Tendering For Care

It is quite amazing how long it is taking for the reality of the new procurement environment to dawn in some areas. A major Trade Union - Amicus appears to have little understanding of what is happening and the legal context which constrains the way in which public purchasers must now approach the procurement process. We hear regularly of Boards of Trustees who believe that this is a current government "fad" which will go away sometime soon. Meanwhile others are trying to get around the tendering process using approaches such as Direct Payment systems, which are themselves governed by procurement rules, and more importantly by employment legislation. On the other hand we are receiving a number of calls each week from organisations who have lost core contracts and do not understand why; how do they need to approach the tendering process in order to be successful?

It has been said that the current requirements regarding the tendering process are a government requirement which will change in time, therefore organisations do not need to plan to ensure that they stand a good chance of success in the procurement process. Nothing could be further from the truth – a matter which was underlined in a speech made by Sir Peter Gershon on 13th November 2006. It is "efficiency savings" which are diving the whole procurement agenda. The full text of the speech is available on the members' section of the website. However these are some of the key points regarding procurement now and in the future:

A stark warning from local councils that vulnerable people will lose social services.

The claims were made in the Local Government Association's Report and were condemned by the local government minister, as "untrue and unhelpful"

The LGA warned that it will need substantial increases in funding to cope with a growing number of elderly people by 2009. The organisation, which represents 400 local authorities, also warned that councils were being hit by higher utility bills, big increases in the cost of road maintenance and a huge increase in the cost of collecting waste and recycling. The Report says that without additional funding, local government may potentially face a situation, by as early as 2009, where it cannot afford to provide support to the 370,000 people with lower levels of need.

It has been said that elderly people, and other vulnerable groups could find themselves on the wrong side of the law if they spend their Direct Payments. In the name of customer choice, a number of County Councils gives this money in the form of cash grants out of its social services budget - under the Direct Payments Scheme. But at a meeting this week of Bedfordshire County Council, Councillors pointed out that this means that the recipients of Direct Payments would technically be the employers of their carers and would have to abide by employment law.

The number of NHS beds in Wales fell by 1.5 per cent between 2004-05 and 2005-06 and by 13 per cent over the ten years from 1995-96 to 2005-06, new figures reveal today.

The Welsh Assembly statistics show that between 2004-05 and 2005-06 the total number of NHS beds, including mental health, learning disability, maternity and geriatric medicine beds, fell by 206 (1.5 per cent) to 13,808.

The number of beds in acute and geriatric specialties fell by 84 (0.8 per cent) to 10,842. Over the ten years from 1995-96 to 2005-06 the number of NHS beds in total fell by 2,143 (13 per cent). The number of beds in acute and geriatric specialties fell by 669 (6 per cent). Beds in the mental health sector fell by 1,285 (35 per cent) to 2,444.

The percentage occupancy increased from 78.0 to 82.9 per cent. Annual throughput (number of patients treated per bed) increased from 32.3 to 36.3. The average duration of stay in acute specialties increased from 5.9 to 6.9 days.

The new Bournemouth and Poole Primary Care Trust officially came into being on 1^st October 2006. The new Trust is the result of the merger of the Bournemouth and Poole Teaching Primary Care Trust and Poole Primary Care Trust. The new PCT has an annual budget of £430 million and employs 1,100 staff. The merger was part of a national reform that has enlarged PCTs - which commission health services on behalf of their local populations - and given them more buying power. There will be job losses, but staff are guaranteed payment until next June and any vacancies are being filled with temporary staff until the structure of the new trust is decided and appointments made. One of the keys to the latest NHS reforms is payment by results, which rewards efficiency. Because the money now follows the patient, the new system supports patients' right to choose where they are treated. Another change underway is practice-based commissioning, in which GP surgeries directly commission services according to their own patients' needs. PCTs will be working more closely with independent healthcare providers, voluntary organisations and charities in providing services. Locally there are plans to expand CART, a successful multi-agency Bournemouth scheme to keep older people out of hospital, and to continue working with the two councils in improving the health of the population.

The Mental Health Foundation has been awarded a contract to work with the Strategic Network for Mental Health to develop recovery focused practice within its mental health services. Over the next two years the Recovery in Action project will enable the Strategic Network for Mental Health to develop best practice about ways to support people with mental health problems. The Strategic Network is comprised of Advance, Mind in Birmingham, Second Step and Sussex Oakleaf. From Autumn 2006 staff and service users from the organisations will participate in training and action learning. The outcomes of the project will include a model of best practice on the best way to deliver support based on the principle of recovery; a set of service user outcomes; a recovery checklist for organisations, a Recovery Training module; a tool to measure recovery outcomes and a report on the findings.