NHS England South Orthodontic Procurement Frequently Asked Questions

Transcription

1 NHS England South Orthodontic Procurement Frequently Asked s Updated 12 th January 2018

2 Contents Contents Dynamic purchasing system (DPS) DPS applications DPS re-registration Partnerships Specification Financial General financial Price Lots Health needs assessments (HNAs) Lot sizes Hub and spoke arrangements Patient Transition Premises Key Performance Indicators (KPIs) Patient Engagement Process Secondary care orthodontic services TUPE Judicial Review To update the table of contents - right click on the contents table and select Update field, then update entire table 2

3 1 Dynamic purchasing system (DPS) 1.1 DPS applications 1 If you are a General Dental with Special Interests (GDwSI) provider can I submit a bid? 2 I am a General Dental Provider (GDP) with a Primary Dental Services (PDS) contract. It is specialist led. Will I be able to tender for contracts? Bids are welcomed from GDwSI providers. The bid will require the organisation structure to contain a Orthodontic Specialist who will take the lead on the contract in order to be compliant with the specification. Bids are welcomed from GDP's the bid will require the organisation structure to contain a Orthodontic Specialist who will take the lead on the contract in order to be compliant with the specification. 1.2 DPS re-registration 3 How do I re-register if my status changes from my original application to becoming a limited company or being part of a partnership with other providers? 4 If I have already registered, but want to register as a different organisation, can I do that? 5 If we have become incorporated and changed our name since being accepted on the DPS and we will be applying for the second stage of procurement under the new name does this make any difference or do we have to formally notify a particular department? We have issued guidance document for the selection questionnaire on how to apply if your company status has changed from since your original accepted application to the DPS, this document can be found under the clarification section of In-Tend. Yes - if you are looking to re-apply with a changed company status please see reregistration guide. Advised guidance on selection questionnaire will be posted for companies that have changed status since their original application. 3

4 6 If we need to form a new company/partnership in order to bid for a contract does this need to be done now or can we do this as part of the contract mobilisation? See section 5 of the guidance document. 2 Partnerships 7 Can the services be provided by partnering with existing general dental service providers? If so can this then be moved to a new specialist practice at a later date? Yes they can but in doing so the provider must demonstrate how the service will be 'specialist led' from day 1. Bids are welcomed from General Dental Practitioners though the bid will require the organisation structure to contain a Orthodontic Specialist who will take the lead on the contract in order to be compliant with the specification. 3 Specification 8 What speciality level will be specified? 9 Why has NHS England South chosen a hub and spoke model and does this favour larger companies/organisations? 10 If setting up from a squat premises, there would not be existing CQC registration or governance policies. Can we use existing policies from other existing dental service provision as proof or evidence that these will be in place? Primary Care providers will be expected to provide services up to 3a as described in the NHS England Commissioning guide for Orthodontics (2015). We will be procuring to a hub and spoke model for some areas where this was considered the best way to provide services to patients whilst also ensuring a contract size large enough to be viable for a provider. You can submit current policies to demonstrate current compliance. Any response would need to describe how you would seek to achieve CQC registration and how governance polices will be reviewed to ensure they are fit for purpose for Orthodontic practices. 4

5 4 Financial 4.1 General financial 11 Will you need to know private income as part of your financial suitability questionnaire to assess viability? 12 As we have submitted accounts information as part of the first stage DPS application will we need to submit these again during stage 2 of the tendering process? Financial suitability is assessed on the whole organisations accounts which should include all income both from NHS and private work. Resubmission of accounts will not be required as part of stage 2 of the procurement process (Call for Competition). 4.2 Price 13 When will the minimum/maximum bracket for Units of Orthodontic Activity (UOA) value be released? 14 With regard to bid pricing, how have socio-economic reasons been factored in? 15 Wouldn t it be fairer to dictate price? The value per UOA is still being considered. A guide price range has been identified which will allow bidders to take into account any local economic factors when pricing their bid. A guide price has been identified to help bidders in understanding how to price their bid whilst also allowing them flexibility in proposing their pricing structure. 5

6 5 Lots 5.1 Health needs assessments (HNAs) 16 How was Orthodontic Health Needs Assessment determined? 17 The Health needs are based on 2018 population figures, will this be re-adjusted to take into account the growing population? The Orthodontic Health Needs Assessments were based on the forecast population of 12 year olds in each local authority in 2018 estimating that 1/3rd will need Orthodontic treatment each year. This has not been agreed at this stage. 5.2 Lot sizes 18 Can you clarify whether the total new UOA's for each area are the same as currently or if not, what the percentage change is? UOAs for each area have been defined based on the local health needs assessments as well as providing equity across the South region. This may mean that in some areas there is an increase in UOAs whilst in others there is a decrease. Details of the current and proposed UOAs were provided at the market briefing events. Slides from the events including lotting information are available on the NHS England South West and South East website pages. 19 Can you bid for part of a Lot? No, bids must be for the complete Lot however you may decide to partner with another organisation to deliver the whole Lot. 20 If contract is 7500 and lowest Lot 6500, can 2nd Lot be for 1000 or does it only go to Lot 1? 21 How have patients in transition been factored into the numbers? Each Lot equates to 1 contract, however should you wish to partner with another practice to split the UOA this is an acceptable model and will need to be detailed within your tender. They are not factored into the needs assessment or the Lots but account is taken in year 1 with a planned reduction in the activity to be commissioned just for that year. 6

7 22 Have waiting lists been taken into account? 23 Why is there a 2 year Lot for Cheltenham? 24 Will patient boundaries be specified? 25 If Lot 1 is issued in January and then another in March, will the results be announced together? 26 Are you going to stipulate specific postcodes? 27 Are the Lots currently set out likely to change significantly in UOA numbers or is that quite firmly established at this stage? 28 Given most areas have a waiting list, why step a contract in the first year? There will be a need from day 1 & during mobilisation these can be contacted. No. It is planned that commissioning based on need will equalise waiting times over the life of the contract. Current waiting times will be taken into account as part of the transition process. This reflects the reduction in activity in year 1 due to possible transition costs relating to completion of treatments by providers not continuing beyond April This applies to all Lots in South Central. No; the boundaries have been used on an indicative basis to identify the geographical area likely to be covered by the Lots. No, call for competition outcomes will be announced as soon as possible once the evaluation is completed and the recommendation signed off by the relevant authorities within NHS England South. No, this has been done to enable providers to come up with the best solution in their bid to provide a locally accessible service. We will be finalising Lots after considering feedback from patients and stakeholders. We do not expect these to change significantly as they are based on the number of 12 year olds resident within each local authority. Arrangements for this are still be confirmed. 7

8 29 Please can you clarify that there will either be a single point of entry for orthodontic services where there is no referral management system; or referral management will move to electronic referrals, where this is not already in place; and that therefore the referrals will be allocated automatically to the most appropriate Lot by way of patient code? i.e. referrals across Lot borders will not be allowed/accepted. The intention is to move towards an electronic referral management system, which would provide a single point of entry. Where there is not a single point of entry in place it would be expected that patients are provided with information about local providers to enable them to make a choice of provider and this should not be restricted to boundaries relating to individual Lots. 5.3 Hub and spoke arrangements 30 Will the contract split for Hubs & Spokes be defined e.g.10,000 Hub 2,000 Spoke? 31 Does the Lot data give specific locations for where Hub and Spokes need to be based? 32 Where NHS England has stated that the Lot is to be provided on a Hub and Spoke basis, is the spoke mandatory? It is not intended to define a split of the delivery of the total contracted Units of Orthodontic Activity (UOAs) between the hub and spoke sites within any contract. It is expected that providers will offer appointments to patients at the most convenient location for the patient and which is appropriate to the particular element of treatment that is to be provided at that appointment. The Lot data for the location of spoke sites has been specified at a locality level rather than a specific town. This has been done to enable providers to come up with the best solution in their bid to provide a locally accessible service. The split provision of services is mandatory to provide services local to patients. 6 Patient Transition 33 How will patients in transition be managed? To date the financial arrangements have been agreed. There will be further work on the process to be followed. 8

9 34 Can you confirm orthodontists have no obligation to finish treatment? 35 As numbers tail off it may no longer be viable for a practice to remain open, will there be any other funding to support this? 36 Will practices be expected to accept patients in active treatment from other practices if they are not willing to complete treatment? 37 How will we know how many patients to expect? 38 If a new contract is won and its suggested that a stepped arrangement be in place as no WIP, if a current provider chooses not to wind down, will the contract be full from day 1?. Or will the transition payments apply to everyone you have to take on as a patient? 39 Do you have access to all current provider waiting lists? These will be needed by all to begin the service so that General dental practitioners don t have to re-refer patients. This will be a choice for the current provider. An offer will be made to the existing provider who can then choose whether to accept the offer. There will be no obligation to complete treatments however we need to consider what s best for the patients for continuity of care and would encourage existing providers to complete treatment. Arrangements will be subject to agreement Funding has been agreed to support practices to complete treatments should they not continue with contracts beyond 1st April This is designed to achieve financial viability to complete treatments. The obligation lies with NHS England to have arrangements in place for patients to complete treatment. NHS England aims to meet this obligation through agreement with practices. At the events we states this would be a requirement of new providers, if we choose not to include this here we ll need to include in requirements. Transition details will be included with the call for competition packs. To be confirmed. It is the intention to request this information from existing providers. 9

10 7 Premises 40 Will NHS England be undertaking practice visits? 41 What facilities will be required for a 'spoke' site? Not as part of the procurement, but any new practices will be subject to a visit as part of the mobilisation process. Paragraph 6.1 of the service specification sets out the premises requirements and the exceptions which would apply to a spoke facility. 41a What happens if a bid is submitted with the possibility of premises being available, however things change and the property is no longer available. If premises stated within the bid submission are no longer available post contract award, the successful provider will be required to source and secure alternative premises which meet the requirements of the specification within an agreed timeframe. If the provider is unable to do this, it will result in a material breach of contract. 8 Key Performance Indicators (KPIs) 42 What Key Performance Indicators (KPIs) will be used? We will finalise details of the contract specification when we have considered all feedback we have received. The contract specification will include details of the KPIs and will be published as part of the documentation when the invitation to tender is published for each call for competition. 9 Patient Engagement 43 How seriously will patient engagement be taken? We are very keen to get patient feedback to help inform the procurement. Patients were involved in developing the national orthodontic commissioning guidance which has been followed in developing the 10

11 specification for this procurement. We are also gaining feedback from patients across the South to help inform how services will be delivered locally. 44 Can we have a copy of the patient questionnaire? You can access the patient questionnaire on the NHS England engagement website. 11

12 10 Process 45 When will bidders find out if they have been awarded a contract? Approximately 12 week post the closing date of the call for competition. 45a 45b Where there is more than one Lot in a specific area, Reading for example, can we bid for both contracts and could we in theory be awarded both or will restrictions be put on the number of Lots allocated to one bidder? Will the quality/financial ratio stay at 90/10? Providers are welcome to bid for multiple Lots and may be awarded more than one Lot should they submit the most economically advantageous bid. If a bidder is awarded multiple Lots financial due diligence will be undertaken to ensure the providers ability to deliver multiple contracts. Following feedback and agreement at the NHS England National Orthodontic Working Group the quality/price ratio will be 80/20. With the 20% comprising of 15% on price and 5% on the assessment of the Financial Model Template. 11 Secondary care orthodontic services 46 Has secondary care information been taken into account when establishing the activity levels? 47 With a national shortage of consultant orthodontists, will work be moved from secondary to primary care? Secondary care information has been used to assess the level of activity to be commissioned in each Lot. This is in recognition that not all orthodontic need is met in primary care. Provision of secondary care is not included within this procurement. Not at the point new arrangements take effect in April 2019, but some areas will see an increase in activity which will enable them to treat more patients in primary care. This issue will be subject to on-going review post TUPE 48 What is TUPE? You can find more information about TUPE on the government website. 49 If you are cutting the number of UOA's in an area by half how We are unable to advise on this scenario, your organisation will need to seek 12

13 can all the staff in that area be protected? How does TUPE work in this situation? 50 What is the outcome of TUPE on the above point - with a 50% reduction in an area? 51 Will the new providers be expected to accept staff from providers who are not successful in gaining new contracts? 52 If TUPE is applicable the regulations state that TUPE information must be given 28 prior to transfer, however, the request from NHS England is to give the notice much earlier than the requirement. Please can you explain why? independent advice. We are unable to advise on this scenario, your organisation will need to seek independent advice. TUPE will apply so providers may be expected to accept staff from previous providers. You will need to seek independent advice on this. NHS England requests this information in advance of the statutory 28 days. The purpose of this is to allow all bidders the opportunity to provide accurate bids based on existing staffing levels. This ensures that the procuring organisation receives bids that have been properly costed to reflect the activity undertaken by the incumbent organisation. It may be sufficient to provide baseline information at this stage to include numbers of staff on particular pay grades/bands and the salary range for the grades/bands. Experience would suggest that if staff, potentially liable to TUPE, are not identified early on the new provider will challenge the validity of the TUPE at the point the employee liability information is provided and the incumbent organisation can be left with significant redundancy risks. At this early stage the TUPE list is only provisional. The actual numbers of staff that TUPE can only ever be known at the point the transfer takes place and could be different to the numbers provided at this stage. 13 Judicial Review 53 Is the Judicial Review ongoing and will it affect the procurement? We can confirm the judicial review is ongoing, at this stage we are unable to advise if it will affect the proposed procurement timelines or 13

14 process. 14