Inventory management and GS1 standards What are the implications on my role as a healthcare professional? Nicola Hall, managing director at Ingenica Solutions (www.ingenicasolutions.com) explains how GS1 standards and inventory management bring much-needed change across the entire NHS, focussing on the benefits it brings to staff. Tipping more than 1.6 million people, the NHS employs one of the world s largest workforces; and every employee contributes to the effectiveness of the healthcare system. So how many know about GS1 standards and inventory management? How many are aware they can make a contribution to its success? Whether staff are aware of GS1 standards and inventory management or not, all staff are involved in this continuous improvement programme. However unless staff are directly involved in the changes such as those working in the procurement and supply chain teams, it is unlikely that communication around these key developments has filtered across to every member of staff, particularly those in the frontline. This oversight misleads people into thinking it does not affect them, or that it does not fall under their remit. In contrast, these changes require commitment from everyone. It s not simply about nurses scanning products, it must be viewed as a bigger picture; a message which should reach the frontline. GS1 standards So what does GS1 mean? A major issue for the NHS is the inability to compare data across systems. The first step towards overcoming this is to have data standards that the sector abides to enable
healthcare professionals to view data across systems and understand what products are being used, when, where and on whom. Between a front-end electronic patient system and back end finance system, a myriad of solutions exist in every trust, which at some point touch patient information. Many hospitals have more than 100 solutions with separate coding, and, or data structures. The use of global standards enables data from these systems to be compared and or talk together, with common data for analysis. It is now mandatory for trusts to implement GS1 standards. Why is the government implementing GS1? GS1 is integral to create efficiencies as good data provides managers with real visibility of the cost drivers at the front line. Product choices, staff choices, and inefficient processes are highlighted and it provides the workforce with a real insight into how many choices and decision are costing. As the NHS becomes increasingly cost pressured, the organisation as a whole has to become more efficient in the way it runs day-to-day processes at all levels. There is always a focus on high-spend areas, traditionally theatres and departments such as cardiology. However, real progress can be gained through looking at inefficient processes and learning the lessons from how the commercial world uses first-class technology to secure efficiencies. Patient safety is at the core of this too. Being able to understand exposure on faulty products, who s at risk and where they are, alongside managing product recalls. Inventory management: what it means for GS1 standards There are three government initiatives where inventory management is a key stepping stone to help understand who, when and where products are used: track and trace, the ability to track products from the supplier to the patient; the eprocurement Strategy, making the replenishment process
more efficient and visible; and patient level costing and service line reporting, to understand the cost drivers in the NHS. Engaging the healthcare workforce The direct link between engaged staff, and better care and happier patients, has already been widely cited, and there has been an increase in employee engagement in recent years. Involving staff in the changes that GS1 standards and inventory management bring, and maintaining communicating every step of the way is vital; staff are more satisfied, efficiencies are improved, it leads to better clinical outcomes, and ultimately improves patient care. Maximising engagement A successful rollout can hinge on how engaged teams are, not only in terms of keeping them up-todate on the changes, but also helping them recognise existing issues that it addresses and opportunities it brings. The current issues that teams should be aware of here is that supply chains in the NHS lack maturity, and this has created a number of problems: Lack of stock control and visibility Wastage of consumables, and costs associated to disposal and reordering Shortage of management information Excess clinical time spent ordering and managing stock Lack of product traceability Large volumes of storage space required Inadequate control of consignment stocks
It is these issues that GS1 standards and inventory management, together, help overcome. With a dispersed, shift-based workforce, it s paramount to include everyone and equip individuals with the drive to adopt change and buy-in. Staff engagement can present a stumbling block, so regularly use a combination of communication methods to diminish barriers and ensure key messages reach everyone. Senior leadership Senior leadership plays a fundamental role in helping to break down boundaries. Senior staff must look to involve staff in the changes, and remain approachable, open and honest about the issues that GS1 and inventory management help overcome, as well as the changes to existing working patterns. Other trusts Support and networking with colleagues at other trusts who are at different stages is incredibly beneficial. This helps share best practice and gain a greater insight into what works, and what challenges to expect. It also help trusts yet to embark on the process, reach new heights in procurement practices. GS1 GS1 itself is a good source of information and advice. The website has a great deal of information including videos that demonstrate the progress achieved in hospitals across the country. Events Throughout the year national and regional exhibitions, conferences, seminars, and workshops help people gather information and share best practice. These are invaluable sources of information to keep visitors up-to-date on the latest developments. Intranet Use the intranet to publish organisation-wide messages such as a guide to the change, how it affects staff, and regular progress updates.
Provision for dialogue between intranet users encourages discussion and opinion around the topic which is also useful. Other internal communication methods Email, videos, notice boards, newsletters, and staff training present excellent ways to promote current progress. GS1 is a good source of assistance here too, and will send a representative into hospitals to provide an in-depth view of the key points. This allows trusts to appoint a GS1 champion to communicate messages throughout the organisation. Social networking Different staff respond to different communication channels so consider social networking. Twitter, LinkedIn and Facebook present opportunities to both find out more about GS1 and inventory management. Healthcare & supply chain media Specialist healthcare publications, as well as those produced for supply chain and procurement professionals are good references for up-to-date news and developments. Department of Health Although the Department of Health has initiated demonstrator sites and has awarded funds to six hospitals for the development of their system to meet GS1 standards and the requirements for inventory management, this means that other trusts still have targets to meet and currently no funding to do so. So what is the Department of Health proposing to do for the rest of the trusts, as they do not expect the rest of the trusts to pause waiting for the demonstrator sites to be available? Certainly more advice, information and support is required, perhaps the Department of Health would have been better placed funding a GS1 consultant to each trust for the next two years?
What s in it for me? Whilst procurement teams are fully aware of the implementation of GS1 standards, views and opinions of clinicians vary considerably, largely because the key messages have not reached them. Whilst some back the changes and acknowledge that it s a positive step forward for their roles, it s clear many frontline workers remain confused and uninvolved in the developments. One of the reasons this may be getting overlooked by clinicians is the belief that it s not my job. Although it is a procurement exercise, clinicians have just as important a role to play as the procurement teams in the future of the strategy. Importantly they need to realise the eventual power of being able to link product selection to patient outcome, so discussions on price are more about long term value to the NHS and patient. The mechanics of being able to get to that point start with the initiatives of track and trace today; clinicians at all levels are critical to the success of this initiative, and evolving new way of ensuring their choices are the best for the patient and also working with the procurement functions. More than this, with an aging population, the NHS and the staff within it are under unprecedented pressures, both financially and being able to supply services to meet demand. We are entering the worst time of year when winter pressures take the NHS to the limit. Funding a spiralling budget for the NHS is a challenge for any political party, and the NHS has to become savvier about how it works, and use the best technology to ensure money is not wasted and instead used on looking after people. The benefits to staff include: Power of data It enables healthcare professionals to access reliable and robust data to make more informed decisions, and perform their roles more effectively and efficiently. It also minimises the risk of errors which benefits patient safety.
Improves processes Former approaches used to manage hospital supplies are now redundant. Innovative technology has transformed the entire process, enabling great strides in terms of efficiency. Returning to the frontline Clinicians want to spend time with patients, not ordering or form filling. In terms of replenishing products required for instance, approaches were often heavily manpower reliant. In fact, a number of studies indicate that up to 25 per cent of nursing time is spent in managing supplies and reordering. Frontline staff would have to put aside significant amounts of time to fulfil largely admin-related tasks, such as ordering and collecting stock, however GS1 and inventory management now reallocates these duties to procurement teams which frees up frontline staff to spend more time with patients. More organised working environment In theatre departments, clinicians historically stored their own supplies, however this is no longer necessary. The physicality of a trust plays a huge impact on the management of supplies. Some have centralised stores rooms and large new PFI buildings, many still work in old Victorian buildings with a lack of storage space; reducing stock on the shelf and managing it more efficiently creates a cleaner, more effective and organised working environment. Innovative approach Trusts are recognising the need to adopt innovative processes, practices and products to take a leap forward. Some of these changes are not huge, yet have a large impact, and require staff to take ownership and get involved. Working for a trust that fosters new innovative approaches is motivating and exciting, and presents an element of kudos within the industry.
Part of the bigger picture There is enormous pressure to reduce expenditure without reducing the standard of patient care, and one of the most effective ways to achieve this is by getting procurement into better shape; reducing wastage, minimising the risk of fraud, cutting costs Everyone is part of the bigger picture, to not only help individual departments improve, and their trust, but the NHS as a whole. The right technology The NHS is notoriously bad at assigning buying technology; there have been some large and well publicised failures. It is so important that the choices made around the solutions for managing and replenishing inventory are well informed. The clinician tends to look at cabinet solutions favourably as it also gives them organised storage (and storage is always an issue) but the technology is outdated and so are the processes, and could never grow into more advanced supply chain processes that could gain further savings. Failed cabinet installations are prevalent, and the capital expenditure is significant. A further issue is solutions coming on to the market that are in the early stages of development, they are cheap for that very reason, and procurement professionals fall into the trap; these options are not cheap in the long term, and waiting for development delays savings. To avoid this scenario, look to select the technology base well; ensure it s modern, maintained and understand where that technology will be in 10-15 years time. Also consider the experience of the team and look to a technology partner rather than a supplier; someone to work closely with to make sure technology is put to the best use.
Conclusion Inventory management and GS1 standards are a catalyst for change, and to enable the NHS to act smarter with budgets, and become truly world class, innovative technologies are at the heart of these changes. It affects, and improves the day-to-day roles of the entire NHS s workforce; even if they don t know it yet.