'Change procurement policies to cut NHS bed blocking'

Will Green is news editor of Supply Management
5 September 2018

Better procurement could reduce the problem of bed blocking in the NHS.

In a report the British Healthcare Trades Association (BHTA) said a focus on lower prices tended to override speed of delivery, which proved to be a “false economy”.

The report said: “Procurement policies need to change to promote speed of delivery and long-term cost/benefit analysis for all involved.”

The BHTA said bed blocking was increasing, from 109,918 instances of delayed transfer of care in August 2010 to 144,997 in April 2018. There was a peak of 200,095 in October 2016.

In April 2018 reasons included awaiting completion of assessment (16,908), awaiting residential home placement or availability (19,777) and lack of community equipment and adaptations (4,950).

Bed blocking “impacts almost every area of healthcare provision”, lengthening waiting times and delaying treatment “which can then exacerbate health conditions or slow recovery rates”, said the BHTA.

The report said: “The continuing division between NHS and local government procurement policies means that many people do not get the equipment that they need provided to them in timely fashion, and overall taxpayer expenditure increases significantly and unnecessarily.”

The BHTA said there were problems with awarding contracts on the basis of Most Economically Advantageous Tender (MEAT).

 “Too often current procurement practice does not allow for cost efficiencies to be taken into account…if the beneficiary is a different department or healthcare organisation to that of the purchasing budget holder,” said the report.

“Invariably lower prices tend to override speed of delivery when it comes to the supply of community care equipment. This often proves to be a false economy when other costs are factored in (including additional community nursing needs, respite care provision and of course all the costs that follow from delayed transfer of care).”

The report went on: “Primary care providers need to change from a strategy of ‘cost effective procurement of goods and services’ to one of ‘cost effective delivery of goods and services’.

“Key to this change will be a clause in all relevant tenders that offers opportunities to identify cost savings and efficacies in other areas of healthcare and beyond. These savings can then be factored into the overall evaluation of tenders when calculating supply contracts based on MEAT criteria.”

The BHTA said delayed discharges should be treated as an emergency with equipment generally provided within five days. “It is also important for many suppliers, especially small businesses, that they are paid promptly if they are to deliver promptly,” said the report.

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