Ausschreibungen

The Norwegian Directorate of Health has been given the assignment of evaluating the quality of palliative care in Norway. Both the specially organised palliative care services and the offer of basic palliative care in the specialist health service and in the municipal health and welfare service shall be evaluated. The assignment shall evaluate the mapping tool Liverpool Care Pathway in order to highlight whether the tool is implemented and quality assured in a good way. The procurement process is covered by the Public Procurement Act, 16.7.1999 no. 69 (LOA) and the public procurement regulations (FOA) dated 7.4.2006 (FOA). Parts I and III of the regulations apply for this procurement. This procurement follows the procedure for an open tender contest. This is a procurement procedure that does not allow negotiations. The Norwegian Directorate of Health is a specialist director and an administrative body under the Ministry of Health and Care Services (HOD). The Directorate is managed by HOD and the assignments are described in the national budget, award letter and in individual assignments. The Norwegian Directorate of Health is divided into divisions and departments. This procurement is anchored in the Welfare Services Section, which is in Primary Health Services Division. The Procurement, Operations and Contract Management Section is responsible for the procurement process. The Norwegian Directorate of Health's vision is Good health and a good life. For further information see www.helsedir.no Name — responsible person for the procurement: Senior consultant Ingrid Køhler Knutsen, Telephone number: +47 24163891, Email address: anskaffelser@helsedir.no All communication between the tenderer and the contracting authority shall be directed to the contracting authority's contact person via the Question and Answer function in our electronic tender system. All questions and answers will be made accessible in anonymous form for all of the tenderers. Enquiries received later than 5 working days before the tender deadline will not be answered. The Norwegian Directorate of Health would like to enter into a contract for the evaluation of the services for persons requiring palliative care. In order to highlight questions connected to the quality of palliative care, the Ministry of Health and Care Services has given the Norwegian Directorate of Health the task of carrying out an evaluation which highlights different sides of the various models that have been developed. Both the specially organised palliative care services and the offer of basic palliative care in the specialist health service and in the municipal health and welfare service shall be evaluated. The assignment shall evaluate the mapping tool Liverpool Care Pathway in order to highlight whether the tool is implemented and quality assured in a good way. The value is estimated to be between 1 200 00 and 1 500 000 NOK excluding VAT. The assignment shall start as soon as possible after the contract has been signed and it shall be completed by 1.6.2016. The contract is subject to the Norwegian parliament's grants for 2016. See the tender documentation part 2 Specifications and the award criteria. The competition is announced in the DOFFIN database — see www.doffin.no and in the TED database. Evaluation: Weeks 30 — 33 The procurement shall be regulated by the contract terms with the accompanying annexes. Tax/VAT certificate Qualification requirement: Tenderers must have fulfilled their tax, VAT and payroll tax obligations in accordance with the legislation. Documented by: The joint form (certificate) from the Norwegian Tax Administration. The certificate(s) shall not be older than six months calculated from the deadline for receipt of tenders. Any arrears or other irregularities must be justified. HSE self-declaration Qualification requirement: Service providers must vouch for the fact that the company works systematically to comply with health, environment and safety legislation and satisfies the Internal Control Regulations. The tenderer must also confirm that the company is legally organised in relation to applicable tax and working environment regulations for employees' professional and social rights, and shall accept that the contracting authority has the right to review and verify the company's system for safeguarding of health, environment and safety. Documentation: A dated HSE self-declaration signed by the manager and a representative for the employees. The form is attached to the tender documentation. Company Registration Certificate. Requirement: The tenderer shall be a legally established company. Documented by: For Norwegian companies: A company registration certificate from the Brønnøysund Register Centre. For foreign companies: Proof that the company is registered in a trade or business register as prescribed by the law of the country where the tenderer is established. Credit rating/annual accounts Requirement: The tenderer shall have sufficient economic and financial capacity to carry out the assignment/contract. Documented by: A credit evaluation/rating not older than one year, which is based on the last known fiscal figures. The rating shall be carried out by an officially certified credit rating institution. Minimum requirement — the tenderer shall be credit worthy. Implementation ability and capacity. Requirement: The tenderer shall have sufficient implementation ability and capacity. If a service provider plans to leave parts of the contract to sub suppliers, a short description shall be provided of the sub suppliers and which part/parts of the assignment the sub suppliers shall carry out. The contracting authority have same requirements to sub suppliers as to the main service provider. The contracting authority reserves the right to disallow the choice of sub suppliers. Any financial requirements from sub suppliers or costs connected to this shall be borne by the supplier. As the tender system does not support signing tenders with an electronic certificate, it is a prerequisite that the service provider prints out a tender confirmation to confirm their tender. Service providers must declare that all the terms stated in the tender documentation are accepted. Print out the tender confirmation letter, signed by an authorised person and enclose it as a pdf-document in the tender. The tender shall be submitted through the electronic tender system. Note that TendSign is open for support on weekdays 8:00-17:00. Contact information for customer service: support.tendsign@visma.no, Tel. +47 40006814. The tender will consist of the tenderer's replies to the questions and requirements for the tender that are in the tender documentation with any attached documents, in addition to the requirements in the tender documentation. In order to get an overview of which parts the tenderer shall respond to, tenderers can extract the report ‘All documents’ under Structured documents on the page ‘Get the procurement's tender documentation’. Service providers shall not fill in the annexes to the standard contract terms that are attached as ‘Attached documents’ in the system. These are only attached to show the contract structure that will be used for the design of the final contract. All deviations from the tender documentation shall be precise, unambiguous and clearly stated in the tender so that the contracting authority can assess them without contacting the service provider, cf. FOA § 20-3. Service providers cannot submit tenders that include significant deviations from the specifications in the notice or the tender documentation,cf. FOA § 20-13 (1) letter e. If a tender includes deviations that, when seen in isolation, are not significant, the deviations can, after a concrete assessment, be seen in total as significant. Any reservations shall be specified below. Reservations that are stated other places in the tender, but which are not specified in the tender letter, cannot be made applicable by the service provider and will not be considered when the tenders are evaluated. Service providesrs cannot have significant reservations to the contract terms cf. FOA § 20-13 (1) letter d. If a service provider has reservations that, when seen in isolation, are not significant, the reservations can, after a concrete assessment, be seen in total as significant. The tender's sub prices and total price shall be stated in the tender, see the tender documentation part 2 Specifications and the award criteria and the attached price from for how to fill these in. Payment and invoicing terms are included in the contract terms. The contracting authority shall, in accordance with the FOA § 20-12 (1) reject service providers that, amongst other things: a) do not fulfil the requirements set for the service provider's participation in the competition. b) have not presented tax certificates c) have not presented a HSE self-declaration The contracting authority can reject service providers if the terms in the FOA § 20-12 (2) apply. The contracting authority shall, in accordance with the FOA § 20-13 (1) reject the tender when, amongst other things: a) it is not submitted by the set tender deadline b) it includes significant deviations from the tender documentation c) it includes significant reservations to the contract terms The contracting authority can reject tenders if the terms in the FOA § 20-13 (2) apply. The award will be on the basis of which tender is the most economically advantageous, based on the criteria described in the specifications and the weighting model described below. Relative weighting The relative weighting model is built on one comparing the tenders with each award criteria. The economically most advantageous tender/tenders will be chosen by the contracting authority stating the price criterium and quality criterium and weighting these against each other. The lowest price will get maximum points, whilst the other prices will be awarded points in relation to the lowest tender price. The system gives the lowest price 100 points. The best tender in each quality criterium will be awarded maximum points equivalently. See the tender documentation part 2 Specifications and the award criteria for responses within the various areas that will form the basis for the assessments and what will be weighted. The contracting authority reserves the right to cancel the competition if there is a justifiable reason, cf. FOA §21-1 (1). A justifiable reason can typically be a lack of competition, unexpected changes in grants etc. The contracting authority can reject all the tenders if the result of the competition gives a justifiable reason, cf. FOA § 21-1 (2) In addition to the notification given upon the award of contract, the contracting authority shall give written notification with a short justification if: — the tender is rejected or the contracting authority decides to reject all the tenders or cancel the competition. Service providers can request in writing further justification for: — why the tender was rejected or — why the tender was not chosen The contracting authority is obligated to reply to this enquiry at the latest 15 days after the enquiry has been received. As regards the general public's insight into the tender and the procurement protocol, the legislation dated 19.5.2006 no. 16 on the right to insight in documents in public entities applies. Tenders and protocols are screened in accordance with the public law § 23 3rd section up until the choice of service provider. After the tenderer has been chosen, confidential information is exempted in accordance with the Public Administration Act § 13, cf. the public procurement regulations § 3-6. The chosen service provider will be asked, upon the award of contract, to assess and mark the text and information in the tender on operational and business conditions that ought to be kept secret for competitive reasons. The contracting authority has, however, the right and a duty to assess whether the information can be kept secret as regards the public law in accordance with the Public Administration Act § 13, cf. the regulations LOA § 3-6. The organisation of palliative care in Norway has mainly followed the model as it is described in the National Action Programme with guidelines for palliative care in cancer care. There are good statistics of the extent of the established offer, primarily to patients with cancer, but there is a lack of knowledge of the quality of the palliative care offer that is built up in accordance with the Life Help Review NOU 1999:2(23). The current situation is described and discussed in the Norwegian Directorate of Health's report on the offer to patients with a need for palliative treatment and care at the end of life, IS-2278. Participation and communication, the relatives' role, various patient groups' needs, including children, are all described. The challenges connected to the organisation of the palliative care offer in the specialist health service, the municipal health and welfare services and in the interaction between the levels are mentioned. In particular being able to be at home at the end of life, the implementation of the hospice philosophy, both in the specialised and basic palliative care offer, and the use of the mapping tool Liverpool Care Pathway (LCP) are discussed. The report includes a summary of the leading documents in this area, including the knowledge centre's systematic overview ‘The End of Life — How to find a suitable treatment level and treatment intensity for serious ill and dying patients’ from 2014. In order to highlight questions connected to the quality of palliative care, the Ministry of Health and Care Services has given the Norwegian Directorate of Health c/o the Welfare Services Section the task of carrying out an evaluation that highlights various sides of the models that have been developed. Both the specially organised palliative care services and the offer of basic palliative care in the specialist health service and in the municipal health and welfare service shall be evaluated. The assignment shall include an evaluation of the mapping tool Liverpool Care Pathway in order to highlight whether the tool is implemented and quality assured in a good way. The Norwegian Directorate of Health, c/o the Welfare Services Section is responsible for ensuring that the evaluation is carried out in accordance with the progress plan with the final deadline for reporting 1.6.2016. The assignment's concrete content is described in point 2.1.1. The assignment's content The assignment shall seek answers to the following: The main element of the evaluation is to highlight the quality and availability of the specially organised and basic palliative care offer for all patient groups, also for children and elderly persons in both the specialist and municipal health service. Important elements in the evaluation will be: Patient and relatives perspective. Who are the patients that receive specialist palliative care, diagnosis and age? Which patients receive an offer of basic palliative care in the specialist health service and the municipal health and welfare services? How do patients and relatives experience the services, have user surveys been carried out that highlight this? Employees perspective. How do employees experience the content and quality of the services? Organisation. How is the offer organised in the different levels in the health service? Which actors are involved in the palliative care offer? To what degree are the offers multi-disciplinary and how are multi-disciplinary activities facilitated? Interaction. How do the different actors interact in the treatment chain? Are there formal cooperation agreements between the service levels connected to palliative care? How are the palliative team and the specialised services used as a resource in the municipal health service? How is responsibility defined and divided between the different actors? What role do GPs have in the follow-up of patients with a need for palliative treatment? How does the specialist health service take care of its guiding responsibility for the primary health service? Competence. What competence, both basic education and specialisations do personnel who work with the palliative care offers have? How is the staffing factor in the palliative care offer? How is competence on basic palliative care in ordinary hospital departments and in the general municipal health service? Quality. To what degree are systematic mapping tools, treatment lines, individual plans and structured conversations implemented in the services? To the degree that systematic mapping tools are used; is the same tool used for all patient groups, or are there differences between illnesses? Volunteers. Is there a structured scheme for using volunteers? How is any voluntary work organised? Is there a structured scheme for training volunteers? Financing systems. To what degree do the financing systems affect the quality and content of the palliative offer? Hospice philosophy. To what degree is the hospice philosophy implemented in the specialist and basic palliative care offer? The evaluation must also include the finds from the national mapping surveys of palliative care from 2012 and 2014. Particular mention of the mapping tool Liverpool Care Pathway (LCP). In addition a specific evaluation of the implementation of the LCP in hospitals and municipalities must be carried out. Important elements that are to be highlighted in this connection are: An important area will be to examine the use of LCP in persons with dementia. Is this used and how? How is the LCP implemented in hospitals and municipalities? What competence do personnel connected with the LCP have? What training has the personnel had to use the tool? How do employees experience the content and quality when using the LCP? How do relatives experience the content and quality when the LCP is used? Do the LCP tool and the training that is provided adequately take into consideration that persons with dementia have a lack of ability to self-report and that it is demanding to spot a need for palliative treatment and treatment effects? Work form The evaluation ought to take the following available basis and informants as a starting point: The National Action Programme with guidelines for palliative care in cancer care. https://helsedirektoratet.no/retningslinjer/nasjonalt-handlingsprogram-med-retningslinjer-for-palliasjon-i-kreftomsorgen. The report on the offer to persons with a need for palliative treatment and care at the end of life. IS-2278. https://helsedirektoratet.no/Lists/Publikasjoner/Attachments/892/Rapport_lindrende%20behandling%20og%20omsorg%20ved%20livets%20slutt_IS-2278.pdf The trial scheme Competence Area Palliative Medicine (with results from the national mapping) https://helsedirektoratet.no/publikasjoner/forsoksordning-kompetanseomrade-palliativ-medisinhttp://www.pallreg.no/ Palliative treatment: Experience summary — grants scheme for competence raising measures for palliative treatment and care at the end of life /Centre for welfare research report series no. 9/2012 http://www.hig.no/omsorgsforskning/nyheter/arkiv/nye_utgivelser The end of life phase — How do you find a suitable treatment level and treatment intensity for seriously ill and dying persons — Systematic overview no. 18-2014 http://www.kunnskapssenteret.no/publikasjoner/livets-sluttfase-om-a-finne-passende-behandlingsniva-og-behandlingsintensitet-for-alvorlig-syke-og-doende. A natural end to life — KS report, Agenda report no. 7543 http://www.ks.no/PageFiles/27782/R7543%20KS%20En%20naturlig%20avslutning%20p%C3%A5%20livet%20_Sluttrapport.pdf The national council for quality and prioritising in the health and welfare service — the council's decision from 7.4.2014 http://www.kvalitetogprioritering.no/saker/palliativ-omsorg-og-behandling-i-kommunene More care less pathway a review of the Liverpool Care Pathway https:/

Evaluation of the service offer for persons with a need for palliative care.

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