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S6 EP8 Beyond Price: Making Value-Based Procurement a Reality
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In this episode of Axrem Insights, CEO Sally Edgington is joined by Holly Ruddock, Jack Bond and value-based procurement expert Brian Mangan, CEO of Luach Consulting Group, to unpack what value-based procurement really means for the NHS and industry. Moving beyond buzzwords, the panel explores how procurement can shift from a narrow focus on price to a broader assessment of patient pathways, long-term outcomes, efficiency gains and environmental impact. At its heart, value-based procurement is about delivering tangible, measurable benefits that improve care while making smarter use of limited resources.
The discussion tackles common barriers including siloed budgets, data access, cultural resistance and the perception that value-based approaches cost more. The panel highlights the growing policy momentum behind the agenda, including pilots and increased focus on outcomes, and makes the case that now is the time for suppliers to build evidence, develop case studies and reframe conversations with procurement teams. For AXREM members and NHS stakeholders alike, this episode offers a practical and optimistic look at how collaboration, communication and better questions can unlock real system-wide value.
AXREM Value Based Procurement Paper
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Disclaimer: This transcript was produced using AI transcription software. It may contain errors, misspellings or inaccuracies and has not been fully edited for verbatim precision. It is intended to accompany the podcast audio and should not be relied upon as a standalone or definitive record of the discussion.
[00:00.000 --> 00:06.160] Welcome to AXREM Insights, developing healthcare through medtech and innovation. Join Melanie
[00:06.160 --> 00:10.480] Johnson and Sully Edgington as they talk with our industry leaders and experts.
[00:11.440 --> 00:17.120] Hello and welcome to the AXREM podcast where we will explore the ideas of innovations and
[00:17.120 --> 00:23.200] challenges shaping the future of diagnostic imaging, radiotherapy and healthcare technology.
[00:23.200 --> 00:27.120] In this episode, we're diving into a topic that continues to spark debate,
[00:27.120 --> 00:33.760] curiosity and importantly, real opportunity across our sector, value-based procurement.
[00:33.760 --> 00:40.240] I'm Sully Edgington, CEO of AXREM and I'm here with Holly Ruddock from Sectra and Jack Bond from
[00:40.240 --> 00:45.920] EIZO representing the AXREM Future Leaders Council. Today we have the pleasure to be speaking to
[00:45.920 --> 00:52.000] Brian Mangan, CEO of Luach Consulting Group. So welcome Brian and thank you for being on
[00:52.000 --> 00:56.720] our show today. Let's start by handing over to you to tell us a bit more about yourself,
[00:56.720 --> 00:59.760] how has your career progressed and what drew you to the industry?
[01:00.800 --> 01:06.880] Thanks for that Sully. My career kind of started a long time ago, I think that's probably first
[01:06.880 --> 01:12.240] to say back in the 1980s. I actually started working on the counter and the post office.
[01:13.040 --> 01:18.400] I did that for about eight, nine years and found myself in the stores and then probably like most
[01:18.400 --> 01:25.200] people I found myself in procurement as well. When I was in Royal Mail I used to buy wonderful
[01:25.200 --> 01:30.800] things like rubber bands and then decided enough of the rubber bands and maybe go and do something
[01:30.800 --> 01:36.480] a bit different. So I joined the NHS back in 2004 and the first job I got was buying drills that
[01:36.480 --> 01:41.440] take people's heads off which was quite an interesting experience. Having like a real sort of
[01:42.560 --> 01:47.440] fear of fears and that I managed to manage to swerve actually going in to see them actually
[01:47.440 --> 01:52.880] in operation. And then right into Wigan and Ley, did another few years there. So I had about nine
[01:52.880 --> 01:59.840] years in operational procurement and I then got a regional job when I started with North West
[01:59.840 --> 02:05.280] Procurement Development. It was when I got the regional job I kind of started looking at this
[02:05.280 --> 02:11.040] thing called value because basically what happened was that when I was a buyer I was a horny. I had
[02:11.040 --> 02:16.000] a very sort of adversarial relationship with suppliers and I did reasonably well. We managed
[02:16.000 --> 02:20.720] to get a load of prices down. I kind of thought well we need to start doing something differently
[02:20.720 --> 02:24.320] and then started working with the University of Liverpool. I came up with the term VBP,
[02:24.320 --> 02:29.920] Valley Based Procurement and then I spent about five years going out sort of you know really
[02:29.920 --> 02:35.840] sort of putting the message out about what VBP was about. With 2019 I got made redundant. I decided
[02:35.840 --> 02:40.480] to set my own business up and having a great imagination I decided to call the business
[02:40.480 --> 02:47.120] Brian Mangan Associates and then I went to a meeting abroad and some fella said to me
[02:47.440 --> 02:52.000] who are you? I said Brian Mangan. He said where do you work? I said Brian Mangan Associates and I
[02:52.000 --> 02:57.360] thought this doesn't sound right to me. So I kind of decided to work with another name for the company
[02:57.360 --> 03:03.520] and it's actually Lowach Consulting and it's value in Irish. So that's very much kind of what I do
[03:03.520 --> 03:08.240] and I support both the NHS industry really to try and get an understanding about what VBP,
[03:08.240 --> 03:12.000] Valley Based Procurement, Valley Based Healthcare is all about and that's for me.
[03:12.000 --> 03:21.040] Perfect thanks Brian and from rubber bands to kind of life-saving equipment what a complete
[03:21.040 --> 03:26.320] contrast. There's a story to tell about the rubber bands but we haven't got time there you go.
[03:26.320 --> 03:32.080] Okay well we'll have to take that off podcast and I'll look forward to hearing that at a later date.
[03:32.640 --> 03:39.280] So last year AXREM published our landmark paper written by Brian evaluating value-based procurement
[03:39.280 --> 03:44.800] principles, practices and impact. A piece of work that's set out to demystify value-based
[03:44.800 --> 03:50.080] procurement and examine how it can genuinely transform decision making, partnerships and
[03:50.080 --> 03:56.560] patient outcomes across the NHS and industry. Today we're building on that foundation. We'll
[03:56.560 --> 04:01.280] be unpacking what value-based procurement really means in practice beyond the buzzwords, how do we
[04:01.280 --> 04:07.280] define value, who decides it, what does good look like and how can suppliers and the NHS work together
[04:07.280 --> 04:12.960] to move from transactional procurement to approaches that reward innovation, long-term
[04:12.960 --> 04:19.120] impact and whole system benefit. Whether you're a supplier, a clinician or a procurement professional
[04:19.120 --> 04:24.320] or simply someone passionate about improving healthcare delivery, this conversation will help
[04:24.320 --> 04:29.360] illuminate where we are now, what's working and what still needs to change. Today we're going to
[04:29.360 --> 04:33.120] do things a little differently rather than questions and answers to and from our guests.
[04:33.120 --> 04:38.400] We'll be having a panel discussion about value-based procurement. So I'm going to let
[04:38.400 --> 04:43.440] Brian as our value-based procurement expert kind of start things off and it would be really good
[04:43.440 --> 04:51.600] Brian just for you to give us. We're stripping away all the jargon and all the you know different
[04:51.600 --> 04:56.480] acronyms and everything else and give us an overview of what does value-based procurement
[04:56.480 --> 05:02.320] actually mean in simple practical terms for the NHS but also for industry and our members.
[05:02.320 --> 05:07.040] Yeah I think for me you see there is this kind of mystique if you like around value-based
[05:07.040 --> 05:12.080] procurement and I think it stems from you know the word value. So what is value? It means different
[05:12.080 --> 05:17.120] things to different people. I think that's that's one of the challenges. So for me it's something
[05:17.120 --> 05:20.960] that's relatively straightforward. If you like there's a couple ways you can describe it. It's
[05:20.960 --> 05:25.680] about holistic procurement. It's moving, it's not just looking at the price of a product, it's looking
[05:26.480 --> 05:31.920] at the pathway itself. So it's looking at you know what your products and what your solutions
[05:32.320 --> 05:37.520] what impact it has on a patient pathway. Understanding what needs to change by how much
[05:37.520 --> 05:45.520] and how industry can actually support to improve patient care, reduce cost, improve efficiency
[05:45.520 --> 05:51.280] and also impact make a positive impact on the environment. So it's not just looking at one
[05:51.280 --> 05:57.360] dimensional price, it's looking at the pathway and what the total cost of care will actually be,
[05:57.360 --> 06:02.160] what's the impact of it. So for me that's what it's all about. I say it's just something that
[06:02.160 --> 06:06.400] there's a lot of it's common sense. You can apply it to health care, you can apply it to
[06:06.400 --> 06:12.720] non-clinical things as well. It's just to say I think traditionally we've always just looked at
[06:14.320 --> 06:20.720] at the price. It's probably the simplest thing and I think that's where we've been but it's
[06:20.720 --> 06:25.120] I say it is it's relatively straightforward today but I would say that you know.
[06:27.280 --> 06:31.920] I think when you talk about and that's really interesting value means different things to
[06:31.920 --> 06:36.960] different people. I think one of my concerns around value-based procurement is how can we
[06:36.960 --> 06:43.120] get everybody talking about value-based procurement the same way and we see this across the health
[06:43.120 --> 06:49.040] system in lots of different things that we're doing where I could read something a paragraph
[06:49.040 --> 06:56.160] about value-based procurement and Holly and Jack and you might all interpret it completely differently.
[06:56.160 --> 07:01.200] So that's where I think although it sounds simple value means different things to different people
[07:01.200 --> 07:08.800] I think we can also interpret it in different ways. I think I went to a meeting a conference
[07:08.800 --> 07:15.120] the other the other month and soon my clinician got on stage and he was saying well for me what
[07:15.120 --> 07:22.560] what is value and they said it's about impact. So what I often use the term when I train people
[07:22.560 --> 07:27.760] I talk about delivering tangible and measurable benefits. So value has got to be something that
[07:27.760 --> 07:33.040] you can touch and feel that makes a difference. So the example I regularly I regularly give
[07:33.040 --> 07:37.520] you are someone years ago coming in and they say I'm going to save you two minutes in theatres and
[07:37.520 --> 07:41.680] that'll save you two million pounds. They go but two minutes in theatres won't save me two million
[07:41.680 --> 07:46.320] pounds no matter how much you aggregate it up. If you come in and you save me half an hour in
[07:46.320 --> 07:50.560] theatres if I'm doing that if I'm doing an orthopedic procedure say a replacement night
[07:50.560 --> 07:55.840] I can list an exorbitant at the end of the day. So that's something that's tangible and measurable
[07:55.840 --> 08:02.240] but I kind of quite like the way that the the clinician phrased it about impact. So I think
[08:03.120 --> 08:08.800] for your members it's looking at what is value it's something that makes the difference so that
[08:08.800 --> 08:14.480] you can touch and feel that has an impact on the patient on the health system itself potentially
[08:14.480 --> 08:22.800] on the environment as well. I think as well when it comes to impact it's not just about the linear
[08:22.800 --> 08:27.280] path you're seeing when you talk about say for example your theatre example there it's obviously
[08:27.280 --> 08:30.960] saving the patient's time and you're getting the doctors the nurses in and out but there's also
[08:30.960 --> 08:35.680] so many more staff involved in that process which may not be thought about in the instance and it's
[08:36.960 --> 08:40.800] the trouble when you start to develop value-based procurement is when you say it's going to make an
[08:40.800 --> 08:45.920] impact on the immediate people actually what its impact is going to make us the wider pathway to
[08:45.920 --> 08:50.480] everyone else involved in it and how then do you get all of those aligned to say well you would
[08:50.480 --> 08:54.320] never immediately jump to the cleaners for example or the people who would be doing the
[08:54.320 --> 08:58.640] turnaround time but actually it may help them and give them more time and what would they then do
[08:58.640 --> 09:02.160] with that extra time you've now given them because you've streamlined the process for them and what's
[09:02.160 --> 09:08.160] the value to them it's keeping so many more people involved in the conversation and asking them
[09:08.160 --> 09:12.400] what is the value to you for something you may not even know is happening in the hospital or
[09:12.400 --> 09:17.360] the environment at the time and for me that's that's one of the things I'm quite excited to
[09:17.360 --> 09:21.840] explore is to say it's not just the people involved in the process of the project it's
[09:21.840 --> 09:25.840] the people outside of it and how does that impact them and ultimately how does that route back to
[09:25.840 --> 09:31.440] the patient yeah I completely agree Jack and I think you know that's kind of at a certain
[09:31.440 --> 09:38.080] point in time but also value-based procurement I think has a really interesting mechanism by which
[09:39.200 --> 09:45.600] it evaluates impact over time as well so you know what is the long-term cost saving what are the
[09:45.600 --> 09:49.760] long-term outcomes and that's something you don't really get at the moment if you're just
[09:49.760 --> 10:01.520] comparing price the way the again the way that I explain it and it is something I've done a number
[10:01.520 --> 10:07.280] of times over the last five or six years where again you're just looking at the pathway so you
[10:07.280 --> 10:12.320] look at your current pathway you get the right people involved clinicians operations people
[10:12.320 --> 10:16.720] of finance because you're trying to you're trying to map out your clinical flows and the financial
[10:16.720 --> 10:22.640] flows and then you see okay what is what is the you know what are the problems that say I mentioned
[10:22.640 --> 10:26.720] it before what are the challenges what are the opportunities what needs to change and why aren't
[10:26.720 --> 10:31.920] much and you can take that literally from someone you know patients having a problem through the
[10:31.920 --> 10:38.320] student being discharged into the community so I think it's something to say to Jack's point
[10:38.320 --> 10:44.080] that it is something that you can do and then you can pick up the other thing that I could
[10:44.080 --> 10:49.520] serve that stuff this stuff for hours but I mean it's looking at data points measures it's not it's
[10:49.520 --> 10:56.960] about 20 percent of 80 percent of the value within a pathway can probably be collected by 20 percent
[10:56.960 --> 11:01.600] of the measures or the data that's required for it so it goes back to what I was saying before
[11:02.160 --> 11:06.960] about trying to keep it simple so it's getting right people involved identifying what needs to
[11:06.960 --> 11:12.080] change by how much and then deciding what your baseline is what your target is and how you're
[11:12.080 --> 11:18.560] going to measure it so I think it's a good way to try and get I did a conference last week
[11:18.560 --> 11:24.560] with the hfma the healthcare finance managers association and a healthcare supplier association
[11:24.560 --> 11:30.320] and I was saying to them the vbp is a good way to bring people together to break down the barriers
[11:30.320 --> 11:38.400] between violence and procurement and clinicians as well so I think yeah and I think as well like
[11:39.200 --> 11:44.400] everything at the heart of what we do in AXREM is around the patient so we want to make sure patients
[11:44.400 --> 11:49.760] get the right diagnosis at the right time you know and they're put on the right patient pathway
[11:50.320 --> 11:56.320] what I see as a bit of a barrier is this ring fencing of budgets so on a patient pathway
[11:56.320 --> 12:03.520] that could be several different budgets across several different departments so it's how I am a
[12:03.520 --> 12:08.960] massive supporter of value-based procurement just to say from the outset and I know our members are
[12:09.600 --> 12:16.800] but it's how can we make that the nhs is such a huge beast how can we get all of the different
[12:16.800 --> 12:21.920] departments doing the right thing by the patient at the right time and not ring fencing their
[12:21.920 --> 12:28.000] budgets and going for the cheapest product which is what we see on a daily basis as industry
[12:32.160 --> 12:37.760] I think that sorry I think that might come back to potentially my point Sally is say well you've
[12:37.760 --> 12:42.480] got so many different people involved you need to make sure everyone's aware of the cost of the
[12:42.480 --> 12:46.400] savings of that particular product is going to happen to their department whether they think it
[12:46.400 --> 12:51.200] they're related or not at the end of the day there are so many different patients part touch points
[12:51.760 --> 12:55.680] a patient will go through a hospital and if you then look at each department each budget
[12:55.680 --> 13:00.560] well if you make a cost saving in one or a value saving in one what is the cascading effect to
[13:00.560 --> 13:06.960] everybody else you need to start somewhere I need to evidence this is a a viable pathway to show
[13:06.960 --> 13:12.560] this is actually the the not only the cost of the time the energy the efficiency savings as you go
[13:12.560 --> 13:17.680] through it's getting all those people in in the same room to say look this is what we're going
[13:17.680 --> 13:21.440] to be doing from our pot of money this is how it's going to help you all of your budget stretch
[13:21.440 --> 13:26.160] further because we're going to be giving you time patients or staff members back yeah and I think
[13:26.160 --> 13:31.040] that's the difficulty with industry is that we don't necessarily have access to that kind of data
[13:32.240 --> 13:40.800] so it really is for the nhs to define what those savings would be for me I think I just feel that
[13:40.800 --> 13:48.080] they actually and again I brought it up last week there is this sort of view that we work
[13:48.080 --> 13:54.240] in silos but if you think about it a finance director is interested in the budget for the
[13:54.240 --> 14:01.920] hospital or for the ice replay they're not it's not each individual business each individual part
[14:01.920 --> 14:07.360] of the hospital isn't even it so isn't its own profit center so it doesn't make sense to it I
[14:07.360 --> 14:11.680] think well I like what jack was saying and it kind of goes back to this thing about the pathway but
[14:11.680 --> 14:17.200] it's about getting the right people in the room so what hallie was saying before about you know
[14:17.200 --> 14:22.640] sort of making sure again that everybody's quite clear about what's happening and I'd say to people
[14:22.640 --> 14:28.960] who have got a problem to your members is it's about getting the right to say we attend industry
[14:28.960 --> 14:36.160] tend to have a real very strong clinical self and the really kind of or technical self so it might be
[14:36.160 --> 14:40.240] you know in jack's case it might be you know actually some IT people or technical cell
[14:40.240 --> 14:45.760] whatever happens to be but we tend to focus on that with me it's getting everyone in the room at
[14:45.760 --> 14:50.480] the same time first of all you get the buy-in from the key stakeholder that would be the clinician
[14:50.480 --> 14:54.640] but then it's then it's bringing people into the site this is what it looks like this is the impact
[14:54.640 --> 15:01.760] so it's not beyond the realms of possibility I think the service generally but it's generaling
[15:01.760 --> 15:08.080] the money from one budget to another but that way so it's not it's just that it's a perceived
[15:08.080 --> 15:13.200] hurdle but I believe it's one that can be overcome reasonably simply by having conversations
[15:14.720 --> 15:19.600] and I think that is what is key here and that's what I've communicated to the department of health
[15:19.600 --> 15:25.280] and social care who are working on value-based procurement is that communication is going to be
[15:25.280 --> 15:30.560] everything to change people's way of thinking and you know it is difficult especially in an
[15:30.560 --> 15:36.240] organization like the NHS that is so big and there's so many people involved in procurement
[15:36.240 --> 15:43.200] and finances and the patient pathway is communication really is going to be key here
[15:43.200 --> 15:48.400] because we all agree that it's what's right for the patient it's also what's right for the taxpayer
[15:48.400 --> 15:53.440] because long-term savings you know it may cost a little bit more now but in the long run it's
[15:53.440 --> 15:58.640] going to save an awful lot of money to the NHS and the taxpayer that's what we should be doing
[15:58.640 --> 16:03.920] and we've been very short-sighted up until this point and you know that Brian's really
[16:03.920 --> 16:09.040] highlighted the value-based procurement piece over the last few years and we need to I think
[16:09.040 --> 16:13.760] we've all got a responsibility to talk about value-based procurement like you know we're
[16:13.760 --> 16:19.440] starting to hence why you know this is a great idea to do a podcast so that people can listen
[16:19.440 --> 16:25.520] and really understand from their perspective the value that it can bring to either their business
[16:25.520 --> 16:33.120] their the NHS their department or whatever it might be so I think from an AXREM perspective
[16:33.120 --> 16:39.280] I wonder how does value-based procurement change the landscape for our members both in how they
[16:39.280 --> 16:45.040] innovate and how they demonstrate value beyond price and I don't I know Brian you've got some
[16:45.040 --> 16:50.000] great case studies don't know if there's anything in our area that you can give an example briefly
[16:50.000 --> 16:57.280] or you know really kind of delve into that for us I think there was there was one in the in the
[16:57.280 --> 17:04.960] report that I did last year but in fairness I think with with AXREM members I think the evidence
[17:04.960 --> 17:12.080] has been quite light and there's loads of stuff that people are doing out there I think they're
[17:12.080 --> 17:18.240] just not articulating it in a way and they're not demonstrating if you look in other medical areas
[17:18.480 --> 17:22.640] there are case studies quite a few particularly with your members now whether that is
[17:23.440 --> 17:31.440] um I can't maybe go off of attending slightly I'm wondering whether people think that value-based
[17:31.440 --> 17:36.480] procurement is just theory and it's not going to happen I think that might be one of the reasons
[17:36.480 --> 17:41.200] why I think there's loads of things that are out there but I think that people aren't just really
[17:41.600 --> 17:47.200] articulating it they're not sharing the stuff that they do that would be would be my
[17:48.480 --> 17:56.720] my suggestion is that people start looking at the solutions that they've got and then sort of building
[17:56.720 --> 18:04.080] up a picture that incorporates like a stakeholder map so you can put down okay what does it mean
[18:04.080 --> 18:10.640] to the clinician what does it mean to operational effectiveness what does it mean to finance what
[18:10.640 --> 18:18.320] does it mean to the environment and then constructing these case studies or marketing
[18:18.320 --> 18:24.960] material in a way that kind of touches a number of different points that's demonstrating like
[18:24.960 --> 18:30.640] value across the whole piece so I think that's where I think just at the moment there's two
[18:30.640 --> 18:35.680] things one is the are your members thinking well actually it's not really gonna happen I think
[18:36.320 --> 18:42.960] it definitely will and the other one is about traditionally it's been very much a clinical
[18:43.600 --> 18:51.040] cell type of thing yeah I definitely think it's going to happen at some point it's just looking
[18:51.040 --> 18:55.360] into my crystal ball to say when is it going to come through that's that's the thing we're
[18:55.360 --> 18:59.520] looking at at the moment is you know we can put forward the values of sort of foreign products
[18:59.520 --> 19:06.560] and solutions and say this is the potential implications for it the reality is it's not
[19:06.560 --> 19:11.360] really being adopted too much in the NHS openly at the moment there is there's a lot of conversation
[19:11.360 --> 19:16.560] people say we're looking into it and what I'm what I fear is it'll always be the eternal we are looking
[19:16.560 --> 19:22.160] into it answer rather than we're doing it this year that unfortunately the budgets are getting
[19:22.160 --> 19:29.120] tighter but the the demand to deliver is increasing if you want innovation if you want things that are
[19:29.120 --> 19:34.560] going to save you time and money and everything else the long long way unfortunately some of
[19:34.560 --> 19:38.160] those products and solutions are going to cost a little bit more and you do need to look into the
[19:38.160 --> 19:43.360] value-based thing so I'm hoping it's going to happen at some point Brian I don't know when I
[19:43.360 --> 19:49.600] think the the nice thing about the community we have at xram is that we can all share our own
[19:49.600 --> 19:54.480] experiences and issues and actually come together as to say look this is the solution we can provide
[19:54.480 --> 19:59.120] that incorporates so many different areas and this is the best value we can possibly give and
[19:59.120 --> 20:02.880] it's something that we've never really understood before because we don't sit around the table and
[20:02.880 --> 20:09.200] say we've got this site or this this instance we need to come up with the best solution that's
[20:09.200 --> 20:13.600] going to help impact the patients as best as possible how can we all come together to come up
[20:13.600 --> 20:17.520] with the best solution and I think that kind of collaborative piece hopefully we'll start going
[20:17.520 --> 20:22.160] through in the future but completely agree with what you're saying at the moment the the evidence
[20:22.160 --> 20:26.960] is light I don't think it's for lack of trying I think unfortunately it's for lack of adoption
[20:27.600 --> 20:34.080] which fingers crossed in the next year couple of years we'll have a very different conversation
[20:34.080 --> 20:37.840] and we'll have to do a two-hour podcast and all the examples we've got and we can put forward for
[20:37.840 --> 20:43.600] you yeah and I think it really does in the end come down to knowledge sharing you know people
[20:43.600 --> 20:48.080] you know applying this approach and then sharing their experience but then also sharing the
[20:48.080 --> 20:53.120] difficulties that they may be encountered and then how they've applied it in their own experience
[20:53.120 --> 20:59.040] but I don't do very much feel that there is a shift kind of you know throughout the procurement
[20:59.040 --> 21:03.760] space in general I mean with the new procurement act as well like for increased transparency about
[21:03.760 --> 21:10.720] how we're spending public funds so I think you know this is this change is happening it's just
[21:10.720 --> 21:15.920] a matter of time before it's applied across the board and I think what we're doing with this
[21:16.000 --> 21:21.840] podcast and you know keep talking about it is is definitely helping but for me because there's
[21:21.840 --> 21:26.480] kind of three I've done I've done a couple of presentations recently on this about the very
[21:26.480 --> 21:32.800] subject you know is this the time for change and there was one I did I think recently it's 2026
[21:32.800 --> 21:40.720] the year the VBP sticks and it is I mean it we ran around a session yesterday and we had the
[21:41.280 --> 21:45.760] 60 odd people there we had one of your members there and we had the departments of health
[21:47.040 --> 21:52.560] nice wither we had a number of NHS organizations both looked soft and we had a representation
[21:52.560 --> 21:57.840] ICB and industry as well and there's kind of three there's three kind of areas that I think
[21:58.480 --> 22:02.640] to try and convince people that this is happening and it's not just something that will happen
[22:02.640 --> 22:07.600] you know in in the distant in the distant future the first one is around policy so you've got your
[22:07.600 --> 22:13.920] 10-year plan so if you've got the joys of going through the 170 pages of the 10-year plan
[22:13.920 --> 22:20.240] I did a I did a word search on it and it mentioned value 77 times and outcome 99 times
[22:21.200 --> 22:27.120] value is part and parcel it's in it's embedded into the 10-year plan it talks about moving
[22:27.120 --> 22:32.880] towards multi-year budgets it should be you know it should be something that is immunity is when
[22:32.880 --> 22:38.800] it comes to your members where they're actually beginning to recognize the fact
[22:38.800 --> 22:43.600] that in order to to deliver benefits sometimes these things don't take six months they might
[22:43.600 --> 22:50.800] take longer so there's multi-year budgets coming in it refers to the pathways so again you might
[22:50.800 --> 22:55.680] incur a cost in one area so when I used to work it right into regularly I wouldn't really be
[22:55.680 --> 23:00.720] bothered about what happened in the community but it could be if there's a cost incurred in
[23:00.720 --> 23:06.160] one area but it reduces the cost in community or the other way around and I think what it's saying
[23:06.160 --> 23:10.960] now is again it takes this with this notion of pathways and looking at budgets and look I'm
[23:10.960 --> 23:18.800] really looking at how the money is is used across the patient pathway so you've got policy and then
[23:18.800 --> 23:24.640] I'll even mention them on the procurement act there's value in there then you've got perceptions
[23:24.640 --> 23:29.760] so I go out and talk to a lot of people and procurements the beginning together
[23:29.760 --> 23:36.080] I was invited to the hfma which was the hfma meeting last week and that was a a joint session
[23:36.080 --> 23:41.680] of hfma trade procurements and finance people and they were really receptive to the presentation they
[23:41.680 --> 23:47.760] gave because if you look at it on a practical level the example that I say is the savings world
[23:47.760 --> 23:52.400] one is right so I've been banging away a lot of people have about chipping away at the price of
[23:52.400 --> 23:57.920] products and screwing people down to the floor same in your area you know when now we go out
[23:57.920 --> 24:02.880] to the tender the potential is the prices are going to go up so the opportunity to get standard
[24:02.880 --> 24:09.520] to get the traditional savings is really getting more and more it's getting a lot smaller the
[24:09.520 --> 24:14.000] opportunities are getting fewer and fewer so we have to do something different and then there's
[24:14.000 --> 24:20.400] this recognition of the total cost of care so people are beginning to get it now we've probably
[24:20.400 --> 24:25.040] got 30 30 30 or a third a third and a third a third of people are really into it a third of
[24:25.040 --> 24:27.920] people are saying yeah this is happening and you're always going to get some people who are quite
[24:27.920 --> 24:33.760] reticent but the other thing is then you've got about practice we've got the department of health
[24:33.760 --> 24:38.320] if it's rhyming this now so the the work the presentation they gave yesterday the work they're
[24:38.320 --> 24:43.840] doing they've got 13 vbp pilots going on at the moment they've got this new compass system that's
[24:43.840 --> 24:49.760] coming in so you've got the clout of the department of health as well so I think you're probably
[24:49.840 --> 24:56.720] talking about over the course of this year you're going to start things you're going to you're going
[24:56.720 --> 25:03.360] to start seeing people's attitudes changing and when we looked at we ran the session we ran yesterday
[25:03.360 --> 25:09.120] this is the third one the first one we did was on october 24 and there's been massive progress so
[25:09.120 --> 25:14.480] I'd say to your members that if you're thinking about vbp these things take time to embed into
[25:14.480 --> 25:19.280] your organization I think you need to start realizing the driving's on the wall it's going
[25:19.280 --> 25:24.960] to happen and are you prepared for it so start start looking at developing case studies and
[25:24.960 --> 25:32.160] this kind of thing because say it will happen and I concur I absolutely I mean I'm probably I'd be
[25:32.160 --> 25:36.640] the biggest cynic you know we see lots of things coming from government around policy and things
[25:36.640 --> 25:42.480] that are proposed and we talk a lot about it and then it doesn't happen but I absolutely believe
[25:42.480 --> 25:47.360] that value-based procurement will happen I think that what I'm seeing from the department of health
[25:47.360 --> 25:52.080] and social care is the ministers want it to happen it's being driven from the top down and it
[25:52.080 --> 25:59.680] you know and also now the bottom up as well which is really good so yeah I have no doubt that it
[25:59.680 --> 26:05.920] will actually happen but I think that there's you know still an awful lot of work to do and like I
[26:05.920 --> 26:13.120] say before in the communications piece and I think how I think it'll be interesting to see
[26:13.120 --> 26:18.720] what you think around how procurement teams will genuinely shift from choosing the cheapest price
[26:18.720 --> 26:24.640] in the current economic situation that we're in with budgets being really tight you know members
[26:24.640 --> 26:31.360] are saying to me it still always comes down to price rather than looking at the bigger picture so
[26:31.440 --> 26:38.000] I just wonder you know how we can get procurement shifting from looking at the cheapest to the
[26:38.000 --> 26:43.360] long-term value and what do we really need to change in reality to actually make it happen
[26:47.440 --> 26:55.600] I think when I talk to the NHS I say it's not about spending more money
[26:55.600 --> 27:01.440] it's about you spending it so you might have a million pound and it gives you the thousand
[27:01.440 --> 27:07.040] operations I want to say this you spend the money in a different way you might be able to do 1200
[27:07.040 --> 27:15.120] operations so it's looking at you're not saying the perception is that you know there's going to
[27:15.120 --> 27:19.680] be yeah you're spending more cash but it's not about that it's just spending it in a smarter way
[27:20.560 --> 27:27.040] so I think there's that I think you've got the challenge with the fact that procurers
[27:27.040 --> 27:35.200] every procure we're having now the 29th of January procures and NHS organizations up
[27:35.200 --> 27:39.200] down at country they're trying to create their work plans for next year about where they're
[27:39.200 --> 27:44.880] going to get the savings targets I'll tell you now as I mentioned before it's getting really
[27:44.880 --> 27:49.040] it's getting more and more difficult to speak to a colleague the other day they look after four
[27:49.040 --> 27:56.160] hospitals and they've got 600 schemes to get their work plan their savings for next year
[27:56.160 --> 28:00.080] so that kind of proves it that things are changing so I think what you need what you need to do
[28:00.720 --> 28:04.720] is about looking at going back to what I mentioned about what are the what are the
[28:04.720 --> 28:10.400] tangible benefits that you're actually delivering and articulating that's why I think if you've got
[28:10.400 --> 28:14.640] a scheme and you're looking at you can prove that it's reducing the total cost of care
[28:14.640 --> 28:19.760] it's something that you should be taking to organizations and we're trying to get
[28:19.760 --> 28:26.880] finance to recognize again in a more sophisticated one the the benefits that are being delivered as
[28:26.880 --> 28:35.680] well Ryan can I ask you a question I know you briefly mentioned about how industry can you
[28:35.680 --> 28:41.680] know create case studies and start working towards this adoption of value-based procurement but is
[28:41.680 --> 28:46.880] there anything else that you know we can do as industry and as individual organizations to kind
[28:46.880 --> 28:54.720] of support this transition within the NHS I think to be honest with you I think it's more about
[28:54.720 --> 29:01.120] it's trying to get the evidence that it works which is why I kind of I'm probably not answering
[29:01.120 --> 29:07.120] your question very well but I think you know the kind of the more evidence that we can give them
[29:07.120 --> 29:12.160] so I wouldn't be I wouldn't be sitting here talking to you now if I hadn't led the national
[29:12.160 --> 29:17.600] project for NHS supply chain and we had the case studies that are on me and some of your members
[29:17.600 --> 29:24.880] were involved in it because everybody likes a story and stories are a great way to explain
[29:24.880 --> 29:30.400] how things are delivered in practice aren't they and I think that the more the more we do
[29:31.360 --> 29:39.360] more evidence that we've got that it works then people can see the wider benefits and if it works
[29:39.360 --> 29:43.280] in one area it could work in other areas as well so I think for me that's what it's about you're
[29:43.280 --> 29:49.920] creating this momentum and again for your area for accident the number of case studies are
[29:50.960 --> 29:55.520] I think you've got bigger opportunities to do stuff here you know when me and Shelly were looking
[29:55.520 --> 29:59.360] at the report and we were trying to put that together we put a note out to the membership
[29:59.360 --> 30:05.760] I think we only got one or two coming back so I think it's it goes down to are people taking
[30:05.760 --> 30:12.000] this seriously you know so that would be where I would say is it's about evidence create the
[30:12.000 --> 30:16.160] evidence it gives people confidence that it's working you can see the benefits and that kind
[30:16.160 --> 30:21.840] of thing and people talk don't be you'll talk to you know they could you pick up the phone and say
[30:21.840 --> 30:25.680] this is happening Liverpool you know there's a bit of different and that's how it works
[30:26.640 --> 30:31.280] but yeah and I think it's just putting it higher on people's priorities and up their agenda
[30:31.280 --> 30:35.440] you know what it's like everyone's really busy it's kind of a firefighting scenario
[30:36.160 --> 30:39.840] I mean especially this time of year where we're leading up to end of year budgets and there's
[30:39.840 --> 30:46.400] that crazy season of a couple of bumps so I think it's how we need to think outside the box of how
[30:46.400 --> 30:51.600] we can get it up on people's agendas because I absolutely agree evidence is key to this if
[30:51.600 --> 30:56.720] we don't have the evidence it works it won't get adopted and I think as well when we were
[30:56.720 --> 31:03.120] talking about kind of perceptions and how people see it now it reminds me a little bit of AI
[31:03.120 --> 31:09.360] when I started AXREM seven years ago AI was like I remember there was so much resistance
[31:09.360 --> 31:12.800] you know it's never going to be used it's never going to be upscaled and look at the world we
[31:12.800 --> 31:20.320] live in now seven years later and the perception of AI has completely changed and it's you know
[31:20.320 --> 31:25.360] clinicians accept it's not there to replace them it's there to create efficiencies
[31:25.360 --> 31:31.680] and that's like value-based procurement it's not there you know to create unnecessary
[31:31.680 --> 31:39.440] burden it's actually there to create long-term sustainable cost savings and better patient
[31:39.440 --> 31:46.720] pathways treatment products services for patients so I think it's just you know I see this moving
[31:46.720 --> 31:52.080] in the same direction and with AI within the space of two years everything changed dramatically
[31:52.080 --> 31:56.640] and I think because there is so much focus from the department of health and from ministers on
[31:56.640 --> 32:02.080] this I think we will see the same I think this year is the year where value-based procurement
[32:02.080 --> 32:07.200] we will start seeing it being adopted and then hopefully next year we'll start flying with this
[32:07.200 --> 32:10.720] and you know it will be standard practice and that's what we need it to be
[32:11.440 --> 32:17.200] Just maybe play a little bit of devil's advocate if I can obviously we talked about efficiencies
[32:17.200 --> 32:21.360] for the patients and efficiencies for the clinicians and Brian you mentioned about
[32:21.360 --> 32:25.360] spending money smarter and I think one of the obvious solutions I can think about is we need to
[32:25.360 --> 32:29.280] educate and communicate back to procurement teams more to say this is the part of the solutions
[32:29.280 --> 32:33.600] that you need to do but Sally's mentioned about efficiencies and getting everything done nice and
[32:33.600 --> 32:38.640] quickly in doing everything I've just mentioned in education communications and spending money
[32:38.640 --> 32:42.480] smarter means you have to slow down to think about the money you're spending do you think
[32:42.480 --> 32:46.880] there's going to be any pushback from procurement teams and say actually we need to get this done
[32:46.880 --> 32:51.440] we're going to carry on doing what we've been doing for the last many years because we've got
[32:51.440 --> 32:55.120] targets our own to hit and we need to be as efficient as possible so Brian is going to ask
[32:55.120 --> 33:01.360] you what what's the kind of response back when you said spend money smarter do you get a good
[33:01.360 --> 33:06.400] adoption or do you get people coming back to say we need to just get on and buy what we've been
[33:06.400 --> 33:14.240] buying for the last 10 years well um I quite timely so my AI I concluded my presentation last
[33:14.240 --> 33:24.000] week with adapt or AI adapt or AI because to me the if procurement don't and finance don't change
[33:24.000 --> 33:30.160] you become more strategic then they can be if you're just a transactional procurer and they
[33:30.160 --> 33:34.960] carry on doing the stuff they're doing you can probably get a little bit more of a response
[33:34.960 --> 33:42.480] probably get an AI system to do it I think the VBP is something that is more sophisticated
[33:43.120 --> 33:48.080] so I think when you're looking at how procurement operates and how finance operates if we're talking
[33:48.080 --> 33:55.120] about the innovations um with AI then yeah there might be certain roles within
[33:56.080 --> 34:04.560] in the the jobs the procurement people do and finance which can be be done through AI
[34:04.560 --> 34:09.840] then that releases time to do stuff like this you know what I mean and I think if you go back
[34:09.840 --> 34:15.280] again probably sound a bit like a broken neck really but the opportunities get even further
[34:15.280 --> 34:20.720] between now if you if you can go into some some more with some of the technologies you've got
[34:21.280 --> 34:23.840] you've got the potential to save significant numbers
[34:25.360 --> 34:29.600] you know you could be talking under the thousand of pounds in terms of benefits across the patient
[34:29.600 --> 34:35.680] pathway I think if your solutions are significant you know people will do it because that's where
[34:35.680 --> 34:41.360] the benefit is we could give you know if you want to take it probably to the ultimate stage if we
[34:41.360 --> 34:45.120] give all the products away for nothing we're still not going to save the ATS because the problems
[34:45.120 --> 34:50.400] are still there you know what I mean it's you you've got you and your members
[34:51.120 --> 34:56.400] have got loads of technologies you're in a really limited space I think it's just about trying to
[34:56.400 --> 35:01.040] get out there and have those conversations if you know what the other phrase that I regularly use
[35:01.040 --> 35:05.680] if you ask ask a better question you get a better answer I think the conversations that we have
[35:05.680 --> 35:10.880] tend to be quite you know transactional one-dimensional you know you've got you've
[35:10.880 --> 35:16.320] got an MRI scanner and what is it going to cost us everything what not like you've got an MRI
[35:16.320 --> 35:20.880] scanner how can it help us improve our patient pathway that kind of thing I think it's having
[35:20.880 --> 35:28.400] a different conversation and industry equally not being wary of having those conversations
[35:30.000 --> 35:34.080] because I tend to find what the training that I've done over the years with with the industry I've
[35:34.080 --> 35:38.000] always been dead surprised that people are quite reticent to talk to procurement I think these
[35:38.000 --> 35:42.720] sales are being a barrier and you know I mean all right I'd say I what I was a horror when I
[35:42.720 --> 35:47.120] when I worked in procurement you wouldn't want to come and see me I'm a reformed character now
[35:47.120 --> 35:51.680] but you know what I mean there's that perception about when you go in but it isn't it's about
[35:51.680 --> 35:56.480] having a conversation with them and you know explaining things in a slightly different way
[35:57.520 --> 36:03.120] and I think it's also very tricky when something isn't mandated so it's not something that they
[36:03.120 --> 36:09.520] have to do but what is really good is that it is mentioned in the procurement act so you know
[36:09.520 --> 36:16.080] it kind of has been if you like being brought into policy and legislation but it is difficult
[36:16.080 --> 36:23.280] when something isn't mandated but I do believe we are you know sort of traveling in the right
[36:23.280 --> 36:29.600] direction I want this to be a positive spin because I think we've come a long way in the
[36:29.600 --> 36:35.520] last year especially and you know some of the questions back to the Department of Health is
[36:35.520 --> 36:41.680] it's I think a lot of people at the top really get value-based procurement and understand the value
[36:41.680 --> 36:47.040] but it's not necessarily filtering down so they've assured me that there's lots of work being done in
[36:47.040 --> 36:53.520] terms of educating people within that kind of supply chain and within the procurement process
[36:53.520 --> 37:00.880] and I think if they get that right absolutely you know you guys as companies providing services
[37:00.880 --> 37:07.840] you too see the value so I think if we can gather more evidence and more case studies
[37:07.840 --> 37:14.240] to demonstrate that value and that gets pushed up the chain and you know it's getting pushed down
[37:14.240 --> 37:20.400] the chain from from government and the Department of Health and all of Brian's fantastic work then
[37:20.400 --> 37:25.920] you know the people in the middle will get to them eventually and it's just you know it takes
[37:25.920 --> 37:32.160] time you know and as we I said before the NHS is such a huge organization it's always going
[37:32.160 --> 37:36.800] to take time to roll anything out because there's lots of different trusts doing lots of different
[37:36.800 --> 37:43.760] things. Okay so I think this has been a really great discussion today about value-based procurement
[37:43.760 --> 37:50.160] so I'm going to lighten the mood slightly now and go to the dreaded quirky question
[37:51.440 --> 37:58.800] so I'm going to go to Brian first so Brian if you could invent a national holiday
[37:58.800 --> 38:05.680] what would you celebrate and why? You know what that's just the worst question isn't it?
[38:06.400 --> 38:11.360] I've got a really really boring one and then a bit of an off the road you could have a national
[38:11.360 --> 38:15.840] NHS day couldn't you? That'd be good let's celebrate the NHS you could do that
[38:16.560 --> 38:20.160] and then the other one you could have a give Brian a break day
[38:21.920 --> 38:29.440] I thought you should have a national holiday for Brian's. Brian I've been haunted by the life of
[38:29.440 --> 38:35.760] Brian I've known for years and all Brian's up and down the country should have a break
[38:35.840 --> 38:42.240] I think with the NHS one wouldn't it be great if there was I mean obviously there can't be
[38:42.240 --> 38:47.040] because there's patients in hospitals but wouldn't it be great if there was an NHS day where
[38:47.040 --> 38:51.840] everyone who works in the NHS gets an extra day off but they couldn't all be off at the same time
[38:51.840 --> 38:58.640] that's the problem. It's a funny one Brian I had actually thought the exact same thing and there
[38:58.640 --> 39:05.680] actually is a national NHS day it's not a national holiday though unfortunately but yeah July 5th
[39:06.720 --> 39:12.160] yeah so yeah my national holiday would be probably something to do with ice cream
[39:15.040 --> 39:22.560] national NHS day so we want a national ice cream holiday where we all have to have a Mr Whippy
[39:22.560 --> 39:26.800] other brands are obviously available yes and they'd have to be in the summer
[39:28.320 --> 39:32.880] absolutely and Jack what would be your national holiday if you could invent one?
[39:32.880 --> 39:38.880] I think mine's got a tie in quite nicely because my first head went to a national pub garden day
[39:39.520 --> 39:44.160] where everyone could go to the pub and there's one day where the pub gardens are all open
[39:44.160 --> 39:48.800] drinks are free are cheaper or free or we get an ice cream and you can just relax and enjoy the
[39:48.800 --> 39:53.280] sunshine. It has to be on a changeable day though because obviously the weather is not that
[39:53.280 --> 39:59.280] predictable but that's just where my head first went. I like that one Jack I think I'll go with
[40:00.240 --> 40:08.240] I was just saying I vote Jack for PM for a national pub day and also wouldn't that be great in an
[40:08.240 --> 40:13.440] industry that's really struggling with all of the economic situation to really promote it
[40:13.440 --> 40:17.760] I was just thinking as you guys were talking and mine would be national seaside day because I
[40:17.760 --> 40:22.080] love being by the sea and again I think it's really good for tourism but I feel we should
[40:22.080 --> 40:26.160] have a day there we all take the day off and we all head to the coast but I dread to think what
[40:26.160 --> 40:31.440] the RAC and AA would say about the roads that day because we'd have queues in and out of our
[40:31.440 --> 40:38.400] coastline but I'm a massive I don't pretend to go abroad and I love the nature and the
[40:39.920 --> 40:46.960] tourism in our country so I'm a huge supporter of staying in the UK and holidaying near some
[40:47.680 --> 40:51.120] seaside it's just you can't say it's going to be a sunny holiday because obviously we can't
[40:51.120 --> 40:55.840] guarantee the weather here but no really great answers and I really appreciate your
[40:55.840 --> 41:01.120] taking part in today's podcast so it's been great to have this conversation about value-based
[41:01.120 --> 41:06.640] procurement it is an important topic to talk about and we hope you found it interesting
[41:06.640 --> 41:11.200] you can find out more about the value-based procurement paper authored by Brian on our
[41:11.200 --> 41:19.600] website www.AXREM.org.uk under the resources page so a big thank you to our panel to Holly to Jack
[41:19.600 --> 41:24.480] and Brian and thank you for joining us and thank you to all of the listeners
[41:25.200 --> 41:28.320] if you have enjoyed today's podcast don't forget to hit subscribe
[41:28.320 --> 41:33.600] or feel free to share the podcast with friends