How will Brexit affect the tendering process once we have left the EU?

Currently businesses in the UK use TED (Tenders Electronic Daily) to get free access to tender opportunities from the European Union, the European Economic Area and beyond. TED is the online version of the Supplement to the Official Journal of the European Union (OJEU). It is dedicated to European public procurement and publishes 746,000 procurement award notices a year, including 235,000 calls for tenders which are worth approximately £485 billion.

Businesses can browse, search and sort procurement notices by country, region, business sector and more and all notices are published in the 24 official EU languages.

However, post-Brexit UK contracting authorities will no longer need to publish procurement notices on in the OJEU. So, what does this mean for UK businesses?

Where will businesses be able to find UK public procurement notices post-Brexit?

The current advice from the UK Government is that from 1 January 2021, UK contracting authorities will need to publish procurement notices through a new e-notification service called Find A Tender. This will replace the requirement to publish notices in the OJEU.

This means from 1 January 2021, businesses will be able to use Find a Tender to view public procurement notices published by UK contracting authorities. They will also continue to use existing portals, such as Contracts Finder, MOD Defence Contracts Online, Public Contracts Scotland, Sell2Wales and eTendersNI to view low value or location specific notices.

Will existing procurement laws change post-Brexit?

The UK’s existing procurement law is derived from EU directives and are contained in The Public Contracts Regulations 2015, The Utilities Contracts Regulations 2016, The Concession Contracts Regulations 2016 and The Defence and Security Public Contracts Regulations 2011. These will continue to apply post-Brexit unless they are repealed and replaced.

UK Prime Minister Boris Johnson has expressed a desire to fundamentally change public procurement rules to “back British business” by moving away from the current level playing field and potentially favouring UK companies over European rivals.

The Government has also indicated that after the Transition Period the current regime will change and the country will join the Government Procurement Agreement (GPA) and the UK’s procurement regime will be based around this.

What would this proposed change mean for UK businesses?

The Government Procurement Agreement (GPA) is an agreement between the 20 parties of the World Trade Organization. It allows UK businesses to bid for government contracts in other countries and foreign businesses to bid for contracts in the UK.

This means post-Brexit UK businesses will have some access to the public procurement markets of the 27 EU member states, as well as the USA, Japan and 18 other countries. However, whilst GPA membership opens up procurement above certain value thresholds, the UK will not have the same level of access to procurement markets that it had as an EU member.

Presently, the UK is signed up to the GPA through its EU membership. From 1 January 2021, the UK expects to join the GPA on substantially the same terms. It may take up to 30 days to come into force after 31 December 2020, but the UK Government believes that the impact on businesses should be minimal. UK businesses will still have access to government procurements in many overseas markets. They may temporarily lose some rights provided by the GPA.

Businesses concerned about bidding on a foreign government procurement shortly after 1 January 2021 should click here to contact the Department for International Trade.

What changes have already been made to UK procurement law?

The Public Procurement Regulations (Amendments etc) (EU exit) 2019 became law last year and its provisions will come into force on 31 December 2020.

One of the most notable changes as a result of this are, as mentioned earlier, that the UK public bodies will use Find a Tender and will no longer be required to publish notices on TED.

Existing templates for contract notices and contract award notices will be replaced with new templates to be used with Find a Tender. UK public bodies will no longer require bidders to explain prices and reject tenders which appear to be abnormally low where the bidder has received State aid.

If you need help with commercial bid writing, get in touch today to see how we can assist you.

Contact info@klowconsulting.com or give us a call on 0330 133 1041.

What does IR35 mean for recruitment companies looking to respond to a tender?

The off payroll working rules – commonly known as IR35 – were introduced by HRMC in 2000 to tackle tax avoidance by workers supplying their services to clients through an intermediary. Such workers are referred to by HMRC as ‘disguised employees’ as they don’t meet the HMRC definition of self-employment and as a result tax and National Insurance Contribution (NIC) aren’t paid correctly. The rules are designed to ensure workers, who would be classed as an employee if they were contracted directly, pay broadly the same tax and NIC as employees.

If a worker is deemed ‘inside of IR35’ they are required to pay tax at the same rate as an employee in the appropriate pay bracket. If they fall ‘outside of IR35’, they are considered self-employed and can tax themself. Those ‘outside of IR35’, are responsible for paying their taxes on time.

‘Deemed employees’ do not reap the same benefits as typical employees. For example, those who fall into IR35, pay the equivalent in tax of a typical employee but are not entitled to sick pay, holidays or pensions.

How is IR35 changing?

The rules of IR35 are not changing, but the administration of the legalisation is.

It is proposed that the assessment of whether IR35 applies will fall onto the private sector end user of the worker’s services for all payments by medium and large businesses from 6 April 2021.

Where the end user decides that IR35 does apply, the fee payer – which may be the end user, a recruitment agency or a third party paying the intermediary – will be responsible for accounting for and paying the related tax and NIC, including the additional cost of employer’s NIC, to HMRC.

The new rules apply to private sector medium and large businesses who are the end user of the worker’s services and to the fee payer, if different, such as fee payers in the recruitment sector.

Small companies are exempt from this legalisation but public sector companies are not.

How will this proposed change impact businesses in the recruitment sector?

If you supply a worker who provides their services through an intermediary to a client in the public sector now, the client must decide if the rules apply. They must pass the determination to the person or organisation they contract with.

If you supply a worker to a client in the private sector, the worker’s intermediary must decide if the rules apply and pay the tax and National Insurance due. The private sector includes third sector organisations, such as some charities.

How does IR35 affect tendering?

IR35 is a concern for lots of employees due to the change in accountability of who needs to make the judgment as to whether the employee is inside or outside of IR35.

As a bid partner to recruitment clients, at K Low Consulting we are noticing a lot more recruitment tenders want to test and scrutinise the supplier’s knowledge of IR35, especially if the contract is outsourcing the management of recruitment processes. Commissioners need to be assured they will not be at risk of financial penalties. Essentially, commissioners are looking to see if the bidders are IR35 compliant.

It is important to identify how IR35 will affect procurement. You should analyse IR35 at your own risk. Having a long-term strategy in place will allow you to be prepared for IR35. Specifically, understanding how to use contractors and procurement interims under the IR35 legalisation will ensure visibility and control.

What should recruitment companies do?

To make sure you can demonstrate your knowledge of IR35 in recruitment tenders it would be advisable to:

  • Assess the current arrangements for your clients and identify the number of workers supplied who operate via off-payroll status
  • Decide who in your organisation will make IR35 determinations and how payments will be made to contractors within the off-payroll rules
  • Identify which clients are outside the rules through not meeting the criteria to be classified as a medium or large business
  • Review internal systems, such as payroll software, process maps, HR and onboarding policies to see if they are up to date.

If you need help with the questions you may be asked on tenders in relation to IR35, get in touch today to see how we can assist you.

Contact info@klowconsulting.com or give us a call on 0330 133 1041.

How to avoid a last-minute panic when bidding for a tender

You have found a tender that your company would be perfect for – fantastic!

But the deadline is tight and now you’re racing against time to submit the tender.

To avoid a last-minute panic when bidding for a tender, follow our Top 10 Tips:

  1. Read tender documents carefully

Download all the documents provided on the portal, read them carefully and consider:

  • Contract value
  • Length of contract
  • Key dates (submission deadline, contract award notice date, clarification dates, etc)
  • Contract details
  • Key requirements

    2. Plan, plan, plan!

Familiarise yourself with the bidding process. Have you been involved in tendering before? If so, what did you learn? Can you transfer any knowledge gained from your previous bids to create a more efficient plan this time?

You need to ensure your company is ‘tender ready’ and that you can fulfil the contract and submit a compelling bid before the deadline.

Often people underestimate the time it takes to prepare, write and submit a tender. From pre-bid to post-bid there is a large time span. Plan your answers so you hit all of the points the commissioner is looking for.

3. Get organised

Bid co-ordination is a key component of planning and organising a bid. Delegate tasks to the people within the company who are best placed to provide the relevant information. You may want to dedicate an individual to co-ordinating the bid and keeping track of the information required.

Create an information spreadsheet or mobilisation plan to keep track of who is responsible for gathering which piece of information. Set achievable deadlines to ensure information is gathered in time. Create shared folders to enable individuals to easily upload relevant information and documents.

4. Formatting

It is vital to consider the formatting of answers. For example, if the commissioner states they want the font to be Arial size 11, follow this guidance.

Answers will also be limited to specific word counts. Specify word counts at the end of your answers to save the commissioner time.

5. Relevant attachments

The PQQ (Pre-Qualification Questionnaire) will state the relevant attachments needed to support your submission. This may include:

  • Company policies
  • Case studies
  • Organisational charts
  • Mobilisation plans
  • Project plans

Case studies take time to write. Ensure you have relevant case studies prior to bidding. Attachments should be ready to be uploaded at the time of submission.

6. Clarify all ambiguities

Clarify any uncertainties as soon as possible. The clarification stage invites bidders to raise queries. At this stage, you should clarify anything you are unsure of.

The commissioner releases a list of these questions and their responses after this stage. Read through this carefully to check if there is anything relevant to your bid.

7. Pricing

Is your price right? A thorough pricing plan, prior to bidding, is essential. Having the means in place to fulfil the contract is vital and commissioners will look for a detailed and thorough pricing plan.

Make sure you have carefully evaluated your pricing – you can lose marks, or even worse, lose out on winning the tender completely, solely due to pricing.

8. Check thoroughly

It is important to check your tender responses thoroughly to check they are grammatically correct and read well. Sharpen your phrasing and key messages in your answers and ensure you are hitting the main answer requirements stated by the commissioner. Look at ways to make what you are saying more concise and ‘to the point’.

Get others to check through the answers to help refine key messages and add in any valuable points.

9. Submit early

Any tenders submitted after the deadline, even if it is only a few seconds late, won’t be considered!

However, before the deadline has expired, tender portals will allow you to amend or upload any additional documents after your initial submission. So, if you are waiting on that final quote or evidence to ‘slot-in’, get a completed bid submitted first. You can re-open, refine, and re-submit when it arrives.

If you’re still in the initial stages, deciding whether to bid or not to bid for a tender, read our ‘To Bid or Not to Bid’ blog post to help you make a decision.

10. Ask the experts

If this is really out of your comfort zone, ask for help. Often the value of the contract awarded by far outweighs the cost of using a consultant or advisor with years of bidding experience and it significantly boosts your chances of submitting a winning tender bid.

If you need help with tendering, get in touch today to see how we can help. Contact info@klowconsulting.com or give us a call on 0330 133 1041.

Getting ‘tender ready’ in tough times

Every industry is experiencing major changes as we continue to adapt to a new way of life thanks to the Coronavirus pandemic. Unsurprisingly, this has had an impact on the amount of tender opportunities that are currently available.

For example, lots of tender opportunities that were expected to come out in March and April have been delayed until mid-May.

But all is not lost, and there is still a lot you could be doing to get ‘tender ready’ for when the opportunities are eventually published.

Bidding for a tender takes a considerable amount of time. From undertaking research and collecting evidence, the tender process can be long, complex and require a lot of attention. So, the most important thing organisations can do now is to make sure they use this time to prepare for future tenders as much as they can.

Remember, if you are not spending this time doing preparation work, your competition might be!

How to get ‘tender ready’
What you can do now will depend on your industry. To begin with, consider the information and resources that you will need for any upcoming contracts and your probable tender submissions. You can then work through activities and start to collate information that you are very likely to need. These may include:

  • Designing your delivery model and mobilisation plans
  • Meeting any compliance requirements and ensuring related policies are in place
  • Completing research
  • Addressing weaknesses and collating supporting evidence

For example, we are supporting a number of clients that have all successfully passed the selection questionnaire for HealthTrust Europe’s (HTE’s) Total Workforce Solutions 2 Framework. The second stage ITT, has been delayed until mid-late May. By taking the opportunity to perform preparation tasks and the draft ITT questionnaire, we are effectively extending the tender submission window which will lead to better higher quality scoring bids.

Review your previous tenders
Take this time to review your previous bids and refine them. Ask yourself: ‘Where could we have scored better marks?’ Identify any weaknesses in your business or your tender bid and tackle them.

Gather evidence
Collect examples of associated works that you have done, or are doing, that demonstrate best practice. Use this time to consult and engage with those you work with. Ask service users or clients for testimonials and any feedback or other information that may be useful. Think about the evidence you may need to give as they can form the questions you could ask your service users. The answers could also help you to make any improvements to your services, communications or processes. Also look at how you can prove your delivery model with statistics.

Get expert help
We might be biased here, but it can really be the difference between a ‘yes’ and a ‘no’ if you employ the services of a professional consultant. Consultants – like us – can help providers with a variety of different processes. For example, we can identify potential holes in the delivery of a contract and can review policies and look for any gaps. Our expert team can anticipate what is needed from a contract and what you need to do to get ‘tender ready’. We identify gaps and weaknesses and can produce a clear plan on what you need to do. We charge on a consultancy basis but can also offer a free advice service.

K Low Consulting is unique in that we don’t just write tenders – we offer a four-stage process to help our clients:

1)      Business & Contract Strategy (Phase 1)

We help you develop a cohesive contract growth strategy aligned to your business and carried through in the opportunities we identify and win.

2)      Opportunity Analysis (Phase 2)

Our opportunity analysis service helps us identify and analyse the right opportunities for you to develop your strategic goals.

3)      Tender Writing & Management (Phase 3)

We are experts in tender writing and management. We have a cohesive tender writing and management process, helping you win bids.

4)      Mobilisation & Implementation (Phase 4)

Winning the bid is only one part of the tender outcome. We work with you to help break down and manage complex contract mobilisation and implementations, delivered against manageable work streams.

If you need help with tendering, get in touch today to see how we can assist you. Contact info@klowconsulting.com or give us a call on 0330 133 1041.

Looking ahead to 2020: A successful year for K Low Consulting

Reflection on 2019

We’ve had a great year at K Low Consulting and are excited about the new year ahead! In this article, our team reflects on 2019 and looks ahead to the future of K Low Consulting.

In 2019, we have experienced significant and rapid growth. We have expanded our associate team, which includes bid professionals with significant writing and management experience, senior clinicians and specialist advisors, such as quality management and accreditation. Our team has been in high spirits throughout the year, keeping up with client demand and workload.

An intern from Nottingham Trent University’s graduate scheme, Mia Penny, was employed as a ‘Marketing and Tender Executive’. With the help of another associate writer from the team, Victoria, they have experienced some fantastic marketing wins in 2019.

“From September 2019 I joined K Low Consulting as a ‘Marketing and Tender’ intern after studying a master’s degree in Media and Public Relations at the University of Leicester. Since joining, I have been involved in different aspects of the business and have benefitted from hands-on experience from the outset. Krisja has helped me in developing my skill set and has guided me when learning new skills. Shadowing Krisja and being heavily involved in daily business activities has been challenging but exciting! I have particularly enjoyed being involved in Marketing the company and launching the website, which has resulted in some fantastic marketing wins at this early stage! I’m looking forward to the year ahead and seeing where my role at K Low Consulting takes me.”
-Mia Penny, Marketing and Tender Executive.

Wins of 2019

Within our first year, we have had some fantastic results. Our STATS have been evidence of our work this year,  we have had circa. 88% of client wins, 90% client retention and delivered 615% social return on investment for an £800k contract.

We strive to strengthen current partnerships with our clients in 2020, helping them to win more high-value contracts and develop their organisations even further. Looking ahead to 2020, we’re seeking to create more partnerships and build our client base.

Progressing on to a digital landscape, 2019 saw the launch of our website and social media accounts. Since the launch, we have had some remarkable results, including being on the first page of Google within 5 weeks of the website launch.

Some Testimonials from 2019

“Krisja and his team are knowledgeable about the Education industry and approached the tender in a systematic and organised manner. Although there was a tight deadline, they went above and beyond to involve themselves with our organisation and gather as much information as possible to produce an excellent tender response. They provided a fresh input into any potential issues and identified these in the early stages. For our most recent project with Krisja, we have been invited to the next stage and we are confident that we will win the tender. I would recommend Krisja and his team to anyone, and plan to work with him in many more projects in the future. Thanks again for the hard work.”

-Business and Resources Executive, Educational Establishment.

“… Thank you so much for the effort you and your team put in.  You kept us on track throughout the submission process and although we only had a short amount of time to work on this tender, you covered every answer in-depth & we were very pleased with that we had pulled together!  Pleasure to work with.”

Chief Executive Officer, Specialist Social Care Recruitment Provider.

“This is the second NHS dental tender we have worked with Krisja on. We won the first and are very confident of our chances on the second. He is always professional, diligent and flexible. His knowledge and input on healthcare bid strategy, delivery models, and commissioner perception is excellent. He always goes beyond compliance, to find creative ways of making our proposal the very best it can be!”

Practice Director, Dental Practice Group.

Click Here to See More Testimonials

Some outstanding wins in 2019

A glimpse into 2020

In 2020, K Low Consulting plans to continue assisting our clients to produce outstanding results. We carry through our ethos and values, continuing to win tenders for clients. There are also plans underway to deliver tender and funding workshops to Practice Managers after partnering up the Practice Managers Association (keep an eye out on details to follow!).

We’re also heavily involved in with the development and launch of an innovative Healthtech tool, MSK Gateway. This tool supports GPs to reduce appointment time, improve patient experience and outcomes. It enables GPs to manage their patients better by assigning them tailored exercises based on their symptoms. This year the tool will be launched into pilot practices, thus, we are looking for partner practices to use the tool to improve patient experience and outcomes. Check out the video below to see a promotional clip for MSK Gateway.

Contact Us Today

If you need help with tendering, give us a call today to see how we can assist you. Contact info@klowconsulting.com or give us a call on 0330 133 1041.

To Bid or Not to Bid: A Step Towards Winning a Tender

Bid Writing

The tender process is often complex and requires close attention to the contract requirements and your organisations’ suitability to a contract.

As part of our services at K Low Consulting, we help clients to make a ‘bid or no bid’ decision in the initial stages of bidding. This often includes evaluating compliance and eligibility, commercial feasibility and competitor analysis.

After overlooking 100s of bids in different industries, it is often encountered that clients are keen to bid for a tender that may not be particularly beneficial to them. The attractiveness of a tender, therefore, is not a reason to bid. There should be careful consideration of many factors.

Providing critical feedback at the initial stages of bidding has placed us in a strong position to advise on how you can come to an informed decision regarding whether to ‘bid or not to bid’ for an upcoming tender.

Factors that may inform the ‘bid no bid’ decision

The bigger the contract, the higher the risk involved when bidding for a tender. Without carefully planning and evaluating if your organisation can deliver the contract requirements, you could be at risk of wasting time, money and resource by bidding for a contract that isn’t right for your organisation.

Here are some of the implications of bidding for a tender that isn’t right for you:

Time

Bidding for a tender takes a considerable amount of time. From undertaking research and collecting evidence, the tender process can be long, complex and require a lot of attention.

Answers will vary from tender to tender, but often, some may require a lengthy response which seeks evidence on how your organisation can deliver the contract. Thus, it is critical that you have internal teams or external bid writers to allocate the correct amount of time needed to undertake the project.

Those in senior management positions usually have to collect the right resources for the bid, which means there may be less focus on training and managerial activities. Employing an external bid team, however, could ensure that time is saved and take the strain off internal bidding teams and senior management.

Cost

There are a lot of costs associated with tendering. If you are choosing to invest in an external bid writer(s), then this will be one of the associated costs.

Evaluating that your business can afford to implement a contract is fundamental. Thus, you must be aware of the additional costs associated with a new contract. It is vital that you understand your current delivery model and what it would take to deliver a new one.

Questioning: have we got the costs to scale up? Would be a good starting point. Some of the additional costs to implement a new contract may be:

  • Recruitment of staff
  • ICT
  • Property
  • Construction
  • Marketing and advertising
  • Equipment

Wasted Resource

Resource can easily be wasted if the tender that your organisation is bidding for isn’t right for you. We understand that for most SMEs, internal resources are crucial and need to be prioritised for bidding. By ensuring that we only bid for the most appropriate opportunities, we optimise where and how our clients deploy their resource. As mentioned previously, time is one of the most crucial aspects of bidding for a tender, and too much time and resource spent on a tender could potentially be wasted if you decide to bid without evaluating the impact.

Low win rates

Losing bids result in low win rates. You must analyse and understand where you are in the marketplace. Compliance is just first base; understanding that you have a proposition that could enable you to win is fundamental to optimising win rates. At K Low Consulting, we have a fantastic win rate of 88% and ensure that our clients have the right standing to bid. Before bidding, you should question the following:

  • Who are our competitors?
  • Where are we at with the delivery model?
  • Do we have a coherent strategy in place?

Making the ‘bid no bid’ decision

If you have found a tender that you want to bid on, there are many factors that you should consider before going ahead. At the very basic level, your organisation needs to fulfil the statutory requirements stated within the tender and have the right financial standing. Demonstrating your organisation’s capabilities in your answers, alongside evidence that presents added value, shows that you can deliver the contract requirements.

You must meet all the requirements for the contract. If you meet ‘most’ of the set requirements and not all, you will still lose the bid.

Thoroughly evaluating your standing as an organisation will help you when making the decision. There are many questions that you can ask to come to the right decision, some are:

  • Do you have an internal or external team in place to help support the bid?
  • Do you have time and resource to implement the bid?
  • Can you present added value to the bid, that will make you stand out amongst competitors?
  • Does the contract fit with your organisation’s strategic growth plans?
  • Have you completed tenders in the past, and if so, what have you learnt that will be beneficial when bidding for this particular contract?
  • Do you have the relevant evidenced experience to support your bid?
  • Are there any factors which would inform the ‘no bid’ decision? If so, what are they?
  • Is your team equipped to deliver the contract?
  • Does the contract align with your growth plans?

K Low Consulting’s approach to the ‘bid no bid’ decision

At K Low Consulting, we recognise that the ‘bid no bid’ decision is critical. Our initial consultation with you will outline whether we think you should bid or not, taking the strain and pressure away. We are open and honest with our clients from the beginning of the process, and unlike other tender companies, will not simply encourage you to bid for a tender for profitability. We will thoroughly evaluate your organisations standing and the likelihood of winning a contract. We strive for strong partnerships with our clients and want them to be aware of the best opportunities that align with their organisation’s strategic growth plans.

If you would like our help to decide whether to bid or not for a contract or to find out about our services, please contact us today on info@klowconsulting.com or call 0330 133 1041.

Primary Care Networks: A Challenging Collaboration?

Primary Care Networks

Primary Care Networks are still in the early stages of formation and many people may be unaware or have little knowledge of them.  

Primary Care Networks were introduced in the NHS Long Term Plan in 2019 and since then, there has been the beginning of many formations to collaborate healthcare services for the benefit of patients and their healthcare.

Since the introduction of the NHS’s Long Term Plan, practices have organised themselves into their Primary Care Networks as of 15th May 2019 and all except a handful of GP practices in England have come together, resulting in around 1,300 geographical networks (Kings Fund, 2019, https://www.kingsfund.org.uk/publications/primary-care-networks-explained).

Aiming to collaborate a workforce and form a more inclusive work environment to better the needs of patients, the particular challenges, risks and successes of these formed Primary Care Networks can be evaluated.

Questioning ‘are primary care networks a challenging collaboration?’, this article will provide a holistic overview of primary care networks, the potential risks and challenges and finally, the successes.

What are Primary Care Networks?

A Primary Care Network is one or more general practice’s working collaboratively together. This usually consists of networks of doctors and other healthcare providers such as dieticians, pharmacists and nurses.

Primary Care Networks ‘form a key building block of the NHS long-term plan’. Whilst there were some different ways of working together before the introducing of PCN’s, they aim to create a formal structure.

How are Primary Care Networks formed?

As stated on the King’s Fund, networks are geographically based and cover all practice within a clinical commissioning group boundary.

It is not a requirement that primary care networks are formed, but if practices choose not to join, they will lose out on significant funding. It’s also important to note that occasionally, a single practice can function as a network if they meet the size requirements. PCN’s will receive funding to employ additional health professionals such as pharmacists and paramedics to enable a greater formation.

Why were Primary Care Networks introduced?

The NHS were facing issues with increased demand in healthcare services. Patients were living longer, with more complex and long-term health conditions. These issues were also coupled with an understaffed workforce.

As a result, the introduction of Primary Care Networks aimed to alleviate the strain on healthcare staff, allowing them to work together to deliver primary care services.

The introduction of Primary Care Networks aimed to ‘build on the core of current primary care services’ enabling a more pro-active and co-ordinated workforce.

Primary Care Homes (introduced in 2015) were an approach to strengthening primary care. The model brings together a range of health and social care professionals to work together to provide enhanced personalised and preventative care for their local community.

On 31st March 2017, NHS England publishes ‘Next Steps on the NHS Five Year Forward View’, which reviewed the progress made since the launch of the ‘NHS Five Year Forward View’ in October 2014. The revised Five-Year Forward View set out ‘practical and realistic steps’ to ensure the delivering of a more responsible and sustainable model.

Healthcare professionals were encouraged to work together, in networks of 30,000-50,00 patients, which built on the Primary Care Home model. Following this, in February 2018, refreshed ‘NHS Plans for 19’ was introduced. This plan set out the plans for CCG’s, encouraging every GP to be part of a PCN so that these could cover the whole country as far as possible by the end of 2018/2019.

The GP contract, agreed in January 2019, is a new extension part of NHS England’s five-year framework for GP services, named the ‘Network Contract Directed Enhanced Service’ (DES). This contract went live on 1st July and enables GP practices to ‘play a leading role in every PCN’.

As part of this contract, the DES announced that PCN’s must appoint a clinical director as their named leader, responsible for delivery. The network agreement states the rights and obligations of the GP practices within the network, how the network will partner with non-GP’s, and a patient data-sharing requirement.

Here are some key legislative dates as mentioned above:

2015: The National Association of Primary Care (NAPC) launched the Primary Care Home model at their annual conference
April 2016: NHS England introduced GP Five Year Forward View
2nd February 2018: NHS England introduced ‘Refreshing NHS Plans for 19’
7th January 2019: NHS Long Term Plan introduced
31st January 2019: GP Contract 2019/20 (outlines what PCN’s will be)
15th May 2019: Practices have to organise themselves into networks and submit signed network agreements to their clinical commissioning group (CCG).
1st July 2019: NHSE expects the network contract to provide 100% geographical coverage

Benefits of Primary Care Networks

As previously mentioned, PCN’s were introduced to allow GP and primary care services to scale up by grouping. As a PCN, workforces can team up to deliver as a larger entity and pull resource where needed.

PCN’s have the potential to substantially improve patient experience. One of the many benefits is that the accessibility of healthcare services increases, allowing them to have access to extended services.

In terms of other benefits, each PCN will encounter their own set of benefits individually. As provided below, success stories present two different sets of benefits for patients and staff.

Examples of these benefits as outlined in the success stories are:

  • Better work relationships and collaboration
  • A stronger focus on patient care and experience
  • Easier to identify key issues within the community through collaboration

Dr Nikki Kanani, a London GP and NHS England’s acting medical director for primary care stated: “people across the country will benefit from access to more convenient and specialist care through their local GP. As part of the long-term plan for the NHS, GP surgeries large and small will be working together to deliver more specialist services to patients”- Guardian.

Risks and Challenges of Primary Care Networks 

As health.org.uk and Nuffield Health outlined, there are a particular set of risks and challenges associated with PCN’s:

1. Speed

One of the most prominent risks of PCN’s is the speed of implementation of these collaborations. With such a tight set of deadlines associated with PCN’s, it may be difficult for people to familiarise themselves with PCN’s and then form their practices into networks within these time restraints.

As Nuffield Health illustrated, these tight deadlines could mean that failure was inherent form the policy design. It could be said that these timescales are unrealistic and ambitious, not giving professionals enough time to adjust to the rapid changes.

2. Funding

 In terms of deciding not to join a network, practices will miss out on the sources of funding. However, even if there is a formation of a PCN, there is a risk that there will be a removal of other sources of income for practices.

In addition to this, NHS England has promised to meet 70% of costs of employing most additional staff need for the PCN, meaning networks must cover the remaining 30% of the cost associated with this. This could be particularly costly for those practices that cannot afford this.

3. Workforce and workload

A particular risk associated with PCN’s is that they may decrease the amount of GP time available.

Additionally, there is no proof that the NHS is supplying 20,000 additional health professionals as stated in their plan. Increasing this workforce also means accommodating for these new staff members, which may pose a particular challenge for some GP’s where workspace is limited.

There could be a lack of operational support to realise the amount of PCN roles that need to be filled in this short time period. Additionally, some practices may not have the funding available to appoint new staff members.

4. Lack of collaboration

There is a risk that PCN’s may not be able to form effective organisations.

The knock-on effects of the lack of collaborations between practices are that there are disputes which could result in isolation and resist, creating further issues amongst networks. Thus, this could result in a lack of collaboration and the failure of an effective network model.

As stated on the King’s Fund website, the research found that collaboration in general practice was most successful when it had been generated organically over several years and if it was reinforced by trust, relationships and support. On the other hand, research has shown that a lack of clarity of purpose and engagement or over-optimistic expectations resulted in less effective collaborations. This suggests that collaboration and focus should be coupled together to form an effective PCN.

5. Lack of focus

There are a large number of objectives for PCN’s. The number of objectives that professionals must fulfil, may be unrealistic and put further pressure on them.

In 2020/21, there are five out of seven service specifications expected to be delivered. This heightened pressure on healthcare professionals may result in intolerable pressure resulting in a lack of focus.

Protecting Risks and Challenges of Primary Care Networks 

Although, as Primary Care Networks are still in the early stages of development, these risks and challenges could be easily rectified at this early stage.

Nuffield Health provides a series of possible solutions to these problems, some of which are provided as examples below:

Issue: Lack of collaboration/ not able to create effective organisations

Possible Solutions:

  • Create a new vision for primary care: defining what an effective PCN looks like and what can be achieved.
  • Carve out time (using paid backfill, ideally from CCG’S/STP’s) to build a shared organisational vision
  • Draft vision statements as practical documents
  • Create clear roles for each of the different levels of the local system

Issue: Lack of focus

Possible Solutions:

  • ‘Work with CCG’s and commissioning support units to undertake multi-level approaches to tackling population health and general operations’
  • ‘share learning across practices and governance levels in a neighbourhood to create a sense of shared ownership’

Issue: Speed

Possible Solutions:

  • ‘Policymakers should acknowledge that an organisational plan can take up to two years, and outcomes 5-10 years to realise’
  • ‘STPS/ICSs and CCGs should work closely with PCNs to agree roles, responsibilities, development plans, timelines and funding arrangements until 2025’
  • ‘PCNs leads and practice liaisons should jointly agree on the purpose of new roles and their contractual terms and conditions’
  • ‘CCGs should examine where their management support should be best placed- this role has had little attention to date in primary care workforce planning and funding’

Issue: Workforce/ Workload

Possible Solutions:

  • ‘create a shared physical space for the PCN and bring people together during their working day to talk about what they want to achieve’
  • ‘help clinical directors to improve the capacity and capability of their network by focusing initially on small, achievable initiatives that help or reduce workload in individual practices and build trust’
  • ‘Appoint leaders who have skills to make sense of the environment and set the direction, as well as managing the many different aspects of the organisation’s functions’

Successes of Primary Care Networks 

Despite the foreseeable risks and challenges to PCN’s, there have been a number of success stories which illustrate the impact that they have already made.

Yorkshire Primary Care Network

A success story on the NHS Confederation website discusses how a Yorkshire Primary Care Network bridged the gap between health and social care by linking up care in their region.

They sought to identify the problems that their patients had and work towards rectifying these issues as a PCN. One of the issues identified was that they had a considerably high percentage of older patients and they had to be attentive when caring for those patients, especially those who were on a terminal decline. Thus, they appointed a care co-ordinator and benefitted from the PCN team across the network.

Alongside this, a Parkinson’s nurse was appointed, a partnership with the York Teaching Hospital has been formed and a rapid cancer diagnosis pathway is underway.

Dr Evans, one of the doctors in the Yorkshire Primary Care Network stated: “The care of our patients is a lot more organized and anticipatory, and [there is] less crisis. But actually, more important, it works”

Chester East Primary Care Network

Chester East Primary Care Network who cover a network population of 37,020 patients.

There has been a substantial impact of this PCN, details of such are as followed:

  • ‘They have been identified by an independent audit on behalf of NHS England as an exemplar of best practice’
  • ‘They use a 0365 platform to share project information and documentation. This has provided visibility of project progress and support collaborative and agile working in the absence of shared file arrangements- dedicated programme support’
  • ‘Dedicated programme support has enabled the work to move at pace, providing a structure for everyone to feed into and embrace’
  • ‘CSU expertise within the programme management provided valuable support in sharing best practice across the network, using case studies to support current and future opportunities in collaborative working’
  • ‘created a robust governance structure has enhanced working relationships and provided visibility and clarity on roles and responsibilities across the network’

Their shared vision is: “Working together to deliver high quality, innovative and sustainable healthcare for our community with commitment, compassion and integrity”.

Successes of Primary Care Networks: Self Evaluation for Staff

As exemplified by the National Association of Primary Care, Figure 2 presents the outcomes of a questionnaire for staff. It shows the self-assessment by PCN supervisors, of how networks have improved the workplace. As shown, there is a lower demand for primary health services and patients are engaging more and benefiting from healthier lifestyles.

Figure 5 (as presented on NAPC.co.uk) also presents that improved self-management, healthier lifestyles and patient engagement has increased pre vs. post PCN.

Contact Our Team Today 

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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.

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.

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.
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