PurposeThe procurement and supply of crucial healthcare products in the early stages of the COVID-19 emergency were chaotic. To prepare for future crises, we must be able to describe what went wrong, and why, and map out ways to build agility and resilience. How can this be done effectively, given the highly complex and diverse network of actors across governments, care providers and supply chains, and the extreme uncertainty and dynamism in the procurement system and supplier markets? The purpose of this study was to capture learning from practitioners in “real time” in a way that could frame and inform capacity building across healthcare systems with varying procurement and supply management maturity.Design/methodology/approachThis exploratory study involved interviews with 58 senior public procurement practitioners in central and regional governments, NGOs and leaders of professional organizations from 23 countries, very early in the COVID crisis. Following the first, inductive phase of analysis leading to five descriptive dimensions, the awareness-motivation-capability (A-M-C) framework was applied in a further round of coding, to understand immediate challenges faced by procurement practitioners, how the complex, multi-level procurement system that shaped their motivations to respond and critical capabilities required to face these challenges.FindingsDevelopments across 23 countries and practitioners' learning about procurement and supply in the pandemic crisis can be captured in five overarching themes: governance and organization, knowledge and skills, information systems, regulation and supply base issues. Together these themes cover the strengths and gaps in procurement and supply capability encountered by procurement leaders and front-line personnel. They highlight the various facets of structure, resource and process which constitute organizational capability. However, to account better for the highly dynamic situation characterized by both unprecedented rivalry and cooperation, analysts must also pay attention to actors' emerging awareness of the situation and their rapidly changing motivations.Originality/valueThe application of the A-M-C framework is unique in the healthcare supply chain and disaster management literature. It enables a comprehensive overview of healthcare procurement from a system perspective. This study shows how increasing system preparedness for future emergencies depends both on developing critical capabilities and understanding how awareness and motivation influence the effective deployment of those capabilities.

Purpose Procurement professionals widely use purchasing portfolio models to tailor purchasing strategies to different product groups’ needs. However, the application of these approaches in hospitals and the impact of a pandemic shock remain largely unknown. This paper aims to assess hospital purchasers’ procurement strategies during the COVID-19 pandemic, the effects of factor-market rivalry (FMR) on strategies and the effectiveness of purchasing portfolio categorizations in this situation. Design/methodology/approach This qualitative study of hospital purchasing in the Netherlands is supported by secondary data from official government publications. Semi-structured interviews were conducted with 13 hospital purchasers at large hospitals. An interpretative approach is used to analyze the interviews and present the results. Findings The findings reveal that product scarcity forces purchasers to treat them as (temporary) bottleneck items at the hospital level. The strategies adopted largely aligned with expected behavior based on Kraljic’s commodity management model. Adding the FMR perspective to the model helped to further cluster crisis strategies into meaningful categories. Besides inventory management, increasing supply, reducing demand and increasing resource coordination were the other common strategies. An important finding is that purchasers and governments serve as gatekeepers in channeling FMR, thereby reducing potential harmful competition between and within hospitals. Social implications The devastating experience of the COVID-19 pandemic is unveiling critical weaknesses of public health-care provision in times of crisis. This study assesses the strategies hospital purchasers apply to counteract shortages in the supply chain. The findings of this study emphasize the importance of gatekeepers in times of crisis and present strategies purchasers can take to assure the supply of resources. Originality/value No research has been conducted on purchasing portfolio models and FMR implications for hospitals during pandemics. Therefore, the authors offer several insights: increasing the supply risk creates temporary bottleneck strategies, letting purchasers adopt a short-term perspective and emphasizing the high mobility of commodities in the Kraljic commodity matrix. Additionally, despite more collaboration uncovered in other studies regarding COVID-19, strong rivalry arose at the beginning of the pandemic, leading to increased competition and less collaboration. Given such increased FMR, procurement managers and governments become important gatekeepers to balance resource allocation during pandemics both within and between hospitals.

PurposeBoth high reliability theory (HRT) and “new school” supply chain resilience (SCR) promote a multi-layered, adaptable, transformational, and holistic perspective on organizing and managing. The authors explore whether, and if so how, HRT offer fresh perspectives on the SCR challenges experienced during COVID-19 and on organizing for future resilience.Design/methodology/approachAddressing SCR at the interorganizational network level, and blending theory synthesis and case study research, the authors assess if and how HRN constructs and practices can guide analysis of SCR in dynamic, complex networks, and help shape development pathways towards organizing for resilience. Findings draw on thick description and iterative coding of data (58 interviews and 200+ documents) on the buyer network responsible for managing the supply of critical medical products in the Netherlands.FindingsHRT highlights the interconnectedness of challenges encountered during COVID-19 and helps design future resilience through three lessons. Organizing for SCR requires (1) both anticipation and containment strategies, (2) stable working relationships characterized by trust, and (3) a clear basis of command underpinned by experience-based legitimacy.Originality/valueDistinctive from SCR, which views crises as “black swans”, HRT organizes around everyday consideration of the risk of failure. Taking a buyer network perspective, the authors move beyond the buyer-supplier network focus in SCR. The authors contend that emphasis on measures such as supplier base management, stockpiling, and domestic production are essential but not sufficient. Rather, HRT implies that deep structural and social ties within the buyer network should also be emphasized.