There was an interesting article from the health care sector recently on Open Access Government about the value-based public procurement nurse. It was written by Paul De Raeve, Secretary General of the European Federation of Nurses Associations (EFN) and makes the case for frontline nurses, who use and have practical experience of a vast range of clinical products, being uniquely qualified to be involved in the process of selecting and purchasing medical products and services.
It’s a process often managed by procurement departments, and he isn’t arguing that this should not be the case, but that a more detailed insight into which items do and do not work should be encouraged. It makes sense: we don’t walk into a car showroom or mobile phone retailer and ask for their cheapest or most ‘economically advantageous’ product. There are so many more factors to consider, you want expert advice even if you think you know the make, model and colour you want. And here we are talking about something much more valuable to all of us.
“Nurses,” he says, “have a key role in addressing the financial and sustainability challenges of the health and social care ecosystem, therefore, they should be involved in the procurement co-design from an early stage, working with procurement officers, to secure funding and successful outcomes. Creating an inclusive relationship between clinical and procurement staff is a crucial first step to ensure that both financial and clinical benefits are considered from the outset.” And he gives his own first-hand experience – read that here.
We’ve been writing about procurement value at length over on Spend Matters UK/Europe recently, talking about how procurement can deliver value in so many ways to its organisation, and savings is just one of them. We highlighted the writings of Jules Goddard of London Business School who wrote “The Fatal Bias,” in which he emphasises research findings that a low-cost strategy (in business terms) is in the vast majority of cases not successful or sustainable in the longer term.
This was published in 2014, also the year when the European Parliament passed Directive 2014/24/EU1 which encouraged buyers to focus on value via the “price-quality ratio,” which can consider full life-cycle costs and other value factors rather than just the up-front purchase cost.
But getting back to procurement nurses, there was an excellent story back in 2015 of a nurse at the UK’s Plymouth Hospitals NHS Trust. (This Trust also has a track record of spearheading innovative procurement practices – read some of that here.) She helped save the trust hundreds of thousands of pounds by ‘introducing new or more efficient equipment and reorganising storage.’ This included a combined saving of £400,000 ‘by changing its brand of sutures and surgery gloves, and starting to use the rib matrix set to help patients recover far faster from broken ribs.’
“We are finding that equipment does not always need to be the cheapest … But it does need to be the most cost effective,” she said. “For instance the rib matrix set means patients with fractured ribs can leave hospital at least seven days earlier and return to work within three months whereas before some would never return to work.”
This was part of a project to buy best-value-for-money equipment and get nurses more involved in procurement. The category manager involved said it was the fact that it was a clinically-led project, in partnership with procurement and finance, that accounted for its success.
And going forward, according to Paul De Raeve, we are seeing procurement nurses becoming more common across the EU, bridging the gap between clinical activity and the contracting/commercial requirements of a care organisation. So will we see a role for a procurement nurse in all healthcare organisations’ procurement teams, or even on their Boards, with the clinical expertise to support effective procurement decision making? Will they be brought in at the early stages of the procurement process, or simply consulted along the way?
It’s an expert and valuable role, which, of course, has to be carried out within the constraints of transparency and compliance, but appears to have considerable potential for healthcare procurement worldwide.
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