Nurse-led team manages clinical testing of products to cut NHS costs

A team of nursing professionals is helping to lower NHS costs and enhance services by more efficient purchasing of essentials such as gloves and syringes.

A team of nursing professionals is helping to lower NHS costs and enhance services by more efficient purchasing of essentials such as gloves and syringes.

Picture: Pete Ellis

The NHS spends £9 billion a year on clinical supplies and services. But better procurement management could lead to annual savings of up to £1 billion, according to a 2016 review by Labour peer Lord Carter into productivity in acute hospitals in England.

A nurse-led NHS clinical evaluation team was set up in April last year to review clinical products used by NHS staff, identifying those that deliver quality, safety and value.

It recently published its first set of reports on four product ranges: examination gloves, open suction catheters and suction tubing, blunt drawing up devices, and syringes.

Nursing input

The team was created following a campaign by the RCN, Small Changes, Big Differences, which lobbied for nursing staff to have a say in the purchasing of products. Clinical staff know which products work and which do not, the RCN argued, but too often nurses are involved in procurement only when important decisions have already been made.

£9 billion

annual spend on clinical supplies and services*

Source: Lord Carter review

The team reviews product ranges independently of suppliers and the NHS Supply Chain, with its members using their frontline experience to review products based on their packaging, opening and application, clinical use and disposal.

Each team member is responsible for about 15-20 products. They then report to Nottingham University Hospitals NHS Trust nursing director Mandie Sunderland, who chairs the NHS clinical reference board, which advises on procurement nationally.

Harnessing experience

Naomi Chapman has been seconded from the RCN as the team’s programme lead. Her brief is to ensure the team’s experience is maximised during evaluation, and to act as an ambassador for the programme.

She says: ‘We meet every week or two and go through plans and strategy. Each person on the team has one or two product groups they are in charge of and takes them through a process to identify which products should be reviewed.

‘They ask questions such as whether the product has an impact clinically, for the patient and whether a lot of it is used.’

Dr Chapman explains that if the product fits the required criteria for evaluation, the team will gather extensive information about it, including from suppliers and frontline staff.

‘We are asking questions about what we need products to do, and developing clinical-led criteria that focuses on what clinicians want and need,’ she says. ‘If, for example, we were looking at IV equipment, we might attend a tissue viability network conference and ask clinicians what they want from a product.’

Up to £1 billion could be saved each year by better procurement management

Source: Lord Carter review

Dr Chapman, who represents the team as a member of NHS clinical reference board, says the team holds stakeholder events where practising clinicians can give their input about a product.

‘What we have learned from the first phase of testing is that different products may take 20, 24 or even 30 weeks to test depending on the clinical engagement we need,’ she says.

Evaluation process

Each product does not have an overall star rating but receives stars for various aspects of its use.

'It is a fully documented, intensive process,’ says Dr Chapman, ‘and it is successful because of the time we take and the passion we have about getting good quality products.

‘At an NHS clinical reference board meeting, there will be a meeting for board members in the morning and, in the afternoon, the team will present their work and can have access to the chair and ongoing advice.

‘If safety issues arise about a product during evaluation, we would aim to contact the supplier and talk it through. After we complete the report, we will send it to the supplier 72 hours before publishing, and they have the opportunity to challenge anything they feel is factually incorrect.

‘Suppliers have had a positive reaction to us so far and our first supplier meetings where we give them information about what we do have just started.’

Rigorous assessment

Ms Sunderland says she is impressed by the team’s rigorous testing: ‘I have even seen the team covered in medical tape and wearing it for a week, testing whether it falls off in the shower or in bed.

‘This is real-time testing by people who have to use the products and can give them ratings for other clinicians to see which is best.

April 2016

NHS clinical evaluation team founded

‘We are generating a lot of interest nationally and, for me, it’s hugely exciting because this shows how versatile nurses can be.

‘You can have a cheap dressing, but if it continually falls off you just use it more. It is not about the cheapest but about the best value.’

Government funding for the team has been confirmed until at least March 2018, and sets of reports about products are due to be published this month and in February.

Ms Sunderland adds: ‘A good model for the programme would be to have a mixture of permanent and seconded staff working together. Clinicians are good at problem solving and this is a great vehicle to showcase that.’


Improving quality, safety and value of products

The NHS clinical evaluation team includes a paramedic, a district nurse, three procurement specialist nurses and two tissue viability specialist nurses.

Among the members is Jillian Best, a district nurse who has been seconded from South Tees Hospitals NHS Foundation Trust for six to eight months. She has experience working in acute and community settings, as a Marie Curie nurse, Queen’s Nurse, clinical practice teacher and non-medical prescriber.

She says: ‘It seemed logical to ask clinicians what they want from a product such as a box of gloves or a 10ml syringe and then actually assess the products according to their requirements. We all know there have to be changes to the way we work to improve quality, safety and value, and this is an opportunity to become actively involved.’




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