NHS wastage

[Downward]

alorotom said:

V8covin said:

Contracts.
Blame the procurement departments who agree to pay over the odds..... I'm sure they get inducements from the suppliers.
Massive amount of waste goes on in the NHS,you only have to speak to someone who works on the front line to know that

This is just I'll informed historic rhetoric, the procurement towers have sorted this and regular procurement is undertaken by highly qualified teams (normally outsourced from CSUs or specialist procurement organisations) and based heavily on value and quality

[SpeckledJim]

Downward said:

slopes said:

V8covin said:

Contracts.
Blame the procurement departments who agree to pay over the odds..... I'm sure they get inducements from the suppliers.
Massive amount of waste goes on in the NHS,you only have to speak to someone who works on the front line to know that

I work in the dental industry and predictably, the NHS sends their hand pieces and equipment to us for repair and i'm not joking when i say we could almost charge what we liked and most times they would get a purchase order number for it and say go ahead.

So how would they know a cost of repair ? And if you doubled the cost what alternative would they have ?

Three quotes. Research. Shop around. The normal ways you prevent getting your leg lifted.

Or, if it’s just NHS money, just make your life easier and use whoever you like, at whatever price they ask.

[Exige77]

SpeckledJim said:

Downward said:

slopes said:

V8covin said:

Contracts.
Blame the procurement departments who agree to pay over the odds..... I'm sure they get inducements from the suppliers.
Massive amount of waste goes on in the NHS,you only have to speak to someone who works on the front line to know that

I work in the dental industry and predictably, the NHS sends their hand pieces and equipment to us for repair and i'm not joking when i say we could almost charge what we liked and most times they would get a purchase order number for it and say go ahead.

So how would they know a cost of repair ? And if you doubled the cost what alternative would they have ?

Three quotes. Research. Shop around. The normal ways you prevent getting your leg lifted.

Or, if it’s just NHS money, just make your life easier and use whoever you like, at whatever price they ask.

What do you think the cost would be of doing the above for many many low value items ?

[SpeckledJim]

Exige77 said:

SpeckledJim said:

Downward said:

slopes said:

V8covin said:

Contracts.
Blame the procurement departments who agree to pay over the odds..... I'm sure they get inducements from the suppliers.
Massive amount of waste goes on in the NHS,you only have to speak to someone who works on the front line to know that

I work in the dental industry and predictably, the NHS sends their hand pieces and equipment to us for repair and i'm not joking when i say we could almost charge what we liked and most times they would get a purchase order number for it and say go ahead.

So how would they know a cost of repair ? And if you doubled the cost what alternative would they have ?

Three quotes. Research. Shop around. The normal ways you prevent getting your leg lifted.

Or, if it’s just NHS money, just make your life easier and use whoever you like, at whatever price they ask.

What do you think the cost would be of doing the above for many many low value items ?

My point is that other big businesses manage not to overpay by 300% on their stuff. Why is the NHS different?

Oh, yup, all the money wasted has zero impact on anyone's very healthy livelihood within a country mile of the operation, so they don't give too much of a toss.

Start sacking staff for wasting money, and let's watch things improve.

(related but different point: my friends in the NHS all complain bitterly about under-staffing. But recent large increases in funding have resulted in lots more much needed staff large pay rises for the already well-paid existing staff.)

[Exige77]

SpeckledJim said:

Exige77 said:

SpeckledJim said:

Downward said:

slopes said:

V8covin said:

Contracts.
Blame the procurement departments who agree to pay over the odds..... I'm sure they get inducements from the suppliers.
Massive amount of waste goes on in the NHS,you only have to speak to someone who works on the front line to know that

I work in the dental industry and predictably, the NHS sends their hand pieces and equipment to us for repair and i'm not joking when i say we could almost charge what we liked and most times they would get a purchase order number for it and say go ahead.

So how would they know a cost of repair ? And if you doubled the cost what alternative would they have ?

Three quotes. Research. Shop around. The normal ways you prevent getting your leg lifted.

Or, if it’s just NHS money, just make your life easier and use whoever you like, at whatever price they ask.

What do you think the cost would be of doing the above for many many low value items ?

My point is that other big businesses manage not to overpay by 300% on their stuff. Why is the NHS different?

Oh, yup, all the money wasted has zero impact on anyone's very healthy livelihood within a country mile of the operation, so they don't give too much of a toss.

Start sacking staff for wasting money, and let's watch things improve.

(related but different point: my friends in the NHS all complain bitterly about under-staffing. But recent large increases in funding have resulted in lots more much needed staff large pay rises for the already well-paid existing staff.)

You sound a bit angry.

[dasbimmerowner]

Not sure it's had a mention yet, but the NHS has preferred suppliers. These aren't set at a local level rather a regional/national level. Companies pay big money to get on the the list, your local NHS orgs procurement depts then have to use these (or provide a very good reason why they're not using them) for all sorts of things. So many of these issues aren't on the ground, rather they're decisions made by those higher up to line the pockets of some very very wealthy businesses.

[SpeckledJim]

Exige77 said:

You sound a bit angry.

A bit.

Frustrated really. So much of this is unnecessary. Things could and should be better.

[Bullett]

Provided some work management software/services to an NHS back office department. To cust a long story short we found efficiency saving of close to 200%, doing double the work with half the people. Cust backlogs from 6 months to almost zero and generally improved everything.

[MikeLowry]

theguvernor15 said:

We've priced maintenance contracts for the NHS before, generally the contracts aren't cheap as there's loads of kit that breaks all the time just to sheer usage etc.
So we price the contracts accordingly to include all labour, we're fair with our parts pricing.
One of our competitors comes in & prices the labour aspect of the contract at literally a fraction of ours, then charges the parts out at 3 x RRP & any additional labour outside of the agreed contract hours at some ridiculous rate, how do i know this?
Someone i know worked in the dept. & was trying to get us to re-quote for the package, but the hospital weren't interested as it still fell within their budgets & in their eyes, if they don't use their budget to it's fullest, they lose it next time around, same as schools.

Not sure if anyone has mentioned this yet, but can someone please explain, why do such rules exist? I can understand that if they're not using the money then why should they receive it, but surely they should have the option to save it for some future use e.g. maintenance/upgrades or even staffing costs. It seems absurd that hospitals knowingly use up their budget in this way, just so that they can receive the funding to do the same again the next year!

[Monkeylegend]

MikeLowry said:

theguvernor15 said:

We've priced maintenance contracts for the NHS before, generally the contracts aren't cheap as there's loads of kit that breaks all the time just to sheer usage etc.
So we price the contracts accordingly to include all labour, we're fair with our parts pricing.
One of our competitors comes in & prices the labour aspect of the contract at literally a fraction of ours, then charges the parts out at 3 x RRP & any additional labour outside of the agreed contract hours at some ridiculous rate, how do i know this?
Someone i know worked in the dept. & was trying to get us to re-quote for the package, but the hospital weren't interested as it still fell within their budgets & in their eyes, if they don't use their budget to it's fullest, they lose it next time around, same as schools.

Not sure if anyone has mentioned this yet, but can someone please explain, why do such rules exist? I can understand that if they're not using the money then why should they receive it, but surely they should have the option to save it for some future use e.g. maintenance/upgrades or even staffing costs. It seems absurd that hospitals knowingly use up their budget in this way, just so that they can receive the funding to do the same again the next year!

At my last company we used to make sure we spent the full budget by year end even if we didn't need to.

If we didn't we knew full well that the next years budget would be cut accordingly on the basis that the Directors surmised that we had clearly over estimated our budgeting requirements for the year and would do the same for the following year.

It was all a game of bluff and double bluff.

[rossub]

dasbimmerowner said:

Not sure it's had a mention yet, but the NHS has preferred suppliers. These aren't set at a local level rather a regional/national level. Companies pay big money to get on the the list, your local NHS orgs procurement depts then have to use these (or provide a very good reason why they're not using them) for all sorts of things.

Indeed. There are 'Framework' suppliers for virtually everything, so local decisions are limited. I'm not sure the companies pay money to be on them - more a case of they are chosen by tendering favourable prices for goods.

[Blanchimont]

There's a lot of parasitic companies leaching off the NHS to make money.
Southmead hospital is a perfect example.

https://thebristolcable.org/2016/08/carillions-sou...

I know people who work in there, and they said simply things like a new internet wall port which would normally cost around £40 to connect. Carillion would charge around £300 and take 3 times a long to do it.

[rossub]

Blanchimont said:

There's a lot of parasitic companies leaching off the NHS to make money.
Southmead hospital is a perfect example.

https://thebristolcable.org/2016/08/carillions-sou...

I know people who work in there, and they said simply things like a new internet wall port which would normally cost around £40 to connect. Carillion would charge around £300 and take 3 times a long to do it.

.... and yet Carillion STILL went bust!

[MikeLowry]

Monkeylegend said:

MikeLowry said:

theguvernor15 said:

We've priced maintenance contracts for the NHS before, generally the contracts aren't cheap as there's loads of kit that breaks all the time just to sheer usage etc.
So we price the contracts accordingly to include all labour, we're fair with our parts pricing.
One of our competitors comes in & prices the labour aspect of the contract at literally a fraction of ours, then charges the parts out at 3 x RRP & any additional labour outside of the agreed contract hours at some ridiculous rate, how do i know this?
Someone i know worked in the dept. & was trying to get us to re-quote for the package, but the hospital weren't interested as it still fell within their budgets & in their eyes, if they don't use their budget to it's fullest, they lose it next time around, same as schools.

Not sure if anyone has mentioned this yet, but can someone please explain, why do such rules exist? I can understand that if they're not using the money then why should they receive it, but surely they should have the option to save it for some future use e.g. maintenance/upgrades or even staffing costs. It seems absurd that hospitals knowingly use up their budget in this way, just so that they can receive the funding to do the same again the next year!

At my last company we used to make sure we spent the full budget by year end even if we didn't need to.

If we didn't we knew full well that the next years budget would be cut accordingly on the basis that the Directors surmised that we had clearly over estimated our budgeting requirements for the year and would do the same for the following year.

It was all a game of bluff and double bluff.

But surely if you hadn't used up all of your budget then you HAD actually over-estimated? I would perhaps implement a system where the budget isn't cut immediately the following year, but perhaps reviewed with a little more scrutiny? If there are savings to be made then surely that should benefit everyone involved, both the workforce and the directors. I'm sure someone will be able to tell me why this would never work!

[Monkeylegend]

MikeLowry said:

But surely if you hadn't used up all of your budget then you HAD actually over-estimated? I would perhaps implement a system where the budget isn't cut immediately the following year, but perhaps reviewed with a little more scrutiny? If there are savings to be made then surely that should benefit everyone involved, both the workforce and the directors. I'm sure someone will be able to tell me why this would never work!

Of course we did because we knew when we presented our budgets to the board they would be looking for savings so if we over estimated by 10% and they cut them by 10% we had what we wanted, and if they didn't cut then that was a bonus.

We then had to make sure we spent that money so we didn't get cut back too much the following year.

As I said it was a game of bluff, not saying it was right but that was the way it was when working for a company turning over billions rather than millions.

[spaximus]

As others have said, companies have to get listed as a supplier before they can quote and this is where some of the problems start.

A friend had a small building company and was looking for work in the local hospital. The amount of red tape was staggering, policies on sustainability, gender equality, etc etc all irrelevant to how good or cheap he could do the job but did his company tick all the boxes.

So you end up with similar sized companies who have people to do all the tender preparation and the admin to support if they won a contract.

They could end this easily. Give all departments a budget, make sure they do what is required and if there is any money left it gets rolled over into the next year not lost. That is what they fear needing a budget that is taken away due to them doing a good job. So just let it roll along until it reaches a certain size then look at how best to absorb that in the following year.

Add a bonus in and watch them change the culture overnight

[slopes]

Downward said:

slopes said:

V8covin said:

Contracts.
Blame the procurement departments who agree to pay over the odds..... I'm sure they get inducements from the suppliers.
Massive amount of waste goes on in the NHS,you only have to speak to someone who works on the front line to know that

I work in the dental industry and predictably, the NHS sends their hand pieces and equipment to us for repair and i'm not joking when i say we could almost charge what we liked and most times they would get a purchase order number for it and say go ahead.

So how would they know a cost of repair ? And if you doubled the cost what alternative would they have ?

Lots of repair houses in the uk -just as an aside until you work in the dental industry, you have no idea just how big it is - and they are not tied to a contract, if they don't want to pay what we quote them for, we return it to them and they are free to look elsewhere. The only thing in our favour is we are a manufacturer and the only one of note left in the UK, however we still have to be competitive with independent repair houses and big corporate dealers.

[HappySilver]

16p vs £10 is comparing apples with oranges.

The 16p is what you pay over the counter, for the apples to apples comparison you would need to factor in your time to get to the chemist, the cost of that travel, the cost of ensuring you had funds in your wallet to pay the 16p e.g. had you had to make a trip to the cash machine etc. etc. Suddenly, a 16p cost could look much more like £10, appreciate that is a ridiculous way to ‘cost’ a 16p purchase but it is all those costs that are being added up to make the NHS £10.

[Dodsy]

Its the cock ups that cost most. Due to some ongoing medical conditions with both kids i Was at the local pharmacy regularly for repeat prescriptions. I learned to check the bags carefully , several times a year id have someone else's drugs included in my bag which they would then just chuck in the bin as they cant take them back. I once got a load of methodone !

Special mention for the day i turned up to collect a bottle of pills and was handed a sack. They had accidentally refilled every prescription from the last year . That all went in their drugs bin too.

[Miocene]

Turn the bloody heating down, that'd be a start! Every hospital I've been in has been sweltering, regardless of the time of year!