Collaborative Clinical Medicines Procurement Collaborative Clinical Medicines Procurement (CCMP) (CCMP)

“Getting Value for Money”“Getting Value for Money”Colette Whigham

Category Manager – PharmacyNHS 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

Logistics

Strategic Sourcing

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.

eP&S

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.

Simplify the physical supply chain using managed distribution systems to achieve economies of scale delivered

from the National Distribution Centre. (Non Pharmaceuticals)

Scottish Pharmacologistics Governance Framework

CLINICAL

INPUT

PROCUEMENT

PharmacologisticsStrategy Group (PSG)

Scottish GovernmentHealth Directorate

Directors of Pharmacy

NP Director PASAG Secratariat

Scottish PharmacyBusiness Technology

Group (SPBTG)

Patient Access Scheme Administration Group

(PASAG)

Emergency PlanningGroup

Homecare Group

PharmacologisticsOperational Group (POG)

VaccinesOperational Group (VOG)

Scottish Pharmacy Market Strategy Group(SPMSG)

Transitional Products Group

East Zone West Zone North Zone

National Contracting Strategy for Medicines

Key Elements:-

– Procurement Regulations– Clinical Involvement– Specification Design– Contract Shape– Supplier Conditioning– Anticipated Outcomes– Implementation

National Contracting Strategy for Medicines

Key Features:-– Clear– Transparent– Planned– Efficient– Joined Up– Delivers Savings Consistently– Clinical Governance– Financial Governance

National Contracting Challenges

• 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

It’s too ambitious

No one asked

me

It will take to long!

It’s tooexpensive

I don’t have authority

It’s impossible

We can’t take the chance

It’s toocomplicated

They won’t fund it

What’s in it for me?

We’ve always done it this way!It’s too

politicalWe are

doing ok as it is!!

We don’t have the

staff

It’s not my job!!

We tried that before

I’m all for it, but…

They really don’t want to

change

We’ve never done that

beforeThere’s not

enough time It needs more

thought

It’s not our problem!!

It won’t work in this department

Clinical Peer Groups in Scotland actively engaged with National Procurement

• 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

• 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

• 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:

– 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):– 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 Advisory Panels

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!