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An easy route to better patient safety

Sentient Health : 10 September, 2010  (Special Report)
Joel Haspel, Chief Executive Officer, Sentient Health, looks at the issues relating to poor stock control and the significant impact it can have on patient safety and cancelled procedures.
There is a huge government push to focus on delivering cost savings across the NHS – but it should not be to the detriment of patient safety. Haspel advises Trusts how to ‘take stock’ and ‘take control’ and realise the significant cost savings that can be achieved through better stock control.

Recent events

This year alone Sentient Health found out-of-date medical supplies on the shelves at five hospitals. In recent months there have been a spate news stories which show that issues about materials and equipment are of growing importance. Medics at Bromley’s Princess Royal University Hospital have complained that ‘crude’ cuts have led to items running out including sealed chest drains, epidural packs and gynaecological and radiological disposables. In Scotland, the Healthcare Environment Inspectorate (HEI) reported that Caithness General Hospital’s maternity unit held out of date sterile medical supplies, some of which expired in 2002. Then there was the GS1 UK Healthcare survey, carried out in conjunction with Nursing Standard magazine, which found that 63 percent of nurses and 56 percent of doctors put real-time views of stock levels in the top three on their IT wish lists.

The impact of poor stock control

As an age of austerity dawns across the healthcare sector there are naturally concerns that these kinds of problems will get worse because the money won’t be around to solve them. And, to be frank, that’s exactly what might happen. If so we can look forward with some trepidation to an increasing number of news stories about operations being cancelled due to equipment shortages, or staff having to rush to other hospitals to get basic supplies. Hospital managers will try to explain that they are doing their best, but there will be precious little sympathy when a mum and dad are saying that the drugs or equipment weren’t available to treat their child. Then we will naturally get into the territory of whether the UK government and devolved administrations are providing enough cash. However, I would argue that much can be done to avoid this kind of scenario.

How to take stock

When hospitals invite us in to do what we call an Evidence Based Savings (EBS) assessment we look at what they have in stock and how it’s stored. At that point we sometimes have staff telling us that more space is needed and they are thinking about converting things like nurses’ areas for storage. Closer inspection often reveals that about 20 percent of what’s on the shelves is stuff that for a variety of reasons – for example it’s a product they no longer use – can be removed. Sometimes we find items which have passed the use by date. What’s needed is a thorough clear-out. It may not always solve the space problem but it helps and it certainly improves patient safety. Some of the old stock can even be used for training rather than just binned. But it has to be separated out so there’s no risk of it getting near patients.

Getting rid of clutter also helps address a frequent complaint that staff end up wasting time because they can’t track down what they need. But this is just the start. Once you have got a handle of what’s overstocked and, more crucially, what’s understocked, you can start making rapid gains that will pay for themselves. Most of the problems come about because the stock control and distribution systems at hospitals either do not exist, or are obsolete. They have not exactly been at the top of the priority list for organisations having to focus on pushing down waiting times and meeting umpteen other targets. So it is not, repeat not, a problem of poor management. Quite the opposite! Managers, clinicians and everybody else know full well that there is a real need to deal with supply chain management.

Realising the benefits

Identifying the problem is one thing, finding and implementing the solution is quite another. An EBS assessment by our team, or equivalent in-house exercise, to look at exactly what’s being ordered, and why, is a vital first step. All too often the purchasing process is unquestioning – regular orders go in and supplies turn up, but some remain unused and stock builds up. Alternatively, when something is used a replacement is ordered regardless of whether it’s actually needed. It’s not the fault of any individual; it’s simply that they are stuck with old-fashioned, often paper-based systems that belong to a past era. Healthcare is now so complex, demanding such an enormous variety of equipment and materials, that such systems are simply not fit for purpose.

The good news is that if IT is good for anything it’s for stock control. Our systems, for example, tell you what’s in stock and where it is, following it through the supply chain from receipt storeroom to patient. That gives immediate control over ordering and distribution, driving down costs by cutting waste and raising efficiency by making sure that the surgeons and maternity ward staff have what they want at the moment it’s needed. As treatments improve and more of us live longer the challenges facing the NHS grow ever more daunting. So if I were a health minister, or the chairman of an NHS trust or board, I’d be looking closely at supply chain issues right now as they offer something very rare – an easy win which pleases staff and benefits patients.


HEI report: Announced Inspection Report - Caithness General Hospital

Bromley story: Cash crisis in NHS leaves patients lying on operating tables

Caithness: Maternity ward supplies eight years out of date

Caithness: Expired supplies found in hospital

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