III. Developing a Public-Private Partnership in Hospital Management (Overview)

Step 1: Determine needs and review the hospital services in the area

The first step requires determining and understanding the main issues and problems related to the needs of an organization (or a local government) for hospital care and management services in a chosen site or area. These concerns will form some of the bases of the PPP in hospital management.

Having identified the problems, the organization will have to come up with proposed solutions, mainly through a market or a feasibility study. This step then involves a review of the supply and demand for hospital services in the hospital catchment area. A PPP in hospital management requires an organization to develop financial models to facilitate its decision making.

Consultations with affected sectors and a review of policies on PPP and hospitals may also be conducted in this initial step.

Step 2: Identify stakeholders and their roles

Now that the organization knows what it wants to do, it should already have an idea of who are its stakeholders and their roles-for example, the department or ministry of health, social health insurer, audit commission, government bank, civil service commission or agency, PPP center or agency, provincial or district council, nongovernment organizations, hospital management operators and staff, local communities, and other institutions and groups. At this stage, the organization may conduct research, meetings, and consultations with stakeholders and prospective PPP partners. This is also a good time to research possible financing options.

Step 3: Develop an implementation plan for the public-private partnership in hospital management

In this step, the organization embarks on the development of an implementation plan for the PPP modality chosen for the project. The plan should include the personnel and advisors to be involved in undertaking the process, the budget, and the time frame.

Step 4: Develop a marketing and promotion plan

Here the organization develops a social marketing plan, which should include strategies for communications, stakeholder engagement, and capacity development (if desired). The social marketing and promotion plan should be based on the organization's aspirations and behavioral change targets.

Step 5: Conduct procurement

Once the plan for the PPP in hospital management is in place, the organization should prepare for procurement. This step includes developing bidding documents, finalizing the terms of reference (TOR), and drafting the contract. This crucial step is the perfect time to ensure that the bidding documents clearly specify the procedures for bidding, evaluation and award, while the TOR and contract cover the details of each party's responsibilities, performance standards, monitoring and evaluation (M&E), and pre-termination, among others.

Step 6: Implement the public-private partnership in hospital management (focusing on monitoring and evaluation)

This step involves the actual implementation of the PPP in hospital management. This is when the partnership between the public and private sector organizations becomes operational. It is the main phase of the PPP, as it is when the desired targets and deliverables are executed by the contracting parties in order to achieve the objectives and expected outcomes of the PPP. This is the centerpiece of the entire exercise.

Contract implementation requires an effective M&E system. In this step, the organization must have a framework and parameters for M&E and a team that will undertake the M&E activities. Some organizations establish an M&E unit while others simply assign specific personnel to do the job. It is important that the PPP contract provides measurable targets and procedures for measuring and reporting.