Category Archives: procurement

Francis Maude reforms by saying “no” – a “massive” number of times

Posted on 23/03/2012 | 1 comment

By Tony Collins

Cabinet Office minister Francis Maude has intervened to reject departmental projects a “massive” number of times says Ian Watmore, Cabinet Office permanent secretary and former Government CIO.

Evidence Ian Watmore gave to the Public Administration Committee last week suggests that the Cabinet Office’s saying “no” repeatedly to departmental projects has changed behaviours within the civil service.

Watmore, the Cabinet Office’s permanent secretary, told Tory MP Charlie Elphicke, that Francis Maude and his officials now have the power to challenge departments’ civil servants who try and ignore Cabinet Office recommendations.

“In the past, those controls did not exist so they [officials in departments and agencies] could ignore us if they wanted to and carry on as before,” said Watmore. “Under the new regime, they cannot do that because in the end, if they ignore the recommendations that we come to, then they have to seek approval for the expenditure they were going to make on their projects and Francis Maude would, in his own words, happily say ‘no’ in such situations, and say ‘no’ again until people actually came to the table and changed what they were doing.”

Elphicke: Has he done so to date?

Watmore: Yes, an absolutely massive number of times.

Changing behaviour

Since departments have found it harder to get the Cabinet Office to endorse their projects, departmental officials are now “bringing their plans to us much earlier in the timeframe because they do not want us saying ‘no’ when it is well advanced”,  said Watmore.

“So we are getting into a dialogue with them early on about what the best way of doing something is. When we have agreed on the best way of doing something, when it comes back for approval, it gets nodded through and that is working much more effectively.”

Watmore added that the Cabinet Office’s controls will become redundant over time “because people will behave the right way”. He said: “Like the Carlsberg complaints department was the analogy I had in my head; it exists but it is never used.. At the moment we use it a lot because, left to their own devices, people would do things that were suboptimal when you look at it from across Government.

“Francis Maude is in a position to say, ‘No, you are not doing that. You are going to do it this way and reuse somebody else’s system or somebody else’s way of doing things’. He is very hands-on and vigorous at doing that.

Comment:

Watmore’s evidence confirms that Maude remains the mainspring of change in the way government works. Without Maude the unreasonably costly status quo would prevail.  He may be in danger of spinning. But how many ministers like to say “no”? He is invaluable for that reason alone.

What will happen when Maude is promoted, stands aside or retires?  The minister who likes to say “yes”  will earn the respect of some of his civil servants. The refreshing thing about Maude is that he is happy to take his plaudits from taxpayers, not officialdom.

Watmore’s evidence to the Public Administration Committee, 13 March 2012.

Institute for Government open letter on civil service reforms – the problems and opportunities.

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Posted in Campaign4Change, CIO, compliance with spending review, efficiency savings, Government IT, IT projects, managing change, private sector lessons for the public sector, procurement, project management, reducing cost strategically

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Tri-borough mutual plans to save £1m in costs for London councils

Posted on 23/03/2012 | 1 comment

By David Bicknell

Council staff across three London boroughs who are setting up their own employee-led mutual to take over school support services expect to save a million pounds over four years.

The three councils – Hammersmith & Fulham, Westminster and Kensington & Chelsea – already share several services, which they say is enabling them to reduce back office costs to help protect frontline services from the public spending squeeze.

Now, a statement issued by Hammersmith & Fulham for the three councils says the staff involved in supplying support services for schools across the boroughs are “putting the finishing touches to plans to set themselves up as an employee-led mutual.”

Andy Rennison, assistant director in Hammersmith & Fulham children’s services, who has been leading the mutual project, said, “Staff in these areas have experience of trading with schools and are excited about the new challenge. We feel that having more control, flexibility and being able to develop a more commercial approach will benefit schools, the mutual staff and the three councils.

“If the venture is successful, and we have every reason to think so, the councils will receive 50% of the mutual’s net profit to reuse in providing educational opportunities.”

The mutual will pilot the new arrangements for four years, with support from a joint venture independent sector partner, currently being selected through European procurement processes.

Hammersmith & Fulham says an open day for potential bidders held on January 24 attracted around 60 delegates.

The project is being supported by the Cabinet Office which picked Hammersmith & Fulham to be a Pathfinder  to explore new ways of delivering public services more efficiently. The services include financial management support and budget planning, IT and building development projects, as well as strategic advice to councils.

Francis Maude, Minister for the Cabinet Office, said: “Front line staff know what local people want from public services. The mutual model being pioneered in Hammersmith & Fulham will give staff the power to do things the way they know works best. The evidence is clear, when staff have a real stake in their business productivity rises and customer satisfaction grows.

“This Pathfinder mutual is particularly groundbreaking as staff are forming a ‘joint venture’ with a partner organisation that will help to develop the business further. I commend the staff leading this exciting project for their achievements and hope many more will follow their lead.”

“We are very pleased that staff across the Tri-borough area are excited about this opportunity and taking the lead in this Pathfinder. After the initial four years, the service will be retendered on the open market to ensure that taxpayers continue to get the best possible value for money in the longer term,” said Hammersmith & Fulham cabinet member, Cllr Helen Binmore.

Independent adviser OPM was asked by the Cabinet Office to provide expert support to Rennison and his team as part of the Pathfinder programme.

OPM chief Executive Hilary Thompson said; “Elected members, managers and staff at Hammersmith and Fulham have shown real commitment and energy throughout the process of developing the staff mutual. This is an innovative example of a council recognising and seeking to realise the potential of employee ownership and new ways of working.”

It has emerged that academies and free schools will provide a future opportunity for the mutual to extend its services. There are currently two free schools and two academies in Hammersmith, with more in the pipeline.

Further background information on the mutual is being made available in a Hammersmith & Fulham Cabinet report.

(Thanks to Ian Makgill of government contracting specialist Govmark for his help with this story)

Related Links

Hammersmith & Fulham Pathfinder tender hints at September start for schools mutual

SMEs – when to choose them and when not

Public services can be delivered by knights and knaves mutually

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Posted in Campaign4Change, local government, mutualisation, mutuals, procurement, public sector, public services

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IT crisis management – an ongoing NHS case study

Posted on 20/03/2012 | 2 comments

By Tony Collins

When a public-facing go-live goes wrong should communications be neutral in tone – or accentuate the positive?

On 8 December 2011 North Bristol NHS Trust went live with the Cerner Millennium electronic patient records system under the NPfIT programme.

At first Trust staff thought the difficulties were confined to a mix-up over outpatient appointments but it later transpired that there were 16 “clinical incidents” between 1 December 2011 and 17 January 2012 that were related to the Cerner Millennium implementation.

The Trust has published regular public information notices on the benefits, expected benefits, and problems arising from the Cerner implementation.

Reassuring in tone, the notices have made no mention of anything more potentially serious than administrative “issues”:  non-existent appointments were set up and letters sent to patients in error. The notices said that though the “issues” caused disruption and frustration, patient safety had not been compromised. The Trust apologised to staff and patients.

Clinical incidents

No mention was made in the notices of staff having reported clinical incidents in which the new patient records system was a causal factor. The NHS usually categorises  each clinical incident as a  “near miss” or “actual harm”.

In Campaign4Change’s various conversations with the North Bristol Trust over the potential seriousness or otherwise of its IT problems, one thing has been clear: it is pleased with the level of public information it has given out over the problems:

–       regularly-updated messages on its website,

–       briefings to the media including interviews for regional BBC and ITV channels by Ruth Brunt, the Trust’s chief executive,

–       board papers,

–       on-time answers to requests under the Freedom of Information Act

–       leaflets and posters placed in outpatient clinics and on car parking machines explaining that the Trust was implementing a new computer system and apologising for any delays patients may experience

The Trust also gave GPs a dedicated telephone number, fax number and email address for GPs or their patients to contact for further advice.

Profuse public information

We agree that the Trust has run a diligent public information campaign; and its communications staff have always responded quickly to our calls –  and with the documents we requested. The staff were frank in answering our questions. They told us that no decision has been taken yet on whether the Trust will publish the results of an independent inquiry into the Cerner implementation.

But if the Trust doesn’t publish the lessons from its Cerner implementation, it may wish to be reminded of a warning by the Local Health Board of Merthyr Tidfil, at the top on its Clinical Incident Reporting Policy paper: –  To err is human; to cover up is unforgivable; to fail to learn is inexcusable.         

If the Trust does not publish how will others learn from its mistakes?

Accentuate the positive?

The quantity of public information released by North Bristol NHS Trust is not an issue – but how informative is  it? Does the wider culture of the Trust still force staff to accentuate the positive?

The first of the Trust’s website statements on the problems of the Cerner implementation came about five weeks after the go-live. The opening sections of the statement made no mention of any problems. Indeed a series of bullet points listed the benefits of the system:

  • Patient records will now be securely stored electronically on a single system, replacing paper records.
  • Authorised clinicians can quickly find and share information on patients and their medical history and no longer rely on paper filing records.
  • Clinicians will also be able to access records at the patient’s bedside and can input information and statistics immediately.
  • Patients will no longer have to repeat their details to different clinicians as they will be accessible in one place.
  • Tests and outpatient appointments can be set up immediately with the patient.

The Trust’s website statement went on to say that “many”wards as well as A&E at Frenchay Hospital [Bristol] are using the new system.

Only if you’ve read this far will you see a reference to problems.

“However, we have experienced some unexpected problems in the last few weeks with outpatient appointments…”

“Huge improvements”

The current media statement is, again, more upbeat than neutral.  The vague mention of problems is countered by the equally vague claim of “huge” improvements.

“At North Bristol NHS Trust we have been implementing a new electronic patient record system to replace an outdated, less efficient system. Our wards, two minor injuries units, the Emergency Department, theatres and maternity are using the new system.

“However, we have experienced some unexpected problems with some of our outpatient clinics resulting in non-existent appointments to be set up and letters sent to patients in error. Our priority is always patient safety and we are clear that this has not been compromised.

“These issues have caused disruption and frustration for our patients and our staff and we recognise that this has not delivered the level of service that we expect, and the public expect, from us. We apologise wholeheartedly for that.

“Our staff have shown real commitment, hard work and dedication to continue to deliver patient care. Our Information Management & Technology Team worked very hard to rectify these problems as quickly as possible and we have seen huge improvements.

“The system in all outpatient clinics has now been rebuilt and relaunched. These clinics are now in a position to effectively use the new electronic records system. We anticipate there will be a further transition period for staff in those clinics. We firmly believe that the new system, once fully implemented, will improve services for our patients and provide real value.”

Campaign4Change pointed out to North Bristol that board papers on the troubled Cerner implementations at Barts and The London were commendably detailed and informative.

Barts had referred breaches of government targets on waiting times, complaints from patients, delays in the reporting of statutory and other trust performance information, extra costs, losses of income because of reduced activity, and the effect of data errors. There has been little of any of this from North Bristol’s public information campaign.

Freedom of information

Indeed North Bristol has refused to answer questions that were asked under the FOI Act by D Haverstock of the South West Whistleblowers Health Action Group.

The Trust refused Haverstock’s requests for:

–        a copy of your Cerner implementation plan, including pilot

–        the criteria on which the go-live decision was taken

–       a copy of the issues log for the implementation, with a full history of closed and open items.

–        reports on Cerner Project Board/Steering Committee meetings.

The Trust did give Haverstock a vague answer to her question on whether the Trust will have to take over the running costs of Cerner from 2015 when the Department of Health’s NPfIT contract with BT ends.

The Trust said the running costs for Cerner will become the Trust’s responsibility from October 2015 – but it doesn’t know for certain what the costs will be.

“The exact costs are still being calculated, but will be around the same levels as our previous patient administration system, we estimate,” said the Trust.

North Bristol declined to answer Haverstock’s other questions because “at this time the Trust feels that to answer your questions regarding the Cerner Millennium implementation would compromise our position with BT and Cerner”.

Rightly, Haverstock challenges the Trust’s use of the word “feels”. Rejections of FOI requests should be based on facts not its feelings.

Says Haverstock in her request to the Trust for an internal review: “Subjective feelings are not a valid reason for rejecting an FOIA request. What is your objective, evidence base for rejecting this request? [Thank to Theyworkforyou.com for this information.]

Comment

Poorly-designed health IT can kill, according to a US Institute of Medicine report “Health IT and Patient Safety Building Safer Systems for Better Care” in November 2011.

The report says:

“Poorly designed health IT can create new hazards in the already complex delivery of care.

“Although the magnitude of the risk associated with health IT is not known, some examples illus­trate the concerns.

“Dosing errors, failure to detect life-threatening illnesses, and delaying treatment due to poor human–computer interactions or loss of data have led to serious injury and death …”

There’s no evidence that the problems at North Bristol have caused any harm to patients. Indeed the Trust, in reporting the clinical incidents in response to a BBC’s reporter’s FOI request, says its “robust safeguarding processes, as well as additional checks and balances in all departments” have “ensured that clinical safety was not compromised and no patients were put at risk”.

It adds: “Our priority is always patient safety and there is no indication that this has been affected.”

But would we know if patient safety had been affected? In its public information campaign the Trust has been prolific. But the accent on the positive, rather than a neutral and factual account of the specific problems, has left us with little confidence that all the truth has yet come out.

In an IT-related crisis it is not a mass of information that the public and media regard as helpful but specific answers to specific questions. Has North Bristol managed its IT-related crisis well? Up to a point, Lord Copper.

MP questions costs of North Bristol Cerner system

Sir David Nicholson challenged on North Bristol’s Cerner costs

North Bristol system has more problems than anticipated.

North Bristol hits appointment problems

Cerner system “too entrenched” to be scrapped.

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Posted in change management, health, health records, IT projects, managing change, NHS, npfit, operational issues, outsourcing, Politics, procurement, project management, public sector, public services, supplier relationships

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Is Francis Maude starting to spin – without realising it?

Posted on 16/03/2012 | 6 comments

By Tony Collins

Francis Maude is, perhaps, the most effective Cabinet Office minister in decades.

If the business world divides into two main types of character, black and white, and grey – neither being better or worse than the other –  Maude is black and white.

He wants clarity. He shuns subtlety and complexity. He has no time for civil service sophistry and equivocation, or the coded language of some supplier representatives. He wants cuts in the cost of contracts and doesn’t want to hear long arguments on why things are not that simple. He had deep reservations over doing a new deal with CSC over the NPfIT.

A strength of Maude and his colleagues at the Cabinet Office has been the absence, or at least scarcity, of exaggerated and unsubstantiated statements of efficiency savings, of the sort made repeatedly during Labour’s tenure.

Is that beginning to change?

In the past fortnight Maude has made two major claims that are not based on published evidence.

• Maude said spending on SMEs has risen from 6.5% to 13.7%.  It’s not clear how that figure is calculated. There’s a good analysis of the tenuousness of the claim by Peter Smith of Spend Matters. How much of the increase in SME work is down to unaudited claims by large companies that they are giving their SMEs more work?

• He said that £200m has been cut from Capgemini’s Aspire contract with HMRC. [Aspire also involves Fujitsu and Accenture.] He has received much good publicity for the claim. Said the Telegraph yesterday:

“He [Maude]  announced that ministers had successfully renegotiated one deal on computers and tax systems for HM Revenue and Customs.

He said the new contract, with Capgemini, would save £200 million on the deal previously agreed.”

Last year Mark Hall, deputy CIO at HMRC was reported as saying that the Aspire contract was on course to save more than £1bn. Is the £200m quoted by Maude in many news articles this week new?

And none of the articles mention the total cost of the Aspire contract – so from what is £200m being cut?

At one point, according to Mark Hall, the estimated cost of Aspire rose to £10bn from its original estimate of £2.83bn over 10 years. This means that cost increases on the Aspire contract are measured in billions – which puts the £200m savings figure mentioned by Maude into context.

And have Maude and his team offered Capgemini anything in return for a price cut, such as an improved profit margin? [The contract is on an open-book accounting basis]. This week’s Cabinet Office statement on the £200m cut gives no help here. An HMRC FOI response in 2010 and an NAO report in 2006 show that costs of Aspire are fluid. They change according to internal demand; and pricing arrangements are complex. HMRC has refused FOI requests to publish the contract so how can anyone put the claimed £200m savings into a contractual content?

In 2007 negotiations between HMRC and Capgemini extended the 10-year contract by three years, to June 2017; and there’s an option to extend Aspire  for a further five years to 2022. In return for the contract extension Capgemini has already guaranteed savings of £70m a year and a further £110m a year from 2012. Are these savings in addition to the £200m a year Maude has announced? Or the £1bn savings mentioned by Mark Hall?

The good news is that HMRC’s CIO is Phil Pavitt who is a natural sceptic of big outsourcing deals. If anyone is going to achieve genuine savings on Aspire it is Pavitt. Indeed he has given some details of his negotiations. But the contractual context remains abstruse.

Comment

Doubtless Maude believes the figures he has announced on SMEs and Aspire are correct but without substantiation they will mean little to anyone except the media. Maude, perhaps, needs to trust his own cautious instincts than listen too much to his advisers. Otherwise he’ll begin to sound more like Labour ministers who repeatedly made claims the NAO found difficult to substantiate.

The important and impressive work Maude is doing to cut the costs of running government should not be trivialised and debased by spin. Announcements on what he is doing to cut costs and make government more open are usually helpful. But Maude should the first to differentiate the real – in other words the factually corroborated – from aggrandising and flimsy political claims.

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Posted in Campaign4Change, compliance with spending review, cost avoidance, efficiency savings, Freedom of Information, Government IT, managing change, managing outsourced services, outsourcing, Politics, procurement, public sector, public services, reducing cost strategically, supplier relationships

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Lessons from “stupid” NHS IT scheme – Logica boss

Posted on 13/03/2012 | 1 comment

Some wise words from Andy Green, CE of Logica, on lessons from the NPfIT and other failures

By Tony Collins

Andy Green, CE, Logica

Andy Green, chief executive of Logica, speaking to the BBC’s Evan Davis about the NHS National Programme for IT, NPfIT, said:

“It is a stupid thing for the supply chain to have answered, and it’s a stupid thing for the customer to have asked for.”

Green was speaking on Radio 4’s The Bottom Line about corporate “cock-ups and conspiracies”. Other guests were Phil Smith, chief executive of Cisco UK and Ireland, and entrepreneur Luke Johnson.

Green, who joined Logica as CEO in January 2008, said he was in one of the bidders for the NPfIT when he was at BT.

The plan, he said, had been to put the same system into every hospital but later foundation hospitals were able to opt out of the NPfIT.

“Half way through [the NHS IT programme] foundation hospitals were invented,  and suddenly foundation hospitals did not have to go with what the NHS said at all”.

He added: “There were fundamental errors in the whole procurement process, and then real difficulty in delivering what had been promised.”

Evan Davis said the NHS IT scheme had cost billions, achieved little and had been running for years. He asked Green: “What’s the story?”

Green said some things went well including the supply of a network that connects pharmacies and doctors. But …

“What  had been promised by the supply chain was fantastic software that had not been designed yet that was going to completely revolutionise hospitals and delivering that proved to be horrendous… in the end it is foolish to set out on a programme that is going to take seven years with a fixed procurement up front, which says we all know everything about it …”

Lessons

Green spoke of the need for the supplier to understand exactly what the customer wants and whether it is deliverable before the parties agree to draw up a project specification.

“I think the world is beginning to learn about incrementalism. Let’s do something that we can all see and understand.

“Some of our clients we now work with in common teams – we call it co-management – and only when we have worked out exactly what is going to work in the client, and we can deliver, do we specify it as a project.

“Those things tend to go a lot better. We have got used to the fact that we don’t know everything.”

Luke Johnson

Luke Johnson, who is a former chairman of Channel 4, criticised IT suppliers for not getting it right often enough.  “I have bought quite a lot of projects and been involved as a customer many times… As a customer it is a very scary thing because clearly you are not an expert. Your providers are experts and yet they do not seem to be able to get it right often enough it seems to me, given how much they charge.”

Green said there is a high failure rate in the IT industry. “The client sets out one view at the beginning and then they have to change. The sensible defence to this is the partitioning into smaller items and relationships.

“We bluntly always think of our clients over the long run. You need to know people so that you can sit down and have a decent conversation. Too often when these things start to go wrong everybody runs for the contract. Experienced buyers and sellers do not do that: they run for each other and they talk it through, and they work it out, and they put it back on track.

“It’s value that matters. It’s doing something that really changes Patisserie Valerie’s business. [Luke Johnson is chairman of Patisserie Valerie.] What can you do that would transform that. If you can get that done, then if it over-runs by 20% it probably does not matter.”

Luke Johnson: “It depends how much money you’ve got.”

Lowest-price bids

Phil Smith, Cisco

Phil Smith of Cisco said government often has the biggest problems because “they squeeze so much in procurement there is little good value and goodwill left”.He said that on good projects problems are tackled by cooperation but “if every piece of value has been squeezed out before you procure it, your only option is to get something back from it”.

Beware procurement experts

Johnson said if procurement experts take control, and their mantra is to save money, it can often lead to trouble. “I fear that in many aspects of business, it gets down exclusively to price rather than value.

“Quality is out the window. They [procurement experts] can show a saving so they have justified their bonus but the supplier may be rubbish.”

Green said government is in a difficult position when a project starts to go wrong. “You are stuck in a procurement and the poor individual responsible is almost certainly facing a union or a consumer group or a doctor who doesn’t want the thing to happen anyway.”

Evan Davis made the valid point that the costs of projects in the public sector have to be underestimated to get approved. Realistic estimates would be rejected as too costly.

“… The person who is championing this project has to demonstrate to superiors that it is not too expensive. It is only by taking the cheapest bid and starting the thing off that you can sell the project higher up and of course down the line it costs a heck of a lot more.”

Luke Johnson: “We all know in many sectors there are providers that will take things at cost or even less with a view that they will somehow bulk it out and make a margin on the way. They know the client will need variations.

Innovation means taking risks

Luke Johnson: “If you want an innovative society, if you want one that is willing to take risks, to generate new technologies, new jobs, new businesses, then it involves failures and cock-ups.

“I think the British have got vastly better in recent years in accepting that as part of the journey and that is incredibly healthy.”

BBC R4’s The Bottom Line – Cock-ups and conspiracies.

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Posted in Campaign4Change, change management, Government IT, health records, IT projects, IT-related failures, managing change, managing outsourced services, NHS, npfit, operational issues, private sector lessons for the public sector, procurement, project management, supplier relationships

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Lean Procurement – an early bird analysis

Posted on 08/03/2012 | Leave a comment

 In this guest blog, John Pendlebury-Green and John Jones from strategic sales architects Landseer Partners discuss the Government’s plans to introduce lean procurements, an approach which should shorten procurement times, reduce bidders’ costs and encourage greater SME participation

Lean procurement is being piloted by the Government with six pilots underway across various departments. We at Landseer Partners have been extensively involved with one of these pilots. Also, we have discussed the emerging characteristics with service providers participating in other lean procurements.

Although it is early days, there are some emerging trends that the Government and bidders would do well to take on board for lean procurements to become successful and ubiquitous across government.

So, what are these emerging trends? Our “early bird” experience of being on a lean procurement pilot suggests that:

·         Lean procurements, by their very nature in attempting to reduce the overall procurement timeline significantly, have the potential benefit of reducing bidders’ costs. They also have the potential to reduce the opportunity to discuss in sufficient detail important commercials such as contract schedules and contractual terms and conditions.

·         Both the client and potential suppliers need to plan and resource better a lean, competitive dialogue. That means supplier submissions need to be submitted much sooner than in previous procurements. It also means that client bid reviews and quality assurance need to be undertaken much quicker and more efficiently.

·         There is an even greater need for strong leadership and decision-making on both the client and supplier side i.e. the need for empowered individuals is greater in lean procurements than in a traditional competitive dialogue. Decisions need to be taken swiftly in order to maintain pace in the procurement.

·         Stress levels for all parties can be high. All parties will be “doing more” in “less time” – so outcomes need to be kept in perspective with a view to the quality of deliverables/schedules not being compromised and

·         Bid teams need to be better resourced at the outset, especially in terms of having the right subject matter experts being available at the appropriate time. This seems to be especially so in the case of lean dialogue.

Finally, our experience, short though it is, suggests that incumbent suppliers, by virtue of their incumbent status, have a slight advantage over other short-listed competitors. They have greater knowledge of the existing services supplied. They need less time in the “data room” and are often able to provide a greater level of detail in their dialogue responses, simply by virtue of knowing the service in greater detail.

In summary, it is still very early days in the lean procurement world.  The obvious benefits of shorter procurement times (and hence reduced costs on all sides) though welcome, might actually mask additional costs that could subsequently emerge.  

Landseer Partners     http://www.landseerpartners.com/

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Posted in government, Government IT, procurement, public sector

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SMEs – when to choose them and when not

Posted on 07/03/2012 | 1 comment

By Ian Makgill

The key to giving business to SMEs is to understand when SME suppliers can meet the needs of government and when it is best not to try and resist the gravitational pull of a large supplier.  

Some of this is obvious.  You wouldn’t expect the government to award banking services or insurance contracts to an SME. On the other hand, there is no real reason why legal services or consulting contracts can’t be provided almost entirely by SMEs, with only a couple of larger providers required for national programmes with multiple sites. In fact, it is a great shame that Government Procurement Service’s (GPS) new tender for consulting services does not utilise the regional model that they’ve previously used for temporary medical staff.

GPS has scored a couple of hits with SMEs, firstly with the appointment of Redfern Travel as the preferred travel management provider and secondly, with the choice to let the G-Cloud IT framework. It may be that Redfern ceases to meet the exact criteria of being an SME once the contract is fully embedded in Central Government, but that’s the whole point, to drive growth through smaller businesses. The G-Cloud framework provides a meaningful opportunity for SME suppliers to sell complex services to government, and may also help government to break their addiction to monolithic, large scale IT projects (as typified by the CSA’s latest IT tender with 90,000 specified requirements.)

Cloud services offer a remarkable opportunity for small teams to serve millions of people. A good example is 37signals, a Chicago web design company that created a project management tool called Basecamp. Its team of 32 staff currently service three million customers.

It is equally important to know when not to try and counter market forces.

Take agency staff.

We’ve been doing some very detailed work in this area, and there is an inexorable move towards using large, national suppliers. These suppliers can provide much more competitive margins and better services and data to public bodies. The market is healthy in terms of competition and there is room for smaller suppliers to become second tier suppliers to some of the national companies. Clearly the option to become a second tier supplier, or to lose their existing business is not good news for smaller suppliers, but with such strong benefits available to public bodies it would make no sense to try and resist developments that are affecting the whole market.

There needs to be a much deeper understanding of the characteristics of contracts that can be fulfilled by SME suppliers and a comprehensive strategy to follow up on that work, and to prevent government issuing restrictive tenders that see SMEs unnecessarily barred from doing business with Government, or spin-out mutuals facing procurement hurdles that are inappropriate to them. Until that strategic work is done, then there is a risk that the appointment of SMEs to government contracts will be haphazard, with a few notable successes and far too many failures.

Ian Makgill is the Managing Director of Govmark, researchers who specialise in government contracting.

Download Govmark’s report into agency staff in local government

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Posted in Campaign4Change, change management, G-Cloud, government, mutuals, procurement, public sector, SME

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Worth reading on mutuals: “Are public sector spin-outs on shaky ground?”

Posted on 27/02/2012 | Leave a comment

By David Bicknell

For those contemplating setting  up public sector mutuals, the headline on a piece by Craig Dearden-Phillips in the Guardian about their legal and contractual prospects may start ringing alarm bells.

“Are public sector spin-outs on shaky ground?’ sounds a very pessimistic view in the wake of a successful action by Michael Lloyd to prevent 3000 NHS staff being transferred into Gloucestershire Care Services, a new social enterprise.

The outcome of the case, as Dearden-Phillips points out, is likely to affect the way in which the NHS and local councils approach the question of how they set up mutuals and social enterprises.

“Last week’s events in Gloucestershire were, without doubt, a setback for the mutuals agenda in the NHS and councils,” he says. “Lloyd may well rue the day he took the action he did, particularly if those NHS services end up in the hands of for-profit operators. But Gloucestershire was not a decisive reversal. What events there showed was not that spin-outs from public bodies cannot be engineered, but that those leading them need to navigate the law, and public opinion, with care.”

Links

Leigh Day & Co Solicitors’ statement

Stroud Against the Cuts statement

Stepping Out

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Posted in Campaign4Change, change management, mutualisation, mutuals, procurement, public sector, public services

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Are SMEs getting more Government IT work?

Posted on 22/02/2012 | 1 comment

Good piece by Peter Smith on why the government’s major IT suppliers may continue their rule over the Whitehall IT budgets (for the time being).

Ten reasons government procurement spend on SMEs isn’t increasing.

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Posted in Campaign4Change, procurement, public sector, reducing cost strategically, SME

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Can officials stop TPP offering gifts to GPs?

Posted on 10/02/2012 | 3 comments

By Tony Collins

On 13 July 2011 CSC gave this written assurance to NHS Connecting for Health at its headquarters in Leeds.

“CSC can confirm that its subcontractor TPP will no longer be sending out letters to practices offering  gifts in return for organising demonstrations of SystmOne.”

TPP has continued to offer gifts, and the Department of Health is now concerned enough to divulge the letters it has sent to CSC.

It can do little more, for GPs are not bound by NHS rules on the acceptance of gifts.

NHS Connecting for Health became involved after TPP sent out a letter in April 2011 offering tea at The Ritz or two tickets to a West End show of the GP choice.

“All we ask for in return is a short slot at your [local practice manager] meeting so we can demonstrate the benefits of SystmOne,” TPP said. “We’re [sic] a proven system and a real alternative to EMIS and Vision. With a third of the country’s patient records and more than 90,000 users, SystmOne is the leader in hosted clinical systems.

“Following recent success in the London area, TPP are looking to sponsor local practice manager meetings. We’ll provide lunch and refreshments for all your attendees. As a thank-you the organiser of the event will will also receive afternoon tea at The Ritz or two tickets to a West End show of their choice …Don’t wait around for an alternative that might not arrive – SystmOne is available, right here, right now…”

SystmOne is supplied to the NHS by CSC under the National Programme for IT, at a cost to taxpayers that remains confidential under NPfIT contracts. GPs can also buy the system directly under GP Systems of Choice. Some PCTs are said to be putting pressure on GP practices to replace existing systems with SystmOne.

Three months after TPP’s “tea at The Ritz” letter, on 6 July 2011, NHS Connecting for Health’s Programme Director, GP IT, wrote to CSC.

Dear Sirs

GPSoC [GP Systems of Choice] Marketing Activity by Subcontractor (TPP)

It has come to the attention of the Authority [Connecting for Health/Department of Health] that TPP have been sending letters to practices which include offers of gifts in return for organising meetings of practice managers  during which SystmOne would be demonstrated. The gifts on offer include tea at The Ritz, two tickets to a West End show and £50 of Marks and Spencer vouchers.

The activities being carried out by TPP state that they are in relation to the provision of SystmOne through GP Systems of Choice. As the Supplier of SystmOne under the Framework Agreement, the Authority requests that CSC review these activities and provides a response to the Authority, by no later than 13 July, to advise whether TPP, as their subcontractor, will be continuing with such activity.”

CSC’s Primary Care Product Executive replied on 13 July:

“CSC was not aware of such activities being undertaken by TPP and immediately entered into dialogue with TPP.

CSC can confirm that its subcontractor TPP will not be sending out letters to practices offering gifts in return for organising demonstrations of SystmOne.”

In December 2011 Campaign4Change learned that TPP was offering £25 Marks and Spencer vouchers to GPs in return for a “short slot at your meeting so we can talk to you and demonstrate the benefits of SystmOne”. By that time TPP put the number of its users at more than 100,000.

We asked the Department of Health in December 2011 whether it approved of TPP’s incentives. It replied:

“We were made aware and asked the supplier about this activity. The supplier has subsequently confirmed that they have ceased offering incentives to GPs.”

Then we learned of a TPP offer of Hotel Chocolat chocolates.

“Happy Christmas and a Happy New Year from TPP.

“To find out why 1800 GP practices have already moved to SystmOne, just call me on the number below to book your short GP demo. Book before 24th December to get a box of Hotel Chocolat chocolates on the day of your demonstration…”

This month, February 2012, TPP sent out this message:

TPP sponsorship for your practice meeting

“TPP are looking to sponsor your practice manager meeting! We’ll provide lunch and refreshments for all of your attendees. As a thank-you, the organiser of the meeting will also receive £25 Marks and Spencer vouchers! All we ask for in return is a short slot at your meeting so we can talk to your attendees and demonstrate the benefits of SystmOne to those practices not yet using it. Anyone that books a SystmOne demonstration on the day of the meeting will also recieve £25 Marks and Spencer vouchers!

“You already know all the great reasons to move to SystmOne, why not share them with other practices in your area? The more practices that move to SystmOne, the more benefits you’ll see.

“To arrange sponsorship for your next meeting and take advantage of this great offer, just contact us on the number below or reply to this email.”

We asked DH why it had suggested that the gift offers had ceased when they hadn’t. Its reply:

“The Department contacted CSC (as the GPSoC supplier) about this activity by their subcontractor TPP. CSC confirmed that TPP would cease offering gifts to GPs in return for organising demonstrations of SystmOne. We have contacted CSC about TPP’s position which is not in line with the assurances previously provided.”

We also asked the DH why it was concerned about the gifts. It did not reply directly but sent us copies of the letter it had sent to CSC, and CSC’s reply.

Is the DH powerless to stop TPP offering gifts?

TPP told Pulse this week:  “We momentarily stopped offering the incentives over Christmas but will be resuming during February … The incentives were offered only to GPs and practice managers and were completely optional.

“Our ‘Tea at the Ritz’ offer actually costs considerably less than the cost of catering for such a practice meeting. We at TPP appreciate that GPs and their staff are extremely busy and so any thank-you gifts we offer staff are simply that, a thank-you for an hour or two of their time.”

CSC has made no comment.

Pulse reports that the GP Systems of Choice framework agreement prohibits software providers from offering gifts to any servant of the authority or a PCT. The ban does not include GPs because they do not sign the framework. Suppliers can offer gifts to GPs without breaching the framework agreement says Pulse.

It quotes Dr Charlie Stuart-Buttle, a former chair of the EMIS user group and a GP in Tonbridge, Kent, as saying the incentives were an unacceptable way of going about things. It also quotes Dr Trefor Roscoe, a GP in Sheffield and former medical IT consultant, as saying the incentives were not a problem as long as the GPs felt the system in question was worth demonstrating in the first place.

Comment

Some will say that GPs are bombarded with offers of freebies from drug companies. So why does it matter if an IT company offers gifts?

Another argument is that drugs are different. GPs can stop offering drugs that become too expensive. They cannot simply stop using a GP system. It’s a big decision for any GP practice to choose a new system even with subsidies from the Department of Health under GP Systems of Choice GPs, while the GPSoC framework lasts. Any new GP system is likely to be a long-term commitment because of the disruption of changing.

GPs should surely choose their IT supplier on the basis of the facts and after shortlisting suppliers.

We dislike the expression “level playing field” but if applied here it would mean that GPs chose new systems only after demos at which all shortlisted suppliers offered tea at the Ritz or Marks and Spencer vouchers to certain GPs.

Alternatively the suppliers could agree that none offers gifts.

IT company’s tea at The Ritz offer to GPs.

Pulse article on TPP incentives

Are PCTs putting GPs under pressure to switch to SystmOne?

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Posted in change, Government IT, health, health records, managing outsourced services, NHS, npfit, outsourcing, Politics, procurement, supplier relationships

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