Digital knowledge resources: economic value of national procurement of Core Content
About the economic benefits of national procurement of digital knowledge resources.
In 2022, the Resource Discovery team commissioned Economics by Design to evaluate the economic benefits of national procurement of digital knowledge resources.
Background
The NHS is committed to delivering evidence-based care and Integrated Care Boards have a duty to promote the use of evidence obtained from research.
NHS England funds a National Core Content (NCC) collection of digital knowledge resources which are available to all staff and learners across the NHS in England. Spending on NCC accounts for roughly one third of the total national spending on digital knowledge resources.
The remaining two thirds of spending takes place at trust level where local NHS libraries are able to supplement NCC by purchasing additional resources. While this provides excellent access for the staff of that trust, funding differences lead to unwarranted variation between trusts. Users tell us they want to know that they have the same access to materials as colleagues in other organisationsi.
Local purchase rarely enables access beyond secondary care so most staff and learners in primary care and community settings only have access to NCC. Within an Integrated Care System where multi-professional teams collaborate across organisational boundaries to improve health and care services, colleagues will not have equal access to digital knowledge resources even when needs are shared.
Many resources procured locally are bought by multiple organisations, duplicating indirect transaction costs like procurement, contract management and remittance. There is also wide variation in the prices paid by different organisations suggesting some don’t achieve best value.
Comparing local and national costs
The starting point for the analysis was the “local procurement audit” carried out in 2021. Every two years, NHS libraries are asked to report on the content and systems that they buy locally and, if possible, to share cost and usage data. This data gives the Resource Discovery team an invaluable picture of what local NHS libraries are buying which informs the strategic direction of the team’s work. Previous audits have already been instrumental in making the case for national procurement of key resources like the NHS Knowledge and Library Hub and BMJ Best Practice.
The results of the 2021 audit showed that about 15 products were bought by over 10% of trusts. Although the cost data wasn’t comprehensive, we were able to calculate figures for:
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Total declared cost
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Number of organisations with access
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Number of clinical staff (FTE) with access
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Cost per organisation with access
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Cost per clinical staff (FTE)
The next step was to liaise with suppliers about the cost of a possible national subscription. Anecdotally, most suppliers are keen to move towards a single, national procurement for their products. Each local purchase requires separate negotiation, contracting, account set-up and administration. Doing this once, for the whole of England saves time and money for suppliers as well as NHS libraries.
Two suppliers were happy to support this economic evaluation with example quotes for national procurement for their products. Using these quotes, we were able to compare the cost and reach of local and national procurement.
| Number of organisations with access to product in 2021 | 70 |
| Total declared costs 2021 | £539,011.17 |
| Total workforce FTEs with access | 421,988 |
| Average cost per FTE with access | £1.28 |
| National cost (quoted) | £1,225,675.00 |
| National cost - negotiated discount | 0% |
| Discounted national cost | £1,225,675.00 |
| National workforce FTEs (Doctors, nurses, health visitors, ambulance staff, scientific, therapeutic and technical staff, support staff, managers, primary care GPs, practice nurses and other patient facing staff) | 1,128,616 |
| National price per FTE | £1.09 |
| Efficiency saving cost per FTE | £0.19 |
| Efficiency saving % | 15% |
| Increased access (FTEs) | 706,628 |
| Increased access (%) | 67% |
| Budget impact | £686,663.83 |
Conclusions
By comparing local and national cost per FTE, Economics by Design have shown a 15% improvement in efficiency cost per clinical FTE with access. This figure is achieved without including any discount which can be achieved through national procurement. The efficiency saving also does not reflect the indirect cost savings which can be gained through centralising procurement nationally rather than undertaking multiple local purchases.
Delivering equitable access to research literature is key to delivering evidence-based clinical care and service design across all sectors of the NHS and one of the guiding principles of Knowledge for Healthcare. This evaluation shows that providing universal access will lead to a 67% increase in the reach of national core content which has the potential to deliver improved outcomes and impact, increasing the effectiveness of healthcare across the NHS.
Page last reviewed: 7 August 2024