3. The NHS is large and complex.....
10 Strategic Health
Authorities
392 Trusts (including
Foundation Trusts)
152 Primary Care Trusts
Total expenditure of £100bn
‘Non‐pay’ goods and services
£30bn
Accounts for a fifth of all
public spending………..
……but only 4% of its funding
is used on prevention
4. The NHS Secretary of State for Health
‐ Structure Department of Health
Taken from The New Independent
NHS: A Guide by A. Regulator
Talbot-Smith and A. M. (Monitor)
Pollock Strategic Health Authorities
Primary Care Trusts
(Social) Care Trusts
Primary Care: Independent Sector:
NHS
GPs, dentists, Walk-in 1. Primary Care NHS Foundation
Treatment
opticians, Centres 2. Treatment Centres Trusts Trusts
Centres
pharmacists 3. Hospitals
NHS Trusts moving to
Statutory Accountability Contractual Accountability
foundation status
5. NHS Priorities & Plans
Improving cleanliness and
reducing infections (HCAIs)
Improving access ‐ 18 week
referral and access to GP
services
Keeping adults & children well,
improving health and reducing
inequalities – in particular Stoke
and Cancer services
Improving patient experience
Preparing to respond to ‘state of
emergency’ e.g. pandemic flu
Reducing local variation and
eliminating poor performance
6. The NHS ‐ Further Reading
The New NHS: A NHS plc The Future of the NHS
Guide
by
by by Dr Michelle Tempest
A. Talbot‐Smith and A. M. Pollock (Editor)
A. M. Pollock
7. Challenging times ahead….
The NHS is entering a period of
unprecedented challenges and the
way we have delivered in the past
will not necessarily deliver in the
future. The NHS will have to make
efficiency savings of £15bn-£20bn
from 2011-14 at a time when we
are pressing ahead with reform to
deliver higher quality care for
patients.
The current economic climate will
lead to the NHS looking for ways
to ensure the health budget not
only goes further through improved
Quality Innovation Productivity Prevention efficiency but also improved
(QIPP) quality, and the only way in which
efficiency and quality can be
achieved is through innovation
9. High Quality Care For All
Quality at the heart of the NHS
Locally‐led, patient‐centred, clinically
driven
Working in partnership with staff
NHS Constitution
Includes specific actions on innovation.......
Legal duty placed on the SHAs to
promote innovation
Innovation fund – aimed squarely at
diffusion
NHS Evidence Service
Series of specific measures on
pharmaceuticals and medical devices 9
11. REGIONAL APPROACH TO TECHNOLOGY‐LED INNOVATION
NHS Operating SHA 10 year
Framework IDENTIFY vision
NEEDS
Quality & PCT
Productivity priorities
REGIONAL
PRIORITIES
NICE, MTAC, CEP NIC
Innovation Fund Identify existing Innovation Lead Innovation Hubs
MedTech r’table & Stakeholder Identify new NIHR
NTAC
innovations that SBRI
Group opportunities
are not being
for innovation
taken up
COMMERCIAL SUPPORT UNIT
Mobilise Develop pre‐
Innovative procurement
procurement commercial
landscape to procurement
speed adoption DH Guidance programmes
MMTSG
NHS Life Science Delivery Board OLS
projects
Procurement Industry Pre‐commercial
11
procurement
13. Necessity ‐ not nicety: The new Commercial
Operating Model
Development and implementation of
regional Commercial Support Units
(CSUs)
Repositioning of NHS Supply Chain
Reshaping of the centre
Closure of NHS PASA and transition of
functions to new organisations during
2009/10
Strong governance through an NHS
Commercial Development Directional
Board
14. Regional Commercial Support Units
(CSUs)
Providing a complete commercial service
across each region
Providing efficient groupings of scarce
commercial skills, and supporting
commissioners to improve acquisition
competencies in World Class Commissioning
Driving uptake of services from national
organisations and be an “intelligent client” in
areas such as demand management
Act as a focus for suppliers to engage with the
NHS and ensure an improved flow of
innovations into the system
14
15. Procurement Landscape for ‘non‐pay’ Spend
Level Benefit Challenge Organisations
National Available to whole of NHS Framework NOT DH PICD & CMU
– ‘widest’ route into NHS commitment. Trusts not NHS Supply Chain/DHL
mandated to use OGC
contracts OGC buying.solutions
NHS PaSA
Regional Consolidate demand form Trust may be selective in Collaborative
a number of trusts – often which contracts they Procurement
commitment but participate in Organisations – the
sometimes frameworks. ‘Hubs’
CSUs now remit to support
innovation
Local Commitment Time consuming to ‘sell’ Local Trust
and trial products over Procurement Teams
and over again in each
trust
17. Medical and Surgical Equipment
Level Orthopaedics Cardiology Diagnostic Dressings Sutures
Equipment (and other
LV/HV)
National NHS Supply NHS Supply NHS Supply NHS Supply
Chain/DHL – Chain/DHL Chain/DHL Chain/DHL
framework (little used)
with local
mini‐comps
Regional Various Hub Various Hub
arrangements arrangements
Local Local Local Local Local Local
contracts contracts contracts contracts – contracts
some via
other
national
suppliers
18. What happened to NHS PASA categories and
functions?
What’s going Where ?
Energy, Fleet, Estates and
Outsourcing Buying Solutions
ICT, Telecare and Telecoms www.buyingsolutions.gov.uk
Professional Services, Temporary
Staffing and Audit
Sid4Health
Pharmacy DH – Commercial Medicines Unit
NHS Development Regional SCU/CPH
Sustainability DH – PICD
Innovation john.warrington@dh.gsi.gov.uk
Commissioning & PCT Toolkits
CEP – medical equipment NICE
evaluations www.nice.org.uk
19. Legal and Governance Framework for
Procurement
All trusts must follow their own Standing Financial Instructions when
‘buying’ – e.g. tenders over £5k spend,
OJEU required for procurements over current threshold (~£100k)
All hub/regional contracts by their size, fall into OJEU processes
OJEU requires that the evaluation criteria and scoring/weighting system is
identified in ITT. Alcatel ‘stand still’ period (10 days) and debriefing of
bidders
OGC issued a ‘sustainable procurement’ guide
Open, fair and transparent procurement – open to audit scrutiny and FOI
Meets all legal requirements ‐ e.g. race & equality
Glover Report – SMEs ‐ £20k threshold
20. So how do you sell to the NHS? (1)
1. Understand the health economy and how it works
2. Be clear about how your product or service helps address national
priorities or efficiencies – align your product
3. Understand the care pathway and touch points for your product
4. Identify key influencers – patients & HCWs – and engage. But remember
they may not be the buyers or budget holders. (Lots of support but no
sales!!)
5. Build evidence – package into a good business case and develop your
sales stories around the benefits (sharper, quicker, safer, easier, cheaper)
6. Identify who buys (cost) and where the benefits go – may not be the
same place
7. Secure any necessary approvals
21. So how do you sell to the NHS? (2)
8. Identify key centres for your product (e.g. Orthopaedics – SWLEOC)
9. Decide the most effective level of entry (local, regional, national) for your
product – identify procurement calendars and forward plans
10. Consider carefully the complexity and cost of pursuing larger national
opportunities
11. Be aware of the human factors on the NHS/buying side and any likely
departmental user interest and conflicts
12. Understand the legal and governance requirements for procurement and
use to your advantage – e.g. monitor OJEU (TED – Tenders Electronic
Daily)
13. If national then check category responsibilities with websites of NHS
PaSA (pharmacy), NHS Supply Chain and Buying Solutions ‐ and make
contact
14. Register with sid4health (www.sid4health.nhs.uk)
22. So how do you sell to the NHS? (3)
15. For CPHs contact details research NPA website
16. For Trust contact details research DH PICD website, Google or Connecting
for Health or Trust websites ‐ seek out contact details for Head of
Procurement. Could also use Binleys (www.binleys.com)
17. For securing local commitment approach CPHs, CSUs or Trusts – even for
national frameworks (uptake)
18. To find a partner (agent/distributor) contact the relevant trade
associations such as ABHI, BHTA
19. For introducing innovative products to the NHS approach innovation
organisations – instead of or as well as procurement organisations
20. Get expert advice for your product development and sales and marketing
teams
21. Hard work, tenacity and persistence
23. Websites for further information
NICE www.nice.nhs.uk
Connecting for Health www.connectingforhealth.nhs.uk
NHS Supply Chain www.supplychain.nhs.uk
ABHI www.abhi.org.uk
BHTA www.bhta.com
NHS PaSA www.pasa.nhs.uk
Sid4health www.sid4health.nhs.uk
Supply2gov www.supply2.gov.uk
Supply2health www.supply2health.nhs.uk
Department of Health www.dh.gov.uk
Tenders Electronic Daily http://ted.europa.eu
24. Websites for further information
NTAC www.technologyadoptionhub.nhs.uk
NIC www.nic.nhs.uk
NIHR www.nihr.ac.uk
SBRI www.innovateuk.org
Innovation Hubs www.innovations.nhs.uk
NHS Procurement Alliance www.npa.nhs.uk
(links to all Collaborative Procurement Hubs)
HITF and MMTSG www.dh.gov.uk/ab/HITF/index.htm
DH Innovation Procurement Plan www.dh.gov.uk/en/
Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/
DH_109969