The Maintenance Manager and the Box Seats
Meridian Care Homes buys medical consumables through a central procurement team. The maintenance manager at the largest home has dealt directly with a supplier's account manager for six years and continues to place orders by phone; the supplier then invoices at prices 8–14% above the contracted rate. Separately, the clinical lead insists on one brand of dressing because 'the nurses are used to it', but the agreed specification only requires a sterile adhesive dressing. The supplier's account manager has offered the maintenance manager tickets to a sporting event in December, when the contract is due for renewal.
1. Map the stakeholders in this situation and explain how the mapping shapes your approach.
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Using an influence/interest grid:
- Central procurement - high interest, moderate influence over site behaviour. Owner of the contract, not of the relationship.
- Maintenance manager - high interest, high influence on the ground, but currently acting against the contract. Engagement: involve, not confront.
- Supplier account manager - high interest, high influence over the maintenance manager. Manage closely, but through the contract and a code-of-conduct conversation.
- Clinical lead - high interest in product suitability, high influence over specification. Engage early; they can veto a change quietly.
- Finance - high interest in the 8–14% leakage, lower day-to-day influence. Ally on the numbers.
- Residents and care staff - high interest in product quality, low direct influence. Represented through the clinical lead.
Why it matters: the temptation is to treat this as a compliance problem and send a rule. The mapping shows the maintenance manager holds the influence, so the practical route is to understand why he bypasses the contract and to make the compliant route better than his current one.
2. How would you deal with the off-contract ordering and the tickets offer?
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Separate the two issues.
Off-contract ordering: start by asking the maintenance manager why. Likely reasons - speed, catalogue not usable, supplier relationship convenience. Fix the cause (a fast catalogue route, a named contact for urgent orders) before announcing enforcement. Then restate the contract terms to the supplier in writing, requiring purchase-order references and confirming that telephone orders will not be accepted or paid at non-contract rates. Recover overpayment where the contract allows, or use it as leverage at renewal. Report the 8–14% leakage to finance with a figure in pounds, not percentages.
The tickets: this is a gifts and hospitality matter, made more sensitive because it lands in a renewal period. The offer should be declined or, if declined would cause awkwardness, declared on the gifts and hospitality register per policy. Advise the maintenance manager in writing of the position. Then raise the conduct expectation with the supplier's account manager directly and record the conversation - a supplier that offers inducements during a renewal is telling you something about how it expects to win business.
3. What would you do about the clinical lead's insistence on one brand?
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Distinguish a genuine requirement from a habit. 'The nurses are used to it' is a preference, not a specification, but it may point to a real requirement the spec has missed - compatibility with other dressings, adhesive performance on fragile skin, or stock consistency.
Steps:
- Ask the clinical lead what the brand does that the specification does not capture. If there is a clinical reason, write it into the specification as an outcome or performance requirement (e.g. adhesion duration, skin-friendliness) rather than as a brand name.
- If a brand is genuinely necessary, document the justification - over-specification without a recorded reason is what auditors and challengers look for.
- Offer a trial of an equivalent product with the clinical lead as evaluator, so the decision is theirs on evidence.
- Do not simply override them. A clinical lead who is bypassed will find another route, and patient safety is their accountability, not procurement's.
The outcome should be a specification that describes need precisely enough to allow competition - and a clinical lead who owns the result.