NHS National Framework Agreement for Medical Locums

1
NHS National Framework Agreement for Medical
Locums

• Supplier Conference
• Warwick University
• 24 October 2007

2
Introduction

• Marcus Brindle
• Director
• Agency and Services

3
Introduction

• Housekeeping
• Sign in
• Toilets
• Fire Alarms
• Lunch

4
Principles

• No recording or photography permitted
• All questions will be taken during the
  presentations and at the end
• Any information presented will be made available
  on the PASA website www.pasa.nhs.uk

5
Introduction

• Welcome and congratulations to everyone for
  completing the PQQ stage and the preliminary
  audit
• Today is to explain the contents of the ITT and
  help with completing it
• Additionally we will have presentations on
  several other topics including one from Kath
  Farmery at NHS Shared Business Services on
  e-business

6
Agenda

• 11.00 Introduction Marcus Brindle
• 11.15 Terms and Conditions Neil Baigent
• 11.45 Pricing schedule Laura Hale
• 12.00 e-business Kath Farmery NHS SBS
• 12.30 Management Information Siu Yau
• 12.45 Lunch
• 13.45 Audit Compliance Jane Conway
• 14.15 The next stage Carol Holroyd
• 14.20 Questions and answers

7
Terms and Conditions

• Neil Baigent
• Category Manager
• Medical Locums

8
Objectives

• To provide Suppliers with
• an overview of
• the proposed NHS Conditions of Contract and
• countering fraud within the NHS
• greater understanding
• by highlighting a number of specific clauses and
  clarifying their requirements

9
NHS Conditions of Contract

• The proposed document including its annexes, sets
  out the terms and conditions of contract that
  shall be used by all Participating Authorities
  when sourcing medical locums of all grades and
  specialties (excluding locum GPs) from the
  Supplier

10
NHS Conditions of Contract (cont.)

• Defined Terms and Interpretation
• Agency Worker
• Authority
• Consortium
• Participating Authority

11
Participating Authority

• All NHS bodies within England, Scotland and Wales
• Additionally,
• NHS bodies within Northern Ireland
• HM Prisons (England, N. Ireland, Scotland and
  Wales)
• Other United Kingdom of Great Britain and
  Northern Ireland Government departments, as
  appropriate, eg Ministry of Defence

12
NHS Conditions of Contract (cont.)

• Defined Terms and Interpretation
• Agency Worker
• Authority
• Consortium
• Participating Authority
• Provision of the Services
• Supplier
• Supply Contract or SLA, as the case may be

13
Specific clauses

• Clause 4 (Scope)
• The national framework agreement is for the
  supply of all medical locums of all grades and
  specialties (excluding locum GPs)
• No requirement for any Participating Authority to
  join the national framework agreement.
• Any provision of the Services to any of the above
  organisations must be supplied at all times under
  the national framework agreement, its pricing and
  its NHS Conditions of Contract

14
Specific Clauses (cont.)

• Clause 5 (Contract Price)
• Hourly charge rate payable by the Authority to
  the Supplier for the provision of the Services
  that is
• subject to shift adjustments, eg on call
• subject to tenure, volume and commitment
  discounts and
• exclusive of VAT
• Comprises of the following two elements
• Hourly pay rate
• Agency Fee, whereby this is comprised of the
  following
• ENIC, as appropriate
• Any WTR payments and
• Suppliers commission

15
Specific clauses (cont.)

• Clause 5 (Contract Price) cont.
• Contract Price shall be subject to the following
  discounts based on
• On call shift adjustments
• Length of Placement
• Volume of business and
• Level of commitment
• The total cost of an invoice shall be subject to
  additional payment based discounts

16
Specific clauses (cont.)

• Clause 15 (Recruitment Procedures)
• sets out the pre-employment screening checks that
  are required to be undertaken by Supplier
• Objectives of these checks are to
• provide a safe and secure environment which
  protects patients, staff, visitors and their
  property and the physical assets of the
  organisation
• ensure that the Supplier relates the information
  provided by the Agency Worker to that person and
  is used by the Supplier to determine that the
  Agency Workers identity is genuine, relates to a
  real and living person and establishes that the
  individual owns and is rightfully using that
  information

17
Specific clauses (cont.)

• Clause 15 (Recruitment Procedures) cont.
• Many of these checks are required by law and
  bring together a range of guidance, advice and
  mandatory requirements from Government
  departments and other organisations.
• The Supplier shall not use any Agency Worker in
  the provision of the Services if
• they have failed such checks or
• would have failed such checks had they been
  conducted immediately prior to the Agency Worker
  being used in the provision of the Services

18
Specific clauses (cont.)

• Clause 20 (Booking Arrangements)
• The Supplier shall respond to requests for the
  provision of the Services as quickly as possible
  and in any event in accordance with the response
  times referred to below

19
Specific clauses (cont.)

• The Supplier shall not put forward or commit an
  Agency Worker in the provision of the Services
  until it has obtained the agreement of that
  Agency Worker to deliver those Services.
• Once agreement has been obtained, the Supplier
  shall provide for each Agency Worker put forward
• a completed Agency Worker Placement Procedure
  checklist
• full curriculum vitae and
• clear copies of associated verified documentation
  retained by the Supplier on the Agency Workers
  file to demonstrate compliance with the NHS
  conditions of contract

20
How will the NFA operate?

• Supply Contract or SLA, as appropriate
• 21 (Coverage and Fill Rates)
• 30 (Supply Contract Monitoring)
• 67 (SLA and Permitted Content)

21
Other specific clauses

• Other specific clauses
• 25 (Uniform and Identification Badge)
• 28 (Person Specifications)
• 31 (Unsolicited CVs)
• 40 (Compliance)
• 45 (Transfer and Sub-Contracting)
• 50 (Inducements to Purchase)
• 52 (Agency)

22
Countering fraud

• NHS Counter Fraud and Security Management
  Service
• created September 1998
• responsible for investigating all fraud impacting
  upon NHS
• powers of seizure/entry/access to staff under
  Secretary of States directions

23
Countering fraud (cont.)

• There is no statutory offence of fraud
• a colloquial term for offences which involve
  the obtaining of property/monies by some form of
  deception or gaining the opportunity to do so

24
Countering fraud (cont.)

• Examples of fraud include
• Falsified timesheets
• False Declarations of qualifications
• Failure to declare convictions
• False identity
• Use of false documents to gain employment and
• Working whilst off sick

25
Countering fraud (cont.)

• Worked in partnership with the NHS PASA to
• develop best practice timesheets and invoices
• incorporate other counter fraud measures
  regarding pre-employment screening checks

26
NHS Conditions of Contract

• Any comments required by no later than 12.00 noon
  on 7 November 2007

27
Pricing schedule

• Laura Hale
• Category Specialist
• Medical Locums

28
e-business

• Kath Farmery
• AP Continuous Improvement Manager
• NHS Shared Business Services

29

• NHS Shared Business Services
• Freeing up funds for frontline Care

30
How does NHS SBS fit in to the NHS?

• NHS Shared Business Services is a 50/50 Joint
  Venture between a private company Xansa and the
  Department of Health.
• The original National Shared Services pilot was
  set up in April 2003 within the NHS.
• Transferred to the current Joint venture
  Structure in April 2005, October 2007 Xansa
  becomes part of Steria.
• Currently services 25 of NHS organisations with
  new clients joining twice a year.
• The aims of the organisations are to free up
  funds for frontline care by efficiency
  improvements and increased control.

31
The Accounts Payable Cycle at SBS
32
Accounts Payable Cycle - Overview
33
Accounts Payables - Volumes

• Nov 2005 Apr 2006 Jul
  2007
• Invoices p/a 1m
  1.9m 2.9m
• Suppliers 30,000 70,000 96,000
• Average Monthly Calls 8,000
  15,000 22,500
• Average Daily Scanning 4,000
  8,000 12,000

34
Client Service Centre - Bristol
0870 850 7862

• Central number for Supplier queries
• Facility to receive supplier queries by email to
  Payables_at_sbs.nhs.uk
• The best time to call is before 10am or after 4pm
  Monday or Friday

35
OB10 and NHS Shared Business Services

• Electronic Invoicing

36
OB10 v EDI

• Electronic Data Interchange (EDI) isexpensive
  and time consuming to implement.
• EDI is only suitable for large organisations
• Setting up an EDI system is resource intensive.
• No image is produced.
• No archive.

• There is no hardware or software required for
  OB10.
• OB10 has an online submission option and works
  equally well with small and large suppliers.
• OB10 enrols suppliers on your behalf so you
  dont have to expend valuable technical
  resources.
• An image is created which is tax compliant and
  digitally signed.
• Full audit trail and archiving service.

37
Why is e-mail unsuitable for invoice delivery?

• Designed as a communication tool not an invoicing
  tool and as such is unsuitable for large-scale
  attachments/invoice delivery.
• Not a guaranteed delivery mechanism
• Proof sent does not equal proof of delivery
• Susceptible to virus
• No backup archive
• Time-consuming to open e-mail, print attachment,
  sort, batch and scan
• No audit trail of rejections
• No validation of data

38
OB10 The Intelligent Postman!

• Deliver electronic invoices from any supplier to
  any customer (buyer)
• Eliminates all paper processing
• Independent of accounting, e-commerce and ERP
  systems
• Connects to all suppliers regardless of size or
  location
• Satisfies legal and fiscal regulations in respect
  of VAT

39

• OB10 is the leading global electronic invoicing
  network
• Trades in over 70 countries
• Over 125 Buyers receiving e-Invoices
• 30,000 plus suppliers (growing at a rate of 500
  per month)
• Annualised throughput of 3 million Invoices (10
  growth per month)
• Annual accumulated Invoice value into the
  Billions
• Tax compliant in multiple jurisdictions around
  the world

40
Current paper process
41
E-invoice process
42
Some Public Sector Buyers on the OB10 Network
43
Some Private Sector Buyers on the OB10 Network
44
Supplier Benefits

• Ability to respond to request of key client's
• Eliminates paper processing
• Invoice printing
• Mailing
• Single electronic data stream
• Confirmation of invoice delivery / non delivery
• One-off, non-intrusive technical implementation
• No software or hardware installed
• Reduced cost / improved cash flow
• Complies with HM Revenue and Customs

45
NHS Benefits

• Leverage Procurement Best Practice
• 3 way matching
• Reduced paper handling
• Improve Supplier payment
• Reduce efforts of dealing with exception
• Encouraging supplier to adopt latest technology
• Less storage for paper
• Response to Government desire to maximise use
  technology

46
Supplier Pack

• NHS Shared Business Services and OB10 agree
  communications packs
• Letter NHS specific
• Frequently Asked Questions NHS specific
• Options document OB10 document
• Link available on the NHS SBS Extranet
• Costs
• File Supplier Annual Fee plus Transaction Cost
  from 22p
• Small Supplier No Annual Fee, Transaction Cost
  from 67p

47
Carbon footprint

• The use of OB10 is an extremely environmental
  friendly act. Last Year OB10 and their suppliers
  saved
• 7.5 million Sheets of paper
• 900 trees
• 106 barrels of oil
• 217,300 kW of electricity
• 130 cubic metres of landfill
• 1422 kg of air pollutants

48
Supplier OptionsUK Price 1st Jul 07

• Data File Supplier
• Annual Fee 750
• Transaction pricing 0.67 to 0.22
• Secure on-line entry of invoices via OB10
• NO annual fee
• Pre purchase in 25 25 (1 each)
• Pre purchase in 50 45 (0.90 each)

49
OB 10 e-invoice Example
50
A sample error report
51
Attachments

• OB10 and NHS SBS have worked together to
  implement a successful attachments process.
• Supplier can now send attachments such as proof
  of delivery and timesheets with electronic
  invoices
• PDF images are much clearer than scanned carbon
  copies which were often illegible.

52
Comment from a supplier already live on the
network

• Healthcare at Home has been part of the OB10
  network since July 2006 initially transacting
  invoices with East Lancs. Financial Shared
  Services. The enrolment process was well
  coordinated and the implementation of the
  electronic invoice data through OB10 was straight
  forward. When the NHS/SBS selected OB10 it was a
  relatively simple process to send our invoices
  electronically to include the SBS also. To date
  we have successfully transmitted over 2000
  invoices via OB10 and we were also very happy to
  be part of a successful pilot project enabling
  PDF attachments to be sent with our invoice data.
  Electronic invoicing should reduce
  administrative overheads, and should help ensure
  that our invoices are paid more quickly and
  rapidly informed of any invoice non-compliance
  issues. I would happily recommend OB10 as the
  preferred network to other NHS Suppliers.
• Dan Black - Financial Controller, Healthcare at
  Home

53
Management Information

• Siu Yau
• Data Analyst
• Agency and Services

54
Medical Locums - Management Information and
Benefits Tracking
55
Introduction

• The BTT Concept System
• System components Objectives
• Sample Reports
• MI Data Template
• Completion and Submission
• Future Development
• Stakeholder Engagement
• Supplier benefits

56
What did we need to deliver?
..... .....
Improved Standard Reporting NHS PaSA (ME,
Category and Uptake)
Integrated Data Warehouse
Platform for future data analysis / reporting

Improved Standard Reporting Hubs together with
data

Improved Standard Reporting Commercial
Directorate, DOH, Other PSO
57
Components of the BTT model
Integrated Data Warehouse

Spend
Savings
Uptake
58
Templates Supplier MI Collection Tool
Lookup Excel Documents
Supplier Management Information (MI)
Web Base MI Upload
59
MI Validation techniques

• Validation lookups built into MI Return documents
• Manual visual checking on each return for format
  and significant errors (eg. Blank Trust codes,
  incorrect contract reference, date etc)
• BTT built in validation tool that checks for
  format and missing compulsory data
• Further validation checks against data provided
  from other internal systems (eg Trust AP data)

60
Sample Reports

• Market Positioning Report
• Ranks a supplier against the reported total
  market value of the contract by spend or volume
• Sales by SHA and by Trust Report
• Shows total sales value and volumes at specified
  periods for SHA and individual Trusts
• Regional Uptake Report
• Compare data with other data sources like
  accounts payable (AP) from trusts to identify
  level of uptake or lack of it
• Tailored Reports
• Collectively agreed format and information by
  both suppliers and PASA to be shared and reported.

61
Supplier Benefits

• A single point of data collection for national
  contract sales information
• Market information feedback to suppliers
• Automated system for information provision
• Improved contract compliance
• Triangulation of data
• Platform for future market analysis

62
In Summary.

• Early stakeholder engagement is crucial
• Accurate and regular supplier sales data is key
• Working together brings benefits in the longer
  term

63
Audit Compliance

• Jane Conway
• National Audit Manager
• Agency and Services

64
Audit Team
Jane Conway National Audit Programme Manager
Meryem Parker Auditor
Duncan Kennedy Auditor
Judy Saddington Auditor
Sian Gorham Auditor
Dawn Brearley Auditor
65
Objectives

• Our fundamental objectives are to ensure that all
  workers supplied to the NHS are of high quality
  and do not present a risk to patient safety in
  the NHS.
• The audit programme is a crucial tool in
  improving quality and NHS commitment to the
  agreement
• It is endorsed by both the NAO and the DH as one
  of the main reasons for advising that NHS trusts
  use only framework agreement suppliers.

66
Pre Award Audit

• The pre award audits are now complete.
• Message
• Prior to supply Doctors must be compliant with
  the audit requirements

67
Audit Programme

• To ensure that all agencies appointed to NHS PASA
  framework agreements are compliant.
• To audit agencies on an annual basis.
• Typically, the first audit will be at your major
  supplying branch, but we will check that
  procedures are standardised across your
  operation.
• To carry out emergency audits as required,
  usually at the request of NHS trusts.
• To report findings and agree next steps with the
  category team.
• To improve quality our main aim is a positive
  one!

68
How Do We Measure Compliance?

• We look for verified evidence to demonstrate
  compliance with the framework agreement
• Agencys application form and employment history
• Verified ID
• Qualifications obtained
• GMC registration
• Immigration status
• Written record of formal interview
• Immunisation status
• CRB disclosure check
• References
• Training

69
Audit Compliance

• CRB
• The agency will obtain an Enhanced Disclosure
  including a POCA POVA check if required
• The Enhanced Disclosure will be obtained prior to
  supply and will be renewed every 12 months and
  will be issued to your organisation

70
Audit Compliance

• Verified Identification
• The supplier is required to identity check the
  doctor. The agency will meet the doctor in person
  in order to identity check the doctor against
  the original documents they present at interview.
• Eligibility to work
• A copy of the Agency Worker's immigration status
  and eligibility to work from the Home Office
  including the Agency Workers Work Permit number

71
Audit Compliance

• GMC Registration
• Details of current registration, including GMC
  registration number, type of registration and
  eligibility to practice
• We wish to see the following
• GMC certificate of registration
• GMC annual registration certificate
• The agency will check the GMC register Prior to
  each placement of a doctor
• Long term placements will require a monthly GMC
  check

72
Audit Compliance

• Occupational Health
• If the Supplier does not have its own
  occupational health service it must establish
  contractual arrangements with an NHS body that
  offers an NHS provided occupational health
  service or other competent occupational health
  service, to ensure that expert and comprehensive
  health assessments are undertaken on all Agency
  Workers prior to being involved in the provision
  of the Services.

73
Audit Compliance

• Occupational Health
• The Agency Worker is capable of undertaking the
  duties required of them has demonstrated the
  required levels of immunity or received
  immunisation (as appropriate) in respect of the
  following diseases in accordance with current DH
  guidelines, prior to the Agency Worker being put
  forward for any placement or being supplied
• - Hepatitis B
• - Rubella
• - Measles
• - Mumps
• - Tuberculosis
• - Varicella

74
Audit Compliance

• Occupational Health
• If performing exposure prone procedures has
  demonstrated the required tests using identified
  validated samples have been conducted and
  appropriate negative results for the following
  diseases have been received
• - Hepatitis B
• - Hepatitis C
• - HIV

75
Day of Audit

• Start time 09.30 hrs.
• As a minimum, the auditor will require
• - desk, chair, and access to workers files
• - access to computer system
• - facility to take away evidence (photocopies)
• - access to policies
• - courtesy and co-operation from on-site
  managers
• We will audit a minimum of 10 workers files at
  any single audit visit.

76
Audit Outcome
Pass
Re-audit one year later
Audit 1
Pass
Re-audit one year later
Fail
Re-audit (4-6 weeks later)
Audit 2
Improvement plan (5 working days)
Fail
Termination of contract
77
Help and Advice

• Please contact
• Jane Conway
• National audit programme manager
• Tel [phone]
• Jane.conway_at_pasa.nhs.uk

78
The next stage

• Carol Holroyd
• Lead Category Manager
• Medical Locums

79
The next stage

• Terms and Conditions Review and comment by 7th
  November via Bravo
• Pricing schedule Review and comment by 7th
  November via Bravo
• Tender issue 9th November
• Tender submission 11th December

80
The next stage

• Thank you for attending the Supplier Conference
  here at The University of Warwick
• The final tender documents will be issued on 9
  November via the Bravo system

81
Question and answer Session

• Marcus Brindle Director, Agency and Services
• Carol Holroyd Lead Category Manager
• Neil Baigent Category Manager
• Jane Conway National Audit Manager
• Laura Hale Category Specialist
• Kim Law Category Specialist