The procurement plan for the NHS hospital development may be undertaken through the following steps and processes:
1. Procurement guidelines:
a) Goods and services shall be procured under and in accordance with NHS guidelines and provisions outlining the functioning and operation of such procedures.
b) Outsourced services, consultants, off-branch goods and services are to be procured in accordance with the requisite NHS guidelines and project specifications.
c) Standard bidding documents/ Proposals/ bidding paper etc will all be finalized as per NHS guidelines and will adhere strictly to NHS quality and safety requirements (Fewings 2010) 2. Selection of goods and services:
The current project is one of re-development and upgrading the current capabilities of the Southmead hospital project. In keeping with that goal there are certain target areas that have been determined as priority areas these can be enumerated as: a) Infrastructure:
The re-developed institute is one that is seeking to combine the two institutions of Southmead and Frenchday into one overarching institution for providing the best quality healthcare to the people of that particular county.
In addition to traditional healthcare services the facility will also host a significant parking facility, concourse, catering facilities and a variety of similar commercial interests that will fill the seven story structure. The facility will also feature a helipad that poses its own unique problems in terms of special infrastructural needs and requirements.
C) Accessibility and environmental compatibility:
One of the main issues facing the institution prior to the redevelopment of the institution was one of accessibility i.e. the acute and non-acute service centers where spread over the various sites reducing accessibility for the clients and patients, thus reducing effective service time and severely affecting patient care. Another issue that was identified as a core issue was that of the environmental integrity of the institution, specifically in regards to energy wastage and infection containment. The existing infrastructure was one of wasteful energy leakages and un-contained infection that resulted in the spread of hospital diseases and led to severely compromised patient care and health infrastructure. Consideration of all the above variables and factors needs to be taken into consideration while considering the infrastructural needs of the institution.
3) Goods and services:
In terms of goods the following generic categories of products need to be stocked up on surplus levels of inventory: Sanitary products
Theater equipment (Gloves, scrubs, gowns, masks etc)
Generic medication (Antibiotics, coagulants, local anesthetic etc ) The above detailed equipment is one that is used in copious amounts and regularly in all major health institutions and healthcare providers need to be well stocked on the above goods and the like. There are certain other kinds of good which form the median range of products to be kept in stock, to be stored at optimum levels: Bed-sheets and related supplies (pillows, blankets etc)
General anesthetic and specialty medicinal supplies (insulin, adrenalin etc) Housekeeping supplies (bed pans, cafeteria supplies etc)
In keeping with the same classification of goods, there is a third level of classification of products and goods that a healthcare institute requires that may be classified as critical products such as: Specialty equipment (Physiotherapy, patient recovery etc)
Specialty medicine (Epinephrine, methamphetamine etc)
The above equipment (especially drugs ) are to be kept on a strictly controlled basis and require to be carefully monitored and controlled, thus these are kept at levels that are closely calculated on a need of use basis.
From time to time the institution may require specialty services in order to aid in its smooth functioning and operation. The different services required may be classified as below: Healthcare services:
These include services related to the medical nature of the healthcare institution, most commonly related to consultative services and operational guidance in the forms of outside medical consultants for specialized medical care for patients in case of ailments that are not routinely treated at the center; secondary healthcare services such as those relating to early infant care and patient outgoing also fall under this category.
These include services related to the commercial aspect of the institution, for example: independent contractors to handle the catering aspect of the institution, or construction consultants to aid in the different infrastructural needs and requirements of the institution. For example: contractors and outsourced services to handle the IT infrastructure of the institution and other secondary and tertiary aspects associated with the facility.
3) Procurement methods:
In keeping with the classification of the different procurement requirements of the institution as outlined above, there can be different procurement methods adapted to each category of product: Category A products:
These include products that are consumed in large bulk in the daily operation of the institution such as; sanitary products, dressing equipment, etc. As these are required to be replenished in continuous cyclical repetition the best procurement method for these kinds of products would be to request competitive quotations from interested parties and entering into long term contractual obligations with the selected parties in order to ensure continuous supply of the said products, bulk buying is required and contractual terms and conditions may be changed to reflect the cost benefit acquired due to the economies of scale achieved through bulk buying.
Category B products:
These include products that are used on a somewhat daily basis, products that may be reused and put into the operational cycle over a medium period of time such as: bed sheets, pillows, cutlery etc. A similar procedure as for category A products may be used for these kinds of products except the period of contract for such products should be short to medium-term periods of time i.e. 1-2 years to provide for changing market conditions and to accommodate favorable, more cost effective offers from different vendors. Category C products:
These generally include highly restricted and seldom used products, mostly in use for highly specialized medical procedures, such as: radioactive isotopes, scheduled drugs, restricted materials etc. These kinds of products are kept under strict control by the medical advisory bodies and are used only in cases of strict and extreme medical necessity.
The procurement method for these kinds of products should be as per use and consists of a strictly formalized approach to the governing and regulatory bodies. Generally use of such products comes with strict guidelines and benchmarks that determine the level of competence of the institution to handle such materials, special care should be taken to ensure strict and absolute adherence to such standards and guidelines before initiating the procurement method for said substances. Services:
These kinds of services are procured by the fixed and sealed tender method wherein fixed tenders are invited from interested parties and the lowest bidder wins the contract for providing the said services to the institution. Medical services:
This category of services is available only from a limited pool of resources and as such traditional methods of procurement give way to new, innovative forms of contracts and agreements such as having a visiting specialist, or having a ‘guest specialist’ who visits the institution regularly or on demand whenever a situation arises requiring the specialists unique skill sets. Procurement issues:
Post-tender negotiations: There are several situations wherein changing market conditions and various environmental variables necessitate the re-negotiation of contracts after the finalization of tenders. One such example may be in the drop in the prices of raw materials required; change in the immigration policy may flood the market with more affordable labor creating the requirement for new terms of contract with longstanding contract partners. However NHS does not permit post tender negotiations. (NHS, Barnet, 2009:37). This creates significant levels of problems in negotiating contract details after the issuance of tenders (Morris et al., 2007).
Fund Management: Typically there are several differences in how the funds allotted to a particular project are managed in respect of public and private interests, for instances privately managed projects have more flexibility in regards to funds allocation and consumption and are subject to less paperwork, therefore are consequently subject to greater independence. However, being a public project, it would require better and more efficient management of public funds.
This translates into tighter controls, apprehension in fund allocations, delayed fund usage and general financial disarray. This is a very real, very serious issue facing most all government institutions and not necessarily limited to just the NHS. Environmental issues: In recent years renewed attention has been paid to environmental concerns emanating from organizational operations.
Medical institutions have traditionally been highly inefficient in terms of energy usage and According to a research conducted by Torbay NHS Care Trust, (2010, p. 10), 60 of the total carbon footprint of NHS originates from the procured goods and services. Implementing IT infrastructure: The business model for a lot of the modern healthcare facilities has integrated the need for a comprehensive IT support framework that supports the operational activities of the organization. Ensuring compatibility with modern standards of IT infrastructure and implementing modern IT concepts like e-commerce etc in the procurement plan is a major challenge for the managers. Procurement strategy:
Core strategic priorities:
To establish a process of sourcing contracts and frameworks to ensure the delivery of best value. To implement and fully utilize efficient on‐line procurement systems and processes that move away from a paper based system and reduce the transaction effort within the Trust. To implement a set of standard policies and processes to ensure that all staff understand and comply with the mechanisms for purchasing goods and services.
To implement a range of management information systems that allow for the results of current procurement patterns to be analyzed to ensure that best value is secured. To develop a materials management structure to allow efficient and effective delivery and stockholding. Establishment of accurate assessment centers catering directly to the diagnostic needs of patients from various medical need backgrounds.
Aesthetic and functional design of the hospital interiors, compensating for the needs of special requirement patients involving senior citizens as well as early childhood care. Combination of easy access as well as synergistic design based construction that combines the best of functionality, environmental friendliness and ease of use. Strategic principles:
The strategic principles on which the procurement strategy will be based can be enumerated as follows: Strive for continuous improvement in quality, price and processes by researching and developing a detailed understanding of potential products and services. Encourage environmentally advantageous products and services by, where appropriate, working with providers to minimize the environmental and social impacts associated with products and services. Strategic Model:
The strategic model which will ensure the application of the strategy formed is described as follows: 1) Control:
Performance: The various parameters of healthcare deliverables, measurable service outputs, and performance indicators etc will be used to measure performance efficiency and effectiveness. Governance: Formulating executive level strategies and policies to guide the procurement process and strategy. Risk: Acceptable parameters of different procurement components such as inventory levels, service delivery time, turnaround time etc.
Sourcing: The activity of determining and defining business demand and the subsequent engagement with the supply market to acquire or fulfill that demand in the most cost effective way for the hospital is to be determined and executed by a central procurement department.
Financial management: The allocation, budgeting and consumption of funds is to be managed in accordance with NHS guidelines and undertaken by the executive level governing body overseeing said functions of the hospital. Data Management: The use of above mentioned IT infrastructure to enable efficient data forecasts and effective material management. References:
Bower, Denise 2003, ‘Management of procurement’ Pearson Publishing Fleming, Quentin 2003, ‘Project procurement management’ SUNY press Zaman, Nadeem 2011, ‘Procurement Management Process’ Toronto Press Sherman, Stanley 1985, ‘Government Procurement Management’ Penguin Publishing England, Wilbur 2009, ‘Modern procurement management’ Harvard Press Ukalkar, Sanjay 2000, ‘Strategic Procurement Management’ Abrahms Publishing Nelson, Clarence 2001, ‘IT use in Procurement Managament’ SUNY press