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Grenfell Tower Inquiry Phase 2 Report – Just Terrible

I’ve generally stayed away from writing about the Grenfell fire tragedy. It just seemed too serious and horrible an issue to be talking about “bad buying” and technical procurement issues. What the victims went through is just unimaginable.

The Phase 2 report from the Inquiry was released recently and it is quite rightly highly critical of quite a range of people and organisations. Companies in the sector that provided materials used in the building; the architects and designers; the local authority and housing managers; central government civil servants; then-Minister Eric Pickles; the London fire brigade… they all bear some responsibility for what happened. Wider failures in building regulations and fire safety also contributed.

CIPS (the Chartered Institute of Procurement and Supply) contributed strongly to the Inquiry, initially chairing the Procurement Working Group as part of the Hackitt Review of building regulation and fire safety (leading to the Building a Safer Future report).  What became clear, CIPS says, is “there were many examples of poor commercial practices in the years leading up to the fire, focusing on price and margin at the expense of safety.”

I often hear complaints that public procurement is “all about price and nothing else”. I always push back on that and say that in my experience, price or even total cost is always an evaluation factor, but the vast majority of procurement exercises also consider other non-cost factors, which have serious weighting in the evaluation model. But it is probably fair to say that some parts of the construction procurement world have not exactly been at the leading edge of good practice thinking.

That seemed evident from the report, where too many decisions were made simply to save money rather than through a proper consideration of all the true “value for money” factors. And if a value for money model doesn’t include looking at the chances of killing people, then it should. This is from the Phase 2 executive summary report. (TMO is the “tenant management organisation” that was responsible for Grenfell).

“Although Rydon’s tender was judged to be the most competitive, it still exceeded the TMO’s budget. As a result, although the TMO had received advice from its lawyers that it would be improper to do so, it entered into discussions with Rydon before the procurement process had been completed leading to an agreement that, if Rydon were awarded the contract, it would reduce its price to an acceptable level”.

Illegal, bad practice, and of course led to Rydon, the principal contractor on the tower refurb, being focused very firmly on cost minimisation.

It was also shocking to see that the firms involved, including those that had basically lied about the products they were supplying, or had hidden test results, continued to win public sector work after Grenfell.

The Guardian reported that “about £250m in public deals have been made in the past five years with corporations involved in the high-rise’s refurbishment, according to searches of public contracts by the outsourcing data firm Tussell for the Guardian. They include companies currently or formerly owned by Saint-Gobain, which made the combustible Celotex insulation used on the tower, and Rydon, the main contractor for the works”.

Now the new UK (excluding Scotland) Procurement Act includes what are in theory stronger provisions to allow firms to be barred from public procurement competitions. The Prime Minister told Parliament that he wanted to ban the firms involved here. “This government will write to all companies found by the inquiry to have been part of these horrific failings as the first step to stopping them being awarded government contracts,” Starmer pledged.

That doesn’t seem as strong as you might expect, but no doubt there will be process that must be followed if we want to avoid legal challenge from those suppliers. I’ve been somewhat cynical about the chances of the new “debarment regime” in the Act really being effective, but I sincerely hope I’m wrong and these firms are kicked out of public business for a very long time.

It is difficult for individuals within large organisations to speak up sometimes. We can all get caught up in the corporate “groupthink” and perhaps misplaced loyalty.  (Look at all the people in the Post Office who knew the Horizon system was dodgy and that postmasters were being treated appallingly, but said nothing).  Grenfell shows how terrible the consequences of that sort of behaviour can be. So if your firm is expecting you to lie or deceive others about the chances of your product killing people, then perhaps you really should say something.

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Big consulting firms fail to “Transform”

A recent report suggested that the majority of clients of the big three strategy consulting firms are unhappy with the performance of the large consulting firms. An article in The Times said this.

“Senior executives who hired the big three strategic consulting firms McKinsey, Boston Consulting Group and Bain often say they are no help, according to a study commissioned by a rival firm.

A survey of 702 executive staff and project managers found that of those who worked with the three biggest consultancies in corporate transformation projects, 84 per cent felt they “were no help at all”.”

The survey was sponsored by digital consultancy Emergn. I’ve never heard of them but they are something of a (much smaller) competitor to the big firms so we might ask about their independence here. But I suspect there will be some nodding heads amongst those reading this with experience of working on “transformation” programmes with any of the big consulting firms.

There is something of a crisis in the industry too, with the number of people employed in Britain’s consulting industry falling last year for the first time since the Covid year of 2020, according to a report by the Management Consultancies Association. Overall headcount dropped by 3 per cent to about 50,000.  This year McKinsey has apparently offered to pay some UK staff to leave the firm following a round of 1,400 job cuts in 2023.

In terms of the firms’ capability and performance, I remember a research firm I spoke to in my Spend Matters days whose business was based on collecting detailed data from staff in client firms via surveys in order to assess consulting firm performance. They were hesitant about telling me too much, but there were findings that I thought were very interesting. Basically, they did not find that the “top” strategy firms such as McKinsey were overall any “better” than the Deloitte / KPMG tier of firms or indeed the more specialist firms. But what was even more startling was the difference in performance within the large firms.

In other words, there were some practices or specialisms in McKinsey, or KPMG etc, that were excellent and got strongly positive feedback from clients. But there were others that were much, much worse. That’s perhaps not surprising when you think carefully. Within a firm, there will be some areas where the firm has developed very strong, market leading IP and knowledge – others where it has not. And perhaps even more importantly, some practices or groups will be led by a partner who is personally inspirational, a great manager, attracts the brightest young consultants and is good to work with for clients.

But on the other side of the office, there may be a partner seeing out their time before retirement, not really interested in new thinking, and known as not a good boss internally. Yet of course when you ask for a proposal from the firm, none of that variation will necessarily come through!

That also supports something I’ve always recommended. For most pieces of consulting work, I would strongly suggest you at least consider a specialist firm rather than just asking generalists to bid.  If you include a pure procurement, or customer service, or retail acquisition specialist, someone truly expert in your requirement area, then you know that they are strong where you want support.  By all means ask McKinsey or KPMG to bid as well, but it is sometimes harder to know if they are real experts in the field, or that their staff are genuinely expert – and great to work with.

So I would always look to throw a specialist firm or two into the mix. And the importance of really understanding what you are looking for in your consultant was something Fiona Czerniawska and I emphasised strongly in our 2010 book, Buying Professional Services. Sadly, it is not readily available today – perhaps we need to do a new edition!

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Prioritisation Matters – A Story about my Phone

I’ve been intending to tell this story for a couple of months now, but prevarication is a terrible thing, as we will see.

I owned – well, I still do – a Huawei mobile phone that I got on a monthly contract with Vodafone in (I think) 2017, although it may have been a little earlier. In October 2021 I fell off my bicycle (embarrassing, 200 yards from home, going up a slightly higher than I expected kerb). I fell onto my phone which was in my pocket, the rear casing got badly cracked, so I “repaired” it with Sellotape. I had the intention to replace the phone from then onwards, but it did work, and I replaced the tape every few months.

Finally I went into the Vodafone shop in Camberley in May. My first visit, it turned out I had to change something on my account before they could do anything for me – that was a bit of a process. So I went back a couple of weeks later and I’m sorry to say the two women working in the shop laughed at me! Twice!

They had met me once before so maybe they felt more comfortable having a good laugh when they saw the state of my phone. Apparently the Sellotape was funny, can’t see why myself…  But then the woman who was helping me laughed again when she opened my account on her system and saw the charges.  It was perhaps more of a gasp than a laugh. “You’re paying how much a month?” she exclaimed.

Well of course I had been suffering from the “inflation plus 79.3%” or whatever it is standard contract for 7 or 8 years, and I didn’t really even look at the monthly direct debit to be honest.  I hate to admit it,  but it was about £40 a month for an ancient, knackered phone and really not very much data at all!

There was some more chuckling when she did the transfer of data to the new phone, which took ages  – “your old phone was pretty much on its last legs”, she said.

The Vodafone staff were great actually, I went for the buy my own phone option then a monthly contract and they saved me £50 on the phone by suggesting something surprising, which I won’t repeat here in case it gets them into trouble. So I have ended up with a total cost of ownership that has probably reduced by 50% and gives me much a better contract, hardware and capability.

So, apart from giving you the chance to have a laugh at me, supposedly a serious and experienced procurement professional, why am I telling you this? It just struck me that putting things like this off is always very easy. There always seemed something more urgent or important to do rather than take an hour or two to go and sort out my phone. I was procrastinating for over two years. Or there was an excuse. “I won’t replace it just before Reading Festival in case I lose it / gets damaged” etc.

And we do tend to do the same in our working lives. We know we should review that contract, or look for a new supplier because our current one isn’t really performing, or check out the latest market forecasts and see if we should go “long” on that commodity. But something more urgent comes up. Our internal customer wants to see us NOW.  The CFO wants a report on how to save 10% on everything by Christmas. If I don’t go online at 10am I won’t get my Taylor Swift tickets…

But the cost of delaying all mounts up. In my case, it’s not just the fact that I probably overpaid by the best part of a thousand pounds over the last few years, it is also that I missed the functionality I could have had with a new phone. So prioritisation, which must be accompanied by good general planning, is an undervalued skill in my opinion. I’ve worked with people who were brilliant in almost every way, but could not prioritise.  If this is you, it is important, do work on it.

Clearly, I’m not perfect (!), but also have a think about whether you’re missing some possibly quick and easy wins, in work or in life generally, just because you “never get round to it”.

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A Walk Through HS2

It is a while since I wrote about the UK’s infinite rail transport money pit, also known as HS2. When I first started criticising it years ago, based on my view that the business case was a con (having seen many dodgy public sector business cases over the years and even having helped write a few), I got some comments on Twitter and LinkedIn saying it would all be a great success and I was being ridiculous when I predicted it would cost over £100 billion. I did think it might get completed for that much, I should say.

Anyway, a couple of weeks ago, two retired CPOs and I went for a 10 mile stroll in the Chilterns in a persistent drizzle. But I saw a badger close up for the first time in 40 years!  I also saw rather a lot of the HS2 works as our route crossed that swathe of land twice. The second time, we had to divert a few hundred yards and use a road bridge going over the works.

But as we approached the first crossing, our path was diverted for a few hundred yards, and then we were directed to a gatepost with high wire all around it. This was the HS2 works, all fenced off of course. At the gate, we were greeted by a chap in high-vis gear.  He nodded and said something into his walkie-talkie. We saw another chap a couple of hundred yards away, at the top of a slope, who presumably checked that no high-speed bulldozers were heading our way over the hill.

Hi-Vis 2 then gave Hi-Vis 1 permission to let us cross. We walked about 100 years across the site, mainly across rough gravel roadway, to another gate manned by Hi-Vis 3. He opened his gate and ushered us into a passage way about 2 metres wide with 3 metre high wire fencing each side. We followed this for another couple of hundred yards, before meeting Hi-Vis 4, who opened another gate which led into more wire-edged walkway.  We asked him how many people he’d seen that morning. “Just you three,” he said. It was noon by now.

So four people employed as far as we could see just to help walkers get across 100 yards of construction site.  Were those posts manned 24 hours a day, we wondered? If each guy is paid lets say £30K a year, the construction firm no doubt charges the tax payer at least twice that. So on a single shift, that’s a quarter of a million a year. If there is 24 hour cover, we’re talking a million a year.

Surely there must be better options. A simple crossing with some warning lights maybe?  Or just one person as an escort? I know it is a cliché but this felt like “health and safety gone mad”.  When we look at the relative costs of capital investment sin the UK, we wonder why it costs us so much more than other European countries, let alone China, India and so on.

Well, this sort of approach partly explains things. And I come back to one of my original fears about HS2. Who actually had a vested interest in getting the best possible value for money? Not the civil servants in Whitehall and the executives running the HS2 company,  who get promoted and bigger salaries if they “control” a bigger budget. Not the hordes of consultants and advisers to HS2, whose fees look more reasonable if the construction firms charge more. And certainly not the first-tier suppliers themselves.

In the greater HS2 scheme of things, four poor guys standing around doing absolutely nothing for hours, days, weeks on end (mind-numbingly boring work, by the way) just doesn’t matter. And that sums up some of the problems with the whole scheme.

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PPE and the UK taxpayer get burnt (again)

The BBC ran a story this week about the UK’s spend on PPE during the pandemic. I was contacted by the journalist, Jon Ironmonger, and did a video interview at the BBC, although I believe it has only appeared (a short excerpt anyway) on a BBC East programme, which I haven’t seen! The report centred on Full Support Healthcare, who are based in Wellingborough in that region.

But there were articles on the main BBC website, quoting my remarks. The journalist actually wanted me to be balanced and give an “expert” perspective on what happened with PPE procurement.  I tried to explain the problems when demand for anything suddenly rockets, but I was critical of a number of aspects of the programme, all of which I have written about over the years since 2020.

One continuing mystery is why the initial forecast of demand turned out to be so far out – about twice what in retrospect would have been reasonable. That was what triggered the “panic buying” in May 2020, so arguably it was the single biggest cause of the subsequent disastrous waste of money (over £10 billion).  The forecast led to some incorrect specifications being issued in haste, use of very strange suppliers (not all of whom were properly vetted, despite the re-writing of history that some politicians have attempted), the lack of anything much in the way of cost / price analysis or negotiation with suppliers, and the infamous “VIP Lane” for suppliers with a contact in government.  

The latest article from Ironmonger focuses on the stock management aspect. It appears that some £1.4 billion of aprons, masks and googles just from Full Support have been incinerated, recycled or written off. A general rule of thumb is that around twice as much PPE was contracted for as was needed, as it turned out. So given the total bought from that firm was £1.8 billion, it is not clear why such a high percentage of their product has been wasted.

The Department of Health and Social Care disputes that loss number, saying some money has been recouped by recycling, but the Department basically refused to engage with Ironmonger while he pursued this story, ignoring his requests, and has failed to provide clear evidence of what has happened to stock or financial details.

Full Support was an established supplier of PPE before the pandemic, unlike many of the cowboys who got in on the game once panic set in. Sarah Stoute of the firm told the BBC the shipping containers that transported her company’s PPE were unloaded “various times up to 207 days post-arrival”. She said the masks were “perishable goods and required to be kept cool and dry” and “not intended to be stored for a prolonged period in a shipping container, yard or field”.

The port of Felixstowe became jammed with PPE containers in November 2020, and they were moved to various airfields, other ports and available land. After some stock was sold off to other dodgy people for disposal, it was found dumped on a site in a New Forest.

Here is is one of the many articles I have written on this topic. This one gives a good summary of what I still feel are the key issues or questions around what happened. It’s right that we remember the desperate situation that faced us back in early 2020, and both users and buyers of PPE were in a particular crisis situation. But I still wonder if we have really learnt lessons from what certainly wasn’t one of UK public procurement’s finest hours.

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Labour Wants to Use “PFI” – Please Be Careful!

As we’re into the election period in the UK, the Labour Party is promising capital investment (in roads for instance) but saying that much of the money will apparently come from the private sector. This has brought back memories of the previous “Private Finance Initiative”, which was actually invented by the conservatives under John Major in the early 1990s but was enthusiastically embraced by Labour after 1997 when Tony Blair won the election.

I was procurement director at the Department for Work and Pensions for two and a half years, 1995-7, serving when Labour came into power, and was involved in some large PFI projects, including new construction programmes and some IT initiatives. Then in the noughties, I was consulting in government and held a couple of interim commercial director posts where PFI or similar initiatives were relevant too, including the ID Card programme.

So speaking from the inside, I can say that there were a number of positive aspects to PFI, despite later criticism. Having a single entity responsible for the financing, construction and then maintenance of a new hospital for instance created a clarity of purpose and an interest in whole-life costs. However, there were some less positive aspects which Labour must avoid if it is to make a success of PFI Mark 2 (or Mark 3, or wherever we are up to now).

In the past, some dubious financial engineering was definitely encouraged to get projects through the business case process. The comparisons were generally made in terms of the basic cost of the building in the case of construction projects. So PFI projects were often compared using “cost per square metre” metric, as the ongoing PFI charges overt the contract period were often based on that as the charging “unit”. That figure included the cost of capital, the construction cost and probably the basic infrastructure maintenance. It would then be looked it against the “public sector comparator”, i.e. what it would cost the government to provide the same facilities.

I actually sat in meetings where the PFI adviser (more on that later) said to a supplier, “the public sector comparator is marginally lower than your figure – you need to improve that”. Now that sounds like good negotiation, but the twist was this. The contract usually included a whole list of ongoing activities where the buyer would be locked into using the PFI supplier. And these were rarely included in that value for money comparison. So suppliers were encouraged to make their money on these extras, often around ongoing supply of goods or services, and keep their base charges low to get through the business case process.

The other way of making the contract attractive for the provider was to make it longer. Hence ridiculous 60 year contract periods, with guaranteed price increases of course, which again circumvented the business case issue as the comparisons would rarely look that far into the future.

So this is why seemingly trivial services or one-off type activities ended up costing schools and hospitals a fortune.  “Another school had to pay £302 for a socket, five times the cost of the equipment it wanted to plug in”, as the Daily Telegraph said in one report. This wasn’t an accident or bad negotiation – this was because the payment mechanisms were constructed deliberately to make the basic occupation charges look lower, with the provider making their money from these ‘extras’.

That would improve the apparent business case; then later on the occupier gets hit with unexpectedly high charges. It represented a conspiracy really between all the parties to make these projects happen, and arguably was a failure of finance and procurement across many organisations while these deals were being done; or at least a failure to stand up to pressure from other quarters and point out loudly the problems that were being stored up for the future.  I will take some credit though – one of the (probably few) good things I did in my DSS job was refuse to allow catering, cleaning and security to be included in one large property PFI deal we did, because I was concerned about future lock in for decades. That probably saved millions.

The other very dodgy aspect of “old PFI” was the role of Partnerships UK (PUK) in all this.  From 2000 onwards, Treasury promoted the use of PUK’s services – at extortionate consulting rates – for advice to public sector clients on particularly the commercial and financial elements of PFI deals. If you didn’t pay your three grand a day for a PUK adviser, you wouldn’t get your project approved by Treasury, was the feeling.

Yet PUK was 49% government owned, and 51% owned by the banks! That was a clear conflict of interest there in terms of PUK’s enthusiasm for PFI deals which made huge profits for those same banks. And the politicians – and even some top civil servants – were probably looking forward to their nice non-exec roles with the same organisations once they retired.

So Labour needs to take care here if it wants to bring back PFI-type ideas. It needs considerable commercial and procurement expertise on the government side of the table – and it must make sure the people who are supposedly representing the taxpayer in those discussion really do have our interests at heart, and are not feathering their own nests.   

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Avoiding Bad Buying in UK Local Councils

As the results come in from local elections in England, it is clear that basically the country just wants the Conservative Party to go, the sooner the better. I don’t think there is huge enthusiasm for anyone else but most of the public are just sick of the infighting, incompetence and idiocy of the ruling party in recent years.

However, will changing our local councils make things better? A very interesting article in The Times   looked at data provided by a new agency, the Office for Local Government (Oflog). Ministers set up Oflog last summer to provide “authoritative and accessible” performance data to support improvement in local government.

The data looks at the efficiency and effectiveness of local councils across 27 categories in five main areas: waste management, corporate and finance, adult social care, planning and roads. It revealed for example that some councils have recycling rates that are twice as good as others and that some authorities are failing to process half of planning applications on time, while others are not late on a single one. The figures also show the extent to which many councils are struggling with debts, with six local authorities already having declared themselves bankrupt since 2021. That is certainly in part becuase of lower funding from the centre of government, but competence (or lack of) seems to come into play too in most cases.

The Times accessed all the data to look at variations, which are huge and pretty inexplicable other than by sheer management competence. For example, in the year to September 2022, Hinckley & Bosworth borough council in the East Midlands completed less than half of household planning applications on time. But Tamworth borough council, just 30 miles away, was not late on any.  

The Times also came up with league tables to see if there was any political correlation with performance. Nottingham (Labour controlled) was the worst performing authority. Torridge district council, on the north Devon coast, came top of the table – it is run by independent councillors.

But the results actually supported a theory I’ve held for years, suggesting it is not that the Conservatives (Tories) are generically better or worse than Labour in terms of competence (with the Lib Dems in the picture too in a smaller way). Of the ten worst-performing councils, six are controlled by Labour. Of the ten best-performing councils, six are in coalition or are run by independents, while the Liberal Democrats and the Conservatives run two each.  Eight of the ten worst-performing county councils or rural unitary authorities are controlled by the Conservatives – while seven of the best-performing ten are in coalition or run by independents.

So what it does seem to show is that the worst-performing councils are almost always in areas, towns or cities where there has been a long-term dominant party, whether that is Labour or Tory. Conversely, the best-performing councils are generally more contested, so independents rule the roost, or no single party has a clear majority, or power has changed hands over recent years.

That stands to reason really. If there is a long-term dominant party, there is more scope for arrogance to creep into decision making, or fraud and corruption to spring up, and there is less scrutiny of decisions. “Bad buying”, whether it is just wasting money on frivolous or unnecessary spending, or more serious fraudulent or corrupt expenditure, is more likely where power is well entrenched. Take fraud for example. You are less likely to bribe a councillor, or to stand as a councillor yourself so you can influence planning decisions for nefarious purposes, if it is not clear who will be in charge after the next election.

Similarly, some of the arrogance we have seen in councils such as Woking, where the dominant Tory council invested hundreds of millions in unwise property deals, or in Nottingham, where the council (Labour in power since 1991, 50 of 55 councillors) thought it could run an energy firm better than the professionals, came about I’d suggest in part at least because the councillors thought they were unchallengeable and had complete power.  My own council, Surrey Heath, has also lost money – not as much as Woking though – on property deals put in place by a very arrogant Tory leadership. But last year for the first time ever the Lib Dems took power here.  

However, the correlation is far from perfect. Thurrock, where the council is now suing “businessman” Liam Kavanagh, who allegedly cheated the council out of over £100 million with dodgy solar farm investment schemes (hopefully the ex-finance head at the council will end up in court too), has actually had a few changes of council over the years.

But Liverpool is another example where single-party dominance led to a culture of corruption. Even after commissioners came in to run the City in 2021, the job description I saw for the Head of Procurement role still did not suggest a real appetite to put in place all the controls and governance you would want to see as a taxpayer!

Anyway, all this suggests that if your main interest as a voter is in the effective running of local services, rather than any deep political beliefs, you should aim to keep your local council and councillors on their toes by creating a competitive environment. How you can best do that will vary by area and even local electoral ward. But that seems the best strategy if you want your money to be used honestly and well.

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The NHS gets “supplier” incentivisation all wrong

(Pic; A&E on a Saturday night)

Incentivisation is a fascinating topic. In a business context, for example in terms of incentivising the right behaviour by suppliers, it can require knowledge of psychology, contract law, finance, economics, and operations management. Most of us in procurement will have seen examples of it going wrong too – indeed, I dedicated a whole chapter in the Bad Buying book to dodgy incentivisation that drove unexpected or simply bad supplier performance.

In the UK’s National Health Service (NHS), the way “the centre” (usually the Department of Health or NHS England) incentivises hospitals and other Trusts that deliver services is very similar to a commercial buyer/supplier relationship. Basically, the centre gives money to Trusts and they agree to aim for certain performance levels.

Now I’ve looked up the cvs of  Sarah-Jane Marsh, National Director of Integrated Urgent and Emergency Care and Deputy Chief Operating Officer, NHS England, and Julian Kelly, Deputy Chief Executive and Chief Financial Officer, NHS England. To be honest, there is nothing in them to suggest that these two are stupid. And yet they have launched one of the daftest and most inappropriate incentivisation-related initiatives I’ve ever seen.

It is in effect a “competition” through which Trusts can receive additional funding for capital expenditure in 2024/5. This is what they say in their letter to Trusts this week.

We recently met with ICB and acute trust leaders to discuss how we best work together to meet the challenge of delivering the agreed target of 76% A&E 4-hour performance during March 2024 so that more patients are seen, treated and discharged in a timely way….

In addition we are now announcing three other routes through which trusts will be eligible for additional capital funding in 2024/25:

  1. The 10 trusts delivering the highest level of 4-hour performance (that means seeing people within 4 hours of their arrival at the accident and emergency department) during March will each receive £2 million.
  2. The 10 trusts who deliver the greatest percentage point improvement in March (compared to January 2024 performance) will each receive £2 million.
  3. The next 10 trusts who deliver the greatest percentage point improvement in March (compared to January 2024 performance) would each receive £1 million.

(It continues…)

So where do we start with this? As I say, I look on it as a supplier incentivisation exercise, and on those grounds I would immediately point out a few major flaws .

  • It was issued on March 12th, and relates to performance in March. So how can Trusts possibly have time to make any significant or lasting changes to their processes to improve A&E within days?  
  • Shouldn’t capital expenditure be allocated based on where it will get the best return rather than on some sort of “Hunger Games trial by A&E”?  You would put money into a collaborative venture with a supplier based on its potential return, not on some spurious “performance measures”, wouldn’t you?
  • Doesn’t relating much of it it to improvement mean those Trusts that were particularly awful in January have more chance of winning then the consistently good Trusts? That seems unfair.
  • How do you stop “gaming” of the process and the data?  I’d pay a few local layabouts to come into A&E with a “bad finger”, see and discharge then in two minutes, then rinse and repeat until my figures look amazing.
  • Indeed, this could lead to patient care that is driven by finance, not needs. See the easy cases in A&E, not those with their leg hanging off…

This strikes me as politically driven, surely the only explanation as to why Kelly and Marsh would take this deeply flawed step. Ministers desperately want some good news from the NHS now in case there is a Spring election. Officials must have been instructed to do this – that must be it? If not, if this really is an NHSE internal initiative, then the NHS really is in even deeper trouble than we thought.

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15 years of government policy failure – can Shirley Cooper change that?

Congratulations to Shirley Cooper, CIPS Past President, who has become the UK government’s “Crown Representative for small businesses”. In that role, she will represent the interests of smaller firms, particularly in terms of their ability to win government contracts. “She will work with the Cabinet Office’s Small Business Advisory Panel, departments, suppliers and trade bodies to further level the playing field for small businesses, start-ups and social enterprises and ensure they can compete for and win more government contracts” says the announcement.

The government’s policy goal to increase the amount of spend going to SMEs is a long-running failure. I worked with Sally Collier of OGC on the implementation of the first review of small business and government procurement, the Glover review, way back in 2009. We recommended that there should not be a target or targets set for spend with SMEs – we felt targets would distract and take resources away from actually doing real stuff that would help SMEs. But the new coalition government disagreed, so a target of 25% was set, with no real logic behind it.  

It wasn’t hit in the first few years, but ridiculously, the Tories said they would increase the target to 33% in the 2015 election manifesto, purely to say something that sounded good to appeal to the small business lobby. Everyone in public procurement knew it was a ridiculous move. But surprisingly, the Tories won the election and the target was increased. Even the Public Accounts Committee in 2016 concluded “it is not clear how the Government decided on 33% as a target or how achievable it is”. 

The answer to the achievability question is that the target is impossible to hit because a few organisations dominate the overall spend figures – particularly MOD and National Highways (previously the Highway Agency). Because SMEs can’t build aircraft carriers or the M25, even if every other department does really well, the target won’t be achieved because of those big spenders.

So the government decided that the target should include second tier spend, the money big suppliers spend with smaller suppliers of their own. Of course, if you are going to add this in, then following the logic, really you should subtract the money SME first tier suppliers spend themselves with big suppliers! Anyway, many of the large suppliers to government don’t really track their own spend with SMEs. I suspect when government asks its first tier suppliers for the data, many of them just make up the numbers.

So in 2021/22, the total spend with SMEs went down from 26.9% to 26.5%, including that indirect second tier spend. Direct spend went down more dramatically from 14.2% to 12.3%.  But what happened in 2022/23, you say? We don’t know yet. The data tend to come out around 18 months after the end of the period in question, either because it is so difficult to put together or because if you publish it really late, it takes some of the potential political heat out of the report. Maybe both.

The decline may be due in part to another trend that has been reported by the National Audit Office. More spend is not competed these days, with more use of frameworks, direct awards and single supplier contracting. Whilst SMEs are on many frameworks, that mechanism makes it easy for buyers to just choose their favourite (usually large) firm. 

There is talk about how the new Procurement Act will help SMEs, and to be fair, there are a couple of positive factors there. “The Act places a requirement on contracting authorities to assess the particular barriers facing SMEs throughout the entire procurement lifecycle, and to consider what can be done to overcome them”, for instance.  

Tougher “rules” on prime contractors paying sub-contractors could also help if policed. A single registration system for potential suppliers is a good move for everyone (Sally and I suggested that in 2009). But the idea that the greater flexibility for buyers and contracting authorities will suddenly lead to a boom for SMEs is just wishful thinking in my opinion.

There are also a whole range of arguments around whether supporting SMEs is a sensible policy goal at all.  Might it be better to support diverse, minority owned business? Or social enterprises? Or innovative start-ups? Or firms based in deprived areas?  Is simply looking at size a sensible way of targeting assistance?

So really, the role of the SME Crown Rep has historically been as a figurehead to show the government “cares” about SMEs, and get some votes from small firm owners. In fact, big firms have continued to rule the roost in terms of actually winning contracts.  Maybe Cooper can change that – we’ll see, but I wish her luck and hope she can have an impact. It woudl also be interesting to know how she plans to measure her effectiveness.

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You Get What You Incentivise

Incentivisation is a topic that probably isn’t discussed in procurement as often as it should be. I find it fascinating, as it encompasses a mix of finance, economics, contract law, psychology, low cunning…  How we construct contracts, the success measures we set for suppliers, how we reward their good behaviour or performance and punish the opposite – these all feed into how they behave.

Suppliers generally behave rationally given the incentives they are presented with. In the Bad Buying book, there is a whole chapter on the topic, because I found so many interesting case studies about incentives going wrong.

We see another example in a slightly different context in the UK at the moment, where the dental element of the National Health Service has failed in its core objective – to keep the nation’s teeth in good condition. A BBC investigation in 2022 found that nine out of ten dental practices weren’t accepting new NHS patients.  In some regions, that figure was 98%. That has led to more and more patients turning up at hospitals with terrible dental problems that require urgent treatment – which puts more pressure on over-stretched hospitals of course. Tooth decay is the most common reason for hospital admission of young children, shockingly. And 20,000 adults and 60,000 children were hospitalised last year to have teeth extracted under general anaesthetic. 

There are stories of people pulling out their own teeth, or making homemade dentures, fillings and crowns. We seem to have gone back to Victorian times. And it is all because the contract for dentists incentivises the profession in a manner that has led to that situation. The NHS contract does not pay dentists based on their actual effort, and does not allow them to make what they consider a reasonable income. So they have learnt that treating only private patients will reduce their patient numbers, but overall, the dentist will make more money. More and more practices are taking this view, unfortunately, making totally rational decisions.  

Funding for dentistry has been cut under this government. And one of the incentivisation issues is that the dentists’ contract does not always relate the income they make to the amount of work they do. So, simplifying the problem, their pay is broadly based on a fee for each course of treatment they deliver to an individual. So they receive the same amount whether they do one filling for me or six.

There is a vicious circle here – if people can’t find an NHS dentist easily, by the time they do, they probably do need more work doing, so they are even less attractive for the remaining NHS surgeries.  The current contract actually goes back to the days of the last Labour government, but the Tories have done nothing to address this issue in recent years – until now, when they see it becoming a potential election issue this year.

One solution would be to increase the supply of dentists, which in classic economic terms should drive prices down in the market – pushing more back into NHS work perhaps. But the five-year training scheme means this is impossible in the short or medium term. Another possibility would be forcing dentists to do NHS work for a certain number of years after qualifying, given they benefit from the taxpayer subsidising their training. Neither option has been tried.

Last week, the government announced incentives to encourage more dentists to do NHS work, but the profession doesn’t think this will work. We will see. But devising a contract that incentivises the behaviour the government (and the taxpayer) want to see should surely not be impossible.

However, politicians have struggled with contracts and incentivisation for the medical profession for years. I remember the new GP contract for first line “family doctors” that was agreed by the Labour government back in 2004. My friend who was a GP told me that he and his colleagues were astonished how favourable it was to them. When he first read the letter about his new payments and contract, he honestly did not believe it.

Anyway, I am fortunate to still have an NHS dentist, although I’m also fortunate to be able to afford private additional treatment when I need it. But the current situation is a disgrace. When we see people travelling from the UK to the Ukraine – a country at war – to get dental treatment, you know something has gone badly wrong with the UK situation.

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