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UPDATE: NHS England’s Pseudo Dynamic Purchasing System (PDPS) framework for GP APMS contracts

APMS

As the PDPS Contract becomes more prevalent, it’s important to be aware of important information.

We recently attended NHS England’s market engagement event in Leeds; the event provided updated information about the contract. This article, therefore, will act as a commentary following on from on our first PDPS blog post.

This article is aimed at those who intend to tender for NHS APMS GP contracts in the future.

Aims of the day

Mark Smith, NHS England – Assistant Head of Primary Care Commissioning, opened and chaired the event. Making it clear aims of the day were to run a split AM/PM session for Commissioners/Providers respectively.

With the contract notice going live on the 1st December and the PDPS going live in Jan/Feb 2020, it was clear that unless there was large Provider take-up, Commissioners without a mandate would not use the framework and would still proceed with the current procurement procedure.

Why Is the PDPS Contract Needed?

The main reasoning behind the introduction to this framework is to create commissioner and provider efficiencies. In turn, this will enable APMS contracts to be commissioned swiftly so that the service disruption is minimised, and patient care can continue to be delivered appropriately.

At the moment across all areas, commissioners are finding less interest from providers across the country to bid for APMS contracts. APMS procurements take around 6 months, and there is no guarantee that they will be successful. The past two years have shown a 10% failure rate in 2017/18 and an 8% failure rate in 2018/19.

Potential Issues with the Contract

One of the main foreseeable issues with this contract is the lack of notice and awareness that GP providers have of it. The NHSE attempts to address this by centralising and standardising the contract channel. However, by locking out non-framework providers, there is a danger that this may have the opposite effect.

It has been evident from our conversations with GPs at the recent Best Practice exhibition, and from the worryingly low numbers in the room that GP providers are unaware of this critical change to the way their contracts may be commissioned.

A big question is how are GPs supposed to know about the framework? Other than the usual contract notices, the answer is given that the message was pushed through local CCGs, who may or may not be passing on the message. It appeared those in attendance had registered either by chance or following their own contract monitoring activities.

How GP’s can be aware of the PDPS Contract and Do You Need to Apply?

The portal to be used for the procurement will be EU supply: https://uk.eu-supply.com/. This will host FAQs and any further updates ahead of hosting the actual PDPS tender process.

The initially proposed 6 rounds of the framework will have around 5-month lead times from entry to award. Please see the timescales captured below:

To Re-Iterate, only those Providers on the PDPS will be invited to tender for any contracts ‘called-off’ via the framework. Therefore, it is highly likely that unless a Provider applies for the PDPS six months in advance of a call-off being made, that they will miss the opportunity to bid.

Market Response for the PDPS Contract

To mitigate the potential impact and reduction in market response, attendees suggested:

  • NHSE should reconsider the length of the rounds, shorten the timeframe and make them monthly.
  • NHSE should publish all APMS contract expiry dates. Whether they will definitely be recommissioned or not, providers could make a decision themselves whether to or not, invest the time to get onto the framework, and do any initial research and model development in advance of the ‘call-off’
  • NHSE supports workshops where practice representatives come in and are supported to complete the PDPS application.
  • At the very least, they need to find a way to make this public knowledge to all GPs. Some form of mandated communication, explaining the very limited time commitment and simplicity of the application, should make it an easy decision for GPs to fill out the application and ensure they are not locked out for the next 4 years!

Digital First- A Risk to Local Providers?

A matter raised within the meeting was that there may be a potential risk to local provision. This is due to the fact that there appears to be an opening to digital-first delivery models. Providers can be accredited to all regions across the country. Some people may point to this as the reason why the fundamental procurement shift has been so under-publicised.

Contact Us Today

To enquire more about how to apply for this contract, contact us today on 0330 133 1041 or info@klowconsulting.com.

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How to present an accessible healthcare service in a tender

Accessible Healthcare

Accessibility in healthcare has been described as a ‘global challenge’. As a prominent challenge that many healthcare providers face, developing and maintaining an accessible service for patients is an ongoing issue across the healthcare industry.

Regularly, healthcare tenders have a question centred solely or partially around accessibility. Therefore, answering this question to demonstrate how your healthcare service is providing accessible healthcare for your patients is crucial.

This article will focus on what accessibility in healthcare is and why it is important, how it can be improved in practice and most importantly, how to answer an accessibility question on a tender.

What is accessibility in healthcare?

The definition of accessibility is given in the name itself; it is all about providing accessible healthcare for all.

Having accessible healthcare services available for those who need them is critical as it allows people to get the appropriate healthcare resources in order to help maintain or improve their health.

In a human rights context, accessibility is described by the World Health Organization as: ‘health facilities, goods and services must be within safe physical reach for all sections of the population, especially vulnerable or marginalized groups, such as ethnic minorities and indigenous populations, women, children, adolescents, older persons, persons with disabilities and persons with HIV/AIDS, including rural areas’.

Healthcare accessibility is a broad scope and relates to many different aspects.

Accessibility, therefore, may mean:

  • Access to buildings
  • Communications with healthcare staff
  • Management of appointments

There may be a variety of reasons as to why patients cannot access healthcare services. Some of the reasons may be:

  • Lack of transport links. Those living in an urban area may particularly struggle with transport
  • Health-related conditions. Certain health conditions may mean that an individual cannot travel to the property
  • Financial barriers. Primarily for transport or service charges (e.g. dental or eye tests)
  • Organisational barriers

Why is accessibility in healthcare important?

As mentioned above, accessibility in healthcare is key because an individual who is restricted from healthcare access can suffer from further or more serious health-related issues. Consequently, it could lead to serious complications such as disease, disability and even premature death.

Healthcare Accessibility Questions on a Tender

A healthcare tender will usually involve accessibility in one form or another. Before answering this question, think holistically about the healthcare service that you are currently providing to patients.

Asking questions such as “what are we doing to make our healthcare service more accessible for patients?” and “what do we plan to do to improve accessibility in the future?” will help direct your answer.

When writing your answer, you may want to focus on these specific elements:

1) Location and Transport

The location and transport links to your service will need to be carefully considered. Are you located in a central part of the city? Do you have transport links to your practice?

Presenting that you have bus routes, car parks or express buses available for your patients, all feeds into the accessibility of your healthcare service.

If you have free parking bays nearby, or even a ‘park and ride’ option, stating this within your answer will show that your service is accessible to patients.

2) Appointments

For healthcare to be accessible for all, there needs to be appointments available for those who need them. Offering on the day appointments is ideal for those who need urgently seen to.

Appointments available out of hours, for example, 6-8 pm, or weekend appointments, will be made accessible for those who can’t make the standard appointment times. Again, having these additional services enables ease of access for those who work full time or have other commitments that mean they can’t get to the standard appointment hours.

Making these appointments easily available, via online booking systems or through telephone lines, is also imperative. If patients are unable to get through to the line, this is an indication that this healthcare service isn’t readily accessible for them.

3) Equal Access

Considering equal access to healthcare services is a crucial implementation within your answer. This will also enable you to present that your service adheres to best practice and the Equality and Diversity (2010) policy.

For this answer, implementing your Equality and Diversity policy and providing details of the training provided to staff which relates to Equality and Diversity, will be beneficial when demonstrating best practice. We have an article centred around Equality and Diversity that has further information about this.

Equal access ensures that those who are part of a minority, are vulnerable, have protected characteristics or particularly ‘hard-to-reach’ groups are being treated fairly and non- discriminatory.

Providing details of any additional work that you do within the community to help those that are disadvantaged or within a minority will add value to this answer. This could include work undertaken with the homeless or the elderly.

Asylum Seekers or individuals that are limited in their ability to communicate also form part of this group. Having a translation organisation in partnership with your healthcare service will again, improve the accessibility for those groups.

4) Domiciliary Appointments

Although domiciliary appointments may not be stated within the contract, providing these appointments to those who cannot get to the service, will demonstrate that you are considering these groups and have additional measures in place for them. Reflecting this within your answer, will again, be highly beneficial.

5) Demonstrating your patient care service

Indicating that you aim to provide an excellent patient-centred service will be rewarded when answering this question.

Showing that you have various methods of feedback in place and that you actively strive towards improving feedback points, presents that you are trying to provide the best possible patient experience; this helps patient experience and accessibility.

If patients are experiencing any problems in terms of accessibility, asking them what their problems are will help you make the right steps to improving this. Feedback can be done in a variety of ways, our last article outlines some methods of feedback and how to improve patient experience overall.

 6) Accessible Information Standard

The Accessible Information Standard states that from 1st August 2016, organisations providing NHS care and/or publicly funded adult social care are legally required to follow this standard. Being aware of this standard and reflecting that your service aligns with best practice is essential.

NHS England stated that organisations should:

  • Ask people if they have any information or communication needs and find out how to meet their needs
  • Record those needs clearly and in a set way
  • Highlight or flag the person’s file or notes so it is clear that they have information or communication needs and how to meet those needs
  • Share information about people’s information and communication needs with other providers of NHS and adult social care when they have consent or permission to do so
  • Take steps to ensure that people receive information which they can access and understand and receive communication support if they need it
  • Contact and be contacted by, services in accessible ways. For example, via email or text messages, receive information and correspondence in formats they can read and understand, be supported by a communication professional at appointments if this is needed to support conversation.

Contact Our Team Today 

If you need help on a tender, contact our experienced team of writers today on 03301 1331 041.
Alternatively, send an email to info@klowconsulting.com for more information and details.

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How to develop a patient-centred service

The five-year forward view presented plans to work towards a more collaborative and informative relationship between patient and healthcare professional. A patient-centred service means that patients are getting the best experience, putting patients at the centre of their own health and healthcare.

In this article, we provide some tips on developing a patient-centred service.

What is patient-centred care?

To understand how to develop a patient-centred service, it is imperative to know what it consists of.

Patient-centred care, as stated by NHS England, “starts with the patient”. It revolves around the notion that the patient is in control of their health and the healthcare services that are provided for them.

Patient-centred care represents collaboration, power and pro-activeness, as the patient works alongside a healthcare professional in partnership to design and shape their own healthcare based on their needs and goals.

To form a greater understanding of patient-centred care, an effective patient-centred service mainly centres around the following ideas:

  • The person is treated with dignity, respect and compassion
  • Communicating and coordinating care between appointments and different services over time
  • Care is shared between a community health service and a hospital
  • Care is tailored to suit individual needs and what they want to achieve
  • Supporting individuals to help them understand and learn about their health
  • Finding ways to help them get better, look after themselves and stay independent
  • Being involved in their healthcare decisions

Benefits of a patient-centred service

Having a patient-centred service benefits the patient, practice and the healthcare professional greatly.

As such, there are many benefits to a patient-centred service, such as:

  • It improves patient outcomes by supporting patients with long-term conditions to manage their health and improve clinical outcomes. When individuals play a more collaborative role in managing their health and care, they are less likely to use hospital services, stick to their treatment plans and take medicine correctly.
  • Patients have the opportunity and support to make decisions about their care and treatment in partnership with health professionals are more satisfied with their care, are more likely to choose treatments based on their values and preferences rather than those of their clinician.
  • Individuals can gain more knowledge, skills and confidence in managing their health and healthcare. In turn, they are more likely to engage in positive health behaviours, which in turn, will create better health outcomes.
  • Person-centred care is good for healthcare professionals too- it increases staff performance and morale.

Putting staff at the heart of a patient-centred vision

NHS England and Public Health England provided a consultation document for the public named ‘Facing the Facts, Shaping the Future’. The workforce strategy is about placing staff at the “heart of a patient-centred vision”. To develop a patient-centred service therefore, staff members need to be actively involved in creating this vision.

NHS England has been drafting a workforce strategy to get staff members involved, by working pro-actively to create a patient-centred care service, one that will benefit them as much as the patient. As one of the many stated benefits of providing this service, staff morale and performance is a result of better patient experiences.

As healthcare professionals are the ones that can help create this vision, they must be aware of how to create a more positive patient experience.

Developing a patient-centred service

To develop a patient-centred service, you must effectively engage with patients, monitor their experience and improve their experience based on their feedback. Asking people if they are receiving the care that they need will give a good indication on that basis and make them feel more secure and cared for.

1) Patient involvement and experience

The first way to develop a patient-centred service is to put the patient at the heart of the service and improve their overall patient experience. A key part of patient-centred care is the patient being actively involved in their own healthcare.

Making patients central to their healthcare involves working collaboratively with people who use the service to support their development, skills and confidence. Patient-centred healthcare largely involves patients making informed decisions about their own health and healthcare.

There are many aspects which allow the patient to have a better experience. Based on Picker’s Eight Principles of Patient-centred Care there are eight main components: respect for patients’ preferences, co-ordination and integration of care, information and education, physical comfort, emotional support, the involvement of family and friends, continuity and transition and access to care. As a foundation for building a patient-centred service, following Picker’s basic principles as a guideline may assist in developing this service.

Part of caring for patients also involves caring for their families; this is otherwise known as family-centred care. If the patient has the support and involvement of their families within their healthcare, they are more likely to react positively.

It all starts with the patient; listening to their needs and designing patient experience based on these needs.

2) Monitoring services

Monitoring patient experience is the key to developing a patient-centred service.

There are some examples of ways to monitor and evaluate patient experience. Some examples are as followed:

  • Friend and family surveys
  • GP Patient Surveys
  • Focus Groups
  • PPG Group
  • Compliments Boxes
  • Patient Member Participation Groups

3) Evaluating data based on feedback

Evaluating data and using it to improve on a patient-centred service, will give you the opportunity to focus on the areas that need developing. Surveys and feedback methods will give you the opportunity to improve your service.

Understanding what is being asked of the patient and analysing this feedback will help you move towards this.

For example, GP patient surveys give a specific indication of what areas need improvement. An example of a GP patient survey is presented below:

As shown from the answers presented in this particular GP survey, patients are less satisfied with the appointment times available to them in comparison to how easy it is to get through to someone on the phone. All of these aspects form a greater patient experience.

Focusing and working on the areas that customers feel less satisfied with, will result in better patient experience and will form a more effective patient-centred service.

As seen from the table above, 34% of national NHS patients have not agreed on a plan with a healthcare professional to manage long-term conditions.

From the table below, a local GP practice shows that 83% of local patients did not have a conversation with a healthcare professional from their GP practice to discuss what is important to them when managing their condition(s).

 As part of a patient-centred service, patients with long-term health conditions should have an active role in their own healthcare. As seen from the chart above, this particular GP practice is scoring low on this, suggesting there were no discussions about managing their conditions and stating their healthcare goals. Thus, this would not particularly represent a patient-centred service.

Thoroughly understanding and analysing selected questions such as these, and developing based on what patients are feeding back, will give a basis for professionals to work with when building and developing a patient-centred service.

These issues can be improved by:

  • Having regular discussions about the patient’s healthcare
  • Discussing the patient’s long-term health conditions and their goals
  • Ask the patient questions such as ‘What’s important to you when it comes to your healthcare?’ ‘What would make things better for you?’
  • Allowing the patient to be involved in making important decisions about their health
  • Involving the patient’s family in their healthcare
  • Setting out a plan of the patients’ health care conditions and practical steps about how to help them

Contact Our Team Today 

If you need help on a tender, contact our experienced team of writers today on 03301 1331 041.
Alternatively, send an email to info@klowconsulting.com for more information and details.