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Page 2 of 2 Fighting delays Significant delays to major projects are damaging and costly. Major health PFI projects are delayed by an average of 21 months on top of the 18-month timescale recommended for these projects by the government. This clearly isn’t good enough. This problem can be combated by setting a clear and realistic procurement timetable for each project. This should include individual commitments for the amount of time it will take to reach preferred bidder status and financial close. The timetable should be set after expressions of interest have been sought. It should be calculated according to the complexity of the scheme and agreed by all key stakeholders, including bidders. There must also be effective sanctions if agreed timeframes are not respected. Finding the right partner Ensuring effective partnerships is central to any major project. The government, the NHS and the independent sector should examine collectively new ways to ensure these develop in the procurement stage of every major capital project, while ensuring a level playing field between bidders. Models that tie the NHS, contractors and other stakeholders together with equal incentives for success should be encouraged. To help better partnership working, the government and the NHS should investigate creating a mediation process, designed to investigate informally procurement delays, help resolve disputes between parties and ensure a level playing field. While the parties would still have recourse to the legal avenues available under competition and procurement law, such a process would help to bring both consortia and the public sector back into partnership where it has broken down. In the new climate of funding the NHS faces, particularly after 2008, it is essential every new purchase of facilities and services represents value for money. Any bids for major capital projects should be assessed on this, not just on price. This should include a wide variety of components that contribute to quality and efficiency. Procuring authorities should not be afraid to award contracts to bids higher in price than others but which provide better value for money. They should also place an emphasis on innovation by ensuring it is weighted strongly in bid evaluation criteria, and by making project specifications outcome rather than input-led. There must be flexibility built in for the future. Given technology’s likely effect on healthcare provision and the impact of policies such as payment by results, the government and the NHS should encourage procurement models that promote flexibility of service provision and critical care. National Procurement Academy Procurement skills need to be improved. The government and the NHS should ensure procurement professionals are properly trained and retained, and that key decision makers have the experience they need. Therefore, the government should establish a national procurement academy to formalise training for procurement professionals. All key members of public sector project teams should undergo similar training. Those trained by the academy could form a cadre of health procurement specialists who work on successive projects, gathering experience as they go. Case studies of good practice in public sector procurement should be compiled and made easily available via a website to those undertaking major capital schemes. They should also include lessons learnt from international procurement methods. And finally, unnecessary bureaucracy must be cut out. At the moment, in some areas of health procurement, there are stages of the process that could be rationalised. The pre-qualification questionnaire, for instance, is lengthy, contains very basic details and adds time and cost to each scheme. A potential way ahead has been shown in NHS commodity purchasing, where the PQQ stage has been streamlined significantly. The NHS Supplier Information Database minimises replication of effort at the pre-qualification stage for the benefit of suppliers and the public sector. Details about suppliers are held centrally and can only be accessed by authorised personnel engaged in NHS purchasing activity. Bidders update the information annually. A similar scheme for complex procurements could streamline the pre-qualification process and ensure much of the information in the PQQ has to be submitted only once. Information about financial standing, currently a key part of the PQQ, could also be held centrally on the database. It is inevitable that issues of technical capability that are specific to a particular project will exist and that bidders will therefore have to submit additional information to supplement that held on a database. But such a database would be a considerable step forward in cutting down the length of the procurement process and avoiding delays. Issues remaining The private sector, through the PFI, has delivered more facilities and services on time and to budget than the old system of public design and construction ever did. Yet most within the industry would acknowledge that problems remain. Trusts and the government must face up to financial realities of schemes early in the process, and avoid time-wasting, expensive reviews. They must look to streamline procurement processes, improve professionalism, consult more widely and ensure better partnership working. Delays and extra costs have a direct impact on health outcomes for people up and down the country. Especially at the present time, the public sector must raise its game and make more of what effective procurement processes can offer.
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