Wound Care Centralised Ordering Project within the Surrey Heartlands ICP’s

The Wound Care Centralised Ordering project led by HPL has enabled Surrey Heartlands ICP’s to move away from the FP10 ordering route into a fully managed service. This allows consistency across the wound care formulary and achieve not only significant financial savings, but would also enable clinicians to free up time previously spent on sourcing, ordering and chasing products. The project has made the best and most effective use of resources, which frees up vital clinical time and money, which can then be reinvested back into the health system.

The Challenge

Prior to the implementation of this project, wound care products were ordered through various routes within the community/primary care settings. This created a disparity in prices and inconsistent practices.  In addition it had been identified that the current model faced challenges such as:

• No consistent & centralised ordering system
• There were examples of over stocking
• A lack of visibility of ordering practises
• Lack of data and visibility for Finance and other key decision makers
• No help desk or support for service users
• Clinicians were spending time sourcing, ordering and chasing products, tying up valuable nursing time

Our Solution

From the very early stages of the project workshops it was very clear that there were a variety of clear opportunities and successes that could be derived from this project.  The intention was to further transform the service with the local health economy to:

• Create efficiencies and standardisation of practise and improved patient care

• Minimise issues with wastage adoption of a minimum and maximum stock level within each area ensured constant  access to  wound care formulary dressings, thus providing consistent quality to all patients

• Ensure compliance with local wound care formulary and promote appropriate use of dressings
• Auditable trail both clinically and financially to allow for transparency of wound care products usage showing both management and the public how monies are being spent.  If required current behaviours could be challenged to successfully tackle non-compliance such as considering implementing budgetary and behavioural controls by using the online ordering platform. 
• Create significant year on year cost savings for the health economy.  For example going into this project it was estimated that 20-30% savings could be attained from the HPL managed centralised wound care dressings’ scheme.

Results

The Results:

From business case approval to go live for the first ICP (Guildford & Waverley) the project took 4 months, with full roll out to all 4 ICP’s completed 3 months later.  This has resulted in the following results:

• A creation of a centralised ordering system across the Surrey & Heartlands Primary care settings.
• Making use of NHS Supply Chain offerings in relation to Future Operating Model and cost savings.
• Greater management of new clinical requests in line with evidence based practice.
• For the first time greater visibility of data/reports of expenditure by ICP – allowing the efficient use of budget management.
• A reduction in ordering time, enabling clinicians to have the right product at the right time for the right patient
• Greater standardisation of the range of dressings leading to continuity of care
• Wider ICS benefit – with acute expenditure.
• Enhanced efficiencies – savings on GP and Nurse Time
• Improved Governance & Control from ICS with HPL helpline.
• Standardisation and enhanced training
• Significant Health Economy Savings of over £950k
• A Reduction of waste and ad hoc ordering

The collaborative and partnership working with HPL and the Surrey Heartland IPC has been a tremendous success for all stakeholders and most notably patients.  This project is one of the first examples of Procurement/Supply Chain/Clinical Staff actively working together on a project of this scale within the region.  Working closely with both the ICB and NHSSC, we were able to respond to all challenges and meet specific requirements throughout the project.  . 

In summary:

• £950K + savings
• A smooth transition of go live dates in all areas
• Enhanced working relationship with the ICP’s, ONPOS & NHS Supply Chain – improved collaboration and communication with all stakeholders
• Better buffer stock management process in place along with strong Supply Chain capabilities
• Optimised product usage through a clinically approved formulary enabled clinicians to have access to the right dressing at the right time  
• Implementation meeting structured to ensure engagement meetings with end users not only allowed for discussion of CCG Wound care project but allowed relationships to be built with end users.
• Time and cost taken off GP having to give prescriptions has been saved

• Better outcomes – Enabling a patient needs-based approach will improve care and outcomes, helping to identify patients with complex needs and triggering specialist interventions. Standardising wound care based upon best practice will also improve outcomes for patients.
• Better experience – The supply system will reduce delays in treatment for patients and keeping track of ordering trends has highlighted training needs and targeted support to some teams and providers. The new system will result in effective and efficient access to dressings for patients and improved patient care.
• Better use of resources – The procurement system will reducing over-ordering and the associated risk of dressings going unused. The scheme could generate cash savings of £800k that has been reinvested back into services such a wound care projects or interventions.

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