As an administrative trainee at Clatterbridge Hospital on the Wirral I spent some months working in the supplies department. A small team handled both procurement ,storage and delivery. The team and stocks were based in disused EMI huts built during world war two. I spent most of my time sitting with those ordering supplies and doing stock takes which never quite balanced. The supplies team was very much part of the hospital family. Internal relationship were helped when the Supplies Officer [ in his brown coat] became director of the hospital pantomime! Ward sisters knew who to ring when the stock they had hoarded in their cupboards grew low. It wasn’t very efficient, but it worked…..most of the time.
During the 1980’s those arguing for procurement at scale and more product standardisation began to win the day. Regional systems began to grow. The training programmes built by the Association and hosted at Nottingham University began to fill up. I taught on them regularly and saw professionalism take root.
In Trent, where I was Chief Executive, the key decision was to appoint a man from outside the NHS, Ian Bradshaw, to build a regional distribution centre at Alfreton and purchase the IT system that would make it work. Local district managers were not keen and, like many, were aghast at the sheer size of the Alfreton operation. It had to work flawlessly first time. Bradshaw was a very demanding professional and it did. Eventually it was trusted to deliver the right goods on time. Local managers got on with other challenges. The best supply systems work silently and efficiently in the background. Other NHS regions started down a similar path and supplies moved into a new age. Exciting for many but not easy for those who had worked locally. Their job had changed radically and there were fewer of them.
Within perhaps 10 years a new word had entered the supplies world…Logistics. Mirroring the main stream NHS, procurement and storage and distribution were separated and national organisations began to emerge, some managed by private sector companies. In the NHS the emergence of independent NHS Trusts complicated matters for a time until the logic of a collaborative supply system worked its way through the system. Suddenly conversations could start in earnest about sensible standardisations in previously exempt clinical areas.
For many products the market place became global rather than local and supply chains became much extended.
Covid was an unhappy experience for the NHS including supplies and logistics. Incompetent leadership at the centre of government rightly came under the most serious criticism. There is much to learn from this experience.
A speculative look at the future suggests some trends.
· The supplies and logistics function with have to keep developing and improving if it is to match, or better, commercial rivals like Amazon. It will need investment which needs to be factored into unit pricing. Artificial intelligence will have to be mastered and deployed. Usage, stock balances, forward orders and pricing will have to go real time.
· The NHS will have to work together better and closer with other public sector procurement agencies.
· The NHS will have to further develop it’s BRAND based on expert and tight specifications at a competitive price and totally reliable storage and distribution. This latter function will come under the greatest competitive pressure.
· Inhouse manufacturing [ including 3D printing for specialised products] and/or strategic commercial partnerships that include product research, testing and development needs to be part of the future. Past experience of public sector manufacturing [blood and pharmaceutical products ] is not encouraging.
· The science of medicine is growing at an enormous rate and new services and products will be demanded by clinicians and patients. Supplies professionals need to know about and understand this science.
· The Association must keep the skill base of its members up to date and developing. The world is changing fast and they must keep up.
As always getting the right balance between national and local decision making and action will be highly influential for long term success.
The future as always will be challenging and exciting.
Prof Brian Edwards
Date: 26 November