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Back in January this column broke the news of a new value based procurement [VBP] methodology coming to the NHS in England. After work to secure buy-in from NHS England, NHS Supply Chain, and the Central Commercial Function, the latest iteration is out with industry, the procurement community and the wider NHS in England for feedback and comment – and boy will it deliver fundamental change in the way that the NHS procures medical products and devices.
In short, the new approach amounts to a paradigm shift in purchasing approach. No longer will a race to the cheapest priced product be the basis of assessment of value, with some reference to environmental impact, business model and supply chain resilience. The coming new dawn will, for the first time in years, see patient experiences and outcomes at the heart of the process.
Products that improve those outcomes will be scored higher, even if their price is higher – something which is hardly surprising for better, innovative products – and there will also be score boosts for those products that reduce relapses and so remove steps from the patient pathway, saving clinical time and freeing up resources, and so reducing overall system costs.
There will continue to be questions to assess environmental impact and commercial aspects of supply, but the model provides for price to be no more than 40% of the score in future assessments. This is real change, and the DHSC’s MedTech Directorate are to be congratulated on the speed with which they have developed a model sufficiently robust now to go out for wider scrutiny.
The change was delivered by a sustained political lobbying campaign by Lord Hunt of Kings Heath, Patron of the Health Care Supplies Association, using as its main lobbying tool a case study produced by continence product supplier, Essity. Based upon the study, it was calculated that if a simple switch to a better quality, if slightly more expensive absorbent continence product were made, then the NHS, at a conservative estimate, could save half a billion pounds per year.
The potential savings across the budget for medical products and devices when this toolkit moves from helpful advice (at present), to formal guidance (October this year), and mandatory (October 2025) are unprecedented.
Up until now, the principle that the patient pathway and outcomes should be at the heart of the NHS and, in particular, the ICSs, has been something of a myth in many situations, but now it can be delivered.
This will require Chief Executives of ICSs to get those purchasing products and devices within the local health and care community to get out of their silo mentality and see the system as a whole, and from the particular perspective of the patient, whether in hospital, in residential settings or in the community.
Purchasers seeking to shave a few pence off the price of the cheapest product can all too often impose substantial costs on other parts of the system. This has to end.
There is no case for delaying the use of the new model until it becomes formal or mandatory guidance. Clinicians, now that they can point to this new methodology, should be absolutely demanding it be adopted, and adopted now, in relation to all medical products and devices, since this will improve their own performance outcomes, improve patients’ lives and reduce the cost to the NHS as a result.
Comments upon or questions about this article can be addressed to chris.whitehouse@whitehousecomms.com
