HCSA Patron Lord Hunt lends his support to a greater focus on value in NHS procurement in this post for HSJ below:
With the general election now looming and Labour’s manifesto being finalised, we need clear and specific policies with which voters can identify. Nowhere is that need more pressing than in our approach to the NHS. So, here’s a win-win idea for Wes Streeting and his team to pick up and run with.
I’ve been championing “value-based procurement” in the House of Lords, driving home to ministers precisely what the concept means, because if it were actually adopted, it could deliver, at pace, dramatically improved quality of life for patients and substantial reductions in overall health and care system costs – whilst significantly reducing demands for additional treatments that are exacerbating the NHS waiting lists crisis.
Put simply, value-based procurement is about looking at not simply which product is cheapest per item, but also at which is best for patient outcomes and quality of life, and for avoiding relapses or unintended side-effects. It can also incorporate elements of environmental impact and sustainability into the formula.
With high-end capital-intensive technology or innovative new products, we can hope such overall value-based assessment will be made as part of the approval and adoption process, but the low hanging fruit, where rapid improvements can be made and savings delivered, can be the most basic technologies, the most-used items in the NHS and social care store cupboards.
Take, for example, absorbent hygiene products used by many millions of patients to manage continence challenges. Yes, the sheer volume of consumption, several items per day per patient, means that the total cost seems high, and a saving of even a small amount by switching to a cheaper product might seem a good idea to a purchasing manager. But, if that decision has consequences, and all purchasing decisions do, then to suggest that it may be a false economy could be a huge understatement.
A recent study in which, where clinically appropriate, a patient upgraded from a cheap basic absorbent hygiene product [a pad held in place by fixation pants] to a slightly more costly product [a better shaped, single-piece, pull-up product] had a dramatic effect. Cost per item up, yes, but, importantly, average number of items used reduced, leaks and associated laundry costs slashed, staff time changing and cleaning patients reduced, skin infections and ulcers down, patient mobility improved and falls reduced – greatly reducing need for additional treatment episodes – and patient quality of life and confidence enhanced.
Integrated Care Systems should be putting patients at the heart of their pathways, but there is little evidence to date of them actually undertaking such value-based assessments. Officials should be empowered by system leaders, whether local, national or ministerial, to look at the impact item price savings are having on whole system costs and NHS waiting lists.
Our Labour frontbench health and social care team need to be driving forward change in this commonsense area, putting a commitment to promotion of value-based procurement prominently in our manifesto, and delivering it from day one of the Labour government.
Lord Philip Hunt
Date: 7 November