NHS Supply Chain and efficiencies in procurement
Closed
What the inquiry looked at
“NHS Supply Chain was set up in 2018, and manages the procurement and supply logistics for NHS trusts in England and Wales. Its original target was to make £2.4bn in savings, which it reports it has exceeded. The NHS spends around £8bn a year on buying hospital equipment and consumables, according to NHS Supply Chain estimates. In 2022, the Committee found that the Department for Health & Social Care (DHSC) transferred management of PPE supply to NHS Supply Chain, with roles and responsibilities in this area still unclear and many issues to be resolved. NHS Supply Chain is now delivering a new strategy, with an aim to be more focused on the needs of the NHS and improve customer satisfaction. Based on a National Audit Office (NAO) report , the Committee will take evidence from senior leaders from NHS Supply Chain, NHS England and the DHSC on subjects including: Progress in delivering savings for the NHS; Barriers to efficient procurement; Customer satisfaction; Management of new strategy implementation. If you have evidence on these issues, please submit it here by 23:59 on Wednesday 24 January 2024. Please look at the requirements for written evidence submissions and note that the Committee cannot accept material as evidence that is published elsewhere. This inquiry was closed due to the 2024 General Election.”
The committee's words, from the inquiry page on parliament.uk ↗.
What it found
NHS Supply Chain was created to solve a known problem and to save the NHS money.
The NHS was not making the most of its collective buying power to get the lowest prices for consumables and medical equipment. To solve this, in 2018 the Department of Health and Social Care (the Department) established the NHS Supply Chain organisation to make savings through aggregating the NHS’s purchasing power. But too many trusts still lack confidence in NHS Supply Chain and choose not to use it for billions of pounds of spending. Of the £7.9 billion that trusts spend on consumables and medical equipment, only £4.5 billion is spent through NHS Supply Chain. Trusts are clearly not engaging with the service that NHS Supply Chain provides at the scale required to harness the NHS’s collective buying power. Net customer satisfaction with NHS Supply Chain is in decline; from a peak of 67% in 2021–22 to 54% in 2023–24 and over two-thirds of trusts say they shop elsewhere because of limited availability through NHS Supply Chain. NHS Supply Chain has so far failed to demonstrate that it is the answer the NHS needs. The Department told us that it was intended that using NHS Supply Chain would become so compelling that trusts would choose not to go elsewhere. So far, this approach appears to have failed.1 NHS England, and before it the Department, have been far too lenient in their oversight of NHS Supply Chain. They have failed to validate savings, do not challenge why trusts do not make more use of NHS Supply Chain and have allowed NHS Supply Chain to get to the point where its systems are not fit for purpose and where it is, by its own admission, years away from being what the NHS needs.
The NHS’s need for an effective and high-performing procurement function remains compelling and this function requires strong national leadership and oversight.
Currently, neither NHSE nor NHS Supply Chain has a clear vision of how NHS Supply Chain can secure the confidence of not only local procurement teams and managers but, crucially, clinicians as local champions for what is best for the NHS and patients. The need is also urgent. Delay and non-delivery risk further undermining the value of NHS Supply Chain. We are encouraged by the recognition by NHS Supply Chain that there is much to do but also much to be gained. We look for swift and sustainable progress from NHSE and NHS Supply Chain and would encourage our successor Committee to continue monitoring this.
What the government said
The government responded on 28 May 2024.
The government states that it "agrees with the Committee's recommendation" on each of the six recommendations in the report on NHS Supply Chain and efficiencies in procurement, with target implementation dates given for some.
- On the 80% market share goal, NHS Supply Chain expects to submit a programme business case to NHSE by Winter 2024. NHSE "cannot mandate the use of NHS Supply Chain", and the 80% target could be met only if the modernisation programme is "delivered in full".
- On oversight, the government says the subsidiary company model provides NHSE with "a proportionate level of oversight", citing an annual business plan review, quarterly accountability meetings and a shareholder director on the company Board.
- On savings reporting, the value and savings methodology applies across the NHS from April 2024, and NHSE "will review the compliance and effectiveness of this methodology after the first year" (target date: Summer 2025).
- On the modernisation timetable, the business case due by winter 2024 "will consider the overall timetable" and include a benefits realisation plan. Delivery is "subject to business case approvals", and NHS funding beyond 2024-25 will be agreed at the next 2024 Spending Review.
Read the government's response ↗ Read the report ↗ Report an error
How the inquiry ran
Each dot is a dated item listed on this page, from the inquiry's opening on 10 January 2024 to its close on 28 May 2024.
- Oral evidence 7 Feb 2024
- Report 27 Mar 2024
- Government response 28 May 2024
- Correspondence 2 letters
What it recommended 8 recommendations · 17 conclusions
2Set out how NHSE will challenge and support NHS Supply Chain's modernisation plans.
3Use procurement data more systematically to challenge trusts to increase NHS Supply Chain purchases.
4Assess trust acceptance of NHS Supply Chain's reported savings after new method implementation.
5Provide a clear roadmap for NHS Supply Chain's transformation, modernisation, and benefit realisation timetable.
6Set out how NHSE and NHS Supply Chain will involve clinicians in purchasing decisions.
1Initial review highlights evidence taken on NHS Supply Chain efficiencies and procurement.
7NHS Supply Chain expects at least three-year delay reaching 80% market share target.
8NHS Supply Chain customer satisfaction declining, failing revised targets due to infrastructure issues.
9NHS England and Department fail to validate reported NHS Supply Chain savings data.
10Department and NHS England intentionally chose not to mandate NHS Supply Chain use.
11NHS England withheld full requested funding, potentially delaying NHS Supply Chain IT improvements.
12NHS England fails to actively use procurement data to challenge trusts' purchasing choices.
13NHS England only challenges financially struggling trusts, not analysing broader procurement data.
14NHS England's procurement data is incomplete, impacting accuracy of savings estimates.
15NHS Supply Chain improvements will take several years to benefit trusts and increase usage.
16Complex challenges hinder NHS Supply Chain's ambitious transformation programme, rated red/amber for delivery risk.
17NHS Supply Chain's capacity and resilience for transformation delivery show notable weaknesses.
18Modernisation challenges and persistent delivery delays plague NHS Supply Chain's eDirect procurement route.
19Multiple, inconsistent methods for calculating NHS Supply Chain savings reduce clarity and cause mistrust.
20NHS Supply Chain's reported savings vary significantly depending on the calculation method used.
21A new aligned methodology developed for consistent NHS savings calculation and reporting.
22Unmanaged disconnect exists between product cost, clinical choice, and patient care outcomes.
23Free' specialised devices create perverse financial incentives, conflicting with clinical judgement.
24Absence of national clinical leadership and outcome monitoring for product use, impacting best practice.
25NHS procurement's focus on acquisition costs alone disregards overall product value and patient outcomes.
Evidence
Oral evidence sessions 1
- 7 Feb 2024NHS Supply Chain and efficiencies in procurement5 witnesses, listed belowparliament.uk ↗
Who gave evidence 5 witnesses
- Amanda PritchardChief Executive Officer, NHS England
- Andrew NewChief Executive Officer, NHS Supply Chain
- Jacqui RockChief Commercial Officer, NHS England
- Julian KellyDeputy Chief Executive Officer & Chief Financial Officer, NHS England
- Shona DunnSecond Permanent Secretary, Home Office
Correspondence 2 letters
- 26 Feb 2024Correspondence from Julian Kelly, Chief Financial Officer, NHS England, re NHS Supply Chain and Efficiencies in Procurement, dated 15 February 2024
- 19 Feb 2024Correspondence from Shona Dunn, Second Permanent Secretary, Department of Health and Social Care, re NHS Supply Chain and efficiencies in procurement, dated 14 February 2024