Procurement of Community Gynaecology Services … · F7617 – Memorandum of Information (MOI) NHS Hammersmith & Fulham CCG - Community Gynaecology COMMERCIAL IN CONFIDENCE Page |

Procurement of Community Gynaecology Services

Memorandum of Information (MoI)

F7617 – Memorandum of Information (MOI) NHS Hammersmith & Fulham CCG - Community Gynaecology

COMMERCIAL IN CONFIDENCE

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Table of Contents

1 PURPOSE AND STRUCTURE ....................................................................... 3 1.1 Purpose of this document .................................................................................................. 3 1.2 Organisation of this document ........................................................................................... 3

2 INTRODUCTION AND OVERVIEW ................................................................ 5 2.1 Introduction and Context to the Planned Care Strategy .................................................... 5 2.2 Outline Scope of Services .................................................................................................. 6 2.3 Aims of the Out of Hospital Strategy .................................................................................. 6 2.4 Objectives of Community Gynaecology Services Procurement ........................................ 6 2.5 Bidder Pool ......................................................................................................................... 7 2.6 Critical Success Factors (CSFs) ........................................................................................ 7

3 NHS HAMMERSMITH & FULHAM CCG – STRATEGY AND DEMOGRAPHICS .................................................................................................. 8 3.1 Strategic Context for Change ............................................................................................. 8 3.2 Stakeholder Engagement ................................................................................................ 10 3.3 NHS Hammersmith & Fulham CCG Demography ........................................................... 10

4 NHS HAMMERSMITH & FULHAM CCG – GYNAECOLOGY SERVICES ... 14 4.1 Current Service Delivery .................................................................................................. 14 4.2 Gynaecology Services Procurement: Scope of Services ................................................ 17

5 PROCUREMENT PROCESS – OVERVIEW ................................................. 19 5.1 Overview .......................................................................................................................... 19 5.2 Gynaecology Services Procurement Timeline ................................................................. 19 5.3 Notice, Memorandum of Information and Pre-Qualification Questionnaire ..................... 21 5.4 Pre-Qualification Questionnaire (PQQ) ............................................................................ 22 5.5 Invitation to Tender (ITT).................................................................................................. 22 5.6 Contract Award ................................................................................................................ 23 5.7 Service Commencement .................................................................................................. 23

6 COMMERCIAL FRAMEWORK ..................................................................... 24 6.1 Contract ............................................................................................................................ 24 6.2 Contract Duration ............................................................................................................. 24 6.3 Clinical .............................................................................................................................. 24 6.4 Workforce ......................................................................................................................... 24 6.5 Premises, Facilities Management & Equipment .............................................................. 25 6.6 IM&T ................................................................................................................................. 25 6.7 Payment Mechanism ........................................................................................................ 26 6.8 Economic and Financial Standing .................................................................................... 26 6.9 Insurance ......................................................................................................................... 26 6.10 Sub-Contractors ............................................................................................................... 26

7 GOVERNANCE AND ADMINISTRATION .................................................... 27 7.1 Requirements ................................................................................................................... 27

8 GLOSSARY OF TERMS AND ABBREVIATIONS ........................................ 31



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1 PURPOSE AND STRUCTURE

1.1 Purpose of this document

This Memorandum of Information (MoI) provides an overview of the NHS Hammersmith & Fulham Clinical Commissioning Group (NHS Hammersmith & Fulham CCG) Community Gynaecology Services Procurement and details of the:

Procurement, strategic drivers and its objectives; Information in relation to current gynaecology services; Anticipated service scope for the procurement; Procurement process; Commercial framework; and Governance and administration requirements.

The purpose of this MoI is to provide any party (Potential Bidders) interested in delivering the required services with sufficient information to enable them to make an informed decision about whether they wish to participate in the Community Gynaecology Services Procurement. This MoI is intended only as a preliminary background explanation of NHS Hammersmith & Fulham CCG activities and plans and is not intended to form the basis of any decision on the terms upon which NHS Hammersmith & Fulham CCG will enter into any contractual relationship.

1.2 Organisation of this document

This MoI is organised into the following sections:

Section 1: Purpose and Structure of the MoI

Details the purpose and organisation of the MoI and the next steps for Potential Bidders.

Section 2: Introduction and Overview

Details the background and aims and objectives of the Community Gynaecology Services Procurement, and the factors critical to its success.

Section 3: NHS Hammersmith & Fulham CCG Strategy and Demographics

Details the strategic context for the Planned Care Programme, information on proposals for stakeholder engagement and demographic information for NHS Hammersmith & Fulham CCG.

Section 4: Community Gynaecology Services



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Details activity volumes and cost of current service provision and the anticipated scope for the Community Gynaecology Services Procurement.

Section 5: Procurement Process Overview

Details the stages involved in the procurement for services and the timescales that Potential Bidders will need to work within should they participate in the process. This Section also highlights the timeframes for public consultation.

Section 6: Commercial Framework

Highlights the key commercial terms and other legal and contractual arrangements for the Community Gynaecology Services Procurement.

Section 7: Governance and Administration

Details key governance and administration requirements of the Community Gynaecology Services Procurement.

Section 8: Glossary of Terms and Abbreviations

Providing a glossary of the terms used in this MoI.



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2 INTRODUCTION AND OVERVIEW

2.1 Introduction and Context to the Planned Care Strategy

Over recent years, the NHS has been increasing its focus on improving the provision, access and quality of care provided outside of an acute hospital setting. The White Paper ‘Our Health, Our Care, Our Say’1 outlined the ambition to create a fundamental shift of care from hospitals to more community-based settings and this was reiterated by Lord Darzi in ‘Our NHS, Our Future’2 with the principle to ‘localise where possible, centralise where necessary’. The drivers underpinning this need to transform services include:

The need to respond to the increased or changing demand for services as a result of an ageing society and an increased prevalence of long terms conditions;

Ensuring that services are centred around the patient; and Achieving clinical and financial sustainability.

The recent NHS England Guidance (2013) highlights that in order to meet the needs of our population, it is not possible to maintain the current duplication and fragmentation of care which drains resources and does not offer consistently high quality and cost effective care. The guidance states that; ‘without transformational change in how services are delivered, a high quality, yet free at the point of use health service will not be available to future generations.’3 While considering the above stated national drivers for change in a regional context, the following key challenges are evident for NHS Hammersmith & Fulham CCG, which mean that how health care in Hammersmith & Fulham is delivered needs to change:

The residents of Hammersmith & Fulham have changing health needs, as people live longer and live with more chronic diseases – putting pressure on health care provision.

Under our current model of care, we need to have more planned and integrated care, provided earlier to our population in settings outside of hospital. Patients do not always need to receive hospital based care and alternative community based services can often be delivered closer to home and be more cost effective.

Capacity within our acute hospital providers is constrained and this is adversely impacting referral to treatment waiting times for patients, indicating that services need to be provided differently to ensure the best clinical outcomes

Variation in both quality and access and standards must improve.

1 Department of Health (2006) Our Health, Our Care, Our Say

2 Department of Health (2007) Our Health, Our Future

3 NHS England (2013) Planning and Delivering Service changes for Patients



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The Community Gynaecology Services Procurement is acting on national, regional and local strategic drivers for change to re-commission local outpatient services, and will contribute to the CCG’s Out of Hospital Strategy4. This programme aims to develop services in the community and focus on self-care, early diagnosis with high quality management of long term conditions, and the diagnosis and treatment of those with ambulatory emergency conditions in the community when appropriate. This would enable acute hospitals to focus on patients who are critically ill and those who require specialist investigations and interventions.

2.2 Outline Scope of Services

This MoI relates to the Community Gynaecology Services Procurement for outpatient services only. Gynaecology services provide care for conditions affecting the health of the female reproductive system. Details in relation to the scope of services covered under the Community Gynaecology Services Procurement are outlined in Section 4.

2.3 Aims of the Out of Hospital Strategy

The Out of Hospital Strategy is an important part of Hammersmith & Fulham’s commissioning intentions, in particular, responding to the current population demographic and health challenges faced across Hammersmith & Fulham. This programme is being designed to deliver improved planned care pathways, which are accessible, safe, and achieve high quality outcomes and improved patient experience. The primary aims of the Community Gynaecology Services Procurement are to:

Deliver planned care pathways in the community using a multidisciplinary approach;

Provide patients with equity of access to high quality, safe and clinically effective care;

Improve patient satisfaction with services; and To deliver high quality and cost effective NHS outpatient services, provided

in the right setting by the right professionals.

2.4 Objectives of Community Gynaecology Services Procurement

The objectives of the Community Gynaecology Services Procurement are:

To reduce the number of unnecessary referrals to secondary care for diagnosis and treatment.

Introduce effective, well integrated patient pathways

4 ‘Better Care, Closer to Home’ Out of Hospital Strategy, NHS Hammersmith & Fulham CCG

(2012)



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Increase the capacity of community based Gynaecology services to facilitate on-going service improvement and innovation

Achieve better value for money

Reduce waiting times for assessment and treatment of Gynaecology conditions

Provide education support to Hammersmith & Fulham GPs on management of common gynaecological conditions

2.5 Bidder Pool

A Pre-Qualification Questionnaire (PQQ), will be applied for the Gynaecology Services Procurement. NHS Hammersmith & Fulham CCG wishes to receive responses to the PQQ from suitably qualified and experienced healthcare providers. This may include GP providers (including partnerships or an alliance of general practitioners) NHS Trusts, social enterprise / third sector organisations and other relevant providers. Potential Bidders will be required to demonstrate the necessary capacity and capability (or a demonstrable ability to provide the necessary capacity and capability) to provide the range of outpatient Gynaecology Services, as set out in Section 4 of this MoI, in a safe and effective manner and to meet the requirements of paragraph 2.6 below. Potential Bidders may bid in partnership with other organisations.

2.6 Critical Success Factors (CSFs)

NHS Hammersmith & Fulham CCG requires the Provider to meet the following CSFs throughout the life of the Contract:

Access – The services must be provided to meet patient access needs and preferences (e.g. easy to access locations, opening hours) and national waiting time targets must be met.

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

Patient Choice – Patients will continue to be able to exercise their choice of provider for services.

Quality – Patient-centred outpatient services, delivered in a safe and effective manner and delivered through a learning environment that includes the training and education of clinicians and other staff.

Value for Money and Affordable – The outpatient services must offer affordability and provide Value for Money for the NHS. Services must be high quality and cost effective.



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3 NHS HAMMERSMITH & FULHAM CCG – STRATEGY AND DEMOGRAPHICS

3.1 Strategic Context for Change

3.1.1 Introduction

NHS Hammersmith & Fulham CCG has taken into consideration national, regional and local strategies and guidance in the development of the Out of Hospital Programme and procurement of gynaecology services. There are strong and robust strategic drivers for change and key related strategies have been highlighted in this Section of the MoI. NHS Hammersmith & Fulham CCG has also taken into consideration the recently published NHS England Guidance: Planning and delivering service changes for patients5 (2013). This document emphasises that changes must be clinically led; programmes should be tailored to local circumstances; and patients, the public and staff should be engaged throughout the process.

3.1.2 NHS England; London: A Call to Action

NHS England’s publication; ‘London: A Call to Action’6, reported that London’s diverse population has resulted in a broad and growing range of health needs and that there had been a failure to close the inequalities gap. It considered that the pattern of healthcare provision with its emphasis on hospital services would not address this problem in the future and that much more should be done to support people to live healthier, independent lives through services provided in community settings that are more accessible to patients. The publication recommended that care needs to move away from traditional hospital-centred delivery and that local community based health services are developed to address the type and severity of local needs and to raise the health and wellbeing of those who are the least healthy to be in line with the healthiest. The report recognises that doing nothing is not an option and that bold transformational change is needed to the way in which services are currently delivered.

3.1.3 Shaping a Healthier Future

‘Shaping a Healthier Future'7 (SHaF) is a programme to improve NHS services for the two million people who live in North West London and will save hundreds of lives each year. This vision for the future of healthcare in North West London is being taken forward by the North West London Collaboration of CCGs, comprising eight Clinical Commissioning Groups (CCGs) in North West London, of which Hammersmith & Fulham is one. The North West London Collaboration of CCGs have a historical system leadership position which formed during the Primary Care

5 NHS England (2013) Planning and delivering service changes for patients

6 NHS England (2013) London: A Call to Action

7 Shaping a Healthier Future Programme, www.healthiernorthwestlondon.nhs.uk

http://www.healthiernorthwestlondon.nhs.uk/



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Trust cluster arrangements and has continued to support implementation of the SaHF programme and more recently submitted an application for Pioneer Status for Integrated Care (Living Longer and Living Well8).

3.1.4 NHS Hammersmith & Fulham CCG Out of Hospital Strategy

In light of the above mentioned strategic context, NHS Hammersmith & Fulham CCG has been through a process of examining and assessing the current service use, provider performance and looking at ways in which services can be better commissioned to achieve;

Improved outcomes; Improved patient experience; and Long-term financial sustainability.

In 2012 NHS Hammersmith & Fulham CCG published our ‘Out of Hospital Strategy’9 which outlined local plans to transform out of hospital care and provide better care, closer to home. This strategy also supports the North West London wide strategy; ‘Shaping a Healthier Future’10, which includes plans for the reconfiguration of acute hospitals services across the whole of North West London, which will be implemented over the next three to five years. The CCGs Out of Hospital (OOH) Strategy is a key enabler for the North West London Shaping a Healthier Future (SaHF) programme. The success of SaHF is predicated on having substantial capacity in the community to meet population health needs, as described within NHS Hammersmith & Fulham CCG’s OOH Strategy. One of the priority areas identified within the OOH strategy was a need to develop ‘clearly understood planned care pathways.’ A care pathway can be defined as a multi-disciplinary management tool used to manage the quality of care for a specific group of patients through the standardisation of care processes based on evidence-based practice. In support of these pathways Hammersmith & Fulham CCGs intention is to transfer of a proportion of outpatient services, which are identified as safe and clinically appropriate to do so, from an acute hospital setting and into community settings. In addition, the King’s Fund recognises that ‘the current fragmented services fail to meet the needs of the population and that greater integration can improve the patient experience and the outcomes and efficiency of care’11.

8 Living Longer and Living Well, North West London’s application for Pioneer Status – June 2013

9 NHS Hammersmith & Fulham CCG (2012), Better Care, Closer to Home

10 The Case for Change - Shaping a Healthier Future Programme 2012

11 Making integrated care happen at scale and pace 2013



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3.2 Stakeholder Engagement

Through various NHS Hammersmith & Fulham CCG engagement activities, Hammersmith & Fulham CCG has the following desired outcomes:

Ensuring key stakeholders are kept informed about the proposed procurement;

Developing an understanding of the impact on patient and stakeholder groups;

Allowing input into development of services and specifications; and Meeting NHS Hammersmith & Fulham CCG’s statutory duties in respect of

disclosure of information and patient and public engagement.

A specific Community Gynaecology Steering Group has been set up to support the delivery of the Community Gynaecology Services Procurement. The group comprises of clinicians with an expertise or specific interest in Gynaecology Services, together with commissioners, procurement, contract and financial expertise and a patient representative. They will support the development of the detailed specification and evaluation of proposals.

3.3 NHS Hammersmith & Fulham CCG Demography

3.3.1 Overview

Administratively, the locality of NHS Hammersmith & Fulham CCG is divided into 16 wards as shown in the map below;



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3.3.2 Hammersmith & Fulham population information

The population of Hammersmith & Fulham has risen by over 10% from 165,242 in 2001 to 182,500 on Census day in 2011; this is 11th lowest population growth in London.

There are more females (51.3 per cent) than males (48.7 per cent) in the Borough, which is different from the London and national averages as shown in table 1 below;

Table 1: Gender profile of Hammersmith & Fulham residents

Area All Persons MaleMale

% of AllFemale

Female

% of All

Hammersmith & Fulham 182,500 88,900 48.7% 93,600 51.3%

Kensington & Chelsea 158,700 78,200 49.3% 80,500 50.7%

Westminster 219,400 111,500 50.8% 107,900 49.2%

Bi-Borough 341,200 167,100 49.0% 174,100 51.0%

Tri-Borough 560,600 278,600 49.7% 282,000 50.3%

West London 1,599,100 795,800 49.8% 803,400 50.2%

London 8,173,900 4,033,300 49.3% 4,140,700 50.7%

England & Wales 56,075,900 27,573,400 49.2% 28,502,500 50.8%



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The age profile of Hammersmith & Fulham continues to be typical of an affluent urban population. There are fewer people near the retirement age and a corresponding lower level of younger children than in London as a whole (See figure 1).

Figure 1: Proportion of population by broad age group

H&F has a higher proportion (75.6 per cent) of population aged 15-64 than both London (70.2 per cent) and England as a whole (65.9 per cent). An estimated 9.0 per cent of the Borough’s population is in their retirement age.

Based on the usual residents’ population, Hammersmith & Fulham is the country’s sixth most densely populated area with density of 111 people per hectare. It is more than twice densely populated as both West London (47 persons per hectare) and London (53 persons per hectare).

Overview of Health Profile of Hammersmith & Fulham Population

There are 31 GP practices in the borough. The number of GPs per 1000 population is the same in Hammersmith & Fulham as in England as a whole. There are 2 main hospitals within the borough: Hammersmith Hospital and Charing Cross Hospital. There is also a specialist maternity hospital, Queen Charlotte’s and Chelsea Hospital. These hospitals are all part of Imperial College Healthcare NHS Trust. In addition, Chelsea & Westminster Hospital is close to the borough boundary, and is utilised by people in the south of the borough. The number of deaths from all causes is higher in Hammersmith & Fulham than expected for the age and sex structure of the population. However, it is lower than in inner London as a whole. SMRs in wards range from 73 in Palace Riverside to 148 in Shepherd’s Bush Green. The female life expectancy in Hammersmith & Fulham is higher than that in London and England. The male life expectancy in Hammersmith & Fulham is similar to that in London and England. For females, life expectancy in wards ranges from 77.9 in Askew to 89.6 in Fulham Reach. For males, life expectancy in wards ranges from 73 in Shepherd’s Bush Green to 80.1 in Sands End.

England and Wales

London

Hammersmith & Fulham

17.6%

18.7%

15.4%

65.9%

70.2%

75.6%

15.4%

11.1%

9.0%

under 15 15-64 pensionable age



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Figure 2: SMR by ward in Hammersmith & Fulham



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4 NHS HAMMERSMITH & FULHAM CCG – Gynaecology Services

4.1 Current Service Delivery

Details in relation to current service delivery for gynaecology services are presented in this section, including:

The current NHS service providers Activity delivered for Hammersmith & Fulham registered patients; The value of services currently delivered; and The first appointment to follow-up appointment ratios for secondary care

services.

4.1.1 Gynaecology service providers and locations

The main acute providers of gynaecology services are:

Imperial College Healthcare NHS Trust; and

Chelsea and Westminster NHS Foundation Trust

4.1.2 Gynaecology Activity and Cost

A profile of gynaecology outpatient attendances and the cost of services provided is shown in Table 1 below. In total there were over 12,000 patient attendances in hospital for Hammersmith & Fulham residents in 2012/13, at Imperial and Chelsea and Westminster. It is recognised by NHS Hammersmith & Fulham CCG that of these patients attending outpatient services, not all may be suitable for the newly commissioned services due to complex needs or where specialist treatment is required.

Activity (Full Year)

Cost (Full Year)

Total Activity (Full Year)

Total Cost (Full Year)

Row Labels

GP Referra

l

Intra Referre

d

Other Referra

l

GP Referral

Intra Referred

Other Referra

l

2010/11 9,476 2,260 1,374 1,187,50

5 261,254 131,15

5 13,110 1,579,91

4

OPFA 3,494 715 490 559,380 116,331 73,846 4,699 749,557

OPFUP 4,122 1,304 536 351,852 105,980 43,692 5,962 501,524

OPPROC 1,860 241 348 276,273 38,943 13,617 2,449 328,833

2011/12 9,311 3,164 1,448 1,469,92

7 439,755 209,74

7 13,923 2,119,42

9

OPFA 2,694 853 505 466,144 147,955 86,333 4,052 700,432

OPFUP 3,303 1,681 630 308,556 160,328 60,036 5,614 528,920



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OPPROC 3,314 630 313 695,227 131,472 63,378 4,257 890,077

2012/13 8,804 3,690 490 1,437,86

7 590,764 77,801 12,984 2,106,43

2

OPFA 2,311 1,030 120 391,691 179,512 20,656 3,461 591,859

OPFUP 2,988 1,655 194 301,681 169,183 19,341 4,837 490,205

OPPROC 3,505 1,005 176 744,495 242,069 37,804 4,686

1,024,368

2013/14 9,107 3,686 198 1,447,73

4 544,541 27,117 12,990 2,019,39

2

OPFA 1,836 630 26 285,707 106,043 3,260 2,492 395,009

OPFUP 2,961 1,667 99 296,222 164,546 8,369 4,727 469,136

OPPROC 4,310 1,389 74 865,806 273,953 15,489 5,772

1,155,248

Grand Total 36,698 12,800 3,510

5,543,033

1,836,314

445,820 53,007

7,825,167

Table 2: Gynaecology services provided for Hammersmith & Fulham registered patients – activity and cost

Potential Bidders must note that the activity and cost data presented in this MoI does not show the levels of activity that will be commissioned through the Gynaecology Services Procurement, nor the value of contracts that may be awarded. The costs shown are based on tariff prices for services in the acute setting and the CCG’s expectation is that savings will be released on the activity commissioned through this procurement.

Community Gynaecology Pilot An 18 month pilot community gynaecology scheme was implemented between August 2012 and March 2014, with further extension until December 2014. Between May and October 2013 the service saw 551 patients that would otherwise have been seen in hospital.

Main operations of pilot

The Community Gynaecology Pilot Service was delivered on behalf of all

Hammersmith and Fulham registered patients and had provision for the North and

South of Hammersmith and Fulham borough to ensure equity of access for

patients.

It had three main features:

1. To triage relevant non-urgent referrals for secondary care (from April 2013),

2. To provide high quality treatment for those suitable within a community setting

3. To provide education and support to local GPs by developing local protocols

and referral pathways, offering telephone advice and information and running

bi-annual conferences to support GPs in remaining up to date with the latest

developments in the field.



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Conditions treated under the current pilot pathway include:

Management of menstrual disorders,

Post - coital bleeding,

Management of prolapse e.g. insertion of ring pessary and maintenance of ring pessary where necessary,

Pelvic pain where appropriate,

Menopause/HRT,

Polycystic ovary syndrome (PCOS),

Endometriosis,

Recurrent PV bleeding

Vaginismus/psychosexual health issues The service is inclusive of:

A single point of triage for all Gynaecology referrals, undertaken by the general practitioners with special interest in Gynaecology,

Appropriate administration for the safe and effective on going management of the patient,

Clinical management of patients attending the clinic,

Clinical treatment of patients, both in the medical section of the service and the Uro-gynaecology physiotherapy section of the service, as triaged by the GPwSIs in Gynaecology.

The pilot shows that it is clinically safe to transfer care to a community setting and that we can deliver an effective service which is well regarded by patients and their GPs. Patient satisfaction for the pilot scheme is high, as shown below;



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This pilot has demonstrated a number of benefits to patients associated with transferring care to the community, including:

Early access to services,

A coordinated approach for a range of services without need for additional referrals

Direct access to hospital care where it is needed,

Cost effectiveness of care provided through the community pathway.

The service continues to operate as a pilot. The services delivered through the current pilot will be included within the scope of the Community Gynaecology Services Procurement. The learning from this pilot service will feed into further development of the Gynaecology services procurement. It will be made in conjunction with user and patient involvement, where possible, and clinical experts and provided to Bidders at the ITT stage of this procurement process.

4.2 Gynaecology Services Procurement: Scope of Services

An outline scope of the services to be procured is provided in this MoI, Section 4.3.2. NHS Hammersmith & Fulham CCG will work together with key stakeholders and service experts to develop a detailed service specification to be provided to Bidders that have qualified for the Invitation to Tender (ITT) stage.

4.2.1 Core principles

In support of the aims of the Community Gynaecology Services Procurement, the development of the service scope will be guided by the core principles of:

The services will be provided within a community setting; The services will need to be well coordinated and integrated to ensure that

patients receive the right care without unnecessary delays and duplication arising from fragmented care

The services must deliver good patient experience and effective clinical outcomes

The services must be led by clinicians with the right skills and use a multidisciplinary approach

Patients must be provided with equity of access to services and in line with national waiting time targets, including national referral to treatment times requirements.

Patients must be able to continue to exercise their choice of provider for services.

The pathways should promote patient self-care and education (and provide, for example, ‘shared care plans’ where appropriate)

It is envisaged that Providers will be required to deliver services from two locations, broadly serving the residents in the north and south of the Hammersmith & Fulham area. NHS Hammersmith & Fulham CCG is investigating whether existing premises can be made available to Providers for the delivery of services.



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4.2.2 Service Scope for Procurement

The scope of the services to be inclusive in the Community Gynaecology Service Procurement will provide the residents of Hammersmith & Fulham with assessment, diagnosis, treatment and care planning for the following non-urgent Gynaecology conditions. This is an indicative broad scope only and further details will be provided to shortlisted Bidders at Invitation to Tender Stage:

Management of menstrual disorders,

Post - coital bleeding,

Management of prolapse e.g. insertion of ring pessary and maintenance of ring pessary where necessary,

Pelvic pain where appropriate,

Menopause/HRT,

Polycystic ovary syndrome (PCOS),

Endometriosis,

Recurrent PV bleeding

Vaginismus/psychosexual health issue

Early fertility assessment with/without PCOS

Ultrasound

Incontinence

Long acting reversible contraception for women with complex histories

Acute gynaecology consultant-led clinics in the community for more complex gynaecology patients

Uro-gynaecology physiotherapy

The following are excluded from this procurement:

Male Patients

Termination of pregnancy

Suspected Cancer- this includes

Postmenopausal bleeding

Irregular (non-cyclical) bleeding in a woman aged 45 and over

Suspected vulval or cervical cancer

Complex ovarian cysts suggestive on ultrasound scan of ovarian cancer

Colposcopy referrals

Early pregnancy problems

Women with multiple/complex co-morbidities

Women who have already had a work up and treatment in the intermediate service without resolution

Hysterectomy

The levels of activity to be commissioned through this Community Gynaecology Services Procurement will be detailed in the ITT documentation.



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5 PROCUREMENT PROCESS – OVERVIEW

5.1 Overview

NHS Hammersmith & Fulham CCG will follow an open and competitive procurement process to commission the services identified in Section 4 of this MoI. The procurement process adopted by NHS Hammersmith & Fulham CCG will be governed under the Public Contract Regulations 2006 and will follow a fair, open and transparent process. It should be noted that under the Public Contract Regulations 2006, the provision of Health Services is regarded as a Part B service and as such falls under a lighter regime. Part B Services are however still subject to the general obligations of transparency, equal treatment, non-discrimination and proportionality. A compressed restricted procurement process will be used for the Community Gynaecology Services Procurement. This process involves the Pre-Qualification Stage and the Tender Stage being released simultaneously :

1. Pre-Qualification Stage: Potential Bidders will be required to complete a Pre-Qualification Questionnaire (PQQ), where interested parties will be assessed on the basis of capability and capacity to deliver the service. The questions will take the format of Yes/No responses from which potential bidders will achieve a ‘qualify in’ or ‘qualify out’ score. Those potential bidders who achieve a ‘qualify in’ score will be invited to participate immediately in the Invitation to Tender stage (ITT).

2. Tender stage: Bidders who achieve a ‘qualify in’ score from the PQQ will be invited to participate immediately in the Invitation to Tender stage (ITT) at which stage further detailed specification will be provided. The questions will be more detailed and require evidence to show development of capability or capacity to deliver the service.

Details regarding the procurement structure are provided for information, and NHS Hammersmith & Fulham CCG may amend these details at any time during the procurement process. NHS Hammersmith & Fulham CCG reserves the right to cease to continue with the process at any stage during the procurement and/or not to proceed to award. If the process were to be abandoned the CCG shall not be held liable for any losses or costs incurred by the Bidder.

5.2 Gynaecology Services Procurement Timeline

The timeline for the Community Gynaecology Services Procurement is set out in Table 5 below. Further details are provided in paragraphs 5.3 - 5.7 below. It should be noted that the dates are indicative dates at the time of issuing this MoI and may be subject to change. If the dates are to be amended, the CCG shall not be held liable for any losses, costs or inconvenience incurred by the Bidder.



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Table 5: Gynaecology Procurement Timeline

Milestone *Date

Advertise on Contracts Finder July

Market Engagement Event Thur 24th July

Phase A (PQQ and ITT) published Bravo Solution Portal w/c 25th August 2014

Deadline for Bidders to submit clarification questions Fri 19th September 2014 12:00 noon

Deadline for Pre Qualification Questionnaire (PQQ) and Invitation to Tender (ITT) submission

Tue 30th September 2014 12:00 noon

PQQ and ITT Evaluation Process 1st Oct – 21st Nov 2014

Supplier Clarification Event (if required) w/c 3rd November

Selection of Preferred Bidder November 2014

Board Approvals November/December 2014

Expected duration of Contract Mobilisation period 3 months

Planned New Service Commencement Anticipated 1st January 2015



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Figure 1: Outline procurement process diagram

5.3 Notice, Memorandum of Information and Pre-Qualification Questionnaire

5.3.1 Notice

A Notice has been published on Contracts Finder describing, in general terms, the services being procured by NHS Hammersmith & Fulham CCG. The notification allows potential providers an opportunity to be made aware of the Community Gynaecology Service Procurement.

5.3.2 Memorandum of Information (MoI)

This MoI provides Potential Bidders with information on the procurement process and the service scope enabling them to make an informed decision about whether they wish to register their interest in the NHS Hammersmith & Fulham CCG Community Gynaecology Services Procurement.

1 - Notice on Contracts Finder - Memorandum of Information

6- Preferred Bidder Selected

5- Evaluation of ITT

3- PQQ and Invitation to Tender (ITT)

2- Final Public Consultation Phase

7- Contract Award (and Mobilisation)

4- PQQ response. If bidder self qualifies in proceed to ITT



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5.4 Pre-Qualification Questionnaire (PQQ)

The PQQ provides detailed information on the PQQ process, guidance on how to complete the PQQ and a series of questions for Potential Bidders to answer. The PQQ (and ITT) will be issued, via BravoSolutions e-Tendering portal in August 2014. At the same time a notice will be placed on Contracts Finder to encourage responses from as wide a range of organisations as possible. Potential Bidders are encouraged to register on Contracts Finder www.contractsfinder.com and essentially BravoSolutions https://soepscommissioning.bravosolution.co.uk All Potential Bidders who have registered via BravoSolutions will be able to download the documentation for completion. Potential Bidders wishing to participate in the Community Gynaecology Services Procurement must respond to the PQQ (and ITT) before the deadline stated. NHS Hammersmith & Fulham CCG reserves the right to reject any PQQ (and ITT) submission received after that deadline. A clarification question and answer process will operate during the PQQ stage and will be explained in the PQQ documentation. The PQQ is designed to evaluate whether the Potential Bidder has sufficient;

knowledge and experience; capacity and capability and organisational financial standing

in order to provide the outpatient services which are the subject of this Community Gynaecology Services Procurement.

The PQQ evaluation will produce a total score from which Potential Bidders will automatically qualify themselves in or out of proceeding to ITT stage. It is anticipated that a minimum of five but no more than seven Potential Bidders are likely to qualify to proceeding to ITT stage. Further details of the PQQ process and self evaluation will be set out in the PQQ stage.

5.5 Invitation to Tender (ITT)

Following the PQQ evaluation, successful Potential Bidders will qualify themselves to proceed immediately to the ITT stage for the Community Gynaecology Services Procurement. NHS Hammersmith & Fulham CCG will use the ITT stage to set out further details on our requirements for Community Gynaecology Services Procurement.

The Invitation to Tender (ITT) provides:

http://www.contractsfinder.com/

https://soepscommissioning.bravosolution.co.uk/



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An overview of the remainder of the NHS Hammersmith & Fulham CCG Procurement process;

Rules and instructions on completing the ITT for the Community Gynaecology Services Procurement;

The Community Gynaecology Services Procurement detailed requirements and service specification

Requests for responses from Bidders; and

The draft Contract to be signed for the provision of the Services.

The ITT supersedes all previous NHS Hammersmith & Fulham CCG Procurement published documentation (including the Memorandum of Information (MoI) and Pre-Qualification Questionnaire) and should be read as a stand-alone document. In evaluating Bids from Bidders, NHS Hammersmith & Fulham CCG will only consider information provided in response to the ITT.

As part of the ITT assessment of Potential Bidder’s capability and capacity, to provide the required service, further details of partnership or alliance arrangements between different organisations will be requested.

5.6 Contract Award

Based on the outcome of the Community Gynaecology Services Procurement ITT evaluation, recommendations will be made to NHS Hammersmith & Fulham CCG Governing Body for consideration. Following NHS Hammersmith & Fulham CCG Body approval, a Bidder will be selected to enter into the contract for the service.

5.7 Service Commencement

Following contract award and in accordance with the Provider’s mobilisation plan (as approved by NHS Hammersmith & Fulham CCG), the Provider will work together with NHS Hammersmith & Fulham CCG and current service providers towards service commencement at the contractually agreed date.



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6 COMMERCIAL FRAMEWORK

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

6.1 Contract

The contract to be entered into by NHS Hammersmith & Fulham CCG and the selected Provider(s) for the Community Gynaecology Services Procurement will be based on the NHS England Standard Contract http://www.england.nhs.uk/nhs-standard-contract It is envisaged that the 2014/15 version of the contract will be used for the Community Gynaecology Services Procurement. The Contract will be separate to and independent of any existing contract currently in place between a Provider and NHS Hammersmith & Fulham CCG.

6.2 Contract Duration

It is anticipated that the 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 for a period of up to two successive years. The Term of Contract will however be confirmed at ITT stage.

6.3 Clinical

NHS Hammersmith & Fulham CCG is seeking Providers with the necessary capacity and capability (or a demonstrable ability to provide the necessary capacity and capability) to deliver high quality, and cost effective outpatient Gynaecology services, delivered in a safe and clinically effective manner and through an environment which harbours integration of services. Providers will need to demonstrate at PQQ stage that appropriate registration with CQC will be in place prior to delivering services. Further clinical requirements will be set out in the PQQ and ITT documentation.

6.4 Workforce

6.4.1 Policies and Strategies

At ITT stage, Potential Bidders will be required to provide evidence that they will be able to meet all NHS England Standard Contract policies in relation to workforce requirements. http://www.england.nhs.uk/wp-content/uploads/2013/12/sec-c-gen-cond-1415.pdf Further details of the staff resourcing and workforce policy requirements will also be included in the ITT stage.

6.4.2 Staff Transfers (TUPE)

If a new provider is selected as the Preferred Bidder and awarded the contract, any person/staff currently providing the services may be eligible for transfer under

http://www.england.nhs.uk/nhs-standard-contract

http://www.england.nhs.uk/nhs-standard-contract

http://www.england.nhs.uk/wp-content/uploads/2013/12/sec-c-gen-cond-1415.pdf



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the Transfer of Undertaking (Protection of Employment) Regulations 2006 ("TUPE Regulations") when the new service provision commences. Details of any staff identified as potentially being eligible for a TUPE transfer under the TUPE Regulations, shall be requested by NHS Hammersmith & Fulham CCG from the incumbent provider. NHS Hammersmith & Fulham CCG will communicate anonymous information provided by the incumbent provider during tender stage in order to assist Bidders in determining what staff may be eligible to transfer in accordance with the TUPE Regulations, in order that Bidders can factor this in to their Bid proposals

6.5 Premises, Facilities Management & Equipment

6.5.1 Premises

If possible, NHS Hammersmith & Fulham CCG will mandate property solutions so as to make use of available existing NHS property stock. In such circumstances, Providers will be required to enter into a lease arrangement for the use of that property. Where NHS Hammersmith & Fulham CCG does not mandate a property solution, Bidders will be required to propose their own premises solution at ITT stage. Further details on such proposals and / or requirements for the Community Gynaecology Services Procurement will be set out in the ITT stage.

NHS Hammersmith & Fulham CCG envisages that the services will be required to be delivered from two sites in the Borough – broadly serving the residents in the north and south of the Borough.

The Provider will be expected to fund rent, rates, utility, and insurance costs for the premises solution. The exact mechanics of the payment mechanism will be detailed in the ITT.

6.5.2 Facilities Management Services (FM Services)

Potential Bidders will be expected to fund FM Services costs except where FM Services at a NHS Hammersmith & Fulham CCG mandated property are provided as part of a separate, wider arrangement. Under these circumstances, NHS Hammersmith & Fulham CCG may require the Provider to utilise existing FM Services. Further details on FM Services requirements for the Gynaecology Services Procurement will be set out in the ITT documentation.

6.5.3 Equipment

Providers will be responsible for the provision and cost of equipment. Further details will be made available at ITT stage.

6.6 IM&T

Providers will be responsible for the maintenance and cost of all IM&T equipment (including IM&T hardware and software, licenses and IT support services), required to meet the needs of the service.



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These will need to meet local and national standards and support CCG direction of travel regarding interoperability. The Information Governance arrangements and processes will need to comply with Health Social Care Information Centre standards to ensure information flows efficiently and securely across the health and social care system, to improve patient outcomes. Further details on IM&T requirements for the NHS Hammersmith & Fulham CCG procurement will be set out in the ITT documentation.

6.7 Payment Mechanism

Payment to a Provider for the services will generally be linked to volume of activity or the number of patients to whom services are provided. Further details on the payment mechanism for the Community Gynaecology Services Procurement will be set out in the ITT.

6.8 Economic and Financial Standing

Hammersmith & Fulham CCG will be considering both economic and financial standing requirements for the Community Gynaecology Services Procurement at the PQQ stage. It is likely to include satisfactory demonstration of a Potential Bidder’s history of profitable trading and an associated positive cash flow, such that the Potential Bidder is able to safely deliver the required services.

6.9 Insurance

Potential Bidders will be required at ITT stage to demonstrate that they currently have or are able to obtain insurance / indemnity requirements as set out in the NHS England Standard Contract prior to contract award.

6.10 Sub-Contractors

Bidders will be required to comply with the requirements of the NHS England Standard Terms when entering into sub contracts with Sub Contractors, and this will include ensuring that all Sub Contractors are appropriately registered with the Care Quality Commission and hold a Provider Licence with Monitor.



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7 GOVERNANCE AND ADMINISTRATION

7.1 Requirements

7.1.1 Procurement Costs

Each Relevant Organisation will be responsible for its own costs incurred throughout each stage of the Community Gynaecology Services Procurement process. Neither NHS Hammersmith & Fulham CCG, nor its advisors will be responsible for any costs incurred by any Relevant Organisation or any other person through this process.

7.1.2 Consultation

NHS Hammersmith & Fulham CCG will lead on all local stakeholder engagement issues. All outcomes received will be considered and necessary details or changes will be included in the Community Gynaecology Services Procurement ITT.

7.1.3 The Public Contract Regulations 2006

The 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 “Pre-Qualification Questionnaire" nor any other indication shall be taken to mean that the Community Gynaecology Services Procurement intends to hold itself bound by any of the Regulations, save those applicable to Part B services.

This is a ‘Part B clinical healthcare service’ and has been advertised through Contracts Finder. The CCG will comply with the requirements for NHS procurement to procure in a fair, transparent and equitable manner.

7.1.4 Conflicts of interest

In order to ensure a fair and competitive procurement process, NHS Hammersmith & Fulham CCG requires that all actual or potential conflicts of interest that a potential Bidder may have are identified and resolved to the satisfaction of NHS Hammersmith & Fulham CCG. Potential Bidders should notify NHS Hammersmith & Fulham CCG of any actual or potential conflicts of interest in their response to the PQQ. If the Potential Bidder becomes aware of an actual or potential conflict of interest following submission of the PQQ it should immediately notify NHS Hammersmith & Fulham CCG via email to [email protected]. 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 NHS Hammersmith & Fulham CCG, then NHS Hammersmith & Fulham CCG reserves the right to exclude at any time any potential Bidder or Bidder from the Community Gynaecology Services Procurement process should any actual or potential conflict(s) of interest be found by NHS Hammersmith & Fulham CCG to confer an

mailto:[email protected]



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unfair competitive advantage on one or more potential Bidder(s), or otherwise to undermine a fair and competitive procurement process.

7.1.5 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 the Community Gynaecology Services Procurement. Each Potential Bidder and 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 an adviser to, either the NHS or the DH in connection with the selection of Bidders or the Provider in relation to the Community Gynaecology Services Procurement.

7.1.6 Freedom of Information

NHS Hammersmith & Fulham CCG is committed to open government and meeting its legal responsibilities under the Freedom of Information Act (FOIA) (2000). Accordingly, any information created by or submitted to NHS Hammersmith & Fulham CCG (including, but not limited to, the information contained in the MoI, PQQ, or ITT and the submissions, Bids and clarification answers received from Potential Bidders and Bidders) may need to be disclosed by NHS Hammersmith & Fulham CCG in response to a request for information. In making a submission or Bid or corresponding with NHS Hammersmith & Fulham CCG at any stage of the Gynaecology Services Procurement, each Potential Bidder, Bidder and each Relevant Organisation acknowledges and accepts that NHS Hammersmith & Fulham CCG may be obliged under the FOIA to disclose any information provided to it:

Without consulting the Potential Bidder or Bidder; or Following consultation with the Potential Bidder or Bidder and having taken

its views into account.

Potential Bidders and Bidders must clearly identify any information supplied in response to the Community Gynaecology Services Procurement PQQ or ITT 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, NHS Hammersmith & Fulham CCG may wish to withhold such information under the relevant FOIA exemption. However, Potential Bidders should be aware that NHS Hammersmith & Fulham CCG is responsible for determining at its absolute discretion whether the information requested falls within an exemption to disclosure, or whether it must be disclosed.



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

7.1.7 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 NHS Hammersmith & Fulham CCG nor any of its 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, Relevant Organisation, Clinical Services Supplier, financiers or any of their advisers, orally or in writing or in whatever media. 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 NHS Hammersmith & Fulham CCG or any of its advisers. This MoI is intended only as a preliminary background explanation of NHS Hammersmith & Fulham CCG activities and plans and is not intended to form the basis of any decision on the terms upon which NHS Hammersmith & Fulham CCG will enter into any contractual relationship. NHS Hammersmith & Fulham CCG reserves the right to change the basis of, or the procedures (including the timetable) relating to, the Gynaecology Services Procurement process, to reject any, or all, of the PQQ submissions and Gynaecology Services Procurement ITT 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 Gynaecology Services Procurement. NHS Hammersmith & Fulham CCG shall not be obliged to appoint any of the Bidders and reserves the right not to proceed with the Community Gynaecology Services 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 NHS Hammersmith & Fulham CCG in relation to this Gynaecology Services Procurement. No person has been authorised by NHS Hammersmith & Fulham CCG 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.



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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 Community Gynaecology Services 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 NHS Hammersmith & Fulham CCG or any of their advisers or consultants in connection with this MoI or any other pre-contract documentation.



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8 GLOSSARY OF TERMS AND ABBREVIATIONS

Term Description

AQP Any Qualified Provider

Bidder A single operating organisation, entity or partnership or alliance, participating in the Pre-Qualification Questionnaire (PQQ) Stage which (if shortlisted) will be Invited to Tender at ITT Stage.

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

CCG Clinical Commissioning Group

CPD Continuing Professional Development

Clinical Services Supplier Any suppliers providing clinical services which are the subject of the Contract. The Clinical Service Supplier may be the same as the Provider.

Commissioning Authority NHS Hammersmith & Fulham CCG

CQ Clarification Questions

CSF Critical Success Factor

DH Department of Health

DMARD Disease Modifying Anti Rheumatic Drugs

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, porter services, 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 NHS Brent CCG is subject

GP General Practitioner

GPwSI General Practitioner with a Special Interest

IM&T Information Management and Technology

IP Internet Protocol

ITT Invitation to Tender

Lead Bidder The Bidder that takes responsibility for completing the PQQ

NHS National Health Service

NHS England Standard Contract

The contract to be entered into by NHS Hammersmith & Fulham CCG and the selected Provider(s) for the Gynaecology Services Procurement will be based on the NHS England Standard Contract (http://www.england.nhs.uk/nhs-standard-contract/).

ODS Operational Data Store

OOH Out of Hospital Strategy

http://www.england.nhs.uk/nhs-standard-contract/

http://www.england.nhs.uk/nhs-standard-contract/



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Term Description

ISHP Independent Sector Healthcare Providers

Potential Bidder A single operating organisation, entity or partnership or alliance that is participating in the Community Gynaecology Services Procurement, but that has not at the relevant time been invited to respond to an ITT as a Bidder.

PPwT Planned Procedures with a Threshold

PQQ Pre-Qualification Questionnaire

Provider The successful Bidder who has entered into a Contract with NHS Hammersmith and Fulham CCG to provide the services specified by NHS Hammersmith and Fulham CCG.

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; and (v) each Clinical Services Supplier

SHaF Shaping a Healthier Future Programme, www.healthiernorthwestlondon.nhs.uk

TUPE Transfer of Undertakings (Protection of Employment) Regulations 2006 (SI/2006/246)

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

http://www.healthiernorthwestlondon.nhs.uk/

Documents

Procurement of Community Gynaecology Services … · F7617 – Memorandum of Information (MOI) NHS Hammersmith & Fulham CCG - Community Gynaecology COMMERCIAL IN CONFIDENCE Page |