LGA submission to the Department of Health and Social Care's supplementary consultation on the Provider Selection Regime

Submitted March 2022


The LGA provided responses to the consultation where the questions were relevant to local authority provision.

About the Local Government Association

The Local Government Association (LGA) is the national voice of local government. We work with councils to support, promote and improve local government.

We are a politically-led, cross party organisation which works on behalf of councils to ensure local government has a strong, credible voice with national government. We aim to influence and set the political agenda on the issues that matter to councils so they are able to deliver local solutions to national problems. The LGA covers every part of England and Wales, supporting local government as the most efficient and accountable part of the public sector.

The LGA welcomes the opportunity to comment on the Provider Selection Regime supplementary consultation on the detail of proposals.

We have worked with a number of councils through our National Advisory Group for Local Government Procurement in formatting this response.

We are keen to continue to work with the Department of Health and Social Care to provide input into proposals through our wide networks.

We outline our detailed responses to the questions, below.


1. Scope of the Provider Selection Regime (PSR)

To what extent do you agree or disagree that the inclusion of a list of Common Procurement Vocabulary (CPV) codes in the regulations for the Provider Selection Regime would help to clarify the scope of the regime and promote understanding of when the regime applies?

We strongly agree.

To what extent do you agree or disagree that the list of codes presented here accurately represent our aims for defining the scope of healthcare services?

Agree.

Are there CPV codes that you think should be included in the list?

We have assumed that the question means are there additional codes to add, we have not identified any.

Conversations with practitioners identify specific public health contracts like:

  • drug and alcohol treatment
  • suicide prevention
  • health visitors

that do not provide support work, domiciliary care or sitting services.

We suggest that Department of Health and Social Care satisfies itself that these are covered by the code list.

Are there CPV codes that you think should be excluded from the list?

No – all codes on this list appear relevant.


2. Mixed procurement under the Provider Selection Regime

Although the question is not specifically asked, we have a comment on the wording around mixed procurement. We think the word 'main' is open to interpretation, and suggest aligning to the PCR predominant use test.

We welcome respondents' insight on other types of services, which when arranged in a single contract with healthcare may further promote the best interests of patients, the taxpayer, and the population.

Services which need to be provided by a qualified professional where only NHS bodies are able to provide the professional supervision of those professionals.

We welcome respondents' views on the extent to which CPV codes may be helpful in the regulations to clarify the scope of services which may be arranged with healthcare as part of a mixed procurement.

We think CPV codes are an appropriate mechanism given their widespread and continuing use in procurement of all sorts. We note the unfortunate and non-inclusive language in a couple of the codes and suggest that a new UK working version of the offending codes might be appropriate.

What other types of service (apart from social care) do you think may be arranged in a contract (for which the main subject matter is healthcare) which we should be aware of?

It is conceivable that health care services might be arranged jointly with social care, education, or transport services.

To what extent do you agree or disagree that the list of codes presented here accurately represent the scope of social care services which may be arranged with healthcare services?

Strongly agree.

Are there CPV codes that you think should be included in the list?

No.

Are there CPV codes that you think should be excluded from the list?

No.


3. Threshold for 'considerable change'

To what extent do you agree or disagree that a threshold for considerable change should require both a change of set amount (£) in contract value and a percentage change in contract value?

Strongly agree.

To what extent do you agree or disagree that a change in contract value of over £500,000 is an appropriate threshold when considering what constitutes a considerable change?

Agree.

To what extent do you agree or disagree that a change in contract value of over 25 per cent is an appropriate threshold when considering what constitutes a considerable change?

Disagree – existing PCR regulation 72 allows change up to 50 per cent. We think a similar figure should be used here for consistency.

Do you have any views on how this formulation may be improved?

Yes – the formulation needs to be clear about ability to widen scope, not just increase value. Commissioners may want to bring in additional services to achieve seamless service delivery or economies of scope/scale. Limits on this need to be clear.


4. Contract variations

To what extent do you agree or disagree that the above list of variations should not warrant the reapplication of the Provider Selection Regime (such as selecting a provider through decision-making circumstance two or decision-making circumstance three)?

Agree – but subject to our comments on broadening scope and on the figure being 50 per cent.

To what extent do you agree or disagree that a threshold for considerable change for the purpose of contract variations should be subject to both a change of set amount (£) in contract value – or – a percentage change in contract value?

Strongly agree.

To what extent do you agree or disagree that a change in contract value of over £500,000 is an appropriate threshold when considering what constitutes a considerable variation for this purpose?

Neither agree nor disagree.

To what extent do you agree or disagree that a change in contract value of over 25 per cent is an appropriate threshold when considering what constitutes a considerable variation?

Disagree – existing PCR regulation 72 allows change up to 50 per cent. We think a similar figure should be used here for consistency.

Do you have any views on how this formulation may be improved?

Yes. The formulation needs to be clear about ability to widen scope, not just increase value. Commissioners may want to bring in additional services to achieve seamless service delivery or economies of scope/scale. Limits on this need to be clear.


5. Patient choice

If establishing lists of providers for non-legal right to choice services for patients to exercise choice, do you think that decision-making bodies would intend to limit these lists to a set number of potential providers?

No LGA response.

If establishing or altering lists of providers for non-legal right to choice services with a limited number of providers, do you agree or disagree that decision-making bodies should select providers using decision-making circumstances two or three of the Provider Selection Regime?

No LGA response.


6. Transparency

To what extent do you agree or disagree that the notice which states the decision-making bodies intention to award a contract to a provider should also include:

a) a statement explaining the balancing of key criteria which they used to make a decision?

Strongly agree. In addition the statement should say which decision route was used, for example, one, two or three, as providing this detail will negate the need for summaries.

b) a statement explaining the decision-making body’s rationale for choosing the successful provider?

Strongly agree.

Is there other information that you think would be helpful to publish in this notice? Please explain your answer including reference to advantages and disadvantages.

Yes. How the market was tested. What soft market testing took place, for example, how did the commissioner assure themselves they knew which market / potential providers to consider when deciding which PSR route to take. Any conflicts of interest and how resolved.


7. Annual summaries

To what extent do you agree or disagree with our proposals around annual summaries?

Strongly disagree. These summaries are an unnecessary duplication of effort given that the information will be published anyway in a standard form.

Is there any additional information you would suggest for inclusion in these summaries? Please provide specific examples where possible.

No LGA response.


8. Further questions

Establishing the PSR

How many people in your organisation do you anticipate will need to be aware of the new Provider Selection Regime?

No LGA response.

What function(s) do these people have? For example, procurement specialists or commissioners or senior leaders.

Procurement, public health officers, commissioners, legal, finance, democratic services and audit.

Where possible, we would be grateful if you could state the function and then the number of people who have that function.

No LGA response.

To what extent do you agree or disagree with this statement: My organisation will be able to successfully transition from the current arrangements to the new Provider Selection Regime?

Agree. Depends on clear guidance and training artifacts being produced by Department of Health and Social Care with case studies. These case studies should include local authority and integrated care system mixed procurement examples.

If applicable, please outline any main challenges you anticipate for implementing the Provider Selection Regime in your organisation.

Mixed procurements. Integration with local authority executive decision-making processes which are set out in statute. Risk of rolling on existing poorly defined contracts that lack performance management provisions.

How useful would each of the following resources be to your organisation?

Webinars (including online questions and answers)

A fair amount.

Template documents for decision-making bodies to use when making and recording decisions under the PSR

Not at all.

Process flow diagrams

A fair amount.

If you think there any other tools or forms of support that would help your organisation implement the PSR, please provide details.

No LGA response.

After the initial implementation phase of the PSR, if you think there are any other ways that the Department of Health and Social Care (DHSC) or NHS England can support your organisation with the successful operation of the PSR in the medium or long term future, please provide details.

Need to provide ongoing VFM benchmarking guidance so if one provider has a service for 10 to 25 years the commissioner, procurement and audit have a standard guidance document they can reference. Need to include a requirement for contracts to report on outcomes in order to avoid a debate later down the line with the provider that provision of outcomes is only voluntary / not necessary. Need to prevent commissioners and providers agreeing to cease performance reporting in order to make a perceived administration saving.

If you know of any existing professional networks or communities of practice that you recommend we should engage with on the implementation of the Provider Selection Regime, please provide details.

No LGA response.

Do you agree or disagree that your organisation would incur short-term costs from the familiarisation of and transitioning to the Provider Selection Regime?

Agree there will be costs.

How do you anticipate these short-term costs would arise?

Training, integrating the decision making process with the broader local government decision making process, producing templates, systems changes.

If possible, please provide a breakdown and estimate of these costs in pounds.

Department of Health and Social Care should undertake a formal new burdens assessment.

To what extent could these costs be accommodated in your organisation's budget?

Any new burdens on local authorities associated with the implementation of new standards need to be fully funded.

Costs and savings: ongoing operational costs and savings

Do you anticipate that your organisation will incur any increased operational or running costs when arranging services under the Provider Selection Regime compared with the existing operational costs when arranging services under the current procurement rules?

Don’t know. Department of Health and Social Care should undertake a formal new burdens assessment.

Do you anticipate that your organisation will realise any operational savings when arranging services under the Provider Selection Regime compared with arranging services under the current procurement rules?

No evidence to say whether or not any operational savings will be made.