Unsung heroes of the NHS

3 February 2011
Yesterday the news was full of the National Audit Office (NAO) report that the NHS is wasting £500 million buying A4 paper, gloves and other things at different prices from different suppliers, throwing away money on repeated low value orders. Not having access to the raw data we can’t assess the veracity of their claims, however, having worked with NHS people for a number of years there are things to say beyond the bold headlines.
  1. The coverage does not indicate how the low value orders were made. Is the NAO including procurement card and online web catalogue “orders” equally with, say, six part purchase order sets? If they are the comparison is invalid for the latter is inefficient and the former highly effective.
  2. Who is the decision-maker for purchasing these low value orders? I don’t work for the NHS but my external observation is that the NHS purchasing and supplies staff continually have to fight to wrest control of spend from others who think they know better. They can only be as effective as their organisation lets them be. I know of one situation where a stationery budget within a hospital department was being used to purchase laptops as the department did not like the Trust’s contract.
  3. Even though the aggregated spend of the NHS on stationery and gloves is big bucks, the NAO has focused on relatively worthless items such as these (we would call them tactical acquisition). Why has it not reviewed and commented on big ticket purchases such as X-ray machines and prosthetics? Here, as I understand it, we find economies of scale being missed because key stakeholders in Trusts cannot agree on a common supplier and, despite the EU procurement rules, insist on their own preferred supplier. As everyone will realise this has a knock-on effect in terms of spares and stockholding, all adding to the total cost of running the NHS.
By and large in my experience procurement teams are the unsung heroes of the NHS fighting a battle to implement best practice, a battle which they all too often lose to characters like Sir Lancelot Spratt and the argument of ‘clinical preference’. By the way, Spratt, for those of us old enough to remember him is ‘alive’ and well, or so I understand!
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