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Lean Enterprise Academy
Unlocking the Healthcare Supply Chain Opportunities
Value Stream Thinking: All activities from Raw material to Finished goods in hands of final customer & order to
delivery to cash receipt
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Price v Cost Structure
Price
Total Cost
Profit
IndirectC
ost
Value Add
Wastes
Direct C
ost
• In the UK alone the NHS must save £20 billion over next 4 years
• The NHS spend on stock is £14 -18 billion per year!
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High Level View of Stock Ordering & Supply into Healthcare
RegionalDistributionCentre(s)
IEnd User(s)ManufactureSuppliers
III II
End User Ordering
Production Control
Production Control
Sales & Operations Planning
TAXI
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Lean Enterprise Academy
High Level View of Stock Ordering & Supply into Healthcare
RegionalDistributionCentre(s)
IEnd User(s)ManufactureSuppliers
III II
End User Ordering
Production Control
Production Control
Sales & Operations Planning
End User Loop
TAXI
Out of control, over-ordering
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Copyright Lean Enterprise Academy 2009
Lean Enterprise Academy
High Level View of Stock Ordering & Supply into Healthcare
RegionalDistributionCentre(s)
IEnd User(s)ManufactureSuppliers
III II
End User Ordering
Production Control
Production Control
Sales & Operations Planning
Supply Loop
TAXI
Forecasting & Demand Amplification
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Copyright Lean Enterprise Academy 2009
Lean Enterprise Academy
High Level View of Stock Ordering & Supply into Healthcare
RegionalDistributionCentre(s)
IEnd User(s)ManufactureSuppliers
III II
End User Ordering
Production Control
Production Control
Sales & Operations Planning
Manufacturing Loop
TAXI
Overproduction
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Lean Enterprise Academy
Introducing Ian Ellio5
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Lean Enterprise Academy
ExerciseWhat’s in it for me?
Suppliers V’s Customers
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ExerciseDo they fit?
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Example -‐ The Glove
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Current State Summary : Gloves
Distance Travelled = 314.55 kmTime Taken (TT) = 6 days 2hrs 40 minCycle Time (CT) = 323 minsValue added Time = 7 minsNumber of people = 24 -26Change in form = 5 typesDifferent Transport= 9 types
Ratio of Value added time to non-value added time:
= 7 mins
323 mins= 2.2%
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The New Terrain
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Lean Enterprise Academy
There can easily be up to 2 years worth of inventory in the pipeline.
Why?
Because suppliers have over produced
Why?
Because suppliers made to stock based on forecast and because it made their produc=vity metrics look good. All of which resulted in lengthening of the supply chain.
Why?
Because they knew that there was always demand for their products (sellers market) PLUS their metrics drove the wrong behaviour.
Why?
Because it was a successful model
Why?
Because the customer tolerated this.
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Now the customer has a lot less money to spend & will no longer tolerate all this
As a result the suppliers model will cease to be successful because there is no longer a
guaranteed demand (buyers market)
As a result metrics now need to drive the right behaviour.
Suppliers will need to make to order based on real demand as opposed to forecast.
They will need to reduce their costs to make their producNvity look good. Which will result in shortening the supply chain.
Ques.on -‐ What’s stopping suppliers only making product when they’ve been paid for it up front????
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In the good old days suppliers took their costs added their margin and
sold at the price they commanded.
Now they will need to sell at the price that the customer demands
(which will be less) which means that
They must either keep their costs the same and reduce their margin orreduce their costs in an a5empt to maintain their margin.
Who knows if they do the la5er they may even increase their market
share at the expense of their compeNNon.
So where do these costs reside?
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Lean Enterprise Academy
I
I I I I I I
Triangles amount to 176 days of sales tied up in inventory
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Typical Cost Reduction Approach – Squeeze the Boxes
Why - Because they can’t see the Triangles
Necessary but non value adding35%
Value adding5%
Non value adding60%
Why not start here instead
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Call to Ac.on
A small group comprising of End Users, Supply Chain organisaNons and
Manufacturers to work with us on this