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1、Accenture’s Proposal for HA’s Tender for the Provision of Consultancy Service on the Business Case Study for Development of a PPP Model for Phase Two of the North Lantau Hospital Project 3.0 PROJECT METHODOLOGY AND ORGANISATION SUPPORT 3.1 Our Understanding of Hospital Authority’s Objectiv

2、es The purpose of this tender is to collaborate with a consultancy partner to conduct a business case study to explore the feasibility of developing a Public Private Partnership (PPP) operating model for North Lantau Hospital Phase Two, with the goal of encouraging greater private sector involvem

3、ent in providing healthcare services at the Lantau facility. The Broader HA Objectives Accenture believes HA has a broader objective to achieve behind this study, which is to investigate how PPP can be leveraged to build a sustainable healthcare system in Hong Kong. A sustainable healthcare s

4、ystem should be cost efficient and well equipped to offer quality heath services to the community, at the same time promote healthy competition and collaboration between the public and private health sectors. With reference to the Hong Kong Healthcare Reform Consultation Document, the major chal

5、lenges facing the Hong Kong Government to attain a sustainable healthcare system in Hong Kong are the growing healthcare needs due to rapidly ageing population and increasing occurrence of lifestyle related illness, imbalance provision of hospital services between public and private sectors, rising

6、medical cost due to medical advancement and public’s expectation of the Government to keep up with the quality of medical services, healthcare expenditure is growing faster than the Hong Kong economy and an increasing burden for the future generation if the Hong Kong Government maintains the present

7、 financing arrangements of the healthcare system. Greater Public-Private collaboration is required to bring about a sustainable healthcare system. Public Private Partnership (PPP) is defined as a contractual arrangement involving the private sector in the delivery of public services, where the

8、 responsibility for the delivery of services is shared between the public and private sectors, both of which bring their complementary skills to the enterprise. In healthcare, PPP has the potential of being a useful tool in increasing the private sector involvement, facilitating collaboration an

9、d sharing of expertise and experience, and promote healthy competition between the public and private sectors for service quality and professional standards. Patients could have more choice of services, and cost and price transparency could be enhanced to the benefit of patients, which is in line wi

10、th NLH’s strategic goal to allow the provision of private healthcare services in public hospital facilities (i.e. NLH Phase Two). A successful implementation of PPP model at NLH will allow HA to roll out the PPP concept to other hospitals in Hong Kong. It is expected that through PPP, a more eff

11、icient and cost-effective services within the healthcare industry will become the benchmarks for both the public and private sectors. The overall capacity of the health care system can also be enhanced. All these factors contribute to improving service quality, efficiency and in turn the sustainabil

12、ity of Hong Kong’s health care system. Project Requirements To achieve NLH Phase Two goals, HA is pursuing a business case study within 12 months to scientifically evaluate potential PPP models in a procedural and structured approach. The study will begin with leading PPP Hospital practice re

13、search, followed by NLH current planned operations/capabilities and local hospital industry investigation, to develop NLH’s PPP requirements which set the stage for a non-committal Expression of Interest (EOI) process to gather PPP proposals and feedback from interested PPP vendors. This is followed

14、 by an in-depth feasibility study of viable PPP options in terms of costs, benefits and implementation risks, to identify the optimal PPP option for NLH, and develop a high level implementation plan for the recommended option. The business case study will hold into account the fact that the Gover

15、nment and the HA envisage that the PPP model to be developed under North Lantau Hospital Phase Two project would possibly take the form of co-location of public and private facilities, either within the same building (vertical co-location) or in separate buildings on adjacent sites (horizontal co-lo

16、cation). HA has already ruled out private financing, shared ownership of buildings and operation of public hospital facilities and public clinical services by private providers. However, apart from the options above that have been ruled out, HA are open-minded about the possible PPP models th

17、at may be developed and that may be operated by the private provider on a profit-making or non profit-making basis. The study will address the specific request of the HA to advice on a most feasible PPP model for NLH that is designed with reference to: Land arrangements Role of Government and

18、 private sector in design construction works Role of Government and private sector in clinical service delivery scope and mode of delivery Arrangements for the delivery of non-clinical and ancillary service Facility maintenance Staffing arrangements 3.2 Our Project Approach Accen

19、ture, with its global experience in consulting and participation of PPP related projects, brings to HA a well defined and proven methodology to conduct the business case study. Our Methodology Accenture’s Business Integration Methodology (BIM) provides a framework for driving and sustaining ch

20、ange in an organization in order to create value. Figure 3.1 Business Integration Methodology Diagram At the highest level, the Methodology has four phases that together depict the entire life cycle of a change initiative. These phases are: Planning, Delivering, Managing, and Operating.

21、 Given our understanding of HA’s scope of study, we propose to drive the HA PPP project using the Planning Phase and Managing Phase Methodologies of BIM to build out the Business Case Study Approach and Project Management respectively. Business Case Study Approach The Planning component provides

22、 a proven structured method to conduct a feasibility study, identification of the most valuable opportunities, formulating the plans to realize those opportunities and develop an implementation plan for the proposed solution aligned with the intended consultancy scope for the HA PPP project. The met

23、hodology serves as the guiding principle and was used to build out the business case study activities of the HA PPP project work plan. Planning Figure 3.2 Planning Phase – Major Phases Overview The Planning phase includes four stages of work: Phase I: Business Diagnosis Phase II: Strate

24、gic Direction Phase III: Operating Strategy Phase IV: Business Architecture Phase I: Business Diagnosis [HA: Requirements Analysis] The project kickoffs with a visioning workshop to clarify and define the NLH’s vision for Phase Two and expectations for the PPP study. (We believe HA would have an

25、 existing (or planned) hospital operating model for NLH Phase One. It would be important for us to understand what this planned operating model for Phase One is and take this "existing" model as a baseline of Phase Two and determine how much they need to transform themselves (in the areas oforganisa

26、tion, process and technology)to the selected PPP models. This would give HA an indication of how much effort is required (and not just financially) to make the PPP leap.) A workplan will be put in place, beginning with a leading PPP Hospitals research, followed by a local hospital industry and NLH s

27、tudy to define NLH’s PPP requirements for the EOI exercise. PPP proposals gathered from interested private vendors and their profiles will be evaluated to identify PPP options for business case development. Phase II: Strategic Direction [HA: Options Analysis] The project team and leadership will

28、 refine the strategic vision and objectives based on research study findings and EOI feedback. The team will begin the evaluation of viable PPP options by stating the value propositions, gaps and implementation risk for each option. Phase III: Operating Strategy [HA: Options Analysis] The next st

29、ep for the business case is focused on running the Public Sector Comparator (PSC) to evaluate Government costs for each PPP option. Operational Impact (e.g. Clinical Outcomes, Access to Care, Clinical Adjacencies and Patient Flow, Impact on Research and Teaching etc.) will also be analysed for each

30、option. There will be a final evaluation of aggregated business case results, and the recommended PPP option(s) for NLH will be delivered. Phase IV: Business Architecture [HA: Implementation Planning] The project team will develop implementation outline for the recommended option(s). Note: The Ma

31、naging component provides the continuous guidance needed to keep an project on track and to ensure that it delivers value. It will serve as the guiding principles to build out the Project Management activities for the HA PPP project. Project Management details will be further discussed in the last p

32、art of this section. Section 3 – Page 68 of 68 3.2.1 Phase I: Business Diagnosis [HA: Requirements Analysis] (Month 1 through Month 5) Objectives Develop a high level understanding of North Lantau Hospital’s strategic goals and vision Define project scope and work plan Defin

33、e possible PPP model outcomes aligned to the strategic goals and vision of the hospital Understand how leading overseas PPP Hospitals set up their partnership for areas that is relevant to HA’s requirements stated in the RFP Identify NLH’s PPP requirements for the EOI Conduct non-committal pub

34、lic EOI to gather PPP model options and gauge local and overseas PPP health industry groups’ interests Approach Step 1: Conduct Visioning Workshop Accenture will conduct a visioning workshop with HA Leadership Team to define: o Strategic goals and vision for North Lantau Hospital Phase Two o B

35、ased on the defined strategic goals and vision, develop desired high-level PPP model outcomes o Discuss potential benefits and cost savings for the government using the PPP model Defining the strategic and operating goals for NLH is a critical step to set the direction and guiding principles for

36、all downstream project activities: Define EOI scope and criteria (i.e. aspects of PPP arrangements that is of greatest interest to NLH e.g. land arrangement, maintenance etc., and HA’s initial thoughts and requirements for these PPP components) EOI vendor evaluation marking scheme Define bus

37、iness case analysis criteria (i.e. other then focusing only on evaluating the benefits, risks and financial implications of PPP options, we should also investigate the operational impact that will be brought about by each of the options e.g. clinical outcomes, access to care, patient flow etc.) Co

38、mponents to focus on during the development of the implementation workplan and deployment considerations Step 2: Conduct Project Scoping Session The project team will conduct PPP project scoping session to: o Define project objectives and how they will address the strategic goals and vision o

39、 Develop work plan. We suggest reviewing the EOI process logistics with private PPP health industry groups to ensure we have factored in adequate amount of time in the process to allow them to inquiry about NLH’s PPP requirements and respond accordingly. This is a good time to engage private sector

40、groups for feedback. o Confirm deliverables and its specifications (i.e. detailed requirements for the PPP feasibility study report, signoff criteria etc.) Step 3: Research on Leading PPP Hospitals The project team will conduct extensive research to identify leading PPP Hospitals (e.g. from the

41、countries known for their PPP Hospital experience: UK, Canada, Spain etc.). It is critical for us to clarify the term “l(fā)eading PPP Hospital” (as mentioned in the RFP) with HA before we commence this research. o We can also coordinate PPP hospital site visit(s) to help HA visualise some implemented

42、PPP concepts and exchange ideas with site management Step 4: Investigate PPP Arrangements from Leading Hospitals Relevant to HA’s Initial Requirements The team will drill into selected PPP Hospital case studies to futher understand how the Hospitals execute their PPP model, especially how they se

43、t up their PPP arrangements with the private sectors Where the PPP Hospital case studies provides us with insights on their PPP arrangements for the following HA requested PPP components, we will include their best practices as reference options: o Land arrangement o Respective Role of the Gover

44、nment and the private provider in relation to design and construction works o Scope of clinical services to be provided by the public and private providers and the mode of service delivery o Arrangements for provision of non-clinical and ancillary services o Maintenance responsibilities o Staff

45、arrangement Please see below an illustrative diagram to help HA conceptualise our proposed way of performing a leading PPP arrangement study. The collated viable PPP arrangement options will serve as guiding principles to help EOI vendors develop their response back to HA. EOI vendors should also f

46、eel free to respond with PPP arrangements not mentioned in the EOI Invitation Document. Figure 3.3 Leading PPP Hospitals - PPP Arrangements Step 5: Understand NLH’s Current Planned Operations and Capabilites, its Macro Environment, Opportunities and Challenges As explained previously, taking

47、the existing/planned operating model for NLH Phase One (as the baseline for Phase Two), the team will perform an in-depth study of NLH’s current planned operations and capabilities, opportunities and challenges, the local Hong Kong hospital industry (both public and private sector), the marco enviro

48、nment to identify NLH’s Phase Two requirements for the EOI Invitation Document. The following list is an example of study areas we will cover in this effort: o Current NLH’s planned operations and capabilities (people, process, technology) People: Hospital Organisation and Governance, Staffing, R

49、ecruiting, Orientation, Training etc. Process: Facility Planning, Business Plans and Financials, Revenue Cycle, Construction, Visiting Physicians, Management of Operations, Policy, Clinical Service Lines, Clinical Research & Trials etc. Technology: ERP, CIS, Medical Equipment, IT infrastructure,

50、 Clinician End User Devices, HVAC/Security/Fire etc., and interfaces o Current public and private hospital operations in Hong Kong o Current competition/relationships between the public and private sectors o Existing legislative and regulatory system for public and private hospitals o Current he

51、alth care standards and performance monitoring of the two sectors Step 6: Conduct EOI Process The project team will conduct a non-commital EOI process, which include the following steps: o Define EOI scope and criteria o Shortlist potential private PPP health groups o Develop of EOI invitation

52、 document o Facilitation the PPP arrangement sourcing exercise (i.e. coordinate vendor meeting, respond to vendor’s proposal specific questions etc.) o Using the EOI evaluation model, evaluate all vendors against predefined criteria and collate additional PPP arrangement options for business case

53、 development People Involved Activities HA Accenture Conduct Visioning Workshop Project sponsor HA Leadership Team (e.g. HA CEO, Head of HA PPP) Stakeholders potentially from other government agencies Senior Executives and Subject Matter Experts in: o New Hospital (Facility) Build o

54、 Public/Private healthcare strategy, and o PPP for healthcare Conduct Project Scoping Session Project manager Project sponsor HA and North Lantau Hospital Leadership Team Project Core Team Senior Executives and Subject Matter Experts in: o New Hospital (Facility) Build o Public/Priva

55、te healthcare strategy o PPP for healthcare o Business case development Perform Leading PPP Hospitals, PPP Arrangement, NLH, and Hong Kong Hospital Sector Study Project manager HA experts in hospital clinical services, hospital facility planning, hospital facility services, hospital financing

56、 Project Core Team Senior Executives and Subject Matter Experts in: o New Hospital (Facility) Build o Public/Private healthcare strategy o PPP for healthcare Conduct EOI Process Project Manager Project sponsor, HA Leadership Team Project Core Team Senior Executives and Subject Matte

57、r Experts in: o New Hospital (Facility) Build o Public/Private healthcare strategy o PPP for healthcare Output Output Description Inception Report Strategic goals and vision for North Lantau Hospital Phase Two Desired PPP model outcomes Work plan Interim Report Understanding of the c

58、urrent local hospital sector o Identified available HA, North Lantau Hospital, government hospital facilities, resources and capabilities o Current local and private hospital operations and the relationship between the two sectors o Local legislative and regulatory environment o Local healthca

59、re standards and monitoring schemes Research findings on overseas PPP hospital case studies Gap analysis findings (i.e. global practice vs. As-Is scenario) and additional requirements for the desired PPP outcome EOI Invitation Document Background/objectives of the EOI exercise EOI process

60、 details North Lantau Hospital strategic goals and visions Overview of the desire outcomes Listing of available HA, North Lantau Hospital, government hospital facilities, resources and capabilities that can be leveraged in a PPP arrangement Vendor evaluation criteria Standard vendor respon

61、se documents, which include the following sample list of vendor response requirements: o General vendor company information o References o Company visits o Assets and best practices o Technical capabilities (equipment, physican network etc.) o Implementation plan o Logistical conditions and d

62、elivery o Vendor service price quotes EOI Evaluation Model Compare vendor’s profile and capabilities EOI Evaluation Report Report on: o Overview of response of the EOI exercise o Overview of interested private parties o Detailed evaluation of vendor’s capabilities, proposed PPP arrangemen

63、ts and implementation plans o Our selected PPP arrangement options for further feasibility evaluation 3.2.2 Phase II: Strategic Direction [HA: Options Analysis] (Month 5) Objectives Refine NLH’s strategic goals and vision based on the research studies and identified PPP arrangement

64、options Identify the value propositions, gaps and risks for each PPP arrangement options Approach Step 7: Refine Strategic Vision and Objectives Upon the completion of the Business Diagnosis phase, we suggest to conduct another mini workshop to review the defined NLH strategic vision and obje

65、ctives, to ensure it is realistically aligned to findings for the research studies, EOI results and feedback from the private parties. We will take this opportunity to give the HA leadership team a project update Step 8: State Value Propositions, and Identify Gaps and Risks For each PPP arran

66、gement options, in terms HA’s required PPP components (i.e. Land Arrangement, Maintenance etc. as listed in the Business Diagnosis phase), the project team will identify the value propositions for each PPP component options, which are all aligned to the strategic vision Gaps for each PPP component options will be identified based on our understanding of the proposed option, and what is currently available to execute the arrangem