Support services

6.40  The NHSScotland body should set out what services it expects to be provided by the private sector as part of the project. NHS bodies will continue to be the employer of clinical staff and staff providing soft facilities management services in a NHS clinical facility when the services are fully integrated with clinical services as covered in CEL 46 (2008). Services which can generally be included in PPP schemes are set out in Figure 5 below, however, NHS bodies should decide what services are to be included in their PPP schemes before they issue the OJEU notice in accordance with the STUC Staffing Protocol as detailed in HDL(2006)10 and CEL 46 (2008) which are mandatory.

6.41  Participants will be responsible for developing the operational policies and identifying their requirement for the facilities for support services based on the output specifications for each service. In this way participants will be able to put forward a solution that will maximise opportunities to deliver efficiencies in the provision of support services - for example, the use of the participant's own commercial, organisational and management systems.

Figure 5: Services which can be included in a PPP scheme

6.42  Separate output specifications should be produced for each of the services for which the short-listed participants will be invited to submit proposals. However, the NHSScotland body should take care not to restrict service delivery to current patterns and should allow participants to come up with innovative proposals. These specifications will define the nature of a partnership with the private sector operator which may run for many years and are therefore extremely important. Output specifications should also cover other non-clinical services for which the NHSScotland body expects to remain responsible.

6.43  Advisers can be used to help the NHSScotland body draw up the specifications but they should, at a very early stage, consult the end users and service managers who will have detailed knowledge of the standards and their relative importance. The NHSScotland body should retain ownership of the specification and not rely entirely on its advisers.

6.44  The scope of the service covered by the output specification must be clearly defined, particularly in relation to the boundaries with other services both included and excluded from the scheme. This will avoid any misunderstandings between the NHSScotland body and the participant about their respective responsibilities. For example, questions over ownership of assets (bed linen, cutlery etc) and responsibility for laundry services. In addition, the NHSScotland body should not introduce constraints on how the participant organises the operatives, for example multi-skilling, unless such constraints are fundamental to the delivery of direct patient services. The NHSScotland body may wish to list assets, other than those which will be provided by the private sector operator, that will be available for use in the delivery of support services.

6.45  The output specifications should also take account of the NHSScotland body's operational policies and service level issues such as response times and proposed monitoring arrangements. The NHSScotland body should also consider what sorts of mechanisms will be used to cater for changes in the level and requirements of services during the contract period.

6.46  In cases where the service will continue to be provided on another hospital site, the NHSScotland body should consider the potential benefits of extending the private sector service to all sites: for example, improved co-ordination, increased flexibility and the opportunity for greater efficiency.

6.47  NHS bodies should also consider IT and equipment services they will require to be provided as part of the project. The provision of IT and equipment as part of larger PPP deals is discussed in Chapter 9 of Section 3 on Technical & Commercial Issues.