Any Qualified Provider (AQP) Elective Surgery Services Cheshire & Merseyside Commissioning Support Unit on behalf of NHS South Cheshire and NHS Vale Royal CCG’s, Halton CCG, Warrington CCG, East Cheshire CCG, South Sefton CCG, Southport and Formby CCG and Liverpool CCG. Reference: CMCSU 14/001/A Document 3: AQP Qualification Questionnaire Guidance Notes Page 1 of 20 Working Smarter for Better Health Table of Contents Section 1 – Introduction 1. Purpose 2. Instructions and Guidance for Completion 3. Qualification Submission Clarification 4. Qualification Timetable 5. Use of the Delta eSourcing Portal 3 3 3 4 4 Section 2 - Assessment Criteria 1. Introduction 2. Assessment 3 Service Delivery 4. Assessment of Financial Statements 5 5 7 19 Page 2 of 20 Working Smarter for Better Health SECTION 1 – INTRODUCTION 1. Purpose 1.1. The purpose of this document is to provide information and instructions to allow Potential Providers to submit a response for qualification to deliver Acute Elective Surgery using the Any Qualified Provider (AQP) process. 2. Instructions and Guidance for Completion 2.1 Where a specific response is required it must be submitted in the box provided. 2.2 All judgements are made solely on the information provided in the submission, so please take care to ensure that full answers are provided where called for. This is particularly important to note if you are known to or have had past or current relationships with the Contracting Authority as prior knowledge cannot be used to assess the documentation. 2.3 There are assessment criteria of Pass/Fail which will be applied to the Service Delivery and Legal sections of the qualification document. A detailed criterion is available in Section 3 Service Delivery and Financial Assessment Criteria. 3. Qualification Submission Clarification 3.1 Cheshire & Merseyside CSU and the Contracting Authorities reserve the right to request Potential Providers to clarify any part of their qualification response. Any requests for clarification will be issued via the Delta eSourcing Portal. Potential Providers are encouraged to check the website regularly during the process as failure to respond may result in your submission not been qualified. When a question has been raised by the assessment team the provider will be sent an email detailing the question raised. Providers will have 48 hours to respond to the query. 3.2 If the Potential Provider fails to provide an adequate response to one or more points of clarification, or fails to respond in a timely manner, the Potential Provider may be excluded from progressing further in the process. 4. Qualification Timetable 4.1 Table 1 is the timetable for the qualification process. This is intended as a guide and whilst Cheshire & Merseyside CSU does not intend to depart from the timetable it reserves the right to do so at any time. Page 3 of 20 Working Smarter for Better Health Table 1 Stage Dates Any Qualified Provider (AQP) questionnaire Fri 20th June, 2014 published on Delta eSourcing Portal AQP Provider Clarification Questions Final Date for Request for Information AQP submissions must be completed Fri 11th July, 2014 Assessment of submissions Mon 21st July-Mon 11th Aug, 2014 Providers notified of qualification Thu 4th Sept, 2014 (Dependent on availability of Board for sign-off) 1st October, 2104 Contract Award Contract Mobilisation Service Commencement 5. Fri 18th July, 2014 October, 2104 Providers will be given a 3 month window in which to commence service ie by 1st January, 2015 Use of the Delta eSourcing Portal 5.1 Bidders must note that any communication in relation to this tender must be made via the Delta eSourcing suite. Under no circumstances should any other form of contact be used to engage with CMCSU or CCG staff. 5.2 Bidders are reminded that you have free access to a range of advisory services within the Delta eSourcing suite. Particular reference must be made to the user guide” Response Manager” to ensure full understanding of the PQQ/ITT response procedure. Telephone access to the Delta e Sourcing helpdesk is also available by ringing 0845 270 7050. 5.3 Within the “Response Manager Guide please refer to “Responding to an opportunity – Three Stage Process” which clearly explains the process to be followed from downloading the ITT documents, preparation of response and response submission. Remember: a. Familiarise yourself with the Delta e Sourcing Suite and the Supplier user guides once you have registered and created a supplier profile. b. Always give yourself adequate time to upload your ITT response. Do not wait until the last minute. Failure to submit your response in line with the closure time and date may result in your response being deemed un-acceptable and unable to be considered. c. Ensure that you follow the procedure for submitting your response, ensuring that you click on the “Submit Response” button. This action will generate a pop up message. Page 4 of 20 Working Smarter for Better Health SECTION 2 ASSESSMENT CRITERIA 1. Introduction Please note that it is a mandatory requirement to respond to every question on the qualification form. In order to qualify for the Any Qualified Provider (AQP) process all questions with assessment criteria of pass/fail must be assessed as a pass. 1.1 In securing services from providers using the (AQP) model, NHS commissioners need assurance of competence, quality and safety. This process aims to ensure that appropriate information is gathered from providers for the relevant sections of the qualification form for this assurance to be secured. This document sets out the criteria against which providers will be assessed after completing the on-line form. 1.2 2. Assessment 2.1 2.2 Table 2 shows how each of the questions will be assessed. Some of the responses required are for information purposes only; others have a pass/fail element to them. Table 2 Section Requirement Required Response Section 1: Offer Details 1.1 Declarations 1.1.1 Service lines/Locality – For information Positive 1.1.2 Confirmation of relevant policies 1.1.3 Pricing model confirmation 1.2 NHS Standard Contract 1.2.1 Agreement to terms of NHS Standard Contract 1.3 Financial 1.3.1 Consent to credit reference 1.3.2 Confirmation of 1.3.2 Section 2: Address 2.1.1 Applicants representatives details 2.2.1 Organisation’s legal entity name & address 2.3.1 Parent organisation 2.3.2 Parent organisation – name & address 2.4 Premises for Service Delivery 2.4.1 Mobile facilities 2.4.2 Percentage of mobile delivery 2.4.3 Premises – address details Assessment Tick as Appropriate Pass/Fail Pass/Fail Positive Pass/Fail Positive Pass/Fail Pass/Fail Information provided Information provided For Information For Information For Information For Information Page 5 of 20 Working Smarter for Better Health Section 3: Organisation 3.1 Organisation Category 3.1.1 Organisation category (one of the following can For Information be selected) Information 3.1.2 Company Registration Number provided For Information 3.1.3 SME For Information 3.1.3 Charitable organisation For Information 3.2 Incorporated Organisation 3.2.1 Registered Name For Information 3.2.2 Trading Name For Information Information 3.2.3 Previous Name (if applicable) For Information Provided (if 3.2.4 Companies House Registered Number For Information applicable) 3.2.5 Date of Incorporation For Information 3.2.6 Country of Registration For Information 3.3 Consortium / Partnership Arrangements 3.3.1 Your Organisation is bidding to provide goods For Information and/or services required itself 3.3.2 Your Organisation is bidding in the role of Prime For Information Contractor and intends to use third parties to provide some of the goods and/or services Information Provided 3.3.3 The applicant is a Consortium or Special Purpose For Information Vehicle 3.3.4 If the applicant is a Consortium or Special For Information Purpose Vehicle please provide further details here 3.4 Proportion of Contract Sub Contracted or Provided by a Third Party (to be completed if you answered Yes to 3.3.2) 3.4.1 Organisation Name For Information 3.4.2 Element of the service they will deliver Information For Information provided (if For Information 3.4.3 Proportion of the total requirement you propose applicable) they will directly deliver (%) 3.4.4 Composition and Governance of the Supply For Information Chain. Section 4: Licence and Regulations 4.1 NHS Provider Licence 4.1.1 Organisation requires NHS provider licence Information For Information provided (if For Information 4.1.2 NHS provider licence details applicable) 4.1.3 NHS provider status details For Information 4.2 CQC Registration 4.2.1 CQC registration 4.2.2-4.2.9 CQC registration details 4.2.10 CQC Documentation 4.3 Staffing Licences 4.3.1 Does the applicant have staff in place to deliver the service 4.3.2 If you have answered "Yes" to question 4.3.1 please provide details of the staff and their Information provided Information provided (if applicable) For Information Pass/Fail For Information For Information Pass/Fail Page 6 of 20 Working Smarter for Better Health relevant licence/qualification. Please provide the Staff Name; Licence/Qualification; Registration Number; and Primary Location. 4.3.3 If you have answered "No" to question 4.3.1, please provide details of staff recruitment will be carried out Section 5: Service Delivery 5.1 Details of Previous/Current Contracts (up to 3 contracts of similar type) 5.2 Service delivery 5.3 Care pathway 5.4 Local services 5.5 Local agreements 5.6 Clinical governance 5.7 Innovation 5.8 5.9 Staff Additional local questions Section 6: IM&T 6.1 IM&T system compliance 6.2 System status 6.3 NHS email account 6.4 Local IM&T requirements 6.5 Data Protection Act Section 7: Legal 7.1 Financial Accounts 7.2 Insurance Information 7.3 Clinical Negligence Scheme for Trusts (CNST) Section 8: Document Upload Area 8.1 Document Upload Area Section 9: Declarations 9.1 Confirmation of clinicians delivery 9.2 9.3 Litigation and Regulatory Declarations Final declaration Pass/Fail Information provided Meets assessment criteria Information provided (if applicable) Meets assessment criteria Compliant Compliant For Information Compliant (if applicable) Compliant Information Provided For Information Pass/Fail Pass/Fail Pass/Fail Pass/Fail Pass/Fail For Information Pass/Fail Pass/Fail Pass/Fail Pass/Fail For Information Pass/Fail Pass/Fail Pass/Fail Pass/Fail For Information Information Provided For Information Meets assessment criteria Compliant Information provided Pass/Fail Pass/Fail Pass/Fail Page 7 of 20 Working Smarter for Better Health 2.3 Each section of the form will be assessed individually and a fail on one or more sections will result in an overall fail. 2.4 Table 4 shows the questions that will be asked on the on-line form and the bullet points give an indication of the areas that the commissioner expects the provider to cover in their response, providing evidence and examples where appropriate. 2.5 Each bid will be divided up into the sections listed in Table 2 and will be allocated and distributed to different members of the evaluation panel. The members of the evaluation panel will only review and score the particular section relevant to their expertise and will not necessarily review the entire tender submission. 2.6 Each member of the evaluation panel will independently score each bid submission using the scoring principles listed in Table 3 2.7 A moderation meeting will then be held where the evaluation panel will convene to review and agree scores for questions where more than one evaluation panel member has evaluated the response. The aim of the moderation meeting is for evaluation panel members to agree on and produce a pass or fail score for each question response based on the scoring principles listed in Table 3. Table 3 Assessment Criteria Question not answered or there is some information missing. The response does not meet the full criteria and there is limited information provided or an answer that largely fails to address the question or that is flawed in aspects. There are significant gaps and no evidence that issues will be addressed and or managed in line with expectations and the standards required. A comprehensive answer to the question in terms of detail, accuracy and relevance. A good degree of evidence to show the Bidder’s ability to achieve what is stated within the response and achieves the required standard of delivery. Result Fail Pass Page 8 of 20 Working Smarter for Better Health 3. Service Delivery 3.1 Section 5 of the on-line form; Service Delivery will be assessed using the assessment criteria as detailed in table 2 and will cover the following areas: 5.2 - Service Experience 5.3 - Care Pathway 5.4 - Local Services 5.5 - Local Agreements 5.6 - Clinical Governance 5.8 - Staff 5.9 - Additional Local Questions 3.2 The Service Delivery questions will be assessed on an individual basis by members of an assessment team against the published criteria. 3.3 Following independent assessments there will be an assessment meeting to discuss responses and to agree whether a Potential Provider’s submission can be qualified. 3.4 Providers are advised to pay particular attention to the bulleted points following the questions that indicate to providers what commissioners are looking for in response to these questions. 3.5 Please note that 5.1 - Contracts and 5.7 - Innovation sections of the Service Delivery section of the on-line form is for information only and will not be assessed using the assessment criteria in table 2. 3.6 It should be noted that those questions that have a word count and applicants are required to use these word counts as the maximum number of accepted words. Any words provided above this word count will not be evaluated by the evaluation panel. Page 9 of 20 Working Smarter for Better Health Table 4 5.2 Service Delivery (Pass/Fail) 5.2.1 With reference to the offer documentation please describe the experience you have of delivering this service and how you intend to deliver this service for the duration of the contract. Word count: 2000 words You are expected to provide full details of your ability to deliver the Acute Elective Surgery for the duration of the AQP qualification period of 3 years. Your response should include but not be limited to details of how you will: Meet the expected outcomes of the service. Use Choose & Book to manage referrals Meet the information reporting and quality requirements – outlining data collection tools, storage, presentation of information to the commissioner. Market/promote service to stakeholders, including an outline of who the key stakeholders will be in relation to delivering this service, and how this will be separate to any private service provision marketing (where relevant). Ensure business continuity and submit any plans to demonstrate your answer e.g. a management plan or operational policy. Gather patient and peer feedback/experience and how you intend to use the information to improve quality. Engage with the commissioner when new guidance is implemented, in advance of any pathway changes that would materially change the service model. Ensure that service provision under this contract is for NHS services and how you will ensure a clear distinction is in place for managing private patients (where relevant). How you intend to work with other organisations to support patients in the management of their Acute Elective Surgery needs. Include evidence of how benefits of treatment and implications are explained to the patient. Show how review periods are set based upon patient's condition and how follow-up appointments are scheduled Include in particular the emergency referral procedures for patients with diabetes, ulceration or infection Indicate how patients contact the service in an emergency, including the emergency out of hour’s protocol. Describe your process for obtaining diagnostic tests e.g. blood tests, x rays, diagnostic ultrasound etc. Describe your approach to ensure that the clinical environment is safe, secure and suitable for clinical practice. Describe your process to ensure that patients receive appropriate health education and information related to their condition and current risk status. Indication of signposting to services out of scope of this service where clinically appropriate e.g. smoking cessation or weight management, examples of patient information leaflets e.g. diabetes, orthoses, etc. Describe how the advice is tailored to suit the individual’s needs (e.g. Leaflets in simple language, verbal/printed advice, speech recognition software etc.) Description of how clinical outcomes are measured and evaluated. Page 10 of 20 Working Smarter for Better Health Please illustrate your answers with any relevant past experiences where appropriate. 5.3 Care Pathway (Pass/Fail) 5.3.1.1 With reference to the offer documentation please provide details of your care pathway – particularly a description of how you will integrate with local health services to deliver your care pathway. Word count: 2000 words You are expected to detail how you would deliver all the required elements of the 3 year pathway to patients, from referral to discharge, including the annual aftercare for those patients at the end of their individual 3 year pathway. Your response should include but not be limited to details of the: Assessment process – including methods of communicating with patients; outcome measures to be used; management options to be offered to patients; individual management plan details; data recording process. Fitting process – including the option of one stage assess and fit and how this is offered to patients; equipment available to patients and how equipment is sourced and managed; patient education. Discharge process. How choice is offered. Review process – any re-call process; and discharge process. Indicate how links are made to appropriate referral pathways when necessary and highlight seamless integration with the health economy and other local health providers Show how care pathways are linked to NICE guidelines (where they exist), particularly in respect to : NICE Clinical Guidelines 10 for the prevention and management of foot disease in people with diabetes and for patients suffering from rheumatoid arthritis Page 11 of 20 Working Smarter for Better Health 5.3.2 Please provide proposals on how you intend to provide follow-up care where appropriate. The response should include the timings, frequency and nature of the follow-up. Word count: 2500 words You are expected to detail how you intend to deliver any necessary follow-up care. If it is not to be delivered by you please indicate how you will ensure the care is delivered. Your response should include but not be limited to details of: How patients can access follow-up and aftercare. Referral process back to GP for any on-going aftercare and process for referral back to GP for re-assessment when needed. How you intend to facilitate movement of patients between providers who are on an existing aftercare pathway, i.e. Diabetes rheumatoid arthritis etc 5.4 Local services (Pass/Fail) 5.4.1 Please describe how you intend to work with local Health and Social Care services, including referral and emergency protocols where necessary. Word count: 2500 words Here you should detail how you intend to work with other local health providers to ensure that your patients receive the best possible care, including referral pathways, should they require further treatment that you cannot provide yourself and emergency protocols where relevant. You are expected to provide the referral process you will undertake, including timescales, to include but not be limited to, how you will manage: Acceptance criteria Exclusions Rejections Discharge points Incomplete assessments Referrals assessed as urgent How you will engage with stakeholders in the management of the referral process You should also use this section to describe your approach to enable data sharing with local stakeholders to ensure continuity of care. Include recognition, understanding and compliance with information governance requirements. Page 12 of 20 Working Smarter for Better Health 5.5 Local Agreements (Pass/Fail) 5.5.1 With reference to the AQP offer documentation please detail any local agreements or contracts that are currently in place. Word count: 1500 words Please detail any sub-contracting arrangements (if using) for any part of the pathway, detailing which elements of the service will be sub-contracted, to whom, and how you will ensure subcontractors are fully compliant with the service model and associated quality and safety requirements. The management process of the contracting lead should be fully explained. Describe how you will work with any sub-contractors, where approved by the contracting commissioners or the provision of Acute Elective Surgery. If you have no experience of using sub contract provision , please demonstrate how you will ensure that appropriate systems and processes are in place to ensure any sub contract provision are capable and competent to deliver the service. Detail any other local agreements or contracts that you have in place that you think are relevant to mention. 5.6 Clinical Governance (Pass/Fail) 5.6.1 Enter the name of your clinical governance lead (CGL). Please include details of their position held and email contact: 5.6.2 Describe the clinical governance process that you have in place. Word count: 2000 words Your response should include but not be limited to details of: Evidence of governance organisational structures, meetings and relevant terms of reference for these meetings Standard operating procedures and evidence of implementation of these Governance Training and how training requirements, including refresher training is managed Continual review of service provision and acting upon any issues Evidence of how risk is managed within the organisation including implementation of risk management policies/processes and how organisational risks are monitored, reviewed and managed by the organisation, from board level down to operational staff level Implementation of risk assessment processes and on-going management of risks. Evidence of how clinical governance systems and processes are implemented in practice throughout the organisation including provision of any relevant examples. Steps you take to ensure that staff work within their scope of practice and hold appropriate qualifications and professional indemnity insurance to support the service. Evidence that your processes fulfil the requirements of Caldicott principles and the Data Protection Act Data Protection number Details of staff training in accordance with Caldicott guidance An outline of the use and storage and transfer of patient records and the appropriate destroying of out of date patient records, including audit processes. An outline of the use, storage and transfer of patient records. Describe how patient confidentiality is maintained Page 13 of 20 Working Smarter for Better Health 5.6.3 Describe how you deal with clinical incident reporting. Word count: 1500 words Your response should include but not be limited to details of: Compliance with National Patient Safety Agency (NPSA) guidance. Details of what clinical audit processes are implemented and outcomes fed into making service improvements. Evidence of incident reporting systems and processes Information as to how lessons learnt are reviewed, themes identified and shared across the organisation Information as to how the organisation promotes an open reporting culture including provision of any relevant examples Compliance with National Reporting and Learning Service (NRLS) reporting Implementation of processes to manage Serious Untoward Incidents, including reporting, investigation and action planning following these 5.6.4 Please describe how your practitioners will deal with immediate critical incidents. Word count: 500 words Your response should include but not be limited to details of: Emergency protocols Training How critical incidents are reported, managed by the organisation, lessons are learnt from these and how any communication/media interest is managed by the organisation Staff support following a critical incident 5.6.5 Describe how you manage your Health and Safety policy and procedures? Word count: 500 words Your response should include but not be limited to: Your answer must include a copy of the written Health and Safety policy. It should also cover: How staff are made aware of the policy and trained in Health and Safety issue. How accidents, incidents and near misses are reported and audited. Awareness of and compliance with Reporting Injuries, Diseases and Dangerous Occurrences Regulations Awareness of National Patients Safety Agency Reporting and Learning System and National Patient Safety alerts How compliance with the Control of Substances Hazardous to Health (COSHH) Regulations is ensured (please provide evidence) Health and Safety rules that ensure the safety of patients, visitors and persons working within the practice including vulnerable adults Review of the policy - how often is this undertaken? By whom? How staff are trained in the safety aspects of their particular role, including fire training? How the practice complies with the First Aid at Work Regulations? Account of risk assessments undertaken, with particular reference to the needs of vulnerable adults and compliance with the Disability Discrimination Act 1995 Details of the secure storage of chemicals, gas cylinders and other hazardous materials Details of the training given to staff for operating equipment and the maintenance arrangements thereof Page 14 of 20 Working Smarter for Better Health 5.6.6 Describe how you manage your infection control policy. Word count: 500 words Your response should include but not be limited to a copy of the written infection control policy and also give reference to: How the Infection Control policy complies with current NICE guidelines The policies and procedures in place to ensure compliance with the infection control policy Details of staff training undertaken to ensure they have the knowledge and skills and equipment to comply with the Infection Control Policy Review of the policy - how often is this undertaken? By whom? 5.6.7 Describe how you manage your decontamination policy. Word count: 500 words Your response should reflect how your decontamination policy is in line with local or professional guidelines and also give reference to: Disposal processes for single use instruments Decontamination processes of reusable instruments in accordance with professional body guidelines on decontamination of instruments in primary care Safety checks and servicing of any decontamination equipment Review of the decontamination process to ensure safe systems of work and continued compliance to guidelines. 5.6.8 Please detail your process for disposal of clinical and other waste. Word count: 500 words Your response should include but not be limited to: Details of the storage, collection and transfer of clinical waste Details of compliance with the Duty of Care of disposal of all waste, including the disposal of clinical waste, medicines and chemical waste Details of clinical waste disposal, in accordance with national and local guidelines on the disposal of clinical waste? 5.6.9 Describe the procedures in place to ensure safe use of local anaesthesia. Word count: 500 words Your response should include but not be limited to: Health Professions Council registration number with local anaesthesia Training and on-going continued professional development (CPD) arrangements for podiatrists who may administer local anaesthetic Describe the procedures in place for dealing with clinical emergencies, including staff training Clinical support available when procedures requiring local anaesthesia are undertaken. Page 15 of 20 Working Smarter for Better Health 5.7 Innovation 5.7.1 Applicants should submit details of any innovation in service delivery you intend to provide not mentioned in the requirements that may add value to the patient. If you have not specifically mentioned a service innovation already in section 5.3, then enter details here. You may include diagrams, which can be inserted or copy/pasted into the online form. 5.8 Staff (Pass/Fail) 5.8.1 Please confirm that all applicable staff have obtained the relevant Disclosure and Barring Service (DBS) checks or vetting procedures prior to providing the services 5.8.2 Please describe how you will ensure that your workforce maintains appropriate levels of continuous development. Word count: 2000 words You are expected to provide details of how you will ensure your staff are appropriately trained, registered and qualified over the period of the AQP offer. Your response should include but not be limited to details of: Staffing model and operational structure: to demonstrate skill mix, staff profiles, skills/experience, roles and responsibilities, accountability and reporting arrangements. Recruitment policy – pre-employment checks, induction process etc. Equality and anti-discrimination policy and your approach to current equality and antidiscrimination legislation. Mobilisation of staff – recruitment strategy. Process for monitoring qualifications and registrations of staff (including details of which registered bodies) and how re-validations will be managed. Details of supervision, training, qualifications and experience of staff to whom care is delegated Process for monitoring training, identification of training needs and provision of continuous professional development (CPD). Process for ensuring staffs maintain clinical knowledge and follow up-to-date national standards and best practice guidelines. Proposals on how staffing gaps will be covered in the event of unexpected sickness or annual leave. Procedure for management of performance and conduct of staff. How you plan to offer and manage student placements. How the training and clinical competence of the person to whom treatment is delegated is ensured Mentoring arrangements for newly qualified staff (Where the practice provides clinical placements) the instructions provided to practitioners involved in clinical training and the supervision of students Insurance provision for support staff and students. Accessibility for disabled staff. If your service model is to use sub-contractors for any part, details of the above must be explicitly provided for all sub-contractors. Page 16 of 20 Working Smarter for Better Health 5.8.2 Describe how you demonstrate compliance with the Public Sector Equality Duty Act. Word count: 1000 words Individuals have the right to quality health care regardless of personal circumstances. You are expected to describe your experience of working with a population of patients with diverse needs including sensitivities to age, gender, ethnicity, religion, sexuality and disability. The following links provide additional information on the Public Sector Equality Duty Act: http://www.equalityhumanrights.com/advice-and-guidance/public-sectorequalityduty/ http://www.equalityhumanrights.com/advice-and-guidance/public-sector-equalityduty/introduction-to-the-equality-duty/ http://www.equalityhumanrights.com/uploaded_files/EqualityAct/PSED/essential _guide_update.doc Your response should include reference to the following key areas and outline the exercise of functions to have due regard to the need to: Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act. Advance equality of opportunity between people who share a protected characteristic* and those who do not. Foster good relations between people who share a protected characteristic* and those who do not. These are often referred to as the three aims of the general equality duty. In addition you should explain how you would also address the following: Remove or minimise disadvantages suffered by people due to their protected characteristics*. Take steps to meet the needs of people with certain protected characteristics* where these are different from the needs of other people. Encourage people with certain protected characteristics* to participate in public life or in other activities where their participation is disproportionately low. * Explanation of protected characteristics can be located using the hyperlinks above. Page 17 of 20 Working Smarter for Better Health 5.9 Additional Local Questions (Pass/Fail) Local Question 1: Location of Service Delivery and Patient Engagement Please describe how you are going to deliver against the location requirements set out in the Service Specification detailing how will you ensure the service is accessible to all those who may require the service. Please outline in your response how you will ensure that your service has a patient centred approach in terms of both care and service improvement. Maximum word count: 1000 words Your response should include but not be limited to: Recognition of the population demographics and an understanding of the geographical boundaries Clear description of how you will meet the population needs for the periphery areas Recognition of access and transport issues for chosen venues Detail of service provision across each locality, balancing continuity of service availability for patients with alternating am/pm/weekend provisions in each locality Demonstrate how service provision in each locality will still meet the desired timescales and waiting times Use patient feedback and dialogue in an active way of improving your services Ensure that patients are assisted as much as possible to support their own care through information, advice and other means of support Have systems in place that put the patients at the centre of their care whilst receiving care from your service Are able to respond to a wide variety of patient needs either due to differences in the patients or their health needs Local Question 2: Mobilisation Please provide a detailed plan (including timescales) of how you will mobilise the service and include how you will interface with existing providers? Maximum word count: 2000 words Your response should include but not be limited to details of: Actions and timescales should be outlined for the following to demonstrate ability to deliver the service at service commencement:; Premises – including compliance with any relevant standards. Equipment – including any relevant maintenance and contamination issues. Workforce – checks, training plans and staffing plans. Marketing strategy. Policies and procedures – equality, health and safety, governance, workforce. IM&T – including Choose and Book and reporting mechanisms Engagement with referring GPs and related local services. Local Question 3: IM&T Information Management &Technology (IM&T) and Governance Please describe how you will meet the Information Management & Technology (IM&T) and Governance Requirements set out in the IM&T Section in the Service Specification? Maximum word count: 2000 words Page 18 of 20 Working Smarter for Better Health 4. Assessment of Financial Statements This assessment is carried out in relation to Question 7.1 from the Legal Section of the online qualification form. This is based on an assessment of the last three years full sets of financial statements submitted by potential providers. Information from the financial statements will be used to perform the calculations below will be scored using a scale of 0 to 5, in accordance with the Scoring Matrix shown in Table 5. 4.1 Liquidity 4.1.1 Liquidity is assessed using the average score of the following three calculations: 4.1.1.1 4.1.1.2 4.1.1.3 4.2 Current Ratio: Current Assets (inc. Stock) divided by Current Liabilities; Creditor Days: Creditors Due within 1 Year divided by Cost of Sales, multiplied by 365; Net Assets: Total Assets less Total Liabilities. Debt 4.2.1 Debt is assessed using the average score of the following two calculations: 4.2.1.1 4.2.1.2 4.3 Capital Gearing Ratio: Long Term Liabilities divided by (Shareholders Funds plus Long Term Liabilities), with the resulting answer multiplied by 100 to generate a percentage. Interest Cover: Operating Profit divided by Interest Payable. Profitability 4.3.1 Profitability is assessed using the average score of the following two calculations: 4.4 4.3.1.1 Return on Capital Employed: Operating Profit divided by (Shareholders Funds plus Long Term Liabilities), with the resulting answer multiplied by 100 to generate a percentage. 4.3.1.2 Net Profit Margin: Net Profit before Taxation divided by Turnover, with the resulting answer multiplied by 100 to generate a percentage. Scoring 4.4.1 Each of the calculations above will be scored using a scale of 0 to 5, in accordance with the scoring matrix in Table 5 of this document; these scores will be used in conjunction with assessing the credit checks. In addition to this, scores will also be used to “test” the financial stability of a provider by collating scores from each area and reworking as an average. 4.4.2 The average score from each of the three areas will then be divided by 2 to give a total score out of 7.5 for each of the three financial periods. Page 19 of 20 Working Smarter for Better Health 4.5 Credit Checks 4.5.1 Credit checks will be carried out using Dun & Bradstreet (or similar) reports based on the information provided in the qualification form. Failure to provide full details to allow credit checks to be undertaken may result in a fail leading to disqualification of the submission. 4.5.2 Credit reports will be assessed as follows 4.5.2.1 Potential Providers that are identified as having an “A+”, “A”, or “B”, credit score will pass subject to achieving no more than two scores of 0 across the measures used to assess financial statements (see Assessment of Financial Statements). An “A+”, “A”, or “B”, credit score with three or more scores of 0 across the measures used to assess the financial statements may fail, subject to financial stability check. 4.5.2.2 Potential Providers that are identified as having a “C” credit score will pass subject to achieving no more than one score of 0 across the measures used to assess financial statements (see Assessment of Financial Statements). A “C” credit score with two or more scores of 0 across the measures used to assess the financial statements may fail, subject to financial stability check. 4.5.2.3 Potential Providers that are identified as having a “D” credit score or lower and have not demonstrated financial stability will be determined as high risk and will be failed at this point without further assessment of financial statements. A Potential Provider will automatically fail if a credit check confirms they are an undischarged bankrupt or is party to an IVA. 4.6 Financial Stability Check 4.6.1 Scores taken from assessments of financial statements will also be used to test the financial stability by collating scores from each area and reworking as an average. The average score from each of the four areas will then be divided by 2 to give a total score out of 7.5 for each of the three financial periods. 4.6.2 Finally, a percentage is applied to each period in order to give weighting to the financial statements which are most current. A weighting of 50% is applied to the most recent set, 30% for the next set and 20% for the oldest set, giving one final score out of 7.5. 4.6.3 The results from the financial stability check will be considered in conjunction with the credit check results by the Contracting Authorities who will allocate a pass or fail. A fail will result in the potential provider taking no further part in the qualification process. Table 5 Score Current Ratio 5 >3:1 4 2:1<3:1 3 1.5:1<2:1 2 1:1<1.5:1 1 0.8:1<1:1 0 <0.8:1 Creditor Days <30 30<45 45<60 60<90 90<120 >120 Net Assets >£1m £0.5M < £1m £0.25m <£0.5m £0.1m< £0.25m £0 < £0.1m <£0m Gearing Capital <10% 10< 25% 25<50% 50<75% 75<100% >100% Interest Cover >3:1 2:1<3:1 1.5:1<2:1 1:1<1.5:1 0.8:1<1:1 <0.8:1 ROCE > 15% 10% < 15% 5% < 10% 2% < 5% 0% < 2% < 0% Net Profit margin > 15% 10% < 15% 5% < 10% 2% < 5% 0% < 2% < 0% Page 20 of 20 Working Smarter for Better Health