Clinical Leadership Development Programme Change Management Project Prosthesis Procurement

1. Clinical Leadership Development Programme Change Management Project Prosthesis Procurement Rowena Dean Chris Tulloch Stuart Burney

2. Change Initiative • The price of implants have been the subject of a number of cost improvements over the years. • A number of initiatives have been tried over the years with only short term improvement. • Following a Foundation Trust Network benchmarking exercise it was highlighted that the Trust was an outlier in terms of its implant costs. (Knee Replacements) • Target pricing was thought to be a possible way forward to reduce costs.

3. Leadership framework for improvement • Set direction, mission, vision and strategy -QIPP agenda - C.I.P - Patient safety - Clinician preference • Establish the foundations • Reframe operating values • Build improvement capabilities • Prepare Personally • Choose & align the senior team • Build relationships Making the status quo uncomfortable Make the future attractive Individual conversations with colleagues

4. Leadership framework for improvement • Build Will -Plan for improvement - Set aims - provide encouragement - Learn subject matter • Generate Ideas • Understand the organisation as a system • Benchmark • Manage Knowledge • Saving’s of £120K • Understand the component • Parts of a TKR • NHS supply chain – role • Use expertise as a lever • Price ranges

5. Leadership framework for improvement Now working with the DOH to use the target pricing concept • Execute the change - Review and guide key initiatives - Spread ideas - Communicate ideas - sustain improved levels of performance Monitor compliance with target pricing and the potential for product creep.

6. Key Achievements • clinical leadership and the conviction of clinical colleagues to switch suppliers if they cannot work within the ceiling price identified. • The concept of target pricing allows the clinician the choice of implants as long as the company provides them within that target price.

7. Lessons Learnt • When working with “suppliers” ensure the “finer” details are scrutinised and monitored. • Understand the drivers for the key stakeholders (NHS supply chain) • Monitor and manage product creep. • The ability to make sustainable change when working as an effective team of clinicians, the support of the management team is essential clinical and management working as one .

8. Conclusion • Change is possible, just because it ‘has always been done that way’ does not mean that is the only or best way.