South East London Sector Bromley Clinical Commissioning Group A meeting of NHS Bromley CCG Governing Body Date: 28 th January 2016 ENCLOSURE 7 Medicines Optimisation Service Procurement DIRECTOR RESPONSIBLE: Mark Cheung, Chief Finance Officer CLINICAL LEAD: Dr Maya Lasrado / Dr Ruchira Paranjape COMMISSIONING LEAD: Karen Hong, Head of Medicines Management AUTHOR: Neil Lynch: Procurement Manager SUMMARY: Bromley CCG commission a Medicines Assessment and Support Service (MASS), which is currently provided by Bromley Healthcare (BHC). The service aims to support patients to access and use their medicines, thereby enabling them to manage their own medicines better, maintain self-management and independence, reduce hospital admissions and medicines waste. The service receives referrals from health and social care professionals, a pharmacy technician will then assess what practical support a patient may need and refers on to other services. Following a review of the existing service in 2015, a key recommendation was that the service should be enhanced with the inclusion of a clinical pharmacist to provide clinical assessment and medication reviews. This role would provide both clinical and strategic oversight and clinical medication review for patients with increasingly complex medication regimens. The inclusion of a clinical pharmacist is an essential element of the service in this procurement. The purpose of this paper is: 1. To update the Governing Body on the procurement process recently undertaken and concluded for this service and to seek approval to award the contract to the preferred provider. 2. To highlight risks associated with the recommendation of the award of contract and mitigation of these risks proposed by the Procurement evaluation team The procurement process was managed by the CCG Procurement Manager and the overall
Commissioning project was managed by Lead Commissioning Manager. The timeline for the process is attached (Appendix 1) and sets out the key milestones and objectives achieved so far. The issue of the Invitation to Tender resulted in Bromley CCG receiving two bids. The outcome of the evaluation of the returned tender bid resulted in the bid from the preferred provider achieving an overall score of 78.49%. out of an available 100% and the second placed bid achieving an overall score of 65.78% out of an available 100% BACKGROUND Aims of new service This procurement aims to continue to pilot the involvement of a clinical pharmacist working as part of the service, providing clinical and strategic oversight of the service, as well as the provision of clinical medication reviews for appropriate patients. The service will continue to assess patients with regard to the practical support they may need to support medicines-taking e.g. compliance aids and signposting to other services. This service is expected to have duration of 2 years, which will then inform the commissioning of a longer term service. The aims of the service include: To improve clinical outcomes for patients from their medicines To support patients to manage their own medicines and maintain independence To improve patients understanding of their medicines and improve adherence To provide clinical medication review to patients identified as having a medicines-related problem To reduce the number of inappropriate drugs prescribed using evidence-based tools To reduce the number of adverse drug events experienced To reduce medicines waste To work collaboratively with other health and social care professionals to support and implement personalised tailored interventions for individual patient needs To work with the CCG and social care to develop and implement guidance/policies on medicines administration support To reduce hospital admissions for medicines-related issues To facilitate hospital discharge for patients who have medicines-related issues To reduce inappropriate use of multi-compartment compliance aids (MCAs) The Clinical Executive Group approved a procurement process for the Medicines Optimisation Service on 12 November 2015. The procurement of this service was being undertaken at this time because: Bromley Healthcare, the provider of the current service, MASS, requested an early exit from the contract; A review of the current Medicines Assessment and Support Service (MASS) highlighted
a number of issues. One of the key recommendations was to include a clinical pharmacist element to the service to provide both clinical and strategic oversight and clinical medication review for patients with increasingly complex medication regimens. The inclusion of a clinical pharmacist is an essential element of the service in this procurement. Procurement Process The procurement timescales outlined in Appendix 1 have been met. The bids received have been robustly and rigorously evaluated, with clarification sought by the procurement evaluation team where required. This team of Subject Matter Experts (SMEs) included staff not only from Bromley CCG and CSU partners, but also two PAG members, alongside the CCG Clinical Lead GP. Appendix 2 identifies the procurement project team involved in the process. The service specification was taken to the BCCG Clinical Executive on 12 th November 2015 and also shared with the Patient Advisory Group, for comment. Of the two tenders that were fully scored the scoring was as follows: Outcome of Tender Scoring Organisation Score % Bidder A 65.79% Bidder B 78.49% The breakdown of the bidder scores against the evaluation criteria and weighting were as follows: Section Title Weight Bidder A Bidder B A Service delivery 30% 16.44% 18.84% B Safeguarding 5% 3% 3% C Quality 5% 3.5% 4.2% D Infection Control 5% 3.25% 4.75% E Human Resource/Workforce 15% 11.2% 11.8% F Information Management and Technology 10% 7.25% 7.25% G Contract Management 5% 3.65% 3.65% H Finance 25% 17.5% 25% Total 65.79% 78.49% Finance Considerations The expected cost of the re-procured services is 449,260 from the preferred bidder over a two year contract award.
Bidder Year 1 Year 2 Total Bidder B 227,130 222,160 449,260 As part of the procurement exercise, the preferred bidder has presented costings for this service within the financial envelope. Contract monitoring will highlight any capacity issues or financial cost pressures. The proposed cost of the service is within the budget and affordability envelope set by the CCG and reflects the service model and expected activity. Issues Two bids were received as the number of local providers with the ability to deliver this service was very limited One submission was not accepted as it was incomplete and was not submitted by the deadline set for the return of tender bids.. The evaluation panel have asked that a number of conditions are met, during the mobilisation process and for some to be conditions precedent after contract award, but with a longstop date for completion. Mitigation of risks 1. A robust scoring system was referenced throughout (See appendix 3), and the procurement process was transparently followed via the Delta e-portal system. All queries raised were logged and managed by the CCG procurement manager within the stipulated timeframes. 2. The Procurement evaluation panel membership rationale for scoring was evidenced in the individual comments section, and an initial moderation meeting was held after the bids were evaluated and after the bidder interviews to ensure that the basis for scores given was clear and any anomalies in scoring discussed and consensus agreed. 3. During the mobilisation stage, the procurement panel s recommendations will be applied as part of the draft service mobilisation timetable. These will be incorporated into any conditions precedent as part of the contract if any aspects remain outstanding and a longstop date applied. The Contract Manager will ensure that there is clear reporting throughout pre contract signature stage and monthly contract monitoring meetings held after, to ensure that we have a clear idea of how the model works in the community, with feedback from patients sought. Are there any consequences of no decision being taken? Yes the BCCG will not have a service provider when the current contract ends in June 2016. Staffing and Equalities consideration TUPE of 2 members of staff will be required to be conducted by the preferred provider.
Summary of Appendices Appendix 1: Project Gantt (timeline) Appendix 2: Scoring Range and criteria Appendix 3: Project Team Membership COMMITTEE INVOLVEMENT: Bromley CCG Clinical Executive Patient Advisory Group PUBLIC AND USER INVOLVEMENT: The Patient Advisory Group (PAG) provided feedback on the service specification. All feedback and comments were incorporated in the service specification and tender documentation ahead of advertising and issuing the tender. Two members of the PAG were also evaluators and provided scoring on the service delivery section. RECOMMENDATIONS: The Governing Body is asked to:- To note the current stage of this procurement To note the number of bids received and evaluated, together with overview. To approve the recommendation of the evaluation panel to award the two year contract to the preferred bidder provider B ACRONYMS PAG: Patient Advisory Group DIRECTORS CONTACT: Name: Mark Cheung E-Mail: mark.cheung@nhs.net Telephone: 01689 866167 AUTHOR CONTACT: Name: Neil Lynch, Procurement Manager E-Mail: neil.lynch2@nhs.net Telephone: 01689 866114
Appendix 1 MOS Procurement Timetable Activity Responsibility Completion Date Establish Project Team Karen Hong Lead Commissioner 12/11/2015 Membership Soft Market Test Notice approved Clinical Exec to approve Soft Market test notice on Delta PL confirmed no PIN advertised 25/9/15 Deadline for EoI is 14/9/15 at 12 noon 4 EoI s received approval required Issue Notice Procurement 25/8/15 notice issued via Delta ITT Questions Set KH / Procurement Project Team 12 th November 2015 Specification and project outline to lay members Service Specification Sign off Develop ITT Questionnaire and Evaluation Criteria Forward ITT Documents to interested parties Interested party briefing session KH to forward to JP for circulation to Lay members for feedback by 26 th October Clinical Exec to sign off the Service Specification Procurement Project Team to develop Bid documents Procurement to Load documents on Delta Procurement Project Team Need to prepare a presentation for the briefing session including Safeguarding information 22 nd October 2015 26th November 2015 6th November 2015 27th November 2015 9 th December 2016 2 hour session 9.30-11.30 am- Muirhead Deadline for returned 29th December 2015 bids Delta Evaluation training Procurement 4 th January 2016 (1-2pm ) Evaluation Evaluation Panel 4 th January 11 th January 2016 Moderation meeting Evaluation Panel 14 th January 2016 (9.30-11.30 am) Room C Clarification Questions to bidders and draft interview Questions and presentation title Evaluation Panel 29 th December 4 th January 2016 Bidder Interview Evaluation Panel 18 th January 2016 12 6pm Enid Blyton Final Moderation Evaluation Panel 18 th January 2016 Meeting Contract Award Governing Body to approve contract 28 th January 2016 award recommendation Contract Mobilisation BCCG Mobilisation Team February 2016 New Service commences Planned for 1 st April 2016 but may be later.
Appendix 2 Project Team Membership & Responsibilities for the Procurement of MOS Area Project Lead Procurement GP Clinical Lead PAG Finance Contracting Senior Contracting Safeguarding Children Safeguarding Adults Information Governance HR Infection Control Complaints, SI s, Quality & Governance Member Karen Hong Head of Medicines Management Neil Lynch Procurement manager, BCCG Dr Maya Lasrado Clinical Lead, BCCG Mr Gary Houlden Mrs Barbara Wall Claire Goslitski Senior Management Accountant, BCCG Daniel Serdoz Contracts Support Manager, BCCG Peter Lewis Senior Contracts Manager, BCCG Sadie McClue Head of Nursing and Safeguarding, BCCG Clare Lewin, Designated Nurse Safeguarding Adults, BCCG Joe Warner Johnson -Adult and Child Safeguarding Team Co-ordinator, BCCG Milton Shoriwa IG Manager CSU Nick Marsden HR Partner, CSU Esther Dias Health Protection/Infection Prevention Lead, LBB Gill Holden Clinical Governance, Patient Safety and Risk Manager, BCCG Sonia Colwill - Director of Governance and Quality
Appendix 3 - Evaluation Scoring Range Grade labels and definitions Score range 9-10 7-8 5-6 3-4 1-2 0 Basis of score Superior: An excellent and comprehensive response submitted in terms of detail and relevance which clearly meets or exceeds the requirements in all areas which is likely to result in increased clinical quality (including improvement through innovation). Good: A good response submitted in terms of detail and relevance which meets the requirements in most areas/all areas Satisfactory: An adequate response in most areas but less detail provided which reduces the extent to which the response merits a good score Below expectations: The response only partially addresses the question. A below expectation response. Poor: very limited response provided or a response that is inadequate or substantially irrelevant Unacceptable: No response given or response is unacceptable