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Since the last general election the number of tenders issued by NHS organisations has grown enormously. This comes as no real surprise given the financial challenges the NHS faces and the need for it to demonstrate and achieve value for money. Tenders are one means of helping a trust achieve this goal. What does come as a surprise is the threshold at which organisations feel they need to put a contract out to tender. For example, one trust (which shall remain nameless) recently put a contract worth £5,000 out to tender. Fortunately the contract was not related to Zircadian, but the instance does beg the question of whether the drive to find best value negates the savings that can be potentially realised through going out to tender. In this particular example I don't know what the administrative costs were or what the trust hoped to save, but I am doubtful if the exercise did little more than tick boxes and delay the procurement process. Worse still, it may have added unnecessarily to the cost of procurement. Who is benefitting if this is the case?

Which leads me on to a bigger concern I have about rostering tenders. In recent months I’ve been invited to numerous ‘trust-wide’ rostering tender presentations. By ‘trust-wide’ I mean all staff in the trust - nurses, porters, doctors etc... Given this broad remit, and the need to ensure the tender process secures the best fit solution for all staff groups at the best price, you would expect to see equally broad representation from the trust at the rostering presentations. What surprises me is the general lack of medical representation. Many of you will think I have to say this since I work for Zircadian, and you will counter with the fact that doctors form only a small proportion of a trust’s workforce (10 – 15%). As a result their representation should be less.

This is all true, to a point. The time spent rostering the nursing workforce far exceeds that for doctors and it is essential the chosen system works for this group. It is equally true that all staff in a trust, apart from hospital doctors, are covered by ‘Agenda for Change’ which will greatly influence the rostering needs of this group.

However, I would counter with the point that it may be misleading to procure a trust-wide system based on majority rule alone. As a proportion of total wages in a trust, the annual medical workforce bill (including locum expenditure) is significantly higher (15 – 20%) than you would expect given the relatively small number of medics in a trust. Small changes to their bill can translate into significant savings or potentially sizeable unforeseen costs for the trust. Couple this with the fact that consultants’ activity rostering is one of the key measures of predicting clinical output and potential earnings for a trust, it becomes very clear that there is a strong financial imperative for getting doctors' rostering right. And then there is that issue about doctors having their own unique terms and conditions which means what they need from a rostering system differs significantly from other staff..

This may all sound rather pedantic and nit-picking to a seasoned procurement manager. Far from it. I raise the matter out a genuine concern that without senior medical representation on rostering tenders, and by representation I mean medical and clinical directors, there is a very real risk that the tender process will not achieve value for money. Worse still is the possibility that a trust may incur additional expenses when it's discovered that the system they purchase for the majority does not work for the minority. Please don’t think I am suggesting doctors are innocent bystanders in all this. They need to become more engaged in the process, but I also believe procurement managers need to understand doctors’ needs a little better and not be swayed by the vocal majority. If trusts follow this advice they stand to achieve a lot more from the tendering process.