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IT Procurement Lessons learnt in the NHS

Matthew Perrott – Strategic Contracts Manager

matthew.perrott@wales.nhs.uk

@perrottmatthew

Agenda

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IT Procurement Considerations

Software and Hardware

The C Word

Buying Complex Solutions

Benefits of IT and Procurement

a bit about me…

• 8 years in NHS Wales Shared Services Partnership covering; • Utilities • Medical Supplies • Pharmaceutical • Homecare services – Enteral & Parentral Feeding • Home Oxygen Services UK Framework with DoH

• 2015 took post as Strategic Procurement Lead IM&T at NWSSP

• February 2017 joined NWIS Strategic Contracts Manager primarily focussed on GP systems and 111 Wales procurement.

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IT Procurement Considerations

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Informatics Through the Ages

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Palaeolithic Cave Art: c. 75,000 BP

Clay tablet for writing Cuneiform: c. 3,500 BCE – 75 BCE

Stone for inscriptions: c. 3,500 BCE

Wax tablets: c. 1,400 BCE

Author: John Frankish, 2017

Paper: c. 2,500 BCE

IT Procurement Considerations

• Its nothing out of the ordinary • just Goods and Services

• Security and Certainty through Conformance

• Innovation through Performance

• There is no leading edge Adapt what you have, Adopt what you need or Innovate

• Don’t look at IT for cash releasing savings • IT enables the savings but doesn’t create them • Systems create efficiency – users create effectiveness

• There is always a way to create quality value though

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IT Procurement Considerations

• Terms and Conditions are King!

• Hardware – Simple Purchase of Goods

• Hardware with support – Goods and Services

• Software – Licensed goods

• Systems and Solutions - Managed Service

• Nearly always use a model form / standard contract • Ensures ability to manage • Creates level field for integration services

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Terms and Conditions

• Public Sector – Crown Commercial Services

• Supply of Goods and Provision of Services Replaced SIMCON & SSCON requires more tweaking for fist use but has excellent coverage

• Model Form Services & ICT Contract Developed by Government Legal Services (UK Cabinet Office) Developed in partnership with Public Sector and Supplier market Groups Made up of a number of documents or Schedules in addition to the Terms and Conditions

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Software and Hardware

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Software

Everything and anything needs to be licensed

• Licences need to be applied to; • servers where the software resides, • the applications accessing it for data • The instances that run

• Terms of the licences are rigid and usually only valid from the day that the license key is delivered. • The clock starts ticking if you have installed or not – timing is critical • Asset sweat relies on up to date records and own audit ability

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Software – how to approach it

• 2 main approaches to licencing • User Based Licensing • Device Based Licencing

• Using only one approach will cost more money than needed

• All licencing needs a hybrid model and lots of thinking

• Application is critical

An acute hospital ward has 4 device terminals and 12 users

TGA office has 500 users and 300 devices

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Software – how to approach it

Asset management software to manage all of the organisations licenses

• Harvest and re-issue licences from devices or users

• Allocate licences

• Manage the contract renewal cycle and aggregate demand

• Transparency of users across the organisation

SAP UK Ltd and Diageo Great Britain Limited

£54M awarded to SAP for missed license payments by third party access to data made available to Diageo customers

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Hardware – Devices & Infrastructure

• PC’s ,Laptops, Tablet & Mobile Devices • Multimedia and Hub devices • Storage • Network devices, load balancers, firewalls….

• Capital Items, Conformance based specification, volume purchase

wide market. • Think long term, obsolescence, model supersedes and monthly price

variation to USD exchange

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Hardware – the difficulties

Typical hardware procurement hurdles

• Brand comfort

• Interoperability

• Quantifying the unquantifiable

• Understanding the future needs and opportunities

• Unpicking the technical reasons from the technical noise

• Managing a fair and transparent specification

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Hardware – Environment

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On Premise Hosting

Datacenter Provisioned

Third Party Hosted

The C word

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Cloud Services

“Simply put, cloud computing is the delivery of computing services—servers, storage, databases, networking, software, analytics, and more—over the Internet (“the cloud”). Companies offering these computing services are called cloud providers and typically charge for cloud computing services based on usage, similar to how you’re billed for water or electricity at home.”

Microsoft, 2017

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Cloud Services Structure

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IaaS

• Infrastructure as a Service (IaaS)

•A virtualized computer environment delivered as a service over the Internet by a provider. Infrastructure can include servers, network equipment, and software.

PaaS

•Platform as a Service (PaaS)

•A computing platform (operating system and other services) delivered as a service over the Internet by a provider. An example is an application development environment that you can subscribe to and use immediately.

SaaS

•Software as a Service (SaaS)

•An application delivered over the Internet by a provider. Also called a hosted application. The application doesn’t have to be purchased, installed, or run on users’ computers.

Cloud Services – The benefits

• Zero Capital overhead

• On demand services – only pay when you need them

• Infinite capacity

• Security and Backup

• Technical expertise – more experts

• Organisational agility and market responsiveness

• Instant version update control

• Focus on the What not the How

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Cloud Services – The Pitfalls

• There is no return

• Subscription for life

• Always online – no bandwidth = no production

• Where data is stored at rest, exchanged and compute differ

• Visibility of network

• Terms and non-negotiable

• Add on’s come at a cost – in a closed market

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CLOUD Services – Things to consider

• Looks great in the short term but it’s a long term game • Consider the compute and business process that are core • Its offshoring for the digital era

• Great for peripheral activities • Do the cost savings balance the technical risk • Can you create synergies with suppliers and customers • Dos third party hosting offer as effective a solution

• In NHS Wales there is a zero cloud policy for all PID and CD • However GPs will have eMail on O365 and Cloud device reg services • Secure connections to third party hosting for hybrid solutions

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Buying Complex Solutions

• Similar to a building or infrastructure procurement • Set timescales – political & regulatory obligations • Budget Constraint • Spider-web integration with existing infrastructure • We know what we want but not how we want it • No two contracts are the same

• What do complex systems look like?

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WCP WCP

Welsh Integration Services

Documents (WCRS)

Results and Reports (WRRS)

Content Index

eForm Library

Imaging Archive (WIAS)

Primary Care

Record

LIMS

RIS RIS

RIS

RIS RIS

Cardiology

RIS RIS Other

Diagnostics

Welsh Integration Services

CCUS

CCUS Database

Image Capture

Welsh System Integration design

Master Patient Index (MPI)

PAS

WCP

Medicines Archive

WRDS

Buying Complex Solutions

For requirements of this nature NHS Wales use Competitive Dialogue

The key features are:

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Call Off Award Evaluation ISFT

Trial feedback

Trial ISFT Detailed Dialogue

Shortlist PQQ OJEU

Advert

Feature Stages of a Competitive Dialogue

• Detailed Dialogue • to refine our requirements • to develop Supplier understanding of our requirements

• Trial ISFT – to improve consistency of the final bids • follows Detailed Dialogue • last opportunity for bidders to get feedback on understanding of

requirements

• ISFT – the final submissions • Clarifications – this is not negotiations or changes • strict management via Secure eSourcing portal

Contract Award

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Benefits of IT Procurement

It enables the business to strive

Creates a robust basis for strategic development

Secures the foundations to deploy services to customers

Creates business synergies up and down stream

It’s the second most important resource after people

When IT & Procurement professionals work together as partners the business is robust in exploiting its strength, defending its weakness, spotting opportunities and blocking threats.

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Questions

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