Insight

Preparing for the challenges of tomorrow with robust continuity planning

Risk management processes play a key role in building the resilience a business needs to operate smoothly during disruption. This is particularly the case in pharmaceutical and MedTech businesses, in which supply chains are often complex and services are multi-layered.

Disruption can come in many forms, including challenges caused by the rapid growth to regulatory changes and rare but destabilising events such as the Covid-19 pandemic. A vigorous business continuity plan (BCP) enables businesses to weather these storms. They have also become a requirement in many commercial tendering processes, which puts companies that do not have one at a competitive disadvantage.

Here we explore how to successfully identify risks and prepare to mitigate them with a robust BCP.

Developing a business continuity plan

Although different parts of an organisation may understand the risks specific to their function, a holistic view of risk across a business is often lacking. Robust organisation-level BCPs will ensure there are structures in place to keep core services running in times of uncertainty and constraint.

The pharmaceutical sector is diverse and each BCP needs to be tailored to each organisation’s specific situation, but there are three overarching steps we would recommend you take when devising one:

  1. Carry out an enterprise-wide risk assessment process to identify, assess and prioritise key risks – to make the most of this exercise, you will want to engage with a broad group of stakeholders, from board level to teams on the ground, ensuring you cover a range of perspectives. This will involve interviews and workshops designed to identify and prioritise risks, pinpoint what risk management initiatives are already in place and establish who, if anyone, is responsible for managing each scenario. This process is likely to reveal risks that may not have been considered previously, which makes this part of the process so crucial.
  2. Examine if and how the risks that have been identified could impact the business and which functions need to be incorporated into business continuity planning – to understand the key priorities, we use our risk assessment matrix, which you can see below. This matrix helps create a risk register by plotting the likelihood of an event occurring against the extent of its impact on revenue and reputation.Akeso risk matrixAkeso risk matrix description
  3. Develop a contingency plan that responds to the information that has been gathered – it will set out the BCP structure and the core roles and responsibilities within it. This plan will also establish recovery strategies that will minimise the impact of any disruption and detail how they should be implemented.

This thorough three-step process will lead to a comprehensive plan that strengthens a business’s ability to respond effectively to change and disruption, as well as embrace the opportunities that often come with it.

A living document

When the facts change, plans need to change with them. The development of a BCP described above is not a one-off event, it is the start of an ongoing process.

From the beginning it should be established that roles and responsibilities outlined are continuous, and the risks posed to the organisation will be kept under regular review. In this way the BCP document can be amended and refined to reflect evolving circumstances.

Those responsible for certain risks can then playback renewed strategies with the business continuity management team, to meticulously test their logic and probable effectiveness.

Our planning in action

Akeso & Co put these principles into play when we developed a business continuity plan for a leading mid-sized pharma company with a range of licensed therapeutics.

As a growing business with a complex supply chain, the disruptions of the Covid-19 pandemic highlighted the need to review and update its continuity plans, including assessing the vital third parties it works with.

A new plan then had to be developed that ensures the organisation and its network of manufacturing and distribution partners is able to respond quickly to disruption in the future. Together with the Chief Operating Officer and a senior team, we followed our three-step approach to do this.

Alongside common risks such as IT failure and disaster, we identified specific issues unique to their business model. For example, certain raw materials where supply could become constrained, and weaknesses in distribution channels such as the Suez Canal. We also located potential single points of failure, where one employee had sole responsibility for a business-critical relationship.

The BCP we developed has provided the business with a flexible framework that will enable the senior leadership team to overcome disruptions to critical business functions. They also now have visibility of the key risks facing the business, supported by effective controls and a process to monitor and manage changes to their risk profile.

Building this kind of agility into a pharma or MedTech organisation enables it to adapt to change and provide a continuous service to its clients. To discuss how Akeso & Co can strengthen your business’s ability to thrive during uncertainty, get in touch.

Scan4Saftey Programme
Case Study

Implementation of a Trust-wide Patient Safety Programme

Akeso & Co supported Homerton University Hospital Foundation Trust (HUHFT) in the design and implementation of a Scan4Safety Programme and Inventory Management System (IMS). Captured in a detailed business case, the initiative is set to drive significant operational efficiencies and improvements to patient safety and care.

Akeso - Homerton Case Study - Healthcare Consultancy

Challenge

Homerton University Hospital Foundation Trust (HUHFT) is a major NHS provider of acute care in the London Borough of Hackney. With services spanning 75 locations across East London, including approximately 450 beds, 11 wards, three day-surgery theatres and six main operating theatres, HUHFT has a complex set of services and supporting supply chain.

Following a thorough opportunity assessment, a number of challenges were identified with regards to the current operations, accumulating in clinical time wasted, health and safety risks, as well as opportunities for cost improvements.

Some of the key challenges identified include:

  • Inefficient and inconsistent supply chain processes across wards and departments
  • Lack of visibility and control of inventory levels due to limited reporting capabilities
  • Segmented spending on products and consumables across wards and departments
  • Limited traceability of theatre implants through the supply chain to procedure due to manual processes
  • Strained working relationships between clinical and material management staff

Solution

To address the challenges identified, the project recommended HUHFT would benefit significantly from a Trust-wide IMS to improve inventory management and achieve patient-level costing. We supported HUHFT through a three-phased approach from business case development through to successful implementation.

Phase 1) Secure investment through a robust business case

With the support of key HUHFT clinical and operational stakeholders, we developed a compelling business case and secured the required backing to proceed to procurement. Through a detailed appraisal of the potential qualitative and quantitative benefits and risks, it was identified that implementation of a trust-wide IMS could deliver £1.4m in benefits over the next five years, from an initial £469k one-time investment.

Phase 2) Source and partner with the optimal provider

Following a route to market assessment, we facilitated a phased procurement process through a formalised ‘mini-competition’ to assist the Trust in their rigorous selection of a suitable IMS provider. Through taking this approach, we were able to secure an optimal solution balancing system capability and total five-year cost.

Phase 3) Implementation through rigorous PMO and change management

We project managed the implementation of the new IMS and change management of associated processes encompassed within the Scan4Safety programme, reporting to the patient safety board. From the outset, programme governance was implemented to ensure the new system and its related benefits were achievable and sustainable.  This involved the recruitment and setup of a programme board of Trust directors, and the chairing of regular meetings and presenting programme updates at Trust-wide Scan4Safety engagement sessions.

Results

The full benefits of the IMS solution will be seen during the next five years but it is already delivering significant savings and process improvements.

The one-time investments equating to £469,000 and subsequent improved processes is expected to generate £1.4m in cost savings, including:

Akeso - Homerton Case Study - Results

In addition to the projected quantitative benefits, implementation of a Trust-wide IMS is also expected to deliver number of qualitative benefits, including:

  • A reduction in the likelihood of ‘never events’ thanks to the patient level costing functionality which improves the traceability of implants, surgical instruments and medical equipment.
  • The release of up to six clinical WTEs, allowing them to re-focus on patient facing activities.
  • Automated processes, such as Barcode-driven ordering, that drive efficiencies in areas including procurement and recall.
  • Additional management information insights that enabled further efficiencies.
  • Increased clinical confidence in supply chain processes.
  • Compliance with GS1 and Scan4Safety.

What is next for HUHFT?

Following the success of the IMS and Scan4Safety pilot programme, HUHFT will continue to drive adoption of Scan4Safety to extended use cases, including potentially Blood Transfusion Scanning, Pathology samples, eMedicine, and many more.

Contact our experts

Scott Healy

Managing Partner
A door to redesigning a one of a kind NHS shared service facility
Case Study

Redesigning a one-of-a-kind NHS shared service facility

We’ve helped shape the NHS Wales Shared Services Partnership (NWSSP)’s long-term use and vision of a one-of-a-kind NHS physical shared service facility.

NHS Wales Shared Services Partnership – Potential

Challenge

In 2018, Welsh Government acquired a 275,000 sq.ft. warehouse in Newport to store core medical supplies as part of the EU Exit preparations. Longer term, the Welsh Government intended that the warehouse would be a strategic investment for Wales. NWSSP were responsible for defining the future shared service opportunity and asked us to develop a strategic outline case, demonstrating that the facility could generate broad benefit to Wales and be financially sustainable in the future.

NHS Wales Shared Services Partnership – Opportunities

Solution

We understood the importance of maximising the warehouse’s potential to contribute towards NHS Wales and broader government strategic priorities. We broke the project into four phases to determine how best to respond to the opportunity.

The first was to engage with key stakeholders to identify how everyone might benefit from the warehouse. The second was to evaluate service options that could deliver clinical, social, operational, and financial benefits for the Welsh Healthcare system. The third was to outline how the warehouse space could be best configured to support different functions and balance a range of benefit opportunities. And the final phase was to draft the strategic outline case and recommend the preferred future option for the Welsh government’s approval.

NHS Wales Shared Services Partnership – ROI

Results

The NWSSP Executive approved the preferred option and ring-fenced ongoing funding, with the adopted approach estimated to generate over £8m in benefits over the next 10 years. The recommended configuration will serve as a cornerstone for key Welsh strategies including the Wellbeing of Future Generations Act, Taking Wales Forwards and A Healthier Wales. It also provides an opportunity to fast track and accommodate initiatives already underway, including the Transforming Access to Medicines Programme.

Case studies – newspapers
Case Study

Delivering a value assessment for regional health and social care collaboration

The Greater Manchester Health and Social Care Partnership, is the largest of the 44 Sustainability and Transformation Partnerships (STPs) defined by NHS England, covering a group of 12 NHS providers (acute, mental health and community), with a non-pay spend of over £2bn per annum, covering a population of 3m and 480 primary care practices. As part of the Greater Manchester devolution agenda, we were engaged to identify and validate in detail the incremental benefits that could result from formalisation of the existing collaborative model and from leveraging the transformational changes from the implementation of the Greater Manchester STP. The project scope included Sourcing and Procurement and Supply Chain of Goods and Services and Pharmacy.

Insight

Whilst the core aim of “ensuring the availability of Goods and Services required to deliver effective and efficient Patient Care to the regions population” will be common to all Healthcare providers in a region, the distribution of this activity and the way in which it is delivered can be very different for each provider. Whilst the benefits of regional working are compelling (greater scale, more cost efficient delivery, sharing of best practice and standardisation, pool investment in technology), understanding each provider’s strategy, their relative areas of focus, priorities, strengths and Procurement capabilities is a crucial first step in the collaborative journey. Our consultants brought a number of methodologies, tools and experiences that have been developed and refined in a Healthcare context, including Capability Assessment and Organisational Diagnostics Tools, a proven Procurement Transformation approach that addresses all areas of capability (People & Organisation, Process and Systems) and Category Intelligence (Client experience, Market Studies etc.).

Action

Our consultants conducted a detailed analysis of resources and costs, capabilities, governance, process maturity and technology to develop a detailed as-is view of the current Procurement Operating Model across providers in the region, identifying areas of commonality and difference. We conducted a total 3rd-party spend analysis with opportunity assessment, analysing four key areas in depth, that would most benefit from a regional approach across Clinical and Non-clinical spend on Goods and Services and Pharmacy. We evaluated a range of options to maximise the return on the collaboration and developed and socialised a Board-level paper which set out the options we had evaluated with a recommendation, underpinned by a HM Treasury 5-case business model.

Results

We developed a fully costed recommendation that reflected the optimal balance between commercial ambition and cost, operational capability and efficiency, and overarching provider strategies. A number of key initiatives from overarching strategy have been taken forward on an advanced basis. We continue to play a role in the delivery of these projects.

Contact our experts

Chris Robson

Chris Robson

Managing Partner
Supply chain value assessments
Case Study

Private Provider Value Assessment

We have been engaged separately by two leading Private Hospital Groups who were keen to explore the potential value of taking a more integrated approach to the supply chains serving their networks of Healthcare facilities. The two projects were delivered independently and confidentially.

Insight

Like public sector Hospitals, private operators have to deal with the receipt, handling and onward distribution of a diverse range of product supplies and equipment. Unlike their public sector counterparts (who until very recently were focussed on Hospital operations within a city or a very concentrated area), private sector Hospital providers have been grappling with the challenge of how to secure supply chain network efficiencies over a wide geographic area for some time. This is compounded by the faster pace of change to their businesses and the need to turn a profit.
Our consultants brought extensive Healthcare and cross-sector experience to these projects including insights on leading supply chain and inventory management practices and established methodologies including a Hospital Supply Chain Maturity Framework, Cost-to-Serve models and Market Intelligence on leading sector Logistics and Solution providers.

Action

We confirmed the scope of supply chain relevant activities, gathered and analysed spend, contract and activity data from across the organisation to built a detailed ‘cost-to-serve’ model for the entire Hospital provider network. We benchmarked the activity and practices to public sector and cross industry (Fast-moving consumer goods, Retail and Automotive) comparators. We engaged with clinical and operational stakeholders to understand the current situation, key challenges and requirements.
We modelled a range of value enhancing supply chain options (using segmented flow models) and jointly, alongside key stakeholders, developed a recommended supply model which reduced costs and improved service levels.
We then developed a final recommendation that achieved the best balance of client and stakeholder requirements, including a full detail business and investment case to take forward on subsequent phases.
We developed an implementation roadmap with interdependencies and priorities clearly specified and mapped. This included a central control capability established to enable benefits to be sustained and tracked over the longer term.

Results

We identified, quantified and developed a series of initiatives that would yield c. 30% to 40% in one-time inventory benefits and 25-35% savings in recurrent supply chain costs, thus reducing average cost-to-serve.

Contact our experts

Scott Healy

Managing Partner