NHS Nightingale North-West - convention centre to critical care in two weeks
The Covid-19 pandemic in 2020 created a unique procurement challenge, requiring multiple field hospitals to be set up within days to provide intensive care to affected patients.
The team at NHS Shared Business Services worked with Manchester University NHS Foundation Trust (MFT) to equip the NHS Nightingale Hospital, based at the Manchester Central Convention Complex. The teams pooled their expertise to identify, source, order and deploy over 10,000 items of equipment, enabling the new hospital to open on time.
The two teams worked in close collaboration, using their combined market knowledge and supplier relationships to enable a fully equipped hospital to open, as planned, on Easter Monday 2020 after a preparation period of less than two weeks.
During this time, with input from clinical leads, everything from beds, to bins, to CPAP ventilation machines and PPE needed to be identified, sourced, ordered, expedited and deployed. This already challenging timeline was complicated further by constantly changing clinical and architectural plans and aggressive global demand for many essential items.
With social distancing and lockdown measures restricting the team's onsite presence, efficient remote working was essential. Microsoft Teams enabled strong communication channels between a team of buyers working remotely and their on-site colleagues who worked closely with the wider project team. This approach provided the entire team with access to consistent, real-time data on each individual requirement, avoiding duplication of effort and enabling accurate, easy to access reporting information.
The small on-site team incorporating Capital Equipment and Project Management expertise were responsible for collaborating with clinicians to scope equipment requirements, centrally managing the sourcing process, and reporting back to the Nightingale NW project board. The intensity of the project delivery environment and the pace of decision-making created a huge number of ad-hoc queries from the wider project team. To help channel discussion to the right individual, a simple triage and approvals process was designed and circulated.
To form the remote buying team, NHS SBS drew upon their existing workforce of Procurement Managers, who were asked to contribute their time flexibly to source items. Buyers were allocated sourcing responsibility according to the time that they had available. This approach meant that the task could be divided between 10-15 individuals, quickly creating the scale and capability necessary to meet the challenge.
With architectural designs and the clinical model constantly changing throughout the course of the project, the buying team initially struggled to source a definitive list of required items. To address this, the team engaged with the clinical leadership team to introduce a mechanism of grading items according to their clinical priority, enabling the buying team to prioritise critical items that were unlikely to change. In addition, the team introduced a formal change control process, ensuring that any amendments to the equipment list would require board approval before being accepted.
The global shortage of many essential items such as critical care beds and volumetric infusion pumps meant that many of the Trust's usual suppliers were unable to meet the demand, forcing the team to search elsewhere. Drawing on the combined knowledge and supplier relationships held by the individuals within the team was essential in procuring all necessary items in time for the hospital's opening. Items that were proving difficult to find were shared with a growing list of well connected colleagues within NHS SBS, who were often able to open their address books to provide leads that would have been otherwise unexplored. In the relatively few cases where it was simply not possible to source to an exact item specification, a suitable closest alternative was negotiated and approved by the appropriate clinical lead.
The reliance on suppliers to deliver on time and in full under such intense time pressure created some understandable concerns for the team, particularly in instances where suppliers had not previously been used. Once an order had been placed it was immediately followed with a telephone call to start building a relationship and agree a plan for delivery. Regular communication with suppliers was maintained until goods had been received. The team also established daily communication with colleagues from NHS Supply Chain, to ensure that they had the most up-to-date information on nationally sourced equipment such as essential Personal Protective Equipment.
MFT leadership allocated resource exclusively to progressing Nightingale orders and the Trust's Procure-to-Pay process was streamlined to enable orders to be approved and placed within hours of receiving a quote.
The team worked closely with suppliers to expedite orders for delivery as quickly as possible and engaged Network Rail and the Armed Forces to support logistics planning and on-site operations.
The fully equipped NHS Nightingale North West field hospital opened on time, accepting its first patients as originally planned on Easter Monday 2020. The facility provides much needed support to hospitals across North West England for as long as required, treating up to 650 patients at full capacity.
In less than two weeks, through effective collaboration and teamwork, over 10,000 individual items of clinical equipment along with all necessary clinical consumables and Personal Protective Equipment were identified, purchased and deployed ready for use.
The teamwork between MFT, NHS SBS and with the wider project team has been exceptional demonstrating just how much can be achieved across organisational boundaries when a clear and important goal needs to be achieved. An important element of that teamwork is also suppliers, who demonstrated their ability to increase their capacity to meet impossibly
The efforts of the procurement team were acknowledged by the project board with Jackie Bird, Chief Nurse for NHS England and NHS Improvement North West, and the facility's Senior Responsible Officer sending her commendation for their individual contributions under extremely challenging circumstances.