NHS Hospitals are wasting up to £500 million a year by paying too much for basic supplies, according to Britain’s spending watchdog.
The National Audit Office found that some health bodies are paying twice as much as others around the country for dressings, clothing and medical equipment.

In some areas, individual hospitals are purchasing 177 different types of surgical glove and putting in hundreds of small orders for A4 paper.

It comes even though the National Health Service is under orders to make £20  billion in efficiency savings over the next four years.

The NAO recommends that the Department of Health make it easier for trusts to compare the prices of products they buy, and that hospitals collaborate with each other to buy in bulk and so save money.

Because local trusts are independent of Whitehall control, the NAO says they should be held to account by Parliament to improve on the “poor value for money” they provide in procurement.

Margaret Hodge, the chairman of the powerful Public Accounts Committee, said: “It is simply unacceptable that so many hospital trusts are currently paying more than they need for basic supplies. Even for some of the commonest items, the price hospitals pay varies by more than 100 per cent.

“Too much purchasing is still done through multiple, low-value orders, which incur high admin costs.

“And the range of similar products that trusts buy is sometimes so wide as to appear ridiculous: how can it be, for instance, that while one trust does its work with just 13 different types of surgical glove, another requires 177?

“These are well-known recipes for poor value for money that really ought to have been addressed by now.”

The NAO report states that England’s 165 NHS hospital trusts spend about £4.6bn a year – a tenth of their total expenditure – on “consumables”, such as surgical dressings, drinks, staff uniforms, pacemakers and replacement hip joints.

Because there is no central system for buying these products, managers in individual hospitals make deals with 17,000 different suppliers. One trust employed 45 people in its procurement team.

Although it is “standard practice” in the private sector, health bodies are not required to give each product they buy an individual code, which would help them analyse data and reduce errors.

As hospitals do not know how much others are paying for products, and they buy items in different quantities at different times, price variation is common and the NAO estimates that up to £150m could be saved if it were eliminated. In some cases the amount paid varied by as much as 183 per cent.

In addition, NHS bodies are putting in on average 4,501 order for surgical gloves a year, and could potentially save £7m a year in admin costs just by reducing orders.

Further savings could be made by buying in bulk or joining regional “hubs” with other hospitals to make economies of scale and improve their bargaining power with suppliers.

Hospitals are also encouraged to standardise the products they use – one trust used 287 different types of tubes known as cannulas, while another bought 15 variations of A4 paper.

Amyas Morse, head of the National Audit Office, said: “At least 10 per cent of hospitals’ spending on consumables, amounting to some £500 million a year, could be saved if trusts got together to buy products in a more collaborative way.

“In the new NHS of constrained budgets, trust chief executives should consider procurement as a strategic priority. Given the scale of the potential savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices.”

The Health Secretary, Andrew Lansley, said: “We welcome the publication of this report. The more efficient the NHS becomes, the more we can invest back into patient care. That is why it’s so important for hospitals to deal with wasteful procurement.

“While it is up to local hospitals to decide how they purchase products, Government has a role in providing support and robust information. We are therefore considering launching a review to help hospitals get better value for money from procurement, drawing on the expertise of Government advisers.”

From: http://www.telegraph.co.uk/Hospitals-wasting-500m-a-year-on-basic-supplies

Whilst Health Direct applauds the NAO’s research, we know that they are under quoting the waste.

On January 11, 2011 we piublished: NHS wasting £1 billion a year on supplies when we found that the NHS is wasting more than £1 billion of taxpayers’ money a year as managers spend vastly differing amounts on the same supplies, the head of a government backed healthcare efficiency drive has claimed.

The only scientist in the House of Commons has called for all MPs to be required to take a crash course in basic scientific techniques.
Julian Huppert, a research biochemist who became the Liberal Democrat MP for Cambridge at the last election, said he was alarmed at the lack of scientific knowledge among colleagues.

In an interview with The Independent, he also accused political leaders of paying “lip service” to the importance of scientific proof and warned that looming cuts to university research budgets could provoke a “brain drain” from Britain.

Although there are other backbenchers with scientific backgrounds, Dr Huppert is the sole MP to have practised past PhD level, specialising most recently on DNA structures.

He said it was a real concern that the Commons – which is full of career politicians, lawyers and economists – lacked scientific expertise. Dr Huppert, a fellow of Clare College, Cambridge, argued that all MPs should be obliged to take a short science training course, covering areas such as how research is conducted, numeracy and the use of statistics.

“It would be really important for all MPs to have some exposure, because some of them will not have studied any science since they were 15 and it’s important to understand how to engage with it,” he said. “You would then have a lot of MPs who were able to understand the information they were being presented with.”

Accusing some MPs of being “anti-science”, he said: “They have a set of beliefs and they will argue that regardless of the science.”

Dr Huppert said political leaders tended to come up with a stance and then tried to make the evidence fit it, rather than being driven by the science. He cited the previous government’s decision to make the drug mephedrone a banned substance after claims about the role it played in the deaths of several young people.

“What we saw was a policy based on media reports, rather than based on evidence, and that does happen too much, ” he said. “As a researcher I will come up with a hypothesis, which I may talk about to people, I’ll then do some experiments and test it and will then change my hypothesis based on what I find. If you do that in politics, that’s a U-turn and a defeat.”

Although he absolved the Science minister, David Willetts, from criticism, he said a “tricky” relationship had developed between MPs and scientists. “Generally, they are two separate camps who do not communicate,” he said.

Dr Huppert gained a seat on Cambridgeshire County Council when he was 22 – the same age at which he gained his PhD. He pursued the two careers in parallel until the election in May, when he succeeded fellow Liberal Democrat David Howarth, who stood down as the MP for Cambridge to return to academia.

Dr Huppert said: “Science in some senses is what I am good at, but politics is what I care about.” He also hit out at suggestions that university research budgets could fall victim to the public spending squeeze being undertaken by the Government.

From: http://www.independent.co.uk/only-scientist-in-commons-alarmed-at-mps-ignorance

The coalition Government ignored scientific advice on the questionable value of homeopathy by continuing to allow the NHS to fund homeopathic treatment despite there being next to no evidence that it works.
Last week, health ministers refused calls from the House of Commons science and technology committee to stop the NHS funding homeopathic treatment on the grounds that such a ban would limit patient choice and contradict the Government’s stated aim of devolving more power to the Primary Care Trusts (PCTs) of the NHS.

However, the Government’s own chief scientific adviser, Sir John Beddington, said that he had spoken informally to coalition ministers about his grave concerns about homeopathy and the Department of Health’s policy of allowing it to be prescribed under the NHS.

“I remain of the view that the evidence of efficacy and the scientific evidence base of homeopathy is highly questionable. It is vitally important that the public can make informed choices on their use of homeopathy, so the evidence base must be freely available in an easily-accessible format,” Sir John said.

The Government does not know how many PCTs prescribe homeopathic treatment or how much it costs but the total annual funding is believed to run into millions of pounds.

Earlier this year, the Commons’ science committee recommended that the NHS should stop funding homeopathy on the grounds that it is a waste of money and it gives patients the false impression that such treatment works.

“When the NHS funds homeopathy, it endorses it. Since the NHS Constitution explicitly gives people the right to expect that decision on the funding of drugs and treatments are made ‘following proper consideration of the evidence’, patients may reasonably form the view that homeopathy is an evidence-based treatment,” the select committee’s report said.

In its response to the report, the Government said that it will keep the position on NHS funding under review. “However, we believe that providing appropriate information for patients should ensure that they form their own views regarding homeopathy as an evidence-based treatment,” it said.

Scientists point out, however, that if patients are told clearly that there is no credible evidence to support homeopathic treatments, this may undermine the only benefit that homeopathy is likely to provide, namely the well-established “placebo effect” where someone feels and gets better because they believe a treatment is working.

“Doctors are not allowed to prescribe an honest placebo, even if they think that is the best they can do for the patient. But they are allowed to prescribe a dishonest placebo by referring the patient to a homeopath,” said Professor David Colquhoun, a pharmacologist at University College London.

“Certainly you may feel better after the pill, because you were getting better anyway, or because of the placebo effect. That can’t justify your doctor giving a pill that contains nothing whatsoever,” Professor Colquhoun said.

“If there is no evidence that homeopathy works beyond the placebo effect, why does the Government pay for it? The answer given to that is ‘patient choice’. I dare say the patient would cheer up if the NHS paid for a bottle of Chanel No 5,” he said.

Professor Edzard Ernst, a specialist in complementary medicine at the Peninsula Medical School in Exeter, said: “If the Government is serious about putting patient choice over evidence, it not only displays a profound misunderstanding of both these issues but should then also give cream cakes to diabetics and cigarettes to someone with a lung disease.”

Evan Harris, a former Liberal Democrat MP who sat on the science select committee when it carried out its inquiry, said that the decision to continue NHS funding homeopathy by the Government is not a good start for the health secretary Andrew Lansley.

“How does the Government justify allowing treatments that do not work to be provided by the NHS in the name of choice, when it allows medicines which do work to be banned from NHS use?” Dr Harris said.

From:  http://www.independent.co.uk/government-ignored-our-advice-on-homeopathic-remedies-say-experts

The House of Commons Science and Technology Committee said using public money on the highly-diluted homeopathy remedies could not be justified.
The cross-party group said there was no evidence beyond a placebo effect, when a patient gets better because of their belief that the treatment works.

But manufacturers and supporters of homeopathy disputed the report, saying the MPs had ignored important evidence.

It is thought about £4m a year is spent on homeopathy by the NHS, helping to fund four homeopathic hospitals in London, Bristol, Liverpool and Glasgow and numerous prescriptions.

Homeopathy is a 200-year-old system of treatment that uses highly diluted substances – sometimes so none of the original product is left – that are given orally in the belief that it will stimulate the body’s self-healing mechanism.

Supporters believe the remedies help relieve a range of minor ailments from bruising and swelling to constipation and insomnia.

But the MPs said homeopathy was basically sugar pills that only worked because of faith. In medicine it is recognised that some people will get better because they believe the treatment they take is going to work.

The MPs said the NHS should not fund treatments on this basis. They argued the effectiveness was often unpredictable and involved a deception by the medical establishment.

They also warned it could lead to a delay in diagnosis if symptoms were cured but the underlying reason for them was not tackled.

The MPs also criticised the drugs regulator, the Medicines and Healthcare products Regulatory Agency, for allowing medical claims to be made.

The bar for licensing for homeopathic remedies is not set as high as for medical treatments, partly because they have been used since the NHS was set up in 1948 before the current system of regulation was brought in.

Committee chairman Phil Willis said this approval and the fact they were funded by the NHS in the first place lent the remedies “a badge of authority that is unjustified”.

But the report acknowledged there was a public appetite for homeopathy with surveys showing satisfaction rates of above 70%.

The British Medical Association said it was concerned about NHS funds being used on homeopathy and called for an official review into its effectiveness.

From: http://news.bbc.co.uk/1/hi/health/8524926.stm

The NHS should be allowed to share the benefits of “efficiencies” made by private companies who have won lucrative contracts to build and manage hospitals under the private finance initiative, according to report from the National Audit Office.
The report into the performance of PFI in the health service praises the private sector for making savings but with the NHS being asked to find £20bn in efficiencies it recommends that the government looks to recoup some of the money by renegotiating contracts – a move that would be fiercely resisted by the private sector.

There are more than 70 operational PFI hospitals in England, costing around £900 million a year and with a capital value of more than £6bn.

PFI contracts are awarded and managed by local health trusts with the private company building new hospitals and in some cases providing ancillary services such as catering, cleaning and portering.

Amyas Morse, head of the National Audit Office, says that PFI hospital contracts are generally well-managed and achieving the value for money originally envisaged but calls on the department of health to ensure that “efficiencies are sought and that an appropriate share of benefit comes back to the public sector”.

There is also some concern over the expense associated with PFI contracts. The NAO says that while catering is on average slightly cheaper in PFI hospitals, hospitals with “PFI buildings spend more on maintenance annually to keep the buildings to a specified high standard”.

The idea of taking on the private sector over the costs of PFI has been rising up the political agenda. Last year management consultants McKinsey said that since NHS contracts were written at a time of high interest rates, by simply adjusting them to today’s lower rates the government could save £200m a year in running costs.

Other experts have questioned whether enough risk is being borne by the private sector or if the end users of the buildings are best served by the contracts.

From: http://www.guardian.co.uk/uk/2010/jun/17/private-firms-hospital-contracts-nhs