Agenda Item 13 Enclosure CKWCB/12/118
Cluster Board 8th May 2012
Title of Report:
Procurement of West Yorkshire Unscheduled Dental Care Services
FOI Exemption Category:
Mike Potts (Cluster CEO and Senior Responsible Officer)
Report Author and Job Title:
Debbie Robinson. NHS Calderdale Head of Primary Care and Lead for this procurement
This paper sets out the need for the procurement, the Governance arrangements in place, procurement timeline and approach, financial support necessary for delivery, Clinical endorsement process, contracting arrangements and contract award.
The 2011-2012 budgets from the five West Yorkshire PCTs need to be committed to this procurement along with a budget to cover the ancillary support costs necessary for delivery.
A procurement Risk Register is being maintained by the Steering Group.
Legal Implications: Health Benefits:
Improved Oral Health as the following unscheduled treatment patients will be signposted to regular dentists for managed care.
There is a potential TUPE implication in connection with the staff employed by the current providers.
Outcome of Equality Impact Assessment:
The advice received to date, states that as the current services and current locations are not changing there is no need to carry out this assessment.
Approval to launch the procurement for Unscheduled Dental 1
Care. Delegate responsibility for the oversight and governance of the procurement process to the Cluster Audit Committee / CET. Approval to commit the 2011-2012 budgets to enable the procurement of services for 2013, 2014 and 2015. Approval of the ancillary costs needed to support the procurement process. Approve the approach and procurement timeline. Endorse the group remit as outlined in the Steering Group Terms of Reference at Appendix 1. Delegated authority to a Joint Sub Committee of the two cluster Boards to approve the award of the contract.
Purpose of Report The purpose of the report is to seek approval for the launch of the West Yorkshire Unscheduled Dental Care Service procurement. This paper describes the programme approach for procuring the Unscheduled Dental Care Service pathway across West Yorkshire to secure a high quality, seamless, efficient service for patients.
Background 2.1 Current contracts for the delivery of Urgent Care Services across West Yorkshire terminate in March 2013 and Unscheduled Dental Care forms part of this contract. In preparation for the NHS Commissioning Board taking responsibility for the commissioning of Dental services in 2013 this element of the existing contract will be removed with the necessity to procure the service separately. 2.2 A paper was submitted to the Cluster Leadership Team on 9th January 2012 which outlined the implications for the Unscheduled Dental Care Service. CCGs were strongly of the opinion that, as they did not believe that commissioning responsibility for Unscheduled Dental Care Services will be part of their remit this service should be removed from the “consult and treat” specification. 2.3 There is a need for the five West Yorkshire PCTs to re-procure the treatment element of the service only as the triage, clinical assessment and booking will be undertaken by the regional 111 service. 2.4 A Steering Group has been established to undertake and manage the procurement process with membership drawn from across all five PCTs who have agreed to work together to procure local services. NHS Kirkless being nominated as the host for the new contract until transition to the NHS Commissioning Board. 2.5 NHS Calderdale, Kirklees and Wakefield District currently spend £544k (2011-2012) on the treatment aspect of the Unscheduled Dental Care Service. The Board are being asked to commit this budget to enable the procurement of Unscheduled Dental Care Services for 2013, 2014 and 2015.
Detail Governance Arrangements 3.1 Governance Structure – The Steering Group has put in place a Governance Structure to support the procurement decision making process and to provide the Board with the necessary assurances as to process. 3.2 The Steering Group is itself governed by their Terms of Reference (Appendix 1). Various specialist Workstream Leads have been identified who will become co-opted as and when required. The Steering Group will escalate significant issues to the Calderdale, Kirklees and Wakefield District Cluster Chief Executive as the agreed Senior Responsible Officer (SRO) across West Yorkshire. Other matters arising will be reported to the SRO on an exception basis only. 3
3.2 Cluster Audit Committee / CET –.this paper seeks confirmation that the Cluster Audit Committee / CET will be the main vehicle for providing assurance to the Cluster Board on the procurement process and will receive regular progress reports on the conduct of the procurement. 3.3 Specialist Procurement Support – This will be provided through the Yorkshire and Humber Commercial Procurement Collaborative (NHS CPC). As members, NHS Calderdale is eligible to receive up to 10 support days which can be made available to this procurement. 3.5 Risk Management – The Steering Group maintain a project risk register which includes overarching project risks and specific risks applicable to individual PCTs. It has been agreed that this risk register will be used for the incorporation of specific risks relating to individual PCTs onto their respective Corporate Risk Registers. Each of the five PCTs will then follow their Risk Management process. Significant risks will be reported to the Cluster Board. 4.0
Timeline The table below outlines the key milestones agreed by the Steering Group during the lifetime of the procurement. This timeline is challenging as it needs to dovetail with the launch of the regional 111 service which allows for a period of parallel running from 12 th March to 31st March 2013. Stage
Return of PQQ
Short List confirmed
ITT Clarification Day
ITT Submission Date
Select Preferred Bidder
Announce Preferred Bidder
Procurement Approach The Steering Group have discussed at length the approach that needs to be taken in respect of the bidding model.
It has been decided that the approach with the lowest level of risk is to make an offer that allows bidders, once they have passed through the PreQualification Stage to bid on the basis of providing services across anything from one to five PCT areas. The advantage of this approach is that it provides a broader market, is a fair approach and therefore the risk of challenge is reduced and does not preclude smaller organisations from the process who may come from the locality and offer local knowledge and links. The main drawback with this approach is that it may result in five providers and therefore five contracts to issue and manage, however with the small scale and peppered nature of this service and therefore the limited application of economies of scale it is viewed that this result is unlikely to occur. The decision to seek one provider for the whole West Yorkshire region has been discounted on the basis that it may force new alliances and limit the market. Having reviewed the list of current providers this approach could be viewed as preferential and therefore brings with it a high level of risk. It would however allow for economies of scale, ease of contract management and onward transfer to the NHS Commissioning Board. Current Provider (2009 – 2013)
PCT NHS Calderdale
Care UK Clinical Services Limited. Sub contracted to Locala.
Local Care Direct
NHS Wakefield District
Local Care Direct
Local Care Direct
NHS Airedale and Bradford
Salaried Dental Services
The tender selection will be based upon the most economically advantageous tender; the quality of the tender offer and price and will be scored against a set of award criteria. 6.0
Financial Support The Steering Group require the Board to commit the 2011-2012 budgets of NHS Calderdale, Kirklees and Wakefield District in the sum of £544k to enable the procurement of the treatment aspect of the Unscheduled Dental Care Services for 2013, 2014 and 2015. Ancillary costs will also need to be allocated and shared across the five PCTs and these are estimated as follows: NHS CPC Legal Costs Project Management
- £14,500 - £10,000 - £26,000 5
Clinical Endorsement Each of the PCTs in the cluster has or will be seeking endorsement of the Service Specification together with their locality specific needs through the respective quality groups or Clinical Commissioning Executives of their respective CCGs as follows: PCT NHS Calderdale
Group Quality Group
Clinical Commissioning 25th April 2012 Executive Clinical Commissioning 22nd May 2012 Executive
NHS Wakefield District
Meeting date 19 April 2012 th
Contracting Arrangements Where PCTâ€&#x;s wish to advertise a procurement for clinical services and wish to be able to specify a contract duration of up to 3 years, the PCT is required to seek â€žsign off' from the Strategic Health Authority (SHA). This approval was granted on the 21st February 2012. The contracting model appropriate for this service is a Personal Dental Services (PDS) Plus. The contract will include a set of Key Performance Indicators (KPIs). Payments will be made in equal monthly instalments representing 95% of the overall contract value with the remaining 5% being based upon KPI achievement. The KPIs and their achievement have been based upon the three domains of` Quality as follows: Patient safety Patient experience Clinical Effectiveness This contract period of three years will provide the opportunity to gather information and data to facilitate a full service redesign with a view to moving to a single operating model across West Yorkshire under the new NHS Commissioning Board.
Contract Award It is acknowledged that each PCT remains a statutory body and therefore, has the power under current standing orders to delegate responsibility for the discharge of functions to sub committees, in view of this, the CKW Cluster Board is asked to delegate authority to approve award of contract in respect of the Unscheduled Dental Care Service procurement to a joint sub committee comprising the CKW Cluster Chair, Chair of Audit Committee, Chief Executive and Executive Director of Finance from across the Calderdale, Kirklees and Wakefield / Airedale, Bradford and Leeds clusters. The date for this Sub Committee meeting has not yet been determined, but subject to approval of this proposal a meeting with be arranged for early November 2012.
Recommendations It is recommended the Board approve: 6
Approval to launch the procurement for Unscheduled Dental Care. Delegate responsibility for the oversight and governance of the procurement process to the Cluster Audit Committee / CET. Approval to commit the 2011-2012 budgets to enable the procurement of services for 2013, 2014 and 2015. Approval of the ancillary costs needed to support the procurement process. Approve the approach and procurement timeline. Endorse the group remit as outlined in the Steering Group Terms of Reference at Appendix 1. Delegated authority to a Joint Sub Committee of the two cluster Boards to approve the award of the contract. 11.0
Steering Group Terms of reference