DBTH, like many NHSTrusts, have faced a significant resourcing challenge exacerbated by Covid-19. Contract management and commercial skills in the sector were already incredibly stretched. Adding to this, general business challenges such as personnel changes, complex or limited data sources and enhanced reliance on third party relationships only heighten the leakage risks. Efforts by procurement to negotiate strong contracts from the beginning cannot prevent leakages from occurring during the contract lifecycle. Without strong contract management and detailed invoice reconciliation, issues often compound over time impacting not only the bottom line, but patient care and service delivery as well.