, including pricing, suppliers, volumes, across the whole hospital system. The opportunities for driving value would be huge.

But then, as "Rob" pointed out, there used to be something with the capability perhaps to do this in health; NHS PASA...

Anyway, thanks to all our commentators, and we’ll have more on health procurement shortly .

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Voices (6)

  1. Elephant in the room:

    NHS PASA may well have had the capability to all sorts of valuable things including gathering spend data….but why didn’t it? The points made are valid, but surely they were also valid 10 years ago. Hindsight is something we don’t have a shortage of in the public sector – must be time to unearth Gershon again – coudl do with a bit more forseight, perhaps.

    As I’ve mentioned Gershon, it reminded me that wasn’t he set up as one of these super clever businessmen who were advising Maude and co on how to do good procurement? I don’t seem to have heard much on the impact he’s been making……

    1. Sam Unkim:

      Mention of Gershon & Efficiency Review = Troll.
      (extraneous comment with the primary intent of provoking readers into an emotional response)
      It worked … Teeth grinding this end………

  2. Stephen Heard:

    I am a member of the National Committee of the Health Care Supply Association (HCSA) and we are working on many fronts inlcuidng being the focal point for all NHS procurement professionals. Have a look at the website and try and come to our free annual conference in Birmingham. HCSA membership is free and it is the only truly UK forum for NHS procurement.

    1. Sam Unkim:

      Hi Stephen

      “Raising our Game” specifically tasks HCSA with

      • Benchmarking facilities, including trust dashboard metrics and price
      • Networking
      • Learning and development for procurement professionals and staff
      • Policy advice and communications
      • Ownership of best practice and the NHS standards of procurement
      • Guidance on how best to use outsourced procurement partners
      • Development of an academy for NHS procurement

      So you could, in effect kill whole topic dead, by giving us a liitle progress update

  3. Little Acorn:

    Didn’t Scotland do something like spend analysis across the board? Perhaps someone north of Hadrian’s Wall could provide some information on how it worked, what benefits accrued etc. Is it still happening?

    1. Ian Burdon:

      Scotland not only did this, it still does and the information is published. The link is here –

      I understand that DoH commissioned an analysis of expenditure in England and Wales from Bravo but don’t have any details to hand.

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