Joint Co-Commissioning Committee in Public

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1 Agenda Item No: 7 Date of Meeting: 27 January Joint Co-Commissioning Committee in Public Paper Title: East and North Hertfordshire Clinical Commissioning Group and NHS England Primary Medical Service Procurements Update Decision Discussion Information Follow up from last meeting Report author: Report signed off by: Andrew Tarry, Assistant Contract Manager, NHSE Central Midlands Dominic Cox - NHSE Central Midlands, Locality Director South Purpose of the paper: At present there are 3 procurements for Medical Services across the East and North Hertfordshire area that will need completing between now and February This paper sets out the proposed process, scope and timetable for these procurements. Appendix 1: procurements update Appendix 2: Ware Road and Orchard Procurement Timeline Appendix 3: Spring House Procurement Timeline Appendix 4: Procurement project plan Ware Road and Orchard Appendix 5: Procurement project plan Spring House Conflicts of Interest involved: There were no conflicts of interest in the preparation of this paper Any conflicts in the debate of this paper to be addressed at the committee

2 Recommendations to the Joint Committee To note and approve the proposed approach

3 East and North Hertfordshire Clinical Commissioning Group and NHS England Primary Medical Service Procurements Update 1 Background At present there are 3 procurements for Medical Services across the East and North Hertfordshire area that will need completing between now and February The total annual value of these contracts is approximately 2.5m The Gantt chart on Appendix 1 provides a list of contracts. The Joint Co Commissioning Group is asked to approve these recommendations to enable the CCG and NHS England to progress in line with the agreements. Section 2 of this paper provides some detail of the service specification for consideration of the Group and section 3 provides information on risks. All of the services that are re procured will be contracted on an Alternative Provider Medical Services (APMS) contract. This is the only contracting route open to NHS England as it allows commissioners to contract with different types of provider such as GP, GP consortia, social enterprises, charities and not for profit organisations as required by European Law. The preferred contract duration is 10 years (5+3+2). 1.1 Orchard Surgery, Buntingford The single handed partner retired at the end of April A caretaker contract procurement was successfully carried out, with the present contractor taking over from 1 May 2015 for an initial 12 month period. NHS England has agreed that the existing Caretaker contract would need to be extended to 31 January This permits sufficient timescale to allow for CCG to be fully involved in the development of the service specification for the contract, full patient engagement/consultation to be undertaken and then a robust procurement process to be managed. NHS England resourcing capacity has also impacted on the timescale, especially in light of the necessary re prioritisation of procurements caused by other short notice contractor resignations within Central Midlands. The resourcing position has been reviewed to ensure that adequate capacity will be sourced going forward. 1.2 Ware Road, Hertford The single handed partner resigned at the end of May A caretaker contract procurement was successfully carried out, with the present contractor taking over from 1 June 2015 for an initial 12 month period. As above, NHS England has agreed that the existing Caretaker contract would need to be extended to 31 January Spring House Medical Centre, Welwyn Garden City This contract presently expires on 31 October, but will be extended to 31 January This will enable a full patient consultation, and subsequent analysis, on the potential reduction of the

4 existing opening hours to be carried out. It again enables the CCG to be fully involved in the development of the service specification for this contract. 2 Primary Medical Services Specification 2.1 Access The CCG and NHS England should consider the service that will be commissioned in line with the relevant primary care Strategies. Where appropriate, NHS England would look to procure Medical Services to operate 8am to 8pm seven days a week to meet the national approach on 7 day opening. Where this is not feasible, it is expected that a lower level access model would be outlined within the service specification for example: A. GMS Core Hours (8.00am to 6.30pm Monday to Friday + plus extended opening hours (EOH) at 30 minutes per 1000 patients per week) excluding weekends (except EOH) and bank holidays B. Increased access (8.00am to 8.00pm Monday to Friday and Saturday Morning 3½ hours) excluding weekends (except EOH) and bank holidays C. Full Access (8.00am to 8.00pm, 7 days) to include bank holidays The Group are asked to accept this as acceptable scope in developing the service specification and that it will be included as part of the patient consultation and engagement process for all three contracts. 2.2 Practice Boundary Consideration needs to be given to the practice boundary. Depending on the size of the service being re procured there may be scope to offer larger practice boundaries coterminous with CCG Areas or in smaller surgeries conterminous with CCG neighbourhoods. Whilst improving patient choice, this would also offer additional coverage and protection to NHS England in cases of practice closures. 2.3 Directed Enhanced Services/CCG/Public Health The service specification will make signing up to Directed Enhanced Services (DES) compulsory including any future DESs that NHS England commission. There is also an expectation that providers will also sign up to all CCG and Public Health services where appropriate (formerly known as Local or Nationally Enhanced Services). These services will be listed within the service specification. 3 Risks There are some risks that the Group are asked to note. Overall risks have been highlighted in this section.

5 3.1 Workload/Timescales The PQQ, ITT and service specification will require input from both NHS England s Primary Care, Nursing and Quality, Human Resources, Finance, Medical Directorate, Information Governance and IT and Medicines Optimisation teams. There will also be input from Patient Participation and the CCG. This needs to be highlighted as a risk as it is dependent on a number of departments and the CCG inputting into the process which could impact on timescales. A summary of the workload has been provided in appendices 2 and 3 with more detailed plans in appendices 4 and Closure / Changes to Services NHS England will have an obligation to consult with patients and stakeholders in any case of a GP practice potentially closing or a reduction of services e.g. shorter operational hours. The result of the consultation may find that patients do not agree with the proposal of NHS England and CCG. Where this is appropriate, it has been factored into the timescale. 4 Process To ensure that the process is as streamlined as possible, all 3 of the contracts will go through the procurement process at the same time with the same deadlines. The exception to this is the Consultation process with Spring House Medical Centre s patients and stakeholders. This is planned to take place from February early May with analysis and a final decision being made during May. There are several key deadlines that must be met to ensure that the process can be completed in time and the service Commences on 1 February These will all require input from the CCG. The key dates are: By end of May service specification and Pre Qualification Questionnaire (PQQ) developed with input from CCG including where appropriate feedback from patient consultation and engagement for publication early June. May August Invitation to Tender (ITT) questions (technical envelope) developed with full input from CCG for publication mid August. July evaluation of and moderation meeting of returned PQQ responses. ALL evaluation panel members to attend moderation meeting. October Evaluate ITT responses. November Moderate ITT scores & Bidder interviews. ALL evaluation panel members to attend. 5 Summary The Group is asked to review the plans for these APMS procurements and approve the approach that is being proposed for each of the three contracts.

6 6 Appendices Appendix 1: procurements update Appendix 2: Ware Road and Orchard Procurement Timeline Appendix 3: Spring House Procurement Timeline Appendix 4: Procurement project plan Ware Road and Orchard Appendix 5: Procurement project plan Spring House

7 Medical Procurements (Version 6) KEY Procurement Period subject to further contract extension Current Contract Expiry Proposed Service Commence Feb 16 Mar 16 Apr 16 May 16 Jun 16 Jul 16 Aug 16 Sep 16 Oct 16 Nov 16 Dec 16 Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Oct 17 Nov 17 Dec 17 Jan 18 Feb 18 East North Herts Spring House Medical Centre Orchard Surgery PQQ and Consultation and analysis ITT, evaluation and interviews evaluation Patient engagme nt Patient engagment PQQ and evaluation PQQ and evaluation ITT, evaluation and interviews ITT, evaluation and interviews Mobilise Mobilise Mobilise Ware Road Surgery

8 Ware Road and Orchard Procurement Timeline Date Stage NHS England Input / CCG Input Early January early June Early April early May Early May late May Early June Early July Service Specification and PQQ development. Patient Engagement Engagement analysis Commence PQQ and publish service specification Close PQQ Input into the service specification: NHS England: Medical / Nursing / Finance / IG / Contracting / Medicines Management External: Human Resources / CCG / Patient representation CCG / NHSE / External provider CCG / NHSE Deadline for specification comment / additions. Mid July to end July End July Evaluate PQQ responses Moderate PQQ scores Evaluation panel to consist of: NHS England: Medical Directorate / Nursing and Safeguarding / Finance / IG / Contracting External: HR / CCG All evaluation panel members to attend. Mid May mid August Mid to end August ITT questions development Complete ITT development. Commence ITT. Input into the technical envelope specific questions for bidders. NHS England: Medical / Nursing / Finance / IG / Contracting / Medicines Management. External: Human Resources / CCG / Patient representation Deadline for ITT questions / comment.

9 Ware Road and Orchard Procurement Timeline Early to mid October Mid October mid October Early November Mid November End November end January to 2017 Close ITT Evaluate ITT responses. Moderate ITT scores. Bidder Interviews Final Score. Executive approval Service mobilisation Evaluation panel to consist of: NHS England: Medical Directorate / Nursing and Safeguarding / Finance / IG / Contracting / External: HR / CCG / Patient representation All evaluation panel members to attend moderation. Evaluation panel members to provide interview questions where appropriate. Some evaluation panel members, including the CCG, to attend interviews. 01/02/2017 Service Commence

10 Spring House Procurement Timeline Date Stage NHS England Input / CCG Input Early January early June Early Feb early May Early May to end May Service Specification and PQQ development. Patient Consultation Consultation analysis and final decision Input into the service specification: NHS England: Medical / Nursing / Finance / IG / Contracting / Medicines Management External: Human Resources / CCG / Patient representation CCG / NHSE / External provider CCG / NHSE Early June Early July Commence PQQ and publish service specification Close PQQ Deadline for specification comment / additions. Mid July to end July End July Evaluate PQQ responses Moderate PQQ scores Evaluation panel to consist of: NHS England: Medical Directorate / Nursing and Safeguarding / Finance / IG / Contracting External: HR / CCG All evaluation panel members to attend. Mid May mid August Mid to end August ITT questions development Complete ITT development. Commence ITT. Input into the technical envelope specific questions for bidders. NHS England: Medical / Nursing / Finance / IG / Contracting / Medicines Management. External: Human Resources / CCG / Patient representation Deadline for ITT questions / comment.

11 Spring House Procurement Timeline Early to mid October Mid October end October Early November Mid November End November end January to /02/201 7 Close ITT Evaluate ITT responses. Moderate ITT scores. Bidder Interviews Final Score. Executive approval Service mobilisation Service Commence Evaluation panel to consist of: NHS England: Medical Directorate / Nursing and Safeguarding / Finance / IG / Contracting / External: HR / CCG / Patient representation All evaluation panel members to attend moderation. Evaluation panel members to provide interview questions where appropriate. Some evaluation panel members, including the CCG, to attend interviews.

12 Engagement Start 04/01/ 05/01/ 06/01/ 07/01/ 08/01/ 09/01/ 10/01/ 11/01/ 12/01/ 17/01/ 18/01/ 19/01/ 24/01/ 01/02/ 02/02/ 03/04/ 04/04/ 05/04/ 10/04/ 11/04/ 12/04/ Send Spec to CCGs Quote for HR Create a Risk Register Request Comms strategy Chase Med Managements for prescribing data Chase Estates for Lease and Delap Finalise scoring panel for PQQ FMT Finance Organise Meeting with CCGs Enhanced Services from CCG and Public Health Chase provider and estates for equipment and asset list and Premises Details Finalise dates Finance and venue for Budgets/Walk in moderation day Send PQQ to CCG Send spec to relavent internal departments Chase provider for TUPE info Deadline for PQQ feedback Opening Times Send ITT to CCG Send ITT and PQQ to relevant departments Practice Area

13 End Engagement Engagement Analysis Engagement Analysis PQQ 13/04/ 14/04/ 01/05/ 02/05/ 03/05/ 04/05/ 12/05/ 13/05/ 14/05/ 22/05/ 23/05/ 24/05/ 25/05/ 26/05/ 27/05/ 28/05/ 05/06/ 06/06/ 07/06/ 12/06/ 13/06/ Send PQQ to GEM GEM Publish PIN Deadline for Lease and Delaps Deadline fordraft APMS Contract Spec Approval Send Final Spec (Exec or DC ono to GEM behalf of exec) GEM Publish PQQ/MOI Finalise Panel for Interviews KPIs Deadline for Premises information/ass et list MOI MOI MOI Finalise scoring panel for ITT Deadline for TUPE information Agree MOI scoring and award criteria Deadline for Meds management data

14 End PQQ Eval Eval End Moderation ITT 14/06/ 15/06/ 07/07/ 08/07/ 09/07/ 10/07/ 11/07/ 12/07/ 21/07/ 22/07/ 23/07/ 26/07/ 27/07/ 28/07/ 29/07/ 21/08/ 22/08/ 23/08/ 15/09/ Finalise dates and Venue for interview days Finalise dates and venue for moderation days

15 Risk Register Risk Identifier Risk Author Date Registered Risk Category Risk Description Probability Impact Proximity Risk Response Risk Status Risk Owner Risk Actionee

16 PIN Specification/ITT MOI PQQ Scoring Panel Comms Strategy Local Data GEM CCG Strategy EnhancedServices GEM Commissioning Meeting Room GEMComms Meeting Room ServiceSpecification ServiceSpec Commissioning Safeguarding Commissioning Scoring/Award Finance BriefEvaluators IT/IG IG ITT Evaluation HR Clarification HR Contracts Opening times/practice boundary Safeguarding Moderation Enhanced Services HNA Commissioning Ims/Dementia/Diabetes RestrictingBidders Rates KPIs Bidder Interviews Finance FMT Budget Patient Participation Lease and HOT Estates/Premises Premises Details Equipment/Asset list Delaps Provider TUPE Equipment/Asset list Medicines Management PrescribingData

17 Start Consultation End Consultation Consultation Analysis 04/01/ 05/01/ 06/01/ 07/01/ 08/01/ 09/01/ 10/01/ 11/01/ 17/01/ 18/01/ 31/01/ 01/02/ 02/02/ 10/04/ 11/04/ 12/04/ 13/04/ 14/04/ 01/05/ 02/05/ 03/05/ Send Spec to CCGs Quote for HR Create a Risk Register Request Comms strategy Chase Med Managements for prescribing data Chase Estates for Lease and Delap Finalise scoring panel for PQQ FMT Finance Send PQQ to GEM Organise Meeting with CCGs Enhanced Services from CCG and Public Health Chase provider and estates for equipment and asset list and Premises Details Finalise dates Finance and venue for Budgets/Walk in moderation day KPIs Send PQQ to CCG Send spec to relavent internal departments Chase provider for TUPE info Deadline for PQQ feedback Opening Times Send ITT to CCG Send ITT and PQQ to relevant departments Practice Area

18 Consultation Analysis Decision PQQ 04/05/ 12/05/ 13/05/ 14/05/ 15/05/ 16/05/ 17/05/ 18/05/ 19/05/ 20/05/ 21/05/ 22/05/ 23/05/ 24/05/ 25/05/ 26/05/ 27/05/ 28/05/ 05/06/ 06/06/ 07/06/ GEM Publish PIN Deadline for Lease and Delaps Deadline fordraft APMS Contract Spec Approval Send Final Spec (Exec or DC ono to GEM behalf of exec) GEM Publish PQQ/MOI Deadline for Premises information/ass et list MOI MOI MOI Deadline for TUPE information Agree MOI scoring and award criteria Deadline for Meds management data

19 End PQQ Eval Eval End Moderation ITT 12/06/ 13/06/ 14/06/ 07/07/ 08/07/ 09/07/ 10/07/ 11/07/ 12/07/ 21/07/ 22/07/ 23/07/ 26/07/ 27/07/ 28/07/ 29/07/ 21/08/ 22/08/ 23/08/ 15/09/ Finalise Panel for Interviews Finalise dates and Venue for interview days Finalise scoring panel for ITT Finalise dates and venue for moderation days

20 Risk Register Risk Identifier Risk Author Date Registered Risk Category Risk Description Probability Impact Proximity Risk Response Risk Status Risk Owner Risk Actionee

21 PIN Specification/ITT MOI PQQ Scoring Panel Comms Strategy Local Data GEM CCG Strategy Enhanced Services GEM Commissioning Meeting Room GEM Comms Meeting Room Service Specification Service Spec Commissioning Safeguarding Commissioning Scoring/Award Finance Brief Evaluators IT/IG IG ITT Evaluation HR Clarification HR Contracts Opening times/practice boundary Safeguarding Moderation Enhanced Services HNA Commissioning Ims/Dementia/Diabetes Restricting Bidders Rates KPIs Bidder Interviews Finance FMT Budget Patient Participation Lease and HOT Estates/Premises Premises Details Equipment/Asset list Delaps Provider TUPE Equipment/Asset list Medicines Management Prescribing Data