Collaborative Clinical Medicines Procurement
(CCMP)
“Getting Value for Money”
Colette Whigham
Category Manager – Pharmacy
NHS National Procurement, Scotland
Thursday 11th November 2010
National Procurement
Commenced activities in Scotland in 2005 following
recommendations made by the McClelland review
of public sector procurement.
Purchasing activities across the NHSS historically had
been managed:– In a sporadic manner
– Limited coordination across NHS Scotland
– Little aggregation of spend across NHS Scotland and more than 23
procurement organisations
Workstream Activity Redesign
Strategic Sourcing
Logistics
eP&S
Maximise the potential savings by NHS Scotland by sharing
the benefits of collaborative buying power. These are
realised by the application of best practice strategic sourcing
processes and working with suppliers to obtain best value
products and services.
Simplify the physical supply chain using managed
distribution systems to achieve economies of scale delivered
from the National Distribution Centre. (Non
Pharmaceuticals)
Coordinate the deployment of world class procurement
technology across Health Boards. This offers users access
to a variety of tools that support strategic and
transactional procurement and enable new methods of
collaboration.
Scottish Pharmacologistics Governance Framework
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Scottish Government
Health Directorate
Directors of
Pharmacy
Emergency Planning
Group
NP Director
Pharmacologistics
Strategy Group (PSG)
Homecare Group
Scottish Pharmacy
Business Technology
Group (SPBTG)
Vaccines
Operational Group (VOG)
Transitional Products
Group
Pharmacologistics
Operational Group (POG)
Scottish Pharmacy Market Strategy Group
(SPMSG)
East Zone
West Zone
North Zone
PASAG Secratariat
Patient Access Scheme
Administration Group
(PASAG)
P
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National Contracting Strategy for Medicines
Key Elements:–
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Procurement Regulations
Clinical Involvement
Specification Design
Contract Shape
Supplier Conditioning
Anticipated Outcomes
Implementation
National Contracting Strategy for Medicines
Key Features:–
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Clear
Transparent
Planned
Efficient
Joined Up
Delivers Savings Consistently
Clinical Governance
Financial Governance
It’s too
expensive
National Contracting Challenges
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What’s in it
for me?
Resistance to and fear of change
Lack of awareness of procurement regulations
Lack of understanding of market dynamics
Industry Resistance
Lack of clinical resource to implement change
I don’t have
authority
It’s too
complicated
They
won’t
fund it
It’s too
political
They really
don’t want to
change
It’s too
ambitious
We’ve always
done it this way!
We’ve never
done that
before
No one
asked
me
It’s
impossible
We don’t
have the
staff
There’s not
enough time
It will
take to
long!
It’s not
my job!!
We can’t
take the
chance
We are
doing ok
as it is!!
It needs
more
thought
We tried that
before
I’m all for it,
but…
It’s not our
problem!!
It won’t
work in this
department
Clinical Peer Groups in Scotland actively
engaged with National Procurement
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Diabetes Action Plan – Scottish Government
Hepatitis C Action Plan – Scottish Government
Scottish HIV Action Group - Scottish Government
Scottish Antimicrobial Pharmacy Group
Scottish Radiological Society
Scottish Society for Rheumatology
Scottish Plasma Expert Panel
Scottish Haemophilia Directors
Scottish Cancer Networks
Scottish Fertility Group
Total Parenteral Nutrition Managed Clinical Network
Scottish Neonatal and Paediatric Pharmacists
Scottish Critical Care Pharmacy Group
Scottish Pharmacists Quality Assurance Group
Patient Access Scheme Advisory Group (PASAG)
Lessons Learned
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Communication (Stakeholders and Industry)
Planning
Change for sake of change
Well developed specifications
Anticipate outcomes
Shared resource (Reduced representation at
Clinical Level but endorsed nationally via
peer groups)
Thankfully
there are not
too many of
these !!
Examples of Successful Collaborative Clinical Medicines
Procurement in Scotland
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Low Molecular Weight Heparin – Product Standardisation
Hepatitis C Action Plan – Volume Matrix
Botulinum Toxin Type A – Clinical Substitution without rationalisation
IVF Fertility – Price Normalisation
Insulin Pumps – Ranked Framework
Clozapine – Single Supplier Framework
Homecare – Single Supplier Framework, HIV & Clotting Factors
Blood Glucose Monitoring Strips – Supplier Rationalisation
Contrast Media – Supplier Rationalisation, release market share
G-CSF – Scotland Wide Clinical Input
Gonadorelin Analogues - Clinical Substitution without rationalisation
Total Parenteral Nutrition
Erythropoetin Stimulating Agents
Transitional Medicines – Time to market, when is the right time?
We do not always get it right first time!!
Collaborative Clinical Medicines Procurement “Getting
Value for Money”
The Results:
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2005/2006 = £4,721,238
2006/2007 = £8,953,191
2007/2008 = £5,873,646
2008/2009 = £5,128,995
2009/2010 = £5,713,346
Total Savings To Date = £ 30,390,416
The Future…
• More complex therapy areas (Work In Progress):
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Continued Therapeutic Substitution
Anti-fungals
Anti-TNF’s
Anti-thrombolytics
• Closer collaborative working with Scottish
Medicines Consortium (SMC)
• Closer collaborative working with
National/Health Board Formularies
• Continued development of focused Clinical
Summary
• No two procurement procedures are the same
• Clinical input at the centre of all procurement
activity
• Savings are a key NHS agenda item
• Change management, whilst challenging, is always
possible
• Future contracts will benefit from lessons learned
• Procurement and Clinical resource is essential
• Make a plan and stick to it!