What can NHS procurement learn from the coronavirus pandemic?
Romy Hughes, Director at Brightman, outlines several lessons that the NHS must take from the pandemic to improve procurement processes for the health sector beyond the pandemic.
The NHS’s procurement response to the coronavirus pandemic appears to be a tale of two approaches. In the early stages there was a sense of optimism and determination as the country pulled together to “beat the virus” any way it could. The Government showed uncharacteristically creative thinking by turning to British industry to meet the demand for ventilators, while some of those who supplied technology to the NHS were praising it for the new speed at which it was deploying new technology solutions. Tom Wicher, Chief Executive of booking software provider DrDoctor said in a Sky News interview that “It feels as if someone’s taken the handbrake off the NHS, it’s like it’s been given permission to go fast.”
Yet at the same time, we all saw the media reports of PPE shortages and many SMEs’ offers to supply equipment being left unanswered. Clearly the NHS faced a situation for which there was no parallel, and there are countless examples of quick thinking and rigid policymaking. However we must strive to bring greater lasting agility to NHS procurement.
Public sector procurement has always had its challenges, many of which will have been compounded when the pandemic put this supply chain under particular strain. It is here where the NHS must focus its efforts to create a new procurement environment after the crisis. We have identified the following causes which need to be addressed:
- Underutilisation of the Digital Marketplace. The Digital Marketplace was launched to make the procurement of IT to the public sector more agile, democratic and transparent by lowering the cost of entry for smaller businesses and making the process simpler and faster for all involved. Yet a lack of training by public sector staff means it remains underutilised.
- Simplifying supplier options. Lots of choice is a good thing, but procurement is simply not equipped to deal with the high number of smaller suppliers that the government has actively encouraged to pitch for government business. As a result, many contracts are still won by larger suppliers.
- Matching the pace of supply with demand. British manufacturers were ready, willing and able to support the NHS but many were left unable to do so due to the inability to contact the right people and/or a lack of specifications on what exactly was needed.
- Inability or unwillingness to react to the situation quickly enough. While there is evidence of some processes being expedited in the technology sector, was procurement as-a-whole willing to change its approach or relax its rules in other areas? This was the time for creative thinking and flexible approaches, but did the “by the numbers” culture of procurement stifle this?
What can be done to address these problems?
- Educate the NHS on the procurement frameworks available – the framework agreements already provide faster routes for procurement, but they fully need to be harnessed.
- Increase standardisation of frameworks and working processes – this will make it easier to scale down/up more quickly and make it easier for suppliers to navigate the market.
- Move the NHS away from primarily using/building its own e.g. NHS trusts routinely build their own datacentres. While some cloud contracts have been awarded to Google and Amazon most recently, the Cabinet Office’s own cloud provider, Crown Hosting, could be better utilised.
- Drive efficiency from the top by appointing a “Minister of Government Efficiency” – someone who can review all public sector procurement practices and drive reform across the whole sector and in every department. This should be a cabinet role to ensure real change.
- Increase the agility of procurement, especially in times of crisis – the NHS demonstrated its ability to be flexible with tech startups during the crisis. It needs to replicate this in other areas, especially since stockpiling often isn’t feasible due to storage costs and the short lifespan of many items.
These recommendations are not intended to be a criticism of the NHS during this crisis; hindsight is always 20:20. But let’s not waste this hindsight. There will be a willingness to learn lessons once this crisis is over. This will be a great opportunity to address many of the procurement problems that have needlessly held back our public services for too long.