Credentialing Schemes add unnecessary cost and delay for Suppliers to the NHS

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AXrEM, the Association of Healthcare Technology Providers for Imaging, Radiotherapy & Care whose membership covers the vast majority of the suppliers to the Radiology and Radiotherapy departments throughout the UK have become aware that some NHS Trusts in England have appointed 3rd party companies to provide a credentialing and accreditation service on their behalf.  We understand that these have been positioned as “free” services to participating NHS Trusts whereby suppliers of technology to NHS Trusts are being mandated to register all of their employees who may need to attend on site at a hospital to support installed systems, failure to do so meaning the employees will be refused access to the site.

AXrEM member companies have been providing X-Ray Imaging Technology to Hospitals in England for over 100 years, the procurement of which is governed through the Official Journal of the European Union. Much of the technology we provide includes the production of Ionising Radiation, and consequently our members are subject to and rigorously controlled and audited by the nominated competent regulatory authorities in all the countries we offer solutions around the world. Our employees are therefore required to be specialists in their field, and receive extensive training, accreditation and are required to go through refresh training to maintain these specialist skills. The tenders for much of the equipment currently installed in UK hospitals have included validation and confirmation that all employees involved in the Sales, Support, Applications Training and Project Management have the necessary formal qualifications to meet the requirements of the tender.

So what is the impact of these credentialing and accreditation schemes?

Whilst the Credentialing and Accreditation schemes are positioned as “free” to participating NHS Trusts, suppliers who register with these schemes are charged a fee, usually on a per employee basis and the fee is payable annually. Some schemes are mandating that all employees undergo training with another separate 3rd party company from the Credentialing Company. We are aware of at least three companies that are offering this service currently. As many of our members are multi-national companies, we have thousands of employees many of who are in customer facing roles, the highest percentage of who are field engineers, applications specialists, project managers and products specialists. The increasing complexity of the solutions our members offer means that international specialists often visit UK hospitals to provide their expertise to NHS staff. The potential costs of registering all of these employees in, at least three accreditation schemes, and to repeat this on an annual basis, are enormous.

It is widely recognised that NHS Trusts are under extreme cost pressure, and suppliers of imaging equipment have taken steps to reduce their cost of manufacturing through implementation of lean processes, optimisation of supply chains and the utilisation of standard operating platforms and components which have enabled manufacturers to drive down costs and reflect this in their respective selling price.

AXrEM position

We recognise that in some areas, improved identification of suppliers visiting hospitals and especially suppliers involved in sensitive areas within hospitals would benefit from improved identification but that any such scheme should be centrally managed and operated by the NHS and not by the current three separate 3rd party companies, some with separate 3rd party training companies.

However, as AXrEM members are already heavily regulated and governed and our staff undergo rigorous training and qualification, these schemes place an unnecessary additional burden on AXrEM members and ultimately, any costs incurred by AXrEM members registering with these schemes will ultimately be passed onto the NHS Trusts through higher pricing, at a time where the NHS is under unprecedented cost pressures.

We believe that our members own corporate self-regulation and QA processes for screening staff, which are internally and externally audited, are sufficient and more comprehensive than the current schemes being proposed and, in many cases, these are documented explicitly in our member companies responses to NHS tender documentation and resulting contracts. It is therefore our position that these schemes are an unnecessary duplication and our members should be exempt from these schemes.

We are also uncomfortable about the fragmented approach taken by the NHS with currently three separate credentialing and accreditation schemes in operation and the increased costs to suppliers in registering with these schemes which are potentially diverting costs savings away from the NHS.  Furthermore, as these schemes are administered by 3rd party companies, we feel it is inappropriate for these additional costs to be potentially used for the economic benefit of 3rd party companies.

So what is the impact of refusing AXrEM members these credentialing and accreditation schemes?

Whilst it is currently unclear how these schemes will be implemented and policed, it is AXrEM’s fear that our members field engineers, applications staff, project managers and product specialists may be refused entry to hospital departments to repair, service and support critical equipment which is used in the diagnosis and treatment of disease in patients in Radiology and Radiotherapy departments in England. This will lead to delays in the diagnosis of disease, disrupting care pathways, delaying treatment for patients and negatively impacting patient care.

We are also concerned at the lack of consultation both by NHS England and participating NHS Trusts and the lack of a joined up and coherent strategy around credentialing.

We are encouraged by the recent communication from NHS England (Publications Gateway Ref No. 02086, dated 8th August 2014 – NHS England review into professional registration for the medical technology industry – update for NHS provider organisations) which recognises the fragmented nature of the current situation and NHS England’s intention to set up a working group to review the current situation and their clear advice in that publication that “Trusts looking to implement credentialing schemes locally might want to wait until the recommendations of the review are published in March 2015”.

AXrEM are lobbying to participate in this review to ensure our views are understood, that there is no unnecessary administration burden and associated costs placed on suppliers (which are ultimately borne by the NHS), and that any such scheme is centrally managed by NHS England with no charges levied and that the Personal Identifiable Information of AXrEM members employees is protected and managed securely.