Agenda item

Purpose of the report:  Scrutiny of Services and Budgets – update about procurement plans

To update the Board on the conclusion of the recent procurement exercise to secure Adult Community Health Services for North West Surrey Clinical Commissioning Group (NWS CCG)  and provide more detail about quality and  performance management metrics and contract governance.

Witnesses:
Rachael Graham, Acting Associate Director of Contracts
Matthew Parris, Evidence and Insight Manager, Healthwatch Surrey
Nick Markwick, Surrey Coalition of Disabled People

Declarations of Interest:

None

Key points raised in the discussion:

1. Witnesses pointed out that the Board had previously requested more information regarding performance and quality measurement within the procurement service. The Acting Associate Director of Contracts highlighted that a comprehensive scorecard of performance indicators had been designed and would be implemented through the new contract to be awarded. Members noted that this was a commendable model; however Members questioned whether this could be made simpler and more transparent to form the basis for a public facing scorecard in future.
   
   
2. The Acting Associate Director of Contracts stated that the CCG had recently concluded a competitive procurement exercise and that a new receiving organisation, Central Surrey Health had been awarded preferred provider status. A new, standardised national NHS contract was being formulated to clearly set out terms. It was highlighted that this was a robust way of formulating new contracts.
   
   
3. The Board queried whether there were any penalties set within the contract for any breaches made or lower standards of service delivery and whether these penalties could be effectively enforced. The Acting Associate Director of Contracts explained that within the contract’s requirement schedules, the consequences of breach are defined for each measure/requirement. The Board asked for an example whereby a financial penalty had been levied. A particular historic case was cited in which a fine of £25,000 was levied for an avoidable pressure ulcer, grade 4.
   
   
4. Witnesses explained that the services are currently delivered subject to a single contract across the Surrey CCGs and other responsible commissioners. Attempts had been made by Surrey commissioners to secure service continuation as a wider geography however, Members were informed that, as of December 2015, the decision had been made to disaggregate some of the service groupings, for example, Guildford and Waverley CCG elected to undertake its own procurement for adult services as a means of providing a more localised approach to service delivery.
   
   
5. The representative of Healthwatch Surrey questioned the consultation with bidders and current patients and whether this had an impact upon the procurement process. It was responded that this had been a long process and that multiple consultations and engagement events had been held the feedback from which had been incorporated into the service specifications., In addition, the process itself the opportunity for bidders to meet with a group of patient and stakeholder representatives during the bidding process to seek feedback on their proposed service and delivery models. It was hoped that bidders would take this opportunity to learn from this feedback and directly revise or tweak their proposals to accommodate what they had heard.  The Board queried the issue of market competition and whether the service had reached the best deal as a result. The Acting Associate Director of Contracts pointed out that this would always be a challenge, but that there was a good level of competition, with seven initial bidders, and two strong bidders to select at the final stage of the procurement process. It was highlighted that there was a culture of transparency within the service with regard to its procurement process to ensure that quality assurance is at the forefront of the service.
   
   

Recommendations:

The Board thanks NW CCG for its report, and welcomes the level of engagement with staff and residents through the procurement process. It recognises a wider concern around ensuring continuity of care during key transition points, and consistency of services across Surrey.

The Board recommends:

1. That the Chairman give further consideration as to the Board’s role in scrutinising and monitoring the questions of continuity and consistency across Adult Community Services in Surrey;

2. That NW Surrey CCG consider developing a public-facing scorecard that will enable residents to understand how providers are monitored and how they are performing;

3. That NW Surrey CCG share lessons learnt through the disaggregation and mobilisation process with the Board, other CCGs and STP leads;

4. That NW Surrey CCG return to the Board with an update following mobilisation
   
   

Rachael Graham left the meeting at 11.35am