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Winning Tenders

Winning Tenders. A Practical Guide. Programme. Contract considerations Uncertainty and innovation Legal status and procurement Provider concerns Procurement process Consultation and conflict of interest Payment mechanisms Organisational capabilities Being paid.

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Winning Tenders

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  1. Winning Tenders A Practical Guide

  2. Programme • Contract considerations • Uncertainty and innovation • Legal status and procurement • Provider concerns • Procurement process • Consultation and conflict of interest • Payment mechanisms • Organisational capabilities • Being paid

  3. How Have Things Changed?Context • Major NHS reconfiguration • PCTs and PbC clusters are commissioning • PCTs are contracting • Contestability means that practices can no longer rely on historic patient flows for their future income • For practices to prosper in the new healthcare market they will need to: • Become more outward looking in their planning • Seek to engage with new opportunities • Adapt their ways of working to meet changing needs and expectations • Develop enhanced skills in planning, marketing and finance

  4. In with the new…

  5. How Have Things Changed?NHS Drivers for Change • The 10 year NHS Plan 1997 • The NHS Improvement Plan 2000 – Ten years of reform • Shifting the Balance of Power 2001 • The two Wanless reports • The best way of funding healthcare • The “fully engaged” public health scenario – “Our Health, Our Care, Our Say” - A government belief in flexible markets and the ‘Choice’ agenda

  6. How Have Things Changed?Key Themes • Efficiency, Efficiency, Efficiency! • Outcome driven • New roles and new ways of working • Quality of service, not number crunching • Patient and Public Involvement • Increased accountability • Plurality of provider – private partnerships • Patient Choice

  7. What Changes Will Patients See? • Standards • Inspection • Independent providers • NHS Foundation Trusts • Flexible Workforce • An end to waiting • Choosing Health

  8. What Changes Will Patients See? And there’s more! • New GMS contract • New pharmacy, optometrist and dental contracts • Choose and Book -’Fair for all, personal to you’ • Payment by results - National tariffs • Plurality and diversity of provision • Practice based Commissioning

  9. Who Else Is Involved?PCTs Can Contract for Additional Services With: • Commercial organisations • Voluntary / Charitable organisations • Mutual providers • Public Bodies • GMS & PMS practices through a separate contract

  10. What Are Others Doing?Competitors • “With a specialist team of experienced professionals assigned to the new APMS initiative, (Private Provider) is happy to exchange ideas and explore options with PCTs. We have a pipeline of doctors at PCTs’ disposal and are adept at using the skills of advanced nurse practitioners, special interest GPs, pharmacists and healthcare assistants to provide a multi-practitioner approach to developing our services. We are experienced in designing and building new healthcare facilities. We can offer diagnostics; emergency avoidance schemes; intermediate care; rehab services; long-term conditions management; and, of course, out-of-hours and in-hours primary care.”

  11. What Are Others Doing?Competitors • “The strengths that (Private Provider) can demonstrate speak volumes about how we aim to fulfil APMS contracts: • We pride ourselves on the closeness, quality and longevity of the relationships we build up with partner organisations • Our key focus is finding – and delivering – solutions to wide-ranging problems, as demonstrated in our contracts to build and run ISTCs • We have an excellent reputation for service provision – and for delivering on budget and on time”

  12. What Is A Tender? • In simple terms, a tender is ‘an offer to do work’ issued by one party to one or more others

  13. What Do We Need To Consider? Considerations for Contracts • The exact service to be provided • The length of contract • Performance monitoring, quality control and governance arrangements • Payment schedules and pricing structures • Employment issues, including protection of employment and pensions • Provision of premises and equipment • Provision of information and contract monitoring • Warranties

  14. What Do They Expect Of Us?Uncertainty • PbC clusters are specifying services and preparing for tenders • PCTs may neither need nor want to specify the type of contract at the start of the process • The same services could be provided under PMS, GMS or APMS • The choice of contract may be not be determined by the PCT but by the contracting party

  15. Do They Want New Ideas?Encouraging Innovation • A PCT/PbC cluster may not have an idea of what the service will look like at the start of the tender process • It may have identified a particular problem or service need and then be looking for creative ideas or solutions to solve it • This type of approach may help encourage more innovative solutions

  16. What’s the Legal Status?Contracts • Section 16CC (2)(b) of the NHS Act 1977 • Directions from the Secretary of State, currently the Alternative Provider Medical Services (no 2) Directions 2004 • Provisions from the National Health Service (Personal Medical Services Contracts) Regulations 2004

  17. Will the Process Be Fair?EU Procurement Directive • EU Treaty means PCTs have obligations of transparency and fairness in tendering processes • The only formal requirement is to publish a contract award notice following the award of the contract – much more will be expected

  18. Will the Process Be Fair?Conflicts Of Interest • Conflicts of interest are particularly likely if: • There is potential for the tendered services to be provided directly by the PCT • GPs in the PCT area are potential bidders for the services • GPs could lose their enhanced services to the proposed scheme • All potential conflicts of interest must be disclosed

  19. Will the Process Be Fair?Experience • Does the PCT have tendering experience? • Does the PbC cluster have tendering experience? • Who is advising them?

  20. What Should Worry Us?Potential Provider Concerns • Repetitive pre-tender quality vetting • Endless discussions that progress nowhere • An over-bureaucratic process • Lengthy private discussions resulting in a competitive tender open to others • A ‘fix’ with only one bidder considered • Risk of losing intellectual capital when discussions put into the public domain and shared with others • Process disproportionate to the value ofthe contract • Competitors using ‘loss leaders’

  21. What Types Of Tenders Are There?Types of Procurement Process • Model A: Competition against specification • Model B: Competition against specification with variant bids encouraged • Model C: Competition to act as a partner in developing and providing a service • Model D: Responding to a direct approach Source: NHS Confederation

  22. Tender Applications • Selection criteria and the parameters of the tender document should be clearly stated in the procurement pack • Contact details and methods of obtaining further information should be stated • Other sources of information may include: • Freedom of Information Act • Annual report and accounts • Public Health report • Local Authority information • Doctor Foster …..

  23. Are We Up To It?Initial Questions • What are the gaps in our skills and knowledge of planning and tendering? • What additional help will we require during the tender process? • What analytical and planning techniques are required? • Who will have to be involved? • Do we have the organisational capability?

  24. What Comes Before Form Filling?Engaging in the Process • Completing tender documentation is not about filling in the boxes with words the PCT wants to read • It is about proving you have undertaken all the essential preparatory work to ensure successful implementation • The documentation is the final evidence of that process • Proving you have the experience

  25. What Sort of Organisation Are We? Your Competitive Strategy • Cost Leadership • Having the lowest costs by being efficient and having economies of scale • Differentiation • Creating a unique service by packaging or quality • Focus • Concentrating in a limited field of activity

  26. What Are Our Capabilities?Your Capability Profile • Is your current organisation capable of winning, sustaining and retaining the contract? • Resources available • Services provided • Systems used • Organisation structure • Quality of outcomes • Financial returns • Proven track record

  27. What Are Our Capabilities?Organisation • Current facilities • Where are the bottlenecks? • Analysis of staffing • Qualities • Skills • Adaptation to change • Analysis of financial performance

  28. What Are Our Capabilities? Expectations • Employees • Job satisfaction • Pay • Working arrangements • Patients • Quality • Access • National and local Associations • Purchasers

  29. What Do We Want To Achieve?Generating Ideas • Time is needed to articulate and discuss perceptions of patient need • Avoid ‘solutionism’ – generating solutions without fully forming the problem • You need an insight into the thinking of the PCT

  30. What Does the PCT Want?Using Marketing in the NHS • A coherent and objective read that: • Responds to patient need • Responds to Ministers’ needs • Responds to targets • Responds to White Papers • Demonstrates value for money • Shows innovation • Ticks some boxes! • Answers the question!!!

  31. How Do We Write The Tender?Putting it on Paper • Clear • Concise • Accurate • Factual • Evidence based • Business-like • Specific to the audience • With impact

  32. What About the Money?Costing of Services • Basic pay • Allowances and enhancements • National Insurance and pension contributions • Additions for long-term sickness and maternity leave • Uniforms, vehicles, mobile phones etc • Equipment, materials, premises costs… • Management and administration • Costs of gathering data, analysing it and reporting upon performance

  33. How Do We Get Paid?Payment Mechanism • Method: • Fixed price • Performance-related • Volume-related • Other measure? • Incentives for high-quality performance • Access to financial information, or an ‘open-book’ accounting system • Price variation mechanism for changes to services

  34. Where Do I Find Out More?Further Information • NHS PASA will be issuing a procurement pack and contract commentary on the NHS PASA website www.pasa.nhs.uk • www.healthskills.co.uk • www.lmcs.info

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