The procurement of public health (and any) services is a difficult job. Aside from the issues raised in this commissioning series of blogs, the scoring system (obviously) has a huge impact on the outcome. Often, outcomes are decided by 1% or 2%. It is imperative that you ensure you have prioritised only the things that will genuinely secure the best provider. A provider that you believe will do the job better could lose out because you over-prioritised something that won’t affect the delivery to the public as significantly.
As a provider, we have seen many instances of under-prioritisation on the service description weighting (one of, if not the, most important elements of procurement) and over-prioritisation of other elements, that are important but not nearly as important as the way a provider is actually going to deliver a service.
Here are some key questions to ask of the commissioning team:
In many cases, commissioners have not experienced the reality of delivering the services they are commissioning. This is not unexpected. Often, the career paths are different and require different skills, so it is not surprising when commissioning team members have not delivered, or have delivered but have never set up, the services they are commissioning. Having volunteered of delivered on services is a good start, but running an organisation that delivers them is much more complex. The importance of great management practices and training budgets should not be overlooked as they support the most valuable asset you are buying – the passionate people delivering the service. If there is not the emphasis in scoring on management practices, staff experience and remuneration, how are the people who are the interface between the commissioned service and the people they are serving incentivised to do the best job they can?
As mentioned in previous blogs in this series, it can be difficult to get candid feedback from providers about the less than ideal elements within a tender. However, getting a full critique from a provider who is not bidding or an ex-provider can offer unique insight into some of the unintended consequences of certain commissioning decisions. It is important to note that it is not ethical to bring a bidding provider into the whole process as they will have unfair access to other providers tenders and this will (or should!) put off other providers. However, before it all goes live, this is an incredibly valuable step to take.
I have heard a lot of my ex-colleagues in local authority, at PHE and providers question the financial modelling and associated scoring required by some tenders. Whilst there is an obvious reason to make provisions for the cheapest services, are you not better to focus exclusively on quality? Since the bids cannot exceed the maximum value available, is it prudent to introduce price based competition? Where the contract value is high and the potential modes of provision wide, it makes sense. But using weight management as an example; the budgets are always incredibly tight, so a focus on quality only, would be advisable.
Often, bids are very similar with only a few elements delineating the winners from the losers. The scoring mechanisms must allow the opportunity to describe and discern between the nuances that can make one service much more effective than the others. Have you made provision for the behaviours you really want to see to be rewarded in the scoring mechanism? For example; if you want to see long term behaviour change, don’t make all of your metrics about results at 4 or 12 weeks. By doing this you are skewing the market to focus on short term results, just because the longer term results are hard. If they were the primary focus – people would find a way to measure them.
In all tenders you are provided with a ‘rubric’; a table describing how to answer a question to get the maximum marks. These don’t need to be individualised, however, they always say something along the lines of “the provider has demonstrated excellent level of understanding of the service specification, accuracy and level of detail”. One of the problems relates to the first in this series of blogs where it is explained that these can often be overly restricted. Before releasing the tender, try to design an answer to each question that you would consider to be 100%. If you can’t – how can a provider? It isn’t enough to write the standard rubric, moving from excellent, to good, to adequate etc. Try to actually answer the question to get 100% in each. It will give you a much better feel for whether an ideal answer is possible and what length is required in each question to demonstrate the nuance and detail to score 100%.
It almost seems too obvious to say ‘scoring matters’ when writing a tender. But our experience, and the experience of many colleagues from both the public health side and the provider side has raised many of the same issues. What do you think is really important? Have you prioritised the evidence base? If so, how? Does it now favour academics who have no experience of on-the-ground delivery? How have you reflected the importance of management, training and staff experience within your tender? Have you specified a mandatory spend on training and improving staff? Do you believe that this is important? It is rarely reflected in tenders but is one of the most important elements of running an innovative and progressive service. Make sure that there is adequate scope to provide the nuance and level of detail necessary to score 100% in each answer – by testing it first.
You will be wedded to this service for the foreseeable future, so it is important to get the scoring right so that the service that demonstrates the traits you are genuinely looking for wins the tender.
If anyone is keen to talk about any of the blogs in this series or would like to chat about upcoming tenders, you can email me on firstname.lastname@example.org. We are also happy to match up commissioners based on their needs and what we have observed in the marketplace over the past 10 years, so please get in touch.