Improving Catheter Care Through Value Based Procurement: A Success Story from University Hospitals Plymouth

Urinary catheterisation is a routine yet high-risk intervention, often associated with complications such as catheter-associated urinary tract infections (CAUTIs). In response to clinical concerns around variation in products and practice, we partnered with University Hospitals Plymouth and the catheter supplier, utilising NHS Supply Chain’s frameworks to deliver a clinically-led, Value Based Procurement (VBP) initiative.

This programme aimed to:

• Improve catheter management.
• Reduce CAUTIs.
• Standardise care delivery across the trust.

Frontline leadership from the Lead Nurse Specialist at University Hospitals Plymouth, in collaboration with our Care Pathway Team and an NHS supplier, played a pivotal role in driving this project’s momentum. Establishing a shared understanding of financial modelling and validating assumptions with clinical data, ensured alignment with system-wide goals and enhancing both accuracy and relevance.

See our Useful Links section to see how this approach worked in practice at the University Hospitals of North Midlands NHS Trust, the pilot case study trust.

Improving urinary catheter management is a shared challenge across the NHS, impacting patient safety, discharge efficiency, continued care, and clinical workflow. University Hospitals Plymouth has demonstrated how collaborative working can drive meaningful change, setting an ambitious target to standardise catheterisation protocols trust wide.

Recurring issues were identified through engagement with community colleagues and ward staff. Patients discharged with urinary catheters frequently experienced complications, often requiring follow-ups with District Nursing teams, GPs, or Emergency Departments.

These concerns highlighted:

• Lack of standardised catheter products.
• Limited staff knowledge of discharge protocols.
• Fragmented access to equipment across wards.

A small internal audit confirmed these issues were widespread. Our Care Pathway Team supported the trust in identifying CAUTI reduction as a strategic VBP priority.

Traditional catheterisation often requires sourcing items individually, which can lead to inconsistencies in practice and delays. These factors increase the risk of infection, with CAUTIs being a major contributor to hospital-associated infections (HCAIs), costing the NHS an estimated £2.7 billion annually.

The solution, an all-in-one Foley catheterisation system designed to streamline both insertion and re-catheterisation includes:

• Pre-connected Foley catheter.
• Drainage system.
• Sterile gloves.
• Cleansing solution.
• Lubricating gel.
• Waterproof drape.

This closed system supports best clinical practice and aligns with national infection prevention guidelines. It improves patient safety, reduces variation, and saves clinical time, making it a valuable tool for NHS trusts seeking to enhance catheter care.

The initiative began with a simple but powerful question: “What catheters are we using?” This sparked a deeper investigation into clinical practice across the trust. A Clinical Specialist Nurse partnered with the Functional Urology Consultant, a Clinical Nurse Procurement Specialist, the Category Manager, and engaged with our Care Pathway Team to conduct a comprehensive audit across seven wards. Their expertise in product supplies, negotiation, and working with suppliers proved invaluable.   

The collaboration enabled an experienced supplier nurse to audit catheter use, staff knowledge, and management practices. This provided a clear view of current performance, highlighting best practices and areas for improvement, focused on enhancing patient outcomes and staff experience. 

A comprehensive audit across seven wards revealed:  

• Inconsistencies in product use.
• Varying levels of clinical knowledge.
• Gaps in documentation.
• Examples of best practice, such as exceptional catheter stabilisation techniques.

Armed with this data, the team influenced practice, improved outcomes, and embedded continuous improvement through seeking a supplier capable of supporting the trust’s wide product standardisation. 

• £230,000 projected annual cost avoidance.
• 80% trust-wide implementation of consistent catheter care protocols.
• Reduced variation and standardised best practice.

What truly sets this initiative apart is the unprecedented speed of implementation. Achieving rapid adoption of standardised protocols across such a large scale is almost unheard of in projects of this complexity. This success is a testament to exceptional clinical engagement and an unwavering collective commitment to patient safety.

A key factor in this achievement was the strong collaboration led by procurement and clinical procurement colleagues. Working closely with suppliers, NHS Supply Chain, and the warehouse team, they coordinated existing product stock while managing demand for new product lines. Through joint planning and seamless execution, the team ensured the right levels of new stock were available throughout the two-week implementation phase, minimising supply risks and enabling uninterrupted patient care.

This programme exemplifies how clinical leadership, data-driven decision-making, and multi-stakeholder collaboration can enhance care quality. NHS supplier collaboration built on mutual respect and open communication have delivered practical solutions to common clinical challenges. Importantly, this is not a one-off initiative but part of a sustained cycle of improvement and surveillance.

See our Useful Links section to watch University Hospitals Plymouth’s Catheter Care video.

By engaging staff, auditing practice, and maintaining open dialogue with industry partners, the trust has:

• Improved catheterisation processes.
• Enhanced patient care.
• Ensured smoother discharges.
• Reduced variation across wards.

The role of our Care Pathway Team has been key in supporting trusts to move beyond product switches toward strategic, patient-centred change. Their expertise in clinical engagement, financial modelling, and strategic procurement is helping NHS organisations unlock measurable improvements in patient safety, efficiency, and Value Based Procurement delivery.

If your team is exploring ways to improve catheter care or would like to explore other VBP opportunities, please connect with our Care Pathway Team.