REDUCING WASTAGE AND

SAVING MONEY

Using the National Surveillance Cent er to Improve Supply

Management in the Eastern Cape

“If we all use the [NSC] report in this manner, I foresee great savings, reduced expired stock, and improved service delivery”.

– Ann Evans, Responsible Pharmacist at Settlers in the Eastern Cape

Imagine having to procure 36 units of an The NSC has helped the country’s important medicine, when your hospital needs and clinics to understand stock-on-hand only two, because of supplier minimum order reporting and facilitate re-distribution of stock quantities. One of the advantages that the between health establishments based on need. National Surveillance Center (NSC) has The GHSC-TA provincial support team (PST) brought to the South African public health is also working with provinces to interpret and supply chain is the ability to identify medicine use the NSC’s reports to understand and stock levels across districts, provinces, and monitor medicine availability at the health indeed the whole country. This enables establishment level. pharmacists to engage each other and work together to transfer from areas is one of the many hospitals where there is excess stock to other health that utilizes the NSC. This hospital is a establishments where they are needed. provincial government-funded health establishment in Makhanda (previously known The National Department of Health and the as Grahamstown), in the rural Eastern Cape United States Agency for International province of South Africa. According to the Development (USAID)-funded Global Health most recent census, Makhanda is home to just Supply Chain Program – Technical Assistance over 67,000 people and Settlers Hospital is the (GHSC-TA) collaborated and developed the main hospital that serves the population. The NSC, a web-based performance monitoring hospital provides a wide range of services, and and evaluation tool. Using nationally agreed key its department provides the performance indicators, medicine availability necessary medicines and medical-related data from hospitals and clinics, pharmaceutical products to meet patient needs. depots, and suppliers of medicine is visualized on dashboards, providing a holistic view of Being the largest hospital in the area, there is availability throughout the South African public an obvious need for Settlers Hospital to health medicine supply chain. practice comprehensive medicine supply

GLOBAL HEALTH SUPPLY CHAIN PROGRAM – TECHNICAL ASSISTANCE management to facilitate optimal medicine Alfred Hospital also avoided a potential loss of availability, promote rational medicine use, and R4,000 by having a high-cost, slow-moving support cost-effective management of these stock item taken off their hands. Settlers costly resources. On a weekly basis, the Hospital now has an arrangement to continue GHSC-TA PST generates a report from data drawing stock of Sevoflurane from Port Alfred extracted from the NSC. This report is shared Hospital to reduce unnecessary expenditure with all the hospital staff in pharmacy and reduce anticipated expired stock. departments in the Eastern Cape. The report provides details of stock on hand in each Preventing medicine stock outs hospital in the province, providing province- Phenylephrine injection is used in the Settler wide visibility to the broader stakeholder Hospital theater and has been in extremely group of pharmacy staff. Settlers Hospital has short supply in 2020. In June 2020, Ann identified several advantages of using NSC data. realized that she was down to the last 10 ampoules. The NSC report showed her that Saving costs and preventing wastage in Queenstown and the Port In June 2020, Settlers Hospital needed to Elizabeth Provincial Hospital each had a large procure only two units of Sevoflurane (an amount in stock. She contacted Frontier inhalational anesthetic) for use by a specialist Hospital (218km away) first, as their availability anesthetist as it is not a commonly used appeared to exceed their demand. The product. The minimum order quantity, pharmacy manager agreed to transfer 30 however, was 36 units with a total cost of ampoules to Settlers Hospital in exchange for R72,000. This would not make sense for the caffeine powder that was required by Frontier hospital as Sevoflurane is a slow-moving item Hospital. This suited Settlers Hospital since and it would take about six years for the they had excess caffeine powder which would hospital to use an order of 36 units. Using the expire in September 2020. Within a few days, report generated by the GHSC-TA, the Settlers Hospital had the Phenylephrine pharmacist at Settlers Hospital was able to ampoules required. Since then, Settlers identify a nearby hospital–Port Alfred Hospital Hospital has continued to make similar (60km away)– which had 16 Sevoflurane units exchanges based on NSC data. that were slow moving and expiring in 2021. It was clear from the demand for the medicine “This is such a fabulous [report] … It is that it was unlikely to be used before it great to see who has stock to share when expired. the depot has none. Great money saver

After obtaining this information from the NSC too …. I was able to draw from Port report, Ann Evans, Responsible Pharmacist at Alfred Hospital who had … slow moving Settlers Hospital, was able to save on the [stock], with an expiry date of next purchase cost of the anesthetic by drawing year.” – Ann Evans stock from Port Alfred Hospital. At the same time, this contributed towards minimizing the As the use of the NSC spreads across the risk of stock expiry before use that would lead Eastern Cape, more pharmacists will be able to to wastage at Port Alfred Hospital. Using the engage each other and work together to NSC report, a mutually beneficial outcome was transfer medicines from areas where there is reached, leading to Settlers Hospital saving excess stock to other health establishments R68,000 from not having to order 36 units where they are needed, saving costs and instead of only the two units needed. Port improving quality of care as they go.

GLOBAL HEALTH SUPPLY CHAIN PROGRAM – TECHNICAL ASSISTANCE