Alot has changed within the world of procurement since the Carter report was published in February 2016 (Carter, 2016).
The Carter report showed large variations in costs for the same products throughout the NHS, with an overall spend of £9 billion on procurement. One third of that spending was on medical consumables, including IV-related products.
The Carter report recommended alignment with NHS Supply Chain and trusts working together within a region to set a benchmark on pricing. Since April 2016 all trusts have been required to publish reports on their top 100 spends, with a view to reducing costs by 10%—and show they are working with a purchasing price index.
The Department of Health (DH) set up a procurement transformation programme (PTP), which set out a future operating model (FOM). This involved setting up 11 ‘category towers’ (six of which will be for medical and surgical consumables) along with local cost improvement programmes (CIPs) (Department of Health and Social Care, 2018).
The first tranche of products for review was released in 2017 and within that list was the following basic IV equipment:
This review made a huge difference to the costs for the trusts, especially with the blunt filter needles as these were triple the cost of the filter needles from some companies. This change in pricing has given trusts the ability to ensure that compliance with the safety sharps directive is managed effectively without compromise.
In May 2018, DHL was awarded the contract for ward-based consumables, including all IV-related products nationally. DHL has been tasked with saving over £480 million within the first 3 years. Within the category tower teams there is general clinical staff involvement but their level of knowledge around IV therapy equipment will not be as good as that of IV specialist nurses.
As part of the model a clinical and product assurance team was set up within NHS Supply Chain, led by a registered nurse. The team will be responsible for working with the allocated towers and contractors to ensure compliance and review products alongside clinical staff (Gander, 2018).
Interestingly, following a DH and NHS England document in 2013, which discussed setting out a procurement strategy (DH and NHS England, 2013), the Royal College of Nursing (RCN) was proactive and set up an independent group to evaluate products for suitability in the NHS, with its vision being ‘quality, safety and value’ (RCN, 2015). This was before the Carter report was published.
As clinicians working in the field of IV therapy, we need to get involved with this work on evaluating products for suitability in the NHS within our trusts sooner rather than later. I am very involved with procurement within my trust and have a voice on IV-related products/devices that are under review and, believe me, there are a lot of them.
“As clinicians working in the field of IV therapy, we need to get involved with this work on evaluating products for suitability in the NHS within our trusts”
If you are not involved in procurement, then you should be—either directly or indirectly. Speak to your head of procurement and find out how things work and if there is representation already and start communicating with these teams or individuals.
Use your expert knowledge in IV therapy to help ensure quality, safety and value are considered in all aspects of care.