15 April 2025 by Tippy Jackson
In the NHS, reducing unwarranted clinical variation is critical to improving patient outcomes, driving cost efficiencies, and ensuring fair access to care. Clinical variation itself isn’t inherently bad—some variation is warranted due to patient-specific needs and evolving medical innovations. However, unwarranted variation—where differences in treatment approaches or procurement choices do not add value—can lead to inconsistent care quality, increased waste, and financial inefficiencies.
Unwarranted variation has been recognised as a core challenge in the NHS Long Term Plan, which mandates a more transparent, data-driven approach to reducing disparities across providers. The Getting It Right First Time (GIRFT) programme and the Model Hospital initiative have already demonstrated the potential for cost savings and operational improvements when variation is addressed systematically.
AdviseInc takes a different approach to tackling clinical variation—one that goes beyond traditional price benchmarking. By leveraging granular product classification and deep spend analytics, we provide procurement and finance teams with the insights they need to engage clinicians in meaningful discussions about product choices and standardisation.
How Our Methodology Differs:
Detailed Clinical Categorisation
Unlike NHS eClass, which categorises products at a broad level (e.g., ‘hip implant’), our classification system breaks it down into more clinically relevant attributes, such as whether it’s a cemented or uncemented hip stem, or a primary vs. revision procedure. This allows for precise comparisons that are relevant to clinical decision-making.
Beyond Price Benchmarking
Instead of comparing only the lowest price paid for an exact product, we assess what we call the ‘good price’—the 10th percentile price across trusts. This ensures we highlight realistic, achievable cost-saving opportunities rather than unrealistic outliers.
Identifying Where to Focus First
Our analytics pinpoint the product categories where trusts have the most significant savings potential, allowing scarce resources to be allocated efficiently.
Trauma Locking and Non-Locking Screws – Potential savings £150k
In a group of three acute trusts, we identified stark differences in screw selection for trauma plates. Two of the trusts were using 90% non-locking screws (lower-cost), while the third was using 90% locking screws (higher-cost). When this was presented to the lead trauma surgeons, two surgeons questioned the surgeon fitting the locking system, citing no clinical reason. The surgeon agreed to switch, citing reps as the reason they fitted the more expensive systems.
Pacemakers – £215k potential savings
Two acute trusts were using nearly 100% high-tech pacemakers, whereas leading cardiology centres employed a mix of high-, medium-, and low-tech devices (e.g., 25% high-tech, 50% medium-tech, 25% low-tech). Our data prompted clinicians to question whether every case needed the most expensive option. This led to a shift in purchasing strategy, aligning with best practices and unlocking £215k in potential savings.
Hips – £125k potential savings
At one ICS, we discovered that a trust had moved from using a cost-effective workhorse hip cup to a significantly more expensive specialist cup. Our analysis revealed that the trust was responsible for nearly half of all specialist cups used across the UK. When we presented this data to the lead surgeon, he immediately recognised the cost implications and agreed to revert to the more cost-effective option—unlocking a £125k savings opportunity without compromising patient care.
Tackling unwarranted variation isn’t just about highlighting discrepancies – it’s about making change sustainable. Our data-led approach enables procurement teams to drive real impact by engaging clinicians with objective, trusted data and ensuring that cost-saving decisions do not compromise clinical quality.
By prioritising the most impactful opportunities – rather than getting lost in minor price variations – teams can focus their efforts where they matter most. Involving the right stakeholders in decision-making helps maintain a balance between financial savings and clinical effectiveness, while ongoing compliance monitoring ensures that improvements are sustained over time.
Don’t just let the contract and walk away
Active engagement with clinical teams ensures procurement agreements translate into real savings.
Standardisation doesn’t mean lowest cost – it means best value
The right data helps differentiate between necessary clinical choice and costly preference-driven variation.
Data should drive the conversation
By integrating spend analytics with clinical outcomes data, we can shift from price-driven discussions to value-based decision-making.
For NHS trusts looking to take control of clinical variation and procurement costs, we offer a tailored approach. Our suite of reports – including the 10th Percentile Report, Contract Compliance Report, and Standardisation Report – provides data-driven insights to help trusts engage in evidence-based decision-making and enact meaningful change. These reports highlight key opportunities for savings, drive engagement with clinicians, and ensure procurement strategies align with clinical best practice.
“Having AdviseInc cleanse and classify our data helped us pinpoint where to focus our efforts, making real change possible. Their insights on wound care standardisation led to a £77k savings opportunity, streamlining our procurement approach across the ICS.”
Grant Thrussell, Hertfordshire and West Essex
“AdviseInc provides a level of insight and detailed classification that clinicians can’t get elsewhere. It’s critical for enabling ICS and regional collaboration to unlock more opportunities.”
Liam Horkan, East Suffolk and North Essex
“At first, it felt like we were just handed a pile of data – like opening a dictionary and not knowing where to start. Now, thanks to the insights team and Platform Plus, we can actually see the value because they turn the data into something clear and actionable.”
Clinical Procurement Nurse, East of England
If you’d like help getting started or have questions, contact Phil and the insights team at insights@adviseinc.co.uk. Let’s collaborate to make smarter procurement decisions and improve patient outcomes across the NHS.
