There isn’t an ‘entire NHS’, it’s devolved for the nations. I hadn’t realised that there are 9 purchasing organisations for England, apologies for that as I can see how that may result in differential purchasing, which doesn’t happen in the others. This paper explains it well.
www.sps.nhs.uk/articles/an-overview-of-nhs-procurement-of-medicines-and-pharmaceutical-products-and-services-for-acute-care-in-the-united-kingdom/
It is within the gift of the Department of Health for England to change the structure if they want to do that, as I understand it it is they who determine the overarching structure of the NHS.
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