Excellence in Supply Awards

Mick Guymer
Chair, NHS Northern Customer Board
Welcome!

Excellence in supply
Better Care Better Value
Jonathan Wood, Deputy Chief Executive &
Director of Finance
Lancashire Teaching Hospitals

Public
sector
debt
as a
%age
of GDP

OECD 2017
Life Expectancy
to spend

Lancashire Teaching
Hospitals FT
• North West
• Lancashire and South Cumbia
Integrated Care System (ICS)
Population 1.7m
• Central Lancashire Integrated
Care Partnership (ICP)
Population 350,000
• Lancashire Procurement
Cluster

Source: Shared Business Services
Industry profit comparison – Opportunity?

Scans, lies and the truth uncovered
at Hull…
Lee Bond, Chief Finance Officer
Rachael Ellis, Scan4Safety Programme
Director

Where’s the money coming from???

Some numbers…
• There are 3,846 unique patients scanned to date
• £8,680,179 value of procedures scanned to date
• We have scanned 365,739 items against patients
• We have scanned 7,112 blood tests so far
• The stock value for “live” areas is £2,113.516 against 5,947
stock lines
All figures correct as at 04-10-19

How did we start?
• Visited all 6 Demo sites, seeing the good and bad!
• Asked the question: What do we want to achieve?
• Put the patient in the middle, follow patient pathways
• Programme approved at Board level
• Get senior clinicians & nursing staff involved

Based on the 4 P’s
• Patient
• Product
• Place
• Process

The Hull Approach vs. the Demo sites approach
Neuro
Cardio
Thoracic
Obs &
Gynae
Max Fax
Cath
Labs
Theatres
& Labs
Perfusion Anaesthetics Physiology RadiologyAssociated
Services
ICU Day Ward Recovery
Surgical Day
UnitWards
Home MortuaryDischarge
Demo sites
Hull

Created the 3 C’s
• Continuous • Complete • Connected to
Patient

Since August 2018 - We are now live
Inventory Management (Stock) Point of Care (Patient)
Sterile Services 
Cardio Thoracic Surgery  
Perfusion  
Anesthetics  
Procurement (Bulk) 
Coronary Intensive Care Unit  
4 x Cath Labs  
Cardiology 5 Ward  
Physiology  
Home Ventilation  
Lung Function  
Mortuary 
Upper GI shortly shortly
Colorectal shortly shortly

Data and transparency
We now know exactly how much procedures cost…
• Users and key clinicians are often surprised at the
actual costs
• It has changed behaviour of clinicians and nursing staff
involved (less runners, less product opened)
• Stock takes are accurate and detailed

Product Recall – in less than 3 hours
Recent product recall within Cath Labs
• 62 products affected
• 91 serial numbers
Using the track and traceability, Within 3 hours…
- Identified 23 patients which used the products
- Identified all stock
- Quarantined all stock
- Set warning flags against the recalled items
Estimated to have saved 62 hours
of nursing time

Product Recall – in less than 3 hours

Systems thinking and improvement
planning
Juliette Kumar, Associate Director of Improvement and
Education

Think about systems – why is this important?
Systems thinking and change – what can we learn?
Explore habits of a systems thinker
Seeing change as a learning process in complex
adaptive systems
Understanding key relationships in your own systems
Planning for improvement and innovation
Systems thinking and improvement planning

Deming's model of profound knowledge
Appreciation of a
system
Theory of
knowledge
Psychology
Knowledge
of variation
Using systems
thinking to
understand the
interactions
between each
parts of an
organisation
How we gather
and use
information in
our
organisations for
continuous
improvement
Motivating people
are supporting
them so they are
productive in our
organisations
Understanding
and controlling
variation,
creating reliable
processes
capable of
delivering high
standards

1. A system is made of parts
2. The system has an objective or aim
3. The parts of the system are related or connected
4. The parts must work together to deliver the aim of the
system
What is a system?

• It’s a way of understanding that emphasises
relationships among a systems parts, rather than the
parts themselves
• Helps us to understand who we need to engage
and get on board with improvement efforts
• Be aware of and avoid making assumptions (this
takes away the capacity to collaborate)
• Systems are dynamic, a change in one part can
bring about an unintended consequence in another
• Systems have their own identity which is
reinforced by artefacts such as uniform, language
that are very powerful – to understand this is to open
up opportunity
Why is important in bringing about improvement?

1. Events = what is seen – what happened?
– React
2. Patterns of behaviour – what has
happened, how often, what are the
trends, what changes have occurred -
Anticipate
3. Underlying structures – things that
influenced the patterns, (e.g. policies,
laws, physical structures) – Design
4. Mental Models – what are the
assumptions and beliefs and values do
people hold about the system? -
Transform
The Iceberg Model
www.socialinsilico.wordpress.com

‘Mental models are deeply ingrained
assumptions or generalisations, or even
pictures or images that influence how we
understand the world and how we take
action’
Peter Senge, The Fifth Discipline 1990

1. Which habits do you practice?
2. Pick out a top two
3. Which habits could be developed?
4. Pick out a bottom two
‘Which habits would your colleagues identify as those you model and practice consistently?’

Volatile, Uncertain, Complex, Adaptive

Classic approach to change management
Establish a sense of urgency
Form a powerful guiding coalition
Create a vision
Communicate the vision
Empower others to act on the vision
Define, plan for and create quick wins
Institutionalise new approaches
Consolidate improvements and produce more
change
Underlying assumptions of
classic approaches to change
management:
 We know today what is
needed to be successful
tomorrow
 We can develop a plan
with realistic targets and
deadlines to get us there
 Achieving the change
goals is primarily a matter
of motivating effort
From Kotter, J. “Leading Change: Why Transformation Efforts Fail,”
Harvard Business Review, 1995 & 2007.

Change as a learning process
Classic change
approach
Top down
Centralised
Planned
Easily measured
Results faster
Works for well understood activities
Change as a
learning process
Collaborative
Decentralised
Emergent
Progress difficult to measure
Results slower
Works for novel innovation activities

1. Work individually or with team members
2. In relation to your own organisation and systems you
work in, generate a numbered list of
relationships/people that are important to effectively
implementing your work including change projects
Identify people and relationships to understand obstacles and opportunities

Require time
and effort to
become
valuable
Require
investment of
time and effort
to discover if
they are
valuable
Generate value
against little or
no effort
Need to be
stopped or
destroyed to
create space
for innovation

1. What do you notice about the balance of the entire
portfolio?
2. What are the implications for your work moving
forward?
3. What is the need to advance any individual relationship
AND maintain flow across the full portfolio
Debrief

NHS Supply Chain
Excellence in Supply Awards – Thursday 17 October 2019

49
Key driver behind the change
Lord Carter’s 2016 report reviewed operational efficiencies in NHS
providers and recommended improvements in the way the NHS chooses,
uses and purchases clinical supplies.
Identified:
• Improvements in procurement efficiency
• Over 600,000 products lines
• Up to 35% variation in product prices
• Adoption of a Procurement Transformation Programme.
Cash releasing saving:
• £2.4 billion
• Investment back into frontline services.
NHS buying power:
• The NHS has the potential, through greater collaboration, to leverage
its purchasing power on a national scale and deliver value for money
for NHS trusts and the taxpayer.
Excellence in Supply Awards - 17 October 2019

50
Grew
business
market share
Investment into
additional
resources
Highest customer
satisfaction
survey score
since 2015
Contracts
awarded
Board
appointed
Delivered
savings
BP=SP
VAT
Team
alignment
Eu Exit
contingency
Successfully
defended a legal
challenge
Key achievements in Year 1 to deliver the model

51
Savings
£150M savings target – Year 2
Delivery
Procurement
Process
Identification
of savings
opportunities
(Strategies)
-
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
Over 100 Strategies
contributing to delivering our
savings target of £150M for
year 2
HOW DO WE ACHIEVE OUR SAVINGS TARGETS

52
• There are 6 known issues with a net financial impact being worked on now
• In total, the impact is small. Fixes are expected to increase savings by 0.1%
• 2 issues have an estimated impact on total results >£1m
• Additional resources have been assigned to ensure all issues currently identified
will be resolved by year end
We ask all trusts to continue to work with us while we resolve these issues.
An interim incremental savings report is currently being tested by sample of trusts,
UCLH, Tameside, Salisbury, Aintree, Shrewsbury, Barking and Sheffield. All
responses/queries were fed back to us On Friday 4 October and we are working
through that feedback now.
Savings challenges

53
Market share position

55
Strategic priorities for 2019/20
Deliver system benefits
Balance finances
Serve our customers
Assure qualityBuild a capable organisation
Transform our technology

56
Meeting the future needs of the system
Serving Customers
• Growing our STP / ICS focus
• Engaging with clinicians, Directors of
Finance, Heads of Procurement - as needed
• Tailoring services to different customer
segments
Evolving services
• Modernising systems and services to meet
future needs
• Meeting the requirements of the Medical
Device Regulations – May 2020
• Embedding value based procurement
• Supporting end to end supply chains
• Enhancing clinical impact
• Working with national programmes

57
There will be significant business change and updating of
processes:
• Order orchestration: how orders are processed and shipped
to customers
• Pricing structure: how we maintain our pricing system, making
it easier for customers and suppliers to do business with us
• Inventory management: how we replenish our distribution
network to improve the availability of products to our customers
• Warehouse management: across all of our Regional
Distribution Centres and our National Distribution Centre at
Rugby, enabling our existing network to support future demand
• Legislative: the ability to Track and Trace medical products
from receipt to customer, to meet our responsibilities under the
EU Medical Devices Regulations (MDR)
Core technology refresh programme
The core technology refresh programme is replacing the NHS Supply Chain’s current core technology
platform (RESUS). This will include new Order Management Technology (OMT) and a new Warehouse
Management System (WMS).

58
Improved analytics
Benefits of the new technologies
Standard, flexible platform
Improved inventory
management
Transparency and
confidence in delivery
The new systems will be more flexible and robust, which will lead to improved service levels.
We’re focusing on getting the basics right first, so some benefits will not be visible straight away. Some of
the long-term benefits include:

59
The Core Technology Refresh Programme will be:
Making the change stick
What skills do we need, and how do we
build them? What should we invest in?
How can we build mutual trust as we all
work together?
Working together as
one NHS Supply Chain
Putting Customer value first
How will this change deliver value to our
customers?
Simplifying our architecture
How can we best simplify our technology
systems environment?
Designing flexible and
reliable systems
What aspects of our systems are
restricting change?
Engaging our people
What do people need from our systems to
be productive? How do we engage them?
Adopting an agile and user-
centric approach
Who will benefit and how can we engage
them? How will we change our approach?
Taking a services mindset
What essential technology services do we
provide?
Enhancing our skill set
What critical skills do we have, and what
do we need?
Our journey to a new core
technology landscape
What are the critical steps on our journey?

60
NHS SUPPLY CHAIN
SUPPLIERS
CUSTOMERS
O
R
D
E
R
O
R
D
E
R
C
A
S
H
C
A
S
H
G
O
O
D
S
G
O
O
D
S
I
N
V
O
I
C
E
I
N
V
O
I
C
E
1
2
3
4
5
6
7
8
1 2 3 4
5 6 7 8
Make ordering as simple and intuitive as possible
Maximise intelligent re-ordering
Improve catalogue
Clinically assured, high value product
Excellent delivery options, reliability and service
Best pricing and value products
Consolidated, error free invoicing
Streamlined payments and cash flow
Commitment deals with large volumes
Integrated ordering
Clinically assured, high value product
Simplified new product introduction / innovation
Integrated data management
Consolidated, error free invoicing
Streamlined payments and cash flow
Focus on Customer and Supplier “Journey”

61
Innovation – Health Tech Connect
Over 200 users
73 Products submitted
13 Organisations with access to
data

62
• 70 Category Strategies reviewed
• 106 Sourcing Strategies reviewed
• Requirement for strategies to have engagement through Trusted Customer or Reference Trusts
• We share an overview with customers of the sourcing strategies in order to bring them on the journey
Category and sourcing strategies

63
Value Based Procurement
In October 2018 a panel comprising of Senior Representatives from Healthcare and the European
Medical Device Industry agreed that Value Based Procurement could be defined as:
‘An approach that delivers tangible, measurable financial benefit to the health system over and
above a reduction in purchase price; and/or a tangible and measurable, improved patient
outcome derived through the process of procurement (tendering, contracting, clinical
engagement and supplier relationship management).’
The management function of the NHS Supply Chain have invested funding in a project to consider the
potential benefits and practicality of a complimentary procurement approach known as of Value Based
Procurement (VBP).
Over the coming months the project will be engage with NHS clinical, financial, commercial and industry
stakeholders to undertake a series of small-scale pilots to generate test and refine the method of delivery
and capture the tangible results delivered.
If successful, this would provide an additional methodology which could be adopted by Category Tower
Service Providers, as a means of driving sustainable increased savings and improved patient outcomes
across the NHS.

64
Developing the way we work with Customers
The new model enables us to make change We can do things differently to deliver more value
1
Account
management
support to all
All Trusts who will be
contributing to the
top-slice
Drive growth
Double the business in
3 years – 40 to 80%,
utilising a ‘Growth
Toolkit’ we are
developing
Increased
headcount
Use increased capacity
to provide more support
to more Trusts
Differential
investment
In the highest performing and
potential accounts - deploying
the right resources on the
right opportunities
Improving
coverage
ratios
Reducing the overall number
of accounts managed by
SPMs and AMs to enable
more dedicated time to deliver
growth and savings
Project based
deployment
For PSMs and Nurses based
on a project charter with clear
outcomes and exit criteria
Commercial
and data
driven
Using data to make decisions
on deploying resource to
Trusts to deliver the best
return for the business

65
What we need from you
Move outstanding BP=SP Demand Capture demand to
NHS Supply Chain
If no demand capture information supplied, please do so.
Don’t leave savings on the table
Maximise opportunities for collaborative working
Help us to help you by engaging in joint workplans

Twitter: @NHSSupplyChain
www.supplychain.nhs.uk
Supply Chain Coordination Limited (SCCL) is the Management Function of the NHS Supply Chain
Thank you, any questions

Excellence in Supply
Awards
Lunch

Phil Clow
Head of Health & Social Care
Fortrus Ltd
Jaki Allen-Free
GDE Programme Director
Liverpool Women’s Hospitals NHS Foundation Trust
Amy Noble
Head of Procurement
Liverpool University Hospitals NHS Foundation Trust

 NHS LTP ambitions:
 Doing things differently
 Making better use of data and digital technology
 Getting the most out of taxpayers investment in the NHS
 Priorities for digital transformation include:
 Digital access
 Artificial intelligence
 Predictive techniques
NHS Long Term Plan

 Fortrus Public Sector Digital Transformation Framework
 (OJEU ref. 2018/S 166-378728)
 Value based outcomes through strategic partnerships
 Collaboration with the NHS to support financial, operational and clinical goals

01 / DIGITISATION
• Managed Print
• Hybrid Mail
• Document Scanning
• Records Management
• Intelligent Indexing
• Digital Mail
• Hybrid Mail
• Document Management
02 / INFRASTRUCTURE
• IaaS
• Interoperability
• Storage (Cloud and on-premise)
• Networks
• Mobile /Telcos
• Compute and Hardware
• Service Desk services
• Full/Partial IT outsourcing
03 / CYBER SECURITY
• Real time monitoring
• Reporting
• Proactive identification of threats
• Proactive resolution
• Disaster recovery
• Security Operation Centre
• SIEM (inc. AI / Machine Learning)
• GDPR
04 / SOFTWARE
• SaaS
• Bespoke software development
• Applications
• UX Design
• Cloud hosting
• Deployment
• Training
• Testing
• 24/7/365 support
05 / INNOVATION
• Industrialising applications
• Innovation blueprints
• Digital Transformation of enterprise
implementations
• Managed service wrap
• Commercial partnerships
• AI (Machine Learning)
• Virtual Reality
• Robotic automation
• International sales
• Grant funding
06 / CONSULTANCY
• Business Case creation
• Digital Roadmaps
• Funding applications
• Workflow optimisation
• Financial modelling
• IT Strategies
• Digital Transformation planning
• Blueprinting
• Data Science consultancy
Solutions

Features
- Outcomes-based
- Best of Breed Technology
- Pan Public sector (associated Economies of Scale)
- Supplier Agnostic
- Business Case development
- Managed Service
- Failing supplier swap-out
- Blueprint Enablement Programme
- Machine Learning and Artificial Intelligence baked-in
- Mini-competition capability

Liverpool Women’s
Paper Free Roadmap
Jaki Allen-Free – GDE Programme Director
www.liverpoolwomens.nhs.uk

2YearJourney2018 –
2020
Deliveringanoutcome
Example-Digitalpaperrecord

2YearJourney2018–2020

2YearJourney2018–2020 toPaperFree
On Premise
2015- 2018
– Introduced Paper Light within the Trust on Unity 1.9
 Documentum
 On-Prem storage
 EDMS
 197 folder/ file types
 23 FTE within Health Records Dept.
 Onsite scanning bureau
 Hybrid of paper and digital
 Paper patient records loss
 RBAC applied
Cloud
2018 – 2020
- Introduce Paper Free aligned with cloud options and
GDE
 UCR
 Cloud storage with AWS
 Off site scanning bureau
 Reduction of headcount within Health Records
 Quality improvements within the scanned records
 Simultaneous viewing of the patient record
 No more lost files
 Contextual links to other clinical systems
 74 Folder/File types
 RBAC applied
 BS10008 compliance
 OCR search function

Benefits to the NHS
- Direct Award
- Speed to market
- Value Based Procurement
- Free to access
- Partnership Approach
- Full 20% VAT reclaim - on everything
- 153 Partners, and growing (Best of Breed)
- Collaboration across STPs and HIMSS stage support
- Sharing innovation, best practice and international
solutions
- Revenue generation for the NHS

How the AHSN’s
Innovation Exchange
supports the
development and
implementation of
healthcare innovation
Kate Lodge
Sophie Bates

Our mission and vision
Mission
Transform lives through innovation
Vision
To improve the health and prosperity
of our region by unlocking the
potential of new ideas

A connected
‘Network of
Networks’

In our region
• 5.8m citizens
• £12bn annual health and
social care investment
• 22 Acute Trusts
• 6 Teaching Hospitals
• 5 Mental Health Trusts
• 20 Clinical
Commissioning Groups
• 770 GP Practices
• 2 Integrated Care
Systems
• 1 Sustainability and
Transformation
Partnership
• 12 Universities

• We are catalysts for innovation
• We connect partners across sectors
• We create the right environment for change
• We are collaborators
What we do

Innovation Exchanges
Innovation Exchanges are an Office for Life
Sciences (OLS) funded and AHSN-coordinated
initiative, delivered through the 15 AHSNs.
Innovation Exchanges exist to identify, select and
support the adoption of innovations which have
the potential to stimulate the economy and
transform the lives of patients.
Innovation Exchanges will help drive the spread
and adoption of innovations, to ensure the latest
technologies reach patients quicker and at a lower
cost to the NHS.
By utilising the skills and knowledge of the AHSN
Network, Innovation Exchanges will provide a
central point of reference for innovators and
healthcare professionals.

The Innovation Exchanges
Innovation Exchanges are delivered through four core pillars:
• Needs Articulation: Working with NHS colleagues from across the system to
identify unmet needs or challenges that could benefit from innovative change
• Innovator Support and Signposting: Working with innovators to identify
innovations which could address the unmet needs and challenges faced by the NHS
• Real-World Validation: Testing innovations in real world settings to develop
evidence which can enable quicker uptake
• Spread and Adoption of Supported Innovations: Supporting the adoption of
innovations identified in the AAC, ITP/ITT and others identified across the Network

The AHSN Network offers a framework
of support to innovators via the
Innovation Pathway, which offers
bespoke assistance at every
stage of the innovation
lifecycle.
The Innovation Pathway

Y&H Innovation Exchange
Identify and Communicate NHS and System Needs
• Clinical Needs Identification Events
Events in conjunction with clinical stakeholders
and networks, designed to identify opportunities
for innovation within the health system.
• Propel@YH
A six-month digital health accelerator
programme, targeted at SMEs based in the Y&H
region.
• Strategic Partnerships
Ongoing relationships with a range of
organisations
to deliver specific outcomes.

Signpost and Direct Innovators
• Network of Networks
Acting as a single point of entry to regional and national organisations and
networks.
• Innovation Champions Network
Upskilling and empowering NHS colleagues to identify opportunities for innovation
and support the implementation of innovative technologies.
• Signposting events
Providing an opportunity for innovators to showcase their innovations
to the healthcare system.
• Supporting regional initiatives
Providing strategic leadership and support to flagship initiatives across the region
including LHCRE and Digital Pathology.
• International
Supporting inward investment by bringing companies to the region, and
supporting local companies to access international markets.

Broker Real World Validation Opportunities
• Advising and supporting innovators to evaluate
their innovations in the ‘real world’, developing
evidence to support adoption and spread.
• Provision of support with health economic
evaluations
• Example: Use of smartphone urinalysis to
measure ACR levels in patients with diabetes.

Supporting Local Adoption and Spread
• STP/ICS engagement
Working in close collaboration with STP/ICS’ to identify opportunities for
innovation and support widespread uptake.
• SME support
Providing intensive advice and support to SMEs in areas such as articulating
market needs, developing business cases/market access strategies, real world
evaluation/evidence generation, and brokering access to the NHS.
• Strategic Industry Partnerships
Working with large med-tech organisations to deliver regional benefits.
• De-Risked Innovation Uptake (Including AAC, NIA, ITT/P)
Supporting the local uptake of innovations by de-risking implementation and
supporting evaluation.

NHS England scheme to support NHS organisations with the adoption of innovative products and
technologies by removing the financial or procurement barriers.
• Non-invasive vagus nerve stimulation for the treatment of cluster headaches.
• Diagnostic PlGF test for the rule out of pre-eclampsia
• High sensitivity troponin assay
• Absorbable hydrogel spacer to reduce rectum radiation exposure during prostate radiation therapy
Evidence Generation Fund:
• Interoperable personal health record
• Digital app to support emergency mental health assessment
Supporting Local Adoption and Spread: Innovation Technology Tariff
https://www.england.nhs.uk/wp-content/uploads/2019/06/itp-technical-guidance-notes-v3.pdf

An online portal for the sharing of information about
innovations and NHS needs.
Y&H Innovation Exchange Portal
https://www.healthinnovationexchange.org.uk/

Photography: Welcome to Yorkshire | https://www.yorkshire.com/
Contact:
Twitter: @yhahsn
Email: info@yhahsn.com
Web: www.yhahsn.com

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