Invitation to register your interest - Metro Auckland Minor Skin Surgery
7 October 2010
Brief Outline
Auckland, Counties Manukau and Waitemata District Health Boards ("Metro Auckland DHBs") wish to purchase the provision of minor surgical services from General Practitioners ("Providers").
You are invited to register your interest in providing minor skin surgery ("the Service") in a primary care setting.
Applicants who are interested in providing the Service must supply the information requested in this document. Following an evaluation of applicants' information, a shortlisted group will be asked to provide some further clinical information to enable a final selection of providers to be made. Following this, selected applicants will be recommended to the Metro Auckland DHBs as appropriate Providers to supply the Service. The DHBs may enter into contracts with any or all of those recommended applicants.
While this invitation has been issued on behalf of the Metro Auckland DHBs as a group, any contracts that result will be with an individual DHB.
Background
1.The Metro Auckland Minor Skin Surgery clinical governance group ("the Group") wishes to improve access to minor skin surgery and believes that this can be achieved by providing such surgery in primary care. The Group is made up of clinical and managerial representatives from the Metro Auckland DHBs and primary care.
2.The Group has developed a regionally consistent pathway for skin cancer diagnosis and management of minor non-pigmented skin cancers (basal cell carcinomas and squamous cell carcinomas) referred to the Metro Auckland DHB hospitals for surgical treatment.
3.As part of the revised pathway, referral criteria for skin cancer lesions will be regionalised and all general practitioners referring skin cancers to any Metro Auckland DHB hospital will require either tissue diagnosis (biopsy) or adequate clinical explanation and appropriate imaging (clinical photo or other appropriate imaging process).
4.Each DHB will provide a single point of entry for all referrals for skin cancer surgery. Regionally consistent triage criteria will be applied for acceptance of care and distribution to the most appropriate provider of the service (i.e. GP or DHB based).
5.The scheme as described has the support of all current secondary care providers of skin cancer services across the Metro Auckland DHBs (Dermatology, General Surgery and Plastic Surgery).
6.In the future the group intends to explore further clinical pathways to enable appropriate management of pigmented skin lesions and other minor skin surgical procedures but this is outside the scope of this Register of Interest.
7.The Group does not represent the Metro Auckland DHBs and is not an agent, partner, employee or contractor of the Metro Auckland DHBs. The Group does not have any power to incur any obligation of any nature on behalf of the Metro Auckland DHBs or to direct the Metro Auckland DHBs in any way.
8.The Metro Auckland DHBs have agreed for Waitemata DHB to act as the lead DHB to facilitate this regional Registration of Interest.
Eligibility
9.Services will be provided exclusively by adequately trained and credentialed general practitioners operating from within primary care facilities (General Practices and Accident and Medical centres) who have been contracted by a Metro Auckland DHB under the provisions of this scheme.
10.The provider will have a current Annual Practising Certificate issued by the Medical Council of New Zealand, and will have professional indemnity insurance.
Term
11.Contracts which are entered into as a result of this selection process will be for a two year term.
Invitation to Register your Interest in providing the Service
You are invited to register your interest in providing the Service.
The Service comprises the following components:
12.Skin cancer referrals sent to the Metro Auckland DHB hospitals that meet the triage criteria for GP surgery will be referred to a contracted Provider based in a location convenient for the patient.
13.Provision of service will include initial consultation and assessment (where referral is not from the general practitioner performing the surgery), surgical excision of the lesion and follow up for the first 14 days.
14.A report of the outcome of the procedure (including histology and complications) will be sent to the patient's usual general practitioner, and to the DHB which contracted the Provider for the Services provided to that patient.
15.Both clinician and facility will need to meet a set of standards (as outlined in Appendix A) agreed to by the Group.
16.All successful applicants will be required to participate in ongoing peer review and clinical education (3 x local DHB meetings and 1 x regional meeting per year).
17.The DHBs are keen to see a greater concentration of service in certain geographical communities in order to meet regions of high demand.
18.The Service will be limited to non-pigmented skin cancer lesions.
19.Should contracts be entered into with successful applicants, there will be no guaranteed volumes of referrals. Any contracts will not be exclusive arrangements and the Auckland Metro DHBs may seek the same services from other providers.
20.Further and more detailed service requirements will be set out in any contract between a DHB and a selected Provider.
Price
21.Payment for service is based on the nationally agreed price for community based minor surgical procedures. The level of payment is not able to be further negotiated.
22.Current payment regimes will be as follows:
a)Initial consultation and assessment (if the general practitioner performing the surgery has not previously assessed the patient). / $50 plus GSTb)The completion of surgical procedures as outlined in the DHB referral. / $150 plus GST
c)If the referral requires the surgical removal of more than one lesion, a single additional payment will be made. / $75 plus GST
d)If the procedure timeis longer than 40 minutes, a single additional payment will be made. / $75 plus GST
23.Follow up for the first 14 days to be included within this price (i.e. handling of complications, removal of sutures, discussion of histology, arrangements for follow-up).
24.The prices detailed above will be the entire amount payable by a Metro Auckland DHB in respect of the Services. There shall be no cost incurred by the patients who receive the Services.
How to Register your Interest
25.If you are interested in providing this service you must let us know by registering your interest in writing using the template provided (Appendix A).
26.Each Registration of Interest should be typed, no more than three pages long and three copiesprovided.
27.Each Registration of Interest must be accompanied with a completed Declaration of Conflicts of Interest form (Appendix B).
28.A separate Registration of Interest form must be completed for each DHB area you are interested in providing the service for.
29.Registrations of Interest are accepted for individuals only, not groups or organisations.
30.All applications must be received by 5pm 29th October 2010. No Registration of Interest will be accepted after this date.
31.Registrations of Interest must be submitted in hard copy. Faxed or emailed copies will not be accepted.
32.Mark your application on the outside of the envelope:
Application - “Metro Auckland Minor Skin Surgery Scheme”
- CONFIDENTIAL.
33.Post threecopies of your Registration to the following address:
Lara Sedcole
Secretariat
c/- Waitemata District Health Board
Planning and Funding
Private Bag 93 503
Takapuna 0740
34.If you wish to deliver your Registration, three copies the application must be handed to the Secretariat or representative at the following address:
Lara Sedcole
Secretariat
c/- Waitemata District Health Board
Planning and Funding
Level 1, 15 Shea Terrace
Takapuna
Auckland
The following information is required to register your interest:
35.Your name and contact details.
36.The DHB area in which you propose to provide the Services.
37.The site(s) from which you propose to provide the Services.
38.Confirmation of the following at each proposed site of surgery provision:
- Operating environment, equipment, and infection control procedures comply with the relevant requirements of section B of the Royal New Zealand College of General Practitioners "Aiming for Excellence" standard for general practice[1].
- Availability of unipolar or bipolar diathermy.
- Capability for cardiac defibrillation.
39.Your training experience in minor skin surgery services (including courses attended, Surgical Registrar experience (in skin surgery), experience and complexity of minor skin surgical service provision, or other relevant information).
40.Your agreement to comply with the following audit processes and any variation to those processes as decided by the Group or the Metro Auckland DHBs:
- All providers will attend three quarterly local peer review and education groups which will occur within their DHB region.
- All providers will attend a combined annual regional peer review and educational session.
Please complete the attached response template (Appendix A) to ensure that all the required information is provided.
Process for Short-listing
41.Initial registrations of interest will be received from Providers.
42.On behalf of the Metro Auckland DHBs, Waitemata DHB will act as the lead DHB to facilitate this regional Registration of Interest. A review panel will be formed including clinical representatives from each Metro DHB to assess each applicant's clinical credentials. In evaluating the registrations of interest, the panel will consider the following factors, which are in no particular order:
a)Qualifications of the applicant;
b)Specifications of proposed operating facility;
c)Compliance with quality requirements; and
d)Relevant training and experience.
43.The Registration of Interest template set out at Schedule A does not necessarily cover all of the information that Metro Auckland DHBs may require in order to make decisions in relation to contracting for the Services. Waitemata DHB as the lead DHB may require applicants to submit additional information at any stage during this process and may also complete site visits to proposed facilities as part of the process.
44.A short-list of candidates will be contacted by the Secretariat and asked to provide additional supporting material for the selection panel to assess clinical competence. This will include but is not limited to retrospective case records of the most recent sequential 50 cases of skin surgery performed personally by the proposed provider. The records are to include date of provision of service, confirmed pathology of lesion, outcome of procedure including adequacy of margins of removal and any post-operative complications (including but not exclusive to wound infection, wound dehiscence or haematoma occurrence). Please note: The provision of this case record is not required for this initial registration of interest.
45.Applicants who have not been shortlisted will be notified in writing by the Secretariat.
46.Following the review of additional supporting material and retrospective case records, a final list of recommended Providers will be provided to the respective Metro Auckland DHBs.
47.Applicants who were shortlisted will be notified of whether or not they have been recommended to the Metro Auckland DHBs.
48.The individual Auckland Metro DHBs are responsible for contracting with the individual Providers. The Metro Auckland DHBs reserve the right to negotiate with any recommended Provider or Providers, with a view to entering into a contractual arrangement.
49.The individual Auckland Metro DHBs reserve the right to select all, some or none of the recommended Providers within each DHB area.
50.There is no obligation on the Metro Auckland DHBs or the Group to disclose who the successful Providers are, or the reason for the success or otherwise of any application.
51.You must not make any public announcement or other statement or disclosure regarding this registration of interest process, either during the evaluation and selection process or otherwise, without the prior written approval of the Metro Auckland DHBs.
Additional notes
52.No legal or other obligations of whatever nature shall arise between any applicant and any of the Metro Auckland DHBs or the Group in relation to, or arising out of, the conduct or outcome of this registration of interest process, unless and until there has been execution of a written contract.
53.Registrations of interest will become the property of the Metro Auckland DHBs, and no registrations of interest will be returned after completion of the process.
54.The information in this document has been compiled to assist applicants in responding to the invitation, and the Metro Auckland DHBs do not warrant or represent the completeness or accuracy of the information.
55.None of the Metro Auckland DHBs or the Group will be liable for any costs or expenses incurred by applicants in responding to or taking any other action in relation to this Registration of Interest.
56.Waitemata DHB as the lead DHB may, in their absolute discretion:
a)Accept or decline any non-conforming proposals;
b)Accept late proposals;
c)Consider any relevant information obtained from any source during the evaluation process;
d)Change the timeframes set out in this document by notice on the Government Electronic Tendering website ("GETS");
e)Re-invite registrations of interest;
f)Change any part of the evaluation or selection process;
g)Terminate this process at any time, and not give any reason for such termination;
h)Select any number of applicants for the clinical review described at clause 44;
i)Select any number of applicants to provide the Service;
j)Not give any reasons for selection decisions;
k)Not progress through to a clinical review, or through to entering into supplier contracts;
l) Waive any irregularities in the process; and
m)Amend this invitation document by notice on GETS.
Information about the Service
57.If you require any further information about the Expression of Interest please contact the Secretariat, Lara Sedcole on or through GETS.
58.All enquiries regarding this process must be directed to Lara Sedcole. No-one else with in the Metro Auckland DHBs or the Group has authority to provide information to applicants or to answer questions, unless Waitemata DHB as the lead DHB expressly advise otherwise.
59.Any information that results from enquiries from applicants may, at Waitemata DHB's absolute discretion, be posted on the GETS website. Such information will be deemed to be part of this Registration of Interest invitation document.
60.No claims that an applicant was disadvantaged by a lack of information or any ambiguity will be considered.
61.You must not seek to influence the outcome of the registration of interest process by canvassing, lobbying, providing any inducement or reward, or otherwise seeking the support of any DHB employee or Group member. Any action of this type may lead to your registration being disqualified.
Thank you for your cooperation in this process. We look forward to hearing from you.
Appendix A
Registration of Interest Response Template
Section 1: Provider details
SERVICE IDENTIFICATION / Metro Auckland Minor Skin Surgery1 / Name of practitioner
2 / Address
3 / Main contact details
4 / DHB area in which you propose to provide minor skin surgery services
5 / Locationof the site/s from which you propose to provide minor skin surgery services (Practice name and address)
6 / Are you GST registered? If yes please provide your GST number:
7 / Annual PractisingCertificate / I have a current Annual Practising Certificate issued by the Medical Council of New Zealand / Tick as appropriate
[ ]
8 / Restrictions on practice / If there are any restrictions on your practice, or your practice is currently under review for any reason, please provide details here.
9 / Professional Indemnity insurance / I have professional indemnity insurance. / Tick as appropriate
[ ]
I have completed Section 1 and 2 of the Registration of Interest response template. I confirm that the information I have provided is complete and accurate, and that the Metro Auckland DHBs and the Group may rely on the information.
Signature______
Print Name______
Date______
Section 2: Facilities infrastructure and provider experience and qualifications
10 / Description of essential infrastructure:Infection control
(The minimum requirement is infection control that equates to or exceeds the requirements for infection control as per the RNZCGP Aiming for Excellence infection control standards) / Please give a full description of the infection control standards of the facilities you propose to provide this service from:
11 / Description of essential infrastructure:
Haemostasis equipment
(The minimum requirement is availability of a uni-polar diathermy device.)
12 / Description of essential infrastructure:
Capability for cardiac defibrillation
(The minimum requirement is capability of cardiac defibrillation equal to or greater than an Automated Electrical Defibrillator Device (AED))
13 / Personnel.
Qualifications and experience
Minimum requirements:
Completion of a minor skin surgery training course at the level of Auckland surgical skills training centre minor surgery course or greater; or
Completion of a general or plastic surgical training to the level of surgical training registrar or higher / Please provide a full description of your qualifications, training, and experience in skin surgery.
14 / Personnel.
Qualifications and experience / I agree to provide the following records within 3 working days if requested as part of their evaluation process:
- A retrospective case record of the most recent sequential 50 cases of skin surgery performed personally by the proposed provider to include day and date of provision of service, confirmed pathology of lesion, outcome of procedure including adequacy of margins of removal and any post-operative complications (including but not exclusive to wound infection, wound dehiscence or haematoma occurrence).
[ ]
15 / Service delivery experience / Relevant local experience
(any relevant information in support of your application)
16 / Other requirements / If contracted, I agree to comply with the following audit processes and any variation to those processes:
- I will attend three local peer review and education groups which will occur within my DHB region
- I will attend a combined annual regional peer review and educational session
[ ]
[ ]
Appendix B
Declaration of conflicts of interest
Potential providers of the service must disclose in writing any interests which they are aware of, or become aware of, that could conflict with the submission of a registration of interest in this service. A conflict of interest must be declared if: