Procurement Strategy - The Royal Wolverhampton NHS Trust
Transcription
Procurement Strategy - The Royal Wolverhampton NHS Trust
The Royal Wolverhampton Hospitals NHS Trust Trust Board Report Meeting Date: 25th June 2012 Title: Procurement Strategy Executive Summary: Proposed 3 years Procurement Strategy – 2012 to 2015. (Financial Years 12/13, 13/14 and 14/15). Action Requested: Approve Report of: Kevin Stringer, Chief Financial Officer Author: Contact Details: Tony Stanyard - Head of Procurement Resource Implications: None Public or Private: Public Tel 01902 694392 Email: [email protected] (with reasons if private) References: n/a (e.g. from/to other committees) Appendices/ References/ Background Reading NHS Constitution: (How it impacts on any decision-making) Appendix A – NHS Procurement “Raising our Game” (Gateway Ref: 17646) Appendix B – NHS Standards of Procurement (Gateway Ref: 17644) In determining this matter, the Board should have regard to the Core principles contained in the Constitution of: Equality of treatment and access to services High standards of excellence and professionalism Service user preferences Cross community working Best Value Accountability through local influence and scrutiny Background Details 1 The strategic priorities are consistent with the key recommendations of the Best Practice Guidelines – NHS Procurement “Raising Our Game” (Gateway Reference 17646) published on 28th May 2012. (Attached at Appendix A). 2 The strategy is also aligned with the NHS Standards of Procurement (Gateway Reference 17644) published on 28th May 2012. They provide a clear vision of good procurement and identify high quality procurement performance. They enable the Trust to assess procurement performance and recognise areas for improvement to ensure value for money (VFM) is delivered through procurement activity. (Attached at Appendix B). 3 On agreement of the Strategy a detailed plan with Work Streams and Key Performance Indicators will be developed. 1 Version 1a May 31st 2012 ROYAL WOLVERHAMPTON HOSPITALS NHS TRUST PROCUREMENT STRATEGY Author: 2012 – 2015 Tony Stanyard MCIPS Head of Procurement Approved by: Trust Board - June 2012 Version: v1 Owner: Head of Procurement An NHS organisation that continually strives to improve patients’ experience and outcomes. 2 Version 1a May 31st 2012 Contents Page Ref: Title Page Numbers A Introduction 4 B Procurement Principles 5 C Financial Scope 5-6 D Compliance 7 E Commerciality 7-8 F Collaboration 8-9 G Clinical Engagement 9 H Stock Control / Receipt & Distribution 10 I Sustainability 10-11 J Local Engagement 11 K Leadership, Governance & Control 11 L Risk Management 12 M Professional Competence & Staff Development 12 N Capital Projects and Service Developments 12 O NHS Standards of Procurement 12-13 P Conclusion 14 Appendices: Appendix A NHS Procurement. Raising Our Game 15-39 Appendix B NHS Standards of Procurement 40-69 3 Version 1a May 31st 2012 A. INTRODUCTION Background The management of Procurement is essential to the efficiency and effectiveness of both clinical and support services. Patient care depends on the guaranteed availability of quality equipment, materials and services. Accountability for the expenditure of taxpayer‟s money requires that sound economic decisions are taken in relation to procurement. In line with national policy the Trust Board originally approved a Supply Strategy in 2002. In March 2006 the Trust Board approved a significantly revised Supply Strategy and again in 2008 an updated 3 year strategy was endorsed by the Board. It is now necessary to revise the strategy, reflecting the integrated acute/community service provision; the move towards Foundation Trust status and the adoption of the new Trust Vision, together with current issues and developments which impact on supply activity. This latest revision builds on the work contained in the previous strategy; it identifies areas for ongoing improvement and review together with initiatives that represent transformation in the way we buy goods and services, from the systems we have in place and the processes that we follow. It recognises and endorses the key recommendations of the Best Practice Guidelines – NHS Procurement “Raising Our Game” and is aligned with the NHS Standards of Procurement, both published on the 28th May 2012. These documents will be the framework around which improvements in procurement performance are measured and are attached as appendices. This document provides detailed focus on financial year 12/13 and sets the tone and direction of travel for subsequent years. The role of the Procurement Department may be defined as follows: To lead and operate a comprehensive best practice supply management service, that adds value to the healthcare provision for patients by delivering value for money. To deliver procurement services that are efficient, innovative, cost effective and continually developing for the overall benefit of the Trust and its patients. In defining a strategy that delivers best practice supply management, it is important to identify the procurement model and key elements on which the strategic priorities are based. These key elements are highlighted below: 1. Ensuring that compliance with local, national and European procurement legislation is maintained. 2. Delivering creative and cost-competitive commercial solutions in the sourcing and purchase of a wide range of goods and services for the Trust. 3. Engaging with other Trusts and / or Procurement Hubs in a collaborative manner to aggregate spend and maximise buying power. 4. Delivering creative and cost-effective stock control and supply chain solutions for a wide range of consumable items. 5. Establishing and maintaining sustainable procurement initiatives. 6. Supporting and developing the use of local providers of goods and services where it is commercially appropriate and where compliance with procurement legislation is not compromised. 7. Harnessing relationships with suppliers in order to adopt existing innovations and stimulate new innovation to deliver quality and value. Each of the above aspects of Procurement is covered in more detail in this document. 4 Version 1a May 31st 2012 B. PROCUREMENT PRINCIPLES In carrying out its procurement activity, RWHT will adopt the following key principles: Transparency We will ensure tender opportunities are sufficiently and appropriately advertised. We will ensure that any conflicts of interest are declared and appropriate action taken. We will involve patients in procurement processes where it is appropriate so to do. We will publish our procurement decisions where appropriate. Proportionality We will ensure that our procurement processes are proportionate to the value, complexity and risks associated with each particular requirement. We will ensure that potential suppliers are not excluded through overly burdensome or bureaucratic processes. We will ensure that the level of detail required in our Pre-Qualification Questionnaires (PPQ) is proportionate to the value of the particular requirement. Equality We will ensure that all suppliers have equal opportunity to compete for our business where appropriate. We will ensure that we treat all suppliers equally and that all financial and due diligence checks apply equally and are proportionate to the value of the particular requirement. Non-Discrimination and Consistency We will apply local and national procurement policies and procedures consistently and fairly. Efficiency We will standardise and simplify our procurement processes wherever possible. Continuity We will work with the appropriate Managers within the Trust to monitor the performance of service contracts to ensure that they continue to deliver best value for money. Development We will provide support to all suppliers to encourage continual improvement in the quality of goods and services that are provided and, where it is in the public interest will target new service areas to encourage new entrants to the market. Innovation We will encourage innovation from current and potential suppliers to ensure that the Trust can adopt existing innovation and stimulate new innovation to deliver quality and value both for Trust patients and for taxpayers. 5 Version 1a May 31st 2012 C. FINANCIAL SCOPE 2012/13 The total non-pay spend in 2011/12 was £139 million. This amount was spent with 2,715 suppliers across a wide range of goods and services. Analysis of type of spend and of spend by supplier has identified influencable spend of £75 million with the top 250 suppliers. A key part of the Procurement Strategy is to analyse this spend in order to identify opportunities for savings. The spend by supplier has been placed into one of four categories: Estates and Facilities. Pharmacy. Medical & Surgical. Non-Medical. Figure 1 shows the spend breakdown across the 4 categories for the top 250 suppliers. (Detailed analysis is underway on a supplier by supplier basis in order to establish an overall sourcing strategy to ensure that Procurement resource is focused on those areas of commercial activity that will deliver maximum financial benefit for the Trust). Figure 1 Influencable Spend £75m 250 suppliers Estates & Facilities Pharmacy Med & Surg Non-Medical £3m £20m £32m £20m 25 Suppliers 25 Suppliers 100 Suppliers 100 Suppliers Indicative savings target of 5% Indicative savings target of 2.5% Indicative savings target of 2.5% Indicative savings target of 2.5% The above figures are based on an analysis of actual activity in 2011/12. The indicative annual savings opportunity for financial year 2012/13 is calculated as £1.95 million based on the analysis of the top 250 non-pay suppliers of goods and services. Actual savings percentage by supplier will vary but averages out at 2.6%. Procurement intends to target this opportunity figure in order to deliver the 12/13 Procurement CIP of £1.347 million. As part of the annual CIP review for 2012/13, Procurement have (in conjunction with appropriate Divisional Senior Management) established target savings for each category based on the application of one or more of the following initiatives: 6 Version 1a May 31st 2012 Aggregation Standardisation Substitution Contract Re-Negotiation Contract Renewal (Re-Tendering) 2013/14 & 2014/15 Further work will be carried out during the year to identify savings opportunities that will support the delivery of Trust CIPs in subsequent years. D COMPLIANCE Procurement are responsible for ensuring that the Trust complies with all local, national and European procurement legislation. Purchasing activity will continue to be conducted in accordance with Trust Standing Orders, Standing Financial Instructions, the Scheme of Delegations and with the relevant EU Public Procurement Regulations and Information Governance requirements. EU Procurement Thresholds are subject to change on a biennial basis. On 1 January 2012, the financial thresholds governing when the European Procurement Rules apply to Central Government bodies (including the NHS) were changed to the following amounts: PUBLIC CONTRACTS REGULATIONS (2006) FROM 1 JANUARY 2012 NHS Bodies Supplies Services Works £113,057 £113,057 £4,348,350 Figures are net of VAT These new sets of thresholds represent an increase on the thresholds which were in force from January 2010 to December 2011. The Purchasing Authority must take into account the possibility of a cross border interest in a tender, even if the total value of the contract is below the threshold, or if the contract falls under part b of the Public Contracts Regulations 2006 where an advertisement in the OJEU is not normally required. If the purchaser considers that there is a possibility of cross border interest, then the purchaser may be required to advertise the tender in the OJEU. The Procurement Department are available to offer help and advice on when the Public Contracts Regulations apply to the purchase of Goods, Services and Works. 7 Version 1a May 31st 2012 E COMMERCIALITY Commercial activity in the sourcing of a wide range of goods and services for the Trust. Delivery of the 2012/13 CIP. The 2012/13 Procurement CIP of £1.347m has been agreed following internal discussions with Divisional management teams and work plans have been produced to reflect this target. Further work will be carried out during the year to identify savings opportunities that will support the delivery of Trust CIPs in subsequent years. Agreement of a clinical products standardisation programme that will support the patient safety agenda and work to reduce clinical risk whilst improving the quality of products used in the Trust. Establish an agreed mechanism for review and adoption of new technology and innovation in clinical products that delivers value for money and improves quality of patient care delivery. Maximise value for money in non-pay spend by the application of procurement and commercial expertise, to deliver a reduction in incumbent supplier spend, an improvement in catalogue management, sustainability and system efficiency. Ensure best price by benchmarking current prices across the NHS to drive more transparency, pricing parity for the products and equipment utilised in the Trust. Performance The current Performance indicators and strategic work plan will be refreshed to present more detailed and comprehensive spend data, demand, contract compliance together with measures for transactional efficiency and performance against carbon reduction targets. These reports will also be structured to produce relevant information at a Divisional level, to compliment the current monthly financial reporting process. Procurement influence and expansion of contract coverage A continued aim of this strategy is to maximise Procurement influence on the non-pay spend. The analysis presented in Figure 1 will highlight further opportunities to increase contract coverage across the 3rd party spend. The on-going work to consolidate the current „siloed‟ data into meaningful comprehensive spend and demand information will enable improved engagement with Divisions and the supplier markets, to effectively target and influence any gaps in spend. Procurement Savings and Strategic Sourcing Procurement has an integral part to play in supporting the delivery of the Trusts overall cost improvement programme and the current 12/13 target of £15.325m for the whole Trust requires continued procurement focus and the application of sound strategic sourcing methodologies in those areas of the delivery of the CIP that are influenced by Procurement; Continued targeted approach to high spend areas and top spend suppliers, applying competitive and modern purchasing techniques. In conjunction with Divisional teams formulate savings plans identifying those areas which will contribute to the savings target. Consolidate supply to reduce the number of suppliers used by the Trust. Effective contract and vendor management incorporating regular reviews to measure operational performance, activity and service improvements 8 Version 1a May 31st 2012 Develop effective benchmarking with other similar organisations/networks Consider, where appropriate the introduction of longer term agreements with major suppliers, including commitment expectations to realise savings benefits Identify and promote lower cost products and sources of supply Understand the logistics and supply chain cost to serve models and determine optimal supply routes, volumes and stocking options for consumables items F COLLABORATION The Trust will continue to maximise the opportunities of collaborating with other organisations on procurement and supply activity in the following ways: Collaborative Procurement Hub, HealthTrust Europe (HTE) – the Head of Procurement will lead the Trust‟s relationship with HTE, identifying and agreeing the joint sourcing work plan and ensuring the savings performance targets are delivered NHS Supply Chain – the Trust will continue to access contracts and services offered where they deliver appropriate benefits and best value Government Procurement Service – on-line access to the public sectors national procurement portal providing a range of supply and service frameworks, with the facility to undertake on-line competitive exercises efficiently and within agreed best value criteria and terms. The Procurement Department will explore alternative collaborative opportunities when they arise and will make a commercial judgement as to their relevance, suitability and potential commercial advantage for the Trust. G CLINICAL ENGAGEMENT A fundamental priority in ensuring that Procurement supports the delivery of quality patient care whilst ensuring value for money as part of the strategic sourcing programme is the effective and on-going engagement with clinical staff in both the Surgical Division (Division 1) and the Emergency, Medical and Community Service Division (Division 2). Whilst in many clinical areas good relationships have been developed there are still opportunities to improve engagement with clinicians, recognising as well the integration of community provider services and the need to improve communications across these areas. Procurement will establish Clinical Engagement Groups in both Divisions, consisting of appropriate Clinical leads and Procurement Managers. The Division 1 group will be identified as the Theatre Products Evaluation Group (TPEG) and the Division 2 group will be identified as the Clinical Products Evaluation Group (CPEG). 9 Version 1a May 31st 2012 Both TPEG and CPEG will be led by the same Procurement Manager who will be able to co-ordinate any crossover activity between the groups as appropriate. The process will be owned by the Head of Purchasing. The sustained focus will be to better align the procurement category leads with departments and directorates to provide a more visible and targeted contracts work plan for these clinical areas. Terms of Reference and Standing Agenda Items will be agreed. Meetings will be held on a monthly basis and will explore opportunities to save money through product standardisation initiatives and through opportunities to switch to better value products that do not adversely impact on patient outcomes and experience. There will be opportunities for existing and/or potential suppliers of Medical and Surgical equipment and consumable items to present outline proposals to TPEG and CPEG for consideration where there are opportunities to maintain or improve current levels of patient outcome or experience at reduced cost. H STOCK CONTROL & RECEIPT AND DISTRIBUTION ACTIVITIES The supply chain review conducted at the end of 2010 highlighted the disjointed and inefficient management of resources, systems and services supporting the clinical and ward areas for materials management. The recommendation to merge the existing Directorate materials management teams together within the Procurement receipt and distribution facility was endorsed by the Trust Management Team, to deliver an extended and best practice materials management service to all the identified clinical areas. This organisational change runs in parallel with electronic information management systems and on-line ordering systems, aiming to have a fully harmonised structure/team and service in place during 2012. Highlighted as a major element in the previous strategy, the recently approved business case investment for the implementation of new systems provides the much needed platform for the Trust to integrate information systems to provide spend visibility and analysis tools and accelerate transactional efficiencies. Introducing these developments represents a transformation in the way the Trust controls stocks and manages the ordering and payment processes. The main objectives/benefits are: The inventory management system (IMS) and electronic ordering programme presented to the Trust Board in September 2011, will effectively deliver electronic ordering for in excess of 80,000 product lines, representing circa £18million worth of expenditure per annum, across 80+ requisitioning areas and departments. The purchase of the Global Health Exchange (GHX) catalogue management tool provides the data-base to hold the Trusts contracts. Utilising the National NHS e-classification coding, departments will have electronic access to the complete portfolio of contracted products available for their area providing up to date pricing and ordering data and ensuring full contract compliance. Additional modules purchased within the Integra finance system enable the import/export of data to transact orders, receipt and pay electronically through the various supply routes, streamlining and automating existing paper driven processes. 10 Version 1a May 31st 2012 The Procurement Department will utilise strategic sourcing techniques to get the best products and services at the best value and will give continuous attention to improving and re-evaluating purchasing and the total supply chain. The Department will continue to develop purchase to pay transactional processes that confirm our contractual requirements with suppliers, allow for electronic receiving at the point of receipt (by either the Receiving Department or the end-user) and for paying for the goods or services through a range of payment options. The transactional processes will provide visible spend data through utilisation of financial, purchasing and inventory management data, informing demand and the sourcing programme. I SUSTAINABILITY The Trust‟s Sustainable Procurement Strategy (developed with consideration of the NHS Procuring for Carbon Reduction Roadmap (P4CRR) will ensure that goods and services procured by the Trust are designed, manufactured, delivered used and managed at end-of-life in an environmentally and socially responsible manner and forms an integral part of the Trusts overarching Sustainable Development Plan, approved by the Trust Board in July 2011. The Trust has calculated its baseline carbon footprint at just over 40,000 tonnes of carbon from Procurement activities. Adopting the nationally recognised flexible framework for sustainability and carbon reductions, the Procurement target over the next 3 years is to reduce the Trusts baseline footprint by 10%. J LOCAL ENGAGEMENT The Trust is one of the largest spending organisations in the locality and the more money that is spent locally, the greater the positive impact this will have on the local economy, particularly for small and medium sized businesses. The Public Services (Social Value) Act was passed at the end of February 2012. Under the Act, all public bodies in England and Wales are required to consider how the services they commission and procure might improve the economic, social and environmental well-being of the area. Procurement legislation and the Trust‟s own Standing Orders and Standing Financial Instructions limit the Trust‟s ability to favour local businesses, but there are numerous ways in which it can legitimately support local businesses including: Working proactively with appropriate departmental managers to support local businesses through consultation, face to face meetings to explain how to do business with the Trust, and obtain their feedback in order to improve processes and relevant documentation. Advertising Trust contracts below EU Tender Thresholds on the Trusts internet site to encourage local businesses and SME‟s (Small Medium Enterprises) to compete for business. 11 Version 1a May 31st 2012 Supporting and attending local “Meet the Buyer” events that may be hosted by the local Council or Chamber of Commerce. Using Government Procurement Cards to procure low value goods (often through local outlets). K LEADERSHIP, GOVERNANCE & CONTROL At Board level the Chief Financial Officer is responsible for the Procurement function, with the Head of Procurement having operational responsibility for the delivery of the service including sourcing, transactional/buying teams, stock control and the Receipts and Distribution function, which will also include the wider materials management provision. High level Corporate Governance and Trust policies are in place defining operational compliance. Controls for performance and risk are in place ensuring operating effectiveness is controlled, measured and managed. L RISK MANAGEMENT Procurement has an established business continuity plan to ensure arrangements are in place for the supply of products and services in the event of an emergency situation. In addition an update to the existing contracts portfolio/database has commenced, alongside the catalogue management roll-out programme, which will integrate with the business continuity plan and risk register, providing visibility at Trust and Divisional level for strategic and/or critical products and suppliers. M PROFESSIONAL COMPETENCE & DEVELOPMENT The delivery of the Supply Strategy requires that all staff involved in supply activity are developed to the appropriate level of competence. Staff within the Procurement Department have been and will continue to undertake appropriate training and qualifications, including obtaining membership of the Chartered Institute of Purchasing and Supply (CIPS). All staff have agreed KSF outlines for their posts and these are used in their on-going appraisals supporting their personal development plans. 12 Version 1a May 31st 2012 N CAPITAL PROJECTS AND SERVICE DEVELOPMENTS Procurement will continue to play a proactive role in supporting the capital equipment and development programmes, with the Pathology Integration project continuing to represent a major Procurement focus for the coming 12 months. O NHS STANDARDS OF PROCUREMENT Procurement has a key role to play in supporting the delivery of the Trust‟s annual CIP. The demands on procurement and the expectations of the efficiencies required are increasing and the Trust needs to develop and respond to the challenges. The NHS Standards of Procurement support the recommendations from the Public Accounts Committee (April 2011) by providing a clear vision of good procurement and identifies high quality procurement performance. The Standards enable the Trust to assess procurement performance and recognise areas for improvement to ensure value for money is delivered through its procurement activity and its procurement partners. The standards provide a structure for the Trust to work within to improve procurement performance and inform the direction and priority for any system level support. They are supported by the National QIPP Procurement programme and other system level initiatives. The standards provide a useful aid to the continuing success of procurement performance. The NHS Standards of Procurement cover four key areas: Leadership Process Partnership People Each area contains a number of measures, all of which comprise: The standard How organisational performance will be improved from achieving the standard Maturity Levels 1 – 3 Level 1 – Building – awareness and building blocks in place Level 2 – Achieving – making good progress Level 3 – Excelling – outstanding procurement performance 13 Version 1a May 31st 2012 Suggested Indicators Each standard will be used by the Procurement Department to measure procurement performance and the indicators used to set goals for continuous improvement in procurement performance. The 4 measures are summarised as follows: A full copy of the NHS Standards of Procurement is attached at Appendix B P CONCLUSION This updated Procurement Strategy re-states the importance of effective supply management to the overall performance of the Trust and moves the procurement function forward significantly by transforming some of the key systems and processes to provide a more integrated and efficient service. It reflects the latest Department of Health thinking and policy in the need for improvements to NHS procurement activity and is designed to ensure that the procurement function becomes a champion of innovation and is responsive to creative ideas from both existing and potential suppliers. Procurement will endeavour to evaluate and support the adoption of innovative solutions at scale and pace across the Trust. The strategy recognises the importance of Clinical Engagement within the Trust and Local Engagement within the Community. The 3 year strategy will be reviewed on an annual basis to ensure its relevance to overall Trust objectives. ====++++==== 14 Version 1a May 31st 2012 Appendix A NHS procurement: Raising our game A PDF version of this document is available at: http://www.dh.gov.uk/health/2012/05/procurement-guidance/ 15 Version 1a May 31st 2012 16 Version 1a May 31st 2012 Contents Foreword Executive summary Introduction Why do we need to improve? The engagement process So what needs to be done? Summary of recommended actions Implementation 17 Version 1a May 31st 2012 Foreword The NHS is a national success story. It is woven into the fabric of our society and is a public expression of our social values. At its best, the NHS is world class. The Commonwealth Fund‟s regular international surveys consistently score the NHS as one of the world‟s leading health systems for quality and the very best value for money. But it can and must improve. The Challenge Throughout its history, the NHS has faced increasing demands: a growing population with an extending lifespan; an increase in its own capability, fuelled by advances in knowledge, science and technology; and ever-increasing expectations from the public it serves. The NHS has responded to these demands in part through the creativity of its staff to find or devise new tools and better ways of working. At the same time industry, often working in partnership with the NHS has made available a constant supply of new medicines, devices and technology. Now and for the foreseeable future, we must meet these demands from within our current real terms funding, whilst at the same time improving quality. This means we cannot afford to continue as we have always done. If that is going to happen we will need better, smarter and more efficient procurement. What we need to do The Government‟s Procurement Pledge is a demonstration of our commitment to ensure that the public sector is faster to do business with and maximises opportunities to drive economic growth and stimulate innovation. The NHS promise is to make this a reality. Procurement should be central to driving quality and value in the NHS, but for many years it has simply not been a priority. That must change. The recent NAO report on procurement in the NHS demonstrated the scope for improvement and cost savings, but it is more than just that, we need to drive improvements in the way we procure services and products to ensure patients get the highest quality care possible. Procurement accounts for over £18bn of the NHS‟ annual expenditure, how we use that resource should become a priority for all NHS Boards and Chief Executives. Anything less would fail the NHS, our patients and the public. This report - NHS Procurement: Raising Our Game - sets out the steps that the NHS must take to respond to this challenge. I want to see every part of the NHS make an immediate start. We must make the best possible use of the huge spending power the NHS has. The NHS must share data so that we can see the prices that different organisations are paying for the same goods and services, and it must do more to make collaborative procurement a reality. I want to see Trusts publish all tender and contract information for contracts over £10,000, and I want to see good procurement practice spread quickly and effectively – in particular the use of GS1 coding. There is much that the centre can do to help. The Department of Health will create a dashboard of procurement indicators to help make benchmarking easier, and will work with Monitor to strengthen Trust accountability for procurement. It will also develop an independent diagnosis and accreditation system to allow the NHS organisations to assess 18 Version 1a May 31st 2012 their procurement capability. But, we must also do more. It is vital that we have a procurement function that is not only better, but is world class. It should be focused on outcomes, not just cost, and must be responsive to creative ideas from suppliers, procurement specialists, clinicians and managers. We have the potential to transform procurement in the NHS, enhancing quality and value. Our collective challenge is to work together to realise that potential. I have asked Sir Ian Carruthers OBE, Chief Executive of the NHS South of England to lead this work, which will start with an „Open Call‟ for evidence to be published alongside NHS Procurement: Raising Our Game I would like to thank the many hundreds of people in the NHS who contributed to ‘NHS Procurement: Raising Our Game’, I know I can count on your continued support and involvement as we move forward. Sir David Nicholson NHS Chief Executive 19 Version 1a May 31st 2012 Executive summary The Government believes procurement can play a valuable role in both dealing with the deficit and stimulating growth in the economy; this is particularly true in the NHS due to its spending power. We believe there is scope for the NHS to save £1.2 billion through improved procurement, but we also know that there is no silver bullet to deliver these efficiencies and benefits. It requires leadership at all levels, but most importantly direction and involvement at board level. Recent reports suggest NHS procurement is lagging behind industry procurement performance, and this cannot be allowed to continue in a time when resources are at a premium. Trusts need to collaborate, share data and harness the immense purchasing power that the NHS represents. Failure to do so will add to the financial pressures already faced by trusts. This document describes the actions that the Department of Health and trusts should take to improve NHS procurement. These actions will address the recommendations made by the National Audit Office (NAO) and Public Accounts Committee (PAC). There are six areas for improvement: 1. Levers for change 2. Transparency and data management 3. NHS Standards of Procurement 4. Leadership, clinical engagement and reducing variation 5. Collaboration and use of procurement partners 6. Suppliers, innovation and growth Head of Procurement’s Note: The 6 areas for improvement identified within this document can be linked to the 4 NHS Standards of Procurement which are Leadership, Process, Partnership and People. Each of these areas contains a number of proposed actions directed at trusts and the Department. These actions – 12 for trusts and 15 for the Department – are designed to raise the game of NHS procurement. However, nothing will change unless trust chairs and Chief Executives and their Boards treat this as a priority. Chief Executives should table this document at their Board meetings and consider the actions contained herein, as they have an obligation to demonstrate that they are spending taxpayers‟ money wisely and will need to assure commissioners, the public and themselves that money is not being wasted that could be better spent on patients. Whilst the focus is very much on provider organisations, we know that procurement is also a vital ingredient in the commissioning process and can play an important role in shaping healthcare services to meet the challenges ahead. Building on this document, we will be working with the NHS Commissioning Board and Clinical Commissioning Groups to ensure commissioners have access to the skills needed to work with private sector suppliers in the future. As the commissioning function matures, we anticipate commissioners will work more closely with providers and their suppliers to ensure innovation flows from the supply base across the entire care pathway. This shift will blur the historic divisions between hospital procurement and healthcare commissioning, as these functions start to work closer together. 20 Version 1a May 31st 2012 Introduction There has never been a time when procurement has been given so much attention. The Government believes procurement can play a valuable role in both dealing with the deficit and stimulating growth in the economy, so it is vital the NHS plays its part and buys wisely. We know there is substantial scope for multi-billion pound cost savings through the application of best practice and standards, collaboration and aggregation and process modernisation. We also know that there is no panacea to deliver these efficiencies and benefits. It will take concerted effort to change the culture and will require leadership across the service, from Boards to clinicians, to the procurement profession and every employee who influences purchasing decisions or spends money with suppliers. The NHS deserves a world-class procurement function, but recent reports suggest we are lagging behind other sectors. It is estimated some £1.2 billion should be saved, but the clock is ticking and we need to start delivering. Trusts need to collaborate, share data and harness the immense purchasing power that the NHS represents. Failure to do so will just add to the financial pressures already faced by trusts. This document describes the actions the Department and trusts should take to improve NHS procurement. These actions will address the recommendations made by the NAO and PAC, but in developing them we have learned that NHS procurement can do much more. We received many comments though engagement with stakeholders, and more comments leading up to the publication of Innovation Health and Wealth, so we know we can go even further, which is why we will be launching a wider call for evidence and ideas for how we can transform the function to become truly world-class. The call for evidence will help us define where we need to be in the longer term, but we need to raise our game now, so the system should begin the journey by taking the steps described in this document. Following the call for evidence, we intend to publish a formal strategy for NHS procurement later in the year. 21 Version 1a May 31st 2012 Why do we need to improve? NHS acute and foundation hospital trusts in England spend over £18 billion a year on the procurement of goods and services, dealing with thousands of suppliers ranging from large multinational corporations to smaller specialist firms. All trusts are expected to achieve Foundation status by 2014, giving them the freedom to operate independently. However, independence does not mean trusts cannot operate collaboratively to obtain the benefits of its collective spending power. The NAO found that the fragmented system of procurement has produced a great deal of waste, with trusts being charged different prices for the same goods and trusts now recognise, following our work with the Foundation Trust Network (FTN), that prices paid bear no correlation to volumes. To put it simply, pricing is based on what trusts are prepared to pay. The NAO highlighted the lack of any formal mechanism to secure commitment to purchase a single item or class of supplies across the NHS. Whilst all trusts have access to procurement intermediaries such as NHS Supply Chain, the Government Procurement Service and collaborative procurement organisations, there is a dependence on framework agreements, which tend not to address variation and commitment for suppliers. Furthermore, the limited data on what is purchased by individual trusts means they cannot easily identify how the prices they are paying compare with those paid by their peers, and more importantly, whether better prices might be available if they were to engage with the market more effectively. This lack of data makes it difficult for trust Boards to challenge their organisations on the efficiency of procurement and there has not been sufficient control over procurement practices. Procurement is a profession and skill and we must bring professionals together to work with suppliers to reduce their costs of serving the NHS, but at the same time significantly reducing the cost of goods. The NAO and subsequent PAC made a number of recommendations to improve NHS procurement. They identified: • A need for much greater transparency on prices being paid to suppliers by individual trusts • A requirement for trusts and suppliers to adopt standard bar-coding (GS1), to improve procurement data and enable price comparisons whilst improving stock control and patient safety • A need for trusts to make greater use of e-commerce systems to improve management information 22 Version 1a May 31st 2012 • A need to standardise and reduce the variation of products used by the NHS • A need to improve control over purchasing and ensure that purchases are made using agreed contracts, rather than „spot‟ transactions • A need to assess stock control and its effect on procurement costs • A need to make better and more professional use of NHS Supply Chain or other procurement partners • A need for trust Chief Executives and Boards to consider procurement as a strategic priority • A need for trusts to collaborate to improve their procurement infrastructure, including sharing of resources A further NAO report and PAC hearing on Managing High-value Capital Equipment in the NHS in England last year, was equally critical of NHS procurement for this particular sector. They found that the NHS is not achieving value for money when it purchases high value equipment and that there is no clear accountability for maximising value across the system. There is no sharing of capital plans and, therefore, no aggregation of requirements. Furthermore, trusts were not making best use of the framework agreements negotiated by NHS Supply Chain and so opportunities were being missed to secure bulk discounts. 23 Version 1a May 31st 2012 The engagement process During 2011 and the beginning of 2012, the Department engaged widely on how the NHS might address the NAO and PAC recommendations. A series of meetings and workshops were held with the following organisations and representatives. • Trust Chief Executives • Trust Finance Directors • Foundation Trust Network • NHS Trust Development Authority • Monitor • NHS Commissioning Board • Health Care Supply Association • Industry trade associations • Individuals, including trust Chief Executives, procurement professionals and clinicians • NHS Institute for Innovation and Improvement • National Procurement Council • Procurement partners, including NHS Supply Chain In addition, we have also established a procurement network to gather interested procurement professionals to discuss the changes needed. From this engagement we learnt that trust Chief Executives already want to professionalise their procurement function. Chief Executives want to: • Be advised of the core technologies and systems required to support better procurement, including technologies to promote price transparency and comparison. They want to see standard coding systems (GS1), national databases for procurement including price comparison and product performance • Leverage commitment at scale across the NHS, to ensure the NHS purchasing muscle is utilised. They also recommended a ban on non-disclosure pricing agreements as they work against the NHS‟s and the taxpayers‟ interests • Implement easily understood key performance indicators for procurement so they can compare their own trust‟s performance with their peers • See a longer term transformational change programme for procurement, including the development of a vision for procurement with performance metrics, leadership programme and accreditation • Learn from the best in the NHS and elsewhere. In addition, NHS procurement professionals want: • Greater support from trust Boards and Executives • Education for Board members on the value of procurement, the role of the supply chain, and development of a common language • Improved alignment of procurement objectives with trust business objectives 24 Version 1a May 31st 2012 • Investment in e-procurement systems to improve data transparency and spend information • More engagement from trust Executives in collaborative activities • Increased opportunities for benchmarking activities, such as product price comparisons • Procurement partners, including NHS Supply Chain, being more responsive to its customers. And Industry wants: • Better written and consistent tenders, with specifications focused more on improved health outcomes • Less burdensome pre-qualification processes, standardised procurement processes and systems including more paper-free systems • Procurement more aligned with trust objectives • More professionalism in trust procurement • Less focus on year-on-year savings, and more focus on long term „value‟ • Greater trust between the NHS and its industry partners • Standard terms and conditions of contract • Committed volume contracts rather than framework agreements • Speedier payments and greater support for SMEs • More risk-sharing initiatives • Greater opportunity for industry to present solutions • Standardised stock management software • Greater ownership by trust Boards. 25 Version 1a May 31st 2012 So what needs to be done? There is no single answer for improving NHS procurement. It requires action at all levels of the system, but most importantly at trust level. Previous strategies have primarily focused on improving the procurement landscape, rather than on procurement in trusts themselves. To deliver the improvements, Boards and their Executives should treat procurement as a strategic priority. Given this, the recommended actions in this document are either focused on trusts, or are designed to support trusts in delivering their responsibility for achieving value for money. There are six areas for improvement 1. Levers for change 2. Transparency and data management 3. NHS Standards of Procurement 4. Leadership, clinical engagement and reducing variation 5. Collaboration and use of intermediaries 6. Suppliers, innovation and growth 1. Levers for change Trust Chief Executives and their Boards are accountable for how their organisation spends public money, but it is rare they take the time to discuss whether they are securing value for money. We want to support Boards in giving procurement a stronger focus. For example, Monitor is considering what could be built into the Audit Code, reporting regime and best practice standards allowing Boards to demonstrate they are securing value from their nonpay spend. In addition, the NHS Commissioning Board is considering how to encourage trusts to focus on their procurement, including possible use of CQUIN payments. We are also keen to explore whether a „dashboard‟ of key metrics might encourage trusts to compare themselves with their peers and strive for improvement. These could be very simple and easy to prepare such as the number of cancelled procedures because of the lack of stock. Linked to this would be a number of „comply or explain‟ initiatives around these metrics, in particular to create an expectation that national framework agreements are the best and trusts are obliged to use them or explain to their Boards, commissioners and local populations why they intend to use alternative arrangements. We know that contract compliance is a key metric in achieving world-class performance and so we want to encourage trusts to put in place policies and systems that deliver this. Action: We will work with the relevant bodies such as Monitor to strengthen trusts‟ accountability for procurement with implementation effective from 2013 Action: By December 2012, we will create a dashboard of indicators and measures to help trust Boards strengthen their accountability for procurement and to ensure the ability to report publicly Action: We will develop a number of comply or explain initiatives, such as compliance to national framework agreements 26 Version 1a May 31st 2012 2. Transparency and data management The Government believes that open access to information holds public services to account, and this applies to the way we spend public money. In May 2010, the Government set out its expectations for greater transparency in procurement. It recommended all public services, including foundation trusts should use Contracts Finder, the Government‟s single portal for publishing tender and contract documentation for contracts valued over £10,000. As a minimum, NHS trusts should be doing this, but we need to go further. We believe trusts should actively share information for the greater good, and ensure we leverage the full power of NHS spend. It is not acceptable for trusts to withhold procurement information believing it jeopardises their competitive position – it does not, as there is no evidence the prices paid correlate to size or status. Action: Trusts should publish all tender and contract information for contracts over £10,000 in Contracts Finder Action: Trusts should share their procurement data with other trusts for the purposes of benchmarking Action: We will work with trusts to help them collaborate to benchmark their purchase information such as prices paid Trusts should actively collaborate to share and benchmark their information, particularly purchase information such as prices paid, products bought and volumes. The Department worked with the FTN last year to benchmark prices paid for a sample of medical products from a small number of trusts. The results showed smaller trusts often secured better pricing than larger ones. Many trusts are already using spend analytics services, and we want to encourage more of this, so we will work with the FTN and the NHS Confederation to explore ways in which this can be done more consistently, possibly through an agreed basket of goods as suggested by trust Chief Executives. E-technology is transforming procurement and supply chains in all sectors, and is an essential part of the journey to world-class performance. The ability to manage expenditure through controlled catalogues, order goods electronically, manage inventory to its point-ofuse, and source via the web is increasing the transparency of data and pricing, but NHS trusts are behind the curve and need to invest in e-procurement systems to improve their processes. Action: We will develop a suite of case studies of current procurement good practice Action: We will provide financial guidance to support trusts‟ investment decisions in procurement technology In April 2012, the EU announced a commitment to driving full e-procurement for all public purchases. In the context of the modernisation of the European Public Procurement Directives, adopted in December 2011, the Commission has proposed to make eprocurement the rule rather than the exception, by making it the standard method of procurement in the EU by mid-2016. 27 Version 1a May 31st 2012 Underpinning e-procurement technology is the need for standard coding. Ministers have already stated that we are committed to GS1 as our preferred supply chain standard and the Department is working with industry sectors to urge them to adopt the standard. However, trusts need to ensure they make full use of the coding system by investing in technology such as bar-code readers and insist it is used by all suppliers. A reference guide to support trusts with this action can be accessed at http://healthcare.gs1uk.org/ Trust Chief Executives tell us they would like to see price and product comparison systems that allow them to benchmark prices and performance, but they are not sure where to invest. Trust Boards can easily play their part by working with GS1 to introduce standard coding of all products, making price comparison easier. Action: Trusts should include the requirement for suppliers to provide GS1 GTINs (Global Trade Item Numbers) and associated data as an integral part of any procurement process. In addition trusts should make it clear to their suppliers that provision of GS1 data will be evaluated positively in any competitive situation and over time provision of the data will become a mandatory requirement There are still too many inefficient systems in the NHS and stories of obsolescent stock. The NAO found that much trust purchasing is administered in multiple, small purchase orders. As a minimum, trusts should ensure they have access to: • Electronic-requisitioning and electronic-ordering facilities as part of their Purchase to Pay (P2P) business software • Electronic-catalogues • Electronic exchange facilities (i.e. the ability to send orders to and receive e-invoices from suppliers) • Electronic-sourcing technology The NHS can make more use of the technology on offer to support procurement and the management of stock. We want to encourage trusts to invest in procurement technology so they can improve their visibility of spend, have real time stock information and be able to share information and compare themselves with their peers. Whilst we know the NHS has a long way to go to improve its procurement processes and systems, we also know there are pockets of good practice and we will ensure that trusts have access to case studies which demonstrate current best practice. The Department has recently supported North East Patches (NEP) Shared System group, the shared services provider serving trusts in north east England, to put in place a national framework agreement for trusts to use to invest in these technologies. We will issue further advice and guidance to support trusts in their understanding of these technologies to ensure they invest wisely and that systems are compatible for comparison of information. Leading procurement organisations understand the importance of compliance with contracts. There is little point in negotiating contracts with suppliers if they are not used, and so a culture of compliance is essential in bringing non-pay spend under control. E-procurement systems can support compliance, by providing information on whether contracts are being 28 Version 1a May 31st 2012 used. We recommend trusts analyse their procurement spend and set themselves targets for compliance against existing contracts. We also recommend trusts seek to ensure more of their non-pay spend is covered by e-procurement systems. The Department will issue further guidance on compliance and coverage as part of the dashboard of key performance indicators for NHS procurement. Action: Trusts should analyse their non-pay spend and assure themselves they are complying with available contracts Action: Trusts should analyse their non-pay spend and set themselves goals to ensure improved coverage by their e-procurement systems 3. NHS Standards of Procurement A recent CPO Agenda/KPMG report on procurement excellence benchmarking suggests that procurement‟s overall value creation across all business sectors has progressed hugely. On average, procurement influences 60% of an organisation‟s spend, and 75% of direct spend is under a contract, with the exception of retail which has a significantly greater level of control. NHS data suggest the NHS is lagging behind with less than 30% of a trust‟s spend being influenced by procurement, and less than 30% under contract, although it should be recognised that these figures do not include pharmacy spend which does have good controls in place. Chief Executives have told us they are not sure what good procurement looks like, and in response we are publishing a set of NHS Standards of Procurement with this document. These standards support the recommendations made by the Public Accounts Committee last year by setting out a clear vision of what good looks like and how it can be assessed and measured. There are 19 standards organised in four domains: leadership, process, partnerships and people. Each one describes the standard itself and how its achievement will improve organisational performance. It also provides a „maturity matrix‟ of three levels setting out the characteristics at different stages on the journey to improved procurement. The Department has co-designed these standards with NHS procurement professionals and trust Executives to ensure they meet trusts‟ requirements, both now and in the future. Each standard has a set of suggested indicators, which enable trusts to measure their improvement, and we expect these to evolve as the standards are used and experience shared. These standards will enable trusts to assess their current position and enable them to plan their improvement. The Department will also explore ways in which trusts can obtain an inexpensive independent assessment of their position (a diagnostic) to create a baseline for improvement. In the longer term, we will work with the Chartered Institute of Purchasing and Supply (CIPS) and the Health Care Supply Association (HCSA) to develop an inexpensive and independent accreditation system for trusts to aspire to and demonstrate their improvement. 29 Version 1a May 31st 2012 A portal for NHS procurement has been launched and is being developed which includes guidance on how to achieve the standards, a library of tools and templates, and national support for each one, where appropriate. Action: Trusts should appoint a Board executive to be accountable for procurement performance, preferably the operations or commercial director Action: Trusts should nominate a non- executive director to sponsor procurement Action: We will launch a set of procurement standards and a portal for the NHS to share best practice Action: Trusts should review their performance against the NHS Standards of Procurement and revisit their procurement strategies to ensure they align with the trust‟s business priorities Action: We will develop an independent diagnosis and accreditation system to allow trusts to assess their procurement capability Action: Trust Audit Committees should regularly review procurement A summary of the standards is shown below. 30 Version 1a May 31st 2012 4. Leadership, clinical engagement and reducing variation Given the growing importance of procurement, NHS leaders need to give it the attention it merits. This includes leadership at all levels, from trust Boards and Chief Executives, to clinicians and major budget holders, and most importantly for the director of procurement and the procurement profession. Even though non-pay expenditure represents 30 to 35 per cent of a trust‟s operating expenses, procurement performance is rarely discussed at Board level. NHS Executives ought to better understand the contribution it can make to their organisations. Leading private sector organisations such as Apple have long since understood the value a high-performing supply chain can bring to their bottom line, and have invested accordingly. Trust Boards need the ability to determine if investments in people, processes and technology can deliver results both in terms of improved patient outcomes and cost reduction. Trust Chief Executives have asked us what they should do to improve their procurement. The ICARE approach below describes some key first steps. We urge Chief Executives to consider this approach • Invest their time by showing procurement is important and if need be, invest in the people, processes and technology • Be prepared to sponsor and, if required, lead Collaboration between trusts on procurement issues • Appoint a Board Executive to be accountable for procurement and a non-Executive director to sponsor the procurement function • Ensure the procurement function gets the attention and Recognition it deserves • Ensure senior managers and clinicians Engage in procurement to drive a cost-management culture Action: Trust Chief Executives should consider using the ICARE approach to lead change in procurement Action: We will support the HCSA in developing as a professional association that provides leadership to NHS procurement Action: We will work with HCSA and CIPS to develop an academy for NHS procurement Action We will work with trusts and clinicians to identify best practice for reducing variation and managing demand for products and services The procurement profession must also raise its game and play its part. For many other NHS functions such as finance, professional associations provide an essential leadership role; this has not been the case for procurement. HCSA has a long history of representing the interests of NHS procurement professionals, but it needs to provide stronger leadership to help NHS procurement professionals raise their game. 31 Version 1a May 31st 2012 We believe the association – working in partnership with the CIPS – could provide a range of functions that can support the development of procurement in the NHS. These include: • Learning and development for procurement professionals and staff involved in procurement activities • Policy advice and communications • ownership of best practice and the NHS standards of procurement • Benchmarking facilities, including trust dashboard metrics and price benchmarking • Guidance on how best to use outsourced procurement partners • Networking • Development of an academy for NHS procurement We are keen to work with the HCSA and CIPS throughout 2012-13 to develop these support functions The third area of leadership is the budget-holder level. Whilst traditional price-focused approaches to procurement will deliver savings, far greater efficiencies can be achieved by focusing on areas such as specification or product rationalisation, complexity reduction and demand management techniques. Equipment requests can be „overheated‟, with too many types being ordered, for far too large a range of tasks, and at too high a specification – all points emphasised by the PAC report last year. Budget-holders are critical in this regard. In a typical trust, 50 per cent of non-pay expenditure is spent on clinical and pharmaceutical products. Trust clinicians are at the heart of how this money is spent, but are often unaware of the significant impact they can have on a trusts‟ costs. Devices such as orthopaedic or cardiovascular implants can often represent a significant portion of the national tariff, so bringing them under control can have a direct impact on a trust‟s bottom line. Clinicians‟ relationships with suppliers are important, in terms of delivering safe and quality care, but we need to ensure clinicians also play their part in managing costs and the commercial relationship with suppliers. We want to encourage clinicians and budget-holders to: • Recognise and own procurement efficiencies in their management of clinical budgets • Link procurement costs to their service line reporting • Reduce variation, challenge specifications, and manage demand for products and services Better performing trusts have „clinical product selection committees‟ in place to help them with these issues and some have appointed „clinical procurement specialists‟ tasked with rationalising commodity selections. In other cases, trusts have devolved procurement savings targets to budget holders, and then encouraged them to work with the procurement function to deliver the required outcomes. We want to see more of this and so we will work with trusts and clinicians to identify best practice to share across the system, but we also know even more value can be delivered by trusts collaborating on these issues. 32 Version 1a May 31st 2012 5. Collaboration and use of intermediaries When we think of collaboration we tend to think of pooling NHS demands to achieve better deals with our suppliers (aggregation and framework agreements), but collaboration between NHS trusts can deliver much more than just aggregated procurement. Indeed, one of the most important roles for procurement leaders in any sector today is to source, manage, combine and blend capabilities and resources successfully, from inside and outside the organisation, to achieve their goals. It is rarely practical for trusts to have their own category management and logistics teams. It makes more sense to share these activities or use specialist procurement intermediaries. Trusts have a history of using procurement partners to support their procurement activities to varying degrees of success, but trusts rarely go through a robust decision-making process to decide what they want procurement partners to provide. Furthermore, they often do not appreciate the range, importance and opportunity procurement partners can provide for improving procurement performance, or indeed that using partners is not about transferring core responsibilities but about gaining additional expertise and resource from outside to support the key functional activities. The green box suggests activities trusts can collaborate on, with or without using procurement partners. Trusts should analyse their own internal capability for these activities assessing their strength, potential for improvement, and whether procurement partners can support and deliver them more effectively. Suggested activities for procurement collaboration: Category management Price benchmarking Logistics Committing volumes to achieve leverage Standardisation / rationalisation of products Supplier information and management Catalogue management Improving procurement performance by sharing good practice and comparing KPI’s The approach to collaboration should be pragmatic and agile; one size will not fit all. However, this flexible approach should consider that many of the benefits of working together could only be achieved through longer-term committed relationships. The key is to match the right type of relationship to the desired outcome. In order to achieve the benefits of collaborative procurement, commitment is required by all stakeholders. We want to help trusts make best use of procurement partners and avoid duplication in the system, but we believe trust Chief Executives need to show a greater interest and sponsor collaborative activity. Indeed, Chief Executives told us they would like to see clustered activity to discuss things like price and product transparency, committed volume contracts, and a focus on the top 10 spend areas/suppliers. The more trusts work together to agree how best to work with procurement partners, the more likely intermediaries will respond better to their demands. 33 Version 1a May 31st 2012 A precedent has been set with the establishment of „customer Boards‟ for both NHS Supply Chain and the Government Procurement Service, where representation mirrors Boards in trusts by involving finance directors, medical directors and nursing staff, and we are already seeing changes in behaviour and a better focus on what trusts‟ need. We want to encourage more of this and so we will work with the FTN and others to find ways in which we can encourage senior trust Executives to engage in clustered activity to become the intelligent client for procurement partner organisations. In doing this, we are keen to find ways in which trusts can deliver stronger commitment to procurement deals, so that suppliers have greater certainty of demand, rather than the myriad of framework agreements that currently exist. We are also working with NHS Supply Chain to explore ways in which they can be incentivised to give stronger commitment to suppliers in return for better terms. Action: We will work with the FTN and others to find ways the NHS can become a more informed customer in the use of procurement partners Action: We will work with trusts and their procurement partners to find ways in which firmer commitment can be given to suppliers Action: We will ask NHS Supply Chain, the Government Procurement Service, and others, to produce information on „lost opportunities for savings‟ for trust Boards to consider Whilst we do this, the NAO and the PAC highlighted that existing arrangements with organisations such as NHS Supply Chain are not being used as well as they might. So we are asking NHS Supply Chain, the Government Procurement Service and others, to produce information on „lost opportunities for savings‟ that can be circulated to trust Boards for their consideration. 34 Version 1a May 31st 2012 6. Suppliers, innovation and growth A succession of government policies has highlighted procurement as an important lever for economic growth, a potential driver for better public service and, equally important, a means of stimulating innovation. The Government’s Procurement Pledge Give potential providers greater certainty of our future demand Work with potential providers to identify and address strategic capabilities in supply chains to ensure providers are prepared to meet this future demand Operate an open door policy for business so that we can develop a more strategic relationship with current and future providers Back UK business when bidding for contracts overseas The Government announced a package of procurement measures in November 2011, designed to support businesses and stimulate growth. This includes publishing potential business on-line, making it 40 per cent faster to do business with government, and collaborating with businesses much earlier in the procurement process so they do not find themselves excluded from opportunities. Furthermore, Government sees Small and Mediumsized Enterprises (SMEs) as critical to achieving UK economic growth and so it wants to ensure they can access the opportunities from Government and the public sector. All government departments have signed up to a „pledge‟ to support this agenda. The Government is also keen to ensure all public sector tenders are posted on Contracts Finder so that suppliers can access contracts through a single portal. Furthermore, public buyers are encouraged to stop using pre-qualification questionnaires (PQQs) for contracts under £100,000. We are keen for the NHS to play its part in these initiatives and so we encourage trusts to acknowledge the pledge and use Contracts Finder. The government has also established a mystery shopper service and supplier feedback service that allows suppliers to complain about individual procurements by any public sector organisation. The Cabinet Office has received over 150 complaints since the service started, most of which are directed at overly cumbersome PQQs. In health, we have received in excess of twenty, again mainly criticising the use of PQQs. Following investigation, nearly all trusts changed their practices to meet government expectations. We are therefore recommending trusts stop using PQQs for low-value contracts. In response to comments from industry, we intend to update and publish an NHS standard set of terms and conditions of contract for goods and services. Action: Trusts to acknowledge the Government procurement pledge Action: Trusts should stop using PQQs for low value contracts (under £100,000) Action: We will update and publish an NHS standard set of terms and conditions of contract for goods and services 35 Version 1a May 31st 2012 The Department recognises the value innovation from suppliers can bring to the NHS reforms, as acknowledged by Innovation Health and Wealth published in December 2011. We know procurement can ensure the process of procurement and specifications are friendly to innovation and SMEs; send strong and early signals to the market on what the NHS intends to procure; engage with suppliers and actively look for new and innovative solutions; conduct open dialogue with suppliers outside of a procurement process; challenge suppliers to develop new products and solutions to meet known healthcare challenges, for example, through initiatives such as the Small Business Research Initiative (SBRI). It can also encourage the adoption and spread of innovative technologies and solutions across the NHS, so we are keen to explore ways in which NHS procurement can meet both the Government‟s objectives and ensure we capture innovation from our suppliers to improve care for patients. We want to ensure the key players in the NHS procurement landscape such as NHS Supply Chain, the Government Procurement Service and procurement partners play their part in supporting the procurement of innovation. 36 Version 1a May 31st 2012 Summary of recommended actions For trusts: 1. Trusts should publish all tender and contract information for contracts over £10,000 in Contracts Finder 2. Trusts should share their procurement data with other trusts for the purposes of benchmarking 3. Trusts should include the requirement for suppliers to provide GS1 GTIN's (Global Trade Item Numbers) and associated data as an integral part of any procurement process. In addition, trusts should make it clear to their suppliers that provision of GS1 data will be evaluated positively in any competitive situation and over time provision of the data will become a mandatory requirement 4. Trusts should analyse their non-pay spend and assure themselves they are complying with available contracts 5. Trusts should analyse their non-pay spend and set themselves goals to ensure improved coverage by their e-procurement systems 6. Trusts should appoint a Board Executive to be accountable for procurement performance, preferably the operations or commercial director 7. Trusts should nominate a non-Executive director to sponsor the procurement 8. Trusts should review their performance against the NHS Standards of Procurement and revisit their procurement strategies to ensure they align with the trust‟s business priorities 9. Trust Audit Committees should regularly review procurement 10. Trust Chief Executives should consider using the ICARE approach to lead change in procurement 11. Trusts to acknowledge the Government procurement pledge 12. Trusts should stop using PQQs for low value contracts 37 Version 1a May 31st 2012 For the Department of Health: 1. We will work with the relevant bodies such as Monitor to strengthen trusts‟ accountability for procurement with implementation effective from 2013 2. By December 2012, we will create a dashboard of indicators and measures to help trust Boards strengthen their accountability for procurement and to ensure the ability to report publicly 3. We will develop a number of comply or explain initiatives, such as compliance to national framework agreements 4. We will work with trusts to help them collaborate to benchmark their purchase information such as prices paid 5. We will develop a suite of case studies of current procurement good practice 6. We will provide financial guidance to support trusts‟ investment decisions in procurement technology 7. We will launch a set of procurement standards and a portal for the NHS to share best practice 8. We will develop an independent diagnosis and accreditation system to allow trusts to assess their procurement capability 9. We will support the HCSA in developing as a professional association that provides leadership to NHS procurement 10. We will work with HCSA and CIPS to develop an academy for NHS procurement 11. We will work with trusts and clinicians to identify best practice for reducing variation and managing demand for products and services 12. We will work with the FTN and others to find ways to find ways the NHS can become a more informed customer in the use of procurement partners 13. We will work with trusts and their procurement partners to find ways in which firmer commitment can be given to suppliers 14. We will ask NHS Supply Chain, the Government Procurement Service, and others, to produce information on „lost opportunities for savings‟ for trust Boards to consider 15. We will update and publish an NHS standard set of terms and conditions of contract for goods and services 38 Version 1a May 31st 2012 Implementation The „call for evidence‟ will deliver a strategy that reaches further than the actions detailed in this document, but we believe the actions herein will raise the game for NHS procurement in the short term. Everyone in the system should be taking action to improve procurement, but we recognise trusts will need support with mobilisation, so we will establish an implementation Board to support improvement. The National Procurement Council (NPC) was formed 2 years ago and includes representatives from NHS, trade associations, procurement provider organisations and the professional association for procurement in health, the Healthcare Supply Association (HCSA). It was formed to address issues in procurement in the NHS through discussion in order to agree actions and principles, as well as a forum to consult on developing NHS procurement policy. This Council will form a support mechanism for the delivery of performance improvement in the short term, and will form working groups along the themes described in this document: 1. Levers for change 2. Transparency and data management 3. NHS Standards of Procurement 4. Leadership, clinical engagement and reducing variation 5. Collaboration and use of procurement partners 6. Suppliers, innovation and growth These groups will be formed from members of the NPC as well as additional stakeholders and subject matter experts, with the core objective of supporting performance improvement. The groups will report progress to the NPC and we will ensure transparency of this through the publishing of all NPC meeting minutes. 39 Version 1a May 31st 2012 Appendix B NHS Standards of Procurement A PDF version of this document is available at: http://www.dh.gov.uk/health/2012/05/procurement-guidance/ 40 Version 1a May 31st 2012 41 Version 1a May 31st 2012 Contents Introduction Aim and objectives Development of the NHS standards of procurement How to use the NHS standards of procurement Annex A : Glossary / Definitions 42 Version 1a May 31st 2012 Introduction Procurement has a key role to play in supporting the delivery of Quality, Innovation, Productivity and Prevention (QIPP), with an already identified contribution of £1.2bn towards the £20bn of efficiencies required. The demands on procurement and expectations of the efficiencies required are increasing and Trusts need to develop and respond to the challenges. Against this background, it is important that the Trust Board and senior management teams have a sound understanding of the standards that they should be meeting in procurement. The NHS Standards of Procurement support the recommendations from the Public Accounts Committee (April 2011) by providing a clear vision of good procurement and identifies high quality procurement performance. They enable Trusts Boards to assess procurement performance and recognise areas for improvement to ensure value for money (VFM) is delivered through its procurement activity and its procurement partners. These standards provide a structure for trusts to work within to improve procurement performance and inform the direction and priority for any system level support. They will be supported by the National QIPP Procurement programme and other system level initiatives. These standards provide a useful aid to the continuing success of procurement performance in your organisation. Aim and objectives Each NHS organisation ensures its own sustainability (in quality, safety & financial terms) supported through effective procurement, leveraging the collective power of the NHS 43 Version 1a May 31st 2012 The NHS Standards of Procurement support the achievement of the aim by providing the NHS and the Department of Health with a clear vision of what good procurement looks like. Development of the NHS standards of procurement The NHS Standards of Procurement have been co-developed with the NHS, the procurement profession, the Health Care Supply Association (HCSA) and independent sector healthcare. In gaining advice from all parts of the system, it ensures that the NHS Standards of Procurement are meaningful, robust enough to stand the test of time and that NHS ownership will lead to these standards being embedded in procurement practice. How to use the NHS standards of procurement The NHS Standards of Procurement are in four domains Leadership, Process, Partnership and People. Each containing a number of standards, all of which comprise: The standard How organisational performance will be improved from achieving the standard Maturity levels 1 to 3 o Level 1 – Building - awareness and building blocks in place o Level 2 – Achieving - making good progress O Level 3 – Excelling - outstanding procurement performance • Suggested indicators They provide a framework for consistent approaches and practices to procurement in the NHS, delivering benefits across the system in procurement performance. Trusts will be able to self-assess themselves based on the characteristics in the maturity matrix, and identify the actions for improved procurement. It should be noted that these levels are cumulative, meaning that to achieve level 3 “Excelling”, the attributes will have been met in level one and two. The principal idea behind the standards is that they should set out in a simple, yet structured, way those key things that NHS Trusts should be looking to achieve to ensure that they are providing a good procurement service to their organisation and value for money is being achieved. This document also provides a glossary of defined terms ensuring a clear and consistent understanding across the system. In order to make the standards more interactive and to promote the sharing of good practice, a forum has been established on “The Knowledge Hub”. This dynamic and interactive site will provide an opportunity for Trusts to share information, tools, templates and a central repository for guidance documents. The NHS Standards of Procurement should, therefore, serve as a useful reference tool for 44 Version 1a May 31st 2012 the Trust Board, Heads of Procurement and their staff as they seek to develop their services and procurement performance. The standards are not in themselves mandatory nor will performance against them be measured by the Department of Health. Each organisation will, therefore, be able to improve its performance against the standards in accordance with its own stage of development. It is important to note that these standards are aimed at an entire organisation, therefore if a Trust outsources, uses a shared service or works with procurement partners for some activities i.e. sourcing, contracting, transactional procurement, the responsibility maybe transferred but the overall accountability remains with the Trust, therefore the Trust should assesses their partner(s) on the relevant sections of the standards. Each standard provides suggested indicators, the decision on which indicators are most meaningful and useful for measuring procurement performance is a decision to be taken by the individual organisation. These indicators can also be used to set goals for continuous improvement in procurement performance. 45 Version 1a May 31st 2012 1 – LEADERSHIP The role of procurement in delivering the Trusts objectives is understood and supported at every level The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 - Excelling Indicators 1.1 The Trust Board is fully accountable and understands the contribution of non-pay spend on the wider Trust and is committed to delivering best value for the taxpayer By demonstrating top-level commitment and support and understanding non-pay spend and its impact on the delivery of patient care, the culture will shift to one that engages and understands the importance of making best use of non-pay spend whilst obtaining fit for purpose products/services and making efficiencies. Reduce spend, Improve patient care, Increase efficiency Procurement strategy developed in support of the Trust strategy. The Trust Board and Senior Managers communicate the importance and contribution of procurement. Procurement represented at Board level (exec or nonexec). Non-pay spend is reported to the Board. Procurement strategy in place with some codevelopment from the Trust Board and communicated across the Trust (with regular review). There are welldefined objectives, operational plans and performance indicators for Procurement approved by the Board. A board member (exec or non-exec) is accountable for procurement activities. Non-pay spend reports segmented into main categories are reported to the Board. Procurement strategy is integral to delivery of the Trust strategy (reviewed and updated on regular basis). Non-pay efficiency measures reported at Trust Board on a monthly basis with goals set for continuous improvement. Evidence of procurement issues regularly discussed and agreed in Trust Board Minutes. Non-pay spend/procurement governance group reporting to the Board. The Trust Board, Senior management and the Head of Procurement demonstrates commitment to procurement through their personal actions and involvement. 1. How often is non-pay spend on the Trust Board agenda? 2. How often is performance measurement of procurement reported to the Trust Board and senior managers? 3. How well is the procurement strategy being implemented and delivered? 4. Progress / benefits of major procurement projects are reported to the Board (timescales / budgets) 46 Version 1a May 31st 2012 The Standard How organisational performance will be improved Level 1 – Building Level 2 – Achieving Level Excelling Indicators 1.2 All nonpay spend is governed by and subject to proficient procurement This will ensure that all non-pay spend is controlled and compliant with EU Directives and conducted in appropriately transparent, proportionate, nondiscriminatory and equal manner. Value for Money (VFM) will have been tested and any unnecessary or fraudulent transactions are eliminated. Reduce risk, Reduce spend, Improve governance Procurement policy in place which covers all non-pay spend. A communicated procurement policy adopted across the Trust. All departments / staff with procurement responsibilities are identified and recorded. A pro-active non-pay spend governance group is in place which as a minimum assesses compliance to the procurement policy and provides a route of escalation for noncompliance. Action plan in place to increase contract coverage in non-pay spend. 1. % of nonpay spend influenced by procurement professionals 2. % of nonpay spend covered by contracts 3. % of category expenditure influenced by procurement professionals 4. Number of incidents of noncompliance to procurement policy 5. Number of legal challenges 6. % / number / value of single tender procurements 1.3 All Trust staff are engaged in making efficiencies in non-pay spend Staff will be motivated and encouraged to make changes, which improve services and delivers Value for Money (VFM). Reduce spend, Improved patient care, Reduce risk All Trust staff have an awareness of and participate to make nonpay efficiencies for the organisation. The Trust Board acknowledges the contribution that all staff can make to increasing the efficiency of nonpay spend across the Trust, and motivate all staff to identify what contribution they can individually make, via their objectives, job descriptions, and other mechanisms. Product prices displayed in clinical areas. The Trust Board promotes and actively supports a culture of making nonpay spend efficiencies and the adoption of “lean” principles. Specific initiatives implemented that incentivise staff to identify and deliver non-pay spend efficiencies. 1. Number of relevant modules of the “Productive series” implemented. 2. % of staff with procurementfocused goals in their job description and annual objectives. 3. Savings delivered from initiatives identified by staff that have been implemented 4. How engaged staff feel in making financial efficiencies 47 Version 1a May 31st 2012 The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 1.4 Critical supplies / suppliers are identified and plans are in place to mitigate risks The risk of failure to deliver quality care is reduced as plans are in place to mitigate risks against failure in any critical supply chains. Reduce risk, Improve governance Critical supplies and / or suppliers identified by assessing the risk of supply failure. Critical supplies identified and mitigation / contingency plans developed. Critical suppliers identified and mitigation / contingency plans developed. Robust supplier relationship management processes in place, which includes measures to reduce failure to supply risks. Supply risks identified, managed appropriately and escalated to the Trust Board and reported through the corporate risk management system / risk register. Evidence of supply market intelligence in order to forecast and plan for future supply risks. 1. Number of procedures cancelled due to lack of availability of supplies / equipment / agency staff? 2. Number of events with "damage to reputation" from non-supply 3. Extra costs incurred due to supply failure 1.5 Being transparent on non-pay spend and pricing information Transparency of procurement information within the Trust, with other Trusts and with the public leads to comparisons being made and opportunities identified to improve efficiency. Improve governance, Reduce risk, Reduce prices Processes developed so that prices paid within the Trust are transparent and variances addressed. Invoice spend over £25K uploaded onto data.gov. Use "contracts finder" to publish tenders & contracts over £10K. Processes or system implemented to ensure internal prices are consistent and transparent. Price benchmarking is carried out with other Trusts (formally / informally). Implemented Trust policy that prohibits price non-disclosure agreements / confidentiality agreements. No discrepancies in prices paid for the same product across the Trust can be evidenced. Implemented action plan based on variances identified through benchmarking with other organisations. All contracts and pricing are publicly available. 1. % of products / services regularly benchmarked 2. Performance on the benchmarking of a) low value / high volume / generic basket of goods b) high value specific basket of goods (e.g. Orthopaedics) 3. % (by number & value) of opportunities over £10k advertised through 'contracts finder' 48 Version 1a May 31st 2012 The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 1.6 Innovative technologies and processes are adopted and benefits measured Fostering a managed culture of innovation will ensure that new ideas are embraced and assessed, leading to more rapid adoption resulting in efficiencies and improved patient outcomes. Improved patient outcomes, improved efficiency Developed a policy that supports the adoption of innovation. A clear process for increasing the adoption of technology innovation is developed. Implemented policy that supports the adoption of innovation. A clear process for increasing the adoption of technology innovation is implemented. Procurement is actively involved with the adoption of innovations related to technology. Evidence of the adoption of innovation and its benefits is reported to the Trust Board. Patient / efficiency outcomes following the adoption of innovation are regularly reviewed by the Trust Board. Policy is regularly reviewed by the Trust Board. 1. Number of finished consultant episodes impacted by the adoption of innovation, as a proportion of total number of FCEs 2.Number of outpatient appointments impacted by the adoption of innovation, as a proportion of total number of outpatient appointments 3.Value generated within the Trust by the opportunities adopted, expressed in £ 4. Value generated outside the Trust but within the healthcare economy, expressed in £ 49 Version 1a May 31st 2012 2. PROCESS All procurement systems and processes are designed and implemented to ensure Value for Money (VFM) is achieved in getting the right product to the right place at the right time The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 2.1 All non-pay spend information is captured to allow complete visibility of product/service, supplier, prices, volumes, requisitions and receipts Knowing what is being spent and with who allows for effective management of non-pay spend. The availability of accurate non-pay spend data is central to the effective management of the supply chain. Access to this information is essential to deliver cost savings, efficiencies, effective planning and improved procurement strategy Reduce spend, Improve governance High level non-pay spend data is mostly generated by initiating orders through an electronic catalogue system. Data is generated and captured as early as possible in the Purchase to Pay cycle in a form that is capable of flowing through all subsequent processes. Procurement Information and knowledge management procedures are in place. The extent to which nonpay spend data is not captured through electronic catalogues is understood. Non-pay spend data is captured by category / supplier and detailed line item through procurement system and checked against Accounts Payable data. Implemented standard coding (GS1) and have mechanisms in place to be able to gather meaningful management information. Procurement Information and knowledge management policy adopted. There is a plan to increase the coverage of non-pay spend through electronic catalogues. Management reporting using data generated from purchase to pay processes (including erequisitioning, goods received and accounts payable data) Limited forecast information available. Integrated electronic tools and systems that categorise expenditure (products / suppliers / prices paid / requistioners) by utilising standard coding i.e. GS1, eclass. Procurement regarded as the key source of information on non-pay spend intelligence. Detailed information available on future demand based on local population health demand (patient level information and costing systems PLICS) forecasts nonpay spend planning. Procurement Information and knowledge management strategy (including the use of spend analytics) is fully implemented with regular review process and benefits tracking evidence of information being used to inform decisionmaking. 1. % of Non pay spend visible through the procurement system and reconciled with invoices and accounts payable 2. Number of individual items per commodity 50 Version 1a May 31st 2012 Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 2.2 Inventory and assets are known and managed Keeping the appropriate levels and types of products in stock reduces waste through obsolescence, frees up space, ensures correct products are used and increases working capital. Knowing and managing assets will enable efficient and effective use and enable future planning of capital resources. Reduce spend, Improve patient safety, Reduce risk Clear inventory management policy and procedures adopted with prioritised action plan. Electronic catalogues implemented with proactive management of content. Inventory management controls in place, stock checks undertaken on a regular basis. Asset register in place. Inventory management in place with different management controls recognising financial value or criticality of supply. Information created by ordering process automatically populates inventory levels. Goods received process verifies stock availability. “Lean” supply chain techniques identified. An asset management system implemented which tracks asset utilisation. Implement inventory management solutions (including automated systems on all or selected products / areas) with full integration into sourcing processes. Evidenced improvement on inventory holding and stock costs. Real-time view of stock held. The ability to track products throughout their lifecycle from manufacturer to consumption Product based patient level costing can be implemented. “Lean” supply chain techniques implemented. Implement robust asset management system and procedures that supports the development of the capital equipment programme. 1. % of requisition points covered by materials management 2. Value (as %) covered by mat man 3. % or £ of stock on balance sheet 4.number of stock checks 5. % of stock with real-time information 6. % of procedures / pathways with product based patient level costing 7. number of stock days / stock turn ratios 8. total carriage costs 9. value of obsolete stock / stock shrinkage 10. cost of noncompliance 11. number of cancelled procedures due to lack of stock 12. Value of savings achieved from implementing “lean” supply chain techniques 51 Version 1a May 31st 2012 Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 2.3 Purchase to Pay processes are effective and efficient Efficiencies are made and risks reduced by effective electronic and automated processes, which enables and tracks everything that is purchased from point of demand to use to invoice payment. Improve governance, Reduce risk, Efficient use of clinical time Some electronic systems / tools exist in the purchase to pay process (erequisition / ecatalogue / inventory management /esourcing / eauctions / eordering / einvoicing and matching / epayment incl payment cards). Defined process and procedures on the use of ecommerce. E-procurement solution operating effectively. Standard coding and pricing exists in e-procurement system. Catalogue and Purchase Order data integrates directly with other Trust systems. E-commerce policy adopted with clear action plan. No purchase order, no payment policy communicated to all staff and suppliers. Fully integrated e-procurement solution embedded across the Trust at point of use. Fully automated Purchase to Pay process available including integration with goods received and inventory management system. E-commerce is outlined and actioned in the procurement strategy. Business case is considered on shared services / outsource of purchase to pay function. 1. % of transactions with GPC used as payment mechanism 2. % (by invoice volume) achievement of payment terms 3. Average Invoice Value 4. % total transactions that are etransactions 5. % payments processed via e-payment system(i.e. through einvoicing, econsolidated billing/self billing, and first time automated match from purchase order to invoice) 6. % of eorders and einvoices matched first time 7. Average number of days to settle invoices 8. Number of invoices received 9. % / value of non Purchase Order based orders 10. average cost to raise an order (requisition to payment) 11. % of orders from electronic catalogues items 12. number of lines per order 52 Version 1a May 31st 2012 The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 2.4 A procurement process is used which ensures that the operational / clinical need is identified, and all market and sourcing options are explored before a contracting procedure is undertaken An effective and EU compliant procurement process will ensure maximum efficiency of resources, effective stakeholder engagement leading to a result that is fit for purpose. Reduce spend, Reduce risk There is a Trust Procurement Procedures Manual in place, which clearly describes the processes and governance for procurement. Specifications are regularly reviewed based on market /user knowledge. Sourcing options identified on project specific basis. Embedded use of SID4Health in sourcing process. A RACI matrix approach is embedded in the procurement process including preprocurement planning. Product / service specifications reviewed on a regular basis with stakeholder user groups (clinical decisionmaking groups). Procurement procedures are regularly reviewed and changes are understood and signed off at the appropriate level. The concept of category management is understood and appropriate category strategies are in place and can be described. E-tendering and sourcing tools implemented and value demonstrated. “Lean” sourcing process and associated procedures developed Lean sourcing process and associated procedures are implemented and value demonstrated. Stakeholder user groups in place (clinical decisionmaking groups) to ensure codevelopment of tailored sourcing strategy. The concept of outcome-based specifications is understood and the approach is considered for all sourcing initiatives. The concept of Market informed sourcing is understood and adopted. Participate in Forward commitment procurement activities. Total cost of ownership is embedded in sourcing / purchasing decisions. 1. % of procurement activities that comply with procedures 2. Average Procurement cycle times 3. Costs incurred due to legal challenge from suppliers on procurement process 4. Cost of procurement as a % of non-pay spend 4. % electronic contract notice 5. % electronic award notice 6. % contracts through esourcing (e.g. electronic tendering systems) 7. number and value of sourcing activities using eauctions 8. number / value of single 53 Version 1a May 31st 2012 The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 2.5 Sustainable development is assessed, considered, implemented and monitored in procurement decision making Early consideration of sustainable development in procurement is shown to highlight opportunities for energy and resource efficiencies as well as identifying risks to the Trust (e.g. security of supply, reputational damage). Reduce spend, Reduce risk, Reduce carbon footprint The case for addressing sustainable development through procurement is documented and can be identified by staff with procurement responsibilities. Trust procures some goods that meet or exceed Government Buying Standards (where appropriate). Documented plan of action based on recognised sustainable procurement models (e.g. Sustainable procurement flexible framework, Procuring for carbon reduction, Ethical procurement for health, Good Corporate Citizenship) and a process for reviewing and reporting progress. Sustainable development is incorporated into procurement training, induction and staff development activity. Significant sustainable development aspects, opportunities and risks identified and addressed within procurement policies and procedures. Progress can be demonstrated against a recognised model of sustainable procurement. Sustainable procurement is incorporated into wider Trust training, induction and development activity. Documented examples exist of procurement exercises where consideration was successfully applied and resulting benefits were captured (e.g. case study, briefing notes, comms articles). Progress to advanced levels of a recognised model of sustainable procurement. Sustainable procurement performance is reviewed by senior management and Trust Board and communicated with key stakeholders internally and externally. Sustainable development related risks are routinely assessed as part of a wider Trust corporate risk management system. Quantitative evidence of the benefit of sustainable procurement. Existence of on-going sustainable procurement initiatives that support policy and strategic aims. 1. Value (£) of efficiency savings realised as a result of sustainable procurement initiatives 2. Tonnes of CO2e emissions avoided as a result of sustainable procurement 3. Tonnes of waste avoided as a result of sustainable procurement 4. % progress against a recognised model of sustainable procurement (e.g. flexible framework, good corporate citizenship) 5. % (by number or value) of procurements including consideration of sustainable development 54 Version 1a May 31st 2012 The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 2.6 All spending is controlled in terms of limits on who can procure and what can be purchased Spend will be reduced as some items will no longer be able to be purchased as only the best value items will be available. Appropriate levels of approval will ensure that members of clinical staff are not spending unnecessary time on procurement activities. Reduce spend, Efficient use of clinical time. Published Scheme of delegation, with EU directives understood and requirements being met. Some ecatalogue management with restricted access. Scheme of delegation embedded within electronic catalogues, which are available across the Trust. Product masking is used to manage demand and improve contract compliance. Scheme of delegation embedded into all supporting IT systems, ecatalogues, ordering process. Spending controls are subject to regular review and audit to ensure Trustwide compliance. Demand management is fully integrated into procurement processes with a real-time view of stock and orders. 1. % of goods / services available through ecatalogues 2. Number / frequency of use of catalogue lines 3. £ savings from standardisation initiatives 4. % maverick spend (non purchase orders) 5. number / % / value of single tender procurements 6. Cost of non compliance (e.g. non contract items purchased) 55 Version 1a May 31st 2012 3. PARTNERSHIPS All relationships with other Trusts and with Procurement Partners are understood and opportunities have been maximised to deliver value The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 3.1 Engagement with other trusts is proactively pursued to maximise Value for Money (VFM) for the Trust There are many forms of collaboration with other Trusts that can lead to efficiencies through sharing of resources, information and good practice. Reduce spend, Reduce costs Activities and Trusts identified for sharing information / good practice but is only implemented in isolated cases. Engaged with NHS Trusts aligned to other collaborative practices i.e. clinical or executive team networks. Contribute to regional / national procurement network to share learning with other organisations. Consideration of pooling resources and shared service models. Established and implemented joint work plans with NHS Trusts (and other likeminded organisations, where appropriate) which support the procurement strategy. Evidence of the benefits realised from sharing information / good practice. Plans to include a commitment to continuous improvement and evidence of increasing the scope of joint working (new opportunities identified). Formal pooling of resources with partners where agreed. Achieved or following the principles of BS11000 – collaborative business relationships. 1. Number of initiatives undertaken from joint working (e.g. price benchmarking/ supplier performance scoring) with like minded organisations that have delivered real benefits 2. £ savings delivered from joint working (e.g. price benchmarking/ supplier performance scoring) with like minded organisations 56 Version 1a May 31st 2012 The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 3.2 Optimising the benefits of working with procurement partners (including leveraging the collective power of the NHS) Understanding and maximising the benefits of working with procurement partners will lead to the realisation of efficiencies and enable Trust procurement resource to concentrate on areas where local action adds the most value. Reduce spend, Reduce costs Demonstrates an understanding of the procurement landscape and selects procurement partner(s) as required. Have researched the procurement offers available to the Trust (options appraisal and cost benefit analysis), with a clear understanding of the risks and opportunities. A policy developed on working with procurement partners. Defined the selection and evaluation criteria for selecting a procurement partner(s). The Trust works with procurement partner(s) in a structured way (commits to working on categories of non-pay spend). Within the Procurement Strategy, a section on optimising the benefits of working with procurement partner(s) is implemented and regularly reviewed. Evidence of management and measurement of procurement partner(s) (regular review meetings and KPIs). The Trust influences the Procurement Partners workplan (including categories of expenditure) optimising resources within the Trust and avoiding duplication. Peer review with other Trusts of the benefits realised. The Trust is able to deliver commitment to the procurement partner(s) and meet its responsibilities to ensure successful delivery of workplan. 1. % of spend addressed through collaborative activity 2. % of spend channelled through procurement organisation(s) 3. £ savings achieved from working with procurement organisation(s) (cash releasing, cost avoidance) 4. Savings achieved from working with procurement organisation(s) (added value services e.g. aggregation / standardisation / commitment initiatives) 5. Overall return on investment 6. Informed client – number of procurement organisations used 7. Number of stakeholder groups / networks that my Trust contributes to 8. Number of procurement activities undertaken at Trust level when product / service already available through a procurement organisation 9. Cost of working with procurement organisation(s) 10. overall performance of the procurement organisation to workplan (delivery of actions / meeting timescales) 57 Version 1a May 31st 2012 The Standard 3.3 Contracts are managed, key suppliers are considered business partners and relationships are suitably managed How organisational performance will be improved Suppliers have confidence in the Trust and are willing to take a partnership approach to finding ways to reduce costs and explore innovative ways to meet needs. Reduce spend, Reduce risk, Improve patient care Level 1 Building Level 2 Achieving Level 3 Excelling Indicators Completed analysis to segment suppliers to identify key suppliers and prioritise opportunities. Contract management processes are developed and implemented with some suppliers. Key Suppliers identified and have structured supplier appraisal with Trust. Crossfunctional team reporting both qualitative and quantitative measures (quality, delivery, total cost of ownership, innovation). Performance data reviewed from key suppliers and compared with Trust management information and variances addressed. Joint meetings / seminars / workshops held with key suppliers with clearly defined objectives and development plans. Contract management implemented for all contracts. Robust Supplier Relationship Management in place with key suppliers detailing clear roles and responsibilities for crossfunctional team members. Plans and mechanisms are adopted to incentivise suppliers to continuously improve and develop (innovative products / services and ways of working, risk and reward schemes). Evidence of measurement. Clear understanding of the cost drivers to suppliers on serving the Trust – plan of action implemented to address behavioural change. Joint knowledge sharing at all levels of the organisation – operational and executive level. Achieved or following the principles of BS11000 – collaborative business relationships. 1. Supplier satisfaction questionnaire – scoring above satisfactory 2. Value/ % of non pay spend covered by supplier relationship management 3. Number or % of suppliers who consider your Trust to be a "preferred customer" 4. Number of initiatives to reduce the costs to serve and cost to procure (innovative ways of working) 5. Average number of days to settle invoices with key suppliers 6. Number of suppliers per commodity 58 Version 1a May 31st 2012 The Standard 3.4 Ensure that opportunities to supply exist for “encouraged enterprises” (e.g. small, medium, micro and minority enterprises, charities and other third sector organisations including supported businesses) How organisational performance will be improved Enabling small, medium, micro and minority enterprises, charities and other third sector organisations to play a productive role in the health economy supporting economic development, jobs, improved wealth, health and well-being. Improve Public Health Outcomes Level 1 Building Level 2 Achieving Level 3 Excelling Indicators The case for engaging „encouraged enterprises‟ is documented and can be identified by staff with procurement responsibilities. Publish all contract opportunities over £10k through „Contracts Finder‟. Systems in place to routinely capture data on suppliers that supports the identification of „encouraged enterprises‟. Engagement of „encouraged enterprises‟ is incorporated into procurement training, induction and staff development activity. Procurement policies and initiatives clearly support engagement of „encouraged enterprises‟. Opportunities are identified and addressed for “encouraged enterprises” within procurement policies and procedures (including direct contracting and subcontracting) Terms and conditions are proportionate and not excessively burdensome so as to exclude „encouraged enterprises‟ (e.g. levels of insurance cover, terms of payment). Documented examples of procurement exercises and initiatives where „encouraged enterprises‟ have been successfully engaged and resulting benefits were captured (e.g. case study, briefing notes, comms articles). Existence of on-going „encouraged enterprise‟ engagement initiatives that support policy and strategic aims. Systems in place to routinely capture data from suppliers that supports the identification of „encouraged enterprises‟ within supply chains. Performance on the engagement of “encouraged enterprises” is reviewed by senior management and Trust Board and communicated with key stakeholders internally and externally. 1. Value (£) of direct spend with “encouraged enterprises” 2. Value (£) of opportunities available to “encouraged enterprises” 3.% (by number or value) of contracted arrangements with “encouraged enterprises” 4. % / value of contracts where “encouraged enterprises” are sub-contracted 5.Average time to settle invoices from “encouraged enterprises” Note *: Trust to determine which encouraged enterprises to monitor based on its policy, strategy and circumstances. It is not recommended to aggregate this data as this would devalue data for key stakeholder groups. 59 Version 1a May 31st 2012 4. PEOPLE All staff across the Trust are appropriately trained and working effectively to obtain and use the products and services to do their job and understand their role in using procurement to deliver safe and efficient healthcare The Standard How organisatio nal performanc e will be improved Level 1 Building Level 2 Achieving 4.1 Procuremen t resourcing requirement s are well understood and plans are in place to meet the needs, now and in the future Having the right mix of skills and knowledge across the Trust will ensure that costs are at an optimum and benefits are maximised. Reduce costs, Reduce spend, Reduce risk New Trust staff with procurement or budget responsibiliti es have a procurementfocused induction session. Procurement staff are able to manage priorities, with clearly defined annual objectives. Head of Procurement develops a plan of the Trust‟s procurement activity. The procurement function has staff with a mix of skills enabling transactional and strategic working. New and existing Trust staff, with procurement or budget responsibilities , have a procurementfocused training session/ refresher session. Head of Procurement holds a plan of the Trust‟s procurement activity, and matches skills, knowledge, experience and ability of staff to the relevant roles. The Procurement function has staff that are able to operate and engage with the Executive team. 60 Version 1a Level 3 - Excelling Indicators 1. % of procurement All Trust staff with staff with an procurement or appropriate budget procurement responsibilities have qualification regular 2.% of procurement procurementstaff studying for an focused training appropriate session/ refresher procurement session. qualification Annual Objectives 3.Cost of for all Trust staff Procurement with procurement Function as a % of responsibilities Trust turnover (QIPP include procurement back office best in elements relating to class is 0.318%)cost non-pay spend base management, 4.% staff turnover in making efficiencies, Procurement and cross-trust Function collaborative 5. Appropriate working. number of The Head of procurement staff Procurement holds (£xM per Buyer) a plan of the Trust‟s 6.% of staff procurement members with activity, and procurement matches skills, responsibilities, knowledge, have procurementexperience and focused goals in job ability of staff to the description and relevant roles. Then annual objectives identifies any 7.Annual capacity or Procurement capability issues Training needs and offers the analysis shows relevant decrease in learning/training skills/knowledge /promotion / gap, year on year. mentoring. 8. Procurement Recruitment/retentio resource plan n integrated with Trust strategies are in place for key planning process. roles. Procurement training 9. % increase in suggestions programmes aligned toon reducing non-pay spend, individual job/project from all trust staff. requirements and business 10. Annual spend (days / £) need. on procurement training initiatives May 31st 2012 The Standard How organisational performance will be improved 4.2 Clinical and nonclinical staff are engaged with the procurement function and understand how it can contribute to delivering their outcomes Working together across the trust leads to effective and appropriate rationalisation and standardisation of products and services, as well as reducing risk of legal challenge and improving the uptake of innovative products and services. Reduce spend, Reduce risk, Improve patient care Level 1 Building Trust staff know when to involve the procurement function. Trust staff collaborate in some applicable product areas, to deliver nonpay spend efficiencies. Stakeholder user groups in place with regular meetings and clear objectives linked to the Trust strategic aims. The procurement function is aware of the importance of driving internal stakeholder engagement. Trust staff collaborate in the majority of applicable product areas, to deliver nonpay spend efficiencies. Active stakeholder user groups in place for product standardisatio n and rationalisation. Procurement induction session and training courses for all clinical and non-clinical staff are provided. The procurement function has defined processes and programme for internal stakeholder engagement, which includes identifying and communicatin g with key stakeholders. Stakeholder confidence questionnaires , relating to the Procurement function, are undertaken annually. 61 Version 1a Level 2 – Achieving Level 3 Excelling Trust staff collaborate in all applicable product areas, to deliver nonpay spend efficiencies, which is embedded in Trust culture. Stakeholder user groups provide a governance structure for measuring compliance to standardisation initiatives. Procurement objectives in directorate annual plans. Clearly defined ownership of, and contribution to non-pay spend efficiencies (i.e. directorate owns the target, and procurement‟s role is clearly defined.) Procurement conduct internal account management with directorates (i.e. programme of meetings) and work together to deliver strategic procurement projects. Procurement function is aware of the resource pressures within Trust directorates and plans accordingly. Indicators 1.% of new staff with procurement responsibilities have completed a procurementfocused induction session within 3 months of job commencement. 2.% of product/category spend covered by Stakeholder user groups 3.% of clinical/non clinical members of stakeholder user groups 4. Stakeholder confidence rating 5. number of legal challenges by % of spend 6. £ savings directly due to increased rationalisation/ standardisation of products and services. 7. number of cross-functional projects May 31st 2012 The Standard How organisational performance will be improved Level 1 Building Level 2 Achieving Level 3 Excelling Indicators 4.3 The procurement function has a leader who can clearly demonstrate the activities of the function to support the delivery of the Trust objectives Having the right leader in place will instill confidence to the Trust Board that everything is being done to ensure that the Trust objectives are being met and maximum value is being achieved. Improve governance, Reduce risk, Reduce spend Head of Procurement is involved in Trust strategic decisionmaking. Head of Procurement communicates regularly with customers, stakeholders and suppliers. Head of Procurement is directly accountable for some overall Trust Objectives. Head of Procurement is engaged from the outset with business and financial planning at all levels of the Trust. Head of Procurement is known and recognised across the Trust. Head of Procurement is a Trust Board member. Head of Procurement promotes procurement through marketing or education within the Trust with full support of the Trust Board. 1. Number of overall Trust objectives that procurement can contribute to 2. Number of overall Trust objectives that procurement are responsible for delivering 3. Level of awareness of the Head of Procurement across staff levels in the Trust. 62 Version 1a May 31st 2012 Annex A : Glossary / Definitions Benchmarking The process of measuring performance with other organisations within a peer group. This can range from business processes to procurement costs, for example individual product costs. BS11000 – Collaborative business relationships The aim of this British Standard is to provide a strategic framework to establish and improve collaborative relationships ensuring they are effective, optimized and deliver enhanced benefits to the stakeholders. Category management A concept in which a range of products / services purchased by a business organisation is broken down into discrete groups of similar or related products; these groups are known as product categories. It is a systematic, disciplined approach to managing a product category as a strategic business unit. CO2e Carbon Dioxide equivalence is an indexed measurement methodology that allows quantities of greenhouse gases with different global warming potentials to be expressed in common units. Further information is freely available through the Defra National Sustainable Public Procurement Programme – Carbon Literacy e-Learning Resource. Contracts finder The Government portal where central government and the wider public sector advertise contract opportunities over £10,000 and closed procurements – tender and contract documents. http://www.contractsfinder.businesslink.gov.uk/ Contract management Contract management is the management and measurement of contracts. This includes ensuring compliance with the terms and conditions, as well as documenting and agreeing any changes or amendments that may arise during its implementation or execution. It can be summarized as the process of systematically and efficiently managing contract execution, and analysis for the purpose of maximising financial and operational performance and minimizing risk. Cost benefit analysis The process for calculating and comparing the costs and benefits of a product / activity. Critical supplies An essential product / service is one that will have an immediate disrupting effect on a department's operation (or an effect within days) or which would interrupt a critical service to the Trust. Critical suppliers Critical suppliers are those that, in the event of their failure, would interrupt a critical service. Data.gov The government website where public data is held. It is focused on bringing transparency from the public sector to the wider population. http://data.gov.uk/ 63 Version 1a May 31st 2012 Demand management The pro-active approach to managing demand, for example standardisation initiatives. This could include product masking (see definition) or it could include the adoption of specific processes for spending authorisation. E-class classification NHS-eClass is a bespoke classification system for products and services, owned by the English NHS. The purpose of NHS-eClass is to facilitate the accurate analysis of expenditure. NHS-eClass is operated for the English NHS and DH and is administered by NHS Shared Business Services. E-commerce Refers to the buying and selling of products or services over electronic systems / networks such as the Internet. It also includes the entire online process of requesting, ordering, delivering, receipting and paying for products and services through electronic funds transfer, supply chain management, Internet marketing, online transaction processing, electronic data interchange (EDI), inventory management systems, and automated data collection systems. Electronic commerce is generally considered to be the sales aspect of e-business. It also consists of the exchange of data to facilitate the ordering and payment aspects of business transactions. E-procurement E-procurement encompasses the functions of procurement through electronic means. It can encompass: 1. ERP (Enterprise Resource Planning): Creating and approving purchasing requisitions, placing purchase orders and receiving goods and services by using a software system based on Internet technology. 2. e-sourcing: Identifying new suppliers for a specific category of purchasing requirements using Internet technology. 3. e-tendering: An electronic tendering solution facilitates the complete tendering process from the advertising of the requirement through to the placing of the contract. This includes the exchange of all relevant documents in electronic format. 4. e-reverse auctioning: Using Internet technology to buy goods and services from a number of known or unknown suppliers. 5. e-informing: Gathering and distributing purchasing information both from and to internal and external parties using Internet technology. 6. e-marketsites: Expands on Web-based ERP to open up value chains. Buying communities can access preferred suppliers' products and services, add to shopping carts, create requisition, seek approval, receipt purchase orders and process electronic invoices with integration to suppliers' supply chains and buyers' financial systems. The e-procurement value chain consists eTendering, eAuctioning, Vendor Management, Catalogue Management, and Contract Management. Encouraged enterprises Small, medium, micro and minority enterprises, charities and other third sector organisations including supported businesses (or other specific types of organisations as defined within Trust policy). Trust to determine which encouraged enterprises to monitor based on its policy, strategy and circumstances. 64 Version 1a May 31st 2012 Ethical Procurement for Health An health and social care focused initiative to develop guidance, tools, training, case examples and other materials to support procurers in identifying and addressing employee and human rights issues (labour standards) within supply chains for good and services procured. Forward commitment procurement Forward commitment procurement is a procurement model, which looks at purchasing from the outcome based specification need instead of purchasing for the immediate perceived need. It addresses the common stalemate where organisations require products or services that are either not available or are at excessive cost. By using this model it alerts the market to the procurement need and offers to purchase the solution, if the needs are met, once they are available, at an agreed price and specification. This provides the market pull to create the conditions needed to deliver innovative, cost effective products and services, and unlocks investment to deliver the requirement. Good Corporate Citizenship Is a model for NHS organisations to assess sustainable development performance across their main activities, including procurement, travel, buildings, facilities management, community engagement and workforce. Government Buying Standards (GBS) (formerly known as Buy Sustainable Quick Wins) are a range of sustainable product standards designed to make it easier for procurers to specify goods and services that address significant sustainable development aspects. Standards have been developed for construction, cleaning, electrical, food, horticultural, furniture, office, ict, textiles and paper products (among others). GS1 Is a means of identifying products, people and locations using a single data standard. The GS1 System is composed of four key standards: Barcodes (used to automatically identify things), eCom (electronic business messaging standards allowing automatic electronic transmission of data), GDSN (Global Data Synchronisation standards which allow business partners to have consistent item data in their systems at the same time) and EPCglobal (which uses RFID technology to immediately track an item). Head of Procurement This role may have responsibility for the following activities – materials management, inventory control, purchasing, managing logistics and the movement of goods, accounts receipting of goods and services, payment of invoices (accounts payable), contract management, supplier relationship management and supplier development. Innovation An idea, service or product, new to the NHS or applied in a way that is new to the NHS, which significantly improves the quality of health and care wherever it is applied. (Innovation, Health and Wealth – December 2011). Innovation can relate to people, processes and technology. Inventory management Inventory management is primarily about determining / controlling stock levels to balance the need of availability against the need for minimising stock holding and handling costs. The scope of inventory management concerns the fine lines between replenishment lead time, carrying costs of inventory, asset management, inventory forecasting, inventory valuation, inventory visibility, future inventory price forecasting, physical inventory, available physical space for inventory, quality management, replenishment, returns and defective goods and 65 Version 1a May 31st 2012 demand forecasting. Balancing these competing requirements leads to optimal inventory levels, which is an on-going process as the business needs shift and react to the wider environment. Key suppliers / strategic suppliers Those suppliers that have been identified as important to the success of your Trust and those that are needed to ensure the Trust strategic aims and met. Key suppliers or strategic suppliers can be identified by supplier segmentation (Kraljic‟s supply positioning) this may be based on spend profile, complexity and risk. Lean "Lean," is a practice that considers the expenditure of resources for any goal other than the creation of value for the end customer to be wasteful, and thus a target for elimination. Market informed sourcing Is a fundamental change in the strategic sourcing process by using technology to open up the market, instead of narrowing the requirement, the market is able to advise how they can best meet the need. Materials management Is the process of managing the physical movement and storage of materials / products within the organisation and is directly related to inventory management. Non-disclosure agreements / confidentiality agreements A document that outlines confidential material / information which restricts access to third parties. It is an agreement where parties agree not to share confidential information. Non pay spend This covers all spend that is not permanent worker pay or associated costs i.e. National Insurance, pensions. This is all third party expenditure and includes all clinical and nonclinical supplies and services / drugs / facilities and estates / non-permanent workers / professional services. Outcome based specification This describes the desired outcome required, and does not identify the inputs for meeting this. Patient level information and costing systems (PLICS) Patient-level information and costing systems can be defined by the ability to measure the resources consumed by individual patients. Peer review Is a process of self-regulation by a profession or a process of evaluation involving qualified individuals within the relevant field It is the evaluation of work or performance by others in order to maintain or enhance the quality of work or performance. Procurement The acquisition of goods and services from third parties. Activities include supply chain management, purchasing, contracting, contract and supplier management. For the purposes of the NHS Standards of Procurement, procurement includes all those departments with procurement responsibilities; this includes but is not limited to pharmacy, estates and catering. 66 Version 1a May 31st 2012 Procurement Strategy It is a plan of action detailing how a particular goal / ambition and objectives will be achieved (where do we want to be, how do we get there, how will we know how we‟re progressing.) It provides a long term focus and direction aligned to meet the overall Trust objectives. Procurement Governance Group / Non-pay spend group This is a cross-functional group within the Trust that measures compliance to procurement strategy, policy and procedures. The group ratifies procurement activities across the Trust, including the implementation of procurement initiatives i.e. standardisation projects and approves savings. Procurement Organisation(s) There are a number of procurement organisations that provide services to the NHS. These include NHS Supply Chain, Government Procurement Service, collaborative procurement organisations (both NHS and privately owned). There is considerable scope in the services provided by these organisations, from transactional procurement solutions, to EU compliant framework agreements and full collaborative partnership working. Procurement policy A set of rules or principles to guide decisions and achieve outcomes A statement of the overall intentions and direction relating to the procurement practice and performance of the organisation, as formally expressed by top management.] Procurement procedures Is a sequence of actions, methods or techniques to ensure a consistent approach to procurement practices. Procuring for Carbon Reduction (P4CR) An NHS project to develop guidance, tools, training, case examples and other materials to support procurers in driving carbon reduction through procurement, contract and supplier management activity. Product masking This is the process of hiding products within e-catalogues, thus limiting choice to pre-selected products and managing product selection (a form of demand management). Productive Series – NHS Institute for Improvement & Innovation Are efficiency techniques taken from leading industry sectors and adapted for the NHS. These include Productive Theatres, Productive Ward and others. A number of the series include initiatives which impact on the supply and inventory of products. Purchase to Pay (P2P) This is the process from requisitioning supplies to payment to the supplier. This includes requesting, ordering, delivery, receipting, inventory, invoicing and payment. Options appraisal Option appraisal is a technique for setting objectives, creating and reviewing options and analysing their relative costs and benefits. Option appraisal should help develop a value for money solution that meets the objectives. 67 Version 1a May 31st 2012 RACI matrix A responsibility assignment matrix, also known as RACI matrix (Responsible, Accountable, Consulted, Informed) describes the participation by various roles in completing tasks or deliverables for a project or business process. It is especially useful in clarifying roles and responsibilities in cross-functional/departmental projects and processes. Return on Investment Is the ratio of total spend cost savings (reduction and avoidance) to the cost of procurement (labour, technology, outsourcing). Hackett Group identified that world class return on investment is 11.3. Scheme of Delegation This document sets out the approval limit or authority to spend of individuals or departments. Service Level Agreement (SLA) An SLA defines the basis of understanding between the buyer and the supplier. They set the quality of service agreed and provide indicators for the measurement of performance. They outline the characteristics of the relationship (what‟s being delivered and how). Shared Services Refers to the provision of a service / function that has been conducted by one organisation moving to a service / function used by more than one organisation. It may be described as the centralisation or consolidation of similar activities. SID4Health SID4Health is the sole official NHS supplier information database holding supplier prequalification information. The service is shared among all purchasing organisations in the NHS and is free of charge to all suppliers and NHS users. This is hosted by Government Procurement Service. Small Business Research Initiative (SBRI) SBRI is a programme that brings innovative solutions to specific public sector needs, by engaging a broad range of companies in competitions for ideas that result in short-term development contracts. Specification A set of requirements to be fulfilled by a product or service. This may involve describing the inputs i.e. product materials or processes to be followed by a service provider. Stakeholder user groups Groups made up of users and other stakeholders with defined objectives, for example to agree on standardisation initiatives and measure compliance. Standardisation The process of establishing a common / standard specification. Supplier relationship management (SRM) SRM is a discipline of working collaboratively with suppliers to maximise the potential value of those relationships. In practice, SRM entails creating closer, more collaborative relationships with suppliers in order to uncover and realise new value, and reduce risk. SRM is about developing two-way, mutually beneficial relationships with your supply partners that deliver greater levels of innovation and competitive advantage than could be achieved by operating independently. 68 Version 1a May 31st 2012 Supplier development Collaboration between the Trust and the supplier to improve performance, and / or capabilities for long-term benefit. Supply chain A supply chain is a system of organisations, people, technology, activities, information and resources involved in moving a product or service from supplier to the end user. Supply Chain Management The integration of business processes from supplier to end user that provides products, services and information that add value. Sustainable Development Development that meets the needs of the present without compromising the ability of future generations to meet their own needs. Sustainable Procurement The process whereby organisations meet their needs for goods, services, works and utilities in a way that achieves value for money on a whole-life basis in terms of generating benefits not only to the organisation, but also to society and the economy, whilst minimising damage to the environment. Sustainable Procurement Flexible Framework A progressive model for establishing sustainable procurement systems and practices, developed and managed by the Defra, National Sustainable Public Procurement Programme, on behalf of the UK Government and wider public sector Total Cost of Ownership (TCO) This is the process of assessing the total costs of product, capital or infrastructure, incurred by the procuring organisation including acquisition costs, delivery, operating costs, maintenance costs and disposal costs. Value for Money (VFM) Value for money (VfM) is about obtaining the maximum benefit with the resources available. It is getting the right balance between quality and cost.VfM is about achieving the right balance between economy, efficiency and effectiveness, the 3Es - spending less, spending well and spending wisely. This means that VfM not only measures the cost of goods and services but also takes account of the mix of cost with quality, resource use, fitness for purpose and timeliness to judge whether or not, together, they constitute good value. 69 Version 1a May 31st 2012