Extract from Tender Specification for Review
1. Objectives
All those who need NHS Wheelchair and Seating services are entitled to expect that the service they receive is efficient, acceptable and meets the highest standards deliverable within the resources to be provided. Services will need to recognise the lifestyle of the wheelchair user and the needs of carers.
The broad aims of the work that NHSQIS wishes to commission are to:
- identify, as far as possible, the people in Scotland who need wheelchair mobility and associated postural and seating support
- identify potential benefits for patients and their carers (presently excluded) which may be realised by the full range of potentially available interventions to meet those needs
- identify current service provision
- undertake a gap analysis to highlight what is required to move from the existing service to one which more closely meets the needs and aspirations of users and carers and which is affordable for the NHS.
This involves improving the current information base.
3.1 Identify as far as possible, the people in Scotland who need wheelchair mobility
From the available data outlined in paragraph 2 and Appendix 3, we already have some understanding of the expressed need for wheelchairs. However, this is very high level and we need to obtain better information about current and future need so that evidence based decisions about future service delivery can be made.
Requirement
NHSQIS is seeking to commission work to undertake an exercise to confirm current known needs and to aim to identify as many as possible that are currently unknown to the NHS. This should include an analysis of:
- user dependency levels which highlights those who are fully dependent on their wheelchair
- users who are having to use their wheelchair inappropriately in the absence of any other suitable seating or the means to access suitable seating.
Based on these findings, an assessment of the impact of demographic change on the service over the next 10 years is also required.
In addition to existing data sources, consultants will be expected to obtain the views of a range of stakeholders.
3.2. Identify and cost potential benefits for patients and their carers which may be realised by the full range of potentially available interventions to meet those needs
A range of potential wheelchairs is outlined in Appendix 2. This needs to be confirmed to ensure that we are as aware as possible of potential interventions.
Requirement
NHSQIS wishes to commission an assessment of the suitability and costs of different chairs for patients to meet their individual needs.
The kind of information required to assess this is outlined in Appendix 5.
3.3. Identify current service provision
The current service provision is summarised in Appendix 3. This needs to be confirmed and developed.
Requirement
This requires a mapping exercise at both local and national levels showing how existing systems work and identifying ( e.g. via benchmarking) where there are opportunities to improve them.
This will require information/evidence along the lines outlined in Appendix 6.
3.4 Undertake gap analysis
The gap analysis should bring together the findings from your information gathering and your analysis. Your synthesis must provide NHSQIS with an understanding of what current and future service users should be able to expect from a quality service and what it will take in terms of investment and effort to achieve that standard.
Requirement
NHSQIS wishes to commission work to identify the gaps between needs and provision including an assessment of the costs and benefits of filling those gaps.
2. Outcomes required/Deliverables
4.1 The commissioned work should achieve the following outcomes for NHSQIS by 28 February 2006 46
- clarity about the extent and type of need for wheelchairs currently and an assessment of how that will change over the next 10 years
- clarity about the range of potential interventions to meet the needs
- clarity about the existing systems in place with good practice identified. This should cover the whole system47 that ensures that user and carer needs are met and continue to be met on an ongoing basis
- highlight any areas where the service is currently failing users
- clarity about the extent of the gap between need and current provision
- practical recommendations, including resource implications, on what needs to be done to improve current services - this needs to differentiate between how things are supposed to work in theory and how they are actually working at ground level
- clarity about the range of professional skill mix required to address potential interventions and the general training requirements associated with the skill mix proposal
- clarity about how to achieve meaningful user and carer involvement to inform, determine and shape policy and practice from an early stage
- proposals for how outcomes should be monitored locally and nationally.
It will be for the contractor to determine how to achieve these outcomes. However, NHSQIS's expectation is that proposals will include plans for desk top reviews and structured information gathering from the main stakeholders, as well as any postal and/or electronic surveys. Given the importance of the stakeholders in this exercise, the SEHD has already committed to hold one national conference on 12 September 2005 and five regional meetings to solicit views from users and get their active involvement in shaping policy. The successful bidder to this contract will be expected to participate in these events.
4.2 The output required is an interim report by 1 November 2005 and a final report by 28 February 2006 which delivers the outcomes specified in 4.1. In particular, the practical recommendations must take account of likely costs and benefits of any proposal.
The report should be in black and white and available in both hard copy and electronic form.