HSJ’s round-up of the day’s must read stories and talking points

A towering procurement challenge

“Considering the health service’s vast size and purchasing power, there must be ample opportunity for it to strike decent deals with suppliers.”

It’s an eminently reasonable statement. But over the years successive governments have found NHS procurement an exceedingly hard nut to crack.

That hasn’t stopped the current government from having a go, and it’s easy to see why – the NHS has to make efficiencies of about 15 per cent by 2021 to remain sustainable, and fixing procurement is seen as an integral part of that effort.

What’s more, in his review of NHS productivity Lord Carter said he had found “astonishing variety” in the number of products and suppliers used across and within trusts. He estimated the savings opportunity to be at least £700m if the health service got its house in order.

To address Lord Carter’s challenge, the Department of Health is planning a shake-up of procurement arrangements. When the current NHS Supply Chain contract ends in October 2018 the DH wants to split the procurement system into 11 “category towers”, each covering a different category of goods.

Private companies will be invited to bid to run the towers. If they pick up a contract they will be responsible for carrying out tenders for the goods covered by the tower in question.

Unfortunately, the DH doesn’t seem to have taken NHS supply chain professionals with them yet. Procurement staff working at the coalface in NHS trusts are worried the new arrangements will cause confusion about who is responsible for what and actually impede the delivery of savings.

On Tuesday, we reported on a warning from the Health Care Supply Association, which represents NHS procurement staff, that the plans could result in the “fragmentation” of the procurement system.

HSJ understands that the DH has made some positive overtures to the HCSA, but clearly more work is needed to put minds at ease about the changes.

The kids’ wards aren’t all right

The question of reconfiguring services and ensuring services are safe and able to meet demand is not a new question for NHS managers, but according to one royal college it’s a question they have ducked.

The Royal College of Paediatrics and Child Health has revealed its latest workforce census on the state of paediatric services and it makes for grim reading.

Despite six years of warning about the need to redesign services, the RCPCH says the NHS has singularly failed to do so, with the result that increasing numbers of wards are understaffed.

The college reported that nine out of 10 clinical directors said they were concerned about how their service will cope in the next six months. More than half of paediatric units were not meeting recommended staffing standards.

HSJ analysis of the last six annual reports by the RCPCH shows there has been fluctuation in vacancy rates across paediatrics and neonatal services since 2009-10.

That year there was an overall vacancy rate for trainee doctors of 9 per cent, which rose to 13 per cent in 2010-11 before reducing to 10 and 11 per cent in 2011-12 and 2012-13 respectively.

In 2014-15 the overall vacancy rate was 12 per cent but this increased to its highest level of 15 per cent last year.