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There is no simple solution to sourcing medical materials in crisis situations

The COVID-19 crisis caused both unprecedented spikes in demand for personal protective equipment (PPE) and respirators worldwide and disruptions in the supply chain for these products. Part I of the Material Supply Strategy in a Crisis (MaSSC) study made public today presents six interrelated solution approaches. This study analyzed the procurement of scarce medical materials such as mouthguards and respirators during the first phase of the COVID-19 pandemic. The study sheds light on the various challenges that hospitals, healthcare facilities and the national initiatives faced - and how these challenges are interrelated. Prof. Dr. Louise Knight and Esmee Peters (Faculty of BMS) were the involved UT researchers.

Thinking about purchasing for the next pandemic

Niels Uenk, director of PPRC and project leader of the study: "We wanted to know what we could learn from the first phase of the COVID-19 crisis with regard to the procurement and logistics of scarce medical materials for healthcare organizations. Based on 60 interviews with stakeholders from organizations at the national level and from the care and cure sector, we present six coherent solution approaches. One is to reduce dependence on foreign producers by setting up production facilities closer to home, or by means of a stockpile. Pooling purchasing power (during crises) and professionalizing purchasing are two others. Administrative aspects have not been forgotten either, such as setting up a crisis protocol and information systems. By combining the insights of different stakeholders, we can now think about the strategies during a possible next pandemic."

From routine procurement to crisis situation: lack of trust and coordination

In stable times, the procurement of these materials, especially PPE, is a routine operation. This changed dramatically, and the scarcity of medical materials threatened to become a bottleneck for the capacity of healthcare systems worldwide. Kees Ahaus, Professor of Health Services Management & Organization at Erasmus University Rotterdam: "During this crisis situation, a number of things came under fire. For example, that managements and staff of nursing and care homes did not feel seen or that not all organizations were willing to share their information on stocks. This has to do with trust and lack of coordination, among other things. In this study, we were also critical of that and wanted to make this picture visible and recognize it." Erik van Raaij, professor of Purchasing & Supply Management in Healthcare at Erasmus University Rotterdam adds: "It turns out that over the course of the crisis there is a difference between the first phase, where you see a lot of creative strategies at the level of individual healthcare institutions and the later phases where the emphasis becomes more on national coordination of purchasing and inventory management."

Being prepared for future crises - No easy solutions

Ensuring an increased supply of critical materials is a clear and obvious goal, but it is far from easy to achieve. Esmee Peters, PhD researcher Public Procurement and Crisis Management at the University of Twente and PPRC: "For example, we don't know in advance exactly which products will be needed in the next crisis, let alone when and where. Keeping stocks is also expensive and products have expiration dates. Should we store the end products or the raw materials that can be used to produce a wider variety of products quickly? There are no easy solutions when it comes to the procurement of scarce medical materials in times of crisis. This is true not only for the Netherlands but also internationally, as we will show in Part II in early 2022."

Louise Knight, Professor of Public Sector & Healthcare Procurement at the University of Twente adds, "An important lesson from our research is that we need to look at the underlying procurement system; not at one organization or one possible solution. Our research is not limited to noting key events and salient initiatives alone; it is a holistic analysis of a very complex, dynamic system. Each of the six solution approaches is just one building block in the development of a more coherent system that can better respond to future crises."

More information

The research (consisting of two parts) is a collaboration between PPRC (Public Procurement Research Centre), University of Twente, Erasmus University Rotterdam and IRSPP (International Research Study of Public Procurement) and is funded by ZonMw as part of the COVID-19 program. The full report is attached.

K.W. Wesselink MSc (Kees)
Science Communication Officer (available Mon-Fri)