Re: Pipe Dream
"The (English) NHS is a lot of large customers (hospital trusts), and a really big number of medium size customers (GPs etc)."
Fair comment. But some things do get decided centrally. I had one job which covered all England and Wales (integrating the two was a pain) and, separately, Scotland. We only missed out on NI. Trusts, GPs & all ordered separately but there was central control.
Thinking back to my comment about not giving the customer reason to review the market, I wonder if some suppliers who have been coasting on the back of supplying a very few products into the NHS might not have sales staff sufficiently on the ball to realise that.
OTOH I'm sure some of us who've worked with more, shall we say aggressive, salesmen will have had the experience of making good on assurances that, yes, we have such a product.