Engagement of PWC re Jersey Care Model (FOI)

Request

Please provide the formal engagement letter sent to PWC, setting out the work they were expected to carry out in order to stress test the Jersey Care Model.

Response

The supplier was engaged via contract, and the Invitation to Tender (ITT), as provided below sets out the work expected to carry out the stress test in the Jersey Care Model (JCM).

Financial and Commercial Advisory Tender, ref CP/19/12/793

The Consultant will provide the following services to the Authority:

Jersey Care Model financial modelling

• develop and maintain a financial review of the proposed models of care delivery to estimate the impact of the anticipated service changes on the budget. This analysis will be supported through detailed financial modelling and include a forecast impact at a granular level. This will involve:

• providing a detailed summary of the current cost and resource base (ITT A1.01)

• showing the financial and resource impact of each of the proposed interventions (ITT A1.02)

• providing a multi-year forecast model (ITT A1.03)

• providing a detailed summary of the future state cost and resource base (ITT A1.04)

• handing over knowledge and skills to the Authority’s team (ITT A1.05)

• identification of one-off investment costs to facilitate the transition between models (ITT A1.06)

• review the fees, payments and contracting arrangements across primary and secondary care (current and proposed) and develop options and recommendations on new financial model to support the Jersey Care Model, eg user pays elements of the systems, commercial arrangements with suppliers including contracting with general practice and community pharmacy (ITT A1.07)

• review of the commercial model for government commissioning of care providers, consideration of fees and charges for community care services and options for moving towards a more standardised and sustainable approach in this sector (ITT A1.08)

• develop a financial model that costs and reflects the outcome of the JCM proposals which are reviewing, developing and / or recommending: (ITT A1.09)

• a fees and payments structure across care settings in order to drive the right behaviour and activity (innovation, collaboration, multi-agency and multi-disciplinary working)

• user pay elements of the system and the impact of the model on the individual (noting commitment that JCM would be cost neutral to patients), including assessing impact on primary care to demonstrate what the impact of the proposals are on GPs

• the funding flows and recommendations for reconfiguration to support the JCM in the long term (noting JCM will be cost neutral to be patient), ie consideration of existing funds, tax revenue and other funding sources

• income streams, eg User payments, private patients, insurance

• funding mechanisms for Health and Care and provide a proposal for sustainable health funding mechanism in Jersey

Our Hospital Project - PMO Services Procurement Invitation to Tender (ITT)

Tender reference: CP19/10/768

Document 2 – Schedule of Services (Amended 14 October 2019)

Summary of the Health and Care Planner and Clinical and Professional Design Team responsibilities:

• thorough testing of the Jersey Health and Care Model that was produced internally, bringing a fresh perspective combined with a deep understanding of Jersey’s context and ambitions

• consultation with stakeholders including patients, the public and voluntary sector as well as specialist clinical users (including primary care physicians, pharmacists and allied health care professionals and 360-degree staff consultation) through a robust and proven framework for engaging and energising a wide variety of stakeholders

• interface and engagement with Social Care professionals and wider system partners to determine whole system capacity requirements both In and Out of Hospital

• mental Health service modelling is required as part of an integrated physical and mental health facility or campus

• understanding of wider health, social and economic modelling for the Hospital and wider care system, drawing on relevant benchmarks or experience

• expertise in community and out of hospital modelling is essential

• conversion of collated information into a functional brief for the new hospital(s)

• establishing a long list, a short list and preferred option for new hospital(s)

• prepare the Employer’s Requirements document for the contract with the Design and Construction Delivery Partner

• oversight of initial design information

• assessment of operational improvements needed now to demonstrate new ways of working that will underpin the future design assumptions

• fresh and independent perspective combined with deep understanding of GOJ financial position and controls.

• proven track record of creating strategy and partnering all the way through to the end of successful execution

• proven track record of working with technology alliance partners to secure outcomes in health and social care

• on island presence and wider social value

• proven track record of creating integrated care systems elsewhere in the world and draw upon capabilities and learning from elsewhere in the world to Jersey

• proven track record of supporting service and productivity improvement across operational health environments

• proven track record of working alongside clinicians and co designing services with multi-disciplinary teams

Service Requirements

3.1 Terms of Reference: Based on the tender documents and your accepted proposal, confirm the terms of reference for the preparation of the Employer’s Requirements brief and strategic case for the proposed development in line with industry good practice. As a minimum this must include definition of clear, measurable objectives and constraints, and an initial definition of the scope of the Hospital Project. A clear mutual understanding of stakeholders, their individual goals and concerns and the wider constraints upon the project must be established at this stage including alignment to the Jersey Island Plan.

3.2 Project Briefing: Attend briefing meetings and ascertain Health and Care Planning service contribution required, programme and output requirements.

3.3 Programme: Provide comment on the Project Programme. Develop the detailed Health and Care Planning services programme, showing each specific task, its’ duration and ownership and link to related tasks, and thereafter work with the team to ensure delivery of services to secure timely achievement.

3.4 Base Data and Information: Identify with the client the required base data and information required to support this stage of planning. Review data and information provided by the client for accuracy, consistency and clarity. Identify any gaps or weaknesses in data and information, highlighting any critical problems, and agree with client how these will be resolved and who will do what to deliver the agreed resolutions.

Agree measures of success

Standards Compliance and Derogations: Establish Health and Care Standards to be adopted. Complete an assessment of the Employer's schedule of standards. Advise whether they are feasible within the agreed constraints of the project and, where necessary, make suggestions for alternative approaches to be adopted.

3.6 Capacity Projections: Critical to the sizing of the project at this stage will be the projections of whole system capacity requirements. The Health and Care Planner and Clinical and Professional Design Team must undertake a detailed review of forecast of future demand and consequent whole system capacity needs. The forecast must include all factors likely to influence demand (eg population, intervention rates, models of care and so on), must be capable of showing the differential impact of each factor separately and must provide an audit trail to enable subsequent adjustments to be compared with earlier iterations. The model must be sufficiently detailed at this stage to support analyses at all stages of planning without changes to the model that would affect audit trails. The model should provide outputs of projected workload, capacity needs and Workforce requirements.

3.7 Engagement / Public Consultation: Provide support to Health and Community Services (HCS) at public and patient engagements, clinical and staff consultation processes.

3.8 Standards compliance and derogations: Advise of any guidance which has been more recently published and that may be relevant and helpful to the project.

3.9 User Group Management: Support management of user groups to produce the brief in terms of functional content, schedules of accommodation, room data sheets and the service delivery requirements that are to be delivered by the project taking into consideration any changes that have been made during the project. (Produce and maintain an audit trail of changes made and their rationale).

3.10 Organisational Statistical Analysis and Scenario Planning: Collect capacity data in terms of demography, age and disease profile including strategic needs assessment, and so on, for all services. Compare data with current service profile using statistical software to determine future activity projections.

3.11 Project Capacity Planning: The Health and Care Planner must be sufficiently experienced in workforce planning and change management. Any new model of care must be tested against the existing Health and Care establishment and demonstrate that any new model is achievable, practical and affordable.

3.12 Project Specific Statistical Activity Analysis and Scenario Planning: Collect relevant activity data to allow robust information to be used within the planning process. The data must be presented within a software tool which allows easy variation of the data and hence allow different scenarios to be tested in simulations. These scenarios could be completely new models or minor changes to existing models. The software should be user friendly for use by HCS planning, medical staff and wider professional groups. The software should be flexible to allow for any Future proposed model(s) to be tested. The software to be the property of the Authority upon completion of the project stage.