Portsmouth Hospitals NHS Trust - Inventory Management - A Journey Jackie Pomroy – Head of Supply Chain

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Inventory Management – A Journey
Jackie Pomroy – Head of Supply Chain
Portsmouth Hospitals NHS Trust

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Queen Alexandra Hospital
• PFI hospital opened July 2009
• Single site acute 1,200 beds
• 27 Operating Theatres
• Approximately 6,500 Staff
• Largest MOD Hospital Unit in UK
• Regional Renal, Transplant and Cancer Unit
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What is Inventory Management ?
• It is an activity of determining the range & quantities of materials to
be stocked in an organisation & regulation of receipts & issues of
these stocks
• It might include managing products at different locations within a
single site or within many locations of a supply chain or network.
• It is also about having those items required available for use when
you need them and in a healthcare environment without risk to
delivering patient care
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Considerations of Inventory Management
• Replenishment and lead times
• Inventory holding costs
• Inventory forecasting
• Inventory valuation
• Inventory visibility
• Physical inventory
• Available physical space for inventory
• Quality management
• Returns and defective goods
• Demand forecasting
• External Supply chain reliability
• Product criticality (Must haves)
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What was the problem?
• No Inventory Management system in place
• No formal processes
• Cost Improvement Programme
• Cultural issues – end user acceptance of change
• Lack of base data to start from
• No Bar codes on many items, no unique or standard bar codes
• Poor contract coverage
• Merging of 3 Hospitals into 1 PFI and lack of storage space
• Receipt & Distribution run by PFI
• Overstocking, inherited stocks and bad practices
• Needed accurate, reliable and accessible information
• Risk of stock outs, out of date products, waste
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How it was
• Clinical staff ‘informally’ managing inventory and placing/approving
orders (waste)
• “Supermarket sweeps” of stores by clinical staff due to lack of
advanced planning
• Poor Consignment stock management
• Waste – not measured
• Incorrect declaration of Inventory value
• ‘Stock turns’ as low as 2 in some areas – 6 months stock
• Much too much – or just too late!
• Poor data
• Supply chain knowledge embedded in Individuals
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How we solved the problem
• Implemented Inventory management system as part of Supply Chain
improvement
• Put processes around a system
• Identify savings and efficiencies, reduce stock holding, increase stock
turns
• Improve information, true usage data by speciality, visibility
• Reduce and record wastage
• Monitor Supplier performance
• Reduce clinical staff time spent on stock issues
• Required a trust wide system, one way of working with no ties to
consumable suppliers
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How we used GS1 standards to help
deliver the solution
• Came across a situation where we found two different types of
clinical products in the theatre store room, from two different
manufacturers, that shared the same barcode and identifier -No
standards in Healthcare
• We knew we had a big problem
• All we wanted was to scan products out at point of use – to capture
essential data - Patient, product, place
• Found the 13 different types of barcode which meant we had to
undertake a large exercise to cross reference all products into the
Inventory Management System
• Engaged with GS1 UK for help
• Carried out Supplier assessment exercise
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2012 20162012 2013 2014 2015 2016
Visit by GS1 Consultant
30/06/2012
6 GS1
Consultants
visited
12/12/2012
GS1 wrote to
our top 30
suppliers
30/04/2013
Reviewed GTINs in place
31/01/2014
Southern Group Meeting
12/06/2014
GS1 video
18/01/2015
GS1 Healthcare User Group
03/03/2015
HUG
12/05/2015
Reviewed GTINs in
place
29/05/2015
HUG
07/07/2015
Southern Group Meeting
11/09/2015
Implement GLNs and GSRNs
04/01/2016
Found 2 products with the same barcode
04/01/2012
Presented at IMS Open Day
28/09/2012
GS1 Southern Group formed
12/04/2013
Healthcare Training
18/07/2013
Southern Group Meeting
12/02/2014
Southern Group Meeting
16/10/2014
Southern Group Meeting
12/02/2015
HUG
14/04/2015
Southern Group Meeting
28/05/2015
Submitted GS1 Strategic
plan to the DH
30/06/2015
HUG
08/09/2015
Submit Business Case to DH
13/11/2015

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Supplier Readiness 2013
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ABBOTT VASCULAR
AMBU LTD
APPLIED MEDICAL UK LTD
ARTHREX LTD
ARTHROCARE UK LTD
ASTRA TECH LTD
BAXTER HEALTHCARE LTD
BIOMET UK LTD
BOSTON SCIENTIFIC LTD
BUNZYL HEALTHCARE
COOK UK LTD
COVIDIEN (UK) COMMERCIAL LTD
GE HEALTHCARE CLINICAL SYSTEMS (UK) LTD
HUNTLEIGH HEALTHCARE LTD
INTERSURGICAL LTD
JOHNSON & JOHNSON MEDICAL LTD
KIMAL PLC
LINA MEDICAL UK LTD
3M HEALTH CARE LTD
MEDARTIS LTD
MEDTRONIC LTD
MOVIANTO UK LTD
OLYMPUS KEYMED
SMITH & NEPHEW HEALTHCARE
ST JUDE MEDICAL UK LTD
STRYKER UK LTD
SYNTHES LTD
TELEFLEX MEDICAL
TIMESCO OF LONDON LTD
69% say they are ready
17% not ready
7% 7%

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Positive direction not quick enough
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Scanning products
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Barcode Checker
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Different Barcode Formats & Types
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2D Data
Matrix
Singular GS1-
128 Linear
Multiple GS1-
128 Linear
HIBCC
Barcodes
Ensure your solution is capable of reading the multiple barcode formats
and types

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Items with no barcodes at all
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Some items don’t have
barcodes at all
Some items only have the
barcode on the outer box
and not at the each level
In order to work around
this issue we create our
own barcodes

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Suppliers on the GS1 journey
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Supplier Product Range Changes -
GTIN
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Supplier Product Range Changes -
GTIN
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• Need to have a process in place to ensure
that GTINs are requested for the new
product range, when changing and
ensuring GTINs are maintained in the
catalogue.
• Ensure there are protocols in place to
rectify any that have been missed.

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Multiple barcodes/close together –
Which do I Scan?
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Understanding which barcode relates to what.
Users need to be trained and systems need to
validate the barcode application identifier that
is scanned is the correct one. Ensuring correct
data is input.

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Extra Identifiers
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Often suppliers will include additional
data to the GTIN, Expiry Date and
Serial or Lot No.
In this example (11) stands for
Manufacturer Date. But there can be
many others that suppliers may add for
their own benefit.
The systems used needs to be able to
cope with Additional Application
Identifiers and know when to
acknowledge or reject them.

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Other anomalies
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• Problems caused by suppliers
creating barcodes with incorrect
Application Identifiers
• A GTIN that is not correctly
formatted e.g. Serial Number AI
(21) present when it should have
been Lot No. AI (10)
• The work around was to manually
enter the Lot No. increasing the
possibility of human error

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Same items different GTINs
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Incorrect Barcode Format
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The Problem
The GS1 barcode shouldn’t contain
the (01) in the bracket within the
barcode.
The Solution
We created an internal barcode

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Suppliers on the journey
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GLNs
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Physical Location – Within the
Hospital
Supplier within the supply chain

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Identifying Items within a GLN
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Patient ID (GSRN)
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The Patient ID bands
use the GS1 Key –
GSRN (Global
Service Relation
Number)
The structure is an
18 digit number,
comprising the
company prefix, 10
digit NHS Number
and a check digit

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What were the benefits
• Patient safety
• Efficiency
• Financial
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Waste Reduction
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Additional Benefits
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Stock Reduction
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Contract coverage
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35%
65%
5%
95%

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Supplier Engagement Program
2015/16
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Key learnings for you to takeaway
• Don’t underestimate the scale of the task
• Don’t run before you can walk
• Data – Quality and quantity
• Change management - culture
• Systems capability – today, tomorrow and the future
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Summary
• Prepare data
• Communicate the message so it’s not a shock
• Involve people – cross department – Clinical and non –clinical
• Identify Champions
• Quick wins to get buy in
• Shout about the successes
• Talk to other Trusts and learn
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Thank you
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