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RESPONSE
TO INVITATION TO TENDER FOR THE PROVISION OF:
QUANTITATIVE ASSESSMENT OF MIGRANT ACCESS TO THE NHS
Quantitative Analysis, Review of Data and Estimate of Future Impacts
RESPONSE BY PREDERI LTD
www.prederi.com
TENDER REFERENCE: 58937
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Schedule One (a): Tenderer Response
SECTION A
A.1
Organisation details
Tenderer name
Please confirm the name of the Tenderer*:
Tenderer Name:

A.2
Full name of organisation tendering (or of organisation acting as the lead contact where a
consortium bid is being submitted)
Contact details*
Tenderers must provide contact details for this tender.

A.3
Prederi Limited
Contact Name*
PERSONAL INFORMATION REDACTED UNDER SECTION
40 OF THE FREEDOM OF INFORMATION ACT.
Telephone number
PERSONAL INFORMATION REDACTED UNDER SECTION
40 OF THE FREEDOM OF INFORMATION ACT.
Email address:
PERSONAL INFORMATION REDACTED UNDER SECTION
40 OF THE FREEDOM OF INFORMATION ACT.
Address:
12 Melcombe Place, London, NW1 6JJ
Contact is the person responsible for any queries relating to this proposal
Organisational status
Please confirm whether (or not) the Tenderer is a Small & Medium Enterprise 1
(SME).
Yes
The Tenderer is an SME (Yes / No)
1
To be considered an SME, an organisation must have a headcount less than 250 Annual Work
Units (anyone that has worked full-time within the enterprise, or on its behalf, during the reference
year counts as one unit. Part-time staff, seasonal workers and those who did not work the full
year are treated as fractions of one unit) AND a turnover less than €50 million OR annual balance
sheet of €48 million.
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SECTION B
Solution Proposal
B1 Overview (Maximum 250 words) 10%
Tenderers must provide a concise summary highlighting the key aspects of the
proposal.
Response
See response below
Ministers have announced an audit of the cost of visitors’ and migrants use of the
NHS. To deliver this, you want a clear baseline of current costs of use of the NHS
by visitors and non-permanent migrants, split by EEA and non-EEA residents; and
an estimate of future costs and how these might change.
This means that you need a robust cost model, built on sound assumptions,
delivered at pace by experts.
To deliver publishable results by 13 September, we will therefore:

Apply modelling best practice, bringing together ONS and Home Office data to
model migrant and visitor numbers for the groups described in the Consultation;
building on Phase 1’s results and using an accepted standard cost modelling
method we will estimate health service usage and costs by primary care,
secondary care and accident and emergency. We will test the results
thoroughly.

Scrutinise the assumptions, making sure that they are based on research and
expert opinion. We will explore the sensitivity of forecasts using different
assumptions and interventions.

Use a highly experienced team with financial analysis and cost modelling skills,
and experience of health and migration. PERSONAL INFORMATION
REDACTED UNDER SECTION 40 OF THE FREEDOM OF INFORMATION
ACT.is a public health consultant and will use epidemiological and evidencing
skills to validate assumptions and obtain expert opinions. PERSONAL
INFORMATION REDACTED UNDER SECTION 40 OF THE FREEDOM OF
INFORMATION ACT.has developed innovative solutions for cost forecasting in
the Home Office and elsewhere. PERSONAL INFORMATION REDACTED
UNDER SECTION 40 OF THE FREEDOM OF INFORMATION ACT.has 15
years’ experience in financial model design.
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B2 Method statement 40%-Describe (with specific reference to the elements of
the requirements and the outcomes expected) how it is intended to deliver the
requirements of the specification.
Response - Provide evidence of understanding
a) Data analysis , including techniques which demonstrate extrapolating data to provide a
national picture of baseline date 15%
See response below
In this section of the proposal we:

Set out our overall approach to deliver your Phase 2 outputs.

Explain the method that we will use for modelling.

Show how we will apply the method to address the specific issues around data
analysis and how this will provide a national picture of baseline data.
Overall Approach
Our overall approach to this Phase 2 quantitative analysis is set out in the
diagram below (Figure 1). This is provisional; we will develop this approach
with you in the Mobilisation stage and refine accordingly.
6/9
9/8
22/7
Mobilise
Scope
Scope
Specify
Specify
Design
Design
Build
Build
Test
Test
Use
Use/Report
Review
Figure 1 Overall Approach
One point that we would wish to highlight is that we would aim to create an
initial version of the model by the time of the first checkpoint to pick up early
on if there are any major unforeseen obstacles to the process.
Our approach is built around the stages of Spreadsheet Modelling Best
Practice (SMBP), which we explain in the table below. The benefits of
SMBP are that the model will be:
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
Easy to use. Using good design makes the model easy to operate, while a clear
specification will explain how the model works.

Focused on the important issues. Spending time on the model scope will make
sure that the model answers the right questions.

Easy to understand. Good design and build techniques will make the model
easier to understand. This aids transfer of the model ownership and ensures
the continuing value of the model.

Reliable. If we specify clearly how the model works and then test it thoroughly
and independently, we are much less likely to introduce errors.

Auditable. By constructing the model following accepted best practice rules, the
model will be easy to audit by external agencies and all required documentation
will be available as a matter of course.

Adaptable. The attention to detail and design in best practice allows for models
to be more easily adapted to reflect changing logic and assumptions and new
output requirements. This quality will be of particular value for this modelling
exercise.
Modelling Method
We will “top and tail” the SMBP method with a Mobilisation stage at the start
and a Review stage at the end. We have set out in the following table the
stages of SMBP that will apply to data analysis (this section of the response,
your reference Section B2 part a (“B2a”)) and forecasting (Section B2 part b
(“B2b”), the following section).
Stage
1. Mobilise
SMBP Method
Mobilisation of the project team to build relationships between the
DH contract manager, the Prederi project team members and other
key stakeholders (e.g. Phase 1 project team).



2. Scope
Confirm what is required from all parties and by when.
Identify issues and risks that need to be managed.
Agree specific knowledge transfer needs that should be
built into the project plan.
Discussions with the DH project sponsors about the priorities and
concerns for the project; specify the format of the model output
data, metrics and charts; agree the detailed plan.
Identify the nature, scale and complexity of the model required to
meet the DH outcome. During the this stage we will:



Decide what needs to be included in the model and what
can be omitted
Consider the level of detail required in the input and start to
prioritise logical assumptions
Understand in outline how the model will work
We will also:


Review what is available from the Phase 1 studies
Engage with known potential information sources
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Stage
3. Specify
4. Design
SMBP Method
 Identify information gaps and inaccuracies
We expect to clarify the scope by developing high-level systems
representation of the problem – this approach would build on the
sorts of analysis in the Evidence and Equality Analysis published
on 3 July with the consultation paper, but expanded to show the
relationships to other drivers of change and to the impacts of these
policies.
The aim of this stage is to define the logic of the model in sufficient
detail to provide an unambiguous statement of how the results will
be calculated and presented to the DH sponsor.
The results of the scoping stage will be turned into a set of inputs
with explicit underlying assumptions with reference to source
information. This will include a list of identified unsourced
assumptions and a defined logic for filling in information gaps with
appropriate statistical methods. This stage will consider how best
to handle uncertainty in assumptions/source data e.g. Monte Carlo
or sensitivity analysis. We will also agree with you the format of
the output data for the groups you have identified in the Annex B of
the Consultation Document, such as the various tables or charts.
In this stage, we will produce the most effective structure for the
model.
Key principles of this design stage are:



Be adaptable and expandable, to allow the model to be
developed to incorporate different/better data
Model uncertainty i.e. produce an understanding of the
impacts of uncertain assumptions on output
Taking care of the basics: clearly identified inputs,
documented logic, clear spreadsheet workbook structure,
uniform worksheet structure and clear colour-coding
through-out, with colour key
These key SMBP guidelines should to make the model easy to use
to achieve the intended DH outcomes and reduce the likelihood of
error.
5. Build
The build stage is where the actual coding of the model takes
place.
Model construction can begin as soon as some elements of the
source data/system dynamics are understood (i.e. construction will
be concurrent with scope, specify, design).
6. Test
We will test the model to identify errors and inconsistencies. The
model will be tested using standard SMBP testing protocol (i.e.
independent of owner/modeller).
We will discuss results with DH sponsor to increase confidence in
the data produced and also see whether any specific validation
e.g. ONS would be useful at this point if they can be involved in
this way.
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Stage
7. Use and
Report
SMBP Method
Besides the technical testing we will use the clinical expertise in
the team test the soundness of the assumptions and how they are
represented in the model.
Present the information to DH in a way that provides the three
outputs and helps it to make well founded decisions in response to
the Consultation. We will:


present sensitivities and scenarios to understand the
important drivers in the business
control the evolution of the model when further changes are
required.
The focus will be on a clear structure and documentation, full audit
trail and client handover plan. We will fully document the
operation of the model and how it is used to create our results,
and allow further development use of the model after this Phase.
8. Review
Review of the project to learn the lessons for the future. Post
contract review as specified in the ITT.
The above approach and method set out above will support the delivery of all
three main outputs listed in part 2 of your ITT, namely:

An estimated cost of the current use of the NHS in England by visitors (including
health tourists) and non-permanent residents (temporary residents including
workers students and others), split by EEA and non-EEA residents.

An estimate of the future costs to the NHS if the current overseas visitors
charging system continues.

How these estimates will change in the future alongside changing composition
of migrant users in the identified sub-groups and impact of external factors.
Data Analysis
The following paragraphs look at what we would expect the model to include
and we look particularly at the first of the three main outputs required, namely:
an estimated cost of the current use of the NHS in England by visitors and
non-permanent residents, split between EEA and non-EEA residents and so
on. As noted above, we would like to develop the model with you so these
steps will be refined initially during the scoping stage and during the life of the
project where necessary.
We see the main steps for data analysis as follows:

Agree the groups and sub-groups of users, matching the requirements of the
Consultation. As indicated in the Q&A (clarification) for the ITT, these will align
with those defined in the Phase 1 work. It may be helpful to further sub-classify
these groups e.g. to identify groups of visitors originating from countries with
high risk of specific diseases or countries with large visitor numbers whose
behaviours may change as a result of the changes in policy. It will be easier to
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aggregate results for the report rather than try to disentangle information about
some specific groups late in the project.

Estimate current numbers within each visitor sub-group. This will be done by
using data from the ONS and the Home Office e.g. the International Passenger
Survey and triangulating with other data sources (e.g. insurers) and the
qualitative findings from the Phase 1 work. We will seek to identify other
relevant and available sources of data from external agencies such as The
Migration Observatory. For the population residing in the UK unlawfully we will
dynamically model new illegal entrants to the UK, deaths, removals, voluntary
departures and the regularisation of the status of members of this group.

Estimate the demand for A&E, primary and secondary care services. For each
group we will estimate the demand for primary and secondary care and for
accident and emergency (A&E) services. The primary information source for
deriving these estimates will be the findings from the Phase 1 report. Our aim is
to apply rates of health service use per visitor group, broken down into A&E,
primary and secondary care use, to the size of the population in each group
calculated above. Phase 1 estimates will be verified by cross-checking with
available research evidence and expert opinion. Another approach is to apply
UK resident rates of health service use, broken down into A&E and primary and
secondary care use, adjusting these rates according to the differences in
underlying characteristics of the visitor group populations. These weightings will
be estimated from applying the age-group and gender weightings from the host
population and moderating these with evidence that emerges from the Phase 1
report and elsewhere. We will decide, in collaboration with you, which approach
to use determined by the precision of the Phase 1 estimates, the availability and
quality of other data and the time available.

Estimate the cost of the current use of the NHS in England by specified visitor
group. We will make use of the sample data from the Phase 1 report and the
Summary report published with the consultation, supplemented with NHS
England data where necessary.

The next step would be to model the financial transactions, i.e. how likely
migrant or visitor patients are to be identified, how likely they are to be invoiced
(directly or indirectly) and how likely the invoice is to be paid, with or without
debt recovery action.

The pattern of migration to the UK is geographically concentrated, so it may be
necessary to recognise that in the costs and to weight the costs accordingly.

Finally in this stage, we would carry out a preliminary validation of the draft
model using the planning assumptions in the DH and the data from the previous
analyses published with the Consultation Document. For instance, if we use the
agreed, assumptions in the model, is it possible to reconcile the £33m estimated
for treatment in NHS hospitals in 2011/12 with the DH estimates for £200m
quoted by the Secretary of State?
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Response –
b) Provide evidence of understanding Modelling to understand future impacts, especially
cost impacts 15%
See response below
Our overall approach has been set out in the diagram below:
6/9
9/8
22/7
Mobilise
Scope
Scope
Specify
Specify
Design
Design
Build
Build
Test
Test
Use
Use/Report
Review
Figure 2 Overall Approach
We have explained our modelling methodology (scope, specify, design, build and
test) in the Table in response to question B2a above and that SMBP method applies
equally to this section of our response. In this section we focus on how we would
model to understand future impacts, especially cost impacts, and how we would
deliver your second and third main outputs:

An estimate of the future costs to the NHS if the current overseas visitors
charging system continues.

How these estimates will change in the future alongside changing composition
of migrant users in the identified sub-groups and impact of external factors

As with the previous section, this is a first draft and our approach may need to
be revised depending on the outcome of our consultations with various
stakeholders and the information emerging from Creative Research and the
Phase 1 study.
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Modelling Impacts
As indicated in the diagram above, our modelling of the future impacts and costs
would build on the first version of the model which we have described in B2a of this
response. In summary, this means that there would be for each defined population
group and sub-group an estimate of:

the size of the population and its demographic characteristics

the demand for NHS services, split over primary, secondary and A&E, built on a
view of underlying need and the propensity to use NHS services

the basket of NHS services relevant to the group or sub-group

weighted costs for the services, reflecting geographical differences, if material

the realisation of the revenue due from the NHS users in that group.
In addition, there will be the need for at least two further analyses to support the
assessment of future impacts. Even if they are not required for this Phase of the
work, they will be required for the assessment of policy options in later Phases.

First, there needs to be some modelling of the costs of administration of the new
policies (e.g. identification in GPs’ practices, any data exchange between the
Home Office (HO) and DH etc.).

Second there needs to be scope for assessing wider economic impacts. These
could include public health (e.g. if visitors are deterred from going to a GP and
they have an infectious disease, what impact will this have?) and economic
prosperity (e.g. will this deter visitors? Will there be change in countries with
which there have been reciprocal arrangements?).
Having agreed the population groups for the baseline, there will need to be forecasts
of visits and migration for the next 10 years. There may be suitable ONS and Home
Office forecasts, but the modelling will have to allow for the uncertainty in this area.
Over the last 10 years for instance, long-term visitor numbers have ranged from
500,000 a year to 600,000 a year. Numbers for some groups have been especially
volatile e.g. estimated students visas went from 200,000 a year in 2002 to 236,000 in
2011 to 177,000 in 2012. And some country numbers have been very changeable
e.g. visa numbers for people from Pakistan fell by 39% between March 2012 and
March 2013.
As noted in the ITT, the data for visitor and migrant numbers are of variable quality.
Some are reliable e.g. those based on visas issued, but some are based on sample
surveys e.g. EEA visitors; and there are some for which inherently there are no
reliable figures e.g. people who are here illegally. Disaggregating the populations
should enable suitable estimating bounds to be set.
To shape the assumptions for the forecasts, we propose to use a PESTELO
framework (i.e. political, economic, social, technological, environmental, legal and
organisational factors) to identify trends that will influence the population numbers,
demographics, health demands and behaviours, health treatments and costs and so
on. We will review relevant reports from other parts of Government (e.g. the DBIS
Foresight unit’s “Dimensions of Uncertainty”) for material elements that need to be
reflected in scenarios. Depending on what emerges it may make sense to have a
“most likely scenario”, tying in with DH and HM Treasury projections, and some
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alternative scenarios e.g. markedly increased travel, markedly decreased
tourism/migration etc. This needs to be decided through the balance between clarity
in the results and the need to explore alternatives. At the very least we will probably
need a “most likely scenario”, a highest plausible scenario and a lowest plausible
scenario so that we can inform the Monte Carlo modelling, which we expect to use in
the simulation.
The scenarios will provide the backdrop for the assessment of future options as
described in Section 2 of the ITT. As the ITT notes, the policy options can only be
assessed when the Department has a clearer idea of what they are.
As we have noted already and as you have noted in the ITT, there will be
considerable uncertainty in the calculations. We will address this challenge in three
main ways:

First, the proposed disaggregated approach to the model will force a conscious
decision to be taken about each group and sub-group at each step of the model.

Second, we will carry out sensitivity testing (i.e. exploring the impact of
changing key variables) to determine the areas of uncertainty that are going to
have the greatest impact on the results.

Third, we will then apply a suitable technique, probably Monte Carlo simulation.
Again there will be a need to balance the clarity in the results and practical
constraints (there may be many variables in the model for which probability
distributions would be required) with the potential for improved results.
The results of the financial analysis need to indicate the impacts on the various
financial stakeholders. We will need to identify what entities within the NHS may
need separate results e.g. impact on GPs.
Applying the Green Book principles means that the focus is on the UK. However, the
Green Book does require that impacts on non-UK residents are identified separately
and quantified. We will therefore have to provide for this in the model so that the
policy options can be correctly assessed later on.
As we have explained above in our response to question B2a, we are proposing to
use a systems approach when we scope and specify the model. That should help to
explore any feedback loops and interactions with other policies. For instance, if there
is reduced access to GPs, will this increase the use of A&E? The systems approach
should also help to identify any other groups, perhaps the HO or the DWP, who might
have a material financial interest in the impacts. The model will be prepared for these
impacts to be identified and quantified.
We suggest that we prepare the model so that the costs of administering new policies
can be assessed. These will include the direct costs (e.g. the cost of identifying
British expatriates in GP surgeries) and indirect costs (e.g. costs to UK employers).
While the details of the policy options are still to be developed, this module cannot be
finalised, but the overall model design can take this into account.
At this stage it seems that using constant prices would give a clearer picture and it is
what is required for the economic analysis by the Green Book. However, there are
some quite marked differences in inflation rates in NHS costs and the rest of the
economy, so these should be explored before reaching a decision about treatment.
We will discuss with you the need to model inflation for the financial analysis.
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The Green Book also requires impacts on different groups to be considered and this
may be useful for later policy impact assessments. The outputs will therefore be
explored to see what material impacts need to be identified and reported separately.
Response Provide evidence of understanding
c) The project plan articulating how the project requirements will be met within the specified
timeframe 10%
See response below
Project Plan
You have set out a number of key dates, notably the presentation of the emerging
analysis and the baseline by 23 August; and the draft report by 6 September, with the
final report on 13 September 2013. In addition, we would suggest that we review the
first draft model in the first week of August, so that we can gain an early indication
that the approach will deliver exactly what is wanted. We would want a follow up
review after 9 August and the presentation of the Phase 1 qualitative analysis, so that
the impact can be gauged. These key dates map to our approach as shown in the
diagram (Figure 3) below:
23/8
9/8
22/7
6/9
Mobilise
Scope
Scope
Specify
Specify
Design
Design
Build
Build
Test
Test
Use
Use/Report
Emerging
analysis
Review
Draft
report
Figure 3 Project Plan
We will prepare a “Goal Directed Project Plan” that we can use to monitor project
progress in the weekly reports. This approach to planning works well for situations
where the milestones are clear (basis for reporting) but flexibility is needed about the
activities needed to achieve the milestones. This approach also lends itself to where
multiple interdependent streams of analysis are need to be undertaken and the
activities needs to be quickly refined as a result of the outcomes of the analysis. Goal
Directed Planning uses the approach of defining milestones in terms of “when we
have…” e.g. when we have completed the first draft of the model, and works back to
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identify the constituent steps required to reach that point. We will agree this with you
in the Mobilisation stage; for the moment we think the overall plan is as follows.
Week ending
Process
Project
Commences
on 22/07/13


02/08/13


09/08/13
23/08/13
06/09/13

Mobilisation meeting with
DH
Scope and specify model
incorporating stakeholder
feedback
Collect baseline data






Further refine model
specification
incorporating Phase 1
results and stakeholder
feedback
Meeting between
Creative Research and
Prederi project team
Collect baseline data
Assess impact of Phase 1
findings
Continue data collection
Build model
Run model
Test model
Complete data collection
Report writing



Refine results
Sensitivity testing
Report writing/re-drafting

Refine report
incorporating DH
feedback



16/08/13
Deliverables
13/09/13




Agreed plan (key milestones
and detail activities) and
progress reporting
Risk and issues log
Model specification 1st
version
First draft list of assumptions
with associated limitations
Audit trail of information
sources used to develop
assumptions


Systems analysis model
Second version of Model
Specification


First version of model built
Assessment of data gaps from
Phase 1

Face to face presentation of
baseline data and emerging
analysis to DH

Draft report (parts a and b)
documenting model,
underlying assumptions with
associated limitations, data
sources and findings given to
DH
FINAL REPORT
This is a tight timescale, running across the most popular holiday period. We have
therefore proposed a core team who have the technical modelling skills, experience
of economic and financial analysis, migration modelling experience, and professional
health and NHS expertise. We have separately identified support for quality
assurance and review and as potential back up.
The core team will be:

PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.
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
PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.

PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.

PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.

PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.
CVs for the core team are included below.
Because there will need to be independent challenge and the potential for further
support if problems arise we have identified in Prederi the following colleagues:

PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.

PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.

PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.
B3
Organisational Capability 30%
Provide one or two examples of recent experience (no longer than 3 years ago)
where you have delivered the following*.
*Tenderers can use the same example project in more than one response field if that
example crosses the different areas of experience, however, response must highlight what
is required in each field.
Response – Recent experience of drawing insights from qualitative analysis and available
quantitative data to estimate robust baseline data 10%
Example 1- Working with COMMERCIAL INFORMATION REDACTED UNDER
SECTION 43 OF THE FREEDOM OF INFORMATION ACT. to produce a business
case for the COMMERCIAL INFORMATION REDACTED UNDER SECTION 43 OF
THE FREEDOM OF INFORMATION ACT.
COMMERCIAL INFORMATION REDACTED UNDER SECTION 43 OF THE
FREEDOM OF INFORMATION ACT.
Recognition of this allowed the client to undertake further work to clarify particularly
sensitive assumptions, and refine the model as actual roll-out data became available.
Example 2 – Working with the COMMERCIAL INFORMATION REDACTED UNDER
SECTION 43 OF THE FREEDOM OF INFORMATION ACT.to cost their activities and
outputs
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Response – Recent experience of drawing insights from qualitative analysis and available
quantitative data to estimate robust baseline data 10%
Response – recent experience in undertaking analysis to estimate future cost impacts 10%
Example 3 – working with the COMMERCIAL INFORMATION REDACTED UNDER
SECTION 43 OF THE FREEDOM OF INFORMATION ACT.to develop the Business
Case for COMMERCIAL INFORMATION REDACTED UNDER SECTION 43 OF THE
FREEDOM OF INFORMATION ACT.
COMMERCIAL INFORMATION REDACTED UNDER SECTION 43 OF THE
FREEDOM OF INFORMATION ACT.
Example 4 – Working with the COMMERCIAL INFORMATION REDACTED UNDER
SECTION 43 OF THE FREEDOM OF INFORMATION ACT.to do a Cost Benefit Review
COMMERCIAL INFORMATION REDACTED UNDER SECTION 43 OF THE
FREEDOM OF INFORMATION ACT.
Response Experience in delivery of successful projects to similar sized organisations and to
similar timeframes, 10%
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Response Experience in delivery of successful projects to similar sized organisations and to
similar timeframes, 10%
Example 5 – Undertaking a VFM and benchmarking review for COMMERCIAL
INFORMATION REDACTED UNDER SECTION 43 OF THE FREEDOM OF
INFORMATION ACT.
Example 6 – Developing of a Commissioning Strategy Plan for COMMERCIAL
INFORMATION REDACTED UNDER SECTION 43 OF THE FREEDOM OF
INFORMATION ACT.
COMMERCIAL INFORMATION REDACTED UNDER SECTION 43 OF THE
FREEDOM OF INFORMATION ACT.
B4
Leadership and Resource Plan 20%
Provide a complete resource plan for the delivery of the Specification including details
of the team involved, what these individuals will be doing and why these individuals
are suitable for this requirement.
Response - identify experience of personnel leading project. Provide a suitable resource plan
for the delivery of the specification including details of the team involved and the
role/activities of these individuals within the project timescales 10%
Table 1 below shows the roles & responsibilities of the proposed Prederi team.
Summary CVs follow immediately after Table 1. The actual resources (person
days) planned are shown later in the pricing schedule.
Table 1 – Resource Plan
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Protect-Commercial
Name of
Prederi
Consultant
PERSONAL
INFORMATION
REDACTED
UNDER
SECTION 40
OF THE
FREEDOM OF
INFORMATION
ACT
PERSONAL
INFORMATION
REDACTED
UNDER
SECTION 40
OF THE
FREEDOM OF
INFORMATION
ACT
PERSONAL
INFORMATION
REDACTED
UNDER
SECTION 40
OF THE
FREEDOM OF
INFORMATION
ACT
Expertise
Responsibilities
Outputs
Stakeholder
Engagement and
Quality Assurance


Manage Project
Engage with Project
Sponsor
Briefings to Sponsor
on progress

Consult & engage
stakeholders
Seek relevant
expert advice
Appraise research
literature
Use findings to
inform assumptions

Deputy PM
Sourcing, analysis
and understanding
of data (ONS, HO)
Identify information
gaps
Appraisal of
assumptions (origin,
relevance, criticality
to the results)
Document critical
assumptions and
their impact on the
results
Analyse current
activities and
opportunities
Cost current
services
Develop model for
financial
assessment of
future options

Project
documentation


Data Assumptions

Stakeholder
Engagement



Relevance of data


Data Assumptions

Extrapolation of
data
Link between the
data and the
project outputs


PERSONAL
INFORMATION
REDACTED
UNDER
SECTION 40
OF THE
FREEDOM OF
INFORMATION
ACT
Designing and
building the model

Populating the
model with
relevant data

PERSONAL
INFORMATION
REDACTED
UNDER
SECTION 40
OF THE
FREEDOM OF
INFORMATION
ACT
Administrative
Support

Producing the
project outputs








Quality Assurance
of all deliverables
Project progress
reports
List of assumptions
underpinning model
inputs and
limitations of each.
Audit trail of the
evidence/informatio
n used to create
assumptions
Current estimate of
the cost to the NHS
of different Migrant
groups
Future estimate of
the cost to the NHS
of different Migrant
groups
Impact of changes
in the composition
of Migrant Groups
and their use of the
NHS
Current estimate of
the cost to the NHS
of different Migrant
groups
Future estimate of
the cost to the NHS
of different Migrant
groups
Impact of changes
in the composition
of Migrant Groups
and their use of the
NHS
Full set of reports
and supporting
material, in agreed
format.
Please find below Summary CVs for our Professional staff:
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Protect-Commercial




PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT
PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT
PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT
PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT
Response – Clearly identify potential risks to achieving successful outcomes 10%
We have identified the following risks which might prevent the successful
completion of the 3 outputs in section 2 of part B of the ITT and therefore may
prevent DH achieving its intended outcome from this piece of work. The risks are
shown in Table 2 below.
Table 2 – Identification and Mitigation of Project Risks
Risk
Political
The sharing of some data is
politically unacceptable
Other Government
Departments don’t cooperate
with the project – for example
this could prevent the
contractor sourcing the
required information to start
the analysis
Impact
Likelihood
Owner
Mitigation
H
M
DH
H
M
DH
Some data is too sensitive to
be placed in the public domain
e.g. HO assumptions about
future migration rates
H
M
DH
Agree principles and
boundaries at outset.
Ensure there are great
relationships between DH and
Home Office / ONS / other
Departments. Actively seek to
improve and grow the
relationship. Keep all parties
fully informed of developments.
Create a most likely scenario
that is in line with published
material and attach disclaimers
to alternative scenarios
Changes in view about what is
required
H
L
DH
Ensure that all stakeholders
including politicians are on-side
before we commence and
regular two-way
communication between DH
and Prederi from the start
M
H
DH
H
M
Both DH
and
Prederi
M
M
DH
Prioritise this project over other
day to day activities.
Keep all work within the team
and essential stakeholders.
Ensure security clearance of
staff.
Clear communication in
advance of timetable of
meetings and briefings to
ensure appropriate DH
representation
H
L
Prederi
Social
Stakeholders are not available
as and when required
Newspaper or other media
becomes aware of the work
and considers publishing
Holiday period limits
availability of key personnel in
DH
Technical
There is no acceptable
technical model
Ensure that the solution is fit
for purpose and as simple as is
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Protect-Commercial
possible. Use well proven
methods. Use the best staff to
develop the solution.
Search for better information
from alternative sources.
Develop plausible estimates
and test sensitivity
Look to improve the quality of
the input information by data
cleansing; test sensitivity to
establish materiality.
Ensure the model is kept as
structured and simple as is
possible. Follow SMPB. Use
the very best people on the
assignment.
Keep the number of population
sub-groups and assumptions
low but within acceptable limits
to support consultation and
policy development.
Information is unavailable
H
L
DH
Information gathered is
unreliable
M
M
DH
The model does not work
properly
M
L
Prederi
We may run over time if we
consult with several external
sources/experts to fill
information gaps and/or carry
out multiple searches of the
literature to build up a granular
picture of migrant health
service use
H
M
Prederi
The complexity of the model
may make the outputs difficult
to interpret by the client and
third party users
H
L
Prederi
Clearly state methods and
underlying assumptions with
associated limitations
Need for further validation
before ONS are happy with
the approach
M
L
Prederi
Early engagement activities
and close communication from
the start with ONS
M
L
DH
M
L
DH
Ensure assets, people and
space are available well in
advance of requirement
Check in advance that the staff
are adequately cleared if and
when necessary
M
L
DH and
Prederi
The “audit” will be required in
any event; retain granularity in
groups modelled.
Lack of readiness to take
decisions on model
specification etc at a pace to
complete the work on time
M
M
DH
Prioritise this project over other
day to day activities
Delay in results from the
Phase 1 Qualitative work or
lack of cooperation from the
Phase 1 authors
M
H
DH and
Prederi
Early engagement activities
and close communication from
the start with Phase 1 authors
Delayed Start
L
H
DH and
Prederi
Contingency plan to delay
production of outputs
Environmental
Locations to work are not
available
Security requirements become
too onerous to continue
Legal
Legal challenge to
Consultation process
Other
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Schedule One: Pricing Schedule
DESCRIPTION OF SERVICE
FIRM PRICE
Management & staff and respective man-days:
Cost per
day
Name & Position
No of
days
COMMERCIAL INFORMATION
REDACTED UNDER SECTION 43 OF
THE FREEDOM OF INFORMATION
ACT.
COMMERCIAL INFORMATION
REDACTED UNDER SECTION 43 OF
THE FREEDOM OF INFORMATION
ACT.
COMMERCIAL INFORMATION
REDACTED UNDER SECTION 43 OF
THE FREEDOM OF INFORMATION
ACT.
COMMERCIAL INFORMATION
REDACTED UNDER SECTION 43 OF
THE FREEDOM OF INFORMATION
ACT.
COMMERCIAL INFORMATION
REDACTED UNDER SECTION 43 OF
THE FREEDOM OF INFORMATION
ACT.
Sub-total/total consultancy cost
Production of interim and final reports
£
0
Any other costs (please describe what these costs are)
£
0
Discount; only applies to this task for DH
Total Contract Price (Evaluation Price)
£ 36,000
This price above excludes VAT at 20%.
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Schedule Three: Contract Monitoring
1.
GENERAL INSTRUCTIONS
Tenderers must provide all the information requested in the following section as part
of their tender proposal. Supporting documents may be submitted but must be
clearly referenced back to the appropriate section.
2.
REPRESENTATIVES
Name of Authority's Representative(s): To be advised at contract award
Name of Contractor's Representative(s): PERSONAL INFORMATION REDACTED
UNDER SECTION 40 OF THE FREEDOM OF INFORMATION ACT.
Deliverables
List of deliverables, outputs and reports Contractor is to supply:
There will be three main outputs. These are:
• An estimated cost of the current use of the NHS in England by visitors (including
health tourists) and non-permanent residents (temporary residents including workers
students and others), split by EEA and non-EEA residents
• An estimate of the future costs to the NHS if the current overseas visitors charging
system continues.
• How these estimates will change in the future alongside changing composition of
migrant users in the identified sub-groups and impact of external factors
For each group the analysis will need to consider utility in primary care, secondary
care and accident and emergency.
3.
MEETINGS
Will be held as per Schedule 1 section 5
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DH Formal
Schedule Three: Confidential & Commercially Sensitive Information
1.
1.1.
1.2.
1.3.
2.
2.1.
GENERAL
All the information that the Authority supplies as part of this Contract may be regarded as Confidential Information as defined in
Condition 1 (Definitions) of Section Three – Conditions of Contract.
The Contractor considers that the type of information listed in paragraph 2.1 below is Confidential Information.
The Contractor considers that the type of information listed in paragraph 2.2 below is Commercially Sensitive Information.
TYPES OF INFORMATION THAT THE CONTRACTOR CONSIDERS TO BE CONFIDENTIAL
Type 1: Confidential information:
INFORMATION CONSIDERED CONFIDENTIAL
Pricing Schedule
2.2.
81922488
REASON FOR FOIA EXEMPTION
(INCLUDE PARAGRAPH REFERENCE)
Commercially Sensitive (Schedule One)
PERIOD EXEMPTION IS
SOUGHT (MONTHS)
12 months
Type 2: Commercially sensitive information:
INFORMATION CONSIDERED COMMERCIALLY
REASON FOR FOIA EXEMPTION
SENSITIVE
(INCLUDE PARAGRAPH REFERENCE)
PERIOD EXEMPTION IS
SOUGHT (MONTHS)
Method Statement (Schedule One, Section B2)
Commercially Sensitive (Schedule One Part B2)
12 months
Prederi Team CVs
Commercially Sensitive (Schedule One Part B4)
12 months
Page 22 of 28
DH Formal
Schedule Four: Administrative Instructions
1.
1.1.
1.2.
2.
2.1.
2.2.
3.
AUTHORISATION
The person shown below person shall act as the Authority's Representative on all
matters relating to the Contract:
NAME
To be confirmed at Contract Award
CONTACT DETAILS
To be confirmed at Contract Award
The Department's Representative may authorise other officers to act on their behalf.
NOTICES
Any notice the Contractor wishes to send the Authority shall be sent in writing to the
Authority's Representative at the address shown in paragraph 1.1 above.
Any notice the Authority wishes to send the Contractor shall be sent in writing to the
Contractor's Representative at the address shown in paragraph 4.2 below.
ADDRESS FOR INVOICES
3.1.
All invoices shall be sent to the Department addressed to:
Department of Health
Accounts Payable
6th Floor, Zone B
Skipton House
80 London Road
London
SE1 6LH
3.2.
NB. Invoices must be sent to Accounts Payable at the above address. Invoices must
not be sent to the Authority’s Representative.
4.
CORRESPONDENCE
4.1.
All correspondence to the Authority except that for or relating to invoices shall be
sent to the following address:
To be advised at Contract Award
4.2.
All correspondence to the Contractor shall be sent to the following address:
Tenderer to provide Address
PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.12 Melcombe Place
London
NW1 6JJ
Page 23 of 28
DH Formal
Schedule Five: Appendix A: Variation to Contract
(FOR INFORMATION ONLY – NOT FOR COMPLETION AT TENDER STAGE)
CONTRACT TITLE:
FOR THE PROVISION OF:
CONTRACT REF:
VARIATION NO:
DATE:
BETWEEN:
The Secretary of State for Health (hereinafter called the Department) and [INSERT NAME
OF CONTRACTOR] (hereinafter called the Contractor) having his main or registered office at
[DN:INSERT ADDRESS]:
The Contract is varied as follows:
(DN:INSERT DETAILS OF VARIATION)
Words and expressions in this Variation shall have the meanings given to them in the
Contract.
The Contract, including any previous Variations, shall remain effective and unaltered except
as amended by this Variation.
SIGNED:
FOR: THE AUTHORITY
FOR THE CONTRACTOR
By
BY
Full name
FULL NAME
GRADE / PAY BAND
TITLE
DATE
DATE
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DH Formal
Schedule Five: Appendix B: Novation Agreement
(FOR INFORMATION ONLY – NOT FOR COMPLETION AT TENDER STAGE)
THIS DEED (THIS AGREEMENT is made on the [dd] day of [month & year] BETWEEN
(1)
THE SECRETARY OF STATE FOR HEALTH (the Secretary of State) whose
principal place of business is at Richmond House, 79 Whitehall, London, SW1A 2NS,
(2)
THE [CONTRACTOR] of [address]
(3)
THE [NEW PARTY] of [address]
WHEREAS
(A)
This Agreement is supplemental to an agreement dated [dd Month Year] between the
Secretary of State and the Contractor (the Contract) under which the Contractor
agreed to provide services to the Secretary of State.
(B)
The Secretary of State has authorised the New Party to replace the Secretary of
State as the contracting Department under the Contract on the terms of this
Agreement and the Contractor is willing to accept the New Party in place of the
Secretary of State on those terms.
IT IS HEREBY AGREED AS FOLLOWS:
1.
Subject to the following Clauses of this Agreement –
a) The Contract shall continue in full force and effect as if the New Party were
named as a party to the Contract in place of the Secretary of State for Health.
b) All rights, obligations and liabilities arising under the Contract from the date of this
Agreement shall be rights, obligations and liabilities between the New Party and
the Contractor.
c) Any existing rights, obligations or liabilities of the Secretary of State relating to the
performance of the Contract up to the date of this Agreement shall pass to the
New Party and shall be enforceable between the Contractor and the New Party in
place of the Secretary of State.
2.
The rights, obligations and liabilities of the Contract shall be exercisable and
enforceable as the rights of the New Party under this Agreement.
3.
This Agreement shall be governed by and interpreted in accordance with English law
and shall be subject to the jurisdiction of the courts of England.
Signed by ....................................for and on behalf of the
Secretary of State for Health in the presence of:
Signed by ....................................for and on behalf of the
Contractor in the presence of:
Signed by ....................................for and on behalf of the
New Party in the presence of:
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DH Formal
Schedule Five: Appendix C: Sub-Contractors
All suppliers to the Department of Health are asked to provide details of all sub-contractors that will be used to perform the contract.
PROVIDE
NAME & ADDRESS OF SUB-CONTRACTOR
NAME:
SERVICE PERFORMED FOR
CONTRACTOR
PROVIDE DETAILS OF STAFF
NUMBERS
2
LATEST
YEAR’S
TURNOVER
Not applicable
ADDRESS:
NAME:
ADDRESS:
NAME:
ADDRESS:
2
This is the average annual numbers of both staff and managerial staff employed over the last trading year
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DH Formal
Schedule Five: Form of Tender
Declaration
PROPOSAL FOR THE PROVISION OF QUANTITATIVE ASSESSMENT OF
MIGRANT ACCESS TO THE NHS
Having examined the proposed Contract comprising of:
(a)
Part A – Section Two, (Conditions of Contract);
(b)
Part B – Schedules One, One (a), Two and Six (mandatory); and
(c)
Part B – Schedules Three to Five inclusive (as amended).
As enclosed in the ITT response dated 4th July 2013. We do hereby tender against
the requirements, and terms and conditions of the proposed Contract.
We undertake to keep the tender open for acceptance by the Authority for a period of
ninety (90) days from the deadline for receipt of tenders.
We declare that this is a bona fide tender, intended to be genuinely competitive, and
that we have not fixed or adjusted the amount of the tender by, or under, or in
accordance with, any agreement or arrangement with any other person. We further
declare that we have not done, and we undertake that we will not do, any of the
following acts prior to award of this Contract:
(a)
Collude with any third party to fix the price of any number of tenders for this
Contract;
(b)
Offer, pay, or agree to pay any sum of money or consideration directly or
indirectly to any person for doing, having done, or promising to be done,
any act or thing of the sort described herein and above.
Unless and until the Tenderer and the Authority have executed a formal agreement,
the Authority's acceptance of this tender with all its enclosures shall not constitute a
binding contract between us. We understand that you are not bound to accept the
lowest price, or any, tender.
Name of person duly authorised to sign tenders:
Date: 8th July 2013
Name: PERSONAL INFORMATION REDACTED UNDER SECTION 40 OF THE
FREEDOM OF INFORMATION ACT.
in the capacity of: Director
duly authorised to sign tenders for and on behalf of:
Prederi Ltd
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Page 27 of 28
DH Formal
By completing this Declaration and submitting your tender you have agreed that the
statements in this Form of Tender are correct.
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