Chris Whitehouse, a political consultant and expert on medical technology policy and regulation at Whitehouse Communications, an advisor to continence product suppliers, chair of the Urology Trade Association, and governor of the Anscombe Bioethics Centre, looks at the impact of delays in the introduction of value-based procurement.
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Over a month on since this column broke the news of a new value based procurement [VBP] methodology coming to the NHS in England, the promised toolkit is still under wraps. Whilst its publication remains imminent, however, the delay to the adoption of the new approach is seeing the NHS waste millions of pounds every week.
The methodology heralds a new approach to VBP that would put patient experience and outcomes at the heart of purchasing decisions, taking fully into account whole system costs. Placing a renewed focus on the patient, it has the potential to deliver a paradigm shift in approaches and attitudes to purchasing, moving away from item price to true value. What’s not to like, as everyone who has caught sight of the new approach exclaims!
But, in the real world, the calendar is moving forward. Indeed, as we approach the financial year end, millions of pounds’ worth of new purchasing contracts are being negotiated on the old model which sets item price on a pinnacle and takes little, if any, account of patient outcomes and experience. Financially, the old approach continues to look at budgets in narrow silos with purchasing decisions being taken without any assessment of, or weight given to, the impact of some product purchasing and provision decisions on whole system costs.
The NHS has always been an oil-tanker of a vessel – so large that bringing about change in priorities and practices can take considerable time to deliver, where innovation adoption is hard to promote, and where nobody, ultimately, seems to take responsibility for whole system costs within primary and social care, hospital trusts or even, as yet, in ICBs. This simply has to change.
Politically, both major parties, as we approach an inevitable general election later this year, are committed to promoting VBP, and to addressing much else that needs to change within our struggling NHS. So, the policy environment is actively supportive.
Good work is going on through and with the Health Care Supply Association to ready the purchasing community for the new approach, and NHS England are giving real consideration as to how to drive forward its adoption over turf that is already being rolled for the launch. But, in the meantime, the old ways are seeing purchasing managers squandering millions of pounds of resources for which services are crying out.
Nowhere is this more apparent than in the context of absorbent continence products, an area which is seeing patient experience and outcomes sacrificed on the altar of price-dominated discussions, despite substantial published evidence of case studies and pilots where real improvements have been delivered for patients, along with cost reductions over whole systems and in residential care settings in particular.
The right hand of the NHS will not deliver the ambitious cost savings from procurement to which it is committed whilst its left hand continues to fritter away huge sums on poor purchasing decisions. Nor will patients experience the benefits of being allegedly at the heart of the ICB pathways whilst purchasing managers are looking away from them, in the wrong direction.
NHS England needs to get a grip on this situation, and need to do so today, not Mañana.
Comments upon or questions about this article can be addressed to chris.whitehouse@whitehousecomms.com
