Responding to Covid-19
Managing essential NHS business services during a pandemic
With the resilience of its services tested to the extreme by Covid-19, NHS Shared Business Services (NHS SBS) worked with NHS England and NHS Improvement (NHSEI), and provider trusts across the country, to ensure that - despite a huge increase in demand - essential services were uninterrupted, helping the NHS focus on the clinical response to the pandemic.
Following government guidance and to protect the health of employees, almost all of NHS SBS's 900 UK office-based staff were set up to work from home by the end of March 2020.
Whilst fulfilling such a major undertaking in just two weeks, NHS SBS also needed to maintain the critical services it provides for the NHS. This included more money being moved around the NHS than ever before, record numbers of payments to ensure vital goods were delivered to NHS hospitals, and an influx of new and existing NHS workers being paid correctly and on time.
In response to the sudden closure of offshore sites by the Indian government, many NHS SBS employees were also reassigned to maintain high standards of service to more than 100 NHS providers and arm's length bodies, and every NHS commissioning organisation in the country.
Critical to the entire NHS pandemic response was the necessity for NHSEI to get money quickly to where it was needed across the NHS.
An NHSEI finance lead explained:
"To respond to Covid-19 we needed to rapidly change our payment operating model to speed up the cash flow to NHS providers. NHS SBS helped to facilitate this major change successfully within a few days."
As the beginning of the pandemic also coincided with a significant CCG (Clinical Commissioning Group) merger programme, the two organisations worked tirelessly to ensure that - despite the challenges of working from home - crucial deadlines were not missed.
An NHSEI systems lead said:
"The pandemic timing was at the most critical point and was the highest number of mergers that we enacted to date. A huge investment of time and effort had been spent by NHSEI, the CCGs and NHS SBS managing the programme delivery and it was clear that we needed to continue forward regardless.
"What really impressed me was how NHS SBS and the impacted CCGs managed to achieve this on time and without impacting operational daily processes for these newly merged organisations."
Despite the unforeseen nature and huge scale of a pandemic, NHS SBS was able to deploy pre-planned business continuity measures to begin a fast recovery of services after the first UK lockdown.
Long-running work between the NHS SBS and NHSEI finance teams to establish a joint governance structure also helped facilitate quick decisions and high levels of cooperation when the pandemic hit.
The NHSEI systems lead added:
"Our work with NHS SBS is very much a partnership and we have set up a strong governance model over the last two years to support that. This helped ensure a very collaborative approach during Covid-19."
When it came to supporting the NHS workforce, meanwhile, NHS SBS worked round-the-clock to make sure almost 400,000 employees across 90 different NHS organisations continued to be paid as normal. It meant that in April 2020 - for the first time ever - all of its 164 weekly and monthly payrolls were processed remotely.
Highlighting the importance of maintaining payroll services for the NHS, James Kendall, Head of Workforce Intelligence at Medway NHS Foundation Trust, said:
"The work of the NHS SBS payroll team during the pandemic has been exceptionally valuable and appreciated - just as vital as anything on the frontline, as no pay equals no staff."
Similarly, whilst shifting to 100% remote working, NHS SBS transactional procurement teams swiftly processed millions of pounds of additional orders as part of the service it provides to NHSEI - including goods for the NHS Nightingale Hospital London.
In Manchester, meanwhile, NHS SBS experts were equipping the NHS Nightingale Hospital North West, partnering with Manchester University NHS Foundation Trust to source the equipment needed to open the emergency 648-bed hospital on time.
And with NHS procurement teams working flat out at hospitals across the country, members of the NHS SBS on-site team at Royal Papworth Hospital NHS Foundation Trust were no different.
Working weekends and bank holidays to provide extra support to the hospital, including helping to increase its critical care bed capacity, one member of the team even moved into hospital accommodation to be on 24-hour call to take crucial deliveries.
Conveying the appreciation of clinical colleagues, Caroline Stackhouse, Acting Deputy Chief Allied Health Professional at Royal Papworth Hospital NHS Foundation Trust, said:
"The NHS SBS procurement team has been exceptional. They have tried so hard to ensure we have the equipment we needed during the crisis, no matter how difficult it was to obtain, how long it took or how many hours they worked."
In April and May 2020 alone, NHS SBS Finance and Accounting (F&A) teams processed 167,000 purchase orders and paid over one million supplier invoices - worth £7.5bn - whilst managing an additional £46.5bn of cash for the NHS.
The organisation also improved processes to enable quicker payment of NHS suppliers and increased take-up of electronic invoicing by 66%.
Peter Burnett, Director of Operational Finance at Surrey and Sussex Healthcare NHS Trust, described the reassurance that NHS SBS had provided to NHS organisations:
"I can only imagine how difficult it has been to keep services fully functioning. Throughout this period, NHS SBS F&A services have always been there. Like a constant electricity supply, one push of the switch and the lights always come on."
During the early months of the pandemic, NHS SBS also processed more than 4,000 new NHS starters a week on behalf of NHS Professionals - an increase of more than 500% compared with before Covid-19.
And, in just one week, it facilitated £1 million of urgent salary payments to additional NHS workers - many of whom were returning from retirement to support the national effort.
At the height of the pandemic, NHS SBS also worked with NHSEI to help move unprecedented amounts of money around the NHS, including £21bn on one day alone (1 April). Overall, the NHS SBS response to Covid-19 centred on ensuring the safety and welfare of its own employees, whilst continuing to provide essential services for the rest of the NHS.
By retaining measures adopted during the pandemic, such as desktop computers being replaced by laptops for full remote-working capability, more flexible working arrangements, and an acceleration of new digital technologies, NHS SBS has further enhanced the resilience of the services it provides to almost two-thirds of the country's NHS provider trusts and commissioners.
"Our approach is to work with NHS SBS as an extension of our own organisation within the NHS - and that's the way we approached it during the pandemic."
NHS England and NHS Improvement Finance Lead