Any Willing Provider Procurement for Dermatology Interface Services

SOUTHWARK PCTPROCUREMENT SCHEME

Memorandum of Information (MOI)

Table of Contents

1 PURPOSE, STRUCTURE AND NEXT STEPS FOR BIDDERS.......................31.1 Purpose of this document...............................................................31.2 Organisation of this document........................................................31.3 Next Steps for Bidders....................................................................4

2 INTRODUCTION AND OVERVIEW.................................................................52.1 Background and Context to the Any Willing Provider Procurement of an Interface Dermatology Service..............................................................52.2 Objectives of the PCT Procurement.................................................52.3 Scope of Services...........................................................................62.4 Bidder Pool....................................................................................62.5 Critical Success Factors (CSFs)........................................................6

3 COMMISSIONING PCT....................................................................................83.1 Commissioning PCT........................................................................83.2 PCT Schemes..................................................................................8

4 PROCUREMENT PROCESS – OVERVIEW....................................................94.1 Procurement Timeline.....................................................................94.2 Advert, MOI & EOI..........................................................................94.3 PQQ.............................................................................................104.4 Contract Award.............................................................................104.5 Service Commencement...................................................................10

5 COMMERCIAL FRAMEWORK......................................................................115.1 Contract.......................................................................................125.2 Contract Duration.........................................................................125.3 Clinical.........................................................................................125.4

Workforce……………………………………………………………………………………….125.5 Training........................................................................................135.6 Premises, Facilities Management & Equipment....................................145.7 I.M & T........................................................................................145.8 Payment Mechanisim......................................................................155.9 Financial Standing..........................................................................155.10 Insurance......................................................................................156 GOVERNANCE AND ADMINISTRATION…………………………………………………..166.1

Requirements…………………………………………………………………………………..17

7 GLOSSARY OF TERMS AND ABBREVIATIONS.........................................18

8 ANNEX...............................................................................................................Annex A – Service Specification for an Dermatology Interface Service.......21Annex B – Format for Submitting an Expression of Interest.......................34

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1. PURPOSE, STRUCTURE AND NEXT STEPS FOR BIDDERS

Purpose of this documentThis Memorandum of Information (MOI) provides an overview of the Southwark PCT Procurement and details of the:

Procurement and its objectives; The Primary Care Trust (PCT) service requirements; Procurement process; Procurement commercial framework; and Procurement governance and administration requirements.

The purpose of this MOI is to provide potential Bidders with sufficient information on the Southwark PCT Procurement to enable them:

To make an informed decision about whether they wish to participate; and

To submit an Expression of Interest (EOI).

1.1 Organisation of this documentThis MOI is organised into the following sections:

Section 1: Purpose, Structure and Next Steps for Bidders

Detailing the purpose and organisation of the MOI and the next steps for potential Bidders.

Section 2: Introduction and Overview

Detailing the background and objectives to the Southwark PCT Procurement, the scope of services to be procured, the bidder pool and the factors critical to the success of the Southwark PCT Procurement.

Section 3: Commissioning PCT

Southwark PCT

Primary Care Directorate

Woodmill Building 1st Floor

Neckinger

London SE16 3QN

Section 4: Procurement Process Overview

Detailing the steps involved in the Southwark PCT Procurement.

Section 5: Commercial Framework

Detailing the key commercial terms and other legal and contractual arrangements for the Southwark PCT Procurement.

Section 6: Governance and Administration

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Detailing key governance and administration requirements of the Southwark PCT Procurement.

Section 7: Glossary of Terms and Abbreviations

Providing a glossary of the terms used in the MOI.

Annexes: Annex A

Detailing specific summary information for the PCT Scheme.

Annex B

Template to be used by potential Bidders for submitting an EOI.

1.2 Next Steps for Bidders Interested parties wishing to participate in the Southwark PCT Procurement must submit an EOI, in the standard format detailed in Annex B, by email to patrick.roberts@southwarkpct.nhs.uk

EOIs should arrive before 5.00pm on 4th March 2009.

Southwark PCT will not consider any potential Bidder who does not meet the deadline.

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2. INTRODUCTION AND OVERVIEW

2.1 Background and Context to Any Willing Provider Procurement of an Dermatology Interface Service

Developing AWP ProcurementsThe term ‘any willing provider’ (AWP) describes a set of system rules whereby, for a prescribed range of services, any provider that meets criteria for entering a market, can compete for business within that market, without constraint by a commissioner or pay or organisation. This is underpinned by no guarantee of volume being afforded to the provider of a specific service tendered under this model. The Primary MedicalServices to which this relates fall within Part B of schedule 3 to the Public Contracts regulations 2006 (‘the regulations’).

The AWP process for award of contracts can either be open or managed. In this managed process, Southwark PCTs is willing to accept proposals from providers within the timescales stated within the MOI and subject to the provider meeting criteria for selection. Southwark PCT will review the process at annual intervals.

The key objectives of the Willing Provider Model are to:

• Provide patients with greater access to a range of services including, elective, diagnostic, and specialist primary care services in community settings

• Improve choice• Deliver high quality affordable and best value for money community based services

Southwark Primary Care Trust (SPCT) is providing this Memorandum of Information (MOI) in order to assist potential service providers, or bidders, understand the requirements of the PCT.

2.2 Objectives of the PCT Procurement

Southwark PCT is seeking to identify providers who are able to commit to deliver the key objectives outlined in this MOI, and who are willing to work with the PCT to improve, and ensure consistency, in the quality, effectiveness and affordability of the service to best meet the local needs of the patients, the referrers, and the PCT.

The key objectives of the AWP Procurement are to:

SPCT has an objective to procure dermatology services through Practice Based Commissioning for patients presenting with dermatological conditions. An overview of the service requirements include:• A high quality service for all SPCT patients that ensures an equitable, effective,

efficient, responsive and affordable service that contributes to the health and well being of the people of Southwark

• Effective demand management of dermatology referrals to secondary care• Specialist triage of dermatology referrals to ensure patients are seen in the right place,

by the right person at the right time• Managing inappropriate referrals through education and support• Achievement of 18 week targets for all dermatological conditions using agreed

pathways in line with the DH Commissioning Pathways

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• Safe, appropriate and timely assessment and treatment of all dermatological procedures (other than those requiring General Anaesthesia) delivered in a primary care setting

• Safe, appropriate and timely onwards referral to secondary care• Patient and referrer satisfaction• Referrer education• Patient and Carer education

The need to work within multi-agency safeguarding guidelines for adults and children (Children’s NSF, 2004, Safeguarding Adults, 2008)

2.3 Scope of ServicesCurrent changes in health service provision, predicated by re-organisations and the need to commission cost effective services, are such that certain services and specialties can be more appropriately delivered in a community setting. Dermatology is a specialty specifically identified by the Department of Health (DH) as being suitable for the relocation of a large proportion of work from secondary to primary care under the “Shifting CareCloser to Home” Policy

As of April 2008 there is no longer a National Tariff for Dermatology. All dermatology procedures undertaken in secondary care will be paid at indicative tariff which will be negotiated locally based on 07/08 tariff.

The PCT target to reduce follow-up rates for dermatology to 1.35 based on national topquartile rates for 2006/07.

• 10-15% of GP consultations are dermatology-related• 15% of the population seek advice about their skin every year• There were 671,283 new appointments nationally for dermatology outpatients in

2005/06

2.4 Bidder PoolSouthwark PCT wishes to receive responses to the Qualification Questionnaire (QQ) from suitably qualified and experienced healthcare providers (including general practitioners, social enterprise / third sector organisations and other providers) with the necessary capacity and capability (or a demonstrable ability to provide the necessary capacity and capability) to provide the range of primary medical care services as set out in Annex A, in a safe and effective manner and to meet the requirements of paragraph below. Potential Bidder’s may bid in partnership with other organisations such that the Clinical Services Supplier may be different to the potential Bidder.

2.5 Critical Success Factors (CSFs)Southwark PCT requires the Provider to meet the following CSFs throughout the life of theContract:

• Patient focussed – Services must be patient-focused and of a high clinical quality ensuring that services are adapted to meet the needs of vulnerable people, people with learning and physical difficulties and mental health needs;

• Access – The services procured must be provided in locations and facilities that meet local patient access preferences. Providers must ensure their opening times will

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accommodate the indicative activity and maximum waiting times as well as supporting accessibility requirements;

• Quality – Services must be delivered in a high quality, safe and effective manner in an environment that provides a positive patient experience ensuring compliance with all relevant policies and procedures both clinical, administrative and regulatory;

• Value for Money and Affordable – The dermatology services procured through the AWP Procurement must be affordable and must provide VfM;

• Integration – Providers will be expected to integrate with, and positively contribute to, the local healthcare community

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COMMISSIONING PCT

3.1 Commissioning PCTThe commissioning PCT for this procurement is:

SHA Commissioning PCT

London SHA SOUTHWARK PCT

Table 1: Commissioning PCT

A map highlighting the geographical location of Southwark PCT is provided in Figure 1 below:

Figure 1: Commissioning PCT location

3.2 PCT Scheme(s)Bids will be sought for the following PCT Scheme(s):

PCT Scheme(s)Services Included

Detailed in

SOUTHWARK PCTDermatology Services

Annex A

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Southwark

PROCUREMENT PROCESS – OVERVIEW

The Southwark PCT Procurement timeline is summarised in paragraph and further detailed in paragraphs to below.

4.1 Procurement Timeline The timeline for the Southwark PCT Procurement is set out in Table 2 below. It should be noted that the dates are expected dates at the time of issuing this MOI and may be subject to change.

Milestones Completed by

Current providers informed of intentions 19/12/08

Data analysis (service level and acute) 02/01/09

Draft Service Specification prepared 09/01/09

Communications to Southwark practices 16/02/09

Acute trusts informed of Procurement process using the AWP Model 16/02/09

Patient engagement exercise 01-31/03/09

Advert placed 23/02/09

MOI and PQQ Published (web based and on 10outhwark web) 23/02/09

Deadline for receipt of Expressions of Interest 04/03/09

Clarification questions received from potential bidders 16-19/03.09

Deadline for receipt of PQQ submissions 27/03//09

Contract awarded 09/04/09

Service to commence 05/05/09

Table 2: SOUTHWARK PCT Procurement Timeline

4.2 Advert, MOI & EOI

Advert

National adverts will be published describing, in general terms, the servicesbeing procured by Southwark PCT Adverts have been placed on the NHS Supply2Healthwebsite and the Southwark PCT website.

Memorandum of Information

This MOI provides details of the Southwark PCT Procurement for Dermatology Services

This MOI should provide potential Bidders with sufficient information on the Southwark PCT Procurement process and the Southwark PCT Scheme to enable them to make an informed decision about whether they wish to register their interest.

Interest must be registered by submitting an EOI in accordance with the requirements of the paragraph below.

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Expression of Interest

Interested parties wishing to participate in the Southwark PCT Procurement must submit an EOI, in the format set out in Annex B, by email to patrick.roberts@southwarkpct.nhs.uk

EOIs should arrive before 5.00pm on Wednesday 4th March 2009.

Southwark PCT will not consider any potential Bidder who does not meet the deadline.

4.3 Qualification Questionnaire (QQ) The QQ provides detailed information on the QQ process, guidance on how to complete the QQ and a series of questions for potential Bidders to answer.

The QQ will be available on the Southwark PCT website from the 27th February 2009 to all potential Bidders who have submitted an EOI by the deadline. All potential Bidders wishing to bid for the Southwark PCT Scheme must respond to the QQ before the deadline stated in the QQ. Southwark PCT reserves the right not to consider any QQ submission received after that deadline.

A clarification question and answer process will operate during the QQ stage and will be undertaken during the period of the 16th – 19th March 2009.

The QQ evaluation will determine the list of preferred providers. All potential Bidders will be told whether or not they have been accepted onto the list of preferred providers.

Further details of the QQ process and evaluation will be set out in the QQ.

4.4 Contract AwardBased on the outcome of the Southwark PCT Scheme QQ evaluation, recommendations will be made to the Southwark PCT Board for the Board to consider. Following Southwark PCT Board approvals, the recommended Bidders will be formally logged as an approved provider and as such will be entered onto the preferred provider list for Dermatology Services.

4.5 Service CommencementFollowing contract award and in accordance with the Provider’s mobilisation plan, each PCT and Provider will work together towards service commencement at the contractually agreed date.

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COMMERCIAL FRAMEWORK

Potential Bidders’ attention is drawn to the following commercial information:

5.1 ContractThe contract to be entered into by the PCT and the selected Provider(s) for the SouthwarkPCT AWP Procurement will be based on the Standard NHS Contract for Community Services. The Community contract will be adapted as necessary to reflect the requirements of the Southwark PCT Scheme.

Each Contract will be separate to and independent of any existing contract currently in place between a Provider and Southwark PCT

5.2 Contract DurationThe Contract will be for a term of three years with the possibility of extending the term beyond the initial contracted duration by mutual agreement with the Provider.

5.3 ClinicalSouthwark PCT is looking for providers with the necessary capacity and capability (or a demonstrable ability to provide the necessary capacity and capability) to deliver high quality, patient-centred and VfM dermatology services, delivered in a safe and effective manner and through a learning environment which includes the training of doctors and other healthcare professionals.

Workforce

5.4 Policies and Strategies

Bidders will be required to provide evidence that all proposed workforce policies, strategies, processes and practices comply with all relevant employment legislation applicable in the UK and in addition comply with the provisions outlined in:

Safer Recruitment – A Guide for NHS Employers (May 2005); The Code of Practice for the International Recruitment of Healthcare

Professionals (December 2004) (the Code of Practice); and Standards for Better Health (April 2006).

At QQ Stage, potential Bidders will be required to provide executive summary information on the following, with full copies of policies and other documentation being required at ITT stage:

Recruitment, Health & Safety and other relevant policies including those on environmental protection;

Procedures for ensuring compliance that all clinical staff, including doctors, nurses and allied health professionals, are registered with the relevant UK professional and regulatory bodies;

Policy for ensuring clinical staff meet the CPD requirements of their professional and regulatory bodies; and

Staff handbook setting out terms and conditions of employment for staff.

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Pensions

Potential Bidders should assume that their staff would not be able to participate in NHS pension and injury benefit arrangements. The only exception to this is if the Provider is an organisation that meets eligibility conditions for PMS or GMS contracting and staff meet eligibility conditions for the NHS Pension Scheme.

Staff Transfers (TUPE)

Where TUPE applies, the Code of Practice on Workforce Matters in Public Sector Service Contracts Guidance (Cabinet Office, March 2005)1 will apply. This means that staff transferring under TUPE should receive access to a pension scheme that is certified as “broadly comparable” with the NHS Pension Scheme by the Government Actuary’s Department (GAD).

5.5 Training

5.51 Any Initial Training and Accreditation plus ongoing Continuing Professional development for clinicians, such as GPwSI, will need to be included as part of QQ This will need to be obtained by the Provider and to be signed off by Southwark PCT.

5.53 All members of the team will be expected to maintain their knowledge and skills by keeping up to date with the dermatological literature, attending meetings and participation in academic and clinical sessions. This requirement would be assessed as part of the PQQ process.

5.53 The Provider will be expected to provide clinical education to practices within the locality to support further development of their knowledge and skills in the ongoing management of patients

5.54 GpwSI will be expected to 13ulfil the mandatory DH guidelines

5.55 The Provider will be expected to provide training on safeguarding children and vulnerable adults (in line with the requirements outlined in the NSF for Children and Safeguarding Adults policy). The provider will be expected to provide evidence of this training.

5.56 The Provider should ensure that all professional staff are supported to undertake clinical supervision in line with the relevant statutory body requirements. Providers must demonstrate how clinical and supervisory links with secondary care departments (where appropriate) will be achieved.

5.57 Health & Safety

The service will operate from premises, with facilities that meet general health and safety requirements. Compliance will be measured against Southwark Primary Care Trust and local NHS Trust and local NHS Trust Health and Safety policies.

1 Code of Practice on Workforce Matters in Public Sector Service Contracts Guidance

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5.58 Infection Control5.59 Providers should meet the requirements (NHS or IS) with respect to

decontamination and infection prevention and control and dealing with infection events as these evolve and develop. Providers should ensure compliance with The Health Act 2006, Code of Practice for the Prevention and Control of Health Care Associated Infections.

5.6 Premises, Facilities Management & Equipment

Premises

The Provider will be expected to fund rent, rates, utility and insurance costs for the premises solution through the tariff price.

Facilities Management Services

Providers will be expected to fund FM Services costs through the tariff price.

Equipment

Providers will be expected to fund equipment costs through the tariff price.

5.7 IM&TProviders will need to manage the selection and deployment of IM&T solutions in conjunction with the PCT.

Providers will be required to use software applications from the GP Systems of Choice Programme (GPSoC). These application services will be provided in accordance with the standard terms and conditions for all providers who receive application services from GPSoC and will be funded through Connecting for Health (CfH) and the PCT. Under the funding agreements for GPSoC there may be certain additional systems (e.g. finance systems and business applications) that the Provider will be required to provide and manage itself.

Providers will also be required to put appropriate information management and governance systems and processes in place to safeguard patient information. This will need to be supported by appropriate training of staff.

Further information on IM&T support under nGMS contracts and the GPSoC programme can be found at the following web-links:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/DH_4133866;

http://www.connectingforhealth.nhs.uk/delivery/serviceimplementation/engagement/gps/systems_of_choice/gpspec.pdf.

5.8 Payment MechanismPayment to a Provider for the Southwark PCT Scheme will be based on a tariff price and activity against a list of procedures.

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5.9 Financial StandingFinancial standing requirements for the Southwark PCT Procurement will be limited at the QQ stage to confirmation of identity, solvency and proposed business structure, with no other financial requirements.

5.10 InsuranceA comprehensive schedule of insurances that the Provider(s) will be required to obtain for the Southwark PCT Scheme will be set out in the Southwark PCT Scheme QQ. This will typically include public liability, corporate medical malpractice and certain property cover. These required insurances are in addition to the Medical Defence Union indemnity insurance carried by GPs themselves and the Medical Protection Society indemnity insurance carried by nurse practitioners.

The insurance requirements will also require Providers to ensure that:

PCTs’ interests are fully protected; Members of the public utilising the primary medical care services are fully

protected to the extent that they have a valid claim against the Provider and / or PCT; and

The Provider maintains insurance which meets at least the minimum statutory requirements.

Providers will be required to indemnify the PCT against any claims that may be made against the PCT arising from the provision of the primary medical care services by the Provider. Southwark PCT will expect the Provider(s) to offer evidence that they have sourced appropriate (and sufficient) insurance or other arrangements. For the avoidance of doubt, this will include provisions for clinical negligence insurance covering all staff and operational risk in the facilities from which the Provider’s primary medical care services are to be provided.

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GOVERNANCE AND ADMINISTRATION

6.1 Requirements

Procurement Costs

Each Relevant Organisation will be responsible for its own costs incurred throughout each stage of the Southwark PCT Procurement process. Neither Southwark PCT, the SHA or DH will be responsible for any costs incurred by any Relevant Organisation or any other person through this process.

Consultation

PCTs will lead on all local stakeholder engagement issues. All PCT Schemes are subject to ongoing patient and public engagement under NHS Act 2006.

The Public Contract Regulations 2006

The primary medical care services to which this MOI relates fall within Part B of Schedule 3 to the Public Contracts Regulations 2006 (“the Regulations”) and Annex II B to Council Directive 2004/18/EC. Neither the inclusion of a Bidder selection stage nor the use of the term “Qualification Questionnaire" nor any other indication shall be taken to mean that Southwark PCT intends to hold itself bound by any of the Regulations, save those applicable to Part B services.

Conflicts of interest

In order to ensure a fair and competitive procurement process, Southwark PCT requires that all actual or potential conflicts of interest that a potential Bidder may have are identified and resolved to the satisfaction of Southwark PCT.

Potential Bidders should notify Southwark PCT of any actual or potential conflicts of interest in their response to the QQ. If the potential Bidder becomes aware of an actual or potential conflict of interest following submission of the QQ it should immediately notify Southwark PCT via email to patrick.roberts@southwarkpct.nhs.uk. Such notifications should provide details of the actual or potential conflict of interest.

If, following consultation with the potential Bidder or Bidder, such actual or potential conflict(s) are not resolved to the satisfaction of Southwark PCT, then Southwark PCT reserves the right to exclude at any time any potential Bidder or Bidder from the Southwark PCT Procurement process should any actual or potential conflict(s) of interest be found by Southwark PCT to confer an unfair competitive advantage on one or more potential Bidder(s), or otherwise to undermine a fair and competitive procurement process.

Non-collusion and Canvassing

Each potential Bidder and Bidder must neither disclose to, nor discuss with any other potential Bidder, or Bidder (whether directly or indirectly), any aspect of any response to any Southwark PCT Procurement documents such as the QQ documentation.

Each potential Bidder must not canvass or solicit or offer any gift or consideration whatsoever as an inducement or reward to any officer or employee of, or person acting as

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an adviser to, either the NHS or the DH in connection with the selection of Bidders or the Provider in relation to the Southwark PCT Procurement.

Freedom of Information

Southwark PCT is committed to open government and meeting its legal responsibilities under the Freedom of Information Act (FOIA). Accordingly, any information created by or submitted to Southwark PCT (including, but not limited to, the information contained in the MOI or PQQ Scheme and the submissions, bids and clarification answers received from potential Bidders and Bidders) may need to be disclosed by Southwark PCT in response to a request for information.

In making a submission or bid or corresponding with the PCT at any stage of the Southwark PCT Procurement, each potential Bidder and each Relevant Organisation acknowledges and accepts that Southwark PCT may be obliged under the FOIA to disclose any information provided to it:

Without consulting the potential Bidder; or Following consultation with the potential Bidder or Bidders and having taken its

views into account.

Potential Bidders and Bidders must clearly identify any information supplied in response to the Southwark PCT Scheme QQ that they consider to be confidential or commercially sensitive and attach a brief statement of the reasons why such information should be so treated and for what period.

Where it is considered that disclosing information in response to a FOIA request could cause a risk to the procurement process or prejudice the commercial interests of any potential Bidder or Bidder, Southwark PCT may wish to withhold such information under the relevant FOIA exemption.

However, potential Bidders should be aware that Southwark PCT is responsible for determining at its absolute discretion whether the information requested falls within an exemption to disclosure, or whether it must be disclosed.

Potential Bidders should therefore note that the receipt by Southwark PCT of any information marked “confidential” or equivalent does not mean that Southwark PCT accepts any duty of confidence by virtue of that marking, and that Southwark PCT has the final decision regarding the disclosure of any such information in response to a request for information.

Disclaimer

The information contained in this MOI is presented in good faith and does not purport to be comprehensive or to have been independently verified.

Neither the Southwark PCT, the DH, nor any of their advisers accept any responsibility or liability in relation to its accuracy or completeness or any other information which has been, or which is subsequently, made available to any potential Bidder, Bidder, Provider, Bidder Member, Clinical Services Supplier, financiers or any of their advisers, orally or in writing or in whatever media.

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Interested parties and their advisers must therefore take their own steps to verify the accuracy of any information that they consider relevant. They must not, and are not entitled to, rely on any statement or representation made by Southwark PCT, the DH or any of their advisers.

This MOI is intended only as a preliminary background explanation of Southwark PCT PCTs activities and plans and is not intended to form the basis of any decision on the terms upon which Southwark PCT will enter into any contractual relationship.

Southwark PCT reserves the right to change the basis of, or the procedures (including the timetable) relating to, the Southwark PCT Procurement process, to reject any, or all, of the QQ submissions bids, not to invite a potential Bidder to proceed further, not to furnish a potential Bidder with additional information nor otherwise to negotiate with a potential Bidder in respect of the Southwark PCT Procurement.

Southwark PCT shall not be obliged to appoint any of the Bidders and reserves the right not to proceed with the Southwark PCT Procurement, or any part thereof, at any time.

Nothing in this MOI is, nor shall be relied upon as, a promise or representation as to any decision by Southwark PCT in relation to this Southwark PCT Procurement. No person has been authorised by Southwark PCT or its advisers or consultants to give any information or make any representation not contained in this MOI and, if given or made, any such information or representation shall not be relied upon as having been so authorised.

Nothing in this MOI or any other pre-contractual documentation shall constitute the basis of an express or implied contract that may be concluded in relation to the Southwark PCT Procurement, nor shall such documentation/information be used in construing any such contract. Each Bidder must rely on the terms and conditions contained in any contract when, and if, finally executed, subject to such limitations and restrictions that may be specified in such contract. No such contract will contain any representation or warranty in respect of the MOI or other pre-contract documentation.

In this section, references to this MOI include all information contained in it and any other information (whether written, oral or in machine-readable form) or opinions made available by or on behalf of Southwark PCT, DH or any of their advisers or consultants in connection with this MOI or any other pre-contract documentation.

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7 GLOSSARY OF TERMS AND ABBREVIATIONS

Term Description

APMS Alternative Provider Medical Services

BidderA single operating organisation/person that has been short-listed through the PQQ evaluation.

Bidder Guarantor

An organisation providing a guarantee, indemnity or other undertaking in respect of a Bidder’s or a Bidder Member’s obligations

Bidder Member

A shareholder or member or proposed shareholder or member in, or controlling entity of, the Bidder and / or that shareholder’s or member’s or proposed shareholder’s or member’s ultimate holding company or controlling entity

CfH Connecting for Health

CPD Continuing Professional Development

Clinical Services Supplier

All suppliers providing clinical services which are the subject of the Contract including, but not limited to, primary medical care services

ContractThe Standard NHS Contract for Community Services, as detailed further in paragraph , to be entered into between the relevant commissioning PCT and Recommended Bidder for the provision of community services

DH Department of Health

EOI Expression of Interest

FM Services

Facilities management services including “Hard FM” (including services relating to security, fire, utility management, utility breakdown, pest control, landscape maintenance) and “Soft FM” (including services relating to cleaning, laundry, health and safety, portering, waste management, clinical waste management, infection control, linen, gowns and bedding)

FOIA / Freedom of Information Act

The Freedom of Information Act 2000 and any subordinate legislation made under that Act from time to time, together with any guidance and / or codes of practice issued by the Information Commissioner, the Department of Constitutional Affairs, the Office of Government Commerce and the NHS in relation to such legislation or relevant codes of practice to which the DH and SOUTHWARK PCT is subject

GMS General Medical Services contract

GP General Practitioner

GSPoC GP Systems of Choice Programme

IM&T Information Management and Technology

MOIThis Memorandum of Information setting out the details of each PCT Scheme and the requirements of the Southwark PCT Procurement

nGMS n/New General Medical Services Contract

NHS National Health Service

PCTThat Primary Care Trust participating in the Southwark PCT Procurement

PCT SchemeThe primary medical care services to be procured by a PCT, as detailed (by PCT Scheme) in paragraph and set out in Annex A

PMS Personal Medical Services contract

potential BidderA single operating organisation or person that is participating in the SOUTHWARK PCT Procurement.

QQ Qualification Questionnaire

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Term Description

Relevant Organisation

An organisation(s) or person connected with a response to a PQQ and / or connected with a bid submission including (without limitation):

(i) the potential Bidder; (ii) the Bidder;(iii) the Provider;(iv) each Bidder Member; (v) each Bidder Guarantor; and (vi) each Clinical Services Supplier

Spearhead

A PCT is classified as “Spearhead” if it is one of a group of 62 PCTs based upon 70 Local Authority areas that are in the bottom fifth nationally for three or more of the following five indicators:

(i) Male life expectancy at birth;(ii) Female life expectancy at birth;(iii) Cancer mortality rate in under 75s;(iv) Cardio Vascular Disease mortality rate in under 75s;(v) Index of Multiple Deprivation 2004 (Local Authority

Summary.

SHA Strategic Health Authority

TUPETransfer of Undertakings (Protection of Employment) Regulations 2006 (SI/2006/246)

VfMValue for Money which is the optimum combination of whole-life cost and quality (fitness for purpose) to meet the overall service requirement

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Annex 8 A – Southwark PCT Any Willing Provider Specifications

Table of Contents

Introduction 21

Specification Overview 22

Clinical & Service Requirements 23

Service Model 24

Equipment 26

I.M. & T 26

Clinical Governance 26

Patient/Public Participation 27

Workforce 27

Accreditation and Competence 28

Choose and Book 28

Finance 28

Contract Management and Reporting 28

Service commencement and Contract duration 27

References 29

Appendix 1 CTR for GPWSI for Dermatology services 30

Appendix 2 PCT Background 31

Appendix 3 Health Needs Assessment 33

Appendix 4 Patient Pathway 33

Annex B Format for submitting an expression of interest 34

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1. Introduction

Southwark PCT is providing this service specification to assist potential service providers, or bidders to understand the requirements of the PCT, in order to develop their applications to tender. Bidders should submit expressions of interest (EOI) to tender for these Southwark PCT Any Willing Provider (AWP) contracts. Southwark PCT is seeking to identify providers who are able to commit to deliver the key objectives outlined in this specification, and who are willing to work with the PCT to improve, and ensure consistency , in the quality, effectiveness and affordability of the services to best meet the local needs of the patients, the referrers and the PCT.

2. Specification Overview

Southwark PCT is procuring a community based dermatological service. The aim of the service is to:

3.1 Deliver Dermatological care and treatment within the community against an agreed set of protocols:

3.2 To demonstrate a reduction in unit costs by utilising this approach

3.3 To provide a local service for the patients in a primary care setting nearer their homes. “Our Health, Our Care, Our Say “(2006)

3.4 To improve access for patients requiring Dermatology by reducing the waiting times and to explore the possibilities of offering early morning or late evening clinics.

3.5 To provide safe, appropriate diagnosis and timely treatment for patients whilst not adding any delay to those patients requiring specialist treatment.

3.6 To increase the awareness and promote best practice about dermatology services to the residents of Southwark, targeting practices and patients with high need or utilisation

3.7 To provide Patient and referrer satisfaction

3.8 Achievement of 18 week targets for all dermatological conditions using agreed pathways in line with the DH Commissioning pathways

3.9 To provide opportunities for professional development.

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Clinical & Service Requirements

3.10 Service Composition

Clinical services must be patient focused and of a high quality and high patient satisfaction levels delivered in an environment that provides a positive patient experience using correct clinical facilities by appropriately qualified clinical staff

The Provider will ensure that all clinicians, nurses and administrative support staff will have completed a full induction and are conversant with the services, policies and operational procedures

The provider must commit to and promote continuous professional development to all clinical staff

The Provider will be responsible for patient management and clinical care

The Provider must comply with Standards of Better Health

The Provider will need to ensure that service provision is adapted to meet the needs of vulnerable people, people with learning disabilities and physical difficulties and mental health needs.

3.11 Referral to Treatment Times and Choice

Maximum wait from receipt of referral to completion of assessment and either onwards referral, treatment or discharge commencement to be no longer than 8 weeks with a working maximum of 4 – 6 weeks.

The Provider should be able to demonstrate the delivery of patient choice and ensure that all patients requiring onward referral are offered choice as per DOH guidelines. Choose and Book to be used where able.

3.12 Additional requirements

The service will be subject to Southwark PCT policies on consent and complaints

The Provider will be required to work in co –operation with Southwark PCT and contracted Primary and Secondary Care Providers

The Provider will be responsible for administrative arrangements such as clinic letters, scheduling appointments etc

3.13 Performance

Patient and referrer satisfaction surveys to be undertaken and reported to Southwark PCT : initially 6 months after commencement of the service then at end of each full year of the contract for purposes of evaluating the service

Provide monthly data on activity and attend contract and performance management meetings with the Contract Lead for this service

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4.Service Model

The primary care Dermatology Service will provide:

1) The management of new and follow up patients with chronic skin conditions such as:

Mild acne

Contact dermatitis

Varicose Eczema

Psoriasis/ Lichen Planus

Urticaria

For the full list see CONDITIONS TREATED BELOW

The provider will

a. Set up and run dedicated weekly clinics with agreed adjustments in holiday periods) at premises located within the Southwark borough for patients registered to practices within the borough of Southwark.

b. The service will accept referrals within agreed referral protocols for the non-malignant Dermatological needs of the population

c. For Clinical pathway please see attached appendix 4

d. Work with the commissioner to determine and develop the optimum model of care including other professionals or practitioners.

e. Deliver high quality management of dermatological conditions in the most appropriate place within a reasonable time scale.

f. This will involve diagnosis, treatment and management of referred patients before either referral to specialist or discharge back to referring GP.

g. This will also involve development of agreed protocols that may be used by all referrers.

h. Review referrals by GP from the start of the service to ensure adequate and appropriate usage.

i. If usage not adequate ensure communicate with GP s practices to establish reasons and action appropriately.

j. If usage not appropriate ensure feedback to GP to encourage correct utilisation.

k. Be responsible and accountable for the prescribing in relation to patients referred.

l. This will involve reviewing quarterly detailed prescribing statements in conjunction with PCT pharmacist to ensure appropriate and adequate prescribing.

m. In most instances longer-term prescriptions will be via the patients GP.

n. Explore the roles of nurse prescribing and / or pharmacist in medicines management.

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o. Provide a computerised, paper light service with photographic documentation as appropriate, keeping weekly and monthly records to satisfy clinical and management requirements (see appendix 4)

p. Feedback to referring GPs by appropriate means- email, phone calls, leaflets, diagnostic guidelines- with a view to sharing dermatological knowledge and skills and raising the level of skin care in the community.

q. This may develop into attendance at clinics by arrangement and might in time encompass GP registrars.

r. Ensure adequate information relayed back to original referrer on treatment, discharge or non attendance by patient

CONDITIONS TO BE TREATED

GPSI CLINIC URGENT – KINGS/GUYS ROUTINE –KINGS/GUYS

Eczema (including Paeds) Patients under 2 week rule Severe acne (roaccutane)

Contact dermatitis SCC Skin malignancies not under 2 week rule

Varicose Eczema Malignant Melanoma Phototherapy

Psoriasis/ Lichen Planus Acute/widespread Rashes Severe Paediatric Dermatology

Acne- mild Acute Lesions in children Conditions not on GpwSI list

Rosacea or other facial racshes

Acute infection- cellulites, eczema herpeticum

Recurrent impetigo

Sycosis barbae

Nail, scalp, hair loss issues

Urticaria

Fungal infections

Vulval/ perianal issues

General itchiness

Keloid scars

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5. Equipment

It is the responsibility of the Provider to purchase, maintain to a high standard and replace all relevant equipment required to provide the service. Equipment must be maintained and decontaminated in line with manufacturer’s instructions.

Equipment required as follows

Hardware Comment

Dermatoscope To aid in the diagnosis of pigmented lesions

Cryo equipment incuding safe storage For Immediate availability of cryotherapy to treat skin lesions

Good Lighting For clear visualisation of the skin

I.T. – laptop and software To ensure accurate record keeping in a form allowing easy audit

Camera For digital recording of skin lesions

Minor surgical instruments For minor surgical procedures ensuring compliance with local sterilisation/infection control guidelines

6. I.M & T

The Provider will have secure IT systems in place for recording patient information and activity;

18 wk requirements; Referral to Treatment (RTT) Patient Tracking List (PTL), Clinical Outcome sheets (COS) and Minimum Data Sheets (MDS) in order to capture Clock starts and Stops

The Provider will work in ways that support national and local programmes and utilise IT in ways that maximise patient care. The Provider will have regard to

Connecting for Health

Choose and Book

Communications and use of e-mail systems

Participation in PCT audits and data collection

7. Clinical Governance

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A “system of clinical governance” means a framework through which the provider endeavours continuously to improve the quality of its services and safeguard high standards of care by creating an environment of clinical excellence can flourish.

The provider is responsible for all aspects of clinical governance through an effective system of clinical governance. The provider shall nominate a person who shall have responsibility for ensuring the effective operation of clinical governance.

The provider will provide the commissioner with evidence that all practitioners providing the service meet the accreditation requirements appropriate to their role. See section 5 below

8. Patient /Public Participation

The Provider will be required to demonstrate:

How it aims to make service accessible and convenient for all patients groups? How it will ensure that its services are appropriate and responsive to patient

needs of all patients groups? How it will involve all patient groups in delivering or designing its services? How progress in the above areas will be monitored and evaluated.

9. Workforce

The provider is responsible for availability of suitably qualified staff to meet the maximum waiting time and for demonstrating their ability to deliver the service.

The Provider is responsible for evidencing competency of all staff The Provider is responsible for ensuring CRB checks and Professional

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10.Accreditation and Competence

All providers of services, for example GPwSI must have formal supervision with consultants in form of a clinic of some ‘new’ hospital patients and others where complex cases are brought from the community for advice/ discussion (minimum of 7 in period of contract)

GPwSI s must be appropriately qualified following B.A.D guidelines to include current log book, appropriate medical Indemnity insurance, current signed competence framework by supervisory consultant (appendix 5)

Clinical providers must maintain professional links and qualifications

Clinical providers must carry out audits of patients seen (at least 2 audits in period of contract

As role of other practitioners develops the provider will assist with developing accreditation for other clinical professionals

11. Choose and Book

The service will be offered as part of the PCT commissioning rules in the Choose and Book software. The provider and the commissioner will jointly develop and maintain the directory of services for the service. The PCT will work with the provider to develop the service as a choose and book provider

The provider and commissioner will work in partnership to develop the use of the service in Choose and Book.

12. Finance

Payment will be made on the basis of a local tariff price of 1st Patient Appointment of £60.00 for both adults and children and £30.00 for a follow up appointment for both adults and children.

All payments will be settled by a monthly invoice sent to Southwark PCT. Invoices to be settled within twenty one days of receipt of the invoice.

The service is for all patients registered with Practices in the Borough of Southwark, circa 300,000 across 47 practices

Any errors or omissions will be required to be rectified

13. Service commencement date and contract duration

Southwark PCT wishes the new service to commence on 5th May 2009. Southwark PCT will agree a 3 year contract with a formal review at 18months.

14. Contract Management & Reporting

The Provider will be required to present monthly activity and key performance indicator reports to Southwark PCT to include:

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Number of sessions

Number of patients seen within each month

Number of new appointments within each session

Number of follow-up appointments within each session

Number of treatments administered

Number of patients referred onto secondary care

Number of DNAs

Patient outcomes to be reported through 6 week diagnostic requirements and 18 week data collection

15. References

1. Standards for Better Health 2008/09

2. Implementing Care Closer to Home April 2007

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Appendix 1

CONTINUING TRAINING REQUIREMENTS FOR GPs WITH A SPECIAL INTEREST IN DERMATOLOGY

o Attend a minimum of 18 hours accredited dermatology meetings per year

o Be involved in a monthly consultant led clinic to ensure on going supervision of difficult cases

o Keep patient records with attached digital photograph of condition for audit

o Maintain a log book detailing record of meetings and tutorials attended in order to facilitate appraisal and accreditation

o Be a member of the Royal College of General Practitioners (RCGP)

o Have taken and passed the Diploma in Practical Dermatology (Cardiff)or equivalent.

o Be a member of the Primary care Dermatology Society (PCDS) or an associate member of the British Association of Dermatologists

o Be appraised on an annual basis. However initially be appraised after 6 months by a consultant dermatologist

o Have appropriate Medical Indemnity Insurance

o Accreditation of GPwSI should follow similar guidelines as those for revalidation. The intention is to undergo re-accreditation every three years with the first re-accreditation occurring after one year. It has been agreed that members of the accreditation team should include

- Clinical leads from primary and secondary care services or their nominated peers

- Consultant in public health

- GP involved in Post Graduate Education

- A manager from the respective trusts

GPs with a special interest in performing Minor Surgery in the Primary acre service will be expected to have attended the British Society of Dermatological Surgeons (BSDS) basic surgery course and to maintain records of procedures performed – both in the primary care service and their own Practice – for audit purposes.

Bidders will need to provide evidence as part of the QQ that the above criteria is adhered to.

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Appendix 2

PCT background information

Southwark PCT was established April 2002. Southwark PCT commissioned £42 million of primary medical care services on behalf of its 304,000 registered population for the year ending 31st March 2007 and employed 1000 staff.

Details about the general practices within Southwark PCT are detailed in the table below:

General Practice Contract

Number

of

Practices

Registered Patients1

Number

of

GPs2

Single-Handed

Practices3

Training Practices4

GMS 6 22,000 7 4

PMS 38 276,000 189 10

PCTMS 1 3,000 2

APMS 1 3,000 2

TOTAL 46 304,000 200 4 10

1 The number of registered patients at 1st April 20082 The number of Whole Time Equivalent (WTE) GPs = 181.703 Single Handed Practices (SHPs) are those practices with a partnership size of only

one general practitioner (GP).4 Practices which are accredited to undertake training

Southwark PCT sub-divides into the 21 wards detailed below: Please note that the ward population are mid-2005 estimates.

Ward Population1

East Walworth 12,692

Livesey 13,207

Camberwell Green 13,707

Peckham 12,790

Nunhead 11,543

The Lane 12,547

South Bermondsey 11,735

Newington 13,420

Faraday 13,267

Brunswick Park 11,956

Rotherhithe 12,302

Grange 13,523

Cathedrals 14,141

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Chaucer 14,935

Riverside 12,283

College 10,935

South Camberwell 11,797

Peckham Rye 12,155

Surrey Docks 12,795

East Dulwich 11,570

Village 10,723

Total Population 264,023

1 population figures are indicative

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Appendix 3

Health Needs Assessment

Southwark PCT has the following key health needs and local drivers for health improvement:

Southwark PCT is a vibrant and rapidly changing borough with complex needs and has the following key health needs and local drivers for health improvement:

Population growth of up to 4,000 additional people each year

Nearly twice the density of population compared to London

Younger population compared to national average (high numbers of under 10 and aged 20 – 50)

More ethnically diverse than England, with significantly high Black population (26%) compared to London (11%)

Ranked 26 in England and 9 in London for deprivation

The main causes of poor health and mortality are cardiovascular disease, cancers, hypertension, diabetes and respiratory disease

High numbers of adults who smoke, teenage pregnancies and obese children

Appendix 4

ACCESS TO SERVICE / TREATMENT PATHWAY (into and out of service)

The proposed community based dermatology services would lead to the following patient pathway:

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Patient attendsGP Surgery

SuspectedLow Risk

BCC

SecondaryCare

ReferralRequired

GP Treats

CommunityBased

DermatologyService

SecondaryCare

Surgery inPrimary Care

RequiresSurgical

Intervention

GP reviewGuidance

CancerNon-Cancer

C

SuspectedHigh Risk

BCC

SuspectedSCC/MM

Patient attendsGP Surgery

SuspectedLow Risk

BCC

SecondaryCare

ReferralRequired

GP Treats

CommunityBased

DermatologyService

SecondaryCare

Surgery inPrimary Care

RequiresSurgical

Intervention

GP reviewGuidance

CancerNon-Cancer

Refer to Secondary Care Skin Cancer

Service

SuspectedHigh Risk

BCC

SuspectedSCC/MM

Annex 8 B – Format for Submitting an Expression of Interest

Potential Bidders wishing to participate in the Southwark PCT Procurement must submit an EOI using the template below:

To: patrick.roberts@southwarkpct.nhs.uk

From:

Subject: Southwark PCT procurement Expression of Interest for Dermatology

Services

Contact Name: [Name]

Organisation name: [Organisation Name]

Organisation Type: [Please choose one of the options below]

GPs 1 Social Enterprise 2

Independent Sector 3 NHS Organisation 4Voluntary Sector 4 Other (please specify) 6

Organisation Address [Organisation Address 1]

[Organisation Address 2]

[Organisation Address 3]

[Organisation Address 4]

[Postcode]

Contact Telephone Number [Tel]

Contact email address: [Email Address]

Organisation Website address: [Website Address (if applicable)]

I wish to attend the Bidder Day event scheduled week commencing 3rd November 2008

Yes / No

Attendance at the Bidder Day will be limited to two individuals from each representative organisation. Please indicate below who will be attending from your organisation.

Name Position or title

Name Position or title

An invitation to this event will be sent following receipt of this document.

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