EEA Healthcare Process and Systems Redesign

Tender description

Why the Work is Being Done The Department of Health is responsible for the administration and operation of a series of processes relating to the statutory provision of healthcare under particular circumstances for UK citizens residing or visiting other EEA Member States, and for EEA citizens in the UK, and consequent financial claims and reimbursement processes. Current processes span several government departments and agencies and are supported by a number of IT systems. An early discovery has already been completed, We now want to commission a short but intensive completion of Discovery by August 2016 that will provide a service design roadmap. Problem to Be Solved Currently processes are handled by different agencies; are mainly paper based, supported by outdated and disparate IT systems. Collectively this can result in significant financial loses due to fraud and error. In addition, the early discovery has demonstrated that citizen user experience is suboptimal, not meeting government digital standards. Who Are the Users There are several channels for citizens to initially register in advance for entitlement to reimbursable healthcare. These channels comprise: • The European Health Insurance Card (EHIC for short term visits to another MS, mainly as a tourist • The S1 form for recipients of state pensions and some other benefits who move to live in another MS • The S2 form for citizens wishing to have planned treatment in another MS Most subsequent reimbursement is administered through govt to govt channels. Administration of both entitlement applications and reimbursements creates multiple administrative users across the end to end process. Early Market Engagement Work Already Done Early discovery exercise has provided detailed as is process mapping, review of current IT systems, Initial citizen user research and outline opportunities for change. Detailed outputs will be made available to inform this further discovery. Existing Team A single contracted supplier team will work with a small dedicated project team from the Department and given full access to all necessary business service operators and service specialists. Current Phase Discovery Work Location Main business functions are located in a number of offices in the Newcastle and Washington Tyne & Wear area plus one function in London. Overall the contractor/department project team will be based mainly in the North East, but we envisage that some remote working will also be possible. Working Arrangments A single contracted supplier team will work with a small dedicated project team from the Department to enable on-going sharing of expertise and ideas. We envisage weekly or more frequent team/group meetings and wider workshops with other stakeholders. Reasonable expenses for travel and overnight expenses in line with Departmental policy will be reimbursed. Security Clearance To Seek Advice Additional T&Cs Skills & Experience Be able to design solutions to connect multiple system applications Have knowledge of Financial Reporting Systems Have knowledge of data protection legislation implications Have relevant technology market insight Be able to undertake citizen user and business application user research Be able to produce a readable cost benefit analysis Provide insight into validation processes and other solutions to reduce fraud and error Work collaboratively with in house team and other key stakeholders Experience of designing cloud based solutions Experience of completing Discovery projects to government digital standards Must be able to have full team engaged by early June Nice to Haves Some familiarity with the EEA health and social security regulatory framework Working with multiple government departments and agencies No. of Suppliers to Evaluate 5 Proposal Criteria The proposed approach and methodology How the approach or solution meets your organisation’s policy or goal Estimated timeframes for the work Team structure Value for money of the proposal Cultural Fit Criteria Work as a team with our organisation and other suppliers Transparent and collaborative when making decisions Works across multiple government agencies Payment Approach Capped time and materials Assessment Method Written proposal Reference Presentation Evaluation Weighting Technical competence 50% Cultural fit 20% Price 30% Questions from Suppliers Budget range to discuss