Journal of Community Nursing

26 JCN 2020,Vol 34, No 4 framework agreement not only have access to these three fully approved delivery providers, but also to the NHS SBS advanced wound care framework, which contains a wide choice of dressings, bandages and scar/burns products. Each product on the framework has been clinically approved by a dedicated clinical stakeholder group, enabling clinicians to feel secure in their formulary choice. Under the total purchase system, wound care products are ordered via an off-script online portal. The framework agreement allows for supplier engagement and direct award, so it is entirely up to the user to decide which portal and delivery provider to choose. Once a formulary is uploaded to the portal, clinicians can order products safe in the knowledge that they will be delivered within 48–72 hours. As a result, formulary compliance is increased and stock holding at bases can be managed with a minimum and maximum process. The system also reduces product wastage caused by short expiry dates and addresses the sustainability agenda, as one box of dressings can be used for several patients rather than just one. It also provides a more timely method of obtaining wound care items, as neither the clinician nor the patient has to wait for a prescription. Furthermore, it enables clinicians to be truly autonomous in their practice, as they are able to choose which dressings they can have on their formulary because the framework is not limiting in terms of product choice. N ow more than ever, the NHS is searching for ways to reduce wastage and achieve efficiency savings, while at the same time improving patient outcomes. One area which can sometimes be overlooked when it comes to innovation and new ways of working is wound care. The NHS spends approximately £5.3 billion on wound care per year, accounting for around 5% of the overall NHS budget (Guest et al, 2015). At least 2.2 million wounds are treated in the UK on an annual basis with at least 200,000 patients having a chronic wound (Posnett and Franks, 2008). Wounds impose a substantial economic health burden on the NHS, equivalent to that of obesity, and the figures are set to increase due to the ageing population and the number of surgeries (Guest et al, 2017). Despite this, district nurse numbers in the community setting are declining year on year (Queen’s Nursing Institute [QNI], 2019), where the majority of wound care management is practised. It is widely accepted that 85% of wound care costs are related to nursing costs and home visits rather than the dressing itself (Surgical Dressing Manufacturers Association [SDMA], 2015). With this in mind, NHS Shared Business Services (NHS SBS) manages a framework agreement focused around helping the NHS reduce the nursing time required to manage wound care in the community by providing a wide choice of high quality dressings to clinicians via a just in time delivery model. Each supplier on the framework agreement (Convatec, Paul Hartmann and North West Ostomy Supplies [NWOS]) has undergone a rigorous evaluation process focusing on quality and cost. Users of the Improving wound care services with a just in time total purchase system Viewpoints Carolyn Lawton, procurement manager (top); Sue Mason, senior clinical advisor (bottom), both at NHS Shared Business Services ‘Now more than ever, the NHS is searching for ways to reduce wastage and achieve efficiency savings, while at the same time improving patient outcomes.’