• 52 acute trusts missing target outlined in Lord Carter’s review
  • However, performance on other Carter metrics has improved
  • Trusts were asked to meet targets by September 2017

More than a third of acute trusts are still missing an efficiency target set back in 2016.

National data for the second quarter of 2019-20 shows 52 acute trusts failed to meet a target outlined by Lord Patrick Carter in his review of hospital productivity, although performance on other Carter metrics has improved.

In his review, Lord Carter said improving procurement could help acute non-specialist trusts save up to £700m.

He included the following targets among his procurement recommendations and asked trusts to meet them by September 2017:

  • 90 per cent of transactions should be matched to an electronic purchase order; and
  • 80 per cent of spending should be on goods in a catalogue.

Only 66 acute trusts met the electronic purchase order target, with 12 failing to provide data. This represents a small improvement on last year’s results, in which 61 trusts met the target and 61 missed it. Eleven did not provide data. There are about 150 independent acute trusts, including specialists, in total.

Trust (2019-20 Q2)% by count of invoices matched to an electronic purchase order
North Middlesex University Hospital Trust 34.2
United Lincolnshire Hospitals Trust 45.7 
Pennine Acute Hospitals Trust 46.1 
South Warwickshire Foundation Trust 49.4 
Leeds Teaching Hospitals Trust 59.6 
Torbay and South Devon FT 60.9 
The Whittington Hospital Trust  63.0 
Rotherham FT  63.5 
University Hospitals Bristol FT  64.9 
Weston Area Health Trust  65.2 

At least 119 acute providers met the catalogue target in 2019-20 Q2. Ten trusts did not provide data. Only one trust — George Eliot Hospital trust — fell significantly below the 80 per cent target, achieving just 49.6 per cent. Airedale FT also missed the target, but only by 0.3 per cent—a figure the trust called “immaterial”.

A spokesman for trade body the Health Care Supply Association said it was “worrying” some trusts still needed to “step up to Lord Carter’s challenge”. But he praised overall improvements and movement among trusts in the league table.

The table used various process efficiency metrics as well as price performance to rank trusts’ procurement overall.

 The top five trusts (2019-20 Q2) The bottom five trusts (2019-20 Q2)
1 University Hospitals Plymouth Trust 127 The Princess Alexandra Hospital Trust
2 University Hospitals of North Midlands Trust 128 South Warwickshire FT
3 Imperial College Healthcare Trust 129 Southend University Hospital FT
4 Salford Royal Foundation Trust  130 Lewisham and Greenwich Trust
5 The Newcastle Upon Tyne Hospitals FT 131 George Eliot Hospital Trust

Some trusts said data issues affected their performance on the league. A Lewisham and Greenwich Trust spokesman explained the trust’s procurement service was provided by Guy’s and St Thomas’ FT, which ranked sixth on the same league table. He said the inclusion of extra transaction data would “correct” the trust’s position on future tables.

Others, like George Eliot Hospital Trust and South Warwickshire FT, said they have invested in new procurement systems to improve their performance. 

The HCSA spokesman said the body was pleased league tables were still on the radar of its members. But he cautioned data issues remain a problem and suggested the table would benefit from a review and updated composition. 

An NHS England and Improvement spokesman said: “The NHS is one of the most efficient healthcare systems in the world with administration costs significantly lower than European neighbours, but we can always do more.” 

He told HSJ the league table helped trusts save £268m last year, but would not answer further questions about how this figure was reached.


HSJ Provider Summit

The HSJ Provider Summit, taking place at the Crowne Plaza, Stratford-upon-Avon from 22-23 April 2020, unites 120+ board members from provider trusts across the country with those shaping national policy, to share best-in-class initiatives in delivering cost-effective and high-quality care for their local populations.

Held under the Chatham House Rule, attendees will co-develop solutions to their local challenges with colleagues from across the country. The summit is free to attend for board-level NHS leaders.