NHS needs it's own Amazon.

[Bollindger]

I often wondered why this has never been done.
If medical supplies were brought and stored and dispatched on an Amazon style system, that any health care facilities could access , the NHS could save Millions, even down to light bulbs and cheap paracetamol, after all if Tesco can do Paracetamol for 50p so could the NHS. Also Amazon can deliver overnight, so that would mean Hospitals would have to carry less stock.

Unfortunately the procurement system elects to use preferred suppliers. Companies compete to become preferred suppliers because once on the list they can basically charge what they want. I know someone who works in procurement. She says that they could save millions of pounds if they could buy on the open market. For example, paper and stationery, she can buy for sometimes half the price off Amazon but is unable to do so.

It's a while since I worked in the NHS but this was my experience too.

Stationary is a particularly good example of how much more the NHS pays for things. I only had one job where I was involved in ordering stationary and I couldn't quite believe how much we paid for some items, sometimes 5x as much as the same thing would cost in Tesco.

On another occasion we needed a new dishwasher for the staff room and paid £100 more from the preferred supplier for exactly the same product we could have bought from a high street chain.

On the one occasion I was involved in trialling and selecting a medical equipment upgrade I have to say the procurement department were useless. I've driven harder bargains for mobile phone contracts. They seemed utterly terrified we wouldn't chose the market leader because they were known for being quite aggressive in demanding justification for why we hadn't purchased their products. Fortunately we ran a very well organised and documented trial of several products so it wasn't difficult to evidence why there product was rejected. I could easily have summarised the decision in a couple of sentences: your product was over priced, the technology was out of date, the support and training during the trial period was rubbish and your product specific consumables were more than four times the price of your competitors which would have added 250k to the 5 year cost. Despite all that the procurement dept (a couple of grey men in cardigans, I'm not joking) really wanted us to order from the market leader to give them an easy life.

@jalisco have you enquired to your consultant about the NHS serum eyedrops programme? X

Obviously I can't speak for the whole NHS, but in the Trust I have just retired from we've been using whatever we're given for a very long time. The days of special instruments etc for particular clinicians that were common when i was a youngster disappeared many years ago. The managers have no problem saying no to anyone. I spent the last few years of my Consultant career wearing gloves a size too big as the decision was made to stop stocking my size as it wasn't cost effective for the small number of staff that needed them. Yes I "got used to it" but my dexterity was never quite as good of course, but that's not important...
Unfortunately procurement isn't always good clinically speaking, or even cost effective. There's a lot of "penny wise, pound foolish" decisions in my experience. As an example, a few years ago we had the 3M sticky tapes that we use for all kinds of things in theatre replaced with unbranded stuff. It was a lot cheaper and was supposed to save the Trust a lot of money. Except it was crap and we ended up using about 3 times as much and still having issues. So it didn't save money at all and left a lot of pissed off staff and patients in it's wake. We went back to 3M eventually, but it took a big fight.
And don't get me started on the rigmarole involved in major equipment purchases. I know there have to be rules, but when there is one market leading thing that virtually every hospital in the land uses and you have to waste time sourcing and trialling at least 3 alternatives it's very frustrating! I once had to go to the Trust Board to beg for permission to order a piece of equipment that a patient had specifically raised a large sum of money for. It was refused because we hadn't used the correct procurement process and had not considered alternatives. That would be because no other company made it at the time, but hey, due process must be followed.🙄
I'm sure it's a difficult job and that there are lots of good, hardworking people in procurement, but certainly in latter years as it became more and more centralised and inaccessible by clinicians I found it all very frustrating. We used to be able to talk to actual humans face to face but by the time I left it was like dealing with Amazon and I didn't see that as a good thing.

@AgeingDoc - that sounds really difficult, in my DH’s trust the consultants very much seem to have a lot of power over getting what they want. My DH is forever scrambling around trying to find specific things because Mr X will only use Y even if that involves overnight couriers from Scotland etc. I guess that’s a byproduct of devolving so much power to the individual trusts.

@Plumtreebob in our Trust Mr X would most likely be sent to the Medical Director for a bollocking for that kind of behaviour. Unless it was something that was actually essential to the procedure of course, not just personal preference.
I think there is probably a happy medium. Lots of things can reasonably be standardised, provided the people actually involved have input, but there are some things where individual needs should be considered.
I think our big issue is that we are a multi site Trust to start with, and then various departments like payroll and procurement are shared with another neighbouring Trust (more "efficient" apparently) and are off site. So we are all absolutely tiny cogs in a massive machine, nobody knows anyone and the "service" departments are completely divorced from the clinicians. I had all kinds of trouble getting my pension sorted when I retired. In the past I could have taken a stroll down to payroll and spoken to someone and it would probably have been easily dealt with but our payroll is in a completely different city now and I'm just a number on someone's computer. Lots of things are like that- bigger isn't necessarily best and it's one of the reasons why I was glad to leave. I never expected bowing and scraping just because I was a Consultant but I did expect to be treated like a human being.

@AgeingDoc - yes that sounds very different and not at all nice