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delivering value to the NHS Delivering value to the NHS 1 © NHS Shared Business Services Ltd 2011 Supplier Forum 14 February 2011
delivering value to the NHS 2 © NHS Shared Business Services Ltd 2011 Objectives of the day Provide more information about NHS SBS and how we work To gain an appreciation of some of the issues suppliers to the NHS face To facilitate a forum for sharing of ideas To enable feedback of concerns To facilitate the ongoing sharing of information To identify improvements and ways in which we could all work better to make this happen
delivering value to the NHS 3 © NHS Shared Business Services Ltd 2011 Steria & Department of Health - a unique joint venture Original shared service centres NHS experienced people Oracle EWA Financial support Management & Business Devt Service optimisation Best practice Offshore capability Commercial expertise saving the NHS £250m over 10 years = 12,500 additional nurses Unique 50:50 JV Commercial organisation Joint governance Customer focus Best practice World Class cost savings Surplus
delivering value to the NHS 4 © NHS Shared Business Services Ltd 2011 About NHS SBS Core Service Lines: Finance & Accounting Payroll & HR Family Health Services Commercial Procurement Solutions Typical savings for Trusts of between 20% and 40% Employing 1,430 people, including 670 in India 40% of NHS organisations are NHS SBS clients 27m people in England have NHS care from NHS SBS clients
delivering value to the NHS 5 © NHS Shared Business Services Ltd 2011 Integrated Delivery model Integrated delivery – India : UK working together in a joined up approach as “One team” Multi shift operations - 17 hours working window - Early morning working – job ready before NHS trusts staff arrives in office Dedicated offshore transition team – cost efficient, understands offshore challenges and requirements
delivering value to the NHS 6 © NHS Shared Business Services Ltd 2011 Customer Profile 130 Finance & Accounting clients Over £31 billion payments / per annum £12 billion of NHS debt recovered per annum 60,000+ trained users on the Oracle system 57 Payroll & HR clients Paying 200,000 NHS employees Processing 2.5 million payroll transactions per annum Extending into HR Shared Services 16 Family Health Services clients NE London sector – seven Trusts East Midlands region – nine Trusts 50 Commercial Procurement Solutions clients
delivering value to the NHS 7 © NHS Shared Business Services Ltd 2011 Voice of the Customer: “would recommend NHS SBS” 2008 YES: 80% NHS Directors of Finance & HR YES: 85% 2007 YES : 39% YES: 95%
delivering value to the NHS 8 © NHS Shared Business Services Ltd 2011 NHS SBS - World Class Hackett Global Benchmark Hackett Value Grid TM High Low High 1Q1Q 1Q1Q Other Companies in 2010NHS SBS Effectiveness Efficiency World Class
delivering value to the NHS 9 © NHS Shared Business Services Ltd 2011 Summary NHS SBS on target to achieve savings for the NHS of £250m over 10 years and play a role in delivering QIPP back office targets NAO verified at least £50 million cost savings to the NHS so far Estimated revenues of around £53.4m in 2010 (12.6% growth) a successful and profitable public/private sector partnership Leveraging NHS SBS capability will result in far greater savings to the NHS NHS SBS can be a key facilitator of change in the NHS – GP consortia, GP commissioning, smooth transition to new landscape £1.06m royalty fee shared with NHS SBS clients in 2010 (in addition to cost and efficiency savings already achieved by NHS Trusts), and expect to do the same in 2011
delivering value to the NHS Delivering value to the NHS 10 © NHS Shared Business Services Ltd 2011 GP Commissioning
delivering value to the NHS 11 © NHS Shared Business Services Ltd 2011 “...the biggest planned overhaul of the NHS in England in its 63-year history ” 19 January 2011
delivering value to the NHS 12 © NHS Shared Business Services Ltd 2011 Aims of the proposed changes The main aim of the change is to put patients at the heart of everything the NHS does; focus on continuously improving those things that really matter to patients - the outcome of their healthcare; empower and liberate clinicians to innovate, with the freedom to focus on improving healthcare services To do this certain admin functions are being removed putting the control into the GP Practices, who will become part of a local consortia There is also a review of the Arms Length Bodies such as NHS Direct, NHS Information Centre
delivering value to the NHS 13 © NHS Shared Business Services Ltd 2011 Expected timeline April 2011 April 2012 April 2013 April 2014 PCT Provider Services ALB’s & SHA’s PCT Commissioner Services All trusts become foundation trusts Services to move to a new home Organisation disappears Gain Foundation status or cease to exist Organisation disappears
delivering value to the NHS 14 © NHS Shared Business Services Ltd 2011 Commissioning will have 3 Main Pillars National Commissioning Development Programme National Commissioning Board GP Commissioning Consortia Commissioning Support
delivering value to the NHS 15 © NHS Shared Business Services Ltd 2011 GP Practice / NHS Link
delivering value to the NHS 16 © NHS Shared Business Services Ltd 2011 Leading people Leading a consortium Serving a local community Leading Commissioning Leading improvement & innovation Managing selfForging partnerships Partnering with patients & the public Engaging professionals Promoting research & development Leading a teamBusiness leadership Partnering with local authorities Setting prioritiesContinual quality improvement Setting visionMedia & communication Partnering with providers Shaping demandPromoting sustainability Leading changeHorizon scanning Evaluating population needs Designing services GovernanceProtecting & promoting health Leading contracting Market shaping Sharing commissioning
delivering value to the NHS Delivering value to the NHS 17 © NHS Shared Business Services Ltd 2011 Review and Comments
delivering value to the NHS 18 © NHS Shared Business Services Ltd 2011 The business of care
delivering value to the NHS 19 © NHS Shared Business Services Ltd 2011 Patients: Choice of practice & provider Practices: Holder of contracts with provider and consortia Consortia: Co-ordinate healthcare development and acute contracting for practices – manage risk pool Reg Health Board: Award Primary Care contracts and assess performance and healthcare with ties to local authorities and public health Care Providers: Deliver care to tariff Manage input prices/costs Health Industry: Supply goods, medicines, equipment, staff And provide managed services The health market choice, commerce and care
delivering value to the NHS 20 © NHS Shared Business Services Ltd 2011 With healthcare organisations facing structural change to align activities to meet healthcare business objectives and pressures……. Challenges and opportunities balance out Income suppressed in line with demand - QIPP and CIP challenges – Costs and risks from block contracts - Greater market competition and choice Increased scrutiny of procurement decisions Increased opportunity for focused optimisation of spend as commercial lever - freedom for collaboration and partnering - greater use of service/supply contracts - rewards for high performance - growth in private patient business
delivering value to the NHS 21 © NHS Shared Business Services Ltd 2011 CPS - translating these challenges into simple service offers to meet healthcare business objectives Systems to direct and manage caresupplies, drive costs down and manage risk Insight to define, design and deliver improvements in care, and business process and performance, driving income
delivering value to the NHS 22 © NHS Shared Business Services Ltd 2011 Procurement and SBS CPS solutions focus on understanding the management of costs, and focus on care Cost of population health utilisation Cost of patient pathway Cost of medicines management Cost of purchasing Cost of provider performance and quality Cost of outcomesCost of the business
delivering value to the NHS 23 © NHS Shared Business Services Ltd 2011 Understanding our costs and spend Contracting compliantly to secure supplies, and drive value Purchasing processes and systems to support day to day operations Financial and accounts systems to manage transactions Tailored Procurement and contracting solutions for bespoke needs The SBS Commercial Procurement Solutions The business cycle driving our services
delivering value to the NHS 24 © NHS Shared Business Services Ltd 2011 SpendContractCataloguePurchasePayPerform The SBS Commercial Procurement Solutions process aligned services
delivering value to the NHS 25 © NHS Shared Business Services Ltd 2011 Optimising Spend Services: Spend analysis and profiling Legally compliant routing and aggregation Optimisation analysis Procurement Services: Contract & framework portfolio Contracting calendar SAP Supplier catalogues Procurement : Spend analysis tools Etendering tools Evaluation tools Catalogue & P2P systems Commercial services: Procurement & contracting project management Contract management services Inventory management SBS group interests CPS – Products and services for business challenges.
delivering value to the NHS 26 © NHS Shared Business Services Ltd 2011 Spend Spend capture and data cleansing & coding Spend profiling Spend & price benchmarking Spend matching Contract Strategic sourcing opportunity assessments Spend mapped to frameworks and contracts to secure supply and value Rolling contracting programme Enhanced contracting through national competitions and SAP Managed contract performance and SRM Catalogue Catalogues of suppliers/products and prices Maintained database Integration service with trust systems Links to spend benchmarking services and P2P The SBS CPS strategic sourcing `contracting’ offer
delivering value to the NHS 27 © NHS Shared Business Services Ltd 2011 Analysis of spend data Data mapped to contracts and frameworks Procurement plan to aggregate volumes and shape markets Volume committed contracts and catalogues Purchase to pay systems providing compliance, control and focused spending Strategy steps in increasing spend management Spend Under Management Benchmarks*: Laggards 30% - Industrial average 30-70% - Best in class 70%
delivering value to the NHS 28 © NHS Shared Business Services Ltd 2011 ReduceIncrease Best practise pathways Product standardisation Use of economies of scale Clinical variation Spend fragmentation Trust objectives
delivering value to the NHS 29 © NHS Shared Business Services Ltd 2011 Reduction in variation, improved performance Aggregation of demand, driving value Managed compliance, supporting control All NHS £ Strategically spent and levered for value The vision for managed spend
delivering value to the NHS 30 © NHS Shared Business Services Ltd 2011 SAP Mini Competitions – Specific Agreements Framework Agreements Spend refined, aggregated and commited over time All NHS expenditure covered by Frameworks/Contracts
delivering value to the NHS 31 © NHS Shared Business Services Ltd 2011 Capacity Review RationalisationStandardisation Market engagement Procurement Contracting commitment Mobilisation Compliance commitment Delivery The SAP pathway – The route to business performance and savings
delivering value to the NHS 32 © NHS Shared Business Services Ltd 2011 Product Phase 1 Pathway Phase 2 Innovation and Continuous improvement Phase 3 SAP Process Project team; CPS, DOFS, SBS, Clinicians Supporting; Procurement, Business partners Project team; CPS, AQuA, NICE, MHRA, NPSA, Clinicians Supporting; Procurement, DOFS, Business Partners Project team; Clinicians, Strategic Suppliers, NICE Supporting; CPS, MHRA, NPSA, Business Partners Analysis - Review Spend data - Benchmark Pricing Pathway Efficiency Review -Review processes in pathway -Product use for patient/ task Deliverables -Efficiency, savings, innovation -Full Standardisation Product Validation -Developing exact specifications -Evidence based selection Selection of Strategic Partner -Drive product development -Deliver further efficiency and utilisation savings Pathway workstreams -Pathway Product workstreams -Patient Level Costing Product efficiency -Demand management - Right product for patient/ task Innovation and improvement -New product development -Implementation of innovative products Savings and benefits delivery -Establishment of ongoing KPI’s and targets Clinical Review -Share clinical expertise -Consider NICE guidance Procurement -Procure with commitment - Initial Standardisation Implementation and savings - Implement contractual outcome
delivering value to the NHS 33 © NHS Shared Business Services Ltd 2011 Framework Agreements Catalogues Strategic Advantage Programme Security of Supply EU compliant procurement Aggregation of expenditure Supplier details Product Pricing Invoice Matching Link to eprocurement Supplier Rationalisation Product standardisation Contracted Volumes Driven compliance 1.We will support securing supplies, procuring compliantly, and in optimising your spend volumes. 2.We will ensure there are business ready catalogues for organisations to use in operational purchasing 3.We will continue to move frameworked volumes, committed customers, and commercially responsive suppliers closer together through continuous SAP rounds.
delivering value to the NHS Delivering value to the NHS 34 © NHS Shared Business Services Ltd 2011 Getting Invoices Paid
delivering value to the NHS 35 © NHS Shared Business Services Ltd 2011 Purchase to Pay Four Locations 350 Staff Oracle i System 55,000+ End Users eProc Procurement
delivering value to the NHS 36 © NHS Shared Business Services Ltd 2011 Purchase to Pay 4.5 M AP Transactions £31B Payment Value £6B Procurement 3.75 M Scanned Invoices 300,000 / 450,000 Electronic
delivering value to the NHS 37 © NHS Shared Business Services Ltd 2011 Purchase to Pay 5% Returns 25,000+ Payments Runs 175,000 Suppliers 40% PO 60% Non PO
delivering value to the NHS 38 © NHS Shared Business Services Ltd 2011 AP Overview Paper and electronic Post and Scanning Paper documents Verification Rules engine Non PO
delivering value to the NHS 39 © NHS Shared Business Services Ltd 2011 AP Overview Notifications PO Automated Payments Compliance Supplier
delivering value to the NHS Delivering value to the NHS 40 © NHS Shared Business Services Ltd 2011 Questions
delivering value to the NHS 41 © NHS Shared Business Services Ltd 2011 Communication Clients SBS Suppliers 175,000 suppliers 55,000 users 350 staff System Outbound Inbound Reporting Statements Web
delivering value to the NHS 42 © NHS Shared Business Services Ltd 2011 Action or Information? All calls recorded Case record created Query or follow up undertaken Automated log When Why What How Process fix Follow up Case closed Action Request Fix Query Client
delivering value to the NHS 43 © NHS Shared Business Services Ltd 2011 Two way communication You don’t tell us when it has gone wrong You don’t tell us when it was resolved The client told me………. What dispute?
delivering value to the NHS Delivering value to the NHS 44 © NHS Shared Business Services Ltd 2011 Lunch
delivering value to the NHS 45 © NHS Shared Business Services Ltd 2011 Communication Self Help Improved support system for Service Desk Auto information responses Statement production Customer Focus Groups 5 Queries Overview of Invoice Status Consistency of communication Across suppliers Across systems
delivering value to the NHS 46 © NHS Shared Business Services Ltd 2011 Process E- invoicing solutions being investigated Root-cause analysis with clients and suppliers Process standardisation initiative E-invoicing ed invoices ADI files, etc Invoice cost Consistency of approach
delivering value to the NHS 47 © NHS Shared Business Services Ltd 2011 Service Context Forum on-going activity Linked-in/huddlespace Procurement Planning horizon being developed by CPS Knowledge about NHS SBS and the wider context NHS SBS as a framework?
delivering value to the NHS 48 © NHS Shared Business Services Ltd 2011 Objectives of the day Provide more information about NHS SBS and how we work To gain an appreciation of some of the issues suppliers to the NHS face To facilitate a forum for sharing of ideas To enable feedback of concerns To facilitate the ongoing sharing of information To identify improvements and ways in which we could all work better to make this happen
delivering value to the NHS Delivering value to the NHS 49 © NHS Shared Business Services Ltd 2011 Close
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