Uncertain future for £1bn saving scheme

The £1bn vision

In December 2016, then health secretary Jeremy Hunt backed a Department of Health-led pilot programme which had the “potential” to save lives and up to £1bn for the NHS over seven years.

Praising the Scan4Safety scheme as a “world first in healthcare”, Mr Hunt said the pilot was a “vital part” of the government’s drive to make the NHS the safest and most transparent system in the world.

Scan4Safety comprised six acute trusts in England getting around £2m each to introduce barcode and scanning technology to improve patient safety and inventory management.

Fast forward nearly two and a half years and some of the results – set out last week at the GS1 UK Healthcare conference – have been impressive. They included:

• Recurrent inventory savings worth nearly £5m across the six trusts, and non-recurrent inventory reductions worth £9m;
• 140,000 hours of clinical time released;
• Royal Cornwall Hospitals Trust reducing pharmacy prescribing errors by 73 per cent;
• North Tees and Hartlepool Hospitals Foundation Trust eliminating never events relating to misplaced nasogastric tubes; and
• Vastly improved ability to track patients and products if products are recalled.

Shunted sideways

It is a little surprising then, that the responsibility for this “vital part” of the government’s plans for the NHS is being moved from the Department of Health and Social Care to the newly-created NHSX.

This effectively means Scan4Safety has been shunted sideways from a team whose staff have dedicated years to the scheme into a new arena filled with technology programmes all competing for prioritisation.

Being put under the remit of a technology body is also rather at odds with one of the key messages from the six pilot trusts in their feedback – namely that, for Scan4Safety to succeed, it should not be seen as an IT project.

The technology is relatively straight-forward, and relies on barcodes, patient wristbands, scanning equipment and inventory management systems, with the most important outcome being safer patient care.

The cash question

Moving Scan4Safety to NHSX also blurs the accountability for the project’s future funding.

Winding back to December 2016 and Mr Hunt’s warm words about the scheme, the fact the six trusts were officially described as “piloting” Scan4Safety implied more money would be on its way if the findings were positive.

One year later, HSJ reported plans to roll out Scan4Safety across another 25 trusts, which would already have access to the learnings of the six pilot trusts.

But the business case for this money never got final approval.

Asked about this at last week’s conference, the department’s Scan4Safety lead Steve Graham said the DHSC – amid the “challenging financial environment” – took the view that NHS trusts should fund their own barcoding transformations because they stand to gain the biggest rewards from doing so.

“I was trying for so long to get a huge pile of money but we’re not going to get it,” he told delegates.

Therefore, it seems the onus is on NHS trusts to get on with this “vital part” of the government’s vision.

The problem is that implementing the technology requires upfront investment, and savings will not start to appear before year two at the earliest.

Given the many various pressures most trusts are under, finding the time and resource to deliver a Scan4Safety transformation is going to be an extremely challenging task without a mandate from the centre.

Look to the north

A very small number of trusts are investing in barcode technology on their own, including Hull University Teaching Hospitals Trust and Salford Royal FT.

NHS Digital hopes to encourage the uptake of the technology by trusts after agreeing a £2.5m partnership deal with GS1 UK, but far more funding is required to roll out Scan4Safety across the NHS.

However, there are two regions that are hoping to forge ahead in the implementation across acute providers in their sustainability and transformation partnerships.

They are West Yorkshire and Harrogate STP – the only STP awarded capital funds (£15m) for the project from the DHSC – and Cumbria and North East STP, whose executive lead Alan Foster was previously in charge of Scan4Safety pilot trust North Tees and Hartlepool Hospitals FT.

He told HSJ he wanted to create an internal pot of money – for example, by taking money out of commissioning – which could be spent on the technology.

“It almost funds itself but it always helps to have a bit of safety funding,” he said.

He said trusts would be incentivised to seek funding for the technology by the integrated care system ignoring proposals which do not “support this agenda”.

But even if both West Yorkshire and Cumbria and North East STPs successfully roll out barcoding technology, the NHS will still be a long way off delivering the potential £1bn worth of savings envisaged by Mr Hunt back in December 2016.

Additional reporting by Jenna Reid.