Good Practice Framework

7/29/2019 Good Practice Framework

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GoodPracticeFramework

Performance Management


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2

Strategic

Review

Continuous

Improvement

Performance

Measurement

Tendering

Evaluation

Plan

Specification

DevelopmentStandard

Contracts

PERFORMANCE

MANAGEMENT

STRATEGIC

PLANNING

STRATEGICCOMMISSIONING

Toidentifythehealthneedsofthepopulationandmakeprioritised

decisionstosecurecaretomeetthoseneedswithinavailableresources

Market

Sounding

Contract

Managem

ent

Procurement

GoodPracticeFramework

Contract

Award

Strategic

Planning

CurrentService

&Demand

ContractReview

Benchmarking

Options

Development

&Resourcing

Market

Assessment &

Stimulation

Pricing

Model

ACQUISITION

Outcomes

StrategyDeve

lopment

CommissioningPlan

and BusinessCase

Contract

Startup

Procurement

Route

Consultation

Procurement

Initiation

Provider

Selection

PolicyContext

Needs

Assessment

Stakeholder

Engagement

DecisionGateway

DecisionGateway

Decision

Gateway

Stakeholder

Engagement


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Performance Management Overview

This stage starts after the contract has been awarded to the successful bidder. Managing the contract efficientlyensures that:Targets agreed in the contract are adhered to and measures can be put in place early to improve performance ifthey are not being met.You can measure performance against key outcomes linked to strategic targets including care improvement andadjust the service according to changing circumstances and demands

Getting the information that you need on the performance of the contractor can be achieved firstly by setting upsystematic methods of measuring and reviewing performance throughout the life of the contract and secondly bymaintaining an open and constructive relationship with your service provider. By achieving such clarity you are in abetter position to make informed decisions about the future of the service.While ensuring that levels of service set out in the contract are met, you should not necessarily regard the contractas a rigid set of stipulations which cannot be changed should circumstances and demand change. By maintainingan open dialogue with your provider, you can achieve a level of service which not only realises planned improved

patient outcomes but which could potentially exceed them.The steps in this stage look firstly at managing the transition from award of contract to contract start-up and then athow you can set up a firm foundation for reporting and Performance Management, as well as providing aframework for continuous improvement.


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Performance Management

Strategic

Review

Continuous

Improvement

Performance

Measurement

Performance

Management

Contract

Managem

ent

ContractStart up

Decision

Gateway Strategic

Planning

h

elpingcommissionersdevelopcomp

etencies

The steps in this stage willcontribute towards developingyour competencies in the

following areas


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Performance Management Step 1: Contract start

up

Summary

The terms and conditions of the contract will have been established during the tendering process. This

stage describes the period between contract signature and the commencement of service The purpose ofthis stage is to ensure a smooth transition of services provided by the provider, and a commonunderstanding of how the management of the contract will be carried out in practice. The primary output ofthis will be a Statement of Readiness.In setting up the contract you should be aiming to establish working practices that will provide aconstructive commercial relationship with your service provider. To do this you will need:

A clear understanding of the business objectives on both sides of the contract

Effective governance and administration of the contract, including regular Performance Management andreporting and the appointment of a contract manager. On the PCT side, the contract manager must have anin-depth knowledge of the care area for which the contract is being provided.A commitment to continuous improvementA thorough understanding of the contract and services specifiedFlexibility over unforeseen circumstances, particularly in long-term contracts and a commitment to managea change in the contract should requirements or scope change.A broad perspective of the contract which looks critically at outcomes as well as outputs.

Who is involved?Project/Contract ManagersClinical GovernanceCommercialLegal

Service specifiers

PrerequisitesProvider selectedContract agreed

Information/Dataset Source

contract

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3

2

1

Strategic

Planning

Performance

Management


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Performance Management Step 1: Contract start up

KeyactivitiestTo ensure that the transition from contract award to service commencement is clearly defined, be clear aboutallocation of responsibilities, including knowing and agreeing who funds the transition.After the contract is signed, you next need to work with your service provider to ensure that you are ready for thestart of the new service.The key steps you will need to address during the implementation stage may include:

Planning and setting up mobilisation meetings with appropriate stakeholders as early as possibleDelivering the change through disciplined project management. Plan carefully to minimise disruption toongoing business requirements.Transition of staff and assets. Designated resources need to be in place for transition (e.g.

communications, HR, contract, finance, IT) Identification of key risks and issues

Building key interfaces between relevant (internal and external) stakeholdersEstablishing an appropriate culture within the retained organisationBuilding the relationship with the provider. Clear communication is a key factor. Clear and formal methodsof reporting progress must be agreed. Ensuring that services are safe and meet contractual requirements before patients are seenIdentifying and realising any quick wins needed to justify the commercial case and demonstrate success.

Depending on nature, size and complexity of the service being provided, the implementation stage will vary

enormously.It is important to ensure that there is a team in place to manage the contract throughout its life


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PerformanceManagement Step1:Contractstartup

ToolsandTemplatesTransition to safe toolkit from the Mental Health Road map

Statements of Readiness templatehttp://www.dh.gov.uk/en/Procurementandproposals/Procurement/ProcurementatPCTs/DH_081031

LinkstofurtherguidanceGood Practice contract management framework (OGC December 2008)http://www.ogc.gov.uk/procurement_documents_best_practice_guidance_.aspContract Management Guidelines (OGC 2003)www.ogc.gov.uk/documents/Contract_Management.pdf

WCCCompetency10 Effectively manage systems and work in partnership with providers to ensure contractcompliance and continuous improvements to ensure sustainable development and value formoney


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Performance Management Step 2: Performance

Measurement

Summary

An effective performance measurement regime should ensure that the provider is delivering againstthe targets stated within the contract. This involves not only measuring agreed quantitative targets,for example volume and timeliness, but also working with your provider to ensure that the contract iscontinuing to deliver the desired outcomes for patients.Contract management activities can be broadly grouped into three areas:

service delivery management ensures that the service is being delivered as agreed, to therequired level of performance and quality.

relationship management keeps the relationship between the two parties open and constructive,aiming to resolve or ease tensions and identify problems early.contract administration handles the formal governance of the contract and changes to thecontract documentation.

Whoisinvolved?Thisprocessshouldbeledbytheperformanceimprovement/managementteamwithinputfrominformationanalysts,contractand

servicemanagers.

PrerequisitesContractsNational and local targetsSpecification

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PerformanceManagement Step2:Performance

MeasurementKey activities

1. MeasurementsIn order to achieve this step you need to consider the following:

Confirm with your service provider the key performance indicators set out in the contract. These will typically cover:

Service standards

Service activity

Financial activityService quality.

Agree the means of measurement and how the evidence will be acquired as described in the specification development you should be

seeking to collect a wide range of evidence including data on patient safety , clinical effectiveness and workforce standards.

When it comes to the agreed review time you need to complete your assessment of the performance. At the same time, your service

provider should be given the opportunity to make their own assessment.

Make sure that you have a balanced set of indicators but it is advisable not to have too many. You need to consider the cost and

difficulty of collecting data.

2. Review process

Ensure that you have a timetable of reviews that meets those outlined in the specification

Gather your information analyse activity and financial data

Review feedback and information from patient groups

Make an assessment against your KPIs. You can score your assessment these can be weighted according to the priorities of your

benefits or targets. You should not allow a part score for a performance indicator that has not been fully met. Scoring your performancewill allow you to present the performance report in a graphical format

Discuss results with provider and give them the opportunity to make a separate assessment

Review joint performance assessment and produce report

Reflect on the results of the report with the provider and within the PCT

Report any concerns to customer departments

Agree a written improvement plan with the provider

Prioritise areas for future review

Ensure stakeholders see results of performance reviews


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PerformanceManagement Step2:Performance

MeasurementKey activities continued

3. Managing Poor performanceHow you deal with poor performance can depend on a number of factors. By fostering a constructive relationship with your provider you

should be able to spot problems early and put in place an improvement plan before the issue becomes serious and before the matter has

become serious. In determining how punitive your action will be you need to consider the risk of any failure to patients and the

consequent severity of the situation, whether there has been a breach of contract and the providers previous record and response to

poor performance. To deal with a problem effectively you need to:

Analyse the reasons behind the problem

Make clear to the provider the problem that has been caused

Give managers the time to develop a corrective action plan


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Performance Management Step 2: Performance

MeasurementTools and Templates

Performance review timetableCustomer review template

Links to further guidance

http://www.ogc.gov.uk/procurement_documents_best_practice_guidance_.aspOGC Contract Management Guidelineswww.ogc.gov.uk/document/contract_management.pdfOGC Category management toolkit

http://www.ogc.gov.uk/documents/SupplierCustomer_Performance_measurement.pdfhttp://www.ogc.gov.uk/documents/Performance_Indicators(1).pdf

Mental Health Road Map Contract Management Toolkithttp://www.pasa.nhs.uk/PASAWeb/PCTzone/mentalhealthservices/HowdoIcontractformentalhealthservices/Procurementtoolkit.htm

WCC Competency10 Effectively manage systems and work in partnership with providers to ensure

contract compliance and continuous improvements to ensure sustainabledevelopment and value for money

Examples

For examples of KPIS seehttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4137271


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Performance Management Step 3: ContinuousImprovement

SummaryThe whole commissioning relationship is based on one of continuous improvement. It is essential that everyeffort is taken to ensure that both stakeholders and service providers seek and exploit any opportunity toimprove the level and quality of the service to the patient.This will be done initially by Performance Management and improving performance and compliance with the

provider. Throughout the life of the contract, it is important to work jointly with the provider to identify andexplore innovation as a means to improve service, quality, cost-effectiveness, etc. as well as seekingservice and cost improvement and containment opportunities. This can be achieved through the use ofservice reports, patient feedback and market developments and enabled by establishing principles forcontinuous improvement as part of the tender specification, which can then act as a lever for ongoingdevelopment throughout the contract term.

Who is involved?This process should be led by the performance improvement/managementteam with input from service managers, clinicians including Clinical

governance and patients.

PrerequisitesUnderstanding of national, regional, organisational and contract targets

InformationrequiredInformation/Dataset Source

KPIs

Patient experience data Patient satisfaction surveys

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PerformanceManagement Step3:ContinuousImprovement

Key activitiesIn addition to managing and measuring performance against the contract. You need to maintain a dialogue with your

providers so that both sides can respond to changing demand this includes:

Monitoring and managing development plans

Involving your provide in joint improvement efforts that will continue to meet the PCTs key strategic objectives

Ensuring that there is resource and assistance in place to develop new opportunities Employing knowledge management to continue to track the provider market, to analyse spend history changes in the health

economy

Where you have more than one provider competing for services it is important to monitor the impact of that competition on

price and quality of services

Involving clinicians is an important aspect of achieving continuous improvement. New innovations or the impact of

improvements is related care areas could have an effect of the service required in the future perhaps introducing new ways of

improving patient care or changing the emphasis of the service provided. Involving all key stakeholders in regulardiscussions about service provision will help foster an environment of continuous improvement.


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PerformanceManagement Step3:ContinuousImprovement

Tools and Templates

http://www.institute.nhs.uk/world_class_commissioning/data_into_information/tools_and_templates.html

WCC Competency8. Promote and specify continuousimprovement in quality and outcomesthrough clinical and provider innovation andconfiguration

10 Effectively manage systems and work inpartnership with providers to ensurecontract compliance and continuousimprovements to ensure sustainabledevelopment and value for money

Further Guidance

For supporting information for benchmarkinghttp://www.connectingforhealth.nhs.uk/systemsandservices/sus


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Performance Management Step 4: Strategic Review

SummaryThe strategic review aims to provide an assessment of the services commissioned based onthe specific characteristics of the performance levels agreed in the contract.This is an ongoing process that should ensure that the strategic need continues to exist forthe commissioned service and that contracts in place remain fit for purpose and deliver valuefor money. However, there should be an annual assessment that will report whether or not

the service in place is still fit for purpose and that the funding and resources associated withthat service are still beneficial. Of particular importance is to continue to check the patient

demographic and environment to ensure that the service is still meeting demand and theimpact of related programmes. For example, how is the performance of the management ofobesity affecting demand for diabetes care?

Whoisinvolved?This process should be led by the project sponsor and the performanceimprovement/management team with input from:PCT BoardPerformance management teamContract managersService managersClinicians

Patients.

Prerequisites

ContractStrategic targets

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PerformanceManagementStep4:StrategicReview

Information/Dataset Source

Activity information PCT

Performance metrics PCT

Financial cost of the service PCT

National & Local (LDP) targets PCT

Performance against key metrics PCT

Performance against national standards PCT/DH

Information required


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Performance Management Step 4: Strategic Review

Key activitiesThere are three elements to the strategic review:

Service performance

How is the service performing against the CSFs in the contract?

How is the service performing against national and local targets?

How is the relationship with the service provider? Is it conducive to providing the best service possible?

Value for moneyHow do resources and costs compare against local comparators?

Service demand

Is there still the same level of need for this service?

Is the same approach to demand management still relevant?

Yourcommissioningstrategyreviewneedstoconsider:

Anymajor

external

factors

that

influenced

the

performance

of

the

service

in

adefined

period

or

any

factors

that

are

likely

toinfluenceprioritiesinthecomingperiod.

Revieweachofyouroutcomesandspecifyprogressagainsteachofthekeyperformanceindicatorsandanyactionsthat

havebeentakenasaresultoftheperformancemeasured.

Recordanychangesthathaveoccurredthatmightaffectthepriorityoftheserviceincludingtheimpactofprogresson

relatedcarepathways forexamplehavethesuccessofpublichealthcampaignsreduced thenumberofpatientsrequiring

treatmentinsomeareasandhowdoesthisaffectthesupplyofthattreatment.

Review

your

original

objectives

measures

and

actions

and

propose

changes

where

applicable

WCC Competency

10. Effectively manage systems and work in partnership with providersto ensure contract compliance and continuous improvements toensure sustainable development and value for money

Good Practice Framework

Documents

Transcript of Good Practice Framework