Procurement details: Norfolk and Waveney Acute Hospital Collaboration - EPR Programme: Design, Build and Test Implementation Partner

• Term or acronym:

  NWAHC

• Definition:

  Norfolk and Waveney Acute Hospital Collaboration (NWAHC) is made up of three hospitals, James Paget University Hospitals, Queen Elizabeth Hospitals Kings Lynn, Norfolk and Norwich University Hospitals who are adopting a shared instance of MEDITECH Expanse.

• Term or acronym:

  DBT

• Definition:

  Design Build and Test. This is the name of the workstream within the EPR Programme.

• Term or acronym:

  EPR

• Definition:

  Electronic Patient Record

• Term or acronym:

  JPUH

• Definition:

  James Paget University Hospitals

• Term or acronym:

  QEHKL

• Definition:

  Queen Elizabeth Hospitals Kings Lynn

• Term or acronym:

  NNUH

• Definition:

  Norfolk and Norwich University Hospitals

• Summary of work:

  Norfolk and Waveney Acute Hospital Collaborative (NWAHC) is seeking an implementation partner to lead the EPR design/build/test (DBT) workstream within the EPR Programme. This is a major change and transformation programme spanning three acute hospitals across Norfolk. The intention is to go live with the MEDITECH Expanse EPR in Q1 2026. NWAHC is seeking an implementation partner to support the DBT stage of a comprehensive Electronic Patient Record (EPR) deployment. The primary objective is to identify a resourcing partner who can provide skilled professional services to facilitate and lead the DBT stage of the EPR implementation. NWAHC has undertaken pre-market engagement in order to further define the specification for this tender. The DBT implementation partner will work alongside the Trust's internal teams to ensure the system is designed to meet the Trusts’ needs and built to function seamlessly within the existing infrastructure. The selected partner will lead a blended DBT team, comprising a mix of the partner’s own resources, dedicated build staff on the Trusts’ own contracts and a number of clinical, operational and change staff who will determine the Design. The DBT implementation partner will be responsible for: • Delivering a successful MEDITECH Build to set timelines. • Supplying experienced professional services with expertise in configuring complex EPR systems, within the NHS context. • Strengthening the overall programme management function of the EPR programme • Ensuring compliance with NHS standards and regulatory requirements. • Supporting system configuration, customisation, testing, creation of Standard Operating Procedures, Integration and other related activities. • Offering support during the DBT phases. • Ensuring knowledge transfer to the Trusts’ staff within the DBT teams thereby providing a resilient legacy.

• Where the supplied staff will work:

  East of England

• Where the supplied staff will work:

  No specific location (for example they can work remotely)

• Who the organisation using the products or services is:

  Norfolk and Norwich University Hospitals NHS Foundation Trust Colney Lane Norwich Norfolk NR4 7UY, Queen Elizabeth Hospitals Kings Lynn NHS Foundation Trust Gayton Road Kings Lynn Norfolk PE30 4ET, James Paget University Hospitals NHS Foundation Trust Lowestoft Road Gorleston Great Yarmouth Norfolk NR31 6LA.

• Why the work is being done:

  The need for a DBT Implementation Partner: MEDITECH’s methodology for delivering a configured EPR system requires the customer to build the system based on outputs from the process design phase. This involves configuring workflows, building dictionaries, creating user-defined tables and forms, and setting parameters, all with the expertise and guidance of MEDITECH. MEDITECH will provide training and skills transfer to the customer's staff responsible for building the system and will offer ongoing feedback on the build content and quality, including identifying deficiencies and errors and providing rectification instructions. Given the ambitious scope of the programme, having a highly productive and experienced build team is essential to mitigate risks such as failure to deliver the scope, poor adoption, and the inability to realise the necessary cash-releasing benefits. These benefits are critical for funding the EPR system by replacing existing digital systems and enabling the release of staff currently needed for hybrid paper/digital support. NWAHC recognises that there would be challenges associated with bringing in experienced contractors to build the system. Therefore, the programme has selected a preferred approach of procuring a specialist DBT implementation partner.

• The business problem:

  NWAHC is seeking a highly experienced implementation partner to lead and be responsible for the planning and delivery of the DBT phases of the EPR Programme, as part of the implementation journey for MEDITECH Expanse. The programme aims to align the objectives of MEDITECH, the implementation partner, and the programme by incentivising all parties to achieve the DBT milestones for the EPR production build. A strong relationship between the implementation partner and MEDITECH is crucial for success; the partner is expected to work with NWAHC and Meditech to agree the approach to implementation provide and share their expertise with NWAHC to ensure a successful implementation. The implementation partner will deliver a structured programme of work through their consultants to support the DBT teams. They will collaborate with MEDITECH and the programme project managers to develop plans and manage the consultants supporting each team throughout the build process. The supplier must have a proven track record as an implementation partner for complex EPRs in the NHS. They should be capable of delivering their services in collaboration with the programme and MEDITECH, utilising the MEDITECH READY methodology. The supplier must develop and deliver training, mentoring and knowledge transfer to Trust staff involved in the design and build stages. The supplier must provide on-site agreed core resources (at least 2/3 days per week) and remote support throughout the design, build, and initial testing phases, providing expert guidance and capacity for the specific DBT projects, mentoring teams through processes and offering continuous support throughout the working week. This includes addressing queries and leveraging MEDITECH training to enhance the productivity of less experienced staff. The DBT implementation partner consultants must possess strong communication and people management skills, along with the analytical capability to support the design and configuration of the EPR system. NWAHC may also wish to call off further specific packages of work to complete particular areas of build that may be delayed due to staff leaving, staff sickness, or unexpected complexity. These packages cannot be defined at this point and would be priced at the time of commission. They would be the responsibility of the DBT implementation partner to deliver, outside the work plans of the relevant DBT team. To provide some pricing certainty, the DBT implementation partner is expected to commit to a rate card covering the skills required to deliver the design and build across the eight design/build teams, as well as the BI and data warehouse design/build teams. The following deliverables are required: • Detailed project plan for the design and build stage with milestones and deliverables in alignment with the established Baseline Programme Plan. • Organisation and planning of typically three or four Design meetings to include Subject Matter Experts, Clinicians, Change Leads, technical experts – aligned to each Sprint, for each of the Design groups • Delivering to time and agreed design, three or four(dependant on complexity) successive Build prototypes for each of the Design groups. The final design for each group must be completed and tested before November 2025. • Leading in all aspects of testing for each prototype • Attend all relevant Meditech Build training • Support with Training, SOP and other key identified document creation • Regular progress reports and status updates. • Design specifications. • Configuration and customisation documentation. • Training programmes and knowledge transfer tailored to the Trusts’ needs.

• User type:

  Strategic Vision For EPR

• Definition:

  The introduction of new EPR capability represents a significant opportunity to contribute to the transformation of care. It will free up more time for patient care and increase capacity through the ability to document once and share information, leading to more consistent care planning and improved handover of care. Overall, this will improve satisfaction levels of service users and staff within the acute Trusts and across the N&W ICS. A contemporary EPR solution will provide clinical staff with real time data access, entry and presentation at the point of care, with consequent reductions in length of stay, improved patient safety and reduction of administration work. There will be increased patient involvement in their own care and information about a patient will be at the clinicians’ fingertips, supporting faster and more reliable shared decision making . Emergency Department (ED) clinicians will benefit from having immediate access to acute care records and the new EPR capability will benefit all clinical areas as it will create one single patient record that will follow a patient on their full pathway, particularly valuable for those patients with long term and multi-morbidity conditions. It will also enable improved accessibility to clinical information and integrate with mobile working access, decision support features, data analysis and business intelligence. Sharing information with clinicians across primary and community care will provide patients with continuity of care, giving them confidence that those caring for them have all the necessary information without repeatedly requesting it from the patient themselves. Details of medication, allergies and treatment plans can be shared, reducing avoidable errors and safety incidents. Beyond this, structured clinical data will provide the foundation for a new era of data-science-driven-health care in Norfolk and Waveney. It is the cornerstone of enhanced public health management for complex and deprived populations. The strategic vision for an EPR is encapsulated within the following statement: “Our EPR will act as an enabler for a greatly improved health and social care system in which care givers and patients have electronic access to more complete health records and are empowered to make better health decisions with this information.”

• Any pre-market engagement done:

  NWAHC has undertaken pre-market engagement in order to further define the specification for this tender.

• Work done so far:

  The existing DBT team plans: The programme has developed outline plans for the DBT teams by incorporating insights from past EPR implementations and guidance provided by MEDITECH on appropriate resourcing levels in order to inform our FBC, budgeting and readiness planning. NWAHC’s existing team plans should be viewed as a guide and background information. We invite potential implementation partners to bring their expertise to bear in designing the DBT resource plans and to describe where their skills can be best deployed alongside NHS-contracted resources. The teams are organised around departmental and care settings rather than by application module. This approach follows the successful model used by the other NHS Meditech customers, who were the “first of type” for greenfield Expanse implementation, as well as other vendor EPR implementations across the NHS. The team sizes have been determined based on MEDITECH’s guidance at the tender stage, the current resource levels used by other NHS Trusts using Meditech, and experience from previous vendor EPR implementations. In the current plans, each DBT project team has the following structure as a minimum: • 1 x Project Manager • 1 x Application Analyst / Training Lead (SME) • 1 x Lead analyst • 1 x Analyst • Assigned MEDITECH Design and Build expert Some teams have additional members to provide additional capacity or Subject Matter Expertise. The Implementation partner should indicate in their response, which team members their service will include. Please refer to ‘Additional information’ 3.1. There are 10 DBTs : • Inpatient • Outpatient • PAS • Theatres • Maternity • Order Comms • Oncology • ED • Pharmacy • Terminology Roles and responsibilities in the current plans: The Clinical Services Programme Manager and the Clinical Support Services Programme Manager will each take responsibility for the delivery of a number of DBT projects to time and within resource. TO BE PROVIDED BY IMPLEMENTATION PARTNER. The project manager's role involves overseeing the DBT team's work and coordinating with change management teams and other SMEs – clinical and operational. This includes collaborating with subject matter expert (SME) design groups to develop future state processes, standard operating procedures (SOPs), and EPR design documentation. TO BE PROVIDED BY IMPLEMENTATION PARTNER/NWAHC. Analyst and Training positions (SMEs) must be filled from within the trusts, typically by staff with subject matter expertise in the relevant clinical or administrative areas who are interested in developing skills in EPR configuration. The application analyst/training lead initially works as an analyst, completing application training and skills transfer. They then transition into lead training roles, developing content for end-user training programmes and delivering this content as part of the training team. TO BE PROVIDED BY NWAHC. The lead analyst function will provide expert support, adding DBT capability and capacity to the specific workstream. They will mentor the team throughout the DBT processes, offering full support during the workweek by answering queries and building on MEDITECH training to expedite the productivity of less experienced staff. THIS FUNCTION SHOULD BE PROVIDED BY THE IMPLEMENTATION PARTNER. Analysts have a dual responsibility: translating requirements into designs and then building and testing these designs. The more senior the analyst, the more time they will spend on translating requirements into designs rather than on the building process. TO BE PROVIDED BY IMPLEMENTATION PARTNER/NWAHC.

• Which phase the project is in:

  Alpha

• Existing team:

  Please refer to the attached document " 3 3. ROLES AND RESPONSIBILITIES IN THE CURRENT PLANS” for more information.

• Address where the work will be done:

  EPR Central Hub County Hall, Martineau Lane, Norwich NR1 2DH Norfolk and Norwich University Hospitals NHS Foundation Trust Colney Lane, Norwich, Norfolk. NR4 7UY. Queen Elizabeth Hospitals Kings Lynn NHS Foundation Trust Gayton Road, Kings Lynn, Norfolk. PE30 4ET. James Paget University Hospitals NHS Foundation Trust Lowestoft Road, Gorleston, Great Yarmouth, Norfolk. NR31 6LA.

• Working arrangements:

  All the roles specified in Table 3.1 under ‘Additional Information’ will form the DBT core team. The DBT core team will have an agreed hybrid work pattern of 2-3 days in our central hub and the rest of time working remotely, based on the complexity of each task; all supplier staff are expected to be on site for the ‘core team hours’. Some restricted elements of the work may be able to be supported by team members working fully remotely. The supplier must describe how high-quality support will be provided to the team under these circumstances and different time zones must not prejudice the provision of timely support. All travel and subsistence expenses must be included in the supplier’s pricing. Occasional on-site working at all three trust locations may also be required.

• Security and vetting requirements:

  Baseline Personnel Security Standard (BPSS)

• More information about the Security requirements:

  Staff will need to work within NHS mandatory training regarding: • NHS Conflict Resolution • Countering Fraud Bribery and Corruption in NHS • Equality, Diversity & Human Rights • Fire Safety • Health, Safety and Welfare • Infection Prevention and Control (Level 1) • Information Governance Including Record Keeping & Caldicott Protocols • Preventing Radicalisation • Lone worker

• Latest start date:

  18 November 2024

• Contract length:

  1 years 2 months 0 days

• Optional extension:

  0 years 7 months 0 days

• special term or condition:

  Termination for convenience The Authority may terminate this Contract by issuing a Termination Notice to the Supplier at any time on one (1) months’ written notice.

• Indicative maximum:

  £6500000

• Indicative minimum:

  £4000000

• Further information:

  The Programme has specific in year funding allocations for both 2024/25 and 2025/26. These allocations are unable to be reprofiled between financial years and therefore any and all budgets must be spent in the periods they are being received. Indicative costings are based on the financial modelling submitted as part of our FBC with an even split between 2024/25 and 2025/26 (expected inflation has been applied to 2025/26). For VAT purposes, indicative budgets are treated as non-recoverable. This will be subject to change based on professional VAT advice being sought at the point of contract award. All IT peripherals shall be provided by the Trust(s). The supplier should provide a fixed price for all essential elements defined in Section 3 of ‘Additional Information’ plus an indicative day rate for any additional optional requirements.

• Contracted out service or supply of resource?:

  Contracted out service: the off-payroll rules do not apply

• How many suppliers to evaluate:

  3

• Technical Competence:

  50%

• Cultural fit:

  20%

• Social values:

  10%

• Price:

  20%

• Essential skills and experience:

  40%

• Nice-to-have skills and experience:

  10%

• Technical questions:

  50%

• Description:

  Demonstrable experience of the overall programme/project management, technical, clinical, and training resources for the design and build and test stage of a major EPR programme in an NHS Trust. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  10%

• Description:

  Proven ability to provide programme management – Processes and experience of delivering the Overall DBT within an EPR Programme of a similar size in the NHS Trusts. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  10%

• Description:

  Proven ability to support configuration, customisation, testing, and integration of complex EPR systems within the NHS, in line with the timescales outlined in section 2.2 of the 'Additional Information. Please provide two examples of where this has been delivered within the NHS before (the examples will not count towards the maximum characters)

• Weighting:

  10%

• Description:

  Knowledge of NHS data standards, information governance, and regulatory requirements.

• Weighting:

  10%

• Description:

  Proven track record in implementing a range EPR systems used within the NHS, such as Oracle Health, Epic, or MEDITECH. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  10%

• Description:

  Risk management skills to identify, assess, and mitigate potential project risks.

• Weighting:

  5%

• Description:

  Experience of working with clinical and operational staff in rapid design situations and managing stakeholder management and communication, including senior clinicians Please provide Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  10%

• Description:

  Understanding of clinical pathways and patient care processes within the NHS, with access to clinicians with experience in EPR systems to provide insights and ensure clinical workflows are optimised during the design stage. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  10%

• Description:

  Understanding of the importance of clinical safety in all DBT planning testing and decision making. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  10%

• Description:

  Development and delivery of training, mentoring and knowledge transfer for Trust staff involved in the design and build stages. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  5%

• Description:

  Experience of working in a blended team managing staff from the host organisation(s) and ensuring that knowledge transfer is in place so the Trust staff can continue to support and enhance the build. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  10%

• Description:

  Strengthening the overall programme management function of the EPR programme Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  25%

• Description:

  Demonstrable experience of implementing a range Meditech EPR systems utilising the Meditech READY methodology Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  25%

• Description:

  Experience of delivering DBT services in a multi-organisation, single instance environment. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  25%

• Description:

  Experience of a complex programme balancing the needs of multiple organisations in a single implementation. Please provide two examples of where this has been delivered within the NHS before (the two examples will not count towards the maximum characters)

• Weighting:

  25%

• Question:

  Please provide a detailed project plan that outlines the design and build stages, including key milestones and deliverables? Include examples from previous large-scale EPR projects you have managed within healthcare settings in the NHS.

• Weighting:

  30%

• Question:

  Please describe how you will deliver Design Build and Test services in a multi-organisation, single instance environment. Including specific case studies.

• Weighting:

  40%

• Question:

  Please describe you expertise in system configuration, customization, and integration with other NHS systems. Include details of NHS data standards, information governance, and regulatory requirements.

• Weighting:

  30%

• Question:

  Please provide details how you will access clinicians with experience in EPR systems who can provide insights and ensure clinical workflows are optimized during the design stage? Include specific examples relating to clinical pathways and patient care processes within the NHS.

• Weighting:

  40%

• Question:

  Please describe how you will ensure the importance of clinical safety is upheld in all DBT planning and decision-making processes? Include examples of safety considerations in past projects.

• Weighting:

  60%

• Question:

  Social Value/Net Zero - NWAHC aims to reduce its carbon footprint by 80% by 2036 and suppliers are expected to contribute 40% of this reduction (excludes medicines). - NWAHC aims to reduce its energy and water carbon footprint by 80% by 2030 and suppliers are expected to contribute 40% of this reduction, albeit by a later date of 2036 (excludes medicines). - NWAHC aims to eliminate non-essential single use plastics at the earliest opportunity and reduce clinical single use plastics by half by 2025. Our supply chain is expected to facilitate this by either eliminating single use plastics from packaging, and/or follow the waste hierarchy by preventing, reducing, reusing or recycling materials. - NWAHC aims to reduce its emissions from transport by 80% by 2036 and suppliers are expected to contribute 40% of this reduction by reducing mileage, consolidating deliveries or electrifying their fleets (excludes medicines). Please describe the commitment your organisation will make to ensure that opportunities under the contract deliver our Social Value/Net Zero ‘aims’. Detail how, through the delivery of the contract, you plan to reduce your carbon emissions (both in your supply chain and embedded carbon within products) through the provision of the product/service. Detail how, through the delivery of the contract, you plan to reduce the road miles required for the provision and running of the service in scope. Detail how, through the delivery of the contract, the service being proposed can be digitised throughout the duration of the award, to reduce emissions and resources used where possible whilst still achieving the same outcome

• Weighting:

  100%

• Pricing model:

  Fixed price

• Additional assessment methods:

  Presentation

  Reference

  Case study

  Work history

• Level:

  Not met

• Score:

  0

• Description:

  The response does not meet any of the requirements or no response has been provided. An unacceptable and / or non-compliant response with serious reservations, demonstrating no understanding of the requirement.

• Level:

  Partially met

• Score:

  1

• Description:

  The response has met some, but not all elements of the requirement, which poses risk that the proposal will not meet the deliverables required. The response does not demonstrate a full understanding of the requirement posing major concerns.

• Level:

  Met

• Score:

  2

• Description:

  The response is acceptable and meets all the basic requirements. However, the response is not sufficiently detailed to minimise risk and / or the proposed approach may require additional support (in addition to that outlined in the Statement of Requirements) from the Contracting Authority to meet its deliverables.

• Level:

  Exceeded

• Score:

  3

• Description:

  The response exceeds requirements, providing detail that minimises risks to delivery. The response is comprehensive and unambiguous, demonstrating a thorough understanding of the requirements and providing details of how the requirement will be met in full without additional support from the Contracting Authority, other than that outlined within the Statement of Requirements.

• Publication of stage 1:

  10/09/2024

• Clarification period closes:

  16/09/2024 17:00

• Deadline for suppliers to submit their stage 1 responses:

  24/09/2024 17:00

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