Change is called for in NHS procurement

Medical devices are becoming a great deal more complex as technology encompasses more and more of our everyday lives. The application of drug eluting stents; of robotic surgery; of copper-based products to reduce bacterial contamination; and a host of new uses for computer-aided diagnostic or therapeutic devices to every imaginable disease process is moving patient care into new realms. How long will it be before we need a biomedical engineer to work alongside us in our high dependency units? However, even the simplest strategy for procurement does not seem to be running as efficiently as possible in English NHS Trusts. Two reports from the National Audit Office (NAO) in the last six months have highlighted many areas where some of the dramatic savings imposed on the NHS, could be delivered. The NAO scrutinises public spending on behalf of Parliament. They hold Government departments and bodies to account for the way they use public money, thereby safeguarding the interests of taxpayers. In addition, their work aims to help public service managers improve performance and service delivery.

Standardisation

 It has been suggested for many years that hospitals use a standardised approach to the purchase of technologies such as syringe pumps and pulse oximetry devices1 – which is common sense when looking from the users’ and engineers’ perspectives, but often flies in the face of capital cost implications. We know that rationalising a range of devices is safer for patients and ensures maintenance is more cost effective, but it may defy the development of technological advances. Consumables should also be rationalised for a number of very good reasons. The cost of each procurement cycle is huge, from planning through to invoice payment – and equally complex through its many stages. Some Trusts have failed to reduce the variation in the number of companies they purchase from and hold huge stock in each hospital. Many savings are possible in this area to reduce, for example, the number of different types of examination gloves held in a single Trust. Shocking figures report that in a sample of 61 Trusts, they had bought 652 types of surgical glove and 1,751 different types of cannula. One Trust alone purchases 177 different types of glove.2