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Procurement

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Title: Procurement


1
Procurement Approvals Complexities for Primary
Care Developments
  • George Murdoch, Nexus Consulting
  • Howard Forster, EC Harris
  • Manchester 14 February 2003

2
Distinguish between
  • perceptions actual barriers
  • approvals procurement
  • brief specification
  • project sponsor covenant
  • capital revenue requirements
  • project viability risk transfer

3
Approvals tools
  • concept of subsidiarity
  • PCT-approvals for GP-led
  • optimising surgery areas
  • StHA approvals for PCT-led
  • fast-track, short-form BC?
  • services premises diffs.
  • Using GMS mirror for PMS

4
Procurement (non Lift)
  • PCT-led schemes invoke PFI
  • GP-led schemes do not
  • GP-led can include PCT
  • OJEU applies to PCT-led schemes 3.2m (
    gtGP-led?)
  • Accounting tax treatment
  • Land ownership in long term

5
Questions being asked..
  • What form of lease for GPs?
  • Will PCT accept assignment?
  • Affect of HBN36e on cost?
  • Will DVO rents reflect cost?
  • How to set up salaried PMS?
  • Impact of new GP Contract?
  • of PCT commissioning?

6
Identifying Projects
  • Develop GP-champions
  • PCT facilitation (eg FW)
  • Capacity constraint driver
  • Service priority push
  • Maintain location access
  • Site availability ( cost)
  • Who is the covenant?

7
Form Function
  • Clinical output specs
  • Operational policies
  • Functional relationships
  • Malleability essential
  • Life cycle costings
  • Energy burden (eg CCL)
  • Patient journey / design

8
Pyramid concept
  • SERVICE MIX

9
Building the pyramid 1
  • Core surgery services for General Practice forms
    baseline bottom layer.

10
Building the pyramid 2
  • Services delivered by Practices in partnership
    with PCT, Community, NHS Trusts come next.

11
Building the pyramid 3
  • Secondary care, outpatient, treatment
    diagnostic on top

12
Procuring the pyramid
  • Maintain locality focus
  • Start with base layer matrix
  • Then build upper layers
  • Embed as much as possible into General Practice
  • Distinguish between surgery non-surgery parts
  • Maintain deliverability.

13
Back to the pyramid
  • Start with General Practice
  • Optimise surgery areas
  • Then PCT/other covenants
  • Secure required approvals use parallel
    processes
  • Keep GPs on board
  • Select procurement route
  • Schemes can run in parallel

14
Some other questions
  • GP loans negative equity
  • Future of NCL funding?
  • Indexing PCT ringfencing?
  • Securing affordabie sites
  • DVO rental levels?
  • Can CIM Business Cases be fast-track, short-form,
    GEM?

15
More questions
  • Other capital sources?
  • Funding equipment / IMT?
  • Can we partner for life?
  • Pharmacy changes?
  • Including Social Services
  • Consulting patients staff
  • Workforce planning links

16
Breakout sessions
  • Draw from questions raised today those
    pre-identified
  • Record main points cant promise answers
    straight away but will help process
  • Ask decision makers to state what they need to
    give required approvals.

17
Toolkits
  • For selecting the best route for approvals /
    procurement
  • For fast-tracking, short-forming documentation /
    GEM for decision makers
  • For offering new structures approaches -
    rentals, VFM, risk, unified budgeting etc.
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