Improving surgical productivity & reducing costs: Introducing a Laparoscopy Managed Service Mike Doyle Head of Procurement Tameside Hospital NHS Foundation Trust A celebration of those ‘light bulb moments’ that are transforming patient experience and care across the North West
Overview 1. Background 2. The Challenge 3. Our Aims 4. What We Did 5. The Benefits
Background Before Managed Service Implementation Limited availability of fully-functioning surgical instrumentation
The Challenge Limited availability of fully-functioning surgical instrumentation Limited capital funding available
Our Aims • For procurement, theatres management and clinicians to work together to deliver new bespoke laparoscopic instrument sets. • To deliver a revenue based arrangement due to lack of capital funding. • To ensure the right instrument is in the right place at the right time. This would lead to: • Increased efficiencies • Reduced costs • Increased quality
What We Did • The Trust developed a new `managed service` approach in partnership with B.Braun Medical Ltd. This followed an OJEU exercise to engage the market for a full end to end managed service arrangement. • Developed robust technical, logistical and commercial KPIs with clinical input. • The supplier ensures there are sufficient quantities of instrument sets available to the hospital but retain ownership of the instruments. The hospital pays a fixed monthly fee. • The instruments are removed from the hospital after every 25 uses and taken to the supplier’s technical service facility in Sheffield to be serviced, repaired, refurbished or replaced if irreparably damaged. • The instrument set is returned to the hospital within 5 working days in a “good as new” condition ensuring the total functionality of each instrument is guaranteed.
What We Did Sample KPI Punches, Bone Cutting Forceps, Pliers Test material : ATS-FF01 not correct correct Put the test material fully in the jaws of the punches or pliers (2/3 for bone cutting forceps) The test is correct if the material is completely punched or cut by closing the instrument
The Benefits After Managed Service Implementation
The Benefits Saving over Saving over Saving Area 3 Years 10 Years Bed day savings (Cholecystectomy) £ 337,500 £ 1,125,000 Bed day savings (Laparoscopic hernias) £ 129,600 £ 432,200 Single use trocars £ 468,000 £ 1,560,000 Single use instruments £ 282,000 £ 940,000 Weekend theatre costs £ 372,000 £ 1,240,000 Reprocessing costs £ 23,625 £ 78,780 Repair Costs £ 88,500 £ 295,000 Total Savings £ 1,701,225 £ 5,670,980 VAT is reclaimed under COS heading 37
The Benefits • High quality Instrumentation...guaranteed. • Costs are significantly down and expenditure is predictable. • Improved patient safety. • Leaner processes in terms of equipment sets and lay out for surgery - easy to access instrumentation. • Increased staff morale - instruments that are always fit for purpose and in the right place at the right time. • Progressively increased our day case rates. • Minimally invasive surgery has been shown to have improved outcomes.
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