Procurement 4 Health HST update

Procurement 4 Health HST updateDr Phil Lewis, Procurement Director, HST

2NHS Supply Chain: Cardio-vascular, Radiology, Endoscopy, Audiology and Pain Management is provided by HST

1. Year 2 contract progress2. Procurement Workplan & Clinical Councils3. Summary & Next steps

Presentation Overview

NHS Supply Chain Tower 6 | P4H 2020 event | Confidential Information


Year 2 contract progress

Contents


4NHS Supply Chain: Cardio-vascular, Radiology, Endoscopy, Audiology and Pain Management is provided by HSTNHS Supply Chain Tower 6 | P4H 2020 event | Confidential Information

Transforming Procurement• National & Regional Opportunities• Flexible approach to Procurement

Development & Implement: Clinical Councils• Driving clinical led specifications for national procurements• Established national coverage plan for England•Cardiac Rhythm Management•Interventional Cardiology•Interventional Radiology

• Clinical Council for South London PCI: significant savings

Foundations: Improving day to day transactional processes • eDirect and transactional model improvements with development and replacement f IT

infrastructure• DHSC eCommerce Strategy alignment (GS1 and PEPPOL)• EDI order transmission methodology and increased order transmission frequency• Supplier Portal flexibility for line level amends and automated back orders• Individual invoicing per order configurability for receipt and 3 way matching ability

HST shaping requirements to enhanced Operating Model


What is it

• End-to-end process for category management• Includes tariff and HCTED • Staff aligned vertically to categories & products

What it requires

• Mapped products into each category service line• Interdisciplinary communication and approach

What it means

• We operate differently – change of approach • Pooled resources flex to service line needs• Functional teams operate horizontally (Service Lines)

Who benefits

• Tower 6 colleagues: clearer roles & responsibilities• Trusts/SCCL: clearer points of contact• Tower 6: achievement of savings targets

Why do this?

• Positions NHS Supply Chain to hit year 3-4 savings

• Embeds Clinical Council model fully

• Aligns to the request to remove overlaps

• Streamlines processes• Integrated delivery to

Trusts (& SCCL)

Service approach: Passionate about exceeding NHS overall requirements


Contract: years 3-4, our strategies & Approach


• Focus remains on reduction of NHS spend in devices, driven by clinical decision-making supported by evaluation of clinical outcomes, device performance and commercial pricing data

Tower 6• Long term procurement strategies informed by clinical councils

driven by data analytics

• Drive collaboration and resource alignment - clinical council members include leading clinicians and key stakeholders aligned to national clinical programmes and initiatives such as NHS England HCTEDs (Device Working Groups ) GIRFT and CaPA

• Utilisation of HCTED volume to drive towards flexible commercial offers for the NHS

• Strong procurement strategies (range rationalisation, standardisation & commitment) will underpin the HST delivery of value & enhanced patient outcomes

• Service Delivery : deliver day-to-day efficiencies & drive SC redesign and innovation


Procurement Workplan & Clinical Councils

Contents



Category Tower Framework/Contract name

Publication of CN on

OJEU date

Award of contract

Framework/contract Go Live date - product

available to order (6 weeks minimum after customer

launch)

6 Audiological Implantable Devices Accessories Consumables Maintenance and Repair 2020 15/11/2019 27/03/2020 31/07/2020

6 Audiological Equipment Services and Related Consumables (AES) 23/02/2020 27/05/2020 28/09/2020

6 Hearing Aid batteries 12/06/2020 12/10/2020 01/02/2021

6 Endoscopy Consumables 21/07/2020 15/01/2021 10/05/2021

6 Endourology 20/08/2020 15/01/2021 10/05/2021

6 Structural Heart, incl perfusion and VADS 03/09/2020 16/02/2021 24/05/2021

6 Oncology Ablation 24/08/2020 22/02/2021 31/05/2021

6 Cardiac Ryhthm Management and Electrophysiology, Interventional Cardiology, Radiology and Neuroradiology 24/09/2020 03/03/2021 14/06/2021

6 Percutaneous Valve Repair and Replacement Devices 07/01/2021 12/05/2021 01/09/2021

6 Hearing Aids and Accessories Live Live 01/04/2020

6 Neuromodulation Devices and associated products Live Live 25/06/2021

Future Work Plan: Framework Renewals



Credible data, physician alignment, shared goals, interdependence, accountability

Standardisation and utilisation of supplies

Physician-clinician alignment on LOS and quality

Reduction of waste (non-value-added processes)

Clinical alignment and operational improvement

Improved pricing on supplies and services

Immediate impact to P&L (operating expense)

Understanding of spend via analytical tools

Cost management

Improved capacity and market share

VBP readiness, bundles and quality of care

Optimised revenue via gainsharing or episodes

Performance optimisation

Savings (£)/quality/ satisfaction/outcomes

LOS = length of stay; P&L = profit and loss.

Agile Regionally Segmented Resource FlowMOU embedded process driving adoption

Monthly Future StrategyResource Reallocation

Implementation / Procurement

Contract Management*

* Supporting national commitment contracts linked to DWG outcomes

Proven approach & methodology leveraging data and process



Notes: • Colours represent various consultant groups: EP, Interventional Cardiologists, Cardiothoracic Surgeons, Interventional Radiologists and Neuro Interventionalists• Potential other product categories include: EVARs, Closure Devices, Atherectomy, Intra Aortic Balloon Pumps, and Vascular Grafts• TAVI will be addressed separately from surgically implanted heart valves

Clinical Council Strategy: organised to exploit market dynamics in line with ‘Category Management’ foundations

Cardiac Rhythm Management

Interventional Cardiology

Structural Heart Valves

Electrophysiology Interventional Radiology Neuroradiology

PRIO

RIT

Y

• Pacemakers, CRT-Ps & Associated Leads

• ICDS & Associated Leads• Loop Recorders• Home Monitoring

• Drug Eluting / Bare Metal Stents

• Cardiac Balloons• Cardiac Guide Catheters• Cardiac Guide Wires

• Tissue Valves• Mechanical Valves• Rings &repair Products

• Diagnostic Catheters• Mapping Catheters• Ablation Catheters

• EVARS• Peripheral Drug Eluting Stents• Drug Coated Balloons• Peripheral Bare Metal Stents• Peripheral Balloons• Peripheral Guide Catheters• Peripheral Guide Wires

• Intracranial Stents• Aneurysm Coils• Neuro Wires


Clinical Council: Priority Categories South London Case Studies

Cardiac Rhythm Management

Interventional Cardiology

Interventional Radiology

• Tower 6’s first full Clinical Council process completed in August 2020 - for key South London Trusts.

• This clinically led initiative has delivered 30%+ savings on the Percutaneous Coronary Intervention (PCI) basket of spend.

• The Clinical Council delivered some of the lowest pricing for Drug Eluting Stents and Balloons we've seen yet.

• Due to award in November 2020 is the South London Cardiac Rhythm Management (CRM) Clinical Council

• South London Clinical Council brings together large London Trusts to drive value for the NHS across HCTED and in Tariff Devices.

• Extensive Engagement with the South London Operational Delivery Network (ODN) and NHSE commissioning team has been key to this councils success

Moving forward, we are now mobilising an Interventional Radiology Clinical Council across South London – which will follow the same Clinically led process.

High cost devices such Devices such as Endo Vascular Aneurysm Repair (EVAR) Stenting in scope.

Tower 6 enhanced Data Analytics are highlighting significant savings opportunities in the Interventional Radiology space.


Summary & Next Steps

Contents



• All medical device strategies are developed on a comprehensive basis with provider insight and are based on a ‘two step’ process:– Category strategy: overall assessment of the market, identifying the opportunities to move from

‘tactical’ into ‘strategic’ procurements, based on ‘system value’ and ‘patient outcomes’– Sourcing strategy: the detailed procurement approach to unlock the ‘system value’ benefit– Embedded within the SCCL ‘Category Council’ governance framework

• Key operating principles:– All awarded suppliers have the opportunity to supporting creation of NHS ‘system value’ – A general approach to standardise, aggregate and commit through contracts, either operated under

the NHS SC frameworks, or under standalone national commitment contracts– A maximum of 80% of market spend committed at any one time, to ensure new technologies are

given ‘space’ for introduction and competition remains

• Tower 6 is a key influencer in the overall operating model and offers the opportunity to work with industry and create more efficient supply chains


Summary: NHS requirement for strategic change in approach


• HST have a strong blend of experience of both NHS & US Healthcare markets to engage and drive clinical change

• HST have a strong track record of delivery, and will provide implementation, procurement, contract management, PMO and contracting resource to ensure success

• STP engagement and commitment to a strategic savings approach via MOU is critical, as without clinical appetite for aggregation, standardisation and long term commitment therefore ‘doing things differently’, savings will not occur.

• All decisions will be strategic and long term and based on data analysis provided by HST for clinical evaluation

• Trusts will need to resource and commit to reference trust and Clinical Council model• Full data transparency will be required from providers regarding all aspects of ‘value add’

Next steps: what this means for NHS providers?


Thank You

NHS Supply Chain: Cardio-vascular, Radiology, Endoscopy, Audiology and Pain Management is provided HST

Procurement 4 Health HST update

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