Driving Better Value in Northern Ireland: A Clinically Led Procurement Transformation

Eleanor Bevan-Davies, Clinical Specialist at NHS Supply Chain, was asked to support a Department of Health commissioned review in Northern Ireland.

Her involvement demonstrates the real change that strong clinical leadership can enable within procurement.

By applying GIRFT methodology, engaging clinicians across every trust, and benchmarking Northern Ireland practice against England, Eleanor helped unlock significant savings, strengthen decision-making, and shape a future model for value based procurement.

This project shows exactly why having clinical capability within NHS Supply Chain is so important – and how it delivers tangible system-wide benefits. 

I initially engaged with Mark Cheetham, Clinical Lead for General Surgery at Getting it Right First Time (GIRFT) whilst writing and developing the service specification for our Minimally Invasive Surgery 3 framework tender in October 2024  

The Getting It Right First Time (GIRFT) programme is a national NHS England programme designed to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change. The programme undertakes clinically led reviews of specialties, combining wide-ranging data analysis with the input and professional knowledge of senior clinicians to examine how things are currently being done and how they could be improved. 

GIRFT is part of an aligned set of programmes within NHS England. The programme has the backing of the Royal Colleges and professional associations. 

Northern Ireland’s Health and Social Care system (HSCNI) faces significant financial pressures, requiring a more strategic and value-focused approach to procurement. In response to the 2024 cross-cutting Trust Efficiency Review which highlighted major opportunities for commercial improvement, the Department of Health commissioned GIRFT Projects at the Royal National Orthopaedic Hospital (RNOH) to deliver a Procurement Pilot Programme.  

GIRFT Projects@RNOH offer a quality improvement process and cycle based on the core improvement methodology, which underpins the NHS GIRFT Programme – these are clinically led and look at unwarranted variation.  

The pilot focused on orthopaedic and endoscopy products – two high-spend categories identified by trusts and Northern Ireland’s Business Services Organisation (BSO), health and social care procurement function, as having substantial savings potential. 

See our Useful Links section to visit GIRFT website and read GIRFT Northern Ireland Efficiency Programme Report.

In October 2024, Mark Cheetham, invited me to join a small project team commissioned by the Northern Ireland Department of Health to review the use of orthopaedic implants, accessories, and endoscopy consumables. This initiative built on a clinical assessment of practice against national standards and aimed to identify opportunities for improved procurement and value delivery. 

My role as Clinical Lead for the project was to review the clinical procurement decision making processes and procedures for each of the five hospitals trusts in Northen Ireland, by designing a survey for face-to-face interviews and reviewing product selection and variations in practice. 

As Clinical Procurement Lead, I engaged with all hospitals in Northern Ireland, interviewing clinical decision-makers on their policies, processes, and collaboration with procurement teams at both hospital and regional levels. This work culminated in a comprehensive report detailing findings, methodology, and recommendations.

The report compared Northern Ireland’s practices with England’s purchasing models, pricing structures, and clinical engagement approaches, benchmarking decision-making against best practice. 

Key outcomes included:

• Identification of recurring annual savings of £2.7 million in orthopaedics, primarily through price alignment and reduced variation. 
• Opportunities for up to 12% savings in endoscopy consumables, equating to approximately £600,000 annually if applied across the Endoscopy Framework. 
• Recommendations for improved product standardisation, competitive procurement strategies, and enhanced use of data to support decision-making. 

Clinical engagement was central to the programmes success, with a Clinical Reference Group and specialty subgroups validating data, agreeing review bundles, and fostering shared ownership of findings.  

The report and findings were presented to David Keenan, Minister of State for Health, in late September 2025. It sets out a future model for procurement transformation in Northern Ireland, including; Robust governance, structured benchmarking, centralised data analysis, sustained clinical leadership. 

It proposes a package of actions under five key themes: 

• Governance 
• Clinical engagement 
• Commercial strategy  
• Data and benchmarking 
• Category-specific opportunities.

The review was led by Mark Cheetham (GIRFT Clinical Lead for General Surgery), Allison Beal (Programme Manager), Ed Bramley-Harker (Data and Analytics Manager), Eleanor Bevan-Davies (Clinical Procurement Lead), and Lisa Paget (Project Manager). 

Since the publication of the final report, I have facilitated discussions between the BSO and NHSSC Orthopaedic category team and the Devolved Nations management team to explore opportunities for NI to access the NHS Supply Chain`s Trauma and Orthopaedic Solutions framework for improved price alignment. Through the collaboration, BSO have also expressed interest in accessing product families through the minimally invasive surgery framework.  

This was my first experience of working with the RNOH and GIRFT team and I found them a pleasure to work with.  With HSCNI facing severe budgetary pressures, the work undertaken by the team identified both some quick wins and some areas that we hadn’t previously considered that could produce longer term savings.  It was particularly helpful to have this work carried out by professionals with a thorough knowledge of the NHS and what is possible whilst being independent of our system.  

The recommendations are now being considered and action plans developed and, while it is too early to quantify results, I`m confident that this project will result in more effective ways of using our resources with the added possibility of cash releasing savings.