Tuesday 2 October 2012

Third sector health warning for addicts


There’s a touch of irony in today’s reports that Cabinet Office enforcers will punish mandarins who opt not to implement government policy, while on the same day we learn that third sector organisations, providing specialist support to NHS patients addicted to prescription drugs, believe they are the victim of a badly designed procurement process that could force them to close.  What happened to Third Sector Commissioning and the Big Society?  This is one example of policy failing to be implemented in  the procurement practice.

To cut a long story short, it appears a new tender approach is underway that requires a comprehensive service in which only bidders which provide support to alcoholics and those addicted to illegal drugs, AND those addicted to legal drugs are eligible to compete.
While I am an advocate of category management, category management needs to be pragmatic.  It has to include understanding the market and how the market works.  It also has to ensure that any bidding which takes place does not stand in the way of making the market work.

However, the approach strategic commissioning is even more baffling. Government and NHS approach to commissioning is to include dialogue with both users and the market as early as possible in order to shape the service.  Third sector criticism of this tender would suggest that dialogue did not take place – can we also assume that specifying outcomes may also have been set aside?

Bizarrely the change in tender approach is being blamed on NHS cuts, yet,
had early dialogue taken place with users and potential providers with a focus on outcome delivery, we may have seen both innovation in service delivery and cost reductions.  Was the proposed tender approach risk assessed?
Now society faces a dilemma. Will there be enough eligible bidders to deliver a meaningful competition and service?  Will those who are dependent on the service, through no fault of their own, suffer more?  When procurement strategy meets public policy it should lead to improvements not deterioration in patient experience.

The NTA, who appear to be responsible for the procurement approach, are in the process of handing commissioning over to local authorities, say they have handed over the data that will help with the strategic needs assessment – will they also handover a legacy of good procurement policy implementation or will it be left to others to pick up the pieces?    

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