UK diagnostics gets respite in grappling with pathology supply chain changes
BIVDA’s core group on procurement has had its fair share of preoccupations of late. These include getting to grips with the direction of the Centre for Evidence-based Purchasing (CEP – now under new head Andy Brown); the NHS’s Supplier Information Database (SID), which is now taking input from industry after a less-than-auspicious start; abuse of contracts; and managed equipment services. But they pale alongside the main issue of the last year: the NHS Supply Chain changes, an initiative controlled by DHL and Novation and designed to save the NHS £1bn ($1.96bn) over 10 years.
Speaking at the association’s spring meeting in London on April 22, BIVDA procurement WG chair Jeff Watson explained that the new contractors were aiming to replicate for the UK’s core pathology disciplines the successful national framework for imaging.
But to the relief of the delegates, he announced that: “[As of today] pathology procurement has been removed from the NHS SC calendar.” He went on: “It has been put on hold; BIVDA sees this as a very positive thing for the market in general.”
Other issues on the procurement agenda include monitoring the procurement hubs and the MMTSG – the ministerial medical technology steering group, seen as the successor to HITF, a body that BIVDA says it is “looking to get input into”. Mr Watson also noted that the Office of Government Commerce (OGC) is at present looking into the “procurement capabilities” of the DH.
BIVDA naturally also has PbR on its work programme, which Roche’s Jacqui Young described as “encouraging a better understanding of costs in the trusts”. She said PbR has “demonstrated its worth in the last couple of years, but needs more input”.
But progress is slow for pathology. The BIVDA expert group has not met for nine months, as matters are on hold for PbR for pathology. This is awaiting the findings of the two forthcoming key reports: Carter and Darzi. “Indicative tariffs are being applied by some commissioners,” she said, but added: “There will be no progress before Carter.” The review is expected to come out in support of managed networks, she said. On timings, it will be a significant time (perhaps three or more years) after Carter before PbR for pathology comes into force, she said.
DH national pathology adviser Dr Ian Barnes indicated that Carter was worth waiting for. “Good information was derived from the pilot sites that were completed 10 months ago,” he said, adding that Lord Carter of Coles had “walked the country and talked to a lot of people”. The report is now with the minister in draft form, he said, opining that the key recommendations are likely to remain intact. They will cover “a strong drive for quality, regulation, efficiency and delivery”. When will it appear? Dr Barnes seemed as impatient as many others must be. “It’s been two-and-half years of waiting: it needs to come out asap.”
On other issues, Dr Barnes mentioned a major thrust on POC in the regions, but, he wondered: Who does the accreditation? Elsewhere, a flexible approach to staffing in the labs is needed; a national test catalogue (with 5,000 entries) is in the final stages of drafting; and the NHS must review how to integrate innovation, for example, in areas such as molecular testing, tandem spectrometers and POC. “We need to move new technology along; we have been embedded in our labs for too long.”
The UK’s pathology modernisation programme has become something of a long-term project, ongoing for some ten years. “Commissioning will drive change,” he said (see Clinica No 1304, page 2), but cautioned that the impact of the Carter recommendations is as yet unknown. Echoing BIVDA chairman Jag Grewal’s session-opening remarks that “IVDs need to be valued in the marketplace, Dr Barnes was clear: “The diagnostics industry is a partner in the technology and the changes needed in pathology modernisation.”
ashley.yeo@informa.com
CLINICA 1305 May 9 2008