Here are the main people issues I see with change in procurement and HR, and some suggestions for bridging the gap between early adopters and those less keen to change: - Fear of job loss or change. Reassure staff that the goal is not to reduce headcount but to work more efficiently. Provide training to help people take on new roles. - Resistance to new ways of working. Clearly communicate the benefits of changes for both the organization and individuals. Involve skeptical staff in designing solutions to gain buy-in. - Lack of understanding of the "why". Educate all staff on the strategic drivers and how their roles fit in. Show how changes ultimately improve patient care. - Different p

1. Working collectively to make best use of
our resources across the NHS in
Scotland.
John Burns
Michael Cambridge Gordon Beattie
Brendan Faulds Lynn Marsland

2. East of Scotland Procurement
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 got to 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 score of 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
• Lower Operating 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 steps for
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 to Make 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 : Continence Products
• 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 the people 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 to get
Better Value through Procurement

21. NHSScotland
Procurement
Supporting the Health and 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 Health and 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 Health and 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 Health and Wellbeing of the People of Scotland
So that‟s the opportunity…..
How do we engage to exploit it?

25. NHSScotland
Procurement
Supporting the Health and 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 Health and 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 Health and 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 the Health and Wellbeing of the People of Scotland
Thank You!

29. Question
Think about the people 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?

30. HR Shared
Services

31. Overarching Objectives
• Born out 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

32. IMPLIFY
TANDARDISE
HARE

33. Scope
if it sits in HR anywhere – its in!!

34. Programme Principles
• Openness and 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
Phase 1 – 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 or comments?