At a time of constrained NHS budgets and competing financial demands, it’s no surprise NHS managers are turning to managed equipment services (MES). But implementing them isn’t easy. In this article, we dig deeper into some of the challenges you might face when implementing an MES and how you can overcome them.
An innovative commercial model
Managed services are already used in a variety of sectors for a range of functions; from IT and cybersecurity to marketing and payroll. And many forward-thinking NHS Trusts are using them to reduce equipment costs and improve the service they offer.
The attraction is clear, particularly for clinical specialities such as renal dialysis and pathology in which all elements of the cost equation can be included.
As the diagram below shows, an MES reduces the need to make large capital investments in equipment and shifts the responsibility for maintenance and upgrades to your provider. It also gives you access to the newest equipment with the highest specification.
Clear and tangible benefits
It’s a commercial model that is already proving its value. As everyone in the NHS is well aware, even without the pandemic, financial pressures are increasing in all areas.
Across Estates and Facilities alone there is huge demand to maintain or replace aging infrastructure. According to the most recent Estates Return Information Collection (ERIC) the cost to overcome the estates maintenance backlog is £6.5 billion alone, an increase of £0.5 billion from the previous year.
On top of this, NHS Providers are having to make do with a smaller slice of the financial pie. Despite its capital funding increasing by 25%, its share of the Department for Health & Social Care (DHSC) budget has shrunk from 80% to 60% in the five years to 2019/20.
In response, Trusts are turning to new funding models like MES. And they’re making a difference. The demand for equipment funding has bucked the upwards trend, decreasing by 34%, despite the fact equipment in a typical NHS Teaching Trust is aging rapidly. The chart below explains this in more detail.
Challenges to consider
Of course, implementing any new system into a hospital or Trust is a complex task and the process of putting MES in place can be unclear and complex to navigate. The benefits will only emerge if it is done with strong governance and a clear view of the value provided.
This is particularly important when it comes to equipment because of the crucial role it plays in the clinical services you provide.
Here are just some of the issues to bear in mind when you’re implementing an MES in your Trust:
Overcoming the challenges
Although each Trust is different, these challenges can be overcome with the right approach and the right support.
Overall, our experience of helping leading Trusts and hospitals with the selection and implementation of MES has shown us that the above challenges can be overcome by organisational alignment, strong governance and value chain thinking.
Here’s a further explanation of what this can look like in practice:
1. Select the right MES provider
A critical step. There are lots on the market and they all have different ways of structuring a contract. Look for one with a proven track record of handling a service similar to yours and engage with them as early as possible.
2. Determine scope and funding
Be clear about the scope of the contract and decide the best way to pay for the service. For example, would a regular fixed fee or a fee based on use levels be right for you?
3. Understand decision-making processes
If there is more than one organisation involved in the MES contract, understanding how they make decisions will help you shape the business case to their requirements.
4. HM Treasury compliance
This includes getting to grips with the demands of the Treasury’s business case process which you’ll need to comply with.
5. Share resources
Use the sustainability and transformation partnerships (STP) and integrated care system (ICS) operating models to your advantage. Through them an MES can be used to share resources across a region, particularly if it is focussed on a care pathway.
6. Learn lessons
Identify Trusts that have successfully implemented a similar MES and talk to them about what they learned from the experience and how they approached the challenges at hand.
7. Find a senior sponsor
The support of a leader will ensure the full engagement of your Trust. Your Trust should also put in place a governance structure with decision making authority.
8. Focus on the positives
Have a clear view of the clinical, operational, commercial, qualitative and quantitative value an MES brings. These benefits, above and beyond saving money, will help bring everyone in the Trust along with you.
9. Appoint a project manager
They’ll develop, manage and control a robust project plan and maintain the support of senior staff. They can be the difference between success and failure.
10. Robust contract management
Ongoing expert oversight of the contract will protect the interests of your Trust, ensuring you remain an equal partner and continue to realise the benefits of the MES.
Finding the best way forward
It’s not easy finding the time or resources to assess whether an MES is right for you, decide on the best way to implement it and provide the ongoing oversight it needs. That’s why bringing in outside expertise is often the best way forward.
For example, an external partner can review your current operations, identify the best MES provider and support you through implementation. They’ll prove the value of an MES with a watertight business case that’ll bring senior staff onside and create clear governance procedures to keep the provider on track.
In the long run an MES that is effectively implemented and managed will increase the time staff have to spend with patients and release more capital to invest in their care.
Get in touch
If you’re thinking about introducing an MES, we’d be happy to chat about the expertise and support we can offer.
We’ve worked with over 40 NHS Trusts in England on inventory and supply chain initiatives, from determining strategy and business case development to implementation, operation and ongoing improvement.
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