The Procurement Of Consumables By Nhs Acute And Foundation Trusts
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| Author | : Great Britain: National Audit Office |
| Publisher | : The Stationery Office |
| Total Pages | : 40 |
| Release | : 2011-02-02 |
| Genre | : Medical |
| ISBN | : 9780102969467 |
A combination of inadequate information and fragmented purchasing means that NHS hospitals' procurement of consumables is poor value for money. The NAO estimates that at least £500 million a year could be saved by the NHS on its spending on consumables, and potentially much more for some products. With no central control over Foundation Trusts, the Department of Health cannot mandate more efficient procurement practices. Responsibility to demonstrate value for money in procurement falls upon the management of individual trusts. The price that trusts pay for the same items varies widely. The average variation between the highest and lowest unit price paid was 10 per cent. Some trusts are not getting value for money because they are buying many different types of the same product. For example, trusts bought 21 different types of A4 paper, 652 types of medical gloves and 1,751 different cannulas. There is also a large variation between trusts: one bought 13 different types of glove, whilst another bought 177 different types. There are unnecessary administrative costs because many trusts make multiple small purchase orders. Hospital trusts have complete freedom in purchasing decisions and can use regional procurement hubs, the NHS Supply Chain or they can buy direct from suppliers. Evidence suggests that new contracts are being established which overlap and duplicate each other. There is no national performance framework for hubs which would enable comparisons to be drawn between them or to allow an assessment of their potential optimal performance.
| Author | : Great Britain: Parliament: House of Commons: Committee of Public Accounts |
| Publisher | : The Stationery Office |
| Total Pages | : 48 |
| Release | : 2011-05-20 |
| Genre | : Medical |
| ISBN | : 9780215559609 |
The 165 NHS acute and Foundation hospital trusts in England spend over £4.6 billion a year on the procurement of medical supplies and other types of consumable goods. Each trust controls its own purchasing and can purchase consumables in various ways: dealing direct with suppliers; through the national supplies organisation, NHS Supply Chain; or via the regional Collaborative Procurement Hubs. They can also choose to join other trusts in collaborative purchasing arrangements for particular localities or types of supplies. The Department sees the future for NHS procurement as a 'pyramid' structure with national, regional and local procurement of different types of goods, as appropriate to the products and the supplier markets. However, this theoretical model does not reflect the current complex reality, with a profusion of bodies involved in the procurement process. Its effectiveness is open to question in the emerging landscape where Foundation Trusts act independently with no explicit incentive to co-operate. The fragmented system of procurement has produced a great deal of waste, with trusts being charged different prices for the same goods, ordering in inefficient ways and failing to control the range of products which they purchase. The NAO has estimated that trusts could save around £500 million annually, 10% of their consumables expenditure, by amalgamating small orders into larger, less frequent ones, rationalising and standardising product choices and striking committed volume deals across multiple trusts. A lack of data has limited progress towards more efficient procurement and there has not been sufficient control over procurement practices.
| Author | : Mike Denham |
| Publisher | : Biteback Publishing |
| Total Pages | : 252 |
| Release | : 2013-02-21 |
| Genre | : Political Science |
| ISBN | : 1849545596 |
Britain is in the midst of a fierce battle over government spending. With debts mounting rapidly, the ?700 billion annual bill is no longer sustainable. But cuts face a wall of opposition, with dire warnings that they will ravage our society: hospital waiting lists will grow, schools will close and the poor will tumble into a new Dickensian abyss. Yet much of what the government currently spends is wasted, and public sector performance is often woeful. In Burning Our Money, Mike Denham casts a critical eye over the services we receive for our hard-earned cash, and finds them radically - often shockingly - wanting. For all the media insistence that the NHS is 'the envy of the world', it stacks up poorly against European healthcare systems. For all our apparently soaring exam grades, our children significantly underperform their future competitors in China, Korea and elsewhere. And for all our hand-wringing about abolishing poverty, our huge welfare system actually damages many of the poor it's supposed to help. Drawing on extensive research and up-to-the-minute reporting, Burning Our Money comprehensively debunks the myth that more public spending means better public services, and shows how we can - and must - get more for less.
| Author | : Great Britain: Parliament: House of Commons: Committee of Public Accounts |
| Publisher | : The Stationery Office |
| Total Pages | : 40 |
| Release | : 2011-10-25 |
| Genre | : Medical |
| ISBN | : 9780215561862 |
The Commons Public Accounts Committee publishes it fifty third report of Session 2010-12, on the basis of evidence from the Department of Health. In the past three years, NHS trusts in England have spent around £50 million annually on buying three specific types of high value capital equipment - Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scanners, used mainly for diagnosis, and Linear Accelerator (Linac) machines for cancer treatment. The current value of these three types of machines in the NHS is around £1 billion. Patient demand for services from these machines has increased significantly in the last decade and continues to grow. Since 2007, the Department of Health has devolved responsibility for procuring and managing these machines to individual trusts but this structure is not conducive to delivering value for money. The committee is concerned that the NHS is failing to optimise its purchasing power, crucial at this time when £20 billion of savings in the NHS are required by 2015. The NHS needs to make high quality, comparable data available on machine use and cost. The procurement and management of high value equipment is fragmented and uncoordinated, leading to wasted resources and variable standards of services. Trusts have three main ways to purchase high value equipment: by dealing directly with suppliers; through framework agreements, managed by NHS Supply Chain; or by joining up with other trusts in collaborative purchasing arrangements. The Committee believes there is a lost opportunity to use collective buying power to get lower prices and the committee expects NHS Supply Chain and other collaborative procurement bodies to work with trusts to share plans on future needs and get better prices and value for money by exploiting the joint buying power.
| Author | : Great Britain: Parliament: House of Commons: Committee of Public Accounts |
| Publisher | : The Stationery Office |
| Total Pages | : 84 |
| Release | : 2011-08-03 |
| Genre | : Medical |
| ISBN | : 9780215561121 |
The National Programme for IT in the NHS is an ambitious £11.4 billion programme of investment. This report is concerned with a central part of the Programme, where the aim was to create a fully integrated electronic care records system, which is expected to cost around £7 billion in total The Department has failed to demonstrate the benefits achieved for the £2.7 billion spent to date on care records systems and has accepted it is unable to deliver its original vision. It is now relying on individual NHS trusts to develop systems compatible with those in the Programme. Furthermore the Department could not explain how potential inconsistencies would be dealt with or what it will cost local NHS organisations to connect up. The Department has not got the best out of its suppliers, despite having paid them some £1.8 billion so far. One supplier, CSC, has yet to deliver the bulk of the systems it is contracted to supply and has instead implemented a large number of interim systems as a stopgap. The Department has been in negotiations with CSC for over a year, but conceded that it may be more expensive to terminate the contract than to complete it. The Department has also revised its contract with BT reducing the number of systems and increasing the price for each system delivered. This has resulted in BT being paid £9 million to implement systems at each NHS site, even though the same systems have been purchased for under £2 million by NHS organisations outside the Programme. The Committee is further concerned about the problems in getting timely and reliable information from the Department. Information provided has frequently been late, has contained inconsistencies and has contradicted other evidence.
| Author | : Great Britain: Parliament: House of Commons: Committee of Public Accounts |
| Publisher | : The Stationery Office |
| Total Pages | : 52 |
| Release | : 2011-09-16 |
| Genre | : Medical |
| ISBN | : 9780215561329 |
In 2009-10 the eleven regional ambulance services in England handled 7.9 million emergency calls and spent 1.5 billion pounds on urgent and emergency services. They are expected to make 4 percent efficiency savings year on year in a time when public demand for services continues to rise. Performance was measured against three response time targets until 1 April 2011, but the incentive to meet these targets has led to some inefficiency, such as when more than one team is sent to incidents. The Committee welcomes the decision to introduce a wider suite of health quality indicators to create a broader performance regime in which response times remain one indicator. There is wide variation in the cost of responding to an incident across the services, and there is a need for more consistent performance data in order to benchmark and share best practice. Under the NHS reforms there is vagueness around who will be responsible for what: who commissions ambulance services; who is responsible for improving efficiency in ambulance services or who will intervene if a service has financial trouble or seriously under performs? There is need for greater clarity on the roles and responsibilities of the Department, commissioners and ambulance trusts with appropriate structures for accountability. Other parts of the Health service affect ambulance services and a more integrated emergency care system is needed to ensure that ambulances are utilised in the most efficient manner. Levels of collaboration between ambulance, fire and police services could be strengthened.
| Author | : Great Britain. Parliament. House of Commons |
| Publisher | : |
| Total Pages | : 708 |
| Release | : 2012 |
| Genre | : Great Britain |
| ISBN | : |
| Author | : Great Britain: Parliament: House of Commons: Committee of Public Accounts |
| Publisher | : The Stationery Office |
| Total Pages | : 52 |
| Release | : 2011-10-11 |
| Genre | : Business & Economics |
| ISBN | : 9780215561664 |
The Efficiency and Reform Group (the Group) was established within the Cabinet Office in May 2010 to lead efforts to cut government spending by £6 billion in 2010-11. Its long term aim is to improve value for money across government by strengthening the central coordination of measures to improve efficiency. The imperative to make savings in the short term has involved the Group imposing new controls on departments, such as moratoria on certain expenditure. Sustained efficiency improvements, though, will need a much deeper change to both the culture and institutional structure of government. The Group also needs to clear up confusion over who is accountable for what in terms of improving value for money, especially in defining its responsibilities and those of the Treasury and individual departments. The Group's actions have resulted in efficiency savings of £3.75 billion across departments in 2010-11. It should continue to describe any future spending reductions accurately and explain any impact on services. The scale of the challenge to deliver efficiencies is huge: the Government intends that half of the £81 billion reduction in spending planned over the next three years should come from efficiencies rather than through cuts to services or delays to important projects. Many of the efficiencies must be achieved in areas where the Group currently has a limited influence, or by local bodies, where it has none. The Group should set out how it will operate to ensure that its approach can be replicated across the wider public sector.
| Author | : Great Britain. Parliament. House of Commons. Committee of Public Accounts |
| Publisher | : The Stationery Office |
| Total Pages | : 41 |
| Release | : 2015 |
| Genre | : Political Science |
| ISBN | : 0215085779 |
This report summarises the key areas of the Committee's work over the past five years. It draws out the areas where progress has been made and where their successors might wish to press in future. The Committee has assiduously followed the taxpayer's pound wherever it was spent. Since 2010 they held 276 evidence sessions and published 244 unanimous reports to hold government to account for its performance. 88% of their recommendations were accepted by departments. In many cases they successfully secured substantial changes, for example with the once secret tax avoidance industry. They secured consensus from government and from industry that private providers of public services do have a duty of care to the taxpayer, and in pushing the protection of whistleblowers further up the agenda of all government departments. By drawing attention to mistakes in the Department for Transport's procurement of the West Coast Mainline, more recent procurements for Crossrail, Thameslink and Intercity Express have all benefited from more expert advice and a more appropriate level of challenge from senior staff. After discovery in 2012-13 that 63% of calls to government call centres were to higher rate telephone numbers, the Government accepted our recommendation that telephone lines serving vulnerable and low income groups never be charged above the geographic rate and that 03 numbers should be available for all government telephone lines. They also secured a commitment to close large mental health hospitals.
| Author | : Great Britain: Parliament: House of Commons: Committee of Public Accounts |
| Publisher | : The Stationery Office |
| Total Pages | : 44 |
| Release | : 2012-04-24 |
| Genre | : Political Science |
| ISBN | : 9780215043764 |
Under the Public Bodies Reform Programme the Government is reducing the number of its arm's length bodies from 904 to between 632 and 642 by the end of the current Spending Review period and will have a substantial and lasting impact. The Programme is intended to improve accountability for functions currently carried out at arm's length from Ministers. The Cabinet Office says it is on track to make £2.6 billion of administrative savings by 2015. However there are substantial reservations about the robustness of this claim. Key concerns are that: there is a risk departments are claiming savings which are actually cuts to services, when they should be including only genuine savings arising from administrative reorganisations; estimates of transition costs such as redundancy and pension costs are incomplete; the savings estimate does not fully take account of the ongoing costs to other parts of government of taking on functions being transferred from abolished bodies and some departments have wrongly included wider savings from bodies being retained, rather than just administrative savings from bodies being abolished or substantially reformed. The Cabinet Office has accepted that its savings estimate needs to be reassessed and has undertaken to 'rebase' it. Focus now needs to be on managing the Programme effectively. Departments have decided on the form of individual reorganisations themselves without clear direction from the centre, leading in some cases to inconsistent treatment of bodies with similar functions. Furthermore, departments may not be getting the best value for money from the sale or transfer of assets of bodies being abolished
