Claire Povey Associate Director of Procurement County Durham & Darlington NHS Foundation Trust. Andrew Daly Partner Hempsons

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2 Claire Povey Associate Director of Procurement County Durham & Darlington NHS Foundation Trust Andrew Daly Partner Hempsons

3 The new procurement regulations has anything actually changed? HCSA 25 November 2015 for more information visit us at -

4 Objectives of the session Brief outline of the key provisions of Public Contracts Regulations 2015 (PCR 15) An assessment of whether PCR 15 has had a substantial practical effect on day to day practice Recent cases Practical advice to minimise the risk of challenge

5 When? PCR 15 came into force on 26 February 2015 The Light Touch Regime for healthcare services commissioned by CCGs/NHSE will come into force in April 2016

6 Which rules apply? PCR 15 not retrospective If advert sent to OJEU prior to 26/2/15 then old rules apply If calling off from existing framework then old rules apply Query application of Regulation 72 Healthcare services for CCGs/NHSE current rules will apply until April 2016

7 Overview of changes Abolish the distinction between Part A and Part B services Introduction of the Light Touch Regime Shorten timescales Introduction of new procedures/modify existing procedures Codification of case law Procedural changes

8 What has stayed the same? Remedies

9 So this means.. Read and understand PCR 15 Ensure that your processes comply with the new Regulations Consider what opportunities they present Watch this space for details of the Light Touch Regime for CCGs/NHSE

10 Have the PCR 15 had a substantive practical effect? for more information visit us at -

11 Documents up front? Electronic Availability of Procurement Documents access to "procurement documents" from date of notice intention and potential effect? (Reg 53) Is this really the case? Is this happening in practice?

12 Reporting and documentation requirements Written report To draw up a written procurement report for every contract/framework agreement/dps established Requirements in Reg 84(1)(a) (i) Timeframe? Documentation of progress and decisions Reg 84(7) document the progress of all procurement procedures Reg 84(8) ensure they keep sufficient documentation to justify decisions taken in all stages

13 The Light Touch Regime (chapter 3) Abolish Part A and Part B New LTR Threshold 750,000 Euros ( 625,050) If below assumed no cross border interest unless concrete evidence Section 75 Regulations (CCG/NHSE)

14 The Light Touch Regime LTR requirements Publication in OJEU of call for competition/pin Publication in OJEU of a contract award notice UK to establish their own rules for the award of these contracts within the framework of the Treaty UK has prepared a minimalistic approach Await guidance on relationship between S75 and LTR

15 New procedures Refined: Restricted (Reg 28) Open (Reg 27) Negotiated procedure without prior publication (Reg 32) 3 procedures to allow a degree of negotiation: Competitive dialogue (Reg 30) Competitive procedure with negotiation (Reg 29) Innovation partnership (Reg 31)

16 Innovation Partnership (reg 31) In procurement documents Identify the need for an innovative product, service or works that cannot be met by purchasing products, services or works already available on the market Indicate which elements of this description define the minimum requirements to be met One partner or several partners Publish advert and PQQ Structured in successive phases

17 Innovation partnership cont. Negotiate with tenderers the initial and all subsequent tenders submitted, except the final tender, to improve their content Minimum requirements and award criteria not subject to negotiation Treat all bidders equally Apply criteria concerning bidder s capacity in the field of research and development and of developing and implementing innovative solutions Define arrangements for intellectual property rights

18 Encouraging access to contracts Turnover maximum 2 times contract value (unless justified) Minimum requirements be related to and proportionate to contract Lots not proposed required to split into lots If not, must indicate why Can still award 1 provider multiple lots (if specified in OJEU) Self cleaning

19 Material variation (Reg 72) Modifications, irrespective of monetary value, which are provided for in clear, precise and unequivocal review clauses or options, provided that: Clause states the scope and nature of possible modifications or options as well as conditions when can be used Not alter the overall nature of the contract

20 Material variation (2) Additional services have become necessary and were not included in the initial procurement where a change in supplier: Cannot be made for economic or technical reasons; and [or] Would cause significant inconvenience/duplication of costs (limited to 50% of original contract price) The change that arises is unforeseeable by a diligent authority provided these changes do not affect its nature or exceed 50% of the price of the original contract But must publish in OJEU notice of modification

21 Material variation (3) New contractor Not entail other substantial modifications and not aimed at circumventing the regulations Insubstantial variations Other suppliers participate Changes economic balance in favour of supplier Extended the contract considerably Minor variations Not exceed 10% (services/supplies) or 15% (works) of the initial value and the relevant threshold

22 Recent cases for more information visit us at -

23 RWIND test Healthcare at Home v The Common Services Agency Manifest error Woods Building Services v Milton Keynes Council

24 Practical tips for more information visit us at -

25 Model use of evaluation criteria Maintain audit trail Future proof processes Preparing to be challenged is the best way to prevent a successful challenge

26 Any questions? Hempsons Solicitors 2015 Disclaimer: These slides are made available on the basis that no liability is accepted for any errors of fact or opinion they may contain. The slides and presentation should not be regarded as a comprehensive statement of the law and practice in this area. Professional advice should be obtained before applying the information to particular circumstances

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29 Andy McMinn Chief Procurement Officer Plymouth Hospitals NHS Trust

30 Insights from the GS1 and PEPPOL Shortlisted Trusts November 2015

31 Accenture have written business cases for four Trusts of varying size and maturity. NTH WWL Leeds Derby Hospitals Beds ,847 1,147 Staff 5,500 4,857 15,000 8,000 Care Income 282m 246m 925m 441m Operating Deficit/surplus 2.7m ( 4.7m) ( 24m) ( 21.2m) FT Yes Yes No Yes Teaching Yes Yes Yes Yes 2015 Accenture All Rights Reserved.

32 Accenture developed a robust methodology to ensure that the economic and financial case for change would appropriately reflect the complexity of each Trust. Case For Change Benefits Tracking Systems Gap Analysis Data Analysis Process Maps Area Visits Stakeholder Interviews In completion of this business case, Accenture has worked with GS1 to consider the methodology used, review the scope and breadth of the business case and programme plan, and believes it to a complete package Accenture All Rights Reserved.

33 A bottom-up approach was developed to ensure accuracy of data and granularity of detail. Stakeholder Interviews Interviews held with Procurement, Supplies, IT, Estates, Pharmacy, Clinical Representation from Consulting and Nursing Workforces, Clinical Risk, Finance Purpose to understand current activity and impact of GS1/PEPPOL standards Mechanism to identify key individuals for detailed input Area Visits Key area visits to investigate current processes/activities Time and motion studies held for inventory/logistics, P2P (Pharmacy, Supplies, Finance) and product recall processes where appropriate Process Mapping Internal processes mapping (full end to end process) Enabled the impact of GS1 / PEPPOL adoption on a process to be highlighted Particular attention to areas of non value add in the process Time (therefore cost) savings identified 2015 Accenture All Rights Reserved. 33

34 A bottom-up approach was developed to ensure accuracy of data and granularity of detail. Data Analysis Data analysis to understand current position and impact of GS1/PEPPOL standards adoption 2015 Accenture using All Rights Trust Reserved. data including: Trust Financial Reports, AP/PO/NHS Supply Chain data, NHS Litigation Authority payments, Datix Incident Reporting, Stock Takes (supplies, pharmacy, theatres etc.) External benchmarks and maturity matrixes used as required System Gap Analysis AS IS IT landscape (as relevant to GS1/PEPPOL standards) mapped Discussions with IT and relevant supplies to understand interfaces and system updates required for TO BE IT landscape State Benefits Tracking Understand current reporting structures in place Propose quantifiable metrics and baseline 2015 Accenture All Rights Reserved. 34

35 The data collection and analysis enabled a range of benefits levers to be quantified to calculate financial savings but, more importantly, clinical time to be released for patient care. Hard Benefits Based on the data analysis, process mapping, industry benchmarks, and interviews Hard Benefits include: Reduced NHS LA Contribution Reduced Adverse Drug Effects (Hard Benefits) AP & Purchasing Time Efficiencies Pharmacy Procurement Time Efficiencies Inventory Reductions Stock Wastage & Obsolescence Obsolete Systems Soft Benefits Based on the data analysis, process mapping, industry benchmarks, and interviews Soft Benefits include the clinical time required for: Reduced Adverse Drug Effects (Soft Benefits) Stock Take Effort Stock Ordering Incident/Recall Reporting Time 2015 Accenture All Rights Reserved. 35

36 Costs were built up from understanding the resources required to implement the project plan successful and what operational / technical changes were needed to support GS1 / PEPPOL adoption. Implementation Resources Based on the delivery plan, a profile of resources needed across mobilisation and 4 defined phases was built Resource skill mix and capabilities understood Governance arrangements and approval processes defined IT, Interface and Systems Development Based on AS IS and TO BE systems landscapes Costs include: System interfaces System upgrades IT Software Storage and Infrastructure Based on required operational / process changes Costs include: Storage and Racking Hardware Infrastructure Changes (e.g. Training) 2015 Accenture All Rights Reserved. 36

37 The costs and hard benefit levers were used to produce a 5 year financial view taking into account one-off and re-occurring costs and benefits. Reduced NHS LA Contribution Benefits Reduced Adverse Drug Effects (Hard Benefits) AP & Purchasing Time Efficiencies Pharmacy Procurement Time Efficiencies Inventory Reduction - Supplies Inventory Reduction - Pharmacy Revenue Stock Wastage & Obsolescence Obsolete Systems Implementation Team Resources Ongoing License Fees Incremental Resource Costs (e.g. an increased materials management team) System Upgrades Storage & Racking Interface Developments Barcode Scanners PIM / Access Point Integration Capital Costs 2015 Accenture All Rights Reserved. 37

38 Through the completion of the business cases, Accenture has build a set of reusable assets and continues to work in close collaboration with GS1 as an Industry Partner. Targeted Interview Questions Project Plan Templates Understanding of Resource Requirements Business Case Structure Procurement & Inventory Management Maturity Tools Development Of Subject Matter Expertise Robust Methodologies for Cost / Benefit Calculations 2015 Accenture All Rights Reserved.

39 Contact Details For more information, please contact the Accenture UK Health team: Sara Ford (Managing Director, UK Health Practice): Colin Webster: Katie Davidson: 2015 Accenture All Rights Reserved. 39

40 . GS1 & PEPPOL Adoption: Strategic alignment & Stakeholder engagement Andy Evason 25 November 2015 Actica Consulting

41 . Our trusts Buckinghamshire Healthcare NHS Trust Integrated acute & community provider Specialist, acute and community healthcare services to 500,000 people Two acute sites and a community hospital, around 600 beds Maidstone & Tunbridge Wells NHS Trust Acute hospital trust covering 500,000 people Specialist cancer services to 1.8m people Two main sites and around 600 beds 4,750 FTEs Cambridge University Hospital NHS Trust One of largest / best known acute trusts Centre for several internationally known specialist, academic, learning and research functions Two main sites (co-located) and over 1000 beds, 8000 members of staff Royal Wolverhampton NHS Trust Acute trust with vertically integrated community service Affiliated with Birmingham University Three main sites and 20 further locations supporting 750,000 people Involved in Lord Patrick Carter s operational efficiency programme Actica Consulting PC203D

42 . Strategic alignment All trusts will be affected by common strategic drivers Requirement to adopt GS1/PEPPOL by 2021/22 from the 2014 eprocurement Strategy and its inclusion in NHS standard contract Expected EU regulation on Unique Device Identification and Falsified Medicines to accurately track medical devices and medicines from supplier to patient EU directive on electronic invoicing all public bodies to be capable of receiving electronic invoices by 2018 But Trusts will start from different positions and will have different strategic contexts and objectives GS1 / PEPPOL adoption should not be seen as an end in itself but a means of achieving the Trust s existing strategic goals Trusts need to identify the strategic improvements to be achieved by consistent identification of people, place & product and relate them to their existing objectives and strategies Actica Consulting PC203D

43 . Strategic alignment An example Other examples To build on involvement with Lord Patrick Carter s operational efficiency programme To support implementation of CQC recommendations Actica Consulting PC203D

44 . Strategic alignment Process Understand the benefits that GS1/PEPPOL adoption bring, eg Patient safety: Adoption of GS1 global standards provides consistently safer healthcare, fewer mistakes, clinicians spending less time on procurement activity and redundant activities and their associated costs being eliminated. Cost savings: Full implementation of eprocurement solutions can yield significant recurrent savings that can be returned to patient care. Quality [of care]: By linking the use of goods to the patient record by scanning the product barcode and the barcoded patient identity bracelet, patient level and clinician level costing can become more accurate, enabling standardisation decisions that generate financial, patient safety and quality benefits. Review Trust s existing strategic objectives to identify where GS1/PEPPOL adoption will support or accelerate the achievement of these objectives In each trust that we worked with, there was clear evidence that the adoption of GS1/PEPPOL would help to achieve the trust s strategic objectives Actica Consulting PC203D

45 . Stakeholder engagement Most stakeholders will not understand what GS1 / PEPPOL are and their impact and relevance The initial stages of any stakeholder engagement need to explain what the adoption of GS1/PEPPOL is trying to achieve in non-technical terms, eg operational improvements (reduced cost, reduced delay, better information) from consistent identification of people, place & product linking information from different sources to enable the full value from the Trust s information to be obtained, supporting capabilities such as service level costing fundamentally, improved patient care Actica Consulting PC203D

46 . Stakeholder engagement Our experience is that once stakeholders properly understand what GS1/PEPPOL can enable, then they become enthusiastic supporters of adoption and identify additional benefits, eg Consultants saving time by finding patients quickly Avoiding missed doses due to medicine non-availability Key lessons from the Trusts we supported include Adoption needs to be lead by a senior clinician (eg Medical Director) to achieve positive engagement with clinical staff / senior managers Adoption can be facilitated or enabled by Procurement or IT Stakeholders need to understand that GS1 is not a system (many of the stakeholders initially thought we were seeing them to promote a system) Working level champions for the GS1/PEPPOL adoption will be needed as well as senior stakeholders Stakeholders are busy people, unless they understand the benefits from this work, it is difficult to achieve the required engagement Actica Consulting PC203D

47 . About Actica Independent technical and management consultancy Specialise in supporting the Public Sector in large scale business transformation We take a Systems Approach to business / technology challenges Effective combination of people, structures, processes, systems and technology to achieve change Identifying causes of problems and developing innovative solutions Work in partnership with our clients Flexible Easy to contract with prime contractor on multiple CCS frameworks Committed to exceeding our customers expectations Actica Consulting PC203D

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50 Top 10 Insights Use existing processes for project planning and implementation Make sure that the project team is truly cross-functional and opens Fortress Pharmacy Realise that the Green Book process is iterative not linear Planning Make sure the plan is benefits-focused throughout Put GS1 & PEPPOL at the heart of systems development Assess change readiness as part of the planning process Maintain the high-level strategic objective throughout Change Management Use a multi-media communications approach Ensure continuity between the business case and implementation teams Gain the depth and breadth of commitment at the earliest stage 50 Insights in Planning & Change Management November 2015 Atos

51 HMT Green Book Five Case Model is iterative not linear 51 Insights in Planning & Change Management November 2015 Atos

52 Maintain the high-level strategic objective throughout Patient Safety Standards of Healthcare Financial Sustainability 52 Insights in Planning & Change Management November 2015 Atos

53 Assess the level of change readiness as part of the planning process The components of change readiness: Commitment Communications HR Processes Structure Culture Change Capability Processes 53 Insights in Planning & Change Management November 2015 Atos

54 Use existing processes for project planning and implementation Reporting Governance & Assurance Resource Management Financial Management Planning PMO Quality Management Risk & Issues! Document Management Communication Change Management 54 Insights in Planning & Change Management November 2015 Atos

55 Another Four Top Insights Build on existing successes Integrate with other programmes as much as possible Planning Don t forget that this is about PEPPOL too Don t underestimate the power of having a committed champion Change Management 55 Insights in Planning & Change Management November 2015 Atos