NHS Supply Chain category tower service provider director, Mark Hart, explains what he needs from the MedTech industry in a Wilmington Healthcare webinar
by Steve How and Oli Hudson, of Wilmington Healthcare
Understanding how to engage with the NHS’s 11 procurement category towers, which are tasked with delivering significant cost and efficiency savings, is a key challenge for the MedTech industry.
In a free Wilmington Healthcare webinar on February 7, our guest speaker Mark Hart, Director of cardiovascular, radiology, endoscopy, audiology and pain management, services provided by Health Solutions Team Limited (HST), which runs Tower 6, outlined his priorities and progress to date.
Tower 6 is the biggest NHS Supply Chain category tower which handles about £1bn of goods annually and has a three-year contract to manage the procurement of equipment. Describing Tower 6 as “very diverse and complex”, Mark explained that there are around 118,000 individual devices within it and significant overlaps between similar brands and devices that all perform similar functions.
“At its worst, we have more than 50 products being procured for the NHS that all perform a similar clinical task. Clinicians recognise this device and brand proliferation needs addressing and are working with us to lead the process of standardising products, reducing variance and starting to aggregate purchasing to create more value. We achieve this by putting deeper and more long-term commitments into the market. That is a foundation of our contract,” he said.
Mark emphasised the importance of value-based procurement for devices that are used inside the human body. He said: “We cannot just focus on unit price. Performance, safety and patient outcomes are all critical.”
In common with the other tower directors, Mark is looking to quickly move to national pricing. However, this is challenging given historic complex pricing structures. For example, historically some High Cost Tariff Excluded Devices (HCTED) have had provider-specific pricing across 126 trusts, with no correlation to commitment, spend value or the services provided around them.
Working with industry is key to resolving these kinds of problems and Mark said he was pleased with its response in helping to achieve the ultimate objective of giving each NHS trust equal treatment, “where they meet similar specifications of service commitment and spend duration” – a style of working known as the National Price Matrix Model.
Full national commitment will be underpinned by clinical desire to standardise, aggregate and offer industry commitment. HST is working to lead this change by developing ‘portfolios of clinical outcomes’, that ultimately will be used to provide insight into national requirements. This approach for tariff-based devices is being focussed around the operating model of Sustainability and Transformation Partnerships (STPs). It is therefore very much regionally driven; hence Tower 6 is already progressing a number of strong regional clinical partnerships.
Asked about the importance of data and analytics in procurement decisions, Mark said: “They are the foundation for engaging with clinicians. The device price is just one dimension, and we find that clinicians want to know far more about the range of devices that are available, and most importantly how they perform, and the total life costs linked to these enhanced clinical outcomes. Device quality and performance is absolutely critical and drives our approach to clinical engagement.”
Tower 6 is already building access to a portfolio of data and has a data sharing agreement with access to Purchase Price Index and Benchmarking (PPIB) data. The tower is focussed on working with system providers and industry to secure more data sets, such as the impact of devices on patient pathway costs.
The towers are driving engagement with Integrated Care Systems (ICSs) through STP contacts. Tower 6 is keen to develop case studies on trusts and share best practice with ICSs.
Mark said: “There are about 106 suppliers that will operate under the national arrangements. We want to give every industry supplier the opportunity to bring value – both multi-national providers and SMEs.”
Asked for his view on the value of in-system managed service contracts such as one run by Guy’s and St Thomas’ NHS Foundation Trust, Mark said there were several examples of independent fully managed services “driving value in areas such as inventory management, and supported by NHS Improvement as a way of improving the services for patients without the need for capital investment, so we support them.” He had a similar view of contracts outside ICSs and said his tower partnered with the Shelford Group, which must “meet the same standards as other trusts and drive clinical change.”
HST has its own clinical evaluation process, which is run by Clinical Councils and is made up of providers known as ‘reference trusts’. The tower also works in partnership to support the NHS England (NHSE) Device Working Groups, which lead on the evaluation of High Cost Tariff Excluded Devices (HCTED). Mark said that he was delighted to be working in partnership with Getting It Right First Time (GIRFT), and that HST is committed to supporting a GIRFT-led clinical approach in the South West with Devon & Cornwall STP providers. This project, which aims to provide a road map for further regional and national evaluation, will help to remove duplication. HST will also work across the system, and with NHS RightCare to help develop a standardised approach to procurement.
In summary, the webinar showed that both industry and NHS trusts must be open to change in contracting and procurement. It is vital for industry to work in partnership and be open to ways of delivering short, medium and long-term value.
To register to listen to the webinar on-demand, log on to https://wilmingtonhealthcare.com/event/how-should-medtech-engage-with-the-procurement-towers/