Responding to information asymmetry in crisis situations: innovation in the time of the COVID-19 pandemic

Figures & data

Table 1. Profile of interviewees and their representative organizations (incl. interviewee’s functions and scope of responsibility) (NB: Due to request for anonymity, the specific job titles for each interviewee have been omitted).

Organization	Public or private	Interviewee’s function			Interviewee’s scope of responsibility
		Procurement	Finance	HR	Local	Regional	National	International
A. Local Government Authority Involved in the sourcing and distribution of PPE	public	✓	✓		✓
B. Healthcare Service Purchasing Consortium Provides purchasing services to support local Trusts and Healthcare Providers.	public	✓			✓	✓
C. Healthcare Service Purchasing Consortium – Complex Regional Project Provides purchasing services to support complex regional project	public	✓				✓
D. Healthcare Aviation Platform Service Support Provides purchasing services support to Air Ambulance services	private	✓					✓	✓
E. Marine Engineering Service Provides purchasing services to blue light services	private	✓					✓	✓
F. Infrastructure Investment Service Investment funding for UK infrastructure projects (cross-sector, includes healthcare)	private		✓				✓	✓
G. Hospital Procurement Service Single service acquisition of medical supplies/resources for a university hospital	public	✓			✓
H. Healthcare Service Regional Hub Shared service acquisition of medical supplies/resources for healthcare system institutions	public	✓				✓
I. Healthcare Service City Hub Shared service acquisition of medical supplies/resources for healthcare system institutions	public	✓			✓
J. Healthcare Service City Hub – workforce Shared service acquisition of medical supplies/resources for healthcare system institutions	public			✓	✓

Table 2. Overview of challenges and innovation responses across interviews.

Case	Key challenges due to the COVID-19 crisis	Related challenge quotes	Public service innovation
			Response	I	II	III	IV	V	VI
A	Rapidly changing supply chain – needed to react quickly to changes to prices and secure stock before it disappeared	‘It is such a fast-moving supply chain literally stop within like 10–15 minutes- you lose it – the prices are going up all the time. That is why we have created a virtual procurement hub to purchase PPE. That’s the main project that we have done major changes on.’	Established a virtual procurement hub for the procurement of PPE			✓	✓	✓
B	Needed to switch from reactive to proactive position; also provided support to other organizations lacking healthcare procurement expertise	‘We have had to change the entire structure of our team. Previously we had a team based on very broad categories, but it was more aligned to the structure of the hospitals we serve. We have had to change it into a proactive team which was trying to understand supply chain and investigate how things come in to us’.	Alter organizational structure from category-focused to supply and need focus, working in remote teams			✓
C	Reduced lead time from 2–3 weeks to next day to deliver project on time and address potential surge in COVID patients	‘Where we would normally be happy to accept a lead time of a week or two weeks. It has been “Can you get it dropped off this afternoon?”’	COVID-19 procurement process – Lighter touch procurement process, autonomy to make major decisions and employ team’s skill sets			✓
D	Procured critical consumables for air ambulance services across Europe – needed to react rapidly in changes in price and demand – air ambulances flying less due to diverting of resources e.g. medical crew to supporting land-based hospital staff	‘Not least now because of COVID – we are flying less. So, there could be an additional risk to fixing and committing to buying critical consumables in the future So, understanding that pattern and the demand, clearly and quickly enough, is crucial’.	Established small team to enable rapid responses and swift decision-making			✓
E	Procured PPE for blue light services and other production sites and was unable to source PPE from contracted supplier	‘We were where the supply chain through that one supplier became stifled in fact it was the, the NHS has effectively directed all of their priorities into their support and quite rightly. So, we’ve basically not had any support for PPE on those product lines of all types of respirator masks, surgical masks, protective coveralls and nitrile gloves are the key product lines that we’ve that we had to react to – globally.’	Change in sourcing strategy from one contracted supplier to strategic tactical and global sourcing			✓	✓
F	Pandemics are not considered at board level risk profiles and investments. Limited contingency plans were in place.	‘They [funding recipient of investment] decided that they should suspend operations and put the project on hold and we [the investor] have agreed to an extension. They have reduced the amount of activity but have not suspended the structure. They have had difficulty to seriously execute’.	Large organizations have quickly changed policy and reconfigured operations utilizing existing technology to overcome challenges, such as remote asset monitoring and virtual working and collaboration	✓	✓			✓
G	Lack of an optimal configuration between centralized and decentralized procurement	‘There is also a massive tension between local decision-making versus the central procurement office. It is the center that is perceived to fail […] in terms of resilience, there is a massive question’.	Organizational and process transformation and reconfiguration to respond rapidly; systematically adapt decision-making and redeployment of staff; adapt to negotiations/terms with new suppliers		✓	✓	✓
H	Dealing with a volatile marketplace around availability of products and services	‘Primarily, we were only dealing with COVID cases and doing nothing, as business as usual apart from key cancer services. […] One minute we were delivering products on a very regular basis to a point of no longer requiring that product, because those procedures were not going on’.	Organizational and process transformation and reconfiguration, with support from use of national analytics service and advanced inventory systems					✓
I	How do we know if the supplier and its products and services will exist tomorrow, how do we ensure continuity of supply?	‘Help them [healthcare service providers] in terms of contacting all of their vendors with regards to business continuity plans to make sure that none of the vendors are going to fold or have issues in terms of service and sustainability’.	Repurposing and reconfiguration of assets and services, thinking laterally to find solutions			✓	✓	✓
J	Significant disruption to human resourcing on-the-ground, and managing sudden spikes in reductions and increases in demand	‘What we have been doing is being a lot more collaborative in how we work’.; ‘I think the speed at which things got done centrally at times, did not meet the pace of where it was needed locally on the ground with the people managing that information’.	Speed of contracting, and the speed of engagement with diverse groups/communities – overcoming bureaucratic obstacles			✓			✓
Innovation response type, based on the typology proposed by Chen, Walker, and Sawhney (2020):
I		Mission innovation
II		Policy innovation
III		Management innovation
IV		Partner innovation
V		Service innovation
VI		Citizen innovation

Table 3. Additional examples of data.

Themes	Supporting representative quotes
Addressing information uncertainty by collecting relevant information	‘Working with PHE [Public Health England, a central body] we have had lots of issues with changes in guidance etc. from that point of view. That has caused lots of issues. Certainly, sometimes I have had to get information from our military liaison forum and through the local resilience forum which has been interesting’. (Interviewee A) ‘It is challenging to secure new information, because there are not any local sources of information to browse through, although there are things like insolvency databases. There is a Cabinet Office tool being developed around how to manage new suppliers and risk assessing them. […] We do work with other organizations to share information’. (Interviewee G)
(2) Making sense of information to address information equivocality	‘Having a broader reach on a full group is vital […] A system that is able to pull real time data from each of the different areas of the business would have been advantageous. Because I have to plug the gap by having individuals in each of the business facilitate the information exchange. Which is time- and resource-consuming. […] You could almost circumvent that by having real time data again which is presented to us centrally in a dashboard view’. (Interviewee E) ‘In terms of technology, on the data side of things are pretty archaic. I mean, there has been some tools to capture data […] I mean it is so far behind, not to anywhere near where it needs to be […] but COVID-19 has speeded things up. […] We have now source coding and other things which normally would be held up by red tape or debates on the specification and interoperability. There has been a lot of that stuff signed off and we have been told “just get on with it”’. (Interviewee I)
(3) Transferring information to make joint decisions	‘I probably have about three conference calls a day. I know that the director in purchasing has many more. Where we are talking individually with either Trusts or the command group within the Trust. We talk through where we are with our work. So, they have a national PPE call, they have a local PPE call, they have a local [hierarchy] Bronze command, Silver command and then it goes up to Gold command which is then all the execs and the chairs discuss it. There are lots of different boards that everybody is talking to. I would probably say there is more communication going on at the moment than there has ever been’. (Interviewee C) ‘Where decisions have been made in the light of something centrally, the central message comes out and it is different to [our approach]. I think for us we gather all of those different sources and information that that we would be able to bring together with decisions on how we can best support our Trusts. […] We are trying to take a view across everything. And then help to make a decision that way for our Trusts’. (Interviewee J)

Table 4. Challenges facing organizations under ‘business-as-usual’ and ‘knowable black swan event’ conditions.

	‘Business-as-usual’	‘Knowable black swan event’
Innovative response	Generally incremental innovation	Agile, time compressed organizational innovation focused on doing things ‘quicker’ as opposed to ‘better’
Information uncertainty & equivocality	Some uncertainty, but organization has some foresight of market demand and contracts in place with preferred suppliers; organizations have more time to interpret messy information	No certainty, messy information from a range of sources, no clear information on stock levels, staff resourcing or demand. Need to quickly find new suppliers or partners
Information gathering	Methodical, traditional tendering process, over several weeks gathering information from a range of suppliers	Rapid over 1 − 2 days, ‘good is good enough’. Information gathered from suppliers, often local, and based on information from trusted network
Information processing	Tightly governed and hierarchical with major decisions made by a board and senior executives	Simplified decision-process, decisions made by a small select team on the day and more autonomy given to teams/managers to make decisions based on their individual skillsets
Information transferring	Fed out weekly or monthly through traditional sources, e.g. newsletter, group, or team emails	Daily to key stakeholders – key stakeholders by phone, others through emails. Internal stakeholders through daily updates and conference calls

Chen, Jiyao, Richard M. Walker, and Mohanbir Sawhney. 2020. “Public Service Innovation: A Typology.” Public Management Review 22 (11): 1674–1695. doi:10.1080/14719037.2019.1645874.

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