One Year On: How NHS Supply Chain Navigated a Major Hand Hygiene Supply Disruption
In April 2024, we received unexpected news that the largest supplier on our Hand Hygiene framework had entered administration. This came as a surprise, as there had been no prior warning signs.
At the time, we held only 8-10 weeks’ worth of stock, prompting immediate action to support our customers and prevent product shortages. Hand hygiene products are essential across all hospital departments, used by staff, patients, and visitors alike to maintain infection control.
We swiftly established an internal resilience working group, drawing on expertise from Resilience, Inventory, Clinical, Customer Services, Category, Governance, Communications, Supplier Relationship Management, and Voice of the Customer teams. This group held daily calls to manage the disruption.
We also collaborated closely with NHS England Resilience and the Department of Health and Social Care (DHSC) to ensure a coordinated national response.
To support affected customers, we launched weekly webinars – 25 in total – with an average attendance of 200. These sessions provided updates and gathered feedback, which helped shape our response. For example, we prioritised the transition of mental health trusts due to the increased patient safety risks associated with switching to freestanding products.
We issued an enhanced Important Customer Notice (ICN), providing proactive information that allowed customers to make the right decisions for their trusts. This was our most detailed and widely accessed ICN to date, with over 10,000 views.
Switching to alternative suppliers presented significant challenges. As the largest framework supplier, it held a 44% market share and, like other suppliers, used proprietary dispensers incompatible with other suppliers’ consumables.
Around 300 customers used its products, with each trust typically having 50,000 dispensers.
With fitters able to replace only 50 dispensers on average per day, a full national transition was estimated to take 6–9 months.
We addressed these challenges by:
- Securing additional stock through negotiations with the supplier’s entities in the US and Europe.
- Navigating regulatory hurdles to expedite approvals for additional stock.
- Working with NHS England and DHSC to develop clinical risk stratification guidance, ensuring product prioritisation was based on clinical risk and need.
- Using Global Supply Chains Intelligence Programme (GSCIP), our supply chain mapping tool, to validate alternative suppliers’ capacity to meet demand.
- Coordinating logistics through our Inventory Management team to ensure stock availability ahead of transitions.
- Creating a comprehensive data dashboard to support data-driven decision-making.
We also segmented customers by spend to prioritise high-risk and high-volume trusts. Manual tracking of product usage and switching intentions, though labour-intensive, was essential to support the transition.
Customer transitions began in June 2024. By the end of the year, 85% had completed or were in the process of switching. Today, nearly all customers have transitioned, with stock maintained throughout to ensure a safe handover.
Customer feedback has been largely positive:
- 69% felt our management of the disruption was effective.
- 61% expressed confidence in our ability to handle future disruptions.
- 79% found our communications effective, though only 41% felt well supported in switching suppliers.
- ICS managers (64%) and Customer Services (65%) were seen as effective.
- Customers valued our relationships and webinars, but highlighted the need for consistent messaging and proactive communication.
Customer testimonials:
We couldn’t have done it without you. Our trust saw the risk to patient and staff safety from this incident. We were able to mitigate immediate risks using the contingencies suggested by NHS Supply Chain. The biggest issue we had was our struggle to get meaningful engagement with a new supplier. It was at this point that NHS Supply Chain’s influence and leverage were invaluable.
Central and North West London
The country could have fallen down, but it didn’t, which is a testament to how this was managed by NHS Supply Chain.
Simon Marriott, Assistant Director of Supply Chain, Nottingham University Hospitals NHS Trust
The NHS Supply Chain team mobilised quickly, providing essential assistance, guidance and support whilst keeping trusts updated on the national position, which enabled us to update our internal stakeholders with up-to-date information.
One Lancashire and South Cumbria
Looking ahead:
We’ve taken key learnings from this experience and are implementing improvements, including:
- A new “Supply Disruption Incident Management Process” with clear roles and governance.
- A Resilience Capability Programme to upskill our teams in handling large-scale disruptions.
- Enhanced supplier financial monitoring standards.
- Exploration of universal dispenser options.
These initiatives aim to reduce the likelihood of future disruptions and improve our response capabilities.
The hand hygiene supply disruption was a challenging time for the NHS and required a coordinated and collaborative response between customers, suppliers, NHSE and DHSC. I’m proud of the pivotal role NHS Supply Chain played in supporting customers to transition to alternative suppliers, ensuring continuity of supply was maintained throughout this time and no patient safety incidents were recorded.
Tom Brailsford, Head of Resilience, NHS Supply Chain