We’ve come a long way from the days of rigid procurement processes, with predetermined specifications and cost-driven decision-making. Alongside a welcome shift towards evaluation based on quality and value for money, we’ve seen a dramatic change in the approach to procuring health services, where collaboration is driving significant improvements.
Warren Simms, associate director of procurement and market management at NHS Arden and Greater East Midlands Commissioning Support Unit, tells us more.
Traditionally, it’s been easy to jump straight into a procurement project, assuming you know what outcome you need to achieve. With set criteria in mind, the focus would be on finding a provider that ticks all the boxes and can deliver the service as cheaply as possible.
This might have been the case a few years ago, but we’ve seen a dramatic shift in the approach to procuring health services in recent years, resulting in improved services, better efficiency, and stronger outcomes for patients.
Collaboration is one of the key elements in gaining better results from the procurement process. This means involving clinicians, patients, partners, providers and other stakeholders right from the start of a project. That’s why we focus on gaining a strong commitment to collaboration at the earliest opportunity – not just in terms of seeking stakeholder input, but involving them in every stage of the process using a co-production approach.
Spending sufficient time and focus at the very beginning and gaining the views of those involved and affected by the potential service is something which is often overlooked – or avoided due to the perceived challenges of reaching any form of consensus. However, managed well, this is arguably the most crucial stage of any procurement, where you reach a clearer definition of the requirements and can design a bespoke approach that will achieve the best possible outcomes.
This was evident in our work with NHS England to establish a national support package specifically for GPs, as part of the Five Year Forward View. We carried out early detailed market research to help build a better picture of the barriers preventing GPs from accessing existing services. We also held market engagement events where we were able to openly debate the pros and cons of various commissioning options.
Using this feedback, it became clear that a single national provider, rather than regional variations, would be the most effective approach. This valuable input set the direction for the procurement, ensuring we had a clear way forward to which all stakeholders were fully signed up.
Robust project management is essential when trying to gain consensus from a wide range of stakeholders and keep progress on track. This was the case in a recent award-winning project to procure community services in Nottinghamshire, working with six clinical commissioning groups (CCGs), Nottinghamshire County Council, Nottinghamshire Healthcare NHS Foundation Trust, Nottinghamshire Hospice and patients.
We worked together to develop a joint vision and put in place strong governance to ensure effective collaboration and quick decision-making throughout the process. Through meticulous planning and the innovative use of technology, stakeholders were able to influence the approach, and the project benefited hugely from the expertise and experience of those involved. The final result was the delivery of improved, patient-focused services as well as quantifiable efficiency gains.
Of course, collaboration doesn’t stop once you have defined the approach, but these strong foundations make it easier to involve all stakeholders at every stage, from inception to evaluation. For example, in the Nottinghamshire project, clinicians were involved in assessing bidders’ responses to addressing the practicalities of service delivery.
Plus, the evaluation panel included people from cross-functional areas such as clinical, quality, commissioning, finance and HR experts, as well as patient representatives, parents/carers and a young person. These different perspectives helped to deliver the strongest possible solution.
This level of collaboration brings a richer understanding of both patient and commissioner requirements to any procurement project, and ensures continuous innovation as we have access to the latest clinical expertise as well as specific local requirements.
Broadly structuring our procurement team into areas of clinical excellence, such as primary care and health and justice, has supported this collaborative approach and ensures relevant procurement process efficiencies are built in to new projects from the outset.
Procurement, like all areas of the NHS, needs to be open to innovation and improvement if we are to successfully support commissioners in their drive to improve quality and patient care. In our experience, being open-minded from the start and encouraging a culture of collaboration leads to stronger buy-in from all partners and the successful delivery of better health services.
Warren Simms is associate director of procurement and market management at NHS Arden and Greater East Midlands Commissioning Support Unit. Follow the organisation on Twitter @ardengem