Public Sector Procurement The publication for public sector procurement professionals JULY 2026
Boost for businesses as new powers save contracts for local areas PLUS... PUBLIC SECTOR EXIT PAYMENTS... PROCUREMENT ECONOMIC DEVELOPMENT... THE REAL COSTS OF UNSAFE HOSPITAL DISCHARGE... COUNTDOWN TO THE NEW ALDER HEY... Public Sector Procurement
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CONTENTS
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CONTENTS Views expressed by contributors are not necessarily those of Smart Fleet Media Limited.
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On 8 July, the Chancellor of the Exchequer announced that she had instructed Treasury officials to undertake a rapid audit of public spending. This document sets out the outcome of the audit, the immediate action...
Every effort is made to ensure Public Sector Procurement’s contents and information are accurate. Information is published in good faith, but no responsibility can be accepted for loss or inconvenience arising from error or omission. Contributors must ensure that all material submitted is not in breach of copyright. While every care will be taken with material submitted, no responsibility can be accepted for loss or damage. No part of this publication can be reproduced without the written permission of the Editor.
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Fixing The Foundations: Rachel Reeves & the Public Sector
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Boost for businesses as new powers save contracts for local areas Billion pound boost for small businesses as councils get new powers to save contracts for local communities. Councils, police and fire authorities in England to now be able to reserve bidding for lower-value contracts...
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£557 million for public buildings to switch to cleaner heating and save on energy bills Schools, pools, and hospitals will be supported to make energy efficient upgrades, and businesses with high energy use will receive funding to help cut bills and emissions..
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The commercialisation challenge The one thing we can guarantee from the forthcoming spending review is that things will get tougher for local government. We will simply have less money, but still have lots to do...
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Why are Sixth Form Colleges being cut? Sixth form colleges are almost universally acclaimed as a success story in British education. They have outperformed other schools and have a proud record in giving adults a second chance to improve their skills and qualifications...
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Fixing The Foundations: Rachel Reeves & the Public Sector 1. EXECUTIVE SUMMARY
bringing the in-year pressures down to £16.4 billion.
On 8 July, the Chancellor of the Exchequer announced that she had instructed Treasury officials to undertake a rapid audit of public spending. This document sets out the outcome of the audit, the immediate action the government is taking in response, and the long-term measures being introduced to restore public spending control.
This £21.9 billion, that the government has already reduced to £16.4 billion, is an estimate of the pressure. It is not an estimate of how much additional funding might be allocated to departments going forwards, or an estimate of how much additional government borrowing may be required this year.
The audit carried out by the Treasury shows that the forecast overspend on departmental spending is expected to be £21.9 billion above the resource departmental expenditure limit (RDEL) totals set by the Treasury at Spring Budget 2024. [footnote 1], [footnote 2]
Economic stability is a priority for the government. That is why it has prioritised being transparent and timely in announcing the scale of these pressures. By making £5.5 billion of immediate savings, the government is taking decisions to begin to tackle these pressures.
The government is taking action to address the pressure by: (i) identifying immediate savings to manage the pressure; (ii) setting out a clear process to the autumn and the Spending Review for reducing the pressure further; and (iii) making reforms to the spending and fiscal frameworks to prevent this happening again.
1.2 The path to the Budget and Spending Review
1.1 Immediate action on spending pressures The government is announcing £5.5 billion worth of savings in 2024-25,
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This is a significant downpayment, but these decisions alone will not be sufficient. The government is setting out further steps to tackle the spending pressures that remain and to take the difficult decisions necessary to secure the public finances. These decisions will be set out in the Budget on 30 October. This will
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confirm the government’s fiscal policy alongside a forecast from the Office for Budget Responsibility (OBR). [footnote 3] The Chancellor will take further difficult decisions across tax and spending.
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These decisions will confirm how the government’s robust fiscal rules will be met: bringing the current budget into balance so that day-to-day costs are met by revenues and getting debt falling as a share of the economy by the fifth year of the forecast.
2.1 Timing of the Spending Review, and approach to adjusting budgets in 2022-23, 2023-24, and 2024-25
The Budget will confirm the full details and OBR-certified costings for the government’s priority tax commitments that will close loopholes and help sustainably fund the government’s priorities. Further technical details of a number of these reforms including to the taxation of independent schools, abolition of the non-domicile regime and extension of the Energy Profits Levy have been set out by the Exchequer Secretary to the Treasury.
the impacts of inflation; recent events, such as the invasion of Ukraine; and public sector pay.
Departmental expenditure limit totals set by the Treasury at Spring Budget 2024 were insufficient to meet the spending pressures facing departments. There has not been a spending review since 2021. As a result, departmental budgets for 2024-25 have not been systematically replanned on the basis of an up-to-date assessment of spending pressures in the last three years. Departmental budgets for the years after 2024-25 have also not yet been set.
The Chancellor is launching a multi-year Spending Review to conclude in Spring 2025. The Chief Secretary to the Treasury will write out to departments with details of the Spending Review shortly. The government will use the Spending Review to change the way public services are delivered by embedding a mission-led approach, driving forward public service reform and making the best use of technology to better deliver services. The Spending Review will set spending plans for a minimum of three years of the five-year forecast period. Departmental expenditure limits for 2025-26 will be set alongside the Budget in October, which will also confirm control totals for 2024-25.
Since Spending Review 2021 (SR21), cash increases in forecast RDEL [footnote 5] due to policy changes by the government at fiscal events totalled £16.9 billion in 2022-23, £23.0 billion in 2023-24, and £10.8 billion in 2024-25 (see Chart 1).
1.3 Strengthening the fiscal framework to ensure this never happens again
Chart 1: Adjustments to RDEL for Policy Measures since Spending Review 2021
Legislation has already been introduced to guarantee that all fiscally significant announcements are subject to an independent assessment by the OBR through the Budget Responsibility Bill.
£25bn
In addition, the government is announcing a series of changes that will fundamentally strengthen the spending framework and ensure that such unfunded pressures should never arise again. These will increase certainty and transparency and prevent spending decisions being repeatedly delayed. They ensure that there will always be medium-term departmental spending plans which the OBR will be able to assess aggregate pressures against. 2. PUBLIC SPENDING AUDIT On 8 July, the Chancellor announced that HM Treasury officials had been instructed to conduct an audit of public spending for 2024-25. This audit has been done rapidly and identified a substantial forecast overspend of £21.9 billion [footnote 4] above the resource departmental expenditure limit (RDEL) totals set by the Treasury at Spring Budget 2024. The sources of this pressure are outlined in this chapter, which include: • unfunded policy announcements;
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In the absence of a spending review, some individual departmental budgets (including for the health service, defence, and education) have been increased across several fiscal events but not consistently across all years.
£20bn
£15bn
£10bn
£5bn
£0bn
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2023-24
Spring Budget 2024
Autumn Statement 2023
Autumn Statement 2022
Spring Statement 2022
2024-25 Spring Budget 2023
Source: OBR Policy Measures Database and HMT Calculations. “RDEL” refers to PCSE in RDEL Most pressures on public spending funded in 2023-24 could reasonably be expected to recur in 2024-25, and many of the underlying pressures, such as those driven by public sector pay and the asylum system, have increased in size this year compared to last year. However, departmental budgets were increased by £12.2 billion less in 2024-25 than in 202324. This contributes to the significant spending pressure the government faces this year.
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2.2 Unfunded policy announcements
2.5 Public sector pay
A number of unfunded policy decisions made since SR21 have increased pressures on public spending in 2024-25 by a total of £2.6 billion. These included: • Extending the Household Support Fund to September 2024, which was announced at Spring Budget 2024 at an estimated cost in 202425 of £500 million. • The Advanced British Standard, which was announced in October 2023 at a cost of £260 million in 2024-25. • Additional bus services support and the extension of the £2 bus fare cap until December 2024, which was announced as part of Network North in October 2023 at an estimated cost in 2024-25 of £250 million.
At SR21 the government set overall budgets in cash terms on an assumption that pay for public sector workforces would increase by around 3%, 2%, and 2% respectively in the three years covered.
2.3 Impacts of inflation Departmental budgets for 2024-25 were set at SR21, [footnote 6] in cash terms, but inflation has been significantly higher than forecast at the time. At SR21 the OBR forecast that the cumulative increase in prices as measured by the GDP deflator over that three-year period would be around 7%. In reality, cumulative inflation over the first two years was around 13% and is forecast to be 15% over all three years. [footnote 7] Inflation spiked to its highest level in over 30 years. [footnote 8] This has placed considerable pressure on departmental budgets, which have not been systematically reset to account for the impact of inflation. This means 2024-25 total departmental spending (TDEL) budgets are at least £15.0 billion lower in real terms compared to SR21 plans [footnote 9]. 2.4 Pressures on public spending due to recent events In addition to pressures from inflation and pay, recent events have increased pressures significantly on public spending since SR21, including: • •
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Military assistance to Ukraine – The UK has committed £3 billion of military assistance to Ukraine in 2024-25 including £1.5 billion RDEL, in response to its invasion by Russia. Asylum – Asylum seeker arrivals, and the costs associated with supporting them in the UK, have exceeded SR21 forecasts. As a result spending on asylum support has increased seven-fold in the last three years, with asylum and immigration resulting in a pressure of £6.4 billion in 2024-25. The Rwanda migration partnership and Illegal Migration Act would have caused these spending pressures to continue rising even faster than before. Rail services – Pressures have emerged on rail finances, primarily due to the weaker-than-expected recovery in passenger demand following the COVID-19 pandemic, leading to a pressure of £1.6 billion in 2024-25.
These events have all taken place against a challenging fiscal backdrop, with public debt at its highest level since the early 1960s. [footnote 10]
Pay for most frontline public sector workers including NHS staff, teachers, police, armed forces and prison officers is set based on recommendations from independent Pay Review Bodies (PRBs). These recommendations have responded to higher levels of wage growth across the wider economy and so actual pay awards across PRB workforces increased by an average of 5% in 2022-23, and 6% in 2023-24. [footnote 11] This – alongside some exceptional pay increases agreed outside the PRB process and pay awards across the Civil Service – has meant that public spending on pay is expected to be around £11-12 billion higher across central government departments in 2024-25 than it was projected to be at SR21, even before accounting for 2024-25 pay awards. [footnote 12] The PRBs’ 2024-25 recommendations – requested in December 2023 by the previous government – then came in materially above the 2% funding departments were provided for at SR21. The previous government did not provide any indication of what was set aside in budgets for pay in its written evidence to the PRBs. Most recommendations are in the 5-6% range and above the funding provided to departments. They are broadly in line with the average expected pay settlement in the wider economy. [footnote 13] This follows a trend of falling public sector pay relative to the private sector, with the Office for National Statistics (ONS) Annual Survey of Hours and Earnings (ASHE) showing that median annual pay in the public sector grew by 7 percentage points less than median annual pay in the private sector between 2011 and 2023 [footnote 14] and Institute for Fiscal Studies (IFS) analysis [footnote 15] from 2022 showing that the public-private sector pay differential was less favourable in 2021‑22 than at any point in the 30 years preceding it. In considering its response to these recommendations, the government carefully considered: • • • •
The cost of the pay awards to the taxpayer; and, The costs of industrial action (including to public service outcomes and the wider economy) that might be expected if the recommendations were rejected; against The benefits from improved recruitment, retention and motivation of public sector workers, on the back of public sector pay having fallen relative to the private sector in recent years; and, The potential impacts of these pay awards on inflation.
In view of these factors, the government has decided to accept the headline pay recommendations in full. Further details on the implications of decisions made on public sector pay for 2024-25, and how the decision was reached are set out in the Annex.
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The 2024-25 pay awards for PRB workforces, alongside a 5.0% award to the delegated Civil Service grades (whose 2024-25 pay award is also due), create an estimated further pressure of £9.4 billion in 2024-25 on top of what the last government set aside for pay. [footnote 16] The pay year for most PRB workforces begins on 1 April. In recent years the PRB process has delivered awards around six months late, because previous governments chose to delay the process. This government intends to restore confidence in the PRB process. As a first step the government will seek to return the process to a timeline which sees pay awards announced as close to the start of the pay year as possible and will start by remitting the PRBs for the 2025-26 pay round in September, three months earlier than for this pay round. 2.6 The results of the 2024-25 audit As part of the audit, the Treasury has worked closely with departments to assess the scale of the 2024-25 pressure on their RDEL budgets (as published at Spring Budget 2024). The Treasury expects capital (CDEL) pressures to be managed through existing budgets this year and has therefore focused the spending audit on RDEL. Based on this audit, the government estimates a pressure of £21.9 billion against the plans set out for departments at Spring Budget 2024. [footnote 17] Table 1 outlines the drivers of the pressure. Table 1: 2024-25 RDEL pressures by category
1 It was agreed that some of the 2024-25 pressures would be funded by switching Capital DEL to Resource DEL. This additional Resource DEL spending is a pressure on the Resource DEL Reserve. 2 All numbers include Barnett consequentials. 3 Reserve claims that meet Consolidated Budgeting Guidance parameters as unforeseen, unavoidable and unaffordable; as well as technical adjustments (e.g. classification changes). 4 Total cost above provision in departmental plans for the 2024-25 PRB workforces, delegated civil service grades and associated workforces. 5 Resource DEL pressure above provision in departmental plans for 2024-25 resulting from 2023-24 pay awards. 6 New policy commitments announced since Spending Review 2021 assumed to be funded from the Reserve. 7 £1.6bn for rail passenger services and £1.3bn for rail maintenance. 8 Resource DEL support for Ukraine this year includes £1.5bn for military support and £0.2bn for civilian support. The total military support package this year is £3bn, including £1.5bn Capital DEL. 9 HMT’s assessment of how much Resource DEL pressures will reduce and underspends will emerge over the course of the financial year. 10 At each fiscal event, the OBR publishes an estimate of how much the government will underspend against its DEL plans, called the Allowance for Shortfall (AfS). To show total pressure against the OBR Spring Budget 2024 forecast, the Resource DEL AfS (£2.9bn) needs to be added to gross pressures. 11 Totals may not sum due to rounding.
3. IMMEDIATE ACTION ON SPENDING PRESSURES The government is taking immediate steps to address the pressures identified in the audit by cancelling unfunded policy announcements made by the last government and taking the difficult decisions it avoided. This document sets out the savings that have been identified. Together these will deliver £5.5 billion savings in 2024-25 rising to £8.1 billion in 2025-26. The specific savings measures are set out in Table 2:
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NEWS 3.1 Table 2: Immediate savings (£ millions)
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Departmental budgets for 2024-25 will be confirmed at the Budget, alongside the OBR forecast. Final departmental expenditure limits will be set out at Supplementary Estimates in the usual way. 3.2 Immediate savings The government is taking immediate action to manage the pressures revealed in the audit. These total £5.5 billion in 2024-25 and £8.1 billion in 2025-26, and include:
1 2024-25 savings assumed to be maintained in cash terms in 202526. 2025-26 budgets will be subject to Spending Review decisions. 2 Winter Fuel Payments are classified as Annual Managed Expenditure (AME). Estimated savings sensitive to forecast take up of Pension Credit. Final savings will be certified by the OBR at the Budget taking account of any behavioural response. 3 In addition, the government is reviewing the New Hospital Programme. Savings from this programme will be subject to this review. 4 Totals may not sum due to rounding. Excludes savings from NatWest retail offer. 5 Costs associated with a NatWest retail offer are not included in current forecast. This figure reflects the avoidance of a future loss of income from share sales should a retail offer take place. It assumes a retail offer of £1bn – £3bn in size, with a package of incentives for retail investors that equates to a discount to market price of between 10-15%. It does not take account of any other potential costs involved in such an offer or any discounts associated with potential institutional sales. For these purposes the offer is assumed to take place in and costs apportioned to 2024-25. The immediate savings identified reduce the pressure from £21.9 billion to £16.4 billion in 2024-25. This is just the first step. As is usual, the government will continue to manage down the pressure and will take further decisions across tax and spending at the Budget.
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Making sure that departments absorb at least £3.2 billion of the public sector pay pressure this year. The Treasury will work closely with departments to identify savings to fund pay. To achieve this, the Treasury will help departments to bear down on waste and drive efficiency, including by: - Taking immediate action to stop all non-essential government consultancy spend in 2024-25 and halve government spending on consultancy in future years. This will save £550 million in 2024-25 and £680 million in 2025-26. To help departments do this and make value for money decisions about how to resource work the civil service headcount cap announced by the previous administration will be lifted. - Delivering administrative efficiencies across government – the Treasury will implement a 2% saving against government administration budgets, cutting down on waste while prioritising the frontline. This will save £225 million in 2024-25. - Reducing communications and marketing budgets – the government will review the hundreds of millions spent each year across government on communications and marketing campaigns, with a view to making reductions. - Continuing to dispose of surplus public sector estates, raising money for public services and enabling assets to be put to productive use where the government can increase their social value and drive greater value for money.
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Targeting Winter Fuel Payments. Winter Fuel Payments will be targeted from winter 2024-25 at households in England and Wales with someone aged over State Pension age receiving Pension Credit, Universal Credit, Income Support, income-based Jobseeker’s Allowance and income-related Employment and Support Allowance. They will continue to be worth £200 for eligible households, or £300 for eligible households with someone aged over 80. This will better target support for heating costs at those who need it, while all pensioners will benefit from the government’s commitment to maintain the triple lock for the basic and new State Pension in this Parliament. Winter Fuel Payments are devolved in Scotland and Northern Ireland. The government wants those entitled to Pension Credit to claim it. The government will bring together the administration of Pension Credit and Housing Benefit as soon as operationally possible, so that pensioner households receiving Housing Benefit also receive any Pension Credit that they are entitled to. The Department for Work
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The government will set out its fiscal plans at a Budget on 30 October in the usual way, alongside a full economic and fiscal forecast from the OBR. This Budget will confirm departmental control totals for 2024‑25.
•
Stopping the Rwanda migration partnership. This will create savings on flights and payments to Rwanda, and removing retrospection of the Illegal Migration Act will allow the government to process asylum seekers and reduce use of hotels.
Second, the government is launching a multi-year Spending Review which will conclude in the spring. The Spending Review will restore spending control in the medium term, setting spending policy in line with the government’s wider fiscal strategy.
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Cancelling the Investment Opportunity Fund. This was announced at Autumn Statement 2023 but has yet to support any projects.
Third, the government is implementing reforms to the spending framework and improving the transparency of the information Treasury shares with the OBR to ensure that this situation does not repeat itself.
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Not proceeding with adult social care charging reforms. The previous government committed to introduce these in October 2025 but did not put money aside for them. The reforms are now impossible to deliver in full to previously announced timeframes.
The pressure revealed by the audit does not therefore represent an announcement of the government’s tax, spending or borrowing plans.
Reviewing the previous government’s transport commitments. This will ensure our transport infrastructure portfolio drives economic growth and delivers value for money for taxpayers. The government is cancelling the A303 Stonehenge tunnel and the A27 schemes. These are low value, unaffordable commitments which would have cost £698 million next year. The government will also cancel the Restoring Your Railway programme, saving £85 million next year. Individual Restoring Your Railway projects will be able to be reconsidered through the Transport Secretary’s review.
The savings set out are the first step the government is taking to manage down the 2024-25 pressure. The Chancellor has been clear that departments should, as is usual, make every effort possible to continue to manage down their pressures.
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Cancelling the Advanced British Standard. The government will cancel the unfunded commitment to additional teaching hours, which would have cost almost £1 billion a year in the medium term. The government will continue to fund more and better maths teaching, additional funding to support young people resitting maths and English GCSEs, and teacher recruitment and retention incentives in 2024-25 and 2025-26. Reviewing the New Hospital Programme and the previous government’s ‘40 hospitals by 2030’ commitment. The government will put the programme on a more sustainable footing, following persistent delays and overruns, and recognising delivery and market constraints. The government is undertaking a full and comprehensive review of the programme while continuing to deliver the most advanced and most urgent hospitals to a realistic timeframe.
4. RESTORING PUBLIC SPENDING CONTROL The government is committed to delivering economic stability based on sound money. The spending audit commissioned by the Chancellor has revealed the scale of the spending pressures in 2024-25. Alongside immediate savings, the Chancellor is also setting out a clear plan to restore public spending control. This plan has three steps. First, the government is initiating a process for identifying further savings.
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4.1 A path to the autumn
The Spending Review The Chancellor has launched a multi-year Spending Review which will set spending plans for a minimum of three years of the five-year forecast period. The Spending Review process will bring spending back under control. The Spending Review will conclude in spring 2025. Departmental expenditure limits for 2025-26 will be set alongside the Budget in October, to provide departments with necessary certainty. This Spending Review will take a mission-led, reform-driven and techenabled approach to improving public services. 4.2 Strengthening the fiscal framework to ensure this never happens again Framework reforms The government is announcing a series of changes that will fundamentally strengthen the fiscal and spending frameworks and ensure that such unfunded pressures cannot arise again. These will increase certainty and transparency and prevent spending decisions being repeatedly delayed. They ensure that there will always be medium-term departmental spending plans which the OBR will be able to assess aggregate pressures against. A revised Charter for Budget Responsibility which confirms the detail of these reforms will be published alongside the Budget. The Charter will set out the government’s reforms to the framework, including committing to:
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A minimum frequency and duration of Spending Reviews; Improving the transparency of the information the Treasury shares with the OBR, particularly on the in-year position; and • Formalising the OBR’s power to forecast overspend against departmental expenditure limits in aggregate. One significant underlying cause of the spending pressures outlined in this document was the failure to hold regular spending reviews to re-plan departmental spending in the face of shocks. Instead, there has been no spending review since 2021. This means budgets are largely based on macroeconomic assumptions which are three years out of date, and departmental planning horizons have shrunk to less than one year. To prevent this happening again, the government will update the Charter for Budget Responsibility to require spending reviews to be held every two calendar years, and with a minimum duration of three years of the five-year forecast period to ensure public services are always planned over the medium term. This will improve value for money, the planning of public expenditure and provide greater budgetary certainty. The OBR forecast in March 2024 for 2024-25 was based on the departmental expenditure limits originally set at SR21, and the OBR was not aware of the scale of the significant spending pressures outlined in this document. The government will ensure that this never happens again, by changing the Charter for Budget Responsibility to require the Treasury to share with the OBR its assessment of pressures against departmental expenditure limits for the current and following financial year. The OBR can interrogate this assessment and request further information required to make an assessment of whether the government is likely to underspend or overspend against those departmental limits in aggregate. Those underspends or overspends will be included in the OBR forecast. When combined with the reforms to ensure regular spending reviews with minimum planning horizons, this will ensure future OBR forecasts are always based on detailed departmental spending plans reaching into the medium term, and that the OBR is able to make an assessment of whether potential spending pressures mean departments are likely to overspend against those plans. The government is introducing a “fiscal lock” in legislation through the Budget Responsibility Bill. This will require that fiscally significant announcements are subject to an independent assessment by the OBR. This will ensure there is always proper scrutiny of the government’s fiscal plans. To support economic stability, the government is committed to one major fiscal event a year, giving families and business due notice of tax and spending changes. The government remains committed to robust fiscal rules: bringing the current budget into balance so that day-to-day costs are met by revenues and getting debt falling as a share of the economy by the fifth
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year of the forecast. 4.3 Making sure government spending delivers value for money Office for Value for Money The government will ensure that it places value for money at the heart of its spending decisions. To do this, the government will establish a new Office for Value for Money (OVfM), led by an independent chair reporting directly to the Chancellor and Chief Secretary to the Treasury who will be appointed in due course. The OVfM will have two primary roles. First, to provide targeted interventions, working with Treasury and departments, so that value for money governs every decision government makes. Second, to recommend system reforms to ensure any changes support the government’s missions and deliver value for money. The OVfM will be a time-limited multidisciplinary team, based in the Treasury, and will take a task and finish approach to its activities. Following the conclusion of the Spending Review next year, the Office will evaluate the effectiveness of systems reforms, and its impact on the wider spending architecture. Its vision is to leave a legacy of concrete, embedded improvements to the value for money ecosystem to minimise the risk of poor value for money in future. Achieving value for money in asset sales As part of a commitment to fiscal discipline, it is important that the government seeks to ensure value for money when disposing of assets. The government intends to fully exit its shareholding in NatWest, resolving one of the last remaining legacy issues from the financial crisis. However, it will do this in a way that delivers value for money for taxpayers that funded these interventions. A retail share sale would not be value for money relative to other options for disposing of shares and so will not go ahead. The substantial size of incentives needed to attract investors in such offers can cost hundreds of millions of pounds, depending on the extent of the discount and how many shares are offered. Instead, the government will continue to use existing disposal methods to deliver value for money sales and expects a full exit to be achieved by 2025-26, subject to market conditions. This will secure the best outcome for the taxpayer and wider public services. 4.4 Reforming the public sector and welfare system Public service performance is at a historic low. Prisons are over 99% capacity [footnote 18] and Crown Court backlogs are at a record high [footnote 19] – with victims waiting up to two years for cases to come to court. [footnote 20] In the health system, the elective care backlog is 7.6 million, with more than 300,000 people waiting more than a year for treatment. [footnote 21] A&E performance against the four hour target averages is at 75%, down from 85-90% pre-COVID-19. [footnote 22] In local government, in 2024, 19 local authorities needed Exceptional Financial Support to set a balanced budget, [footnote 23] with spending on social care increasing to 54% of councils’ general
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service expenditure. [footnote 24] Through the Spending Review process, the government will take forward work on a number of priority themes, including a greater focus on longtermism, investment in prevention, managing demand, and increasing devolution and local integration of services. Increasing demand driven by demographic changes is set to further increase pressure on these services. Reform will be crucial in ensuring that the government can deliver better public service outcomes within a challenging fiscal context. Mission-led public services The government will change the way public services are delivered by embedding a mission-led approach. This will support preparations for the Spending Review, where the government will ensure departments are working together to deliver key priorities in a more effective and efficient way. Missions are about much more than how public funding is allocated; they are about using all the tools at the government’s disposal to drive change and reform to improve outcomes. Mission boards will drive collaboration, delivering robust performance management practices that track progress and outcomes. Reform-driven public services The government will take action to improve public service outcomes. This includes developing a 10-year health plan to change and modernise the NHS, with the first step launched through an independent external assessment of the current state of the system led by Lord Darzi of Denham. Another example is the government’s commitment to transform the system for supporting children and young people with special educational needs and disabilities, in order to build an inclusive system that delivers better outcomes and is financially sustainable. The government is committed to a more empowered, accountable and sustainable local government system, which will support strong public services. The government will use the Spending Review to improve how different tiers of government work together. This will include consolidating funding streams for local authorities into the Local Government Finance Settlement and rolling out integrated settlements for further Mayoral Combined Authorities that can show exemplary management of public money. The government will also work with councils to overhaul the local audit system as a crucial part of repairing the foundations of local government and ensuring taxpayers get better value for money. The government is committed to tackling tax non-compliance, including from fraud and tax avoidance, to ensure everyone pays their fair share. The government will increase HMRC’s compliance staff, invest in HMRC’s resources and technology infrastructure, and make legislative changes to tackle tax non-compliance and raise revenue. The government will also carry out an urgent programme of work to ensure welfare spending is sustainable, including by supporting people into work. The Work and
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Pensions Secretary will also assess levels of fraud and error in the welfare system, and consider how to bring that down ahead of the Budget. The government is considering how to reduce the cost of politics and government over the long-term. This includes bearing down on departmental administration budgets and reviewing the size of the House of Lords, including by removing hereditary peers, to ensure that the costs associated with the Lords are proportionate. The government will also ensure that ministers demonstrate responsibility and restraint with their pay and allowances. To support this, the government will consider tightening eligibility on severance payments to ministers leaving office to cut costs and to ensure value for money. This will include linking severance payments to time served, thereby ending the possibility of ministers receiving payments when they could have served a single day in office. The government will also explore options to withhold severance payments to ministers who have not met the standards expected of them. Tech-enabled public services The government will focus on improving the productivity of the public sector to deliver high quality public services and achieve value for money. The government will create the conditions for successful digital adoption in the public sector by addressing legacy IT and utilising cloud services and data sharing. This will allow the public sector to realise the opportunities of Artificial Intelligence (AI) and improve public service outcomes. The Artificial Intelligence Opportunities Action Plan, announced by the Department for Science, Innovation and Technology, [footnote 25] will set out a roadmap for government to capture the opportunities of AI to enhance growth and productivity and deliver better services for the public. Better data and digital infrastructure will enable a move to more personalised public services that meet people’s needs, improving user satisfaction and efficiency. This new approach will transform public services by giving people more choice and control over the services they use. Reforming infrastructure delivery The government will launch the National Infrastructure and Service Transformation Authority (NISTA) which will drive more effective delivery of infrastructure across the country and support the delivery of a 10-year infrastructure strategy. Workforce reforms The government has accepted the recommendations of the independent Pay Review Bodies (PRBs) for 2024-25. This will ensure that UK public services can recruit, retain and motivate the people they need. It provides a basis for government and those working in the public sector to work together to reform and repair UK public services. These pay awards provide the foundation on which workforce reform
NEWS can be delivered over the Parliament. This will be a key theme for the Spending Review, with a particular focus on: •
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NHS workforce. The government is committed to training the NHS staff needed to get patients the care they need on time and will reform the way care is delivered, including a greater focus on community and preventative care. This will include enhancing medical training to create a more productive workforce by equipping doctors with both generalist and specialist skills to treat patients with increasingly complex care needs. In 2022-23, the NHS spent £9.3 billion on agency and bank staff. [footnote 26] While agency spend is now falling, the government and NHS England will review ways to go further and faster to rapidly reduce the costs of temporary staffing. Police. The government is committed to tackling waste through the Police Efficiency and Collaboration Programme. The programme will set nation-wide standards for procurement and establish shared services and specialist functions to drive down costs. Teachers. The Secretary of State for Education will work with the schools’ sector on how to make the most effective use of the workforce, particularly in the context of changes in demographics with pupil numbers decreasing in primary schools. Armed forces. The government will fundamentally overhaul the way the Ministry of Defence operates, through the Defence Secretary’s work on the Defence Operating Model. This will break down the barriers to productive working through a new central productivity portfolio, expose ineffective procurement practices, and reduce duplication and bureaucracy across defence – enabling the Armed Forces to be more productive. Civil service. The government will develop a strategic plan for a more efficient and effective civil service, including bold options to improve skills, harness digital technology and drive better outcomes for public services. The civil service will also be required to make efficiencies through reducing use of consultants and making sure back-office functions are as streamlined as possible. The government will move away from capping civil service headcount to an approach that ensures departments consider overall value for money in resourcing decisions.
5. ANNEX: RESPONDING TO THE 2024-25 PAY REVIEW BODIES’ RECOMMENDATIONS The government is committed to the independent Pay Review Body (PRB) process as the means for setting pay. The PRBs weigh up a number of factors when forming their recommendations, including recruitment, retention and affordability. The PRB process is independent and seeks input from both workforces and the government. The integrity of this system – including the expectation that the government will honour the recommendations – means it plays an essential role in ensuring smooth industrial relations. In considering its response to the PRBs’ recommendations for 2024-25 pay awards, the government carefully considered:
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The cost of the pay awards to the taxpayer; The costs of industrial action (including to public service outcomes and the wider economy) that might be expected if the recommendations were rejected; The benefits from improved recruitment, retention and motivation of public sector workforces, given that public sector pay has fallen relative to the private sector in recent years; and The potential impacts of these pay awards on inflation.
5.1 Costs from industrial action Industrial action in the public sector has had significant impacts on public services, with disproportionate impacts on the most vulnerable in society, the public finances and the economy. Recent industrial action across the NHS has resulted in direct costs to the Exchequer, affected patient care, and had adverse economic consequences. •
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Direct fiscal cost: a total of £1.7 billion of funding was provided to NHS England to mitigate against the direct cost of industrial action in 2023-24 and ease pressures on hospitals. This was provided through a combination of reprioritised Department of Health and Social Care funding and new funding from HM Treasury. [footnote 27] This includes the cost to cover shifts and lost pay efficiencies, whilst subtracting salary savings across those staff on strike. Impact on patient care: industrial action has had a significant impact on elective care and placed services under increased pressure. Over 1.5 million appointments have been rescheduled to date (as of July 2024) [footnote 28] due to strike action from December 2022 to March 2024. NHS England analysis estimates that the waiting list could have fallen by an extra 430,000 since December 2022 without industrial action. [footnote 29] Direct economic impacts. ONS GDP data covering previous strike days highlights lost activity across the health sector. In July 2023, one of the main contributors to the fall in monthly output was the human, health and social work activities sub-sector, which fell by 1.2%. This was attributed to a 2% fall in the human health activities industry amidst strike action from healthcare workers (senior doctors, radiographers and junior doctors). [footnote 30] Indirect economic impacts. There are also likely to be indirect economic effects from the impact of industrial action on health outcomes. The NHS elective waiting list in England reached a record high of 7.8 million in September 2023 up from 4.6 million in December 2019, in part exacerbated by industrial action. [footnote 31] Over a similar period, ill-health related inactivity has increased sharply and has been the leading reason for rising economic inactivity, standing at a near-record 2.8 million people in the three months to May 2024. [footnote 32] Analysis by the National Institute of Economic and Social Research has highlighted that the record size of healthcare waiting lists has likely contributed to the increase in ill-health related inactivity. [footnote 33]
School teachers’ strikes have also affected students and parents, with economic impacts.
Public Sector Procurement
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NEWS Effects on students: The Department for Education estimates that strike action taken by school teachers across 2023 led to over 25 million school days being lost. [footnote 34] The loss of school days also has longer run impacts on children’s attainment, particularly if repeated over a sustained period. Direct economic effects: School closures and lost days of schooling directly translate into GDP impacts, as they reduce output for the education sector. GDP data highlights this loss of activity, for example in July 2023, amidst teacher strikes, monthly output in the education sector fell 1.7%. [footnote 35] Wider economic effects: There are broader and significant economic effects from parents having to take time off work to care for children who are unable to attend school during strike days, reducing output across a wide range of sectors. According to ONS survey data, 59% have to work fewer hours or are unable to work at all if schools close due to strikes. [footnote 36] If 10% of the 25 million lost school days led to a parent having to take a day off work for childcare, that would equate to 2.5 million working days lost, worth around £900 million in lost output to the economy. [footnote 37]
the recruitment and retention impacts from pay awards. [footnote 39] Recruitment and retention has deteriorated across many public sector workforces since 2011, with previous governments having capped or frozen pay on multiple occasions. ONS’ Annual Survey of Hours and Earnings (ASHE) shows that median annual pay in the public sector grew by 7 percentage points less than median annual pay in the private sector between 2011 and 2023. [footnote 40]. The PRBs’ recommendations are calibrated to support recruitment and retention of their workforces. This has benefits for the taxpayer and the users of these services. •
• •
5.2 Benefits from improving recruitment and retention The PRBs’ recommended awards are broadly in line with the average expected pay settlement in the wider economy. [footnote 38] Pay growth in the private sector provides an important benchmark when considering 1 2 3 4 5 6
7 8 9 10 11 12 13 14
15 16 17
RDEL represents the day-to-day (“current”) running costs of public services, grants, and administration. This figure accounts for the OBR’s Allowance for Shortfall – the OBR’s forecast of underspends. See Table 1 for an explanation of how this has been calculated. At the Budget, the OBR will provide an updated AME forecast, which will recognise the expected costs of Annually Managed Expenditure (AME), including the cost of compensation payments arising from the recommendations of the Infected Blood Inquiry. Including the £2.9 billion Allowance for Shortfall forecast by the Office for Budget Responsibility. Cash increases in forecast RDEL due to policy changes at fiscal events refer to Public Sector Current Expenditure in RDEL, which is the OBR’s measure of RDEL. These budgets were set with reference to the OBR’s forecast for the GDP deflator, which measures the change in prices across the domestic economy. This measure better reflects the inflationary pressures which departments face than other measures of price inflation, such as Consumer Prices Index (CPI) inflation. Outturn data from ONS. SR21 figures calculated from Economic and Fiscal Outlook - October 2021, OBR, latest forecast from Economic and Fiscal Outlook - March 2024, OBR. GDP deflator, Quarterly National Accounts, ONS, June 2024. In 2024-25 prices, HMT calculations based on Economic and Fiscal Outlook - October 2021, and Economic and Fiscal Outlook - March 2024, OBR. Public Sector Finances June 2024, ONS, July 2024. All public sector pay award decisions available on gov.uk. This has largely been absorbed by departments, and therefore does not feature in Table 1. The Bank of England report in their Monetary Policy Report from May 2024 that the latest Agents’ intelligence suggests that pay settlements will average 5½% across 2024 – Monetary Policy Report – May 2024 – Bank of England ‘Annual Survey of Hours and Earnings (ASHE)’, ONS, March 2024. Median pay, across all employees. ASHE data is recommended by the ONS as the principal source of data for comparing public and private sector pay due to its large sample size and coverage of the entire United Kingdom Public spending, pay and pensions, IFS, October 2022. Total cost above provision in departmental plans for the 2024-25 PRB workforces, delegated Civil Service Grades and associated workforces. The government laid Main Estimates for 2024-25 before Parliament on 17 July, the earliest available opportunity after the General Election and considerably later than the usual timetable. These Estimates were prepared before the General Election, and the government was forced to lay them unchanged in order to allow them to be voted on before the summer recess. This was necessary to avoid departments experiencing cash shortages over the summer. The pressures
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18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Improved public services outcomes: retaining experienced teachers is key to boosting teaching quality, [footnote 41] which evidence suggests is the single most important in-school factor affecting pupil outcomes. Reduced reliance on expensive temporary staffing, particularly in the NHS: In 2022-23, the NHS spent £9.3 billion on temporary staffing due to workforce shortfalls. [footnote 42] Reduced turnover and so recruitment costs: Over the mediumterm, improved retention will result in savings associated with recruiting and training new personnel. For example, it costs an estimated £92,000 to recruit and train an infantry soldier and between £500,000 and £600,000 to train and pay for a Service person to become a Corporal air engineer. [footnote 43]
set out in this document represent a more realistic assessment of DEL spending. As usual, departmental spending limits will be finalised at Supplementary Estimates. ‘Adult Male Prison Population and Capacity Release’, Ministry of Justice, July 2024. ‘Criminal court statistics quarterly’, Ministry of Justice, March 2024 ‘Criminal court statistics quarterly’, Ministry of Justice, March 2024 ‘Referral to treatment waiting times’, NHS England, May 2024 ‘A&E Attendances and Emergency Admissions’, NHS England Exceptional financial support for local authorities for 2024-25, MHCLG, February 2024. Local authority revenue expenditure and financing England: 2022 to 2023, MHCLG. Excludes policing, schools and the Better Care Fund, June 2024. AI expert to lead Action Plan to ensure UK reaps the benefits of Artificial Intelligence, DSIT, July 2024. NHS England Financial Performance Report, NHS England, Q4 2022-23. ‘2023 To 2024 revised financial directions to NHS England’, DHSC, March 2024. ‘NHS faces fresh strike disruption amid heat health warnings’, NHS England, June 2024. Based on NHS supplementary statistics and published IA analysis. ‘Monthly GDP low level industry dataset’, ONS, May 2024. ‘Referral to treatment waiting times’, NHS England, May 2024. INAC01 SA: Economic inactivity by reason (seasonally adjusted) - Office for National Statistics (ons.gov.uk) NIESR Spring 2024 UK Economic Outlook, Box B, May 2024 School closures during the 2023 teacher strikes – GOV.UK (www.gov.uk) Monthly GDP low level industry dataset, ONS, July 2024. ‘The Impact of strikes in the UK: June 2022 to February 2023’, ONS, March 2023 June 2022 to February 2023. Based on 2.5 million parent working days lost at 8 hours per day, using the ONS average hourly productivity figure for 2023 of £44.64, Output per hour worked, ONS, May 2024. Monetary Policy Report, Bank of England, May 2024. Assessing the impact of pay and financial incentives in improving shortage subject teacher supply, National Foundation for Education Researchers (NFER), 2022. Median pay, across all employees. ASHE data, March 2024. ‘Does Teaching Experience Increase Teacher Effectiveness?’, Learning Policy Institute, June 2016. NHS England Financial Performance Report, NHS England, Q4 2022-23. Internal Ministry of Defence (MoD) analysis.
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Public Sector Procurement Public Sector | MAY/JUNE Procurement 2024
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NEWS
Boost for businesses as new powers save contracts for local areas
Billion pound boost for small businesses as councils get new powers to save contracts for local communities. Councils, police and fire authorities in England to now be able to reserve bidding for lower-value contracts to just local and UK suppliers. Reforms pave way for more than £1 billion of potential spend to be reserved every year for local and UK firms. Latest in a series of reforms to open up government work to small businesses and create skilled local jobs.
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Small businesses are set to benefit from £1 billion of funds every year through laws proposed today allowing local authorities to reserve some contracts for suppliers in their area. These reforms are the latest in a series to unlock growth by slashing commercial red tape, simplifying the public contracts regime and removing barriers for smaller firms to work with government. Under the changes, councils, fire and police authorities in England will now be able to reserve competitions for their lowervalue contracts to UK-based suppliers and
suppliers in a defined local area. Chris Ward, Parliamentary Secretary at the Cabinet Office, said: “We’re changing the rules that have held back councils from investing in local businesses that are the lifeblood of local economies. This will put power back in the hands of our communities to drive growth, unlock skilled jobs and create local investment that rewards working people. “ Alison McGovern, Minister of State for Local Government and Homelessness at the Department for Housing, Communities
Would you like to get that important information off paper5 as soon as possible? and Local Government said: “We want councils to help create jobs, opportunities and growth right across the country. Making sure they can prioritise our brilliant local businesses is a huge step forward in achieving that, and will mean more money going to firms that know their areas best and can invest in the communities they serve.” The move, disapplying section 17(5)(e) of the Local Government Act 1988 in certain circumstances, gives local authorities the tools to support growth in their communities, while maintaining the core principles of fair competition and value for money when awarding below-threshold contracts. The new voluntary rules also brings the public sector in line with theto»the»Dementia»Friends»initiative,»with»a» flexibility that Whitehall has to buy goods and services. view»to»all»FRAs»joining»the»scheme»over»
Do you want to:
the»coming»years.
It follows a new National Procurement Policy Statement published inCllr»Jeremy»Hilton,»Chair»of»the»LGA’s»Fire» February, which set out an expectation for public Services»Management»Committee,»said: bodies to provide wider social and economic value when awarding their contracts. Over the summer, the Government “Fire» rescue»that services» also consulted onand» proposals would have» utiliseproven» spending by how» effective» they» can» public sectorjust» bodies when buying everyday goodsbe» andby» services halving»the»instances»of»fire»over»the»last» to create more opportunities for local small businesses and decade»deliver through» both» responses» social enterprises, social valuetheir» by creating good local to»work emergencies» jobs, open up opportunitiesand» and their» boost extensive» skills.
programme»of»prevention»work,”»said»Cllr»
Jeremy» Hilton,» Chair» of» the» LGA’s» Fire» Tina McKenzie, Policy Chair of the Federation of Small Businesses,Services»Management»Committee. said: “It’s great to see the Government listening to small businesses and taking action. This is exactly the kind of practical “They»are»now»exploring»how»they»can»use» reform we called for - giving local authorities the their»expertise»in»further»prevention»work» tools to make it easier for small firms to take on public work. to»improve»the»public’s»health»by»providing»
interventions,» promoting» Small firmscritical» bring deep local knowledge, stronghealth» community messages» to»clears appropriate» ties and specialist skills. and» Whenreferring» the system unnecessary hurdles andservices.» lets them compete on fair terms, the whole community benefits. Today’s announcement is a welcome “Over»half»of»all»fire»related»deaths»and» sign that those barriers are finally starting to come down.” injuries» in» the» home» happen» to» people»
over»60»and»we»know»that»impairment»and» Cllr Dan Swords, Chair of the LGA’s Public Service Reform disability»increase»the»risk»of»harm»from» and Innovation Committee, said: “Councils have a key role in and» other» This»them work»greater driving localfires» growth and thesehazards» changestoo.» will give freedoms tomeans»that»not»only»can»we»prevent»fires» buy local, keeping more of what they spend in and»other»emergencies,»but»action»can»be» their local communities. taken»to»help»people»who»may»not»even»
realise»that»they»need»extra»help.” Local suppliers, SMEs and voluntary and community organisations will all benefit from councils being able to The» Local» contracts Government» Association» reserve below-threshold for them, creating jobs and represents»all»49»fire»and»rescue»authorities» increasing supply chain resilience, to help meet our shared (FRAs)»in»England»and»Wales»and»more» ambition with government to boost inclusive local and national than»370»local»councils. economic growth.”
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NEWS NEWS
Only eight per cent of public sector frontline workers equipped with 4G 5G The»UK»public»sector»could»be»missing» The UK public sector could be missing out out»on»the»opportunity»to»provide»faster» on the opportunity to provide faster and more communityand» more» cost-effective» cost-effective community based services to based»services»to»citizens»due»to»slow»4G» citizens due to slow 5G adoption amongst adoption»amongst»Britain’s»vital»frontline.» Britain’s vital frontline. Fewer»than»one»in»10»public»sector»frontline» Fewer than one in 10 public sector frontline workers»are»currently»using»4G»technology,» workers are currently using 5G technology, research»amongst»public»sector»decision» research amongst public sector decision makers» by»YouGov YouGov» Vodafone» makers by forfor» Vodafone UK UK» has has» revealed.» The» slow»ofuptake» of» 4G» revealed. The slow uptake 5G technology technology»in»the»public»sector»appears» in the public sector appears to be attributable to»be»attributable»to»a»lack»of»knowledge»of» to a lack of knowledge of the benefits it can the»benefits»it»can»provide»and»perception» provide and perception of overall costs of»overall»costs»involved,»which»was»cited» involved, which was cited as one of the key as»one»of»the»key»obstacles»to»adoption»by» obstacles to adoption by those that don’t those»that»don’t»already»have»4G.» already have 5G. Frontline»workers,»such»as»police»officers,» Frontline workers, such as police officers, nurses»and»social»workers,»could»all»benefit» nurses and social workers, could all benefit from»4G’s»greater»speed»and»capacity»to» from 5G’s greater speed and capacity to
access» access critical» critical information» information and» and update» update records» while»out out»inin» the» records electronically» electronically while the community.»»Fast»mobile»connectivity»would» community. Fast mobile connectivity would improve» critical» decision decision»making making»inin» the» improve critical the field,»reduce»time»spent»on»administration» field, reduce time spent on administration and»ultimately»help»to»improve»the»service» and ultimately help to improve the service provided»to»citizens.» provided to citizens.
administration.» They» can»they’re reinvest» time» time and resource where needed and»resource»where»they’re»needed»most,» most, whether that’s visiting a patient in their whether»that’s»visiting»a»patient»in»their»own» own home, on the beat, or elsewhere in the home,»on»the»beat,»or»elsewhere»in»the» community. In frontline services such as the community.»In»frontline»services»such»as» police where every second counts, 5G really the»police»where»every»second»counts,»4G» can make a big difference.” really»can»make»a»big»difference.”
“As» public» sector» organisations» face» “As public sector organisations face continued continued»budget»cuts,»delivering»quality» budget cuts, delivering quality services to services» is» challenge,” an» increasing» citizens is to» ancitizens» increasing said challenge,”»said»Mick»Wayman,»Head»of» Mick Wayman, Head of Public Sector at Public» Sector» Vodafone» UK.» “Armed» Vodafone UK. at» “Armed with cost-effective with»cost-effective»mobile»devices»and»4G» mobile devices and 5G connectivity, frontline connectivity,»frontline»workers»can»access» workers can access and update centralised and»update»centralised»records»such»as» records such as medical and criminal history medical»and»criminal»history»while»they»are» while they are out in the field. This helps them out»in»the»field.»This»helps»them»to»make» to make better decisions in the moment, better»decisions»in»the»moment,»eliminates» eliminates the need to go ‘back to base’ the»need»to»go»‘back»to»base’»to»complete» to complete paperwork and reduces time paperwork» and» reduces» time» on» spent on administration. They canspent» reinvest
Fast,» reliable» to» information» on» the frontline is access» vital. With 5G, large files, the»frontline»is»vital.»With»4G,»large»files,» applications and critical information can be applications»and»critical»information»can»be» uploaded and downloaded in an instant: a uploaded»and»downloaded»in»an»instant:»a» feature that over half (54 per cent) of public feature»that»over»half»(54»per»cent)»of»public» sector respondents said is very or fairly sector»respondents»said»is»very»or»fairly» important to their organisation. important»to»their»organisation.»
Fast, reliable access to information on
Crucially, giving those on the frontline fast,
Crucially,» giving» those» on» the» high capacity connectivity and frontline» access fast,» high» capacity» connectivity» and» to information would also support public access»to»information»would»also»support» sector decision makers’ top three priorities public»sector»decision»makers’»top»three» which were cited as improving operational priorities»which»were»cited»as»improving» efficiency, improving customer experience operational»efficiency,»improving»customer» and reducing overall business costs. experience»and»reducing»overall»business» However, the research found there is still costs.»However,»the»research»found»there» some way to go for the public sector to is»still»some»way»to»go»for»the»public»sector» realise 5G’s potential to help meet their top to»realise»4G’s»potential»to»help»meet»their» priorities, as the benefits are not widely top»priorities,»as»the»benefits»are»not»widely» understood and cost is still seen as barrier understood»and»cost»is»still»seen»as»barrier» to adoption. to»adoption.» “We are working with public sector
“We» are» working» public» sector» organisations to tearwith» down the barriers organisations»to»tear»down»the»barriers» standing in the way of putting 5G connectivity standing» the» ofway» of» frontline,” putting» said 4G» in the handsin» of more Britain’s connectivity» in» the» hands»organisations of» more» of» Mr Wayman. “We are helping Britain’s»frontline,”»said»Mr»Wayman.»“We» to understand how the technology can are»helping»organisations»to»understand» assist in driving efficiency, delivering better how»the»technology»can»assist»in»driving» services to citizens and meeting their key efficiency,» priorities. delivering» better» services» to» citizens»and»meeting»their»key»priorities.» We» want» ensure» that» those» on» the» We want to to» ensure that those on the frontline frontline» able»advantage to» take» advantage» of» are able are» to take of the right the»right»technologies,»such»as»4G,»that» technologies, such as 5G, that will help them will»help»them»to»do»their»jobs»in»the»most» to do their jobs in the most effective way effective»way»possible.” possible.”
Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
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Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
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NEWS
Farizon SV earns its racing stripes with Team BRIT thanks to Brian Currie Ltd Nathan Wooldridge, Team BRIT’s number two mechanic, said: “As well as transporting a full complement of wet and slick tyres, we also carry other items that we can’t bring in our truck, such as catering packs and simulators. The SV is easy to load heavy items into, and there’s lots of anchorage points, making it easy to strap and secure items.” A comfortable companion Throughout those long-distance journeys criss-crossing the country, the SV has proven to be extremely comfortable, seating three team members and providing plenty of storage space. According to Wooldridge, the SV is also far quieter than a conventional diesel van, and feels more like driving a big car rather than a large van.
Brian Currie Van Centre – the commercial vehicle dealer for Farizon in Milton Keynes – is proud to sponsor Team BRIT, the world’s only competitive team of all-disabled racing drivers. This partnership has kicked off in earnest, with Team BRIT utilising a Farizon SV provided by Brian Currie Van Centre. The electric workhorse has already proven itself integral to supporting Team BRIT’s work, both on and off the racetrack. The team opted for the largest SV in Farizon’s range, the L3H3 model. With cargo capacity of 13m3, a payload of 1045kg and a range of up to 247 miles (WLTP combined), the L3 H3 is ideal for carrying items long distances.
Public Sector Procuremenr
Mike Scudamore, Team Principal at Team BRIT, said: “Motor racing is not always seen as the most environmentally friendly sport, so we work hard to minimise our impact away from the circuit. The logistics behind our race operations are significant, and our van is a crucial part of our fleet. The all-electric Farizon SV was a great solution.” Straight into service The Farizon SV quickly became a key tool for Team BRIT, delivering equipment and personnel to race venues across the UK. The van regularly manages 310 miles on a single charge in real-world conditions, so it can reach most circuits without needing to stop. When a charge has been required, the van can be topped up from 20% to 80% in as little as 40 minutes.
Team BRIT have been well-served by the high levels of kit provided as standard, including a leather multifunction heated steering wheel, heated and ventilated leather seats, Bluetooth, wireless Apple CarPlay and Vehicle-to-Load (V2L) technology. With over 5,000 miles now under its belt, Team BRIT’s Farizon SV continues to play an important role for the race-winning team. Scudamore summed-up: “The high spec of the Farizon means we’re guaranteed to have a safe and reliable van for a long time to come, and the fact it’s electric is a bonus.” Tom Osborne, Managing Director at Brian Currie, said: “Team BRIT isn’t just about racing. They’re about resilience, inclusivity, and showing that disability is no barrier to competing at the highest levels. Their mission aligns perfectly with our values, and it’s an honour to be working with them.”
CareCheck
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NEWS
6
Delivering Data Digitally
Get precise information from paper, books, maps, plans and archive material and electronic files as efficiently as possible. Abergower’s» history» in» document» in»a»way»where»the»user»can»quickly»and» processing»can»be»traced»back»over»the» effi»ciently» fi»nd» the» exact» information» or» last» 15» years.» In» that» time» they» have» image»they»want. delivered» national» projects» for» clients» such»as»The»National»Archive,»The»British» This» philosophy» can» be» illustrated» with» Library,»The» MOD,»The» United» Nations» the»project»they»carried»out»for»The»City» and»The»Scottish»Government.»They»have» of» Lincoln» Archives.» This» involved» the» also»worked»with»many»local»authorities» digitisation»of»precious»probate»registers» throughout»the»UK»to»convert»their»fi»nancial» which»were»over»200»years»old»and»large» records»and»planning»applications»to»digital» maps» and» illustrations» of» the» county» content»in»the»most»effi»cient»way. spanning» a» similar» time» frame.» They» organised»this»work»to»be»carried»out»on-site» Their» expertise» is» in» working» with» their» using»the»most»sophisticated»large»format» clients» to» deliver» digital» information» to» scanners,»specialised»book»scanners»and» improve»their»business»processes»or»make» hi-»resolution»paper»scanners»to»create» information»available»to»a»wider»user»base» very»high»quality»images.»
Their»team»worked»with»the»city»archive» department» to» ensure» that» all» original» material»was»handled»with»precise»care» and» attention» and» that» all» processes» met» with» the» highest» standards» in» the» conversion»process.» The»project»delivered»a»key»component»in» the»highly»prestigious»“Lincs»to»the»Past”» website»which»has»been»a»great»success» in»opening»up»a»treasure»trove»of»valuable» information»to»members»of»the»public»and» specialist»archive»agencies»with»regard»to» the»rich»and»comprehensive»history»of»the» county.»»
www.abergower.co.uk
Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
712 HEALTH HEALTH & SOCIAL SOCIAL CARE CARE
LIvING FOR CICSS
The problem with health and social care crises is that they require a rapid response. In many areas, the only really rapid response available is hospital. Not in Nottingham, though, where commissioners at Nottingham North and East Nottingham West CCGs have worked with the British Red Cross to develop the Crisis Intervention Community Support Service to prevent admission to hospital or respite care by providing short, targeted interventions.
This» is»a» service»that» other»CCGs» could»do»well» to»look» at Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
HEALTH CARE 138 HEALTH & SOCIAL CARE
The»service»is»known»locally»by»its»acronym,» CICSS,»pronounced»“kicks,”»and»has»been» running»since»2010.»»Last»year,»just»over» three»quarters»of»the»people»referred»to» the»service»did»not»need»an»admission.» This»adds»up»to»748»admissions»avoided,» saving»the»two»CCGs»a»combined»total»of» nearly»£1.5m.»
“We» call» to» say» that» the» GP» thinks» you» might»want»some»help»and»ask»if»we»can» come»to»make»an»assessment.»If»they»say» yes,»we»go»and»see»them»in»their»home.”» More»than»90»per»cent»accept»the»offer.»
The» response» is» rapid» rather» than» emergency,»says»Ruth.»GPs»can»ask»for» patients»to»be»seen»within»the»hour»and» “Our»main»theme»at»British»Red»Cross»is» very»often»that»is»possible.»Usually,»though,» refusing»to»ignore»people»in»crisis,”»says»» first»contact»is»within»12»hours. service»manager»Ruth»Beedel.»“It»doesn’t» matter»what»size»that»crisis»is,»it»is»what» “We»find»it»really»helps»if»a»relative»or»friend» matters»to»the»person.” can» be» there» for» the» assessment» visit,”» says»Ruth.»“The»service»users»do»not»know» “So»the»idea»of»CICSS»is»to»put»in»some» us»and»it»is»important»they»feel»safe.” support» very» quickly» for» a» short» period» of» time» to» help» people» over» a» difficult» The»team»doing»these»visits»consists»of» period» and» either» help» them» return» to» 12»healthcare»assistants.»The»minimum» independence»or»give»their»GP»time»to»set» requirement»is»NVQ»level»2»although»in» up»a»package»of»ongoing»support.” practice»they»are»all»either»at,»or»working» towards,»level»3.»They»cover»two»shifts»–» The»service»is»available»to»anyone»over»the» 7am»to»3pm»and»3pm»to»10pm»–»365»days» age»of»18,»though»in»reality»the»client»group» a»year. is»overwhelmingly»65-plus.» “At»the»initial»assessment»we»look»at»the» “We»had»one»lady»of»102,”»says»Ruth.» whole»picture»to»try»to»understand»what»the» service»user»wants,»what»they»understand» When»any»of»the»GPs»in»the»two»CCG»areas» about»our»service»and»what»we»can»offer,”» identifies»someone»who»is»struggling»and» says»Ruth.» for»whom»a»short»package»might»prevent» an»admission,»they»call»a»central»hub»run» “We»ask»what»they»want»to»achieve»and» by»community»provider»Nottinghamshire» usually»that»is»something»like»they»want» Healthcare»County»Health»Partnerships.» to» be» independent» again» or» to» do» their» shopping»on»their»own»or»to»be»how»they» “Most»of»our»referrals»come»from»GPs»but» were»before»they»got»ill.»Then»we»have» we»do»also»get»them»from»pharmacists,» to»unpack»that»a»bit»and»work»out»how»to» who»are»worried»about»medication,»and» achieve»it.” from»physios»and»OTs,”»says»Ruth.» Sometimes»it»is»daily»activities,»helping»the» The» service» does» not» take» referrals» for» service»user»to»prepare»meals»or»prompting» people»who»have»been»in»hospital»more» them»to»take»medication.» than»24»hours,»with»one»exception»–»the» Ling’s»Bar»rehabilitation»hospital»–»as»there» “I»could»be»helping»them»to»mobilise»more» is»a»Home»from»Hospital»service»to»support» effectively,”» says» Ruth.» “It’s» not» rocket» them. science»but»it»needs»very»special»people» to» do» it» effectively» and» we» have» some» The»hub»collects»some»basic»information» wonderful»HCAs.” and»refers»on»to»CICSS»where»co-ordinators» take»the»case»before»making»contact»with» These»are»Level»1»service»users»whom» the»potential»service»user. CICSS»can»support»for»14»days.»More»and»
Mr W was 84 and at home, receiving palliative care for terminal cancer. When his health deteriorated rapidly, the district nursing team called in CICSS to provide 48 hours of care while they set up a care package. CICSS visited him three times a day, helping with personal care safely and comfortably and with dignity. The HCAs were able to alert the district nursing team to an area of soreness and prevent it getting worse. When the care package was delayed because paperwork did not arrive in time, CICSS extended its support. A week later, CICSS handed over care. Mr W stayed at home comfortably and surrounded by his family throughout.
Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
814 HEALTH HEALTH & SOCIAL SOCIAL CARE CARE more» frequently,» though,» service» users» require»help»with»personal»care»–»toileting» and»washing.»These»are»Level»2»service» users»who»can»receive»seven»days»more» intensive»help. The»HCAs»report»back»to»the»coordinators» after» this» initial» assessment» and» put» together»a»schedule»of»visits.»The»service» keeps»GPs»informed»along»the»way.» “That»means»the»GPs»are»aware»and»they» can»mobilise»other»services.»»We»are»a»bit» like»the»eyes»and»ears»of»the»GP.»We»see» their»patients»regularly.” They»also»signpost»service»users»to»other» organisations»that»might»help»and»liaise» with» GPs» and» community» and» social» services»about»ongoing»support.» Like»the»NHS,»CICSS»is»seeing»rising»levels» of»dependency»and»complexity,»including» early»signs»of»dementia,»people»needing» end»of»life»care»and»those»with»high»body» mass» index.» Recently,» commissioners» have» asked» CICSS» to» accept» referrals» of» patients» assessed» by» GPs» as» high» risk»of»admission»–»adding»again»to»the» complexity»of»work. The»CCGs»have»provided»additional»funds» and»CICSS»is»responding»with»training»to» support»the»HCAs.»“We»are»trying»to»build» some»resilience»into»the»team»as»well»as» enhanced»skills,”»says»Ruth.» Dr»Guy»Mansford,»who»is»clinical»lead»for» Nottingham»West»CCG»and»a»partner»at» the»Oak»Medical»Centre»in»Beeston,»says» quite»simply»that»CICSS»is»“brilliant”. “It’s» really» raised» our» expectations» of» what»can»happen.»In»the»past»we»would» see»someone»not»coping»at»home»and»we» might»make»a»referral»to»Social»Services» who» might» say» they» could» see» them» in» two»weeks»if»we»were»lucky.»There»was» no»assurance»and»often»we»would»end»up» admitting»them»to»hospital.» “Now» I» can» call» CICSS» and» know» that» someone»will»be»there»within»the»hour.»I»
can»tell»the»patient»and»be»sure»that»it»will» happen.»They»are»as»responsive»as»we» are.” His»only»worry»is»that»CICSS»may»end»up» filling»rather»more»of»the»gap»left»by»social» services»than»it»should.»“We»have»to»hold» social»services»to»account,”»he»says.» Candice»Lau,»senior»service»improvement» manager»at»Nottingham»North»and»East» CCG,»says»the»feedback»from»providers» and»service»users»is»excellent»and»that» CICSS»fills»a»real»gap.»The»fact»that»CICSS» is»CQC»regulated»provides»an»added»layer» of»assurance»about»quality,»she»adds.» It»costs»the»combined»CCGs»just»under» £250,000»a»year»to»run»and»with»just»under» £1.5m»saved»through»avoided»admissions» on»paper»this»is»value»for»money.»»However,» she» would» like» to» evaluate» this» more» closely.»“It’s»always»very»difficult»to»allocate» savings»exactly,”»she»says. Certainly»CICSS»is»adding»value»not»just»for» service»users»but»also»the»NHS»locally»and» it»is,»says»Ms»Lau,»a»transferable»model.» “The»Red»Cross»is»very»experienced»at» running»these»sorts»of»crisis»services,”»she» says.»“This»is»a»service»that»other»CCGs» could»do»well»to»look»at.”
Mrs P was 82, in poor health and living alone with some support from her son. She was referred to CICSS by her GP after a visit to A&E for help with personal care needs. The»team»visited»every»morning»to»help»her»wash»and»dress»and» have»some»breakfast.»They»also»helped»make»her»environment» safe,»for»example»by»having»a»key»safe»fitted»so»she»did»not» need»to»go»to»the»door»when»her»son»was»not»present.»They» referred»her»to»the»Department»for»Work»and»Pensions»for» financial»advice.»Meanwhile,»social»services»informed»CICSS» that»they»were»not»able»to»provide»support»for»Mrs»P.»The»GP» and»CICSS»pressed»the»case»and»eventually»a»care»package»of» morning»and»evening»visits»was»commissioned»–»but»not»until»30» days»after»the»initial»referral.»CICSS»continued»to»support»Mrs»P» throughout.
Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
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Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
19
Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
20 CIPD
CIPD
HELPING THE SANDWICH GENERATION REMAIN IN POST
Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
10
CIPD
Of»all»public»sector»workers,»NHS»staff»are» most»likely»to»work»through»their»breaks» and» lunchtime,» according» to» a» report» published» last» month» by» the» Guardian» newspaper.» The» newspaper’s» Clockoff» survey,»which»analysed»the»well-being»of» more»than»3,700»public»sector»staff»across» the»board,»found»that»85»per»cent»of»those» who»took»part»in»the»online»survey»insisted» stress»was»a»fact»of»life»for»them. Dr» Jill» Miller,» Research» Adviser» at» the» CIPD»and»an»expert»on»staff»wellbeing,» isn’t»particularly»surprised»at»the»findings.» She» authored» the» 15th» CIPD»Absence» Management» Survey» which» provided» benchmarking» data» for» both» public» and» private»sector»organisations»throughout» the»UK.»
CIPD 21
•Worries»over»job»security»and»because»of» this»not»wanting»to»take»time»off •Not»wanting»to»shoulder»colleagues»with» an»even»higher»burden»than»they»already» had •Concerned» about» letting» their» clients» down»if»they»were»absent»(this»particularly» applied»to»those»working»in»the»care»field» such»as»social»workers»and»health»visitors)
Despite»the»increase»in»absence»rates»Dr» Miller»is»optimistic»that»organisations»are» starting»to»recognise»the»need»to»focus»on» staff»well-being,»with»the»public»sector»in» particular»faring»far»better»in»this»respect» than» private» organisations.» She» has» been»particularly»impressed»by»housing» associations»she’s»studied,»and»notes»the» Her»figures»showed»that»although»absence» NHS»is»also»gearing»up»activity. as» a» whole» had» fallen» by» one» day» per» employee» (6.6» days)» compared» to» the» “There»is»a»lot»of»more»proactive»activity» previous» year» (7.6),» the» figure» was» still» going»on»now»than,»say,»five»years»ago.» far»higher»for»public»sector»staff»than»in» Many» more» organisations» are» putting» the»private»sector»(7.0»days»per»employee» good» initiatives» in» place» such» as» Work» compared»to»5.5»days»respectively). Life»Balance»programmes,»Healthy»Eating» initiatives»and»offering»employees»access» With» lots» of» public» sector» restructuring» to»counselling,»or»at»least»signposting»them» and»job»losses»as»a»result,»it’s»thought»one» to»areas»where»they»can»find»people»to»help» reason»for»higher»absences»in»government» them. –» and» voluntary» sector» -» jobs» could» be» presenteeism-» staff» turning» up» at» work» “However,» we» still» have» a» while» to» go» when»genuinely»ill.» until» it» becomes» business» as» usual.» In» an»ideal»world»it»would»be»great»to»see» “Our» survey» found» that» one» third» of» staff»wellbeing» become» a» key» business» organisations» had» seen» an» increase» in» operation.» Realistically,» though,» it’ll» be» presenteeism,”»said»Dr»Miller.»“And»it»was» some»time»before»we»can»celebrate»that» higher»in»the»public»sector»where»there» particular»day.” were»also»higher»levels»of»workload»and» stress.» Communicating»honestly»and»openly»with» staff» –» particularly» around» restructuring» “If»people»come»to»work»when»they»are» exercises» -» would» be» another» way» of» genuinely»ill»then»it»takes»them»far»longer» reducing»stress»and»absenteeism,»insists» to»recover»from»an»illness.»Instead»of»taking» Dr»Miller.»That»includes»allowing»staff»to» one» or» two» days» off» to» get» over» it» they» ask»questions»rather»than»simply»dictating» eventually»end»up»having»to»take»much» what’s»about»to»happen. more»time»off»as»their»illness»worsens.” “Employees» often» get» anxious» about» The»reasons»those»interviewed»gave»for» the» reasons» for» changing» the» structure» presenteeism»included: of» an» organisation» and» what’s» going» to»
Dr»Jill»Miller happen»to»their»role»within»it.»Management» ignore»these»feelings»to»their»detriment,”» she»said.»“Where»there»is»a»vacuum»of» information»and»no»communication,»staff,» understandably,»start»to»hypothesise.” Introducing» flexible» working» is» another» method» of» which» she» is» in» favour.»This» is» particularly» relevant» today» with» the» ‘sandwich»generation,’»she»says,»where» many» workers» find» themselves» with» children» and» caring» for» elderly» parents» while»at»the»same»time»trying»to»hold»down» a»full-time»job. “Asking» employees» to» work» core» hours» allows»people»time»to»build»their»working» day»around»their»other»responsibilities»and» helps»the»burden»of»juggling»of»all»these» roles»on»a»continual»basis.»People»don’t» just»automatically»switch»off»their»caring» role»when»they»come»to»work.” Home»working,»which»happens»less»in»the» public»sector»than»the»private,»is»another» initiative» which» can» help» with» juggling» responsibilities.»However,»this»involves»a» different»mindset»for»managers»–»who»often» need»guidance»and»how»to»manage»such» a»scenario. Getting» staff» to» work» flexibly» and» from» home»doesn’t»cost»an»organisation»much» more»money»–»and»in»fact»could»lead»to» savings»with»rent»and»utility»bills.»Health» and» wellbeing» initiatives,» on» the» other» hand,»can»cost»money.»However,»as»far»as» Dr»Miller»is»concerned»it’s»definitely»money» well»spent.
Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
22 FDA
WHAT IS THE REAL IMPACT OF A CAP ON PuBLIC SECTOR ExIT PAYMENTS? .
Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
11
NHS
£557 MILLION FOR PUBLIC BUILDINGS TO SWITCH TO CLEANER HEATING AND SAVE ON ENERGY BILLS Schools, pools, and hospitals will be supported to make energy efficient upgrades, and businesses with high energy use will receive funding to help cut bills and emissions More public buildings and businesses will benefit from over half a billion pounds in funding to help reduce their energy bills and carbon emissions.
corridors to the businesses that power up our economy, we want to make sure buildings of all shapes and sizes are supported to deliver net zero.
Schools, pools, and hospitals will be supported to make energy efficient upgrades, with over £557 million government investment. The new projects will help reduce emissions and cut bills, as part of the government’s plan to reach its world-leading net zero targets in a sustainable, pragmatic way.
By allocating over £557 million today, we are standing steadfast behind our public sector and local businesses, providing the help they need to make the switch to cleaner, homegrown energy.
Heat pumps, solar panels, insulation and low-energy lighting will be rolled out to reduce the use of fossil fuels across the public sector and strengthen the UK’s energy independence, helping save taxpayers hundreds of millions of pounds. This follows significant progress already made towards reaching net zero – with the UK becoming the first major economy to halve emissions. Decarbonising the public sector is expected to save an estimated £650 million per year on average to 2037. Minister for Energy Efficiency and Green Finance Lord Callanan said: “From school Public Sector Procuremenr
This will not only help cut bills in the long term, but ensure we keep reducing our emissions – having already led the world by halving them since 1990.” Over 1,000 projects have now received funding since 2020 to upgrade thousands of buildings through the Public Sector Decarbonisation Scheme. New projects receiving funding in this phase include: • Royal United Hospitals Bath NHS Foundation Trust has been awarded over £21 million to decarbonise 3 buildings by installing new heat pumps alongside other measures including wall, loft and roof insulation, double glazing and LED lighting
• Loughborough University has been awarded over £2 million to decarbonise their Olympic size swimming pool by replacing old gas-fired boilers with more efficient, cleaner heat pumps • Surrey County Council has been awarded over £5 million to cut emissions across 19 sites including 6 libraries, 4 nursing homes, 2 community centres, Guildford Fire Station, 5 schools and the council’s own headquarters in Reigate The government has also announced the award of £27.5 million from the Industrial Energy Transformation Fund to support businesses with high energy use to reduce their bills and carbon emissions, with new projects including: • Pilkington UK will relocate its glass manufacturing line to a single facility in St Helens, helping to reduce their carbon emissions by producing glass from one, upgraded furnace, rather than running two • Sofidel plans to replace their current natural gas steam boiler with one that can run on green hydrogen at their
Leicester paper mill, helping to transform their energy intensive manufacturing process
more energy efficient as well as being comfortable places to use thanks to this funding.
• Plastipak UK will upgrade 13 drying systems at their Wrexham plant to help save energy during the production of preforms and containers for food, drink and dairy products
Every day our teams at Salix work with the public sector to achieve ambitious net zero goals and we’re looking forward to working with the latest successful Public Sector Decarbonisation Scheme grant recipients.
Today’s announcements demonstrate further progress towards the government’s commitment to spend more than £12 billion on energy efficiency by 2028, helping even more organisations and businesses to benefit from cleaner, more secure energy.
Together we will continue to take positive action to address our impact on the climate.”
Salix Chief Executive Emma Clancy said: “The climate crisis is one of the greatest challenges of our time. It requires all of us, including governments and businesses, to make change and reduce our carbon footprint. The Public Sector Decarbonisation Scheme enables the public sector to tap into a fund which can transform our public buildings. These are the sites we use every day; our schools, universities, leisure centres and others will become
Royal United Hospitals Bath NHS Foundation Trust Chief Executive Cara Charles-Barks said: “We are beginning to make great strides to reduce our emissions, through initiatives such as decommissioning our entire nitrous oxide manifold and a sustainable travel plan. This grant is therefore invaluable. It will enable us to make these essential changes in the coming years and will have a positive impact on the environment and the experience of being in hospital. We know that getting this right will be better for the health and wellbeing of the people we care for, the people we work with and the
people in our community.” Managing Director of Pilkington UK Neil Syder said: “This project represents one of the single biggest investments we’ve made in our UK manufacturing facilities in decades, and will ultimately secure the future of rolled glass manufacturing in the UK. Working out of one furnace will enable us to make a permanent and significant saving in CO2 emissions. It’s a radical shift in the way we operate, but we know that if we are to achieve our net zero ambitions, we need to make change across all areas of our business. The Watson Street site has been operating since the 1800s and forms a key piece of our history. Throughout the years, the site has been instrumental in the development of different products, paving the way for a rich history of innovation in glass solutions. Yet this move marks a new chapter in our story that allows us to embrace more sustainable ways of making glass and continue to drive forward our vision for change in partnership with the industry.” Public Sector Procurement
12
NHS
NHS DELIVERY AND CONTINUOUS IMPROVEMENT REVIEW Recommendations: How can improvement-led delivery enhance the quality of outcomes for our patients, communities and our health and care workforce? The delivery and continuous improvement (DCI) review considered how the NHS, working in partnership through integrated care systems (ICSs), delivers on its current priorities while continuously improving for the longer term. We know that focusing on improvement, as an essential component of quality, enables
us to achieve more consistent, highquality care. The review team explored how we ‘improve with purpose’, using all the assets at our disposal: data and evidence, digital transformation and the skills and experience of our health and care workforce. Having assessed the current approach to delivery-led
improvement both within NHS England and more widely, the review team made 10 recommendations which were endorsed by NHS England’s Executive Group (outlined in this report). NHS England’s Board has now consolidated these recommendations into three actions:
1. Describe a single, shared NHS improvement approach. NHS England will set an expectation that all NHS providers, working in partnership with their integrated care boards, will embed a quality improvement method aligned with the improvement approach to support increased productivity and enable improved health outcomes. This will require a commitment from NHS England itself to work differently, in line with the improvement approach and the new Operating Framework.
2. Co-design with our health and care partners a leadership for improvement programme, commissioned and supported by NHS England, enrolling all providers and systems (including primary care) in it to support a whole-system focus on improving healthcare outcomes with our workforce, patients and communities.
3. Establish a national improvement board, to agree the small number of shared national priorities on which NHS England, with providers and systems, will focus our improvement-led delivery work, with national co-ordination and regional leadership. The new board will support more consistent, high-quality delivery of services to improve performance and reduce unwarranted variation.
Public Sector Procuremenr
NHS
13
BACKGROUND TO THE DCI REVIEW
Public Sector Procurement
14
NHS
THE THREE NHS ENGLAND ACTIONS
THE NHS IMPROVEMENT APPROACH NHS England will set an expectation that all NHS providers, working in partnership through integrated care systems, will embed aquality improvement method aligned with the NHS improvement approach. This will inform our ways of working across services atevery level of place: primary care networks, local care networks, provider collaboratives and integrated care systems. It will require a commitment from NHS England itself to work differently, in line with the new NHS operating framework.
Public Sector Procuremenr
NHS
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Context: the evidence for improvement-led delivery
WHAT IS IMPROVEMENT-LED DELIVERY? Improvement-led delivery involves a whole-system (or whole-organisation) focus on quality, using evidence-based quality improvement methods to increase productivity and deliver better health outcomes for patients and communities. It is underpinned by the use of data and measurement to achieve these outcomes.
WHAT IS THE EVIDENCE? Improvement-led delivery is a long term approach to delivery that facilitates stronger organisational governance, productivity and positive cultural change over time. Many parts of the NHS have a long tradition of embedding approaches focused on quality improvement:
Public Sector Procurement
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NHS
Appendices: These DCI review’s 10 recommendations were presented to NHS England’s Executive Group in October 2022
PROPOSED TIMELINE FOR IMPLEMENTING THE THREE ACTIONS
*19 April 2023: Publication of this Delivery and Continuous Improvement Review at NHS England’s NHS leadership event with ICB and trust CEOs
Public Sector Procuremenr
NHS
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DCI REVIEW METHOD AND ENGAGEMENT PROCESS The review team gathered evidence and insights directly from more than 1,000 people across the health and care system. Participants who have provided their insights and feedback include: •
Lived experience partners through NHS England’s experience of care team
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ICB chief executives and non-executive directors (NEDs)
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Provider chief executives and NEDs
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Clinical leaders and people working at the point of care, such as nurses, GPs, consultants, and pharmacists
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Strategic roles including operational, improvement and transformation specialists
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ALB partners and collaborators, such as AQUA, CSUs and Health Data Research UK
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Networks, think tanks and academics, such as Q community, The King’s Fund, and The Health Foundation.
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National bodies, such as CQC, local government representatives, and NHS Confederation
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Regional groups, such as local health and social care partnerships, and Academic Health Science Networks
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NHS England national and regional teams
Emerging insights were reported to the review’s fortnightly steering group chaired by Sir David Sloman and Anne Eden.
During the course of the review, we provided inputs into several concurrent work programmes, seeking to align our emergent findings where appropriate. These included: •
The operating framework programme
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The Creating the new NHS England change programme
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Finance and productivity board
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NHS England business planning and guidance
The review team did not undertake original quantitative research or analysis. It focused on collating and considering existing research and evidence to inform our recommendations. While we have set out implementation plans to sit alongside these recommendations, we recognise that: •
our recommendations are closely interdependent with the ongoing NHS England change programme, which will shape how NHS England’soperating framework is realised.
•
full implementation of our recommendations across the NHS (and, in time, health and care systems) will require ongoing co-designbetween national and regional teams with leaders in systems and providers as well as wider partners, using a collaborative approach centred on learning.
Public Sector Procurement
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EVERY CRISIS IS PERSONAL Every year the British Red Cross helps hundreds of thousands of people live more independently in their own homes. To find out more about our integrated services visit: redcross.org.uk/commissioners Public Sector Procurement|Sept/Oct 2015 The British Red Cross Society, incorporated by Royal Charter 1908, is a charity registered in
Public Procuremenr EnglandSector and Wales (220949), Scotland (SC037738) and Isle of Man (0752).
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LOCAL GOVERNMENT
LOCAL GOvERNMENT
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THE COMMERCIALISATION CHALLENGE
The one thing we can guarantee from the forthcoming spending review is that things will get tougher for local government. We will simply have less money, but still have lots to do. Resolving that dilemma is the challenge for the rest of this decade,»says» Joe Simpson. We» have» five» possible» strategies» to» address»the»problem.»One»is»to»raise»more» taxes.»What»we»know»is»that»there»is»no» public»appetite»for»this.»The»most»recent» illustration»of»this»was»the»referendum»in» Bedfordshire»seeking»public»support»for»a» higher»police»precept.»Police»are»one»of»the» more»popular»(and»visible)»public»services» but»the»vote»against»was»clear.»
My»fifth»strategy»is,»therefore,»to»deliver» services»which»people»or»organisations» are»prepared»to»pay»for.»Some»might»say» this»would»go»against»the»very»ethos»of» local»government.»Whenever»people»hark» back»to»a»golden»age»of»local»government,» they»always»reference»Joe»Chamberlain.» But» the» gas» and» water» he» provided» for» Birmingham»were»not»free»goods.
A»second»option»would»be»to»reduce»service» provision,»but»as»we»see»more»economic» recovery»that»strategy»too»will»find»little» public»support.»Our»third»option»is»greater» efficiency.»We»should»always»be»vigilant» and»seek»further»efficiencies,»but»the»low» hanging»fruit»has»already»been»collected.» There»may»still»be»some»big»opportunities» (could»digital»rework»our»basic»services?)» but»it»is»unlikely»that»the»scale»of»efficiency» changes»saving»can»be»sustained»to»match» the»saving»targets»we»need.»»
In» his» book» Joseph» Chamberlain:» Entrepreneur»in»Politics,»Peter»T»Marsh» writes»“his»main»object»was»not»municipal» takeover»of»the»local»gas»supply»so»much» as»a»large»increase»in»the»town’s»financial» base» for» further» civic» undertakings...he» assured» (the» council)» ...that» municipal» consolidation»of»the»gas»companies»would» yield»the»town»an»annual»profit»of»at»least» £15,000»rising»to»£50,000»within»fourteen» years-»a»provision»which»proved»to»be»a» great»underestimate”.
So»if»the»first»three»options»cannot»deliver» the» solution» we» need» to» focus» on» the» remaining»two.»First»is»behaviour»change-» so»that»the»call»on»our»services»is»reduced.» To» give» an» example,» if» weight» levels» returned»to»their»1992»average»there»would» be»one»million»fewer»people»with»type»2» diabetes.»Achieving» that» change» would» save»money»and»make»people»healthier.» Indeed»there»are»five»million»people»at»risk» of»getting»type»2»diabetes,»so»addressing» this»is»critical.»So»a»real»focus»on»behaviour» change/early»intervention»makes»sense.» The»problem»is,»however,»that»the»savings» achieved»are»in»the»future.»Indeed,»we»may» even»have»higher»short»term»costs»as»we» twin» track» sustaining» existing» provision» whilst»also»funding»the»strategies»to»deliver» the»behaviour»change.
Such» enterprise» was» not» restricted» to» Birmingham.» As» Barry» Quirk,» chief» executive» of» Lewisham» likes» to» remind» us,»in»the»19th»century»the»public»baths»of» inner»London»all»ran»at»a»profit,»(something» city»treasurers»of»today»can»only»dream»of» when»they»consider»the»running»costs»of» swimming»pools).»Into»the»20th»century»we» have»the»example»of»Hull»and»its»phone» company.»Today»consider»the»success»of» Manchester»Airport,» owned» by» its» local» authorities.»The»company»now»also»runs» Stansted»Airport.
Joe»Simpson
it» difficult» to» operate,» or» where» public» investment»delivers»benefits»both»to»the» public»and»private»sectors.»Chamberlain’s» investments»in»utilities»delivered»benefits» not»just»to»Birmingham’s»citizens,»but»also» to»Birmingham’s»businesses.»The»“city»of»a» thousand»trades”»needed»effective»utilities. The»question»we»need»to»ask»is,»what»sort» of» commercial» challenges» should» 21st» century»local»government»consider?»The» whole»devolution»debate»has»been»framed» around» questions» of» economic» growth,» schemes»involving»“earn»back”»and»the» like. Commercialisation»is»more»than»effective» procurement,» or» tough» negotiation,» but» it» does» require» commercial» rigour.» Not» every»place»can»become»a»world»leader,» so»we»must»recognise»what»commercial» strengths»we»might»have.»Secondly,»like» every»old»skill»we»have»sort»of»forgotten,» or» which» have» become» rusty,» on» day» one»we»do»not»attempt»the»most»difficult» manoeuvre.»So»let’s»start»by»being»more» commercial»amongst»ourselves,»building» on» the» practice» of» different» authorities» which»already»have»developed»expertise» in» certain» areas» and» have» traded» that» expertise.»Finally,»let’s»share»the»learning» and»let’s»do»it»quickly.»Seize»the»opportunity» to»embrace»commercialisation»and»then»we» have»a»chance»to»shape»our»own»destiny.»»
Commercialisation»therefore»is»not»a»“new”» idea»but»part»of»local»government’s»DNA.» But»this»is»not»about»replacing»the»private» sector.»It»is»about»looking»at»opportunities» Joe Simpson is Director of The where» either» the» private» sector» finds» Leadership Centre
Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
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Taxpayers. The media. Watchdog groups. If you’ve ever dealt with government
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Individual metering of energy and water
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kamstrup.com/submetering Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
19 44 ESTATES
Life Safety fire riSk aSSeSSment
(SP205)-BAFE Scheme for Fire Protection
What»does»BAFE»scheme»SP205»offer»to» specifiers»and»building»owners/managers?
Everyone» responsible» for» a» building,» whether»in»the»public»or»private»sector,»must» be»aware»of»the»importance»of»adequate» fire»protection»for»their»customers,»staff»and» property.»
which» has» been» accredited» by» UKAS» and»is»delivered»by»a»number»of»licensed» certification» bodies.» This» scheme» was» launched»in»May»2012»and»organisations» are»now»being»certificated»across»the»UK.
The»legislation»(Regulatory»Reform»(Fire» Safety)» Order» and» Fire» (Scotland)» Act» 2005)»requires»that»the»‘responsible»person’» or»‘duty»holder’»for»a»building»carries»out» an» adequate» fire» risk» assessment» and» follows» the» requirements» in» providing» fire» protection.» There» is» a» wide» range» of» standards» and» guidance» documents» available,»which»can»be»complicated»and» therefore»there»is»often»a»need»in»all»but» the»smallest»buildings»to»gain»expert»help.
BAFE»(based»at»the»Fire»Service»College» at» Moreton» in» Marsh,» Gloucestershire)» is»the»independent»registration»body»for» companies»that»have»achieved»third»party» quality»certification»of»their»fire»protection» services.»Users»and»specifiers»currently» gain» the» reassurance» that» over» 1250» BAFE»registered»providers»of»fire»alarms,» For more information go to the BAFE portable» extinguishers,» and» emergency» website www.bafe.org.uk lighting» meet» UK» standards» and» are» Key points of BAFE regularly»audited.»
Whilst»for»some»premises»it»is»perfectly» possible»for»the»responsible»person»(duty» holder» in» Scottish» legislation)» to» carry» out» the» fire» risk» assessment,» for» larger» or»more»complicated»premises,»it»may»be» necessary»to»call»in»an»expert.»
The»Government»publishes»guidelines»for» fire»protection»in»a»range»of»premises»which» state:
In» the» public» sector» this» is» even» more» important»to»ensure»that»safety»is»seen»as»a» professional»priority»and»that»every»aspect» of»their»duty»of»care»has»been»considered.» There» are» a» number» of» professional» accreditation» bodies» which» offer» lists» of» assessors,» but» nowhere» to» find» independently» certificated» companies» that»meet»nationally»accepted»standards.» A»number»of»major»facilities»management» companies»who»offer»services»to»public» bodies,» now» recognise» that» they» need» to»have»independent»certification»of»the» quality»of»their»work.»
scheme SP205
»‘Third»party»certification»schemes»for»fire» protection»products»and»related»services» are»an»effective»means»of»providing»the» fullest»possible»assurances,»offering»a»level» of»quality,»reliability»and»safety»that»noncertificated»products»may»lack.»This»does» not»mean»goods»and»services»that»are»not» third-party»approved»are»less»reliable,»but» there»is»no»obvious»way»in»which»this»can» be»demonstrated.’
Many» public» bodies» and» commercial» organisations»now»specify»the»requirement» for»their»fire»protection»service»providers» to»be»third»party»certificated.»There»are»a» growing»number»of»tenders»now»stating» this»as»part»of»the»pre»qualification»criteria.» This»is»not»a»question»of»recommending» one»company»over»another,»as»there»is» BAFE,»the»independent»quality»approvals» now» such» a» wide» range» of» companies» body»for»the»fire»protection»industry,»has»a» available»who»are»certificated,»but»a»matter» scheme»for»companies»who»provide»Life» of»refining»choices»for»end»users. Safety» Fire» Risk»Assessment» (SP205),» Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
Under»the»legal»provisions»that»apply»in»the» UK,»the»duty»holder»or»responsible»person» for»a»building»is»required»to»make»a»fire»risk» assessment»to»clarify»the»fire»precautions» necessary»to»ensure»the»safety»of»staff,» service»users»and»property.»BAFE»scheme» SP205»will»identify»organisations»that»have» been»independently»certificated»to»deliver» this»service.
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This»scheme»has»been» developed»by»a»group»of» industry»experts»to»help»the» building»‘responsible»person’» meet»the»requirements»for»Fire» Risk»assessments»under»the» Regulatory»Reform(Fire»Safety)» Order»2005»and»Fire»(Scotland)»» Act»2005 SP205»specifies»that»companies» must»have»the»required»technical» and»quality»management» capabilities. Risk»assessment»staff»need»to» meet»appropriate»standards. The»scheme»has»been»designed» to»meet»the»requirements»of» companies»large»and»small,» recognising»that»there»are»many» individuals»working»as»assessors. BAFE»has»been»working»closely» with»the»Competency»Council» which»was»independently»set» up»to»monitor»and»develop»Risk» Assessor»competence»criteria. SP205»is»delivered»by»UKAS» accredited»certification»bodies.
DON’T GAMBLE WITH YOUR FIRE RISK ASSESSMENT! If you are responsible for a business premises, the law requires that you have a fire risk assessment. To find competent providers, you need BAFE. Under the provisions of the Regulatory Reform (Fire Safety) Order 2005, the Duty Holder or Responsible Person for a building is required to make a Fire Risk Assessment to clarify the fire precautions necessary to ensure the safety of staff, customers and property.
info@bafe.org.uk 0844 335 0897
At present there are no adequate means to ensure the competence and reliability of a company commissioned to carry this out. BAFE scheme ‘Life Safety Fire Risk Assessment SP205’ has been developed specifically to address this situation, and will provide reassurance to the Responsible Person that they are doing everything possible to meet their obligations.
Don’t leave everything to chance. Make sure that your suppliers are registered with BAFE.
WWW.BAFE.ORG.UK
Public Sector Procurement
20 50 EFFICIENCIES
HOW TO MEET SAvINGS TARGETS WITHOuT SCRAPPING FRONTLINE SERvICES Nigel»Scorey»
spending cuts across the public sector needn’t be at the cost of quality or service
Public sector workers have been under immense financial pressure to find savings for a number of years now and still the challenge increases with the current government now looking for further 40% cutbacks, whilst the demand for goods and services continues to grow,»says Nigel Scorey. Traditionally,»the»top-down»approach»would» have»been»to»make»the»necessary»budget» cuts,»then»apply»pressure»on»managers» to»find»further»slashing»of»the»quality»or» quantity»of»services»to»meet»targets.»The» prevalent»attitude»amongst»beleaguered» managers»has»therefore»not»surprisingly» been» to» try» and» protect» services» and» quality»and»defend»requirements»in»their» area,»hoping»other»services»will»take»the» hit,» rather» than» embracing» change» and» working»collaboratively»to»find»solutions» that»reduce»cost»whilst»maintaining»service» standards.» The»public»sector’s»receptiveness»to»the» value» and» advantages» of» professional» procurement» has» been» mixed» as» the» process» is» understandably» seen» as» cumbersome» and» often» the» buyers» are» seen» as» at» odds» with» the» needs» of» frontline»staff.»However»with»the»pressure» increasing,»more»and»more»public»sector» professionals» are» embracing» more» forward»thinking»procurement»solutions,» transferring»lessons»and»tactics»gleaned» from»the»corporate»world»into»the»public» sector.»This»is»by»no»means»a»revolutionary» idea,»but»with»a»change»in»attitude»from»
Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
both»the»user»and»the»buyer»communities,» the»benefits»associated»with»this»approach» are»being»firmly»recognised.» Long» before» government» accepted» the» need»to»look»at»cost»cutting»measures,»big» business»had»been»ravaged»by»recession.» The»private»sector»learned»early»on»not»to» cut»back»on»the»customer»experience-»at» the»risk»of»losing»custom»and»the»business» itself.»Instead»it»forced»managers»to»work» across» functions» and» with» procurement» to»find»solutions»that»were»fit»for»purpose,» whilst»enhancing»the»consumer»experience» of» the» brand.» Local» government» needs» to» take» heed» from» grassroots» level» up.» Spending»cuts»across»the»public»sector» needn’t» be» at» the» cost» of» quality» or» service.» Quality» frontline» services» can» be»delivered»within»available»resources» through»a»simple»review»of»a»spend»area’s» direct»impact»on»the»consumer»versus»the» savings» achievable» through» an» aligned» procurement» strategy.» The» programme» then»starts»with»low»impact»/»high»savings» areas,»quickly»proving»the»model.»Savings» are» delivered» through» a» fit» for» purpose» collaborative»approach,»consolidating»the» huge»range»of»suppliers»and»specification» in» use,» without» comprising» the» public» services»that»affect»millions»of»local»people.» Now»is»the»time»for»widespread»change»to» embrace»a»new»way»of»resolving»cuts.»It» has»to»start»with»changes»in»attitude»from»a» defensive»and»protective»approach»to»one» that»embraces»the»need»for»collaboration» and»new»ways»of»working.»Then»changes»
21 EFFICIENCIES 51 in»the»approach»to»procurement»from»a» process»and»criteria-led»doctrine»to»one»that» is»consumer»needs-led.»Finally,»managers» have»to»embrace»changes»to»supplier»and» specification»that»sees»one»fit»for»purpose» solution»utilised»across»functions»and»user» communities» from» the» multitude» in» use» within»one»organisation»today.»In»short,» embracing»change»to»develop»strategic» improvements»that»will»help»reduce»costs» and»improve»social»value.» Embracing» change» on» this» scale» is» tough»for»any»organisation.»Public»sector» managers» can» benefit» greatly» from» combining» their» insight» into» their» areas» with»hands-on»procurement»professionals» operationally» experienced» in» delivering» such»programmes»on»both»sides»of»the» public» and» private» fence.» Providing» a» 360» overview» to» help» overcome» the» inevitable» challenges» of» defensiveness» and»protecting»services,»whilst»ensuring» that» procurement» teams» are» seen» as» understanding»the»needs»of»the»consumer» and» what» genuinely» constitutes» fit» for»
purpose.» Ultimately» developing» and» benefits»tracking»within»the»Council. delivering»a»truly»collaborative»approach» to»‘change»management’.» In»year»one,»more»than»£1m»collectable» savings» with» significant» other» cashable» Procure4» is» one» of» a» number» of» and»non-cashable»efficiency»gains»were» small» businesses» that» provides» such» delivered.»In»the»second»year,»a»further» professionals» in» both» local» government» £1m»was»delivered.»The»tangible»savings» and»the»NHS.»It»was»engaged»by»Solihull» enabled»budgets»to»be»re-assessed»and» Metropolitan»Borough»Council»a»number» freed»up»resources»for»use»on»back»office» of»years»ago»to»achieve»cashable»savings» systems»which»then»supported»frontline» which» would» help» with» investment» in» a» services.» More» importantly,» through» new»shared»services»infrastructure.»The» broader» training» and» skills» transfer,» a» Council» knew» it» had» to» gain» control» of» refreshed»attitude»to»change»management» spending»and»reduce»the»high»number»of» was»established»which»ensured»that»the» low»value»transactions.»Procure4»analysed» Council»could»move»forward»independently» the» spend» data» and» current» processes» to»tackle»larger»and»more»challenging»areas» across»a»number»of»categories,»prioritising» of»budget»cuts»with»confidence»and»a»truly» temporary» labour,» telecoms,» strategic» collaborative,»cross»functional»approach.» highways,»print,»office»supplies,»property» services,»adaptation»works,»books»and»ICT» The» public» sector» is» dealing» with» huge» as»the»place»to»start»a»major»programme» spending»cuts»and»unwavering»demand» of» change.» » Approach» strategies» were» for»services.»Swift»change»is»hard»to»come» established»for»each»category,»including» by,»but»change»is»taking»place»in»some» use»of»eProcurement»tools»and»traditional» areas»of»local»government»where»forward» tender.»A»fully»auditable»savings»process» thinking» CEOs» embrace» learning» from» was» implemented» and» enabled» clear» other»sectors»and»new»models»of»service» delivery»are»developed»to»address»financial» pressures.»As» the» Solihull» Metropolitan» Borough»Council»contact»demonstrates,» through»embracing»change»on»a»number» of»levels,»local»government»can»adopt»a» truly»collaborative»and»proactive»approach» to» reducing» budgets,» utilising» simple» procurement» techniques» to» ensure» the» quality» of» frontline» services» and» the» consumer»experience»remain»the»priority» of»public»service»provision.» In» recent» years,» Procure4» has» taken» learning» from» blue» chip» business» to» public»sector»organisations»as»diverse»as» Suffolk»Council»and»South»Staffordshire» NHS,»helping»under»pressure»managers» to»comfortably»meet»budget»constraints» across»multiple»categories.»
Nigel Scorey is CEO of Procure4 www.procure4.com Public Sector Procurement|Sept/Oct 2015 Public Sector Procurement
22 52 EFFICIENCIES
HOW TO CuT YOuR POSTAGE COSTS
Communication is vital to government organisations but the estimated cost to the public sector is around £1.10 to send a letter, printed and delivered. One smart and efficient solution is helping to bridge the gap With» public» sector» spending» now» firmly» »“We»have»saved»weeks»in»staff»time»and» and»slashes»postage»costs.»Free»Dotpost» in»the»spotlight,»the»pressure»for»public» hundreds» of» pounds» using» Docmail» for» accounts»can»be»offered»to»all»citizens»so» services» and» healthcare» providers» to» large»runs»–»it’s»more»efficient»than»the» they» can» benefit» from» free» storage» and» deliver» more» for» less» is» greater» than» more»traditional»method.»Our»flu»campaign» delivery» of» documents» from» all» public» ever.»Public»sector»managers»must»try»to» alone»saves»us»over»£800.»By»using»EMIS» sector»departments.» balance»budgets»and»increase»efficiency» Web»searches,»we»save»even»more.»We» without»affecting»services»or»patient»care.» believe»that»other»medical»practices»should» Dotpost»was»used»recently»by»Ian»Brown,» benefit»from»it,»too.”» Head»of»Revenue»and»Benefits»at»Wiltshire» Docmail» is» used» by» over» 20,000» Council. organisations» across» the» UK» as» a» vital» From» appointment» letters» and» clinic» communication»tool»and»has»printed»and» campaigns»to»result»reminders,»invitations» “The»Dotpost»system»is»slick»and»easy»to» delivered»over»68»million»letters»since»its» for» QOF» indicators» and» invoicing,» the» use,»and»we»are»hopeful»that»this»will»lead» launch» in» 2008.» Of» these,» a» third» have» capabilities» of» the» innovative» Docmail» to»a»reduction»in»our»usual»postage»and» been»sent»by»healthcare,»local»government» system» offer» limitless» options» for» stationery»bill.»The»Dotpost»system»helps» and»education»institutions,»including»GP» healthcare»and»medical»organisations.»In» us»to»access»customers»in»a»more»personal» surgeries,» schools» and» local» councils,» recognition»of»its»benefits,»CFH»Docmail» way»and»to»take»a»step»towards»our»ambition» representing»a»collective»saving»of»around» recently»secured»a»new»agreement»with» of»a»much»more»efficient»communications» £8»million»on»the»cost»of»traditional»print» GP»Systems»of»Choice»as»part»of»its»Lot» system.»It»has»also»allowed»us»to»manage» and»mailing.» 2»Additional»GP»IT»Services»Framework,» our»database»more»effectively,»and»meet» which» include» the» Docmail» hybrid» mail» customer’s» expectations,» in» terms» of» Docmail’s»hybrid»mail»solution»allows»users» solution.» electronic»delivery.” to»benefit»from»savings»in»administrative» time»and»postage»costs.»Faster,»more»cost- As»part»of»its»ongoing»strategy»to»develop» CFH» Docmail» Managing» Director» Dave» effective»and»secure,»Docmail»relieves»the» innovative»mail»delivery»mechanics»which» Broadway»believes»the»Dotpost»solution» labour»intensive»task»of»a»manual»postal» save»their»customers»time»and»money»as» is» an» ideal» way» to» deliver» documents» mailing,»especially»at»peak»times»-»all»for» well»as»well»as»reducing»the»impact»on»the» securely»in»the»digital»age. just»39p»per»letter.» environment,»CFH»Docmail»has»recently» launched»Dotpost,»an»innovative»online» “Mass»mailing»is»an»expensive»task»and» Through»the»secure»online»portal,»Docmail» document»delivery»solution.» email»is»wholly»unreliable.»We»believe»that» users» create» personalised» letters,» print» this»way»of»sending»letters»and»reports»–»is» and»deliver»a»high»quality»communication» Dotpost»is»a»secure»online»platform»that» a»great»alternative»to»print»and»post,»and» piece»securely»to»all,»or»a»selection»of»their» allows»users»to»store»documents»easily» of»course»much»easier»for»citizens»if»they» database.» –»and»free»of»charge.»Recipients»simply» can»store»and»view»all»paperwork»in»one» register» using» a» unique» invitation» code» secure»portal.” Martin’s» Oak» Surgery,» a» small» practice» and» they» can» view,» save» and» print» the» in»East»Sussex,»has»been»using»Docmail» documents»they»need»on»any»device»(PC,» for»four»years.»Practice»Manager»Carey» smartphone»or»tablet).» Sinclair»says»the»difference»it’s»made»to» their»practice»is»significant: Dotpost»reduces»the»amount»of»paper»used» www.docmail.co.uk Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
54
COMMISSIONING
COMMISSIONING
23
the DemoniSation of the Private ProviDer
David Pearce looks at the commissioning of musculoskeletal physiotherapy and its outstanding improvement on patient care After» 18» months» and» thousands» of» amendments,» the» Health» and» Social» Care» Bill» was» passed» in» Parliament» in» March»2012.»The»writing»was»on»the»wall» for» NHS» Providers» and» staff» to» either» embrace» the» changes» or» disappear.» In» East» Kent,» GPs,» Commissioners» and» Independent» Providers» embraced» the» changes»and»became»the»pathfinders»for» the»development»of»GP-Commission-led» services,»delivered»to»Key»Performance» Indicators»which»would»provide»value»for» money,»and»safe»and»efficient,»high-quality» physical»therapy»services. Working» as» the» superintendent» physiotherapist» for» the» Canterbury» and» Coastal»area»gave»insight»into»a»failing» NHS»physiotherapy»service.»New»to»Follow» Up»ratios»were»climbing,»Did»Not»Attend»» rates»were»as»high»as»20%»and»waiting» times» even» reached» a» maximum» of» 53» weeks»for»routine,»chronic»conditions. In»partnership»with»local»GPs»and»Practice» Based» Commissioners,» EKTRA» was» established»in»2007»with»the»prime»objective» of» tackling» the» deplorable» » problems» in» East»Kent»NHS»Physiotherapy»services.» An»independent,»contracted»service»was» commissioned»by»the»NHS»and»produced» a»truly»efficient»and»seamless»service»for»its» patients.»The»independent»management»of» patient»referrals»allowed»for»patient»choice» and» expansion» of» service» availability,» delivered»by»a»plurality»of»providers.» Where» patients» were» previously» being» funnelled»into»secondary»and»primary»care» physio»centres»and»hitting»bottle»necks»of» high»waiting»times,»they»are»now»allowed» to»choose»to»have»their»physio»in»their»GP» surgery»near»home»or»their»workplace»or»
even»in»one»of»EKTRA’s»six»private»clinics.» NHS» patients» can» now» experience» the» quality,»integrity»and»care»of»real»private» healthcare,»without»the»worry»of»having» to»find»the»funds»to»pay.»»This»is»what»is» commonly» referred» to» in» the» media» as» privatisation»of»the»NHS.» With» this» phrase,» media» outlets» and» politicians»have»incited»a»belief»and»scared» off» the» public,» reminding» them» of» past» problems»experienced»from»privatisation» of»the»public»sector»and»grossly»expensive» Private»Finance»Initiatives.»Ultimately,»they» have»demonised»the»private»companies»as» fat»cats»creaming»off»the»profits.» Sadly,»we’re»not»shown»the»full»picture.» Providing»a»contract»for»companies»like» EKTRA»is»similar»to»finding»a»decorator» to»rejuvenate»your»house.»You»tell»them» what»you»want,»they»do»what»you»want.» You»don’t»worry»about»when»you’re»going» to»decorate,»the»materials»you»will»need,» the»planning»and»execution»of»the»process.» This» method» is» tried» and» tested» in» all» walks»of»life,»yet»we»seem»more»reluctant» implementing»this»in»our»health»service.»
capacity.»Therefore,»demand»has»grossly» exceeded»supply! Over» 8» years» of» experience,» EKTRA» has» seen» its» physical» therapy» services» bring»DNA»rates»down»to»4.98%»and»the» NFU»ratio»to»1»:»3.35.»Waiting»times»are» massively» reduced» with» appointments» booked» » within» one» week» and» urgent» cases»within»48»hours.»This»is»a»startling» improvement» on» the» historical» average» NHS» wait» of» 12+» weeks.» Numbers» and» statistics»have»become»a»very»important» element»of»controlling»overstretched»and» under» resourced» services.» However,» patient»care»is»paramount»as»each»single» patient»referral»is»the»most»important»asset» to»EKTRA,»a»growing»healthcare»company.
The»local»CCGs»benefit»from»our»services» as» it» reduces» their» financial» burden» by» decreasing»secondary»care»referrals»and» prescribing»and»administrative»costs.»The» service» provides» real-time» records» with» flawless» communication» between» GP/ physiotherapist» and» the» patient.» Both» GPs»and»physiotherapists»have»a»sense» of»ownership»and»control»over»the»service.» Equally,»physiotherapists»are»empowered» This»aspect»of»NHS»service»is»not»being» and» supported» to» work» autonomously» privatised.» There» is» no» selling» off» or» with»flexible»working»patterns,»according» ownership»of»the»NHS.»EKTRA»and»other» to»demand.» providers» must» provide» the» service» to» agreed» NHS» standards» or» will» fail» and» If» you» want» to» provide» a» first» class» disappear»quickly.»The»contracts»are»zero- community-based»service»that»could»be» based»in»value.»They»cost»nothing»to»the» recommended»to»your»friends»and»family» NHS»when»not»providing»treatments»or»for» then»this»is»the»business»model»to»follow.» failed»appointments,»down»time»or»peaks» It»works. and»troughs»in»demand.»This»ultimately» results»in»highly»efficient,»cost»effective» David Pearce is Principal Physiotherapist and»VFM»patient»care.»»The»private»sector» and Company Director, EKTRA Ltd. is»only»providing»what»the»NHS»»failed»to»do» and»has»not»been»able»to»provide»within»its» www.ektralimited.com
Public Sector Procurement|Sept/Oct 2015
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55
Market leaders in the supply of therapeutic services
An and Private Provider of Physical Therapies • Physiotherapy • Acupuncture • Osteopathy • Chiropractic We provide the right treatments at the right time at a convenient location such as a GP surgery or Health Centre. All EKTRA therapists are experienced and fully qualified with a commitment to patient and customer care.
Public Sector Procurement|Sept/Oct 2015
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www.ektralimited.com ( 0800 999 7919
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24 60 COMMENT COMMENT
WHY SIxTH FORM FORM COLLEGES COLLEGES WHY ARE ARE SIXTH BEING CUT? CuT? Sixth form areare almost universally acclaimed as a success story in story in British education. Sixth formcolleges colleges almost universally acclaimed as a success British education. They have outperformed other schools and have a proud They have outperformed other schools and have a proud record record in giving adults a second chance to improve their skills and qualifications. in giving adults a second chance to report improve skills and qualifications. Yet a recent from their the Sixth Form College Association (SFCA) shows that six years of cutsreport in 16-19from education fundingForm is having a devastating impact on Yet a recent the Sixth College Association (SFCA) shows that six years the sector and the choices available to students, says Ben Thomas. Ben»Thomas of cuts in 16-19 education funding is having a devastating impact on the sector and the choices available to students.
Most»colleges»were»established»in»the» 1960s» when» a» group» of» progressive» Most colleges were established in the Local»Education» Authorities»established» 1960s when a group of progressive Local a»more»rational»and»efficient»approach» Education Authorities established a more to»delivering»post-16»education.»By»size» rational and efficient approach to delivering efficiencies»they»were»able»to»increase» post-16 education. By size efficiencies they the» number» of» courses» available,» were able to increase the number of courses provide» specialist» teaching» at» both» A» available, provide specialist teaching at level» and» in» vocational» training,» offer» both A level and in vocational training, offer better» extra-curricular» activities» and» better extra-curricular activities and provide provide»a»vital»bridge»between»school» a vital bridge between school and university and»university»education. education. The» sector» has» seen» funding» cuts» The sector has seen funding cuts across across» England» of» 33%» since» 2011,» England of 33% since 2011, and the SFCA and»the»SFCA»report»found»that: report found that: •70%»of»college»leaders»do»not»believe» •70% of college leaders do not believe that that» the» amount» of» funding» they» are» the amount of funding they are likely to likely»to»receive»in»2016»will»be»enough» receive in 2016 will be enough provide a provide»a»high-quality»education high-quality education •72%» of» colleges» have» dropped» •72% of colleges have dropped courses as a courses»as»a»result»of»cuts»since»2011 result of cuts since 2011 •76%» of» colleges» have» reduced» or» •76% of colleges have reduced or removed removed» extracurricular» activities» for» extracurricular activities for students students •81% of colleges are now teaching students •81%» of» colleges» are» now» teaching» in larger class sizes because of funding cuts students»in»larger»class»sizes»because» of»funding»cuts These cuts, along with a discriminatory funding system are placing the very future
These»cuts,»along»with»a»discriminatory» of the sector at risk. Many of the cuts have funding» system» are» placing» the» very» been in modern languages, science and future»of»the»sector»at»risk.»Many»of»the» maths - subjects ministers are purporting to cuts»have»been»in»modern»languages,» encourage. science»and»maths»-»subjects»ministers» are»purporting»to»encourage.» The unanswered question remains, if the government is committed to a compulsory
The» unanswered» question» remains,» education till eighteen and sixth form if» the» government» is» committed» to» a» compulsory»education»till»eighteen»and» sixth» form» colleges» provide» such» an»
efficient» and» effective» education,» why» are»they»being»starved»of»funding?» colleges provide such an efficient and
effective education, why are they being Most»believe»it»is»simply»a»question»of» starved of funding?
fashion.» Because» sixth» form» colleges» are»not»new»and»the»government»is»so» Most believe it is simply a question of fashion. intent» on» demonstrating» the» success» Because sixth form colleges are not new and of» the» academy» and» free» school» the government is so intent on demonstrating programme,» they» are» blind» to» their» the success of the academy and free school success» and» unwilling» to» divert» any» programme, they are blind to their success resources»away»from»their»pet»projects.» and unwilling to divert any resources away from their pet projects.
It» has» also» been» suggested» that» the» experience» of» sixth» form» and» further» It has also been suggested that the education» colleges» in» general» is» so» experience of sixth form and further divorced» from» the» typical» ministerial» education colleges in general is so divorced background» of» private» school» and» from the typical ministerial background university» that» they» simply» do» not» of private school and university that they understand» the» value» and» benefit» simply do not understand the value and that»they»provide»for»those»from»more» benefit that they provide for those from more disadvantaged»backgrounds.» disadvantaged backgrounds. Or»is»it»simply»that»sixth»form»colleges»
Or is it simply that sixth form colleges hark hark» back» to» the» days» of» planned» back to the days of planned provision by provision»by»the»hated»Local»Education» the hated Local Education Authority and Authority»and»progressive»educational» progressive educational ideas of the 1960s?
ideas»of»the»1960s?»
Whatever the answer, the dogmatic insistence Whatever» the» answer,» the» dogmatic» that academisation is the only solution for insistence» that» academisation» is» the» improving educational outcomes,increasing only»solution»for»improving»educational» student choice and eliminating the skills and outcomes,increasing» student» choice» productivity gap is actually making these and» eliminating» the» skills» and» problems worse in the post 16 sector.
increased.
Further»cuts»will»make»it»unsustainable.» Colleges»are»already»reducing»vocational» Further cuts will make it unsustainable. courses» and» the» extra-curricular» and» Colleges are already reducing vocational enrichment» activities» that» have» made» courses and the extra-curricular and them»special.»The» number» of» colleges» enrichment activities that have made them in» England» has» already» reduced» from» special. The number of colleges in England over»110»to»93.»Many»are»considering» has already reduced from over 110 to 93. converting»to»academy»status»to»benefit» Many are considering converting to academy from» more» favourable» VAT» treatment,» status to benefit from more favourable VAT but» this» will» reduce» their» academic» treatment, but this will reduce their academic freedom»and»ability»to»innovate.» freedom and ability to innovate. The» government» needs» to» re-think»
The government needs to re-think its its» approach» to» post» 16» education» if» approach to post 16 education if it wants it» wants» to» avoid» a» crisis» in» provision.» to avoid a crisis in provision. It is no longer It» is» no» longer» sustainable» to» protect» sustainable to protect schools budgets at schools» budgets» at» all» costs» and» at» all costs and at the expense of the post 16 the» expense» of» the» post» 16» sector.» sector. Sixth form colleges are an education Sixth» form» colleges» are» an» education» success story that we cannot afford to lose.
success»story»that»we»cannot»afford»to» lose.»
productivity» gap» is» actually» making» these» problems» worse» in» the» post» 16» The unplanned growth in academy sixth sector.» forms is having a perverse outcome in that
The government needs to rethink its approach to post 16 education if it wants to avoid a crisis in provision
forms» is» having» a» perverse» outcome» in» that» it» is» actually» reducing» subject» choice» and» learning» opportunities.»
Ben Thomas is uNISON national officer
it is actually reducing subject choice and The»unplanned»growth»in»academy»sixth» learning opportunities.
Public Sector Procurement|Sept/Oct 2015 Public Sector Procuremenr
As» sixth» form» colleges» are» being» squeezed,» the» choices» available» to» As sixth form colleges are being squeezed, students» in» many» areas» are» being» the choices available to students in many restricted»and»inefficiency»is»increased.» » areas are being restricted and inefficiency is
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