Can devolved procurement work for the NHS?

NHS trusts have been under fire recently for paying over the odds for medical locums to staff under-resourced shifts.

NHS chief executive Sir Simon Stephens admitted last year NHS foundation trusts in England had spent more than double the planned amount on agency staff.

So is it time for NHS Trusts to reconsider their devolved model of procurement? Would a more centralised approach help the NHS get its finances back on track? Or, can the devolved approach be adapted to deliver greater benefit and efficiency?

The NHS is in a difficult position when it comes staffing and those running departments are under enormous pressure to balance resource versus budget. In an attempt to achieve a better work life balance, many nurses and doctors are choosing to move out of the permanent workforce and re-engage as locums. Hospitals can’t allow shifts to be unfulfilled so of course department heads have to prioritise saving lives over saving money.

The sourcing of medical locums is a major challenge for the NHS due to the high level of demand and complexity involved in managing contracts with multiple recruitment agencies. It’s no surprise trusts pay over the odds for locums, considering staff shortages could close wards or put patient safety, quality of care, performance and reputation at risk. But because demand exceeds supply, they feel they have no other choice but to pay overinflated fees.

But hospitals don’t need to pay over the odds for staff if they plan more effectively and monitor exactly what level or type of support they need. Without effective planning, trusts run the risk of firefighting, staffing issues and acting like panic buyers – scrambling to get whatever they need never mind the price or whether they need that level of support or not.

Despite headlines to the contrary, some NHS trusts are doing all they can to better manage spend on medical locums. In our work with Harrogate and District NHS Foundation Trust we provide them with a neutral vendor managed service as a single point of access for locums and as a result we have been able to make significant savings for them in just a few months.

Devolved procurement doesn’t have to mean out of control procurement. Effective planning on the exact type of support needed can prevent the need for panic buying, and ensure shifts are fully manned at the right price.

Charles Austin is client services director at Comensura

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