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In this post, we examine a report on public procurement in the National Health Service in the UK. It focuses on bed occupancy and how contract management techniques can be used to improve efficiency. We also look at what they could mean for public procurement contracts in Ireland.


The NHS and Public Procurement Contract Management

The British Healthcare Trades Association stated in a recent report that better contract management is a key to preventing bad operational outcomes. This includes “bed-blocking“, a practice that causes delays across the NHS. As a patient safety measure, hospitals in the UK cannot have more than 85% of their beds filled at any one time. Successfully adhering to these standards reduces the spread of bugs like MRSA. Last winter, persistent issues arose with several hospitals hitting or coming close to 100% bed occupancy. As capacity maxed out in the system, the provision of health care deteriorated in quality (too many sick people together at the same time) and quantity (stretched resources). Additionally, NHS England statistics show a rise in the number of delayed days (when a patient is ready for release but has not been processed).


The HSE and operational issues

Meanwhile in Ireland, the Health Services Executive (HSE) saw the number of patients awaiting a bed rose to unprecedented highs according to (contested) trade union reports.  HSE national director Damien McCallion stated that the overcrowding problems arose from the annual winter flu virus in large conurbations. This said, access to healthcare was an issue that presented in less populous areas like the midlands. The fact that the HSE and NHS have similar issues means that they may benefit from similar solutions.

In response to the issues experienced by the NHS, a recent report suggests increased capital expenditure is essential.

On the other hand, in the Irish State, an increased budget of €320m is being sought to satisfy the future needs of elderly citizens. This increase is merely keeping pace with demographic changes as the country ages. The Sláinte health care plan seeks billions in extra annual funding for the second costliest system in the EU. Many doubt the wisdom of increased investment in a system that seems incapable of reform. While debates on pay increases in return for productivity improvements never end, consensus on a path forward rarely emerges either. The health system has weak accountability structures and is remarkably resistant to reform.


Public procurement contract management as an agent of change

The aforementioned British Healthcare Trades Association report approaches the deficiencies in the NHS from a different angle that could be relevant for Ireland. They recommend a change in focus from cost to the value services providers can generate. For this to happen, the emphasis in procurement changes to how suppliers can solve known issues. Subsequent contract management processes focus on the delivery of the solutions.

The MEAT (most economically advantageous tender) method is designed to ensure benefits can be delivered this way. While value add is in the evaluation phase, the focus can fall off during the contract management phase. By delivering greater value for money through innovation, pressure comes off operational budgets. The BHTA report offers the old-fashioned advice that when managers manage, they deliver high performance.

Outstanding competency in contract management is a characteristic of the highest performing organisations in the world. These practices do happen in parts of the Irish Health System and the NHS. This said the skills to undertake work like this are not prevalent outside units that specialise in contract management.


More help on sourcing and procurement

We also have lots of experience in sourcing and procurement across all spend categories.  So, check out our Procurement Sourcing services to see how we can help with your procurement needs. Not only that, you can also search for ‘Procurement Sourcing‘ articles on our blog.

Public buyers in Ireland can get more advice from the Office of Government Procurement on the best tendering procedure to use and you can use to request a tender. Likewise buyers in the UK can find the best tender portal for them by checking our handy list.

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