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New ICS benchmarking blueprint for NHS finance and procurement

ICS Diagnostics 1

ICS Diagnostics 1NHS SBS partners with Norfolk and Waveney Integrated Care System to develop Insight Diagnostic solution

With the move to Integrated Care Systems (ICSs) presenting a significant opportunity to drive national best practice and consistency - and realise huge cost and efficiency savings - across NHS corporate services, NHS Shared Business Services (NHS SBS) and Norfolk and Waveney ICS have pioneered a unique Insight Diagnostic solution, which provides unprecedented system-wide data and intelligence to inform decision-making around finance and procurement practice.


The challenge

ICS Diagnostics 2 With NHS trusts joining other health and care providers in Norfolk and Waveney to form one of the country's 42 ICSs, the Norfolk & Waveney Health and Care Partnership provides services to more than one million people.

In addition to benefiting its residents via access to more integrated frontline services, the forward-thinking Norfolk and Waveney ICS was also keen to explore the opportunity for greater collaboration across its corporate services.

However, with individual member organisations using a range of complex finance and procurement systems - and each with its own unique processes - the ICS needed a comprehensive, system-wide understanding of its current practices to inform robust decision-making and achieve service improvements and efficiency savings.

Stephen Beeson, Deputy Director of Finance at Norfolk and Norwich University Hospitals NHS Foundation Trust and ICS Programme Lead, explained:

"As we started to work together more formally across the ICS, we needed to be sure that we were talking about things in the same way, with the same understanding.

"We wanted to look at standardising systems to achieve consistency and efficiencies, and how we could improve our digital maturity by working together more closely. We were also mindful of being able to respond to national expectations and contribute to the standardisation agenda."

The solution

To ensure Norfolk and Waveney ICS had access to the right resource and specialist expertise, it partnered with NHS SBS - as the county's leading provider of NHS corporate services - to carry out a detailed assessment of the existing finance and procurement processes across five of its member NHS trusts.

A key consideration was NHS SBS's ability to act and advise in an objective capacity. NHS SBS experts worked with the ICS to baseline the current finance and procurement practices of the different trusts, comparing processes at individual organisations against industry best practice.

This included a maturity assessment using Future-Focused Finance (FFF) standards, Procurement Target Operating Model (PTOM) benchmarks, and the latest commercial standards (known as the Commercial Continuous Improvement Assessment Framework) published by the Government Commercial Function and NHS England (NHSE).

Stephen said:

"Partnering with NHS SBS to carry out an independent diagnostic of our current ICS position ensured it was not dominated or influenced by any individual organisation's perspective. It was essentially a self-assessment, but with parameters designed in collaboration with NHS SBS.

"The fact NHS SBS is part of the health service and has such a large NHS footprint makes it stand out as a partner. It means it has a vested interest in ensuring the solutions it develops are focused on quality healthcare reporting and outcomes - which was important to us."

The result

ICS Diagnostics 3The work between NHS SBS and Norfolk and Waveney ICS - as a national pathfinder - resulted in the development of an innovative new Insight Diagnostic solution, which can be invaluable to every ICS in the country.

Providing a new system with a detailed understanding of its current position, the co-designed Insight Diagnostic service analyses finance and procurement data on both an organisational and system-wide level, helping an ICS to identify and agree priority areas for improvement and where investments can be best targeted.  

This includes taking the appropriate steps to improve financial visibility and controls, ensuring compliance with national policy, and unlocking significant savings opportunities. 

At Norfolk and Waveney ICS, the evaluation highlighted the potential for system-wide service improvements and identified significant savings of £7.3m (26%) on operational expenditure over the next ten years, including cash releasing savings of almost £4m.

Stephen said:

"The Insight Diagnostic process with NHS SBS showed that the amount of variation between organisations within our ICS was still quite significant - despite the fact we had been trying to work together for some time.

"It was clear that the only way to move beyond this and get to a better place as a system was to work together more formally and do things as a single unit.

"Without going through an exercise like this with NHS SBS, we just would not have collated the data we needed in a consistent and transparent way. Having a baseline to build a case for what we do as a system has been really useful and valuable."

The tailor-made Insight Diagnostic solution also enables ICSs to easily comply with NHSE's directive - via the 'NHS revenue finance and contracting guidance 2022/23' - which says systems should 'carry out a diagnostic exercise to establish the scale of opportunity' in relation to implementing the PTOM and best-practice transactional procurement.

Stephen concluded: "Having the support of the national team at NHSE for us carrying out this Insight Diagnostic with NHS SBS was an important consideration for us as an ICS - as was having a natural path from this exercise to implementing collaborative, system-wide finance and procurement practices for the future."