Sell your services to the NHS (and other public sector bodies)

The NHS is huge and changing fast with lots of opportunities for consultants, training providers and any other clever business service you can think of...

However, despite the most verdant of sales pastures, organisations find it notoriously difficult to persuade the NHS to send this wonderful cash in their direction. Most spend many days and weeks toiling over a great pitch, only to fall at the first hurdle. Immensely frustrating.

In this article, we lift the lid on what goes on behind the scenes. How do NHS procurement teams make decisions? Is previous NHS experience the real route in? Are contracts basically awarded based on price? And can you ever hope to beat a large competitor to the prize? Read on…


 How the system works

The NHS, like most public sector bodies, works in a specific way which is designed to be fair to all parties. Here’s a summary of how it works:

  • Every potential supplier is entitled to the same information. No supplier should receive a document or any other kind of specific insight which the other suppliers do not have access to. This rule is so extreme that if you ring a member of the procurement team, ask a question and receive an answer, they are expected to call all the other suppliers and relay the same information. Needless to say, this is wildly frustrating if you have used your initiative and asked a particularly intelligent question which your competitors will then benefit from.
  • The procurement process is designed to offer equal opportunities for every business. If an incumbent supplier is also pitching, their past track record in the NHS should not be taken into account. The playing field is intended to be level for all. This extends to size of business. The NHS has a specific remit to smooth the path for SMEs and offers a range of free services to help smaller businesses compete successfully. Visit the Small Business section of the NHS Purchasing and Supply Agency website .


First stop - the rules

  • Stick to deadlines rigidly. If your documents are late, they will be discounted. It’s the law (almost).
  • To qualify, your proposal must explicitly outline the total cost – any hidden or extra costs and your proposal will be discounted.
  • The invitation to tender will detail specific criteria your organisation and tender must meet in order to qualify. If you do not measure up on each of these, your tender may be disqualified. However, the good news is that the NHS may not discount you on the basis of a criterion which is not stated in the invitation to tender.


Mugging up

The Agenda for Change, the Modernisation Agency and the NHS Institute for Innovation and Improvement are the three key issues you should have a comprehensive knowledge of before submitting a tender.

To find out about these three issues, the broader challenges facing the NHS and the specific projects which might influence your tender, try the following sources:

The key publication is the British Medical Journal - always up to date, often controversial!


Pushing the right buttons

There are four key messages that every NHS buyer is listening out for, ears pricked. These reflect the internal themes of the organisation that buyers are expected to select for.

BME – supporting Black and Minority Ethnic people is a major focus for the NHS at the moment. There are numerous initiatives around supporting career development for this population. The buying team will need to ensure the solution/supplier they choose covers the NHS requirements in this area. Brownie points are on offer if your tender proactively tailors solutions for BMEs and/or if you can demonstrate previous experience or capability in this area. As a minimum, ensure that the diversity of your project team reflects the profile of the people you will be working with in the NHS. If you are using associates as part of your proposed solution, use their biographies to show diversity of background, experience and approach. It goes without saying that a project team exclusively made up of ‘Humphrey Trumpington-Smythes’ is unlikely to wow the buying team. However, be warned – tokenism will stand out a mile. Articles and insight on BME issues in the NHS here ->

Local customisation – the NHS are looking for solutions which can be customised locally for particular PCTs, hospitals, geographic areas or regions. Though, arguably, many different parts of the NHS share similar characteristics, ‘local’ is a hot topic for the organisation and your tender should reflect this. It’s worth noting that the BME profile may vary greatly across the various parts of the NHS that your solution will impact – one of a number of segmentation factors you should consider.

Partnership – whilst many NHS teams and buyers (possibly unjustifiably) feel that expertise outside the NHS is far superior to that inside, spending on consultants and external expertise has been heavily criticised and is under close scrutiny. The organisation is far less willing to buy a complete solution to a problem and instead is keen to work in partnership, upskilling individuals internally and retaining involvement in every aspect of the project.

The reality is that if you win the business, you may well end up managing the project independently as the internal team focus attention on new issues – but the perceived need is for partnership working.

Beautifully bespoke vs proven product – two important attributes to hold in balance. If you have invented a solution specifically for the brief which is unsubstantiated by any kind of research or past track record, it will be difficult for the buying team to justify the risk associated with choosing you. Likewise, if you have clearly offered your standard product range, your level of understanding of and commitment to the brief may be called into question. It is important to indicate both proven success and a degree of customisation.

If your standard product range is difficult to customise (or if it is unprofitable to do so), here are some thoughts on how to ensure you don’t lose points…

Creating your tender document

Just like a CV, a tender document is primarily used to screen and exclude unsuitable candidates. The deal is not won at this stage – only lost. Consider this when creating your tender document, taking great care to cover off all criteria on which suppliers might be excluded at this stage. Differentiation is still important – but it is really the focus of the beauty parade, not the tender document.

Buyers are human – unlikely as this may seem. Just like test examiners, their conscious focus is on grading against explicit criteria. But inevitably these grades are swayed by the quality of the document. Your check list should include:

  • Structure – follow the structure laid out in the invitation to tender as closely as possible. Make it easy for the buying team to find and award marks.
  • Sectioning - different sections may be evaluated by different buyers, so make the context clear in each different part of the document.
  • Judging the length/volume – the end result should be the shortest possible document which leaves out no required detail. In practice, what qualifies as ‘required detail’ is highly subjective. Add a step to your internal review cycle, asking someone to comb through a draft version, highlighting any text they feel is superfluous.
  • Tone of voice – simple, Anglo Saxon language is usually the most straightforward to read and digest. It’s fine to use the first person plural (e.g. "We use a jointly agreed Service Level Agreement to ensure that both parties understand their roles and responsibilities"). Short sentences are more compelling and easier to understand.
  • Any technical terms or abbreviations should be added to a glossary, or better still, a footnote system for instant reference. How to...
  • Use plenty of white space. Consider adding an extra space after each full stop. If you create a draft which has been created with single spaces, use Find (.) and Replace (. ) to add spaces throughout.
  • Summarise key points in inset boxes to break up the text and clarify content.
  • Use tables and bullets to convey voluminous information quickly.
  • Visual signposting is critical – guide the reader instantly to the information they need. Make use of MS Word to its fullest to automate this process e.g.
  1. Automatic Table of Contents generation (so that each time text is changed, the contents page updates automatically).  How to...
  2. Header and footer bars – record key information on every page e.g. "page 10 of 40". How to...
  3. Styles – automate control the look and feel of the fonts used throughout. How to...
  • Proofing should be conducted by someone who has had no part in creating the document and at least ½ day in elapsed time is needed to do a thorough job. The checklist should include:
  1. Spelling, punctuation and grammar. If any names or internal buzzwords are used regularly which the dictionary does not recognise, add them to your custom dictionary. This will help you pick up any typos in these non-standard words.
  2. Double and triple check any individual client names used in the document. Getting one of the buying team's name wrong is a fairly obvious, but a surprisingly common no-no.
  3. Test any urls by clicking them.
  4. Check phone numbers by dialing them!
  5. Review any text which feels like it may have been cut and pasted.
  6. If a previous document was used as a template, deploy the ‘Find’ button to make sure the previous company name does not appear anywhere.
  7. If you are sending an electronic version alongside the hard copy, edit the ‘Properties’ to ensure that they accurately reflect the name of the document, the author and the client.
  8. Widowed headings/orphaned text (this should be the final check after every other change has been made).
  • Physical presentation of the document is important. If you don’t have a binding machine, you will need to outsource this process. Dividers help to break up the document further, particularly if appendices have been used heavily.


Pushing the right buttons

There are four key messages that every NHS buyer is listening out for, ears pricked. These reflect the internal themes of the organisation that buyers are expected to select for.

BME – supporting Black and Minority Ethnic people is a major focus for the NHS at the moment. There are numerous initiatives around supporting career development for this population. The buying team will need to ensure the solution/supplier they choose covers the NHS requirements in this area. Brownie points are on offer if your tender proactively tailors solutions for BMEs and/or if you can demonstrate previous experience or capability in this area. As a minimum, ensure that the diversity of your project team reflects the profile of the people you will be working with in the NHS. If you are using associates as part of your proposed solution, use their biographies to show diversity of background, experience and approach. It goes without saying that a project team exclusively made up of ‘Humphrey Trumpington-Smythes’ is unlikely to wow the buying team. However, be warned – tokenism will stand out a mile. Articles and insight on BME issues in the NHS here.


Local customisation – the NHS are looking for solutions which can be customised locally for particular PCTs, hospitals, geographic areas or regions. Though, arguably, many different parts of the NHS share similar characteristics, ‘local’ is a hot topic for the organisation and your tender should reflect this. It’s worth noting that the BME profile may vary greatly across the various parts of the NHS that your solution will impact – one of a number of segmentation factors you should consider.

Partnership – whilst many NHS teams and buyers (possibly unjustifiably) feel that expertise outside the NHS is far superior to that inside, spending on consultants and external expertise has been heavily criticised and is under close scrutiny. The organisation is far less willing to buy a complete solution to a problem and instead is keen to work in partnership, upskilling individuals internally and retaining involvement in every aspect of the project.

The reality is that if you win the business, you may well end up managing the project independently as the internal team focus attention on new issues – but the perceived need is for partnership working.

Beautifully bespoke vs proven product – two important attributes to hold in balance. If you have invented a solution specifically for the brief which is unsubstantiated by any kind of research or past track record, it will be difficult for the buying team to justify the risk associated with choosing you. Likewise, if you have clearly offered your standard product range, your level of understanding of and commitment to the brief may be called into question. It is important to indicate both proven success and a degree of customisation.

If your standard product range is difficult to customise (or if it is unprofitable to do so), here are some thoughts on how to ensure you don’t lose points…

  • If you decide to use your standard product range, explain in detail why it is appropriate in the context. Use previous examples of how other similar organisations have deployed these services successfully, drawing parallels with specific elements of the brief.
  • …or, alternatively, use your standard product range and demonstrate how it could be locally customised.
  • …or, finally, offer a range of options(albeit standard), indicating the advantages and disadvantages of each.


Your relationship with the buying team

During any normal pitch process, canny bid teams will take every opportunity to build a strong, face-to-face relationship with the decision makers. In fact, at Onefish Twofish, we advise clients not to compete in a tender process if they are not granted a meeting prior to tender submission as without this interaction the odds of success are just too low.

However, formal public sector tenders are very different from standard private sector buying procedures – and if you’re committed to working with the NHS, you will have to fall into line. Here are some tips:

  • Always ask (politely) for a meeting – even though the buying team are unlikely to agree.
  • Aim to build a phone relationship over 2-3 calls – any more than this and you’ll waste their time, any fewer and you’re unlikely to get enough insight and ‘feel good’ factor to win the pitch. This means preparing your questions carefully to avoid unplanned additional calls.
  • Your calls should be about building rapport and showing your commitment to understanding the brief – overt selling at this stage is an absolute ‘no-no’


The beauty parade

NHS buying teams will call in all potential suppliers who are genuine contenders for the project. There is no numerical cut off, either relative (e.g. top 30%) or absolute (e.g. maximum of 3).

Buying teams view the beauty parade as a chance to gauge style and fit and gain extra insight about the solution. A summary/rehash of the tender document is definitely not going to hold their attention.

It’s imperative to bring at least one member of team who will actually deliver the solution to the presentation. So, if you are pitching for a development programme which will primarily be facilitated by associates, aim to bring two of the ‘anchor associates’.

Expect questions not just on the specific details of the tender you have submitted but also on:

  • Local customisation
  • BME support
  • How the proposed solution would link to existing NHS policies and frameworks e.g. the NHS Leadership Qualities Framework
  • Your opinions/insights on the current NHS challenges/climate
  • Differentiation – how is your solution different and better?


The opposition

When preparing for the presentation, consider the four main categories of competitors and where your competitive advantage lies. Here are some points to consider about the range of competitors you are likely to face.

Large competitors

  • Often benefit from economies of scale
  • More likely to propose a generic/standard solution
  • Scalable – with implications for local and BME customisation

Small competitors

  • Current policy is focused on making it easier for small businesses to win bids – they are a greater threat than they may seem
  • The associate model is well understood and accepted by NHS buying teams, so in house consultants/deliverers are not necessarily an advantage
  • Smaller businesses are far less likely to have a proven or well known model/framework to leverage

Incumbent suppliers

  • The buying team is not officially permitted to consider their past experience of working with the existing supplier as part of the decision making process
  • Incumbents are just as likely to slip up as any other supplier – they are not to be feared!

Ex-NHS professionals

  • Changes to internal organisation in the NHS have released a large number of internal specialists onto the marketplace
  • Many have set up consultancy/service business and are selling their expertise back into the NHS
  • Their competitive advantage is clearly their relationship capital and knowledge of the NHS
  • However NHS buying teams are often looking for fresh thinking and external expertise


How decisions are made

The buying team will use a marking grid to grade each tender and presentation. Usually, individuals will complete their own grid, form their own ranking and then compare individual rankings as a group, discussing differences, until a consensus is reached.

The highest ranking supplier wins, irrespective of any other consideration.

The grid will contain a range of criteria including:

Previous experience
A track record in the NHS is not a prerequisite but is strongly favoured. Other public sector experience is also considered relevant. Our advice to small businesses without previous experience in the NHS is to source and leverage associates who are ex-NHS or who have worked directly with the NHS in the past. Without this credibility, it would be hard to score highly enough in all other areas to win the pitch.

Size and stability of business
Small business are encouraged to apply for NHS tenders. However, as a rule of thumb, Onefish Twofish would usually counsel against tender for a project:

  • in the first year of trading
  • where the value of the project is greater than the last complete year of turnover


In these instances, the probability of winning the project is likely to be outweighed by the cost of tendering.

Price
Despite the Best Value initiative (also fondly known as Lowest Cost Provider Wins), we are reliably informed that cost really isn’t the deciding factor. Like most of us at the supermarket, buying teams are unlikely to buy at extreme ends of the cost spectrum.

For training and development solutions, norms are as follows:

  • Design and delivery work command different prices – expect to charge 15-25% less for design work, versus in person development.
  • Daily rates for delivery typically range from £700-£1200. £1500 per day is the upper limit beyond which a supplier is likely to be considered unaffordable.
  • Quality is definitely more important than quantity. Buying teams would almost always rather buy one excellent deliverer at £1200 per day than two average deliverers at £600 each.

More important than daily rates are options! Buying teams warmly welcome tenders that offer them several ways of achieving the same results or incremental levels of sophistication together with associated costs.

In addition, a full and transparent break out of costs is favoured by buyers. Without clear costings, it’s hard for the team to compare suppliers, like-for-like. Feedback shows that granular costings build trust whereas aggregated costings can raise suspicions.

However, detailed cost breakdowns can appear confusing if not carefully signposted and presented. To ensure your costs don't inflict the deadly Proposal Eye Boggle, ask for a copy of the Onefish Twofish

Onefish Twofish offer a Pitch Doctor service to help organisations interpret a brief, project manage proposal creation, meet all criteria and prepare a compelling presentation for the beauty parade. Ask us about Pitch Doctor.

Further information and help

The Small Business Service Guide to Public Sector tenders (pdf)

The government's supply2 website (covers all tenders up to £100k)

Official Journal of the European Union (covers tenders above £100k)