Tweet from the Trust CEO

THE CHALLENGE

In 2005, the Department of Health established a number of nationally funded Local Service Provider contracts for PAS/ EPR (Patient Administration System/Electronic Patient Record) solutions. By 2011, BT was providing a number of London and South Acute NHS Trusts with the Cerner Millennium solution under these arrangements. At this time, DH made clear that it would not provide funding beyond the contract expiry in October
2015, and therefore the Trusts needed to make their own arrangements.

The challenges for the Trusts were significant:

  • The existing contracts were between DH and BT, with service delivery managed by HSCIC – meaning that the trusts had little knowledge of the details underpinning the service that they were receiving
  • The costs of the existing service were understood to be significantly higher than was affordable
  • Undertaking a procurement on this scale would be a ‘once in 10-years’ event for each organisation for which the local teams were not set up, and suppliers would be unable to cope if approached by each trust separately

In early 2011, the Chief Executives of a number of London trusts jointly recognised the issue and commissioned Nautilus Consulting Limited to undertake a strategic options appraisal for how to manage the “2015 problem”.

The objectives were threefold:

  • To ensure continued provision of the Clinical Information services needed to support the delivery of patient care
  • To deliver this service as cost effectively as possible
  • To provide for a solution that is ‘future proof’ – both meeting current needs and providing the ability to extend/ adjust to meet the future needs of the Trusts
THE PROJECT SOLUTION

The review of options identified benefits in pooling resources and establishing a joint procurement programme, and led to the development of a Strategic Outline Case that was presented to the individual Trust Boards. By October 2011, seven Trusts (which subsequently reduced to six after a merger) had formally agreed to collaborate “for as long as it remained advantageous to each trust to do so”, and the London Acute 2015 Procurement
Programme was formed.

The procurement approach was to maximise the buying power of the combined organisations, and drive cost-efficiency in the procurement process by establishing framework contracts; and then enabling each Trust to undertake its own Call Off minicompetition quickly and easily. The services were divided into 3 Lots to drive competition (particularly in areas away from the expertise of the incumbent provider):

Lot 1: Integrated PAS / EPR

Software & Services

Full range of administrative and clinical functionality

‘Integrated’

Catalogue of ‘modules’

Cerner
Epic
InterSystems

Lot 2: Clinical & Patient Portal

Software & Services

Integration capability to wide range of Trust solutions

Highly configurable (by Trust) front end

Over nww and www

Harris
Logica
Orion

Lot 3: Hosting

Vanilla application hosting capability

Extensible beyond Lot 1 and Lot 2

 

 

 

Capita
Cerner
HP

Once the Framework contracts were in place, the Trusts each put in place individual Call-Off contracts to address the scope of services that they had deployed, aligned to their timetable for exiting the LSP programme.

Nautilus led the programme from start to finish:

Engaging at CEO and CIO level to identify options, define the strategy and develop the plan;

Managing the joint programme to establish the framework, including:

  • Project management of the procurement process, including bidder communications, record keeping, organisation of evaluation, demo events, site visits etc.
  • Defining detailed functional and non-functional requirements
  • Liaising with HSCIC/DH to ensure input about the existing solution and to assess transition risks (e.g. TUPE)
  • Appointing and working with legal advisors to develop arobust solution-specific set of contract documentation
  • Leading final contract negotiations on behalf of the Trusts with the 8 suppliers
  • Supporting trust governance through management of the CEO and CIO Forum meetings

Supporting each Trust through its Call Off processes, including:

  • Preparation of the Trust’s Outline and Full Business Cases (including support for Board, NHS TDA and Monitor approval)
  • Design and execution of the mini-competition process and Trust evaluation metrics to drive quick and effective procurement
  • Identification of the Trust’s local requirements – scope, roadmap and any special needs
  • Detailed advice on contractual options and operationalising the service management regime

And, now following Call Off contract award, Nautilus remains involved:

  • Providing commercial and contractual advice with respect to Contract Changes
  • Project managing transition projects and the set up of new service management arrangements
THE OUTCOME

The results from the London Acute 2015 Programme were:

  • A robust, challenge-free and competitive procurement that enabled Trusts to establish their own Call Off contracts
  • All six London Trusts plus two further South Trusts have agreed contracts that secure exit before the current contract expiry
  • A consistent solution and approach driving cost savings of 40-50% for the core PAS/EPR; and maximum prices were fixed for a wide range of additional services
    A number of key improvements in service provision were included in the final contracts
  • Continuing collaboration between the Trusts to share lessons and better manage common suppliers

Nautilus has a wealth of experience, expertise and a proven track record of assisting Trusts to navigate the procurement, transition and deployment of Healthcare IT solutions. We have created valuable collateral that can take a Trust through procurement to deployment, including:

  • Targeted procurement documents (OJEU Notices, PQQ, ITT)
  • Acute PAS/EPR output based specification
  • Cost and benefits models (related to key solutions)
  • Evaluation approach, metrics and templates (including for evaluated demonstrations)
  • PAS/EPR business case templates and content (aligned to the 5-case model)

As a result, Nautilus is able to deliver accelerated, assured PAS/ EPR procurements.

download the full case study