In addition to his Trust role, Andy joined NHSI in 2017 with responsibility for the NHS Nationally Contracted Products programme and more recently as lead for the development of NHS Spend Comparison, an NHS wide price benchmarking solution.
You can watch or read their conversation below.
I thought it would be a brilliant idea to give the audience a bit more information about the University Hospitals Plymouth NHS Trust and how procurement is viewed.
I believe it’s the biggest single-site hospital in the UK.
There will be bigger hospitals, but they have multiple buildings where we’ve got a single building pretty much, with 8,000 staff, we cater for about 457,000 people for secondary care, but because we’re a specialist hospital, people get flown to the hospital. We cover a wider population of about two million, it’s one of the bigger hospitals in the UK.
I came from the private sector. I used to work in global manufacturing, supply chain management for an OEM manufacturer to HP, Dell, IBM. I’m an engineer by background and was getting a bit tired of the travel abroad and being away from family and wanted to switch sectors. At the time, health was paying a bit more money than I was earning, but I did recognise that I was taking a step back in seniority and responsibility.
That was 2007, I came into this role on large infrastructure schemes, not to the scale of this opportunity that we’re talking about today, but I think it was about £40-50m projects at a time.
This one’s about £125m on just one of the schemes.
I loved it, to work for a not-for-profit organisation and for more altruistic reasons, is great.
I think that’s when you make a connection in this role, why you’re here, and the difference it makes to people and health and wellbeing and the improvement of life.
It is the best job I’ve had and I’ve had some good jobs in my career.
In my time, we’ve implemented inventory systems, built warehouses, optimised inventory, all to improve the service and availability at the point of care.
The progression for me was to then take over the department four years after I arrived – that was more than 10 years ago! Now I have a national role with NHS England. I think that’s probably a really good example of the opportunities that exist in the NHS.
Both within the organisation with Non-Exec and with Execs, we’ve got a highly credible brand.
Although the league table hasn’t been published for about a year now, the regulator has a league table of procurement performance by each of the 135 acute hospitals in the NHS, and for the last two publications, which was the last year of its publication, before COVID, our team and this Trust became a supply chain management team ranked number one and has always been in the top five.
You’re coming to a highly credible team, recognised within and outside of the organisation.
How have you gone about that? Because, you know, different NHS Trusts will have a different view of procurement and how that sits around value within an organisation and clearly, you’ve got it right, what are you attributing that, that success to and that that credibility piece?
Hard work and results!
We’ve been able to deliver that through talent.
We buy 175,000 unique items a year, or six times bigger than the biggest Tesco. I’ve got three times more inventory than the biggest Tesco in the southwest. It’s a big infrastructure, we have 30,000 people on site a day, that’s the same as a small town.
This is a big context and when I first joined, 55% of the team of that 60 or so people were earning less than about £20,000 per year.
It was very much a transactional team but did have some strategic procurement as well, it was more advanced than many of the hospitals across the NHS, but when you compare it to the private sector, really significantly different in the volume of resources in strategic and complex commercial matters.
Fast forward to now we’ve got far more now that the balance of the team has shifted very much to give more balanced to strategic and complex commercial matters and over that period, traditionally, a lot of NHS procurement teams just deal with medical and surgical, possibly a bit of IT, but are kept out of other matters.
I can guarantee you every single commercial penny in this organisation, other than drugs, which you need a chief pharmacy for, every single commercial element comes through my team.
What I think is different for my team is that we have taken on commercial bidding and driving income, which is unusual. There are a few trusts doing that, so we’re not just procurement and supply chain management, we’re then commercial as well.
That’s come from how I’ve been taught in manufacturing, deliver some value.
I then asked for a little bit of that money back to reinvest, and we invested in new posts, attracted more talent, and we’ve constantly built on that thinking.
Today, we have a broad number of people in that £40k+ salary bracket, being solely responsible for some complex commercial matters in that category management methodology.
So it’s coming from hard work, absolute results, proving that we’re capable, and delivering what we said we would.
The job is easy when you can do that!
Let’s talk about the projects you’ve got in the pipeline. This role in particular, which is all about building the future hospital programme that the government has set out, can you tell the audience about what that project ultimately looks like for this individual?
Yes, so they may have heard of, probably called crudely in the press, Boris’s new hospitals, but there was an announcement of 14 new hospitals and Plymouth has always been in that group.
Initially, we have got funding for the scheme now that I urge anyone interested in the role to watch the following video as it really brings the scheme to life.
The first phase is significant in scale extension to our emergency department. Generally, there are two pathways into a hospital, either through planned care, o you get a letter come in on this day you will have a procedure, or emergency care, you come in through the emergency department. That’s our constraint as a hospital, we’ve outgrown the current facility. The first phase of the scheme is to build a four-floor extension onto the front of the hospital, which gives us more capacity, but also an ability to integrate elements of care within the emergency department process.
When you come into that emergency department, you’ll go through some diagnostic care process to try to identify what is the matter with you or what your ailment to be treated is. There’ll be imaging equipment, diagnostic processes that will be integrated, and in this new facility that enables more efficient care and integrated care. That’s the big chunk of this programme and then the second phase is then to build a c£600m new hospital.
Where you’d like to get to in healthcare is to separate emergency care. Our hospital is a single site where it’s all integrated and if the pressure is always on emergency, it stops the planned care from being been delivered, which you’ve probably heard in the press.
Now, the stories of the waiting list extending because of Covid, because that’s medical patients; if you can separate one from the other, it removes that impact.
That’s what a new hospital would give us, the freedom to just breathe and spread out more.
It’s fantastic for the city.
I grew up in the shadow of this hospital being built and I remember we got a big hospital and I remember watching that emerge from the ground when it was first built.
The chance to be involved in building something that’s going to shape this hospital for the lives of our population for the next 20-30 years is quite a proud moment for a number of us.
How long do you anticipate the first phase taking?
So that would probably take us up to 2024/5.
At the moment we’re mid-business case, and for anybody who’s going to apply, I’d encourage them to Google the Treasury Green Book process, because that’s the business case process for having to go through, we will help you learn that, but it’s a significant process to get an approval for capital investment and sign off.
We’re at the OBC stage there are basically three stages, we’re at the second stage now and are probably going to submit that in the next five or six months so then you’ve got your commercial, your procurement to appoint the vendors, get your designs done, get your final costing and then you submit your final business case and start to build. We’re probably looking at about 18 months of business case process and then you’re probably into a two-year build. But those are just off the top of my head I’m not close enough to it day-to-day to know the exact details.
What do you need from this person? What are the key skills and behaviours that you are looking for that mean this person can be successful and build in this role?
Clearly, they must be technically competent and experienced in large infrastructure projects, be that public or private sector.
I know that what it’s like to transition from private to public and while I’d love people to have experience of the public contract regulations and running formal tenders, as we have to do in the public sector, it’s a nice to have. Above that is the commercial experience of large infrastructure schemes, whether you do a formal tender, public tender, or run a private procurement, the stages and what you consider are not that different.
If the person comes to us hasn’t got public contract regulations experience, they’re not going to be alone in the role, we will absolutely give them the training and development they need and we will support them through the process.
What I personally put above all of that is the soft skills.
This game is all about relationships, as far as I’m concerned and the stakeholders in this project are going to be wide and varied. They’re going to be national, they’re going to be the regulators may be some Department of Health colleagues will get involved from time to time, you’re going to be exposed to Chief Execs, Execs, Non-Execs, the public, the media might come into play.
Having someone who’s comfortable in those types of environments, or has had some exposure to them, to be able to hold a conversation with any one of those stakeholders is going to be really important. Those skills are naturally about building rapport, really actively listening and speaking.
Being able to be comfortable in a relaxed way, have a conversation with anyone at any level, is a really important skill and to be able to just relax and really listen to people. Sometimes it’s not a skill that comes naturally to many but I’m expecting the candidates that we’re going to be looking at are competent, they’re going to have the knowledge we need and there will be a panel that will test that technical competency out.
I really want to get a feel for the person, we constantly talk about recruiting for fit.
In our team, we have fun, we have laughter, we’re energetic, tough, we have quite high expectations of one another but we do everything with a smile on our face and it’s really important that we support one another. We’re compassionate, we’re caring, the environment we’re in dictates that, but you’d be a fish out of the water if you didn’t have those values and beliefs.
I’m at that point now where I’m recruiting more around how they’re going to fit in, and are they going to get on with other people? Are they going to be able to challenge views that maybe are the wrong ones?
Yes, you’ve got to come with the background of capital projects and infrastructure, but you could have gained that from the private sector. And actually, this has been more about assessing the fit, the interaction with key stakeholders, and I think that’ll be refreshing for a lot of people that you’re not limiting the talent pool as a result of that.
What would you say about kind of supporting people’s learning and development, because I know you’ve got a best in class function there and you’ve probably more than any Trust I’ve ever spoken to have a really good programme in place to support people’s learning and development.
Could you just talk us through that?
Yes, again, for prospective candidates, I encourage you to Google Positive Purchasing, Jonathan O’Brien is the owner there is one of the I’d argue the foremost t authors in the globe on category management and has done some fantastic books on negotiation as well and supplier relationship management.
In the NHS, we were the first Trust to launch its own procurement academy. Alongside that we have training, Jonathan is running the courses on each of those subject matters.
The academy has a mixture of video, slides, content, and then tests at each at the end and it has three headlines subject matter category management, supplier, relationship management and negotiation and then the model for category management, which is a five-step model, and negotiation which an eight-step model is how all our Buyers are and commercial people are trained, and we’ve even colleagues in finance have been trained in our approach to negotiation as well. Whenever we work as a team, we have similar learning and experiences. It’s a fantastic tool.
We mix that with face-to-face training – hopefully, we’ll get back to that post-Covid. We also put people on courses at Cranfield, a couple of us have done strategic leaders probe programmes there which were fantastic. There is an NHS future stars programme, which is soft skills orientated, probably more than a dozen people have been through that programme.
There is the NHS Leadership Academy and lots of in house training and development courses around resilience, health and wellbeing and I think in summary, you won’t be short of options to continue your own professional development.
There is an expectation from me and a challenge from me regularly to my team for them to demonstrate what they are learning at the moment. We will support whoever comes in whatever they want to do to learn and develop.
How would you describe your leadership style?
And how would your team describe what it’s like to work for you?
I’d think they’d say I was demanding, I’m challenging of them, but I’m incredibly supportive of them all. I think I’m a democrat and I give them all the freedom to decide how they want to work.
I don’t expect any of them to work overtime or long hours.
I want them to come in to be 100%, effective, 110% effective probably for the time they need to be and then I want them to go home, to spend time with family, to rest, relax, do fitness, get out in the fantastic part of the world that we live in, to recharge and come in and go 110% the next day.
Now we all know that from time to time we have to work a few long hours because the need is that at the time, but I expect them to take it back when the pressure is off.
So they’ll I feel I empower them to do their role.
I’m behind them and supporting them and sorting problems out for them.
Laughter is important. Like I’ve said we smile, we have a joke, we laugh – but when necessary, we need to be serious. We work in healthcare and the context is can be serious from time to time.
I hope they would say they love working for me because that’s the feedback I do get from them.
But they would tell me that of course!
What’s your view on kind of hybrid working flexible working, you know, if someone’s looking at this role thinking, that sounds just like me, but Plymouth as a location might not be ideal.
What’s your kind of view on where this person can be based and do their job?
Yesterday morning I didn’t start my day till 10 o’clock.
I went up to the moors with the dogs at about 8. We went for a walk for an hour, helping me make sense. I just wanted to get my brain in the right place and to do physical activity.
Last week I went for a long walk with a colleague, in a stunning part of Devon, we had some food and worked out the next steps.
You’re not going to do that in London or Burnley.
That said, as far as where do people need to work, I don’t mind, whatever is best for that individual and obviously to get the job done where they’re going to be happiest.
I think given the nature of the task and responsibility of the role, they’re going to be a need to be on-site from time to time.
Given that it’s a build, and its infrastructure scheme is difficult to manage that remotely.
Sometimes you might be running events on the hospital site.
But look, on the 21st of March last year, my whole commercial team moved off-site, and we’re still off-site and we’ve delivered the biggest capital programme we’ve ever delivered, responded to global PPE issues, built a lighthouse lab for test and trace in four months, which will probably normally take 12-15 months, built mass vaccination centres, we’ve done all that, while we’ve not even been in the same room together.
I really haven’t got a view on it, my only view is you tell me what you want to do, as long as the job is done, as long as the clients are happy, as long as you’re happy, that’s what’s really important, because what I can say is the outputs that we’ve delivered in last year have been extraordinary.
Don’t get me wrong, I’ve got some people who are really eager to come back to work and they don’t think homeworking is for them, but for those who do want to stay at home I am happy, and then from time to time, come in and spend some time on site. It’s back to that empowerment, particularly for this role, it’s going to be a senior position within our team and within the organisation.
The senior folk in my team know that they don’t ring me up to say, I’ve got a dental appointment today I’m going to be off-site. I don’t need to know these things. If you feel it’s okay for you to leave work early to go and do something cool, crack on. You’ve decided is individual that you can take that time out. I’m comfortable with that.
If we get behind on something, and you’ve been taking a bit of time off, it might be a different conversation, but it’s never happened, I find people you trust them, they tend to do the right thing.
That’s really refreshing and I think will resonate with a lot of people.
Someone’s looking at this thinking, I’ve got an understanding about the Trust, about Andy his team, his culture, the role, if you’ve got any kind of last thoughts for somebody that might be looking at this and thinking about applying, they’re in a stable job in a stable environment that this might appeal, but they’re maybe unsure about having a conversation with us.
What are your kind of final selling points, I guess, to anyone watching this?
I probably just reflected on my own experience of coming to the NHS when in 2007. My judgment at the time was that taking a step back, I was looking solely at the role of the remuneration that I was going to get.
What I would want to tell that person now is what what you are coming into, the role that you’re going to come in into is the tip of an iceberg that you’re going to get involved in throughout your time here and the opportunities are just so wide and varied.
It’s down to that individual, and how successful they are and what they can achieve in this sector, the scale is enormous.
You know we influenced about £150m spend at the Trust capital programme of £71mn this year, the biggest we’ve ever had was £220m annual.
With the new legislation around integrated care systems, there is this expectation from the government now around shared services and shared procurement finance functions may be across providers.
So the opportunity there for more senior roles working across counties in respect for Devon, because our integrated care system is Devon, so that would be then taken from the north of the county right to the south and east and west. So that’s Exeter, Torbay, Barnstable and Plymouth and uniquely for Plymouth as we pull east of Cornwall.
I would look to tell our personnel look, when you come in, just imagine that in four or five years, you could probably be a couple of bands higher, maybe have a department, as I never would have thought that when I came in 2007, but it’s down to the individual.
I’ve got enough examples, not just me, of people who came into the organisation, maybe from the private sector, mid-tier, and are now in far more senior roles and I guarantee you that each one of them will say this is the best place they’ve worked in from a sense of purpose.
It’s really important to recognise that in this role you are going to make a difference to the lives of 457,000 people in our city and the wider rural area, and possibly two million, you’re going to be involved in building something that is going to make a difference for the next generation.
I mean, there are not many jobs, you’ll get involved in that sort of to influence that many people’s lives.
Please do get in touch or if you know anyone in your network this will be suitable for I would absolutely love to have a conversation.