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1 Copyright © 2013, Health and Social Care Information Centre.

Health and Social Care Digital Service Market Engagement

August 2013


Part A:

Background Information



1 The Health and Social Care Digital Service procurement market engagement

1.1 Purpose of this documentThis 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 documentsThe documentation provided during this market engagement event is detailed in the table below.

Part Section Title Description

A

1 Introduction to the Health and Social Care Digital Service market engagement

Section 1 of this document

2 Health and Social Care Digital Service Section 2 of this document describes the Health and Social Care Digital Service programme

3 Proposed Commercial ArchitectureSets out the planned contract structures and associated commercial opportunities

4 Implementation Describes the programme and the next steps

B 5 QuestionnaireRequests your views on the provider market and feedback on our planning options

C 6 Appendices Illustrations regarding commercial options



2 Health and Social Care Digital Service2.1 BackgroundThe 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 investmentThe 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



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 ServiceThe 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 First1).

1 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



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 pipelineTo 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

Transactional Access

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

Improving access to services Convenient functionality to allow customers to access services, including booking appointments and repeat prescriptions

interactions.”



Controlling relevant information Mechanisms to allow customers to control their consent and access to their information

Participation 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



3. Proposed commercial architecture

3.1 Operating Model OptionsAn 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 DesignUntil 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 sub-

contracts 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 DesignIn 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.



3.3.1 Programme Management Organisation and Procurement HubA 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 in-

house or outsourced. If outsourced, it may have more flexibility commercially.

3.3.2 Delivery - Service ProvisionService 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.



3.3.3 PartnersThe 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 ProvidersAny 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 AnalysisAt 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 ModelsVariant 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 ModelsVariant 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

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 stepsCurrent 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.



4.2 Next Steps for the Market EngagementYou 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.



Part B:

Questionnaire

Return address - [email protected]


mailto:[email protected]


About You1. 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 Market4. 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 HSCDS8. 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 Delivery11.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?



Operating Model14.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 Options17.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 Steps22. 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?



Part C:

Appendices



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

Service Strategy

Content Strategy Procurement, Investment and Commercial Control

Content Assurance and Commissioning Platform and Technical Assurance

Clinical Content

Non Clinical Content (Copy)

(Open) Data and Tran-sparency

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

Governance

Controls

Delivery



Appendix B: This represents the likely configuration of a ‘leverage’ commercial and operating model.

Governance

Department for Health

NHS England

Controls

Service Strategy



Clinical Content


(Open) Data and

Tran-sparency

Digital Content

(AV)



Digi

tal M

a rke

ting

SEO

and

Cam

paig

n M

anag

emen

t

UX &

UI D

evel

opm

ent &

Mai

nten

ance

Appl

icati

o n D

evel

opm

ent

Data

Man

agem

ent a

nd V

isual

isatio

n

Soci

al M

edia

/ Us

er C

ont e

nt M

ana g

emen

t an d

Mon

itorin

g

Insig

ht a

n d A

naly

tics

Infr

astr

uct u

re D

eliv

ery

Cust

omer

Ser

vice

s

Contract Contract Contract Contract Contract Contract Contract Contract Contract

Delivery

Authority / Authority SPV

Many Individual Contracts



Appendix C: This represents the likely configuration of a ‘strategic’ commercial and operating model.

Governance

Department for Health

NHS England

Controls

Service Strategy



Clinical Content





Digi

tal C

onte

nt M

anag

emen

t & In

form

ation

Arc

hite

ctur

es

Digi

tal M

arke

ting

SEO

and

Cam

paig

n M

anag

emen

t

UX &

UI D

evel

opm

ent &

Mai

nten

ance

Appl

icati

on D

evel

opm

ent

Data

Man

agem

ent a

n d V

isual

isatio

n

Soci

al M

edia

/ Us

er C

onte

nt M

anag

e men

t and

Mon

itorin

g

Insig

ht a

nd A

naly

tics

Infr

astr

uctu

re D

eliv

ery

Cust

omer

Ser

vice

s

Com

miss

ions

Delivery

Hack

Mod

App

Start Up

Grants

Authority / Authority SPV

Alliance – circa 5 partners



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

Service Strategy



Clinical Content






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

Governance

Controls

Delivery



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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