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PLANNING ALL CARE TOGETHER (“PACT”) MARKET TESTING PROCESS

WANDSWORTH CCG (“the CCG”), FEBRUARY 2015

MEMORANDUM OF INFORMATION AND PROCESS OVERVIEW v10

DISCLAIMER Information: The information in this document is presented in good faith and does not purport to be comprehensive or to have been independently verified and the CCG and its advisors accept no liability in relation to its accuracy. Nothing in this document or any pre-contractual documentation shall constitute an express or implied contract nor shall such documentation be used in construing the meaning of any such contract. Costs of submitting responses: Bidders shall be solely responsible for all costs and expenses incurred in connection with or associated with the preparation and submission of their responses and all future stages of this process including costs incurred in finalising any contract for signature. Under no circumstances (including cancellation of the process for any reason whatsoever, and whether before or after final selection) will the CCG, or any of its advisors, be liable for any costs or expenses borne by a bidder or any of its consortium members or subcontractors (as applicable) in connection with this process. Right to cancel or make amendments to the process: The CCG is not obliged to appoint any bidder or to award any contract and, at its reasonable discretion, reserves the right to cancel or vary the process in order to support continued competition, avoid unnecessary costs associated with a bid and adhere to technical, legal or commercial guidance. Without prejudice to the generality of the above paragraph, the CCG reserves the right to:

• Change dates and times for each Stage of the process set out in Appendix A; • Modify any aspect or stage of the process itself and/or to introduce additional steps or

stages into the process in order to maximise value for money solutions and/or efficiencies; and

• Reject any expression of interest or further stage submission of any bidder and not invite a bidder to proceed further.

PROCESS Background In developing a future vision for the improvement of patient care through General Practice services across the Wandsworth borough, one of the outcomes identified to enhance patient experience and delivery of care, was the development of a single provider model for delivery of the PACT specification in a service model which integrates with the delivery of primary care services. The overall aim of the PACT specification is to achieve the overarching outcomes for the Wandsworth CCG objectives of:

Meeting the needs of patients and providing a better patient experience;

Improved quality of clinical care;

Improved efficiency in provision of care, e.g through reduced utilisation of secondary care resources;

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Greater integration of service delivery.

In summary, this specification requires the provision of a set of enhanced services to improve patient care (enhanced services are those which are over and above the requirement set out in core primary care General Practice contracts, commissioned by NHS England). It uses risk stratification at a Practice level to identify patients most at risk of a future hospital admission and then incentivises GPs or other providers to pro-actively co-ordinate their care across the whole borough, and integrate delivery with other services, using a range of local tools and pathways to help avoid or reduce potential future hospital admission and reduce costs. In addition, the specification includes a range of other requirements that support appropriate “shifts” of patient care from secondary care into community primary care eg DMARD drug monitoring and disease screening and prevention (eg bowel cancer screening and falls prevention). A written overview of the PACT specification is available to potential providers. A full detailed specification will be available later in the procurement process. The PACT specification is currently commissioned individually (as LES contracts) from each of the 43 GP Practices across the Borough. The current PACT contracts will extended by 6 months to expire on 30 September 2015. This commissioning model places a considerable administrative burden on the CCG) and impacts on access to care, increasing inequality of access for patients, as the CCG does not have effective contractual levers to ensure a whole population, integrated and co-ordinated delivery of the service requirements by all General Practices. In contrast, commissioning these services via a single provider would enable the CCG to ensure equitable, integrated and improved service delivery and patient experience for the whole registered patient population of Wandsworth. Additionally, the proposed service model would enable a shift towards outcomes-based rather than activity-based payment models. For further information on the CCG, its strategic vision and aims and objectives relevant to the PACT service, this process, and the demographic profile of the local patient population see http://www.wandsworthccg.nhs.uk/ Purpose of the market testing process The CCG has decided to conduct a market testing exercise which will enable identification of potential providers who are most capable of delivering the PACT services specification for the registered population of Wandsworth in 2015/16 and beyond. The key objective is to identify a lead provider who can hold the contract with the CCG and to ensure that the PACT services are a) delivered in a co-ordinated and integrated manner with primary care services and (b) may be delivered via appropriate subcontracting arrangements to the most appropriate and capable sub-contractor(s) as may be acceptable to the CCG and as assessed via the process described below. This market testing process is designed to be flexible and to meet the CCGs requirements in the Procurement, Patient Choice and Competition (No.2) Regulations 2013 and to align with the CCGs obligations to ensure it awards any contracts in a

Fair and open manner

Non Discriminatory manner

Transparent manner

Manner which treats all potential providers equally

Proportionate manner. This flexible process is not intended to be a process which adheres strictly to the rules and timelines in the EU Directives or the Public Contracts Regulations 2006/15, although many of the processes have been adopted to meet best practice in such regard.

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Proposed timeframe and term of the contract The existing PACT contracts (commissioned directly from GP Practices) are due to expire on the 31 March 2015 and will be extended until 30 September 2015 in order to allow this process to take place. This timeframe will enable a robust market testing and contract award process to conclude, as well as ensuring a seamless transfer of contractual arrangements and service delivery to the winning provider organisation. The contract start date (Effective Date) is intended to be 1 July 2015, with a transition period to a Service Commencement Date of 1 October 2015. The term of the proposed contract is 4 years to 31 March 2019. In order to ensure consistency in care delivery for patients and to support a smooth transition within a new contractual framework, the CCG requires the new Provider to work collaboratively with GPs to enable them to continue to deliver the requirements to patients until (at least) 31 March 2016. This avoids the potential for mid-year changes in service provider, considered to be detrimental to patient care. A more detailed proposed / indicative timetable for the market testing process is attached at Appendix A. Providers are reminded that the CCG may vary the process in order to support continued competition and avoid unnecessary costs or to adhere to technical legal or commercial guidance issued subsequent to the start of the process. Market testing process

The provider selection process will involve 2 distinct Stages with a third discretionary Stage. The third Stage is subject to more than one potential provider meeting qualification requirements at Stage 2. These Stages are designed to give all potential providers equal opportunity to express an interest in providing these services and then allow the CCG to rigorously assess their capability against key criteria required for delivery. The stages are summarised below:

STAGE PROVIDER ACTIVITY DOCUMENTATION CCG ACTIVITY

STAGE 1

Expressions of Interest submitted by potential providers in response to Contracts Finder notice, together with completion of Stage 1 Qualification Questionnaire

Contracts Finder notice;

Memorandum of Information, including timetable;

PACT specification overview document;

Expression of Interest template/Stage 1 Qualification Questionnaire

Scoring criteria and weightings for Stage 1.

Following closure date, panel review against set criteria of interested provider responses to questions contained within the Stage 1 Questionnaire. Clarification requests from the CCG (where required). Feedback outcome to providers.

STAGE 2

NB: Progression to

Stage 2 is subject to providers meeting

qualification requirements at

Stage 1

Stage 2 Questionnaire completed and submitted by potential providers

Stage 2 Questionnaire

Scoring criteria and weightings for Stage 2;

Detailed PACT specification.

Clarification requests from potential providers Following closure date, panel review against set criteria of potential provider responses to questions contained within the Stage 2 Questionnaire.

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Clarification requests from the CCG (where required) Feedback outcome to participating providers.

DISCRETIONARY STAGE 3

NB: Progression to

Stage 3 is subject to providers meeting

qualification requirements at

Stage 2.

If no more than one provider passes

Stage 2, Stage 3 may not take place

Attendance at interview and presentation

The provider will be required to respond to up to 3 generic and up to 3 provider- proposal specific questions relating to the CCG’s requirements and the provider’s response at Stage 1 and 2. Questions, scoring criteria and weighting for each question and presentation will be notified in advance.

Final assessment against set criteria and selection of preferred provider by a panel. Feedback outcome to participating providers. Complete contracting process.

Completion of the selection process will result in identification of a preferred provider who will undergo more detailed due diligence checks prior to contract award.

More details in relation to each stage are provided below. Stage 1 This stage requires an Expression of Interest to be submitted by potential providers, together with completion of the Stage 1 Qualification Questionnaire. This questionnaire requests information relating to the proposed supplier’s relevant experience, capabilities and resources and on a number of qualification requirements to comply with the CCGs legal duties and probity requirements and which are set out in applicable procurement Regulations. As will appear from the Expression of Interest questionnaire and from the scoring template, many of these requirements must be confirmed to be in place and, if not, interested providers will not be invited to submit any further submissions. On successful selection at the end of this process, a successful provider will be required to demonstrate evidence of such requirements in the due diligence checks. Following closure date, a designated panel (membership to be determined) will review provider responses to questions contained within the Stage 1 Questionnaire against the set and weighted criteria, as disclosed. During the evaluation stage, the CCG may request written clarification from interested providers on any responses which may be unclear or to correct any minor inconsistencies. Any request by the CCG for clarification shall be made in writing to the interested provider’s named contact. If such clarification is requested, a provider’s response will normally be required to be submitted via EU Supply e-procurement portal and within two business days of request. Failure to respond adequately or within the stated deadline will be reflected in the evaluation of the responses and may result in lower scores or even the exclusion of the interested provider from the process.

The CCG will inform all suppliers who have expressed an interest as to the outcome of their initial Expression of Interest submission. Up to a maximum of the five highest scoring bidders will be taken through to the Stage 2 process and sent the further Stage 2 Questionnaire. If there are any two bidders with equivalent scores, they will each be counted to make up the 5 successful bidders going through to Stage 2. If there are 4 bidders in the highest ranking already and the fifth place consists of

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two bidders with equal scores, the CCG reserves the right to disregard both 5th equal placed bidders and only take through the top 4 scoring bidders, or to take through all 6 bidders, at its sole discretion. Answers to the Stage 1 questions will be related to specific criteria and will be weighted for scoring purposes – please see further information attached at Appendix B. Stage 2 Progression to Stage 2 is subject to providers meeting the Expression of Interest qualification requirements at Stage 1. Responses to the questions within the Stage 2 Questionnaire will be evaluated by the CCG’s designated panel of assessors against set and publicised criteria and weighting in a fair and transparent manner. This Questionnaire collects, in a standard format, the information required to ensure that all applications received are given equal and fair consideration. It is important therefore that potential providers provide all the information asked for in the specified format and order. In order to evaluate the ability of potential providers and their proposals to meet the advertised requirements, this Stage 2 Questionnaire asks for information about the organisation’s relevant experience and on their proposals to meet the CCG’s requirements. The CCG will evaluate each potential provider’s response against the set award criteria. ONLY if more than one provider meets the relevant criteria, will the CCG invite those who qualify to participate further in the Stage 3 procurement process (see below). During the evaluation stage, the CCG may request written clarification from interested providers on any responses it does not understand or on any minor inconsistencies in submissions. Any request by the CCG for clarification shall be made in writing to the Bidder’s named contact, Interested provider’s responses to such clarification questions will normally be required to be submitted via EU Supply within two business days of request. Failure to respond adequately within the stated deadline will be reflected in the evaluation of the responses and may result in lower marks or the exclusion of the interested provider from the process. Answers to the Stage 2 questions will be scored against disclosed further criteria and will be weighted for scoring purposes. Stage 3 (Discretionary stage) Progression to Stage 3 is subject to providers meeting qualification requirements at Stage 2.

Stage 3 is a discretionary stage and will only be undertaken where more than one potential provider attains a qualifying score of 60% or above at Stage 2. In the situation where multiple providers have achieved weighted scores of 60% or above at Stage 2, a maximum of the top 3 providers (or if more than 3 achieve above the threshold, those top 3 who also fall within 5% of the highest scoring provider) will be invited to take part in the Stage 3 process.

The Stage 3 process will involve a formal presentation and interview. A series of 3 set/generic questions will be asked of each such qualifying bidder plus 3 bespoke/provider solution -specific questions. The questions will be centred on their proposals for delivery of the CCGs requirements. Those that qualify will be notified in advance of the set questions and the weighting applying to each part of this process.

Provider presentations and interview responses will be assessed by a panel against the set scoring criteria (panel membership to be determined).

The highest scoring provider will be eligible for contract award, subject to passing the relevant due diligence checks, and finalisation and signature of a Contract.

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Submission of documentation Bidders must return their completed Expression of Interest Form including the completed Stage 1 Questionnaire via the EU Supply portal. Interested provider’s responses will be required to be uploaded by the deadline 12 noon on 13th April 2015. Failure to respond adequately or within the deadline will be reflected in the evaluation of the responses and may result in the exclusion of the interested provider from the process Contract The Provider will be expected to sign up to the National Standard NHS Contract and all the terms and provisions contained therein. This is the compulsory form of contract and is not negotiable. Standards National Standards:

The service must be provided in accordance with the service specification, the National Standard NHS Contract and all other applicable national standards of service quality and clinical governance. The Provider must ensure that its proposals will be fit for purpose and comply with the aims and objectives described in the specifications and, as a minimum, must comply with any standards set by or through the following (as may be amended or revised from time to time):

Care Quality Commission Fundamental Standards;

National Institute of Health and Clinical Excellence (NICE) Guidelines;

National Service Frameworks relevant to the services;

Data Protection Act;

Freedom of Information Act;

Equality Act;

General Medical Council guidance on Good Medical Practice (2013);

RCGP Guidance on Good Medical Practice 2008;

National Quality Requirements for relevant services;

Any applicable primary care requirements and standards. Applicable local standards: The Provider shall:

Adhere to the CCG’s relevant policies as will be notified in the specification, and agree to abide by any future amendments of these policies which may affect the provision of the Service;

Work effectively with other entities within the healthcare sector, including but not limited to Clinical Commissioning Groups, General Practices, Community Services, Acute Trusts, Local Authorities, private and voluntary sector organisations as required

Fully integrate with the local healthcare system to deliver services based on local community requirements, which are sensitive and responsive the range of need within the locality, and which are based on clinical need, sensitive to diverse people and cultures, such as those from ethnic minorities, those with disabilities, those with long term conditions and mental illness and which encourages continuity of care.

Local Leadership

Good local leadership is fundamental to promoting patient safety and to improving quality of care. The Provider must, at a local level, have leadership that encompasses medical leadership and clinical governance.

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Appendix A

Timetable for process

ACTIVITY CCG

ACTIVITY PROVIDER ACTIVITY

RELEVANT DATE

CONTRACTS FINDER NOTICE ISSUED 20th March 15

STAGE 1

CLOSING DATE FOR EXPRESSIONS OF INTEREST SUBMITTED BY POTENTIAL PROVIDERS, INCLUDING COMPLETION OF STAGE 1 QUALIFICATION QUESTIONNAIRE

9

th April 15

12 noon

PANEL REVIEW OF INTERESTED PROVIDER RESPONSES TO QUESTIONS CONTAINED WITHIN THE STAGE 1 QUESTIONNAIRE. CLARIFICATION REQUESTS FROM THE CCG AND EVALUATION OF CLARIFICATION RESPONSES

14th - 20

th April

FEEDBACK OUTCOME TO PROVIDERS, INCLUDING PROVIDING STAGE 2 QUESTIONNAIRES TO QUALIFYING ORGANISATIONS

21st April 15

STAGE

2

CLARIFICATION OF QUERIES ON THE STAGE 2 DOCUMENTATION FROM INTERESTED PROVIDERS CLOSING DATE FOR STAGE 2 QUESTIONNAIRES COMPLETED AND SUBMITTED BY QUALIFYING PROVIDERS

8

th May 15

12 noon

PANEL REVIEW OF INTERESTED PROVIDER RESPONSES TO QUESTIONS CONTAINED WITHIN THE STAGE 2 QUESTIONNAIRE. CLARIFICATION REQUESTS FROM THE CCG AND EVALUATION OF CLARIFICATION RESPONSES

11th – 22

nd May

FEEDBACK OUTCOME TO PROVIDERS 26th May 15

STAGE

3

PROVIDE INVITE TO STAGE 3 PLUS STAGE 3 QUESTIONS AND WEIGHTING TO QUALIFYING ORGANISATIONS

26th May 15

FINAL PROVIDER INTERVIEW AND PRESENTATION

w/c 1st June 15

FINAL ASSESSMENT AND SELECTION OF PREFERRED PROVIDER BY CCG

w/c 22nd

June15

FEEDBACK OUTCOME TO PARTICIPATING PROVIDERS.

w/c 29th June 15

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CONTRACT EFFECTIVE DATE By 1 July 2015

TRANSITION AND SET UP July – Sept

2015

SERVICE COMMENCEMENT DATE 1 October 2015

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dix B

PACT SPECIFICATION PROCUREMENT: STAGE 1 SELECTION CRITERIA AND WEIGHTING

SELECTION CRITERIA EVIDENCE REQUIRED WEIGHTING

1

Experience and ability to access the primary care record of Wandsworth patients (for example in order to access clinical information held on the record or to record new information).

a) Demonstration of a working knowledge of the

principles of how data is shared for direct care, including implementing data processing arrangements such as use of sharing agreements, protocols or contracts.

b) Confirmation from the potential provider that it will

accept any and all costs associated with putting any data sharing agreement into place or in relation to gaining access to patient records; and

c) Confirmation that appropriate working arrangements

can be put into place by 1 September 2015 to enable contract delivery with effect from 1 October 2015.

NB: Bidders do not have to attach documents at this stage but the CCG reserves the right to request evidence at any stage. This information will be verified during the due diligence process at the end of the process. For the purposes of this response, evidence should be provided in the form of a statement within the Expression of Interest document.

IN ORDER TO QUALIFY FOR STAGE 2, BIDDERS MUST SCORE 2 OR ABOVE FOR EACH OF CRITERIA 1a – 1c IN LINE WITH THE INDICATIVE SCORING LEVELS BELOW. NB: In assessing the CCG’s satisfaction, the CCG will apply its reasonable discretion in a proportionate and non-discriminatory way taking into account the need to procure services from the providers most capable of achieving the CCG’s objectives for this service and to improve services through their provision in a more integrated way.

2

Experience and ability to maximise the coverage of all the specified services to patients across Wandsworth.

a) Clear demonstration/description and explanation of how the organisation will approach maximising the coverage of all services to patients across Wandsworth;

b) Evidence/description of means that are practical,

considered workable/effective and are acceptable to

IN ORDER TO QUALIFY FOR STAGE 2, BIDDERS MUST SCORE 2 OR ABOVE FOR EACH OF CRITERIA 2a – 2c IN LINE WITH THE INDICATIVE SCORING LEVELS BELOW. NB: In assessing the CCG’s satisfaction, the CCG will apply its reasonable discretion in a proportionate and non-discriminatory way taking into account the need to procure services from the providers

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the CCG; c) Evidence of experience of doing similar (ie

maximising coverage across a geographical area and population reflective of Wandsworth). Stated experience must be considered relevant and be acceptable to the CCG.

most capable of achieving the CCG’s objectives for this service and to improve services through their provision in a more integrated way.

3 Legal and Regulatory

questions Potential providers must answer the questions included in the Stage 1 questionnaire and Annex 1.

The CCG reserves the right to “fail” a bidder in line with the statement contained within Annex 1 in relation to circumstances contained in Paragraphs 1 and 2. “Failure” will result in exclusion from the procurement process. In assessing responses to the stated questions and where appropriate, the CCG will apply its reasonable discretion in a proportionate and non-discriminatory way having regard to balancing the need to ensure probity in spend of public money and the need to procure services from the providers most capable of achieving the CCG’s objectives for this service.

4 Financial information Potential providers must answer the questions included in the Stage 1 questionnaire.

Financial standing requirements will be confirmation of identity, solvency and proposed business structure. Financial reports of the potential providers provided by an external independent source may be obtained and reviewed as part of the evaluation. However, the use of such data is secondary to the core criteria to be applied to the decision making process. The CCG acknowledges that a credit reference is a snap shot and does not necessarily provide an indication of plans or indeed recent events and so potential providers are encouraged to provide any additional financial information that may aid understanding of financial status. The CCG reserves the right to re-assess financial information throughout the duration of the process. In assessing the CCG’s satisfaction, the CCG will apply its reasonable discretion in a proportionate and non-discriminatory way taking into account the need to procure services from the providers most capable of achieving the CCG’s objectives for this service and to improve services through their provision in a more integrated way.

5 IM&T questions

Criteria 5a: Information Governance Response should evidence the following:

Organisation assurance on information governance:

In assessing the CCG’s satisfaction, the CCG will apply its reasonable discretion in a proportionate and non-discriminatory way taking into account the need to procure services from the providers most capable of achieving the CCG’s objectives for this service and

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Achieving the requirements of the Health and Social Care Information Governance (IG) toolkit at the mandated minimum performance level 2 and/or have a detailed and credible plan to achieve that level before contract signature

OR

Achieving ISO27001 certification for information security management. Staff vetting and training: Pre-employment checks carried out on staff and provision of staff training on confidentiality and information security; Organisational & technical measures: Corporate Information security policy and associated procedures; Information incident management: Process for reporting and managing information incidents; Information legal registration & regulation: Data Protection( 1998) Registration with the Information Commissioners Office( ICO) Question 5b: Experience of IT systems Response should include/demonstrate as a minimum (but not limited to):

Knowledge of NHS GP clinical systems such as EMIS, TPP System One, INP Vision 360 or any other spine compliant or HSCIC approved systems (within the GPSoC model);

Knowledge and use of NHS England approved Risk Stratification tools such as Solis ACG tool;

Knowledge of use of applications such as Choose and Book, GP2GP, Summary Care Record (SCR), Patient Demographic Service (PDS) and Electronic Prescription Service (EPS).

to improve services through their provision in a more integrated way.

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AWARDING OF MARKS/INDICATIVE SCORING LEVELS

Where relevant, the maximum number of marks available for each question is provided above. As these vary, it is not possible to provide an accurate description of marking levels. However, to ensure a consistent approach, the table below provides further information on how the provided information will be assessed and marked accordingly. Bidders are expected to not only meet the requirements but, where applicable, to exceed them in order to obtain the maximum available score.

ASSESSED LEVEL

POTENTIAL SCORE

DESCRIPTION

Poor 0 A response that is significantly deficient or limited information provided and fails to demonstrate that the potential provider has the relevant ability, understanding, experience, skills, resource, and quality measures required to deliver the requirement.

Limited 1 A response that is inadequate or only partially addresses the question or does not fully demonstrate that the potential provider has the relevant ability, understanding, experience, skills, resource, and quality measures required to deliver the requirement.

Fair 2

An acceptable response submitted in terms of the level of detail, accuracy and relevance and demonstration by the Bidder of the relevant ability, understanding, experience, skills, and resource and quality measures required to deliver the requirements with only some minor reservations.

Good 3

A comprehensive response submitted in terms of detail and relevance, fully meeting requirements. Above average demonstration by the potential provider of the relevant ability, understanding, experience, skills, resource and quality measures required to deliver the requirements.

Excellent 4 As Good, but to a significantly better degree and an exceptional demonstration (with examples) of the potential provider’s relevant ability, understanding, experience, skills, resource, and quality measures required to deliver the requirements.

Exceeds requirements

5 Response significantly exceeds the requirements set out in the specification and demonstrates the bidder’s intention and ability to deliver a significantly improved level of service beyond those specified.