Effect of clinical engagement on value, standardisation, decision-making and savings in NHS product procurement.

BACKGROUND: UK healthcare expenditure is now £193.8 billion a year. The procurement function is seen as central to driving efficiencies within the NHS. This comes with an increasing onus on clinicians, including nurses and allied health professionals, to accept procurement outcomes to realise efficiency savings, with or without prior engagement. AIMS: This empirical study seeks to examine whether clinical engagement in the procurement of healthcare products in the NHS is necessary to achieve value, savings and standardisation; it will thereby address a gap in the research. METHODS: A multi-method qualitative case study design was used, which included a survey and eight semi-structured interviews. FINDINGS: Results identified three factors that influence the achievement of value, savings and standardisation around clinical engagement: micro-level processes for clinical engagement; clinical stakeholders and clinical procurement professionals as experts at the centre of procurement activity; and clinical value in standardisation. A shift away from standardisation to resilience was identified, resulting from current market supply pressures. CONCLUSION: This research brings empirically derived findings to address gaps in research, supports the benefit of clinical engagement through specific forums for collaboration at a trust level and provides a clinical/expert impact/preference matrix as a resource for procurement professionals to facilitate clinical engagement.

The voice of stoma care nurses: an exploration of stoma care in England.

BACKGROUND: This article is part two of a series presenting the findings of stakeholder surveys with ostomates and stoma care nurses (SCNs) for stoma services in England. Part one explored the experiences of ostomates. This article focuses on the views and experiences of 108 SCNs in England. AIM: To understand the experience of SCNs in England in relation to current services provided. This includes the scope of the SCN role, the service they provide, and SCN experience and views on areas for improvement. METHOD: SCNs were invited to share their experiences and views in a national online survey. Questions considered the experience of the nurse, where the care they provide is delivered, how their post is funded and their views on current issues such as responsibility for managing waste of stoma product. Two free-text questions asked what areas of stoma care services worked well and what areas could be improved, results of which were coded and thematically analysed. FINDINGS: Themes included patient care, industry involvement and prescribing process. CONCLUSION: Overall, survey respondents felt that they provided a good standard of care. Nurses reported complex industry relationships. Awareness of the Nursing and Midwifery Council Code, Bribery Act 2010 and NHS England guidance on managing conflicts of interest is advocated, as is promoting transparency in funding arrangements. It was noted that there appears to be variation in the care provided to ostomates.

The voice of ostomates: an exploration of stoma care in England.

BACKGROUND: This article is part one of a series presenting the findings of stakeholder surveys with ostomates and stoma care nurses for stoma services in England. Due to the volume of data and publication limits this article focuses on the views and experiences of 2504 people living with a stoma (ostomates). AIM: To understand the experience of ostomates in relation to the current services provided in hospital and at home, the delivery of care and views on areas that work well and areas that require improvement. METHODS: Ostomates were asked to share their experiences in a national online survey, promoted via multiple organisations. The survey included sections for respondent demographics, interactions with the stoma care nurse (SCN), products and dispensing services, as well as patients' experiences relating to both hospital-based care and home-based care. Free-text responses relating to service delivery in hospital and at home were coded and thematically analysed. FINDINGS: Results are presented, and verbatim quotes used to demonstrate themes. These include care provision and access to visits from the SCN, physical and psychological care, information sharing, specialist knowledge and products. CONCLUSION: Overall, the survey respondents praised the care given, however, the experiences and views shared via the survey show significant variation in the care and services received. This article presents the findings of a survey of ostomates living in England. A second article, presenting the findings about the experiences of stoma care nurses will be published in a forthcoming issue.