Camden Primary Care Trust
Public Consultation on Service Specifications
and
Selection Criteria for
Tendering of a Homeless and Substance
Misuse Primary Care Service In Camden
September 17th 2007
Camden Homeless and Substance Misuse Primary Care Tendering Process Consultation
17th September 2007
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Contents
Page No
1
Why are we doing this?
3
2
Background
3
3
How did we arrive at the service specification and
selection criteria?
4
4
How do I have my say?
6
5
The Service Specification
7
6
The Selection Criteria
33
7
Glossary of Terms
37
8
Feedback
41
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1
Why are we doing this?
Camden PCT has developed a new service specification for a Camden wide
homeless and substance misuse primary care service, and also selection
criteria for choosing who will deliver this. We would like to hear your
comments on both the specification and the selection criteria.
PCT’s (Primary Care Trusts) are NHS organisations that are responsible for:
o improving the health of the local community with a strong focus
on public health, community development, health promotion and
partnership working
o securing provision of health services
o the integration of health and social care
o involving patients and the public in designing and delivering
services
One of our main roles as a PCT is to commission a comprehensive and
equitable range of high quality, responsive and efficient services, including
those provided by primary care teams. The PCT wants to make sure that we
take into account the public’s view when we commission services for Camden.
2
Background
In July 2005 the Department of Health announced two consultations that
would form the basis of a single White Paper. The Paper recognised how
NHS and social care services work together and identify how the delivery of
these services could adapt to provide individuals with the health and social
care services they need closer to their homes.
The proposals in the White Paper, Our health, our care, our say: a new
direction for community services, aim to:
o
o
o
o
change the way these services are provided in communities and make
them as flexible as possible
provide a more personal service that is tailored to the specific health or
social care needs of individuals
give patients and service users more control over the treatment they
receive
work with health and social care professionals and services to get the
most appropriate treatment or care for their needs.
The principle all these policies lead up to, is that patients should receive the
right care, in the right place, at the right time. In most cases the most
appropriate, cost effective and convenient place for patients to receive
assessment and treatment is in primary care, usually at a GP surgery.
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There are currently 2 providers of primary care services for homeless and
substance misuse clients within Camden: The Primary Care Unit (PCU)
managed by Camden & Islington Mental Health and Social Care Trust
(C&IMHSCT) and Primary Care for Homeless People (PCHP) managed by
Camden Primary Care Trust (CPCT). Both PCU and PCHP work with both
these vulnerable client groups, who can find it difficult to access mainstream
primary care (GP) services. Camden PCT recognises that specialist primary
care services for this client group are required to help to meet their health
needs.
Both PCU and PCHP have recently been reviewed by CPCT and it was
identified clients attending PCHP and PCU have the same needs. It is the
view of CPCT that there needs to be one single service, commissioned to an
agreed specification able to meet the needs of homeless and substance
misuse patients and performance managed within primary care.
The service specification CPCT is consulting on makes sure that the services
provided for Camden’s homeless and substance misuse clients, are the right
ones for the needs of these groups.
3
How did we arrive at the service specification and
selection criteria?
The service specification is the most important document for the provision of a
homeless and substance misuse service in Camden, as it sets out what the
PCT wants to commission from the provider in future. So far there has been
senior clinical and managerial input, including representation from both
existing providers, into the draft specification, as well as working to national
and local policies ‘Our Health, Our Care, Our Say’, and the Camden Local
Delivery Plan. These polices and the national patient survey findings have
informed CPCT about what local people have said they want from their local
primary care services, which in turn has guided the development of the
service specification and the selection criteria for potential primary care
providers.
This consultation is an important step towards finalising the service
specification and the selection criteria. Once we have heard your views, and
incorporated them into the documents where it is possible to do so, this will
become the service specification for choosing the provider of a specialist
homeless and substance misuse service in Camden in the future.
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What do local people want from primary care?1
Location
Quality of service
 geography – locally
 to meet national and
available services
local standards
 transport – easy to get to  in line with latest
guidance
 access to parking for
 working effectively with
patients who need it
other services
 achieving QOF standards
 achieving clinical
excellence
Responsive to a broad
spectrum of needs
 old and young
 those with high and with
low need
 Those living in care
homes and those living in
their own homes
Components for
 people with long term
conditions
access to quality
 people with learning
primary care
disabilities
 people with mental
illness
 carers
 encourage continuity of
care for all patients
 shift from hospital to
community
Providing a range of core Providing a range of
services
enhanced or specialist
services
 Promotion of good
physical & mental health
 minor surgery
 Identification of
 childhood immunisations
underlying health
and vaccinations
problems
 flu immunisation
 Prevention of disease
 near patient testing
 Treatment of illness &
 shared care for
injuries
substance misuse
 Care of long terms
 practice based therapy
conditions
 appropriate and effective
 Shared care of mental
follow up after hospital
health
stay
 Prescribing of medicines  phlebotomy (blood
 Supporting self-care
taking)
1
Availability
 flexible opening hours
 appropriate and
responsive appointment
system
 accessible urgent care
 out of hours services
with single point of
access
Sensitive to all
communities including
 deprived populations
 ethnic minorities
 refugees and asylum
seekers
 offenders
 those with disabilities
 housebound
Efficient and effective
referral to specialists


community services
mental health service
Table assimilated from feedback from PCT patient survey 2005 and national guidance.
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4
How do I have my say?
The service specification that the PCT will be using to tender for this service,
and the selection criteria that we will use are included in this pack. At the
back of the pack is a form for you to fill in to let us know what you think of the
service specification, and the selection criteria. You can give us feedback in
the following ways:
1. Fill in the form at the back of this pack, and send it to the freepost
address that has been included. You do not need to use a stamp. Our
Patient Advice and Liaison service can get you copies in other
languages and formats
2. You can get this information, and fill in a form on the internet. Go to
our website www.camdenpct.nhs.uk and click on the “Consultation On
Tendering for a Homeless and Substance Misuse Primary Care
service” link.
3. Speak to us – talk to your health worker/keyworker/hostel worker; give
your views and ideas to the person who provides health services to you
4. Phone us - 020 7530 6315 (Patient Advice & Liaison Service); Minicom
no. 020 7530 3186
5. Email us - PALS@camdenpct.nhs.uk
6.
Write to us: PALS, Camden PCT, FREEPOST RRCA-BHXE-HUSR,
London NW1 0PE.
We look forward to hearing your views on our service specification and
selection criteria. Please let us have your comments by Friday 2nd November
2007
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5
The Service Specification
Following is the draft service specification. There is a form following this that allows you to give us your comments.
SPECIALIST PMS SERVICE
SERVICE SPECIFICATION FOR THE PROVISION OF SERVICES TO
SUBSTANCE MISUSERS AND HOMELESS PEOPLE
Introduction
This is the service specification for the provision of primary care services to substance misusers and homeless patients which has been developed as part of
a service redesign for both Primary Care for Homeless People and Primary Care Unit. . This is a specialist personal medical services (PMS) specification,
which acknowledges that significant groups of the homeless patient population and substance misuse population are not well service by traditional PMS and
the new general medical services models. This may be for a number of reasons:
 These models do not meet their needs or are inaccessible.
 These patients have complex needs which go beyond the ability of standard PMS and new GMS practices to address.
Through the provision of this service specification Camden PCT aims to provide:
 Flexible person-centred health care arrangements for this vulnerable homeless population
 Accessibility
1. The specification takes account of national priorities and is therefore subject to change as national and local priorities change. The specification takes
account of the key areas of development within primary care and on DoH guidance.
2. The Department of Health has given clear direction of travel that services should be commissioned which are:
Patient centred
Clinically effective
This specification outlines key requirements and targets within the 6 areas:
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Value for Money
Support national & local targets
1. Core Services
3. Governance
4. Infrastructure
2. Access
5. Contract Monitoring
6. Patient Involvement
The Specification provides the PCT with an opportunity to define what it considers to be the core services that this specialist PMS facility should be delivering
to its patients and refers to locally agreed service specifications where appropriate.. It further strengthens the requirements for primary care providers to
achieve the growing patient expectations around access and supports innovation. The specification details the governance arrangements that are required
within primary care facilities to deliver robust clinical and cost effective care and the infrastructure needed to support that delivery. It also stresses the
increasing importance of accountability through robust contract monitoring. Finally it places significant focus on the provider to demonstrate effective
partnerships with patients through a range of patient involvement initiatives. “Managed within Primary Care” refers to management of patients within the
practice without the need to refer to hospital. Patients may well be involved with other community based services as part of their overall package of care. All
targets outlined are not inclusive of those who have been exception reported .The Service Specification is subject to ongoing review and change through
national and local guidance.
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Targets to be negotiated for this service
AREA
REQUIREMENT
TARGET
CORE CONTRACTUAL
SERVICES
Cervical Screening
Contraceptive Services
The Contractor shall provide a cervical screening
service targeted to meet the needs of the identified
patient population . Evidence suggests women
within the homeless populations are at high risk of
abnormal cervical screening results and there is low
uptake of screening offered. This service will:
 Offering cervical screening to all women
 Give follow up appointment times to patients
at time of screening
 Engage in proactive/opportunistic follow up
The contractor shall assess patient suitability and in
response to need/suitability provide the following
contraceptives
 IUCD’s
 Depot injectables
 Implants
 Barrier methods
 Oral Contraceptives
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The Contractor shall achieve XX% uptake rate
The Contractor will measure morbidity
The Contractor shall achieve:
 XX % target of contraceptive uptake
POINTS
AREA
Vaccinations and
Immunisations
Maternity Services
Minor Surgery
Anticoagulation Monitoring
REQUIREMENT
The Contractor shall provide all necessary
vaccinations and immunisations to all high risk
groups within its registered adult population in line
with national guidance and standards. (includes
provision of additional and DES services) (see also
Patients suffering from drug misuse).
The Contractor shall provide to pregnant patients all
necessary maternity medical services throughout the
antenatal period via shared care with local obstetric
services (e.g. midwifery led shared care service,
parenting support groups etc). Routine postnatal
care (including contraceptive advice) shall also be
provided.
Obstetric services delivered via the primary care
service will be recorded in the primary care records
as well as within obstetric hospital notes.
The contractor shall provide routine minor surgery
including incision and drainage of abscesses
The Contractor shall provide prescribing and
monitoring for anticoagulation patients in line with
level 1 of PCT guidelines
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TARGET
The Contractor shall achieve the flowing uptake
rates:
 Flu: XX% uptake of risk groups
 Pnemococcal:
The Contractor will undertake an annual audit of
vaccinations and immunisation rates
The Contractor shall provide shared care obstetric
services to all pregnant patients including
homeless, drug using, alcohol dependent and HIV
positive patients liaising with and referring to HIV,
Hepatology, drug treatment services and social
services appropriately. An annual report/audit
indicating the number of pregnant women seen
and detailing attendances, treatments/referrals
provided as well as uptake of services and
outcomes will be provided to Camden PCT.
The Contractor shall be able to provide services to
all registered patients requiring care within agreed
local guidelines
The Contractor shall provide Level 1 service
provided for all appropriate registered patients
POINTS
AREA
Patients Suffering from
Drug Misuse
REQUIREMENT
The Contractor shall provide a service to patients
suffering from drug misuse including substitute
prescribing
TARGET
The Contractor shall provide service to min of XX
patients with drug misuse and meet the national
specification
The Contractor shall work within the framework of
Department of Health national guidelines and
Models of Care (2006) and within the established
local drug treatment system pathways and
prescribing protocols
The Contractor shall be aware of local detoxification
and rehabilitation procedures
The Contractor shall ensure staff operating needle
exchange should be competent to provide
information on the range of drugs injected
The Contractor shall provide keyworking. The
Models of Care; Update 2002 defines the keyworker
as “the dedicated and named practitioner who is
responsible for ensuring the care plan is delivered
and reviewed... This would normal involve regular
meetings between the keyworker and the client
where progress against the care plan would be
discussed and goals revised as appropriate”. The
provider shall work closely with hostel key workers to
ensure integrated approach to health and housing.
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The Contractor shall achieve a return rate target,
to be agreed with Camden PCT, which will
contribute to the overall borough target.
POINTS
AREA
Blood Borne Virus (BBV)
Screening, Immunisation &
Treatment
Patients suffering from
alcohol misuse
REQUIREMENT
TARGET
The Contractor shall provide screening for hepatitis, The Contractor shall meet the locally agreed
tuberculosis and HIV for those patients for whom it is protocols for management of BBV’s and achieve a
clinically indicated and/or at risk of infection
minimum of:
 Hepatitis B vaccination 80% (eligible and
The Contractor shall provide immunisation against
agree to vaccination)
hepatitis A/B
 Tuberculosis screening for:
Clinically indicated
The Contractor shall work with specialist partners to
HIV and immunosuppressed
ensure treatment compliance with tuberculosis
Previous contact
hepatitis C, Hepatitis B and HIV medications.
 Hepatitis C screening : 80%
 HIV screening : 100% offered with 80%
The Contractor shall provide advice and referral to
uptake and serial testing if continued risk
specialist services (where appropriate) for all blood
borne viruses.
The Contractor shall provide screening for alcohol
The Contractor will provide within the first year
misuse.
 No. of brief interventions with patients
The Contractor shall provide brief interventions for
within the first year for harmful and
alcohol misuse in line with protocols
hazardous drinkers (alcohol consumption
definition)
The Contractor shall provide community
detoxification for appropriate patients in line with
agreed protocols.
The Contractor shall have knowledge of and refer
into care pathways for enhanced interventions.
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POINTS
AREA
REQUIREMENT
TARGET
Supporting People with
Learning Difficulties
The Contractor shall recognise learning difficulties
and refer into appropriate services
Sexual Health Services
The Contractor shall provide a range of sexual health The Contractor shall meet the local specification
services targeted to meet the needs of the identified
population group and in line with the local service
specification.
Diabetes
Asthma
Chronic Obstructive
Pulmonary Disease
The Contractor shall ensure provision for:
 Routine care for HIV patients
 Access to and treatment with specialist HIV
services
 Routine care for diagnoses and treatment of
STIs including urine testing for all men for
chlamydia
The Contractor shall identify (usually
opportunistically) diabetic patients and be able to
effectively manage these identified and existing
diabetic patients
The Contractor shall provide routine care to patients
identified with asthma
The Contractor shall provide a service to patients
with COPD in line with patient pathway and service
specification
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The Contractor shall manage a register of all
patients identified as having learning difficulties
POINTS
AREA
Mental Health
REQUIREMENT
TARGET
The Contractor will ensure that mental health issues
of patient are addressed and in particular::
 SMI Registers are kept in line with national
and local policy
 Patients on SMI Register receive annual
review in line with local specification
 Patient with anxiety are managed in line with
national and local protocol
 Patient with depression are managed in line
with national and local protocol
The Contractor will:
The Contractor shall provide a service to meet
patients psychiatric and psychological health needs.
Psychiatric assessment and where appropriate,
treatment initiated for patients with dual diagnosis.
XX% of patients diagnosed with dual diagnosis
The Contractor shall work in a multidisciplinary way,
in line with the CPA policy, with CMHT’s and patients
under an enhanced care co-ordination approach for
mental health needs. The model of delivery will take
account of the mental health pathway and those
involved in its delivery
XX% of patients managed in partnership under
enhanced CPA policy.
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Provide evidence
Provide clinical audit of reviews
Manage XX% of patients with anxiety in primary
care to agreed specification
Manage XX% of patients with depression in
primary care to agreed specification
POINTS
AREA
REQUIREMENT
TARGET
New Patient Registration
Screening Programme
The Contractor shall undertake new patient
registration checks including the following areas:
 Diabetes
 COPD
 Hypertension
 CVD Risk
 Smoking
 BMI
Case Management
The Contractor shall will facilitate the “move on” of
Number of patients moved on during each quarter
registered and non-registered patients to mainstream
PMS and nGMS practices in line with criteria for
“move on”
 substantive address
 level of stability
to ensure throughput and continued accessibility for
this target population.
Stop Smoking
The Contractor shall provide Level 1 and 2 stop
smoking services
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The Contractor shall achieve targets set out by the
PCT in specification and commissioning intentions
POINTS
AREA
Wound Management and
Suture removal
REQUIREMENT
The Contractor shall provide basic and chronic
wound management and suture removal as required
by the patient population including:
Ulcer dressings (in liaison with specialist tissue
viability service where appropriate)
Sutures and skin clip removal post operatively
Re-dressing or simple packing post operatively
Suturing of simple lacerations
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TARGET
The Contractor shall:
Provide annual audit of wound management
activity detailing numbers of patient seen,
attendances, referrals to specialist services (tissue
viability nurses, vascular and/or plastic surgeons
etc)
Minimise risk of patients attending A&E for wound
care
POINTS
AREA
Health Promotion
REQUIREMENT
TARGET
The contractor shall build prevention into all their
care pathways and protocols. Wherever possible, the The Contractor shall provide referral and treatment
contractor shall use opportunities (such as the new
data. Targets to be set with Camden PCT
patient registration) to raise awareness of how to
prevent diseases that these patients may be at risk
from (including Hepatitis B and C, HIV, TB, sexually
transmitted diseases, unwanted pregnancy, dental
problems, malnutrition, foot problems, smoking,
alcohol and drugs misuse, wound infections, mental
illness).
The contractor shall also encourage self-care
wherever appropriate. This will include providing
appropriate self-care information as well encouraging
supporting and signposting patients into relevant
services (such as smoking cessation, screening
programmes and the Health Trainer service) and
groups such as Alcoholics Anonymous, Narcotics
Anonymous, Cocaine Anonymous, Groundswell and
the Expert Patient Programme.
The contractor shall work with Camden PCT health
promotion department to ensure that health
information is accessible and appropriate and should
actively engage with the PCT’s health promotion
campaigns.
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POINTS
AREA
Out-of-Hours
Clinical and Cost Effective
Prescribing
Practice Based
Commissioning
Relationship depends on
model of new services
REQUIREMENT
The Contractor not be required to provide OOH but
will work with OOH provider to ensure appropriate
sharig of information about high risk patients
The Contractor shall ensure that prescribing within
the practice is both clinically and cost effective and in
line with national and local prescribing guidelines and
legislation
The Contractor shall be required to:




Actively participate in the appropriate PBC
Consortium
Sign Accountability Agreement with PCT
Manage delegated commissioning budgets
with consortium
Have effective referral management systems
in place
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TARGET
The Contractor shall work with the PCT
commissioned OOH provider
The Contractor shall achieve the prescribing
targets as agreed with their prescribing advisor
and where appropriate negotiate targets for this
population group (e.g. TB drugs)
Agreed formulary
Agreed stock drugs/treatments
Agreed drugs budget
The Contractor shall have achieved:




Signed Accountability Agreement
Refer to agreed alternative services
Manage budgets in accordance with
current PBC guidance and move towards
fair shares
Referral to acute care within agreed range
and protocols
POINTS
AREA
Acute and Specialist
Services Liaison
REQUIREMENT
TARGET
The Contractor shall provide liaison with acute
services for continuity of patient health care,
specifically:
To keywork homeless inpatients, with a view to
arranging safe discharge, prevent bed blocking and
minimising readmissions
To work effectively with Local Enhanced Service
Practices, provide advice and support in patient
management and support practice in tne transfer of
patients between services
To access appropriate clinical and non-clinical
information to support discharge and follow up
To liaise and work collaboratively with Hepatology,
Sexual Health services, HIV services and Substance
Misuse services
To assess patients with complex needs and address
issues relating to housing, benefits, substance
misuse and primary care
To facilitate the discharge of non Camden patients to
their appropriate home borough
To minimise the use of A&E by arranging for GP
registration if below service threshold
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and information
to A&E
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a view to minimise re-attendances
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staff with
To ensure that effective links are
POINTS
AREA
Acute and Specialist
Services Liaison
REQUIREMENT
To ensure links with referral routes into hostel
pathway
Facilitate management of substance misuers in
hospital to prevent self discharge
Act as central points regarding information about all
admissions
Take referrals from existing substance misuse
services within hospital
To minimise the use of Ambulance and A&E services
by assisting homeless patients to register with local
GPs
Non Clinical Intervention
To provide health promotion services around healthy
eating, drugs and alcohol, sexual health, women’s
health, dental and personal hygiene, and smoking
cessation
To reduce DNA rates for all health appointments,
such as those at hospital, including acute
outpatients, by escorting patients
The Contractor shall report the number of patients
move on for each quarter
care provisions
To link patients who are moving into mainstream
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practice
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training
and education
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To assess and keywork patients with complex needs
and address issues relating to housing, benefits,
TARGET
POINTS
AREA
Non Clinical Intervention
REQUIREMENT
TARGET
By working closely with the Mayor of London’s office (Notify
Project) to provide equal access to health care provisions
To link patients who are moving into mainstream general
practice into relevant training and education
To assess and key work patients with complex issues and
address issues relating to housing, benefits, substance
misuse, primary care, immigration and mental health where
appropriate and co-ordinate with other designated key
workers involved in the person’s care (i.e. Hostel Workers)
to avoid duplication.
To provide training and information to partner agencies, staff
team and hostel staff
To ensure that effective links are maintained between the
primary care provider for homeless service and other
statutory and voluntary agencies providing support to
homeless people
Continuity of Care
The Contractor shall ensure that continuity of care is
provided through stable staff establishment and low
turnover of staff
The Contractor shall continue to provide services
(with the exclusion of home visits) for patients
housed outside the borough until the local provider
can take over treatment to prevent interruption of
care/treatment.
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Patient Survey will demonstrate high level of
satisfaction with the service
The Contractor shall facilitate “move on” of
temporary patients.
POINTS
AREA
Continuity of Care
Opening Hours
Appointment System
Patient List
REQUIREMENT
The contractor will work with LBC to integrate health
as part of the new hostel pathway model and work in
partnership with Supporting People and hostel
providers in the borough to encourage access to
appropriate health services commensurate with the
level of support needs of hostel populations.
The Contractor shall ensure that the practice base is
open for patient consultations for a minimum of 45
hours per week
The Contractor shall provide flexible operational
structures (e.g. open surgeries, satellite clinics,
telephone clinics) to maximise accessibility for the
identified patient group.
The Contractor shall ensure that patients can access
services through appropriate walk-in
The Contractor shall ensure that its list is open at all
time to registering new patients
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TARGET
The contractor will support the movement clients
onto mainstream primary care services, and will
seek to provide ongoing support to these clients to
maintain them in mainstream primary care
services. The contractor shall monitor the rate of
move-on clients re-registering in specialist primary
care, and the reasons for this.
The Contractor shall report the number of patients
move on for each quarter
Min 45 hours per week
10 hours outside of 9-6.30
To be defined during modelling but 2 late evenings
per week
Open List
POINTS
AREA
Home Visits
Consultations
Disabled Access
Effective Communication
REQUIREMENT
The contractor will provide home visits to patients
where clinically appropriate. This may include the
provision of clinical services within a range of sites
including hostels. The contractor shall ensure that all
hostel dwellers have equal access to full range of
services. The Contractor shall work with
commissioners to agree levels of input into local
hostels based on clinical need and suitability of
environment. The Contractor shall work with hostel
providers to ensure that the Pathway minimum
services thresholds for health services are met
The Contractor shall provide a range of consultations
including times to meet the nee of the client groups
The Contractor shall ensure that it has taken all
steps to enable wheelchair users and people with
poor mobility are able to access services
The Contractor shall ensure that it accesses
appropriate BSL and Language interpreting services
to meet the needs of its patients
TARGET
The Contractor shall evidence a range of
consultations including 30min appointments
The Contractor can identify all patients requiring
interpreting
Interpreting use appropriate to needs of patients
Choice
The Contractor shall implement Sign Health for use
with deaf patients
The Contractor shall ensure that patients requiring
referral have opportunity to discuss choice of
providers
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Sign health implemented and operational
Information about providers readily available within
practice
POINTS
AREA
REQUIREMENT
Ethnic Monitoring
The Contractor shall comply with national standards
for ethnic coding
Local Access Service
The Contractor shall participate in any local or
national access service
The Contractor shall adopt the joint Camden &
Islington exclusion policy as agreed with
commissioners.
Exclusions
AREA
The Contractor shall, in addition to health and safety
policies, ensure all staff are provided with training,
safe and secure premises and are aware of and
adhere to a level of staffing safety policy.
REQUIREMENT
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TARGET
80% of registered population has valid ethnic code
in the first year increasing to 98% over the life of
the contract
The Contractor will meet the local or national
specification
The Contractor must demonstrate exclusions are in line with
agreed policies and the rationale is clearly laid out.
The Contractor shall hold guardianship of the patients care,
continuing to provide care for XX number of days.
TARGET
POINTS
AREA
REQUIREMENT
TARGET
GOVERNANCE
Patient Experience
Contractual and Statutory
Requirements
Good Medical Practice
Standards for Better Health
Complaint and Incidents
The Contractor shall have due regard to the Patient
Experience including the quality of the consultation
and to how the patient feels communicated with by
the practice
The Contractor shall meet all 25 Contractual and
Statutory Requirements as defined in the contract
The Contractor shall ensure that all GPs comply with
GMC’s Good Medical Practice
The Contractor shall be familiar with all Core and
Development al Standards for Better Health and
support the PCT to delivery
The Contractor shall review all complaints and
incidents and produce annual report and action plan
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Patient Survey will demonstrate high level of
satisfaction with the service
Evidence available to demonstrate compliance
The Contractor can evidence the requirements
The Contractor can evidence the requirements
The Contractor can evidence requirements
POINTS
AREA
Workforce Development
REQUIREMENT
The Contractor shall ensure that its workforce is able
to meet the needs of the service including taking
account of:
 Professional Registration
 CRB Checks
 All GPs on Performers List
 Appropriately trained and qualified staff
 Mandatory Training
 Training and Development Plans for all staff
 Ensure clinical workforce able to meet
patient needs
 The practice shall participate in training for
 Medical students
 Hostel staff
 Registrars
 Hospital staff
 Any other identified group
 Equal opportunities Policy
The Contractor shall ensure as far as possible that
there is an ethnic mix in the staff group to
appropriately represent Camden’s demographic
diversity
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TARGET
The Contractor can evidence all the requirements
The Contractor shall ensure all primary care staff
recruited to provide or support this service shall
conform to NHS clinical standards, shall be
employed under Agenda for Change or medical
grades and be suitably qualified and competent in
accordance with KSF standards.
POINTS
AREA
Clinical Governance
REQUIREMENT
TARGET
The Contractor shall ensure that robust clinical
The Contractor can evidence all the requirements
governance processes in place to include:
Clinical Governance Lead
Incident reporting
Infection Control
Significant Event Analysis
Managing Alerts
Quality Assurance
Prescribing of controlled drugs
Health and Safety (including needle stick injury policy
and sharps policy)
Compliance with national and local standards
including NICE and NSFs
Child Protection and
Protection of Vulnerable
Adults
Compliance with locally or nationally agreed audits
The Contractor shall ensure it has systems in place
to effectively manage cases of child protection or
adult protection
The Contractor shall ensure:



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Identification of all child and adult
protection cases
Complies with Laming recommendations
Can demonstrate multi-agency liaison
POINTS
AREA
Financial Robustness
Information Governance
Business Continuity
Planning
AREA
REQUIREMENT
TARGET
The Contractor shall manage the allocated budget
with due regard to the administration of public funds
take account of
Cost effectiveness and fraud
The Contractor shall ensure that information relating
to patients is safeguarded and take account of:
 Confidentiality
 Caldicott Guardian
 PCT Information Sharing Protocols
 Consent
 Record keeping protocols
The Contractor shall ensure that it has a Business
Continuity Plan as part of Emergency Planning to
include:
Short term major incident
Flu Pandemic
REQUIREMENT
The Contractor shall have in place:
The Contractor shall ensure that:
The Contractor can evidence the requirements
Fraud Policy
The Contractor shall have in place:



Caldicott Guardian
Confidentiality Policy
Consent Policy
The Contractor shall have in place a robust
Business Continuity Plan
TARGET
INFRASTRUCTURE
Human Resources
All transferring staff do so under TUPE
Induction training in place
HR Policies in place
Appraisal system in place
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POINTS
AREA
Choose and Book
REQUIREMENT
The Contractor shall ensure that 100% of referrals to
acute care are via Choose and Book unless other
system in place
TARGET
100% of eligible referrals via Choose and Book
The Contractor shall ensure local procedures and
linked to hostels to ensure referrals to acute care are
followed up with hostel case workers.
Information Technology

The Contractor shall work in ways that
support national and local programmes and
utilises IT in ways that maximise patient
care. The Contractor will have regard
to:Connecting for Health
 Choose and Book
 Electronic Prescription Service
 Pathology order
 Communication Use of NHS Mail
 Participation in PCT audits and data
collection
Future developments
GP2GP
Spine migration for patient summary notes
Full participation in Connecting for health
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The Contractor can evidence the requirements
POINTS
AREA
Premises
REQUIREMENT
The Contractor shall ensure that::








Signed lease in place
All necessary equipment and maintenance
contracts in place
The Contractor will ensure that the premises
is maintained to minimum standards as
described under schedule 1 of the 2004
Premises Directions.
The Contractor will abide by the provisions
as laid out in the GMS – PREMISES COSTS
(ENGLAND) 2004 directions.
Any works to improve the premises or bring
it up to minimum standards shall meet the
standards provided under the “Primary and
Social Care Premises – Planning and
Design Guidance” and CPCT control of
infection policy guidance. All works must be
discussed and approved with the PCT prior
to any work commencing on site.
Signed lease in place
Signed service level agreement in place.
All necessary equipment and maintenance
contracts in place
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TARGET
The Contractor can evidence the requirements
Agree HoTs without amendment at tender return
The Contractor to agree that payments for pass
through costs as itemised in the service level
agreement are top sliced from their global sum.
POINTS
AREA
REQUIREMENT
TARGET
CONTRACT
MONITORING
Minimum Data Set
Monitoring Meetings
AREA
The Contractor shall submit information relating to
commissioned services in line with the PCTs
Contract Monitoring Booklet detailing information
required and the timescales.
The Contractor shall attend quarterly contract
monitoring meetings convened by the commissioner
and shall provide detailed information as required.
REQUIREMENT
The Contractor submits all information requested
against agreed timsescales
TARGET
PATIENT INVOLVEMENT
Patient Participation
The Contractor shall work with patient sin ways that
foster partnerships and include:
Patient Participation Group
Comments and suggestions box
Work with PALS service
Local complaints process and annual review
Patient survey
Promote Self Care
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The Contractor can evidence all the requirements.
It was agreed that input on some non-clinical aspects of the service specification (non exhaustive list) would fit into the remit of hostel support staff.







provision of basic homeless services - bare essentials (underwear, socks, second hand clothing, start up packs for newly housed);
Social & Housing Assessments/input
Offending issues
Immigration and asylum support
benefits and financial support
Screening and Assessment processes (common tools?)
Escort to secondary care appointments (is this part of this service’s remit?)

Outcome measuring tools
However it was also recognised that hostel support staff may not have the flexibility, expertise or time to offer the support, non clinical staff members of a
specific and targeted service could provide
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6
The Selection Criteria
The following selection criteria show how we will choose from the people who decide to put in a tender to win the contract to provide
the homeless and substance misuse primary care service in Camden. In order to be shortlisted bidders would have to meet all of
the essential criteria listed below. Any organisation or person that puts in a bid to win the contract to provide the homeless and
substance misuse service in Camden will have to submit a large amount of information to show the PCT that they will provide the
right services for this client group. The table shows the plans and documents that the PCT would be looking at when it makes a
decision to give someone the contract. We would like your opinion on whether we are using the right selection criteria and how
important each of these are to you. The selection criteria are set out in the table below.
Area of Service
What the Contractor will need to include
in their bid
What the PCT will use as evidence
that the Contractor would meet the
requirements
The contractor will develop a 3 year plan to show
how it would deliver the range of core services
during the 3 year period of the contract.
The PCT will make sure that the contractor has
submitted a 3 Year Plan covering all the areas
set out in the specification, as part of the
application. The plan must line up with relevant
PCT and DoH plans
The contractor will submit, as part of its 3 Year
Development Plan, an Access Plan dealing with
how it will meet all the requirements of the service
specification, and any potential development during
The PCT will make sure that the contractor has
submitted an Access plan that demonstrates
how they will meet the access targets outlined
in the service specification.
Core Services
3 Year Development Plan
Access
Access Plan
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the period of the contract.
Governance
Clinical Governance Plan
Workforce Development
Plan
Financial Plan
The contractor will submit, as part of its 3 Year
Development Plan, a Clinical Governance Plan
outlining how it will meet all the Clinical Governance
requirements within the specification, and any
development likely during the period of the contract.
The contractor will submit, as part of its 3 Year
Development Plan, a Workforce Development Plan
outlining how it will meet all the workforce
requirements within the specification, and any
development likely during the period of the contract.
The contractor will submit, as part of its 3 Year
Development Plan, a detailed Financial Plan
outlining the contract value (how much they will ask
the PCT to pay) required to deliver all areas of the
specification.
Infrastructure and Contract Monitoring
Information Management
and Technology Plan
The contractor will submit as part of its 3 Year
Development Plan, an Information Management
and Technology Plan outlining how it will meet the
requirements of the specification including
information requirements, and any potential future
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The PCT will make sure that the contractor has
submitted a Clinical Governance Plan that
demonstrates how they will meet the Clinical
Governance requirements under the service
specification.
The PCT will make sure that the contractor has
submitted a Workforce Development Plan that
demonstrates how they will meet the workforce
requirements under the service specification.
This should include a Workforce Utilisation
Plan that shows staff requirements and the
skill mix of the staff.
The PCT will make sure the contractor has
submitted a Financial Plan with clear contract
value outlined.
developments during the period of the contract.
Patient and Public Involvement
Patient Participation Plan
The contractor will submit, as part of its 3 Year
Development Plan, a Patient Participation Plan,
outlining how it will meet the requirements of the
specification and any potential developments over
the period of the contract.
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The PCT will make sure the contractor has
submitted a Patient Participation Plan
demonstrating all aspects of the specification.
7
Glossary of terms
Business Continuity Plan - This is a plan that shows how services would
manage in the event of an emergency for eg. a terrorist attack or pandemic
flu
Cardiovascular Disease - A range of conditions affecting the heart and
circulatory system
Caldicott Guardian - This is a person who takes responsibility for, and
advises on, all issues relating to the sharing of patient information.
Choose and Book - This is the system within general practices that allows
patients to agree which hospital they will be referred to and allows the patient
to book an appointment at that hospital at a time convenient to them
CHD - Coronary heart disease
Community matrons - Community matrons are qualified nurses and other
health care professionals who manage and co-ordinate the care of patients
with long term conditions in the community and at home in order to prevent
illness and admission to hospital
Connecting for health - NHS Connecting for Health, came into operation on
April 1st 2005. It is an agency of the Department of Health. Their purpose is to
deliver the National Programme for IT, and to maintain the national critical
business systems previously provided by the former NHS Information
Authority. It involves the creation of a national spine which would store patient
information from a number of services.
COPD - Chronic obstructive pulmonary disease.
Desmond - This is a an education course for people with Type 2 diabetes to
enable them to understand their condition better and to learn ways to manage
their diabetes.
Directed Enhanced Services (in relation to primary medical services) These are services which relate to the provision of medical services which
are under national direction with national specifications and benchmark pricing
which all PCT’s must commission to cover their relevant population.
Electronic Transfer of Prescriptions - The electronic transfer of
prescriptions from GP practices to pharmacies, will allow some of the new
pharmacy contract Essential Services, such as repeat dispensing to be
carried out more efficiently, by using new advances in technology.
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Enhanced Services (in relation to primary medical services) - These are
services which relate to the provision of medical services and include:
i)
essential or additional services delivered to a higher specified
standard, for example, extended minor surgery
ii)
services not provided through essential or additional services.
These might include more specialised services undertaken by
GPs or nurses with special interests and allied health
professionals and other services at the primary-secondary care
interface. They may also include services addressing specific
local health needs or requirements, and innovative services that
are being piloted and evaluated.
Essential Services (in relation to primary medical services) - These are
services which relate to the provision of medical services and include:
iii)
management of patients who are ill or believe themselves to be
ill, with conditions from which recovery is generally expected, for
the duration of that condition, including relevant health
promotion advice and referral as appropriate, reflecting patient
choice wherever possible
iv)
general management of patients who are terminally ill
v)
management of chronic disease in the manner determined by
the practice, in discussion with the patient
Expert Patient Programme - The Expert Patient Programme (EPP) is a 6
week education course for people with a particular Long Term Medical
Condition and its aim is to enable people to manage their condition as
effectively as possible
Foundation Trusts - NHS Foundation Trusts are a new type of NHS Hospital
tailored to the needs of local populations and run by local managers, staff and
members of the public. The Health and Social Care Act 2003 established NHS
foundation trusts as independent public benefit corporations modeled on cooperative and mutual traditions.
GMS – General Medical Services contract is a national contract for the
provision of primary care services
Healthcare Commission - The Healthcare Commission is a national
organisation that sets standards for all NHS organisations and assesses them
against those standards
Laming Recommendations - Laming recommendations are those that came
out of the enquiry into the death of the child Victoria Climbie and a number of
items relate to general practices.
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Local Enhanced Services (in relation to primary medical service) - These
are enhanced services that are developed locally. The terms and conditions
of these services will be discussed, negotiated and agreed locally between the
PCT and potential practices, providers and with the involvement of the Local
Medical Committee.
LMC - Local medical committee. A statutory representative committee for
general practitioners.
LTC - Long term conditions. Also known as chronic diseases. These are
diseases which are treatable but for which there is no cure eg. diabetes, heart
failure, chronic obstructive pulmonary disease and asthma.
National Enhanced Services (in relation to primary medical services) These are enhanced services which have national specifications and
benchmark pricing but are not directed. These include:
i) intra partum care
ii) anticoagulation monitoring
iii) intra-uterine contraceptive device fitting
iv) more specialised drug and alcohol misuse services
v) more specialised sexual health services
vi) more specialised depression services
vii) multiple sclerosis services
viii)enhanced care of the terminally ill
ix) enhanced care of the homeless
x) enhanced services for people with learning disabilities
xi) immediate care
xii) first response care
xiii)minor injury services
NICE - The National Institute for Clinical Excellence is a special health
authority that promotes the best possible service and effective use of
resources within the NHS. It sets clear national standards to improve the
quality and consistency of NHS services throughout the country.
NSFs - National Service Frameworks. These are set national standards and
define service models for different services or care groups
Out Of Hours
This refers to:
i)
the period beginning at 6.30pm on any day from Monday to
Thursday and ending at 8am on the following day;
ii)
the period between 6.30pm on Friday and 8am on the following
Monday; and
iii)
Good Friday, Christmas Day and Bank Holidays;
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PMS – Personal Medical Services contract is the local alternative to the
nGMS. It gives primary care teams scope to offer innovative ways of meeting
the needs of their local patients and to address inequalities in health care
provision.
Pathology Order - This system enables practices to receive blood results
they have requested from laboratories directly to their practice electronically
Patient Forum – Each PCT must have a patients’ forum which allows local
people to be involved in the work of the PCT. These were established by
Section 15 of the National Health Service Reform and Health Care
Professions Act 2002.
Practice Based Commissioning - This enables groups of practices to work
together to develop new types of services within primary care to enable
patients who may have attended hospital to be cared for in more local settings
Primary Care Trust - Primary Care Trusts bring together GP practices,
nurses and allied health professionals within a geographical area and have a
key role in the commissioning of services for patients
QOF - Quality and Outcomes Framework. This is a framework which supports
the GMS contract. The framework is designed to systematically reward
practices on the basis of the quality of care delivered to patients. The
framework consists of 4 domains which represent clinical disease areas,
organisational aspects of general practice, additional services and patient
experience.
SHA - Strategic Health Authority
TPCT - Teaching Primary Care Trust
TUPE - Transfer of undertakings (protection of employment) (1981)
The Transfer of Undertakings (Protection of Employment) Regulations 1981
(as amended) – commonly known as the TUPE Regulations – safeguard
employees’ rights where businesses change hands between employers.
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8
Feedback Form for Consultation.
Please use this form to give us feedback on the points raised in this
consultation pack. We have suggested some questions or issues below, but
you might want to raise other points here as well. We do ask that you keep
your comments broadly in keeping with the subject of this consultation.
Please return this form by Friday 2nd November 2007. Please feel free to add
additional sheets of paper with your comments if you need to. Thanks for
giving us your views.
About your information.
We respect any wish to be anonymous in responding to this consultation.
However, it’s very helpful to us to know at least something about you, and if
you want us to we will also get back to you after the consultation to let you
know the outcomes.
Name (Optional) _______________________________________________
Address (Optional) _____________________________________________
Phone (Optional) _______________________________________________
Date of Birth (Optional) _________________________________________
Are you responding to this document as: (you may tick more than one box)
A patient
A parent/carer
A member of staff
If you are a member of staff please state your position/job title:
A voluntary agency
A statutory organisation
Other:______________________ Your Postcode ____________________
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Question 1.
Do you believe that the requirements we have in the service specification are
the right ones? (Please bear in mind that a number of the items are nationally
prescribed and therefore the PCT does not have a choice about them).
Question 2.
Are there other requirements you think that are important to have in the
service specification?
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Question 3.
Do you think that the selection criteria that we plan to use are the right ones?
Question 4.
What other criteria do you think we could use? What importance would you
give to these criteria?
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Thank you for taking the time to give us your views. There are several ways
you can respond to the consultation:
Fill in this, and send it to the freepost address below. You do not need to
use a stamp. Our Patient Advice and Liaison service can get you copies in
other languages and formats
You can get this information, and fill in a form on the internet. Go to our
website www.camdenpct.nhs.uk and click on the “Consultation On
Tendering for Homeless and Substance Misuse Primary Care Services
link.
Speak to us – talk to your health worker/keyworker/hostel worker; give
your views and ideas to the person who provides health services to you
Phone us - 020 7530 6315 (Patient Advice & Liaison Service); Minicom no.
020 7530 3186.
Email us - PALS@camdenpct.nhs.uk
Write to us: PALS, Camden PCT, FREEPOST RRCA-BHXE-HUSR,
London NW1 0PE
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