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UKINNOVATION UK75 process seemingly bent upon cost saving itself out of existence! Dick states that procurement's business role is to con-tribute to company strategy, distil out its supply implica-tions, and then act to make strategy happen, whereas its task role is to create and sustain supply markets the business needs for it to succeed now and in the future. The slicing and dicing approach to procurement doesn't fit with this ambition. Herein lies the biggest problem for public procurers. Whilst we are under constant pressure to deliver broader strategic objectives, such as sustain-ability, the link to business objectives is harder to make, and in any case that's not what is measured. The measure is value for money which, unfortunately, is translated into " savings" ( reducing costs), and if this is what drives public procurement then it is perfectly understandable that innovation takes a back seat. Procuring innovation requires procurers to understand the value of the innova-tion to the business. " Innovation" or " strategic" procurement is very different to the more well- known transactional procurement of goods and services. Traditional procurement of goods and services is usually focused on the delivery of cash-releasing savings that can be used elsewhere on the front-line, whereas strategic procurement is focused on the delivery of business objectives and priorities. In health-care this translates to supporting the delivery of better and more efficient patient care. Transactional procure-ment still has high priority to ensure taxpayers' money is not wasted on routine goods and services used in the delivery of healthcare, but strategic and innovative pro-curement has now become an imperative in helping the NHS innovate to deliver the high- quality care for all in the deteriorating economic climate. So how can we drive inovation procurement in the NHS? The new regional duty to promote innovation coupled with the creation of regional Commercial Support Units, provides an opportunity to embed innovation procure-ment into the fabric of the NHS. Regional Innovation Procurement Plans embedded into local planning can be an important driver to mobilise the NHS commercial landscape to source innovation from outside. Regional Innovation Procurement Plans ( RIPPs) can be used to articulate local priorities and objectives and identify the opportunities for sourcing innovation from outside the NHS to meet them. They can also be used to mobilise the various players in the NHS landscape - co- ordinated by the new CSUs - to present a united face to industry and brigade innovation activity so that it becomes more focused on meeting local needs. RIPPs can also help to accelerate what we already know. There are many innovative technologies that already exist that can help NHS organisations deliver their strategic objectives but awareness and take up has tended to be slow. The National Innovation Centre has recently devel-oped a web tool to showcase and help accelerate the uptake of such technologies and RIPPs can ensure they become embedded into local planning. RIPPs can also set out the measures for success, ensuring that procurement is not solely focused on saving money. The Department will be publishing guidance for SHAs in the Autumn to help them think about Innovation Pro-curement Planning. There are already many good examples of innovation pro-curement in the NHS, for example, the HCAI Technology Programme, which is encouraging suppliers and innova-tors to develop technologies to help the NHS combat healthcare- acquired infections such as MRSA and Cdiff, and the forward commitment procurement project at Rotherham General Hospital, which is looking to use procurement to create a step- change in energy efficiency by acting as a lead market for new ultra- efficient lighting. RIPPs can be the vehicle to making these approaches the norm rather than the exception. 1 http:// www. dh. gov. uk/ prod_ consum_ dh/ groups/ dh_ digitalassets/ documents/ digitalasset/ dh_ 098541. pdf 2 http:// www. dh. gov. uk/ en/ Publicationsandstatistics/ Publications/ PublicationsPolicyAndGuidance/ DH_ 085825 3 http:// www. dh. gov. uk/ en/ Publicationsandstatistics/ Publications/ PublicationsPolicyAndGuidance/ DH_ 098876 4 Innovation Nation, Department for Innovation, Universities & Skills, March 2008 5 Transforming Government Procurement, H M Treasury, January 2007 6 Finding and Procuring Innovative Solutions, Department for Innovation, Universities & Skills/ Office of Government Commerce, June 2007 7 http:// www. dius. gov. uk/ innovation/ demanding_ innovation/ procurement_ policy/ innovation_ procurement_ plans 8 At the helm or all at sea, article by Dick Russill in CPO Agenda, Spring 2008 edition 9 http:// www. showcase. nic. nhs. uk/ 10 http:// www. clean- safe- care. nhs. uk/ index. php? pid= 28 11 http:// www. dius. gov. uk/~/ media/ publications/ C/ CS03_ RFT John Warrington is currently Director of Policy and Innovation at the Purchasing and Supply Agency ( PASA) and is shortly to take up a post as Deputy Director, Policy & Research at the new Procurement, Investment & Commercial Division of the Department of Health. Healthcare NHS Purchasing and suply agency ( PASA)

76INNOVATION UKINNOVATION First experiences of setting up an economic value assessment of medical device innovations with healthcare decision- makers using a spreadsheet tool. By M. P. Craven, S. P. Morgan, J. A. Crowe and B. Lu Innovation - what's it worth? Early stage evaluation of medical device innovations is important for healthcare decision- makers as much as for manufacturers, meaning that a wider application of a basic cost- effectiveness analysis is becoming neces-sary outside the usual expert base of health technology assessment specialists. Resulting from an academic- industry- healthcare profes-sional collaboration, a spreadsheet tool is described that was designed to be accessible both to professionals in healthcare delivery organisations and to innovators in the healthcare technology industry who are non- experts in the field of health economics. The tool enables a basic cost- effectiveness analysis to be carried out, using a sim-plified decision- tree model to compare costs and patient benefit for a new device- related procedure with that of standard care employing an incumbent device or other alternative. Such a tool is useful to: » » Healthcare professionals - because it enables them to rapidly elucidate the cost- effectiveness of heterogeneous innovations by means of the standard quality adjusted life year ( QALY) measure of clinical outcome, which is intended to be broadly comparable across treatments. » » Innovator or manufacturer - it helps them focus on what is required for future stages of development, in order to fill gaps in the input data and so further strengthen their case from a health economics perspective. Results are presented of first experiences from deploying the tool on three medical device exemplars, in face- to-face meetings of the NHS National Innovation Centre ( NIC) along with the innovator or clinical champion. The results show that mapping of device- related innova-tions to the tool is achievable in a short meeting between the NIC and the innovator using expected costs, out-comes data from the literature and estimates of ranges for unknown input data. Whilst the result of a simplified analysis is not expected to be definitive, the process of reasoning is found to be illuminating for the parties involved, enabling innovators to articulate the benefits of their innovations and for all Healthcare match