Of 34 integrated care systems who responded to a survey from HSJ, only 12 had appointed a dedicated procurement lead
“ICSs are very aware of their statutory responsibilities around procurement; as they progress with their sub-ICB appointments, they will inherit some staff from former CCGs including procurement teams." Louise Patten, director, NHS Confederation’s ICS Network
The majority of integrated care systems (ICSs) have not appointed a procurement lead, an analysis by HSJ has found.
In January 2021, NHS England asked ICSs to aggregate their buying operations by April 2022, ahead of becoming statutory bodies in July 2022. Of the 34 ICSs who responded to HSJ’s survey, however, only 12 had appointed a dedicated procurement lead. Another five have appointed individuals responsible for, or involved in, procurement, but are not dedicated heads of procurement. Eight ICSs failed to respond to the survey, HSJ reported.
NHS England reported last summer that trusts were struggling to form ICS-based procurement systems. At that point, only four had nominated a procurement lead, one of a handful of “critical activities” that NHS England said providers “should undertake as a minimum” by the end of 2021. Its 34-step plan for achieving ICS procurement, released in January last year, said the process should culminate in a cohesive structure to govern procurement across each ICS, and eventually across multiple ICSs.
ICSs have been hampered by the pressures caused by Covid and staff shortages. Procurement teams have had to deal with the recent disruption in global supply chains causing delays to deliveries and shortages of certain products.
HSJ asked the ICSs what structure they have in place or expect to adopt. Twenty-eight of the 34 systems that responded said their expected structure is a work in progress.
Several said they could not name their procurement director or the procurement structure they would adopt as their governance structures and executive portfolios were yet to be finalised.
Some said the final structure would depend on the final shape of the Health and Care Bill, which gained royal assent at the end of April
Of the six ICSs that provided details of the structure they are using, two – Birmingham and Solihull, and Somerset – said they were using a hub-and-spoke model arrayed around acute providers. A third, Greater Manchester, has been running a combined procurement operation for several years and told HSJ it would continue its provider federation procurement model, in which constituent trust procurement teams “work closely together supported by a small central team”.
Lancashire and South Cumbria said it had made good progress in developing its five trusts into a provider collaborative combining back-office corporate functions in the next year or two. North Central London has “a collaborative system approach to procurement, with a programme board and organisational representatives rather than a single ICB employed lead”. North West London said its trusts were on the cusp of approving a business case for “a fully shared procurement service” called “NWL Procurement Services” hosted by Central London Community Healthcare Trust.
South East London said it was still developing its governance structures and has so far appointed people to the chair, chief executive and chief finance officer posts. Its system-wide procurement function is already served by the SmartTogether shared service, based at Guys and St Thomas’ Foundation Trust.
Louise Patten, director of the NHS Confederation’s ICS Network said: “We’ve always said that when ICSs are ratified on 1 July and take their place on the statute books this will be the start rather than the end of their integration journey.
“They are very aware of their statutory responsibilities around procurement; as they progress with their sub-ICB appointments, they will inherit some staff from former CCGs including procurement teams. This means they will have access to ready-made procurement expertise from the outset and this is something that will evolve and be strengthened further over time.”
“We’ve heard how the environment is under pressure and patient lead times are lengthening. It is essential that commissioning and procurement decisions are fit for purpose incorporating the lessons already learned not only from within but also beyond local ICSs. A dynamic, progressive and pragmatic culture needs to underpin this.”