Sort of confirmed my suspicions

[vetran]

Fraud & sleaze is a different conversation to bad management.

Jeez you lot want to eat a herd of elephants in one go not just one bite at a time.

Centralising procurement and run like Tesco / Aldi where they constantly make decisions based on price and quality by comparing to the market and the medicine market is international. Comparing costs and outcomes of treatments should also be done.

[malvolio]

Fraud & sleaze is a different conversation to bad management.

Jeez you lot want to eat a herd of elephants in one go not just one bite at a time.

Centralising procurement and run like Tesco / Aldi where they constantly make decisions based on price and quality by comparing to the market and the medicine market is international. Comparing costs and outcomes of treatments should also be done.

Cost and outcome, yes. Time to wait before being attended at an OP clinic, or throughput in a department with a highly variable workload (A&E being the classic case, but there are a dozen others), or stocks of petri dishes (when JIT would work far more efficiently), or any one of a hundred other targets, not so much. They are down to local management anyway, pointless trying to collate it nationally beyond admissions and discharge rates and cases treated.

[WTFH]

Fraud & sleaze is a different conversation to bad management.

Jeez you lot want to eat a herd of elephants in one go not just one bite at a time.

Centralising procurement and run like Tesco / Aldi where they constantly make decisions based on price and quality by comparing to the market and the medicine market is international. Comparing costs and outcomes of treatments should also be done.

Fraud and sleaze are the result of top level decisions - many outside the bounds of the NHS.
You can't fix bad management by starting at middle management.

Centralise procurement. Yes.
Do not make Procurement a business that is supposed to turn a profit. (SCCL reported £150m profit in 2019/20) https://find-and-update.company-info...pdf&download=0
Clear out PFI.
Bring back vocational nursing, not just classroom. The idea of classroom only started with Project 2000 in 1986. It may mean we need different categories, but a vocationally trained nurse will be better equipped to deal with patients.
Make nursing about patients, not paperwork.
I could go on...

The issue with all these things is that they cost money and are not headline vote winners. So it won't happen without a shake up in politics.

[malvolio]

Fraud and sleaze are the result of top level decisions - many outside the bounds of the NHS.
You can't fix bad management by starting at middle management.

Centralise procurement. Yes.
Do not make Procurement a business that is supposed to turn a profit. (SCCL reported £150m profit in 2019/20) https://find-and-update.company-info...pdf&download=0
Clear out PFI.
Bring back vocational nursing, not just classroom. The idea of classroom only started with Project 2000 in 1986. It may mean we need different categories, but a vocationally trained nurse will be better equipped to deal with patients.
Make nursing about patients, not paperwork.
I could go on...

The issue with all these things is that they cost money and are not headline vote winners. So it won't happen without a shake up in politics.

Take the steps I outline earlier and you will save money over any sensible RoI period - three years is usual in government cycles.

Not my words either. Apart from being married to a retired (but still engaged) NHS senior lab manager I have close friends in the pharma supply world, both drugs and equipment, so reasonably informed expert opinion. Put it this way; procurement rules meant my friend couldn't supply an analysis machine for free as part of an ongoing clinical trial (as a two-year supply so the trial itself could be run more efficiently and consistently). He had to go through the whole competitive tender process, even though the cost to the NHS for his kit was still zero. He lost the bid...

[vetran]

Cost and outcome, yes. Time to wait before being attended at an OP clinic, or throughput in a department with a highly variable workload (A&E being the classic case, but there are a dozen others), or stocks of petri dishes (when JIT would work far more efficiently), or any one of a hundred other targets, not so much. They are down to local management anyway, pointless trying to collate it nationally beyond admissions and discharge rates and cases treated.

The possible improvements of implementing say an ITIL style solution can be significant adding a standard process and measurement designed by people who know the problems well.

As you say stocking is an issue but if they planned it properly across the whole organisation you could fix the problems once.

[vetran]

Fraud and sleaze are the result of top level decisions - many outside the bounds of the NHS.
You can't fix bad management by starting at middle management.

Centralise procurement. Yes.
Do not make Procurement a business that is supposed to turn a profit. (SCCL reported £150m profit in 2019/20) https://find-and-update.company-info...pdf&download=0
Clear out PFI.
Bring back vocational nursing, not just classroom. The idea of classroom only started with Project 2000 in 1986. It may mean we need different categories, but a vocationally trained nurse will be better equipped to deal with patients.
Make nursing about patients, not paperwork.
I could go on...

The issue with all these things is that they cost money and are not headline vote winners. So it won't happen without a shake up in politics.

The thing about making a profit is it stops the organisation becoming a bottomless pit for cash, next year they will be pushed harder.

[WTFH]

Take the steps I outline earlier and you will save money over any sensible RoI period - three years is usual in government cycles.

Not my words either. Apart from being married to a retired (but still engaged) NHS senior lab manager I have close friends in the pharma supply world, both drugs and equipment, so reasonably informed expert opinion. Put it this way; procurement rules meant my friend couldn't supply an analysis machine for free as part of an ongoing clinical trial (as a two-year supply so the trial itself could be run more efficiently and consistently). He had to go through the whole competitive tender process, even though the cost to the NHS for his kit was still zero. He lost the bid...

I'm in agreement with you, I just don't think the RoI will be that quick, and as I say, I don't think it's a vote winner or headline grabber.

[vetran]

I'm in agreement with you, I just don't think the RoI will be that quick, and as I say, I don't think it's a vote winner or headline grabber.

Small changes make big savings in large organisations.

As per the story halving the cost of toilet roll is millions in seconds. Same for Aspirin & other over the counter medicines.

You may be wrong in thinking such actions would not be a vote winner. People know the NHS is a massive monolith at least trimming the easy to understand fat would make people support it better.

[vetran]

Try this

https://www.scotsman.com/health/reve...cotland-287448

At present the average cost of a pack of 16 paracetamol tablets is around 30p, and around three billion tablets have been dispensed for free.

The NHS in England has spent almost £400m prescribing paracetamol in the past five years at a cost of £3.23 per item, despite the pills being sold over the counter at a fraction of the cost.

[malvolio]

The thing about making a profit is it stops the organisation becoming a bottomless pit for cash, next year they will be pushed harder.

The old Palmerston "bag of gold" budget approach did have its better points, not least telling the organisation that this is what you have to spend this year and when it's gone, it's gone. That only went wrong when at year end the organisation started (a)_ spending all of it whether they needed to or not and (b) going into debt to prove they needed more. Using the profit motive only reverses that concept, it doesn't make it more efficient.

When the MOD started accounting properly, part of the handover uncovered a lot of strange practices, not least of which was the team buying futures in ship coal - when they hadn't had a coal-fired ship for 30 years or more.