15 December 2010 | Lindsay Clark and Angeline Albert

More standardisation in the purchase of medical devices and using economies of scale could save money for the NHS, a health service management group has said.

As the government launches the legislative framework for its overhaul of public sector healthcare, the NHS Confederation issued a report recommending measures for savings.

The health service is expected to save between £15 billion and £20 billion over the next four years.

In one example, the NHS Confederation said that in neurosurgery, between 10 and 15 models of shunts, which drain brain fluid, are currently in use. “If standardised to a small number they could be procured more cheaply and with no adverse effect on quality, so long as variation from this was permitted if it was part of a trial.”

Meanwhile it pointed out that spinal implants vary from £500 to £10,000. “It is questionable whether they are necessary at all and, even if they are, whether the range currently in use needs to be as wide,” the Confederation report, which was based on consultation with royal colleges and medical societies, found.

Meanwhile it added there was scope for increasing economies of scale in procurement through joint working between vascular surgery and other specialties, particularly as provision becomes more concentrated.

“There is possibly some scope for vascular surgeons to agree to further limit the number of these devices available (although the range is already fairly small) or for manufacturers to agree to a set procedure price in order to continue supplying to the NHS.”

A separate report published today by think tank Civitas criticised the Department of Health’s policy, re-affirmed today, which puts GPs at the centre of the purchasing medical care.

It said innovation and diversity in suppliers of care were needed. “Choice is only going to drive performance if there are alternative options to choose from: it is a gamble to expect new providers to enter a politically uncertain market, without the active encouragement of commissioners prepared to develop a supply base.”

The report said there were big risks in the aim of abolishing all primary care trusts and transferring commissioning responsibilities to new GP consortia by 2013. It said: “It is very uncertain that this approach will make commissioning more effective in the short, medium or long-term, over alternatives.”