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. Background2. The Challenge3. Our Aims4. What We Did5. The Benefits

BackgroundBefore Managed Service Implementation

Limited availability of fully-functioning surgical instrumentation

The ChallengeLimited 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.

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Sample KPI

Punches, Bone Cutting Forceps, PliersTest material : ATS-FF01

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

What We Did

The BenefitsAfter Managed Service Implementation

The Benefits

Saving AreaSaving over3 Years

Saving over10 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

•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.

The Benefits