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An independent procurement consultant has written a white paper calling on procurement to learn the lessons from the Francis Report into Mid Staffordshire NHS Foundation Trust.
Published last month, the Francis Report made 290 recommendations following an inquiry into the quality of care at Stafford hospital between 2005 and 2009. Most points concerned clinical care but it also concluded the trust may have lacked the ability to draft procurement contracts in sufficient detail to specify standards. Means of measuring compliance and remedies in the case of non-compliance “requires expertise which may well not have been available to many PCTs,” said Robert Francis QC. He also called for PCTs to “secure procurement skills that ensure robust and viable contracts”.
Following this, David Loseby, who was formerly CPO of Westminster City Council and hospitality group Stonegate, has recommended that trusts appoint a single CPO to help reposition procurement as a more strategic function in their organisations. “This would mean all procurement activity coming under one CPO reporting into either the CEO or CFO,” he said. He said many trusts did not have such a chief or they were not operating at a senior and strategic enough level.
Loseby recently spent a year working for Brighton & Sussex University Hospitals NHS Trust who asked him to come in and review its commercial set up. The trust has just appointed a CPO and plans to use his paper as a basis for its arrangements. While there, Loseby researched good and bad practice at other trusts around the country.
In terms of Mid Staffs he said it appeared that some complex multi-million pound contracts were managed by people outside procurement and sometimes by procurement professionals who lacked the training to handle such responsibility.
Meanwhile he said UK medical and pharmaceutical suppliers had invested heavily in their sales and relationship management teams, meaning they were better trained and equipped and giving them an advantage over the NHS when it came to negotiating and managing contracts. “It’s almost like they’re profiting from the NHS,” he said. “If ever there was a case for investing in procurement skills in the NHS, this is it.”
Loseby said he believed these issues were typical among many trusts. “If you look at the way the NHS is structured and the lack of training and development it’s not surprising that (procurement officers are) underperforming.They’re both undervalued and underdeveloped in terms of training.”
He believes many procurement professionals “don’t have the training, development and experience to manage complex multi-dimensional supplier relationships”. And because clinicians had largely been the dominant force within the NHS a partnership “hadn’t been forged with management, though there were exceptions”. He said around 10 per cent of hospitals properly embraced a partnership approach between procurement, other senior management and clinicians, he said and Manchester, Birmingham, Portsmouth and Sheffield were among them.
Referring to his recommendation for trusts he said: “The CPO will ensure that strategically focused resources are in place.”