Can one written query ship a paradigm shift in NHS buying?
Chris Whitehouse, a political advisor and professional on medical know-how coverage and regulation at Whitehouse Communications, chair of the Urology Commerce Affiliation, updates readers on key latest bulletins impacting the medtech sector within the UK and EU.
A whole bunch, if not hundreds, of written parliamentary questions are put down each sitting week in each the Home of Commons and the Home of Lords. The equal of throwing confetti at weddings, there’s a hazard that the solutions they obtain are all too usually little greater than a brush-off, they usually have little influence.
Infrequently, nonetheless, there’s a query so drafted and well timed, that it elicits an actual reply of substance that commits ministers to insurance policies and targets for the supply of which they are often held to account. Such a written reply emerged lately within the Home of Lords, committing authorities ministers to the supply of “worth primarily based procurement” throughout the NHS.
The query was put down by Lord Hunt of Kings Heath, considerably of an professional on well being coverage having served as a well being minister in Tony Blair’s authorities and previous to that as the primary chief govt of the NHS Confederation. He has additionally served as chair of an NHS Basis Belief and president of the Royal Society for Public Well being, so he knew what he was asking about when he put down this query:
To ask His Majesty’s Authorities what is supposed by the time period “value-based procurement” within the context of NHS Provide Chain; whether or not it’s their coverage that such a value-based procurement method applies to medical units and related product procurements by the NHS; and what steps they’re taking to advertise the widespread adoption of this method to procurement of medical units and related merchandise.
Usually, such a query dangers receiving solely a quick, presumably terse, and never significantly informative response; however to many coverage watchers there was a surprisingly detailed reply which dedicated authorities ministers to a coverage method talked about for a while, however which up to now had delivered little greater than heat phrases, saying:
“Worth-based procurement (VBP) is a procurement method that delivers a discount in the entire life prices of healthcare the place worth may be created from monetary, effectivity, affected person, and environmental advantages.
“In Might 2019, NHS Provide Chain launched a mission to contemplate the potential advantages and sensible software of VBP. This concerned a sequence of pilot initiatives to check the idea of VBP in follow, with a view to producing a scalable mannequin for potential wider deployment.
“An inner toolkit for the usage of Class Tower Service Suppliers was produced as an output of the VBP mission. It’s designed to be flexibly utilized to the various product ranges procured by NHS Provide Chain. Central to the information has been the creation of two fashions: one may be utilized to the renewal of present frameworks/contracts for product ranges, the opposite for the procurement of innovation. Exercise will probably be delivered throughout a variety of classes together with cardiology, orthopaedics, sterile intervention tools and ward-based consumables.
“The Authorities’s new Medical Know-how Technique, revealed in February 2023, commits to creating an atmosphere that helps the understanding and supply of worth for cash and affordability throughout the entire affected person pathway, utilizing prime quality information to make sure that costs are each cheap for the well being system and sustainable for suppliers. The applying and adoption of VBP within the Nationwide Well being Service is a key precedence beneath the technique to grasp the potential of medical know-how to enhance affected person outcomes and assist the NHS workforce. The Division’s Medical Know-how Directorate is working intently with NHS Provide Chain and NHS England to construct on the work already undertaken to make sure that a constant methodology is now developed and adopted at each a nationwide and native stage.”
Those that work on the interface between the NHS and people supplying the merchandise, whether or not units or consumables, know from expertise that the aim of negotiations is to get down the unit price of buying, while, at greatest, paying solely lip-service to affected person high quality of life and outcomes, and influence upon the broader well being and care system.
That the idea of value-based procurement has been so lengthy talked about, however has not been delivered, has been a frustration throughout the medtech sector and extra broadly amongst many alternative classes of product supplier. This dedication by authorities that it ought to underpin buying choices throughout the brand new ecology of the NHS, no less than in England and Wales, may be very well timed.
The brand new ICB/ICS construction is meant to deal with the affected person expertise and outcomes. VBP, if correctly taken up, might, for the primary time, create an atmosphere during which entire system prices are recognized and reductions in them might ship big financial savings.
If a buying supervisor goes for a less expensive product, it won’t be as efficient, it may be related to the next stage of complication, a slower restoration, and extra remedy incidents than a costlier however extra acceptable product. However a buying supervisor is often incentivised solely to get buy price down, to not contemplate, frankly, a affected person’s high quality of life or the associated fee implications for the broader system.
May one written query assist ship a paradigm shift in NHS procurement? As David Lawson, head of the federal government’s MedTech Directorate lately requested an viewers of members of each Homes of Parliament, “if not now, then when?”.
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