Partnership Working with Lancashire and South Cumbria ICS Identifies Savings of £640,000 on Wound Care Dressings

Most wound care products within primary care are prescribed to individual patients via an FP10 prescription and supplied through a community pharmacy. There are several issues with prescribing wound care products via this FP10 route:

• Increasing demand and resource constraints.
• Delays in the supply of dressings to patients.
• Wide variations in clinical approach, inappropriate use of products and infection control practices.
• Poor formulary compliance leads to additional costs.
• High levels of waste.

As a result of these issues and challenges, several commissioners and providers have moved away from using the traditional FP10 route to an off-prescription direct supply solution provided by suppliers. However, supplier solutions cannot always commit to required volumes and can allow subtle pressure when promoting their dressing products.

This project was to design and implement a value-based proposition for an ‘off script’ wound care dressings solution across the Integrated Care System (ICS) Health Economy, optimising care and improving the patient experience. As well as realising the following additional benefits:

• Savings through better pricing.
• Alignment with the National Wound Care Strategy Programme.
• A consistent, clinical approach to wound care by producing a standardised ICS formulary across both community and acute settings.
• Reduced product usage at the clinician level, nurses only using the required product amount.
• Access to products clinically assured by our Patient Safety Team.
• Reduced wastage at the patient level and improvement in efficiencies and productivity.
• Better governance and control with dynamic reporting.

We worked collaboratively with stakeholders from across the Lancashire Integrated Care Board (ICB). They co-created a value proposition that enabled the region to implement the direct supply of wound care products, created an integrated regional view of spend at system and organisational level, and aligned this to agreed key performance indicators (KPIs). This proposition was broken down into a series of workstreams:

• Phase one – Co-create a shared value proposition.
• Phase two – Mobilisation included a full formulary review and standardisation.
• Phase three – Transformation focuses on incorporating a mobile eCommerce platform.

East Lancashire Healthcare NHS Trust (ELHT) was the first trust to go live with us. Weekly meetings were held with Clinicians, Procurement, and Materials Management alongside stakeholders from NHS Supply Chain following a project-managed process up to, an agreed go-live date. The onboarding was broken down into a series of managed stages with weekly meetings to maintain focus on allocated tasks. ELHT carried out a highly successful launch event attended by all suppliers with products on the agreed formulary and over 160 community nurses.

The ICS worked closely with us to produce a standardised formulary. The formulary supported the delivery of wound care products by healthcare professionals, allowing them to select the most appropriate products for their patients. Using the formulary ELHT identified savings of £140,000.

Across the whole ICS, a total of £640,000 in savings has been identified through the usage of the National Pricing Matrix (NPM) savings tool, in addition to product switching.

The storage of products are now held in community nursing hubs, where products can be readily accessed and used as needed based on individual patient’s wound requirements, thereby minimising waste.

Dynamic reporting is being provided and additional savings opportunities are communicated in monthly meetings supported by our dedicated Hospital Care Team, to continually review the formulary, identify additional savings with clinically assured products, discuss any issues and review options for best clinical practice.

This creates new opportunities for the ICS clinical teams to work directly with Category Management Service Providers (CMSP) to evaluate and feedback on new technologies and advances in wound care to improve the patient journey, leading to better outcomes and further savings opportunities.

Continued data analysis will look to establish additional savings from minimising product waste.
We are now working with other trusts within the ICS to onboard the direct supply of dressings.

If you would like further information on how we can support your ICS to move FP10 wound care dressings to a direct model, please contact our dedicated Hospital Care Team.