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Parallel Session 2.7 Working Collectively to Make Best Use of Our Resources Across NHSScotland
- 1. Working collectively tomake best use of our resources across the NHS in Scotland. John Burns Michael Cambridge Gordon Beattie Brendan Faulds Lynn Marsland
- 2. East of ScotlandProcurement Consortium (ESPC)
- 3. Partners • NHS Borders • NHS Fife • NHS Forth Valley • NHS Grampian Heavy use of Video and • NHS Highland Teleconferencing • NHS Lothian • NHS Orkney • NHS Tayside • National Procurement/SG
- 4. Aims • Productive opportunities of sharing services • Test change • Build a consortium business model • Provide lessons learned for similar projects • Contractual economies are a given • Create value as well as savings • Shift from a „club‟ to a disciplined consortium • Reduce fixed costs Ensure we buy the “right thing” for the patient as well as buy in the “right way”
- 5. What‟s it gotto do with me? • Integrates with overall improvement/quality plan • Reinvesting savings in direct patient care • Ensuring fit for purpose products • Capturing end users clinical knowledge • Refining Commodity Advisory Panel reps • Pooling Clinical Procurement Specialist knowledge • Effective Supply Chain reduces waste and saves you time – Closing the Gap, RTC, Productive Ward, 6S • Continuous quality by contract/supplier management • Corporate Governance and Legal risks • Back office - but vital back office
- 6. Defining Drivers • Clinical Need • Clinical Pathways • Risk Management • Financial constraints • Policies • Procurement Strategies and Innovation • Competitive Tender requirements • Legal requirements (incl. E&D) • Logistics
- 7. Measures • PCA scoreof 90% or more • Price savings on aggregated contracting • Reduced operating costs • Savings are formally tracked • Dashboards for budget control and predictive modelling • Customer Surveys
- 8. Changes • Re-model/share resources to excel for all • Save time by using a “bottom-up approach” • Share and spread local innovation and success • Bank organic economies and cash efficiencies • Longer term – redesign? • What needs to be done x 8…? • TUGs/CAPs
- 9. Changes – Q‟s • Processes fit for purpose from a user's stance? RTC… • More freedom of product choice rather than less? • Regionalise supplier markets through MCNs - ie. endoscopy? • Do controls on waste and variation = negative impact on care? • Do controls on waste and variation really save money? • Can we incentivise clinical staff to change? • Horizon scanning - do our systems stifle new technology? • Clinical Procurement Specialists embedded? • Can we influence how suppliers influence clinicians? • Ageing population - are we forecasting demand impacts? • Too much bureaucracy? Will less bring clinical improvement ?
- 10. Examples of Improvement– non cash AREA OF EXAMPLE OF ACTIVITY IMPROVEMENT Enhancing patient Discrete supply chain for IV needles; experience incontinence products, which respect patient sensitivities, with delivery to home rather than public collection at HC or hospital Improving flow Stock management system trials that build confidence to avoid both shortages and “just-in –case” ordering Improving patient Sharing of product safety info and equipment safety specifications; common Hazard/Alert systems and comms; Common HAI action plans
- 11. Non Cash Benefits • Consistent reporting and systems • Enhanced and sustainable capability • Effective MI dashboards • Increased non-pay spend influence • Shared templates and T‟s & C‟s • Shared specifications • Shared learning and innovation • Better access for SMEs and Third Sector • Fosters wider public sector partnering • Improved compliance and governance • Reduced carbon footprint
- 12. Cash Benefits • LowerOperating Costs • Cost avoidance • Regional savings Increased supplier and market leverage Increased market influence Reduced duplication Improved affordability/VfM Reduced IT Systems support Single instance catalogue management Joint Supplier and Contract Management
- 13. Kotter‟s 8 stepsfor successful change • Increase urgency • Build a guiding team • Get the vision right • Communicate for buy-in • Empower action • Create short-term wins • Don‟t let up • Make change stick
- 14. Working Collectively toMake Best Use of Our Resources Across NHSScotland TECHNICAL USER GROUPS – HARNESSING EXPERT OPINION
- 15. Technical User Groups(TUGS) Back Ground: • New West of Scotland Project. • 5 HB‟s working collectively. • Need to make effective decisions not just advise. • Geographically spread. • Different Organisations • No existing regional decision making forums. • Need to harness the expert knowledge of local product users
- 16. Technical User Groups(TUGS) Creation of TUGS: • Populated by expert users from each Health Board. • Experts formally appointed to TUG. • Each have DELEGATED AUTORITY OF CEO. • Decisions made once covering all 5 HB‟s. • Expert Users of the services to take primary responsibility for the selection of the supplier of the products/services • Product decisions catalogued and loaded onto local PECOS /Cedar system. • TUG experts maintain „formulary control‟ and review.
- 17. Procurement Team Supplier TUG Agree a Deal + Product Range. Feedback Add to PECOS Catalogue User Paper Indent Online eProcurement System Goods Issued Supplier Paid
- 18. TUG : ContinenceProducts • West of Scotland Health Boards spend around £7m per year • Supplied to Primary & Secondary care environments. • TUG of senior Continence Advisors, Service Managers and Procurement Specialists. • National multi –supplier framework let Dec 11. • Mini Competition specification focused on service delivery and cost Outcome • Technical Users across the region worked closely together to establish the benefits of a regional approach. • This collective approach delivered improved patient services while delivering enhanced savings through economies of scale and standardisation. • The WoS regional approach to the implementation of this National Framework has also delivered saving of around £1.5M to the five Health Boards.
- 19. Question Think about thepeople issues around change in Procurement and HR. What are the main people issues you see? How do we best bridge the gap between early adopters and those who are less keen to change?
- 20. Engaging Stakeholders toget Better Value through Procurement
- 21. NHSScotland Procurement Supporting the Healthand Wellbeing of the People of Scotland National Procurement – who are we? • We are NHSScotland‟s Centre of Procurement Expertise, set up in response to the McClelland Review of Public Procurement in Scotland (2006) • We provide goods, services and procurement expertise to NHSScotland‟s 14 Regional Health Boards and 8 Special Health Boards • We are a Division of National Services Scotland and work closely with the Scottish Government‟s Health and Procurement Directorates • We strive towards procurement best practice and delivery of new, innovative ways of working that deliver significant financial and service efficiencies across NHSScotland
- 22. NHSScotland Procurement Supporting the Healthand Wellbeing of the People of Scotland Our Key Aims • Become effective supply chain partner by working collaboratively with NHSS to identify and implement joint efficiency solutions • Provide a total customer service package including Logistics, Procurement, Systems, Improvement and Development Services • Be innovative and forward looking by assessing and implementing more effective ways of working through processes, systems and technology • Add value to Health Boards via improvement programmes to identify and deliver real solutions in support of our customers‟ challenges
- 23. NHSScotland Procurement Supporting the Healthand Wellbeing of the People of Scotland Health Expenditure 2010/11 • Non-Pay Spend in 2010-11 was £2.559bn in NHS Scotland • Trade supply spend = £2.017bn
- 24. NHSScotland Procurement Supporting the Healthand Wellbeing of the People of Scotland So that‟s the opportunity….. How do we engage to exploit it?
- 25. NHSScotland Procurement Supporting the Healthand Wellbeing of the People of Scotland Intensive Improvement Activity • A short, sharp consultancy engagement • Provides a focus and creates momentum for change • We guarantee to borrow your watch and tell you the time! • There will be very little in the way of surprises • You well get out of it what you put into it • Delivers detailed and specific recommendations recognising Risks, Challenges, Constraints and first steps to implementation • Planning & Preparation are PARAMOUNT • Needs executive engagement and organisational commitment to take responsibility to follow it through
- 26. NHSScotland Procurement Supporting the Healthand Wellbeing of the People of Scotland How it has been received.. Nick Kenton said “We clearly recognised the need to • The IIA is a structured rapid . Laura Ace commented, “This exercise raised the focus on improve and the benefits that would accrue when we improvement style event focused procurement throughout the did. It was an easy sell to the Board members and we on an individual health board – organisation, increasing the visibility of what we were quickly gained cross Board sponsored by a Health Board spending on and bringing support to proceed.” together all the strands of Senior Executive procurement within a common framework. It coincided well • Tailored “consultancy-style” event with a growing awareness on the ground that we needed to Caroline Lamb said “We have standardise, collaborate and been looking for the right solution to getting the most from • Within a structured process follow best practice to get best value and I am confident procurement for some time ….the focus that the NP team – Identification, Definition, savings will flow as a result.” brought has helped me make Delivery, Closure – Generate energy, awareness, some key decisions. I am confident NES will really benefit Calum Campbell said from the IIA experience.” visibility, momentum, action “Having seen and heard of plans and owners the success of IIAs in other Boards and recognising NP’s role our Centre of Robert Stewart said, “We Expertise for are really keen to move on Procurement, I saw this as and tackle these something that could help recommendations and me identify the maximum although resource is . Pamela McLauchlan summarised, “A good amount of savings from always a challenge the IIA exercise at a good time for the organisation. procurement in as short a has helped all of us It will help us maintain our continuous time as possible”. understand more about the improvement in this area and will result in an benefits of better additional £100k of savings in the next year.” procurement and was well worth the effort involved.”
- 27. NHSScotland Procurement Supporting the Healthand Wellbeing of the People of Scotland Success so far…. • 16 IIAs delivered since January 2010 • 2 recent events targeted purely on identifying additional savings – £2.2M identified on top of existing projects – Equates to approx 1%-1.5% of targeted Trade Spend • Funding being sought to take this approach to remaining 20 Health Board organisations – Using a conservative 1% estimate this would equate to £20M in additional savings • Beyond investment, it just needs engagement and a common purpose to realise the benefits!
- 28. NHSScotland Procurement Supporting theHealth and Wellbeing of the People of Scotland Thank You!
- 29. Question Think about thepeople issues around change in Procurement and HR. What are the main people issues you see? How do we best bridge the gap between early adopters and those who are less keen to change?
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- 31. Overarching Objectives • Bornout of Efficiency and Productivity agenda • 1 of 3 strands to Shared Services - Finance - HR - Facilities • Balanced “scorecard” of benefits - Quality of service (governance) - Delivery of service (productivity) - Cost (efficiency) - People (value-add, career progression) • Identify, quantify and realise benefits from eESS • Support revised national Workforce Development Strategy
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- 33. Scope if it sitsin HR anywhere – its in!!
- 34. Programme Principles • Opennessand transparency: key stakeholders indentified and all documentation is made accessible • Partnership: with formal Partnership representatives, NHS staff and external partners • Robust benchmarking and data analysis: establishing a baseline of current internal data as well as comparisons with external best practice • Engagement: involving groups of HR staff from across NHS Scotland to ensure ownership for implementing the models developed • Based on a future model where services are most appropriately delivered either locally, regionally or nationally • Service and process redesign methodology: lean best practice and programme management disciplines
- 35. Risks and Interdependencies •Implementation and functionality of eESS • Leadership from HRDS, other Directors “in scope” and other HR staff • Effective partnership working • PIN policies • Health and Social Care integration • e-Payroll, e-Rostering etc • Our “customers”
- 36. Workstreams and Timescales Phase1 – April 2012 to March 2013 • Employee Services • Medical Staffing • Recruitment • Payroll and Benefits Advice Phase 2 – April 2013 to March 2014 • Organisation Development • Learning, Development and Education • Workforce Planning, Workforce Information etc • Occupational Health and Safety
- 37. What‟s happening now.. • HRD lead for Phase 1 workstreams - Ian Reid: Recruitment - Kenny Small: Medical Staffing - Jacqui Jones: Employee Services - Annie Ingram: Payroll and Advice • Baseline for current staffing levels etc • HR “Customer” survey baseline • Understand benefits from eESS implementation • Engage! – Communicate! – Change!
- 38. Any questions orcomments?