Greater Manchester NHS

Greater Manchester NHS

COVID-19 – The catalyst for doing things differently

Briefly describe the initiative/ project/service; please include your aims and objectives

The Greater Manchester NHS Procurement Team combined experience, expertise, contacts and industry knowledge to successfully lead Greater Manchester’s Health & Social Care sectors to source and distribute appropriate, Personal Protective Equipment (PPE) in volumes which met demand during the Coronavirus pandemic. At its peak, more than 1.2million items of PPE were being used across Greater Manchester. The scale of the task included calculating volume and demand of the PPE required at eight acute trusts, one specialist trust, two mental health trusts and North West Ambulance Service, and directly procuring it at best value in a highly-inflated market where prices being demanded from suppliers were upwards of 500% more than usual.

In addition, the three-strong Greater Manchester NHS Procurement Team worked with procurement colleagues in local authorities to ensure continuity of PPE supply for social care, primary care and emergency dental centres. The team developed a wealth of tools and systems so that secondary and primary care workers as well as social care workers and allied health professionals could treat Covid-19 patients with confidence and assurance of PPE supply. The team has created a lasting legacy which includes: an innovative on-line stock system; a central warehousing and distribution facility, stocked for future Coronavirus outbreaks and a collaborative health and social care PPE procurement system; new, local sources of PPE supply. Our work has been characterised by collaborative working across Greater Manchester’s public sector organisations and the establishment of a number of new networks which will sustain and support the health and social care sectors we the fight against Covid-19 continues.

As the Covid-19 pandemic began to take hold in the UK March, the team set a number of aims and objectives:
– Support Greater Manchester’s NHS Trusts to procure the PPE required to keep front-line workers safe and to avoid duplication of procurement activity
– Establish strong links with social care providers and other public sector bodies in Greater Manchester to support the sharing of mutually aided PPE and relieve pressures across the system
– Set up a central receipt and distribution centre – and accompanying logistics operation – for Greater Manchester which would be handle millions of items of PPE and quickly deliver them to where they were most needed across the system.
– Implement a single data and analytics platform which would provide real-time information about PPE stock levels, burn rates and demand for the Health & Social care system to enable efficient procurement of vital PPE
– Support GM NHS Gold Command with robust, real-time PPE data to inform critical decision-making at its daily Covid-19 meetings.
– Work with the Manchester Growth Hub and local businesses to establish new PPE supply lines to reduce the demand for overseas procurements of limited supplies of PPE.

What are the key achievements?

In mid-March, and within four days, we met our first objective – build a data and analytics platform. We worked with AdviceInc, experts in healthcare data and analytics to build Stockwatch. Key priorities in its development were:
– To be able to track and forecast PPE from day one across more than 20 public sector organisations in GM.
– To build a system which was simple to use, did not require excessive user-training and provided a quick-response support service to user queries and issues
– To build a system which gave ‘member’ organisations the ability to ‘mutually aid’ PPE.

Stockwatch replaced the cumbersome and ineffective single inventory systems being used by GM Trusts trying to cope with the rising demands for PPE. It enabled us to accurately target our procurement of PPE categories – we procured >4million items of PPE at the height of the first wave of the pandemic. Daily reports were run-off from AdviseInc and presented to GM Gold Command to inform their decision-making and to provide them with the confidence they needed in knowing that stocks of PPE were available in GM to keep front-line workers safe. Stockwatch has now become an integral part of GM Trusts’ daily materials management activity and is enabling us, and more than 20 public sector organisations in Greater Manchester including Local Authorities, Transport for Greater Manchester, Greater Manchester Police Force, Greater Manchester Fire & Rescue Service (GMFRS) and North West Ambulance Service, to be able to track, forecast and meet the continuing demands for PPE.

To support Greater Manchester’s NHS Trusts to procure PPE, we set-up a GM Sourcing Group within two weeks of lockdown; each of our Trusts’ Head of Procurement nominated a procurement professional to sit on the group. Each representative led on a category and sourced, managed the quality assurance for, and ordered the PPE products. A process was put in place to ensure visibility of orders placed, price, expected delivery dates and invoicing. The work of the group avoided duplication of procurement effort across our 11 NHS Trusts. We partnered with GMFRS to establish a warehouse facility to store more than 10million items of PPE and to do daily, targeted deliveries of PPE to where it was most needed to hospitals sites, local authority depots, primary and emergency dental care and care homes. We set up links with procurement colleagues in our social care system to ensure efficient and effective direct sourcing of PPE to support their needs. Mutual aid was a feature of this partnership which benefitted secondary and primary care as well as social care settings. We joined with the Manchester Growth Hub to source supplies of locally manufactured PPE from companies who diversified production. A legacy of this is that a Salford company now holds a DHSC contract to supply Type IIR masks, while a textile company in Tameside has a contract to provide gowns for the national NHS pandemic stockpile.

What are the key learning points?

Our commitment, since we were set up in 2018, to build strong working relationships with procurement colleagues at GM trusts paid dividends; it helped us to quickly establish new systems and processes to successfully manage the challenge of PPE procurement and distribution. Understanding the value of data and analytics was also key to our success. The regular and various communications we’ve implemented, as part of our BAU programme delivery, were stepped up during the pandemic and played a key role in our ability to react to an ever-changing and diverse demand for PPE, support our health and social care partners to continue to treat Covid-19 patients and to provide GM leaders with confidence in the successful outcomes of our work. Members of the GM NHS Procurement Team attended the daily GM Gold Command meetings, presenting the Stockwatch data and providing assurance to GM Gold Command of the PPE procurement activity taking place. Daily meetings of the GM Sourcing Group were held between April and July to ensure health & social care’s changing demands for PPE could be actioned swiftly; weekly Microsoft Teams meetings with Heads of Procurement were a useful forum for sharing of local intelligence around national PPE push stock activity and the sharing of mutual aid; daily calls with NHSE/I and regional procurement leads from Lancashire, Cumbria, Cheshire & Merseyside supported pan-regional mutual aid. We also set up a Whatsapp Group for Trusts’ Heads of Procurement. This was an efficient way for them to raise mutual aid requests and was particularly useful at the weekend when TfGM and GMFRS logistics support was limited.

At the start of our procurement activity, it was apparent that Infection Prevention Control would play a critical part in assuring the quality and standards of the PPE being procured. In a fragile and chaotic world-wide supply market we had to be sure we were buying products which would not expose front-line staff to risk. We recommended to GM NHS Gold Command that a coordinated approach for quality assurance of PPE being procured was needed. Gold Command designated an Infection Prevention Control Lead as a single point of contact to work with the Sourcing Group to review samples of PPE and their standards and certifications. This was an efficient way to ensure PPE supplies for Greater Manchester were fit-for-purpose and met quality and clinical standards and minimised the risk of introducing sub-standard PPE into the system. The temporary receipt and distribution centre at Greater Manchester Fire & Rescue Training Centre in Bury was set-up initially with seconded staff from GMFRS. As Covid-19 progressed it became apparent that a new, longer-term solution to sourcing, stocking and supplying PPE was needed. Early recognition of this fact enabled a project lead to be appointed to set up a permanent warehousing and logistics facility for health & social care PPE items in Salford.

COVID-19 Response Recognition Award

The speed with which we reacted to the sudden and substantial demands placed on the health & social care system enabled us to source and supply vital PPE to front-line workers who might otherwise have been inadequately protected. Our work, before the outbreak of Covid-19, to build relationships with key stakeholders in NHS Trusts made that possible. Similarly, the working relationship we’d already established with AdviceInc which enabled Stockwatch to be built and go-live in four days helped GM leadership keep frontline staff protected in hospitals, social care and other public sector services throughout the first wave of the pandemic – and continues to do so. We were able to negotiate a five-month period when Stockwatch was provided free of charge. There is now a low-cost fee in place and AdviseInc continues to provide a valuable and value-for-money service to GM. All GM organisations have signed up to StockWatch, confident of its value in the fight to keep the population of GM safe.

StockWatch laid the foundations for increased collaboration across GM and the development of the regional warehousing, receipt, distribution and logistics facility. Having a single R&D facility, with stockholding informed by StockWatch, meant that mutual aid across health and social care and other public sector partners was swift and effective. Ready access to PPE has kept patients, front-line staff and the wider public, for example schoolchildren and teachers, safe. The ability to understand volume requirements and procure these in bulk on behalf of the Greater Manchester economy has enabled the GM NHS Procurement Team to obtain best prices – even at a time when the market inflated prices substantially. One of the items procured using data from StockWatch was a transparent mask which has been used extensively by front-line workers from Local Authorities to communicate with hard-of-hearing residents in social care – and in audiology departments in some of our NHS trusts. Without StockWatch, understanding the volumes of masks required would have been a manual process and gathering such data from more than 20 organisations would have been time-consuming.

The GM NHS Procurement Team is made up of just three people – Procurement Hub Lead Neil Hind and Clinical Project Managers Celia Poole and Gareth Hudson. But the scale and scope of what has been achieved has far-outweighed the sum of the team’s parts. It demonstrates what can be achieved by working flexibly, having confidence in other’s decision-making and effectively harnessing the professional relationships and stock of ‘goodwill’ which has been built up over the last two years. Virtual, remote working meant that we held daily team meetings in order to understand and support each other’s activities, proactively manage challenges and keep close track of the new systems and processes we had put in place. It was a new way of working which worked for us and enabled us to ‘build better’.

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