Health and Social Care Digital
Service Market Engagement
August 2013
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Health and Social Care Digital Service Market Engagement
Part A:
Background Information
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Health and Social Care Digital Service Market Engagement
1 The Health and Social Care Digital Service procurement market engagement
1.1 Purpose of this document
This document is designed to inform suppliers and other potential contributors who have an interest
in the planned delivery, structure and procurement of a new Health and Social Care Digital Service,
which shall utilise the current digital asset known as NHS Choices.
The document provides some detail as to the current market engagement, outlines the immediate
background to the procurement, the proposed commercial architecture, implementation steps, and
the vision for the Health and Social Care Digital Service.
Formerly referred to as the Integrated Customer Services Platform (ICSP), the programme was
recently renamed as the Health and Social Care Digital Service as this reflects the both the scope of
the strategic vision in terms of empowering citizens to take more responsibility for their health and
wellbeing as well as acknowledging digital services as a fundamental enabler in this transformation.
1.2 Market engagement documents
The documentation provided during this market engagement event is detailed in the table below.
Part
Section
Title
Description
1
Introduction to the Health and Social Care
Digital Service market engagement
2
Health and Social Care Digital Service
Section 2 of this document
describes the Health and Social
Care Digital Service programme
3
Proposed Commercial Architecture
Sets out the planned contract
structures and associated
commercial opportunities
4
Implementation
Describes the programme and the
next steps
B
5
Questionnaire
Requests your views on the
provider market and feedback on
our planning options
C
6
Appendices
Illustrations regarding commercial
options
A
3
Section 1 of this document
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Health and Social Care Digital Service Market Engagement
2 Health and Social Care Digital Service
2.1 Background
The strategic vision for this investment is to deliver a Health and Social Care Digital Service which
provides the single ‘front door’ to digital NHS, Public Health and Social Care services. The intention
is to provide digital tools that will empower citizens to take greater control over their health and care.
The HSDS will build upon the widely acknowledged success of the NHS Choices service by driving
up the quality and breadth of web-based services and by providing new channels of access to health
and social care information and advice.
NHS Choices has been operational since 2007 and is the leading health and social care information
service in England. Website visits now reaching significant volumes at one million unique visits to the
site every day (Jan 2013 figures). Market research and user surveys indicate that the service is
highly valued by the public with satisfaction levels consistently over 80%.
In web terms, six years is more than long enough for technology to have completely moved on. With
the original single-supplier contract coming to an end, the programme now has the opportunity to
update the core technology whilst simultaneously expanding the functionality and the reach of the
service by introducing new channels for participation and transactions such as text messaging, apps,
voice and social media.
There is significant government strategy that not only supports investment in this type of digital health
innovation, but actually requires it. The 2012 Information Strategy for Health and Care, The Power of
Information, sets out a ten-year framework for change and innovation to improve services and
outcomes for all users of health and social care services. The Health and Social Care Act 2012 sets
out the Secretary of State for Health’s duty to secure continuous improvement in the quality of
services, and NHS England’s duty to promote ‘the involvement of each patient, carer and
representative in decisions relating to their care and treatment’. The Government Digital Strategy
(Nov 2012) affirms the commitment to make government services digital by default, with key drivers
being not only the efficiencies and savings to be made, but also an improved customer experience
from services designed around user need.
2.2 The proposed investment
The proposed investment is to deliver a Health and Social Care Digital Service that provides the
single ‘front door’ to digital NHS, Public Health and Social Care information and services. This will
fundamentally change the digital customer experience and manner in which health and care
information is accessed by creating a personalised experience, with the relevant information
delivered at the right time, to empower the public. It will follow the approach set out by the
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Health and Social Care Digital Service Market Engagement
Government Digital Strategy to procure modular, ‘agile’ functionality that can be modified quickly and
easily to meet user needs and expectations.
It is proposed that the Health and Social Care Digital Service components will be delivered by a
number of providers addressing different aspects of delivery rather than a single provider as has
been the case previously.
2.3 The Vision for the Health and Social Care Digital Service
The Health and Social Care Digital Service is best thought of as a new multi-channel information,
feedback, transactions and participation customer excellence programme from the NHS, public
health and social care partners. Delivered through mobile apps, SMS, phone and online channels,
the service will:

Directly connect people to transparent information about health and care, and
associated services.

Enable people to feedback about their experiences of health and care and ensure that
they are listened to and their comments acted upon.

Support people to transact their health and care online, catching up with many other
sectors that have embraced the digital landscape and empowered their customers.

Provide a platform for participation in individual health and care and the opportunity to
connect to others to operate as “change agents” to improve services.
This Health and Social Care Digital Service is based on evidence for a growing demand for digital
health and care services, aligned with increasing access to the Internet and changing consumer
behaviour. Harnessing of social media tools will therefore be an integral component of the
programme by positioning the Health and Social Care Digital Service as a responsive and engaging
platform. The programme will also play a critical role in widening digital participation, by supporting
and training people with online skills to increase health literacy. It will be a world-leading, multi
channel, interoperable service that will harness the power of technology to create the ‘front door’ to
transform the way the public engage with health, public health and social care services in England. It
will empower people to take more responsibility for their health and wellbeing and is being developed
to fulfil government commitments to raise patient engagement, improve patient experience and safety
and to create a more effective, sustainable and transparent health and care system.
The Health and Social Care Digital Service has the potential to transform the way health and
social care are configured, with digital as the preferred route wherever possible (Digital
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First1).
It is an ambitious vision that will build upon the success of NHS Choices and NHS Direct, but offer a
more joined-up experience, providing people with the right information at the right time, enabling
more online transactions, and removing the burden from users of the need to understand the
organisational boundaries and processes of the health and social care system. It will be developed
to meet the user expectations created by other industries such as banking and travel, where the
benchmarks for convenient, personalised, secure and transparent digital services have been set.
The Health and Social Care Digital Service will create and drive innovation in the health and care
and support markets through the supply of an open and accessible interface that third party
developers can use to create innovative products for consumers and further exploit the data,
information and knowledge of the health and care system.
2.4 Service deliverables and product pipeline
To ensure that the Health and Social Care Digital Service can achieve its objectives and continually
contribute to the priorities of health, public health and social care, a set of service categories and
themes have been developed to inform, guide and define its deliverables
Service
category
Service theme
Deliverable description
Transparency
Helping people choose the services
that meet their needs
High quality and timely information to support customers
in choosing services and treatments
Supporting people to hold their
services to account
Relevant data, such as population-level, financial or
performance, to enable people to hold local services to
account
Helping people participate in the
designs of their services
Evidence into local and national service re-design to
enable people to engage in service design and
improvements
Encouraging providers to improve
their services
Transparent publication of data to stimulate high quality
care
Supporting innovators to add value to
health and care data
Open data platform in order to create and stimulate the
health market to innovate
Helping people to understand their
health and care
Tools to support the assessment of customers’ health and
to guide them through their treatment and care
Making decisions
Decision support aids to help customers with their health
and care needs, including real-time information
Transactional
Access
Digital First – According to the Department of Health (2012), Digital First’s aim is to “…reduce unnecessary
face to face contact between patients and healthcare professionals by incorporating technology into these
interactions.”
1
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Participation
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Improving access to services
Convenient functionality to allow customers to access
services, including booking appointments and repeat
prescriptions
Controlling relevant information
Mechanisms to allow customers to control their consent
and access to their information
Listening and responding
Social media and insight and feedback tools to gather
comments from customers in order to drive performance,
including the digital insight and analysis tools of the DIME
Programme
Helping people choose
Tools to support customers in choosing and accessing the
most appropriate health and care services given their
individual circumstance
Personalisation
Curated and personalised content and tools to support
customers to manage their health and care, including the
promotion of Personal Health Records
Giving back
Mechanisms to allow customers to contribute to the health
and wellbeing of the wider health and research community
Coming together
Coordination tools to enhance community-based support
and integrated responses to outbreaks
Widening digital participation
Supporting and training people with online skills to boost
health literacy
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Health and Social Care Digital Service Market Engagement
3. Proposed commercial architecture
3.1 Operating Model Options
An options appraisal is being conducted in accordance with the business case process. Six options
have been shortlisted:

Option 1: Do nothing; no re-procurement activity.

Option 2: Provide health and social care digital services in house.

Option 3: Outsource the provision of health and social care digital services to a prime
contractor.

Option 4: Outsource the provision of health and social care digital services to a commercial
organisation and a number of service providers.

Option 5: Keep the ‘controls’, management and integration of health and social care digital
services in house and outsource services to service providers.

Option 6: Outsource the provision of health and social care digital services to a sponsored
Social Enterprise with a commercial partnership vehicle delivering core services and
supplementary funding model for market priming.
As part of this market engagement activity we will be soliciting the views of potential suppliers on the
perceived advantages and disadvantages of these models.
3.2 Current Operating Design
Until mid-2013, NHS Choices, is delivered mainly by a team of around 150 personnel employed by a
prime contractor. The prime contractor sub-contracts some specialist and non-specialist services to
around 35 suppliers. The prime contractor team has been insourced to the HSCIC and the subcontracts novated to the Department of Health managed by HSCIC; this is a temporary measure
only, undertaken only as a step towards a future outsourced arrangement.
3.3 Future Operating Design
In July 2013, NHS England announced an intention to procure Health and Social Care Digital
Services and began a consultation with Industry (of which this event forms a part).
It is likely that the new operating design will consists of three principle levels of Commissioning,
Management and Delivery.
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3.3.1 Programme Management Organisation and Procurement Hub
A Programme Management Organisation is required to organise the delivery of the commissioner’s
requirements, as an integrated system within allocated funding. The Programme Management
Organisation could be provided either in house or outsourced.
A Procurement Hub is required if the core services of the Health and Social Care Digital Services are
supplied by a variety of providers, which is likely in order to maximise the participation of the third
sector and SMEs and achieve best of breed in all areas. The Procurement Hub could be provided inhouse or outsourced. If outsourced, it may have more flexibility commercially.
3.3.2 Delivery - Service Provision
Service Provision could be split according to a number of ways, for instance into:

Hosting Service

Social media monitoring and management service

Digital content management and insight service.

UI and UX development

Application and Development Services.

Online and Digital Marketing Agency Services

Data management and visualisation services

SEO and Campaign management

Content and editorial services

Operational Service Delivery
The split will depend on what the market can offer, and if procurement were kept in house it would
also depend on what is available through framework agreements.
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3.3.3 Partners
The Health and Social Care Digital Service will work in partnership with patient organisations, care
and support, voluntary sector organisations and professional associations for the provision of some
content services.
3.3.4 Providers
Any of the services, the Programme Management Organisation or the Procurement Hub could be
provided by a new company or an existing company in any mix and could be either social or
commercial enterprises.
3.3.5 Current Preferred Commercial Models and Further Analysis
At this stage, a single preferred option has not emerged as a front-runner from the options available,
however we are specifically interested in pursuing validation, delivery implications and options in
respect of Options 4, 5 and 6 as outlined above. Utilising commercial terminology we shall be
pursuing detailed consideration of ‘leverage’ models vs. ‘strategic’ commercial and contracting
models.
Leverage Models
Variant models within this category assume that supply risk is low and market capability and
purchaser power may be exploited with relative ease. The purchasing entity would be comfortable
assuming risk associated with overall delivery of capability and outputs, and would atomise or
disaggregate the total supply chain in order to ‘commoditise’ and drive market competitive behaviour
wherever possible. Contracting lifecycles would typically be short and commitments low as an
expression of purchaser power. The purchasing entity would stand up an active management
function in order to maximise value advantage on a continuous basis. Some services may be
performed in house or partnered where they are considered of specific strategic concern.
The ‘new breed’ of contract and delivery model for Government ICT primarily follows this model.
Specifically GDS operate a variance of this model, G Cloud is designed to support it and the new
Digital Services Framework to complement it.
Strategic Models
Variant models within this category assume that supply risk is high, but that benefits or value release
is also high. Typically unlike Leverage models, value discussions are not focussed on cost and
efficiency but on delivery of strategic benefit. In models within this category other forms of provision
would be envisaged which control the relationship between the delivering parties, and seek to
manage the relationship primarily, rather than focussing on market forces or supply risk. Examples
of Strategic Contracting models include partnerships, Joint Ventures, and relational contracts such as
Alliance Contracting. Contract lengths would be mid to long term. In respect of the Health and Social
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Care Digital Service a Joint Venture is not currently deemed appropriate as the commercial
proposition governing financial viability is not clearly visible, and the opportunities for monetisation
specifically are not deemed wholly appropriate at this point in time.
These forms of arrangement are relatively rare within the public sector though are gaining traction,
specifically for complex problems or large scale projects requiring significant levels of innovation.
An appendix to this document represents some key potential commercial designs in diagrammatic
form.
4. Implementation
4.1 Programme and next steps
Current activities are focussed on the development and assessment of final model options, and the
selection of the same.
Of specific concern from a programme perspective is

the arrival at an appropriate scope definition over a defined planning horizon (for instance,
what do the first 2 to 3 years look like, and what are the objectives and boundaries of core
supply lines),

the associated delivery structures and their organisational boundaries,

the methods and mechanisms for funding

associated with this, the links to wider market generation objectives, and

the commercial and entity constructs which shall govern the delivery of managed capacity
over the medium term
We are currently finalising the Strategic Outline Case, which will present the preferred Operating
Model and refine to very small numbers the sourcing and commercial structures and approaches. We
expect to have submitted this case for approval at the end of this month (August).
Immediately subsequent to this, we shall utilised some of the key findings of this market engagement,
to arrive at a final preferred position, which shall be presented in the Outline Business Case, which
we expect to have delivered for approval by October. Approval of the Outline Business Case will
mark the commencement of full delivery operations, including procurement and commercial activity.
Which we hope to have executed by March 2014.
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4.2 Next Steps for the Market Engagement
You should have been given a Part B paper, alongside this you are currently reading. In it you will
find a series of responses we would like to elicit from you in written form.
You are invited to submit responses to Part B by close 30th August 2013. Completed Questionnaires
should be sent to HSCIC by email to [ ]. Electronic copies should be submitted in either PDF or MS
Word formats
It would help us if responses were to follow the format and content requested in Part B. Submissions
may also contain a cover note and executive summary detailing key points and annexes with
additional information if you should choose to submit it.
Please note that information contained within submissions is not deemed to contractual in nature or
confer obligations on the part of participants; nor shall such information be considered within the
context of any subsequent procurement activity. These considerations should specifically be borne in
mind when engaged in any estimation activity requested.
You are encouraged to be as open as possible in your responses. Based on reading of submissions
we shall select further parties for further sessions; these sessions shall be relatively informal in
nature and interactive. Should you at this stage feel that NDA cover is necessary then this can be
arranged.
HSCIC broadcast information is in the public domain. All information supplied will be treated as
confidential and only used to inform internal strategies, tactics and document creation. NDA cover is
available for stage two participation if deemed necessary (as noted above).
We very much hope that you feel sufficiently interested to participate further in this pre procurement
process.
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Part B:
Questionnaire
Return address - [email protected]
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About You
1. Please tell us a little bit about your business operations, including which markets you
principally operate within?
2. Are you a regular supplier of services to the Health and Social Care Sectors?
3. In respect of your operations within the Health and Social Care Markets, who would
you consider to be your principle competitors or contemporaries?
What You Think About the Health & Social Care Digital Market
4. In respect of your area of operations and expertise how mature do you feel the market
serving Health and Social Care is?
5. In respect of the digital market more generally, do you consider that Health and Social
Care is a mature customer? What behaviours or approaches would improve your
perception of us as a customer?
6. What do you think the principle barriers to entry are for an economic operator
attempting to supply digital services to the Health and Social Care sector?
7. Do you believe that the digital market needs development support within the Health
and Social Care domain? If so, why, and what makes it distinct from the general
digital market for public services?
Your View of the Vision for HSCDS
8. As it has been presented to you, do you believe that the vision for HSCDS is a)
desirable, b) achievable?
9. What do you consider might be the principle barriers to achieving the objectives of the
vision? How might these be overcome?
10. Based on your understanding of the potential benefits we are seeking to obtain, if you
were tasked with delivery, where would you address your initial efforts to achieve
maximum benefit within the shortest period of time?
Chronology and Delivery
11. How long do you think it would take to achieve a mature end state for the HSCDS as
it has been presented to you?
12. If you were tasked with its delivery what would your general approach be?
13. If you were tasked with its delivery what funds would you seeking fo the first five years
of development and operation?
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Operating Model
14. Based on the options for an operating model which have been presented to you,
which option would you consider most likely to achieve the desired objectives, and
why?
15. We have presented a possible option for a Special Purpose Vehicle Social Enterprise;
please give you views on the proposed scope? How do you believe that its presence
would affect the general commercial market operating in this space?
16. We have presented a possible approach which combined direct (procured)
commissions, with grants delivered over set ‘investment rounds’. Do you consider that
this would be an effective means of promoting innovation within the broader market?
Do you foresee any problems with this approach, if so, what are they? Do you
consider that the market a) requires this, or b) could deliver capability in this fashion?
Commercial Options
17. Have you any experience with Alliance Contracting within digital or other service
arenas?
18. Would you bid for a place within an Alliance Contract?
19. Which model would you employ if you were charged with delivery? Why?
20. What do you consider the principle benefits of your chosen model, and why? What
drawbacks influenced your disfavour of the rejected alternative?
21. Do you consider that the service categories presented are correct/or optimised. If not,
what would you categorise differently?
Next Steps
22. If we were to ask you to speak to us with a small group of your peers or other
potential suppliers, would you be interested in participating in further discussions prior
to finalising of procurement plans?
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Part C:
Appendices
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Appendix A: This diagram represents the basic categories of ‘requirement’ that we consider as a
minimum necessary to deliver the HSCDS.
Funding
Strategic Control and Commissioning
Governance
Service Strategy
Content Strategy
Procurement, Investment and Commercial Control
Content Assurance and Commissioning
Platform and Technical Assurance
Controls
Operational Service Delivery
Clinical
Content
Non Clinical
Content
(Copy)
(Open) Data
and Transparency
Digital
Content (AV)
Digital Content Management & Information Architectures
Digital Marketing
SEO and Campaign Management
UX & UI Development & Maintenance
Application Development
Data Management and Visualisation
Social Media / User Content Management and Monitoring
Insight and Analytics
Infrastructure Delivery
Customer Services
Delivery
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Appendix B: This represents the likely configuration of a ‘leverage’ commercial and operating model.
Department for Health
NHS England
Authority / Authority
SPV
Governance
Service Strategy
Clinical
Content
Content Strategy
Procurement, Investment and Commercial Control
Content Assurance and Commissioning
Platform and Technical Assurance
Non
Clinical
Content
(Copy)
(Open)
Data and
Transparency
Operational Service Delivery
Digital
Content
(AV)
Digital Content Management & Information Architectures
UX & UI Development & Maintenance
Application Development
Contract
Contract
Contract
Contract
Customer Services
SEO and Campaign Management
Contract
Infrastructure Delivery
Contract
Insight and Analytics
Contract
Many Individual
Contracts
Social Media / User Content Management and Monitoring
Contract
Data Management and Visualisation
Contract
Digital Marketing
Controls
Delivery
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Health and Social Care Digital Service Market Engagement
Appendix C: This represents the likely configuration of a ‘strategic’ commercial and operating model.
Department for Health
NHS England
Authority / Authority
SPV
Governance
Service Strategy
Content Strategy
Procurement, Investment and Commercial Control
Content Assurance and Commissioning
Platform and Technical Assurance
Non Clinical
Content
(Copy)
Clinical
Content
(Open) Data
and Transparency
nts
Gra
Digital Content
(AV)
Commissi
ons
Controls
App
Alliance – circa 5
partners
Operational Service Delivery
Hack
Customer Services
Infrastructure Delivery
Insight and Analytics
Social Media / User Content Management and Monitoring
Data Management and Visualisation
Application Development
UX & UI Development & Maintenance
SEO and Campaign Management
Digital Marketing
Mod
Digital Content Management & Information Architectures
Start Up
Delivery
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Appendix D: This represents the potential scope of a Social Enterprise operating the HSCDS on
behalf of the Department for Health / NHS England.
Funding
Strategic Control and Commissioning
Governance
Service Strategy
Content Strategy
Procurement, Investment and Commercial Control
Content Assurance and Commissioning
Platform and Technical Assurance
Controls
Operational Service Delivery
Clinical
Content
Non Clinical
Content
(Copy)
(Open) Data
and Transparency
Digital
Content (AV)
Digital Content Management & Information Architectures
Digital Marketing
SEO and Campaign Management
UX & UI Development & Maintenance
Application Development
Data Management and Visualisation
Social Media / User Content Management and Monitoring
Insight and Analytics
Infrastructure Delivery
Customer Services
Delivery
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Appendix E: What is an Alliance Contract?
An alliance contract is a single contract between the contracting Authority and an alliance of parties
who deliver the project or service.
There is a risk and benefits share across all parties and collective ownership of opportunities and
responsibilities associated with delivery of the project or service. Gain and pain is linked with good or
poor performance overall and not to the performance of individual parties. The contract delivers to a
target cost, identified by the alliance post contract, and to an expression of outcome objectives only.
The Authority seeks to encourage innovation and continuous improvement in the approach to
delivery and the delivery of any services over time.
An alliance contract is designed to create a collaborative environment without the need for new
organisational forms; supply components integrate themselves in pursuit of the overall objective.
By entering a single contract, all parties are working to the same outcomes and are signed up to the
same success measures. The form and expression of the contract aligns the success of all parties in
order that problem solving and innovation is shared across all participants.
The parties in the alliance are guaranteed coverage of basic costs by the contracting Authority, they
place corporate overheads and profits at risk based on their ability to deliver outcomes at target
costs. There are significant ongoing rewards for exceeding targets in both cost of delivery and
performance against outcome objectives.
Change control in its standard form is kept to an absolute minimum.
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