Industry Briefing - Independent Clinical Assessments of the Medicare Urgent Care Clinics Program

Transcript

This is the official Industry Briefing for the Request for Tender for the Provision of Independent Clinical Assessments for the Medicare Urgent Care Clinic Program 2025-26 to 2027-28.

It also provides an overview the Medicare Urgent Care Clinics Program, Operational Guidance and Independent Clinical Assessments.

The Department of Health, Disability and Ageing acknowledges the Traditional Custodians of Country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to Elders past and present.

The agenda for this information session will include the following information on the RFT including Probity, an overview of the Medicare UCC Program, RFT scope and process overview, and the contact details should you have any questions related to the RFT following this presentation.

This section of the industry briefing relates to the probity requirements of the RFT.

Probity is: “the evidence of ethical behaviour, and can be defined as complete and confirmed integrity, uprightness and honesty in a particular process”.

The department is committed to ensuring the highest standards of accountability, fairness and transparency in all procurement processes.

The department’s expectations in relation to the conduct of itself and Tenderers are outlined in the RFT.

Approaches, direct or indirect, to other officers, employees or agents of the department or the purpose of obtaining information in respect of this RFT are prohibited.

All communications must be through the Contact Officer address.

Tenderers should address any concerns to the Contact Officer in the first instance. These may include potential conflicts, a confidentiality concern, or any other ethical or fairness question relating to the procurement.

Tenderers should familiarise themselves with the Supplier Code of Conduct which applies to this activity and is incorporated in the Draft Contract.

This section of the industry briefing provides an overview of the Medicare UCC Program. It provides details on the purpose of the program, Medicare UCC Operational Guidance and Independent Clinical Assessments.

Medicare Urgent Care Clinics or UCCs are walk-in healthcare services funded by the Australian Government.

They provide urgent care for non-life-threatening health issues.

Designed to reduce pressure on hospital emergency departments.

There are key features of Medicare UCCs:

• The are open extended hours
• No appointment is needed.
• Clinics are primarily GP-led with some exceptions.
• There is a minimum staffing model that includes a GP, Nurse Practitioner/Registered Nurse, and Receptionist.
• Clinics are Bulk-billed and provide timely care for conditions that are urgent but not life-threatening.

The purpose of Medicare UCCs is to:

• Reduce pressure on emergency departments.
• Improve access to affordable urgent health care.
• Introduce an intermediate model between emergency department and general practice.
• Build upon learnings of other countries.
• Opportunity to test different workforce models.

Medicare UCC footprint

Two tranches of the Program have been completed to date:

• Tranche 1: Established 58 clinics by December 2023.
• Tranche 2: 29 Additional clinics by December 2024.

Planning is also underway for the implementation of a third tranche of up to 50 additional UCCs in the financial year 2025-26. Once all UCCs are fully implemented, this will bring the total to 137 UCCs across Australia.

Depending on the jurisdiction, Medicare UCC Commissioners are PHNs or state/territory Government.

Medicare UCC Commissioners play an important role in the Medicare UCC Program. They are responsible for negotiating and managing contracts with individual Medicare UCC providers, and they oversee the establishment of ongoing operations of the Medicare UCCs.

The Medicare UCC Operational Guidance has been developed by the Australian Government in consultation with state and territory governments.

This guidance outlines the scope and minimum services to be offered at Medicare UCCs and will be reviewed on a regular basis.

This guidance sets a minimum standard for the activity, infrastructure and staffing of these UCCs while allowing sufficient flexibility for services to adapt to local conditions and needs.

The guidance is a living document and reviewed regularly by the department.

A copy of the guidance is available on the Department’s website.

The Operational Guidance is comprised of 11 sections including scope of conditions, accessibility, staffing and the Appendix section which provides an indicative list of core equipment and drugs required by a UCC.

What are Independent Clinical Assessments (ICAs)?

ICAs are structured reviews conducted to ensure that UCCs comply with requirements as outlined in the Operational Guidance.

ICAs are a key program assurance mechanism to ensure Medicare Urgent Care Clinics meet operational standards prior to clinic opening.

ICAs are conducted prior to the opening of clinics; with the pre-opening ICA report identifying areas where the clinic meets the required standards and highlights recommendations for improvement in areas that do not meet the criteria.

In some instances, post-opening ICAs may be conducted where there is an identified operational need to reassess the Medicare UCC, such as changes to Medicare UCC provider or clinic relocation.

As stated in the RFT there are requirements for ICAs:

Scheduling and delivery of all ICAs within agreed timeframes.

The summary reports of ICAs must be provided to the department within 2 business days after the on-site clinical visit. The Tenderer must ensure the reports are clear and accessible.

The Tenderer must demonstrated professional clinical judgment and behaviour while conducting ICA on-site visits and reports, maintaining confidentiality on clinic operations and report outcomes.

This section of the industry briefing provides an overview of the RFT Scope.

The Department is seeking Tenders for the following Services:

• Independent Clinical Assessments (ICAs) for the Medicare UCCs Program, 2025-26 to 2027-28.
• The Tenderer will be required to undertake ICAs to support the opening of up to new 50 clinics and the ongoing assurance requirements of the established clinics as needed, over the period 2025-26 to 2027-28.
• The detailed specifications and requirements for the Services are set out at SCHEDULE 1 - Statement of Requirement.
• The Department proposes to engage 1 or more successful Tenderers to provide the Services in accordance with the Draft Contract set out in SCHEDULE 7.
• The Department encourages a consortium approach to ensure national coverage of UCCs.

The RFT conditions of participation are as follows:

1. The Tenderer must not have had any judicial decisions against it (excluding decisions under appeal) relating to employee entitlements and have not satisfied any resulting order.
2. The Tenderer, its personnel, and any Subcontractors proposed on the Tender must not, at the Closing Time, be listed as terrorists under section 15 of the Charter of the United Nations Act 1945 (Cth).
3. The Tenderer (or any Subcontractor proposed in the Tender) must not be named in the Consolidated list referred to in Regulation 40 the Charter of the United Nations (Dealing with Assets) Regulations 2008 (Cth).
4. The Tenderer(s) holds all Valid and Satisfactory Statements of Tax Record required for its entity type.
5. The Tenderer(s) must have appropriately trained staff or access to trained staff (including clinicians such as nurses and/or medical doctors) with sufficient experience to assess safe delivery of Medicare Urgent Care Clinics. Such experience may include Emergency Medicine, Urgent Care and/or General Practice (where this has included delivery of urgent care).

The expected deliverables/outcomes of the RFT are as follows:

• The Medicare UCC program is a national program, with clinics located in Australian jurisdictions across metropolitan, regional and remote areas. The Tenderer must identify in their response which jurisdictions they can service to deliver independent clinical assessments. Options include nationally or select states and territories.
• While it is preferable that the Tenderer demonstrate the capability to deliver ICAs in multiple jurisdictions, the Tenderer should outline their current geographic coverage and explain how they can deliver ICAs in the regions they service.
• Tenderer(s) may propose delivery models that include partnerships or scalable solutions to ensure coverage and cost-effective service delivery in required locations. This may include forming a consortium with organisations servicing complementary Australian states and territories to meet this requirement.
• The Tenderer(s) may consider developing an assessment approach methodology for virtual on-site visits in certain circumstances e.g. rural and remote locations, or during infectious disease outbreaks where it can be demonstrated that the virtual on-site assessment is a reliable and valid substitute for in-person attendance.
• This methodology may include but not limited to consideration of several modalities to examine the Medicare UCC: pictures, set times for interviews, privacy, all relevant staff members, video tour, list of equipment, triage data, interviews with local health area network and emergency department representatives.

This section of the industry briefing provides an overview of the RFT Process.

The minimum content and format requirements of the RFT are as follows:

1. The Tender must be in English, and measurements must be expressed in Australian legal units of measurement.
2. The Tender must include a completed, signed and scanned Tenderer Deed substantially in the form at SCHEDULE 2.
3. Tenderers must substantially complete and submit the Pricing Schedule in SCHEDULE 5 in accordance with the instructions provided in SCHEDULE 5.
4. Tenderers must substantially complete and submit the Modern Slavery Schedule in SCHEDULE 6 in accordance with the instructions provided in SCHEDULE 6.

The RFT also lists several Schedules and Attachments required in your submissions. Please note where some templates are included and the specific requirements of each schedule as part of your submission. Please refer to Attachment D of the RFT documentation on AusTender for further detail.

Please note, Schedule 7: Draft Contract is not a requirement for tender. The Contract will be updated based on successful Tenderer/s response and service model. Please ensure Attachment A: Checklist for Tenderers is completed, and Key Performance Indicators are included in as part of your response to Schedule 3. Please also include a Risk Management and Data Security Plan as part of your application. The submitted Plans will remain in draft until contract negotiations are finalised. The Plans will form part of the Contract.

Evaluation criteria

Value for money is a comprehensive assessment including technical, commercial and risk components. The Department will use the following criteria in the evaluation of Tenders:

• Capability – which is comprised of your solution, collaboration, flexibility and improvement as well as performance. Specific definitions for each component of capability are provided in the RFT documentation.

Please note, the capability component of the evaluation criteria is weighted at 40% of your entire application. Please ensure you read the criteria carefully to address this component.

Capacity is a secondary evaluation criterion and is weighted as 35% of your application response.

• It includes organisation, as in the extent to which the Tenderer has the organisational capacity to deliver services across multiple states and territories, including suitable resourcing and governance arrangements, especially during identified peak periods to meet the Requirements and provide the outcomes described in the Statement of Requirement. Preference may be given to Tenderers with a broader geographic footprint; however, Tenderers with a presence in select regions are still encouraged to apply, provided they can demonstrate the ability to meet the requirements of the Statement of Requirement in those regions.
• It also includes personnel defined as the extent to which the Tenderer has sufficient Personnel with the experience, ability, skills and qualifications to perform the Requirements of the Statement of Requirement within required timeframes.

Experience is weighted as 25% of your application response and includes the extent to which the Tenderer has demonstrated experience and quality of performance in providing goods/services the same as, or similar to, the Requirement to other organisations.

Pricing does not have a weighting on your response.

Tenderers will also be evaluated against the tender prices and the following non-technical Evaluation Criteria (which are unweighted).

1. The Tenderer’s proposed approach to:
   • using Indigenous enterprises in its supply chain; and
   • the employment of Indigenous Australians.
2. The degree of financial viability of the Tenderer, including any associated risks to the Department.
3. The degree of the Tenderer's overall compliance with the RFT and Draft Contract and the likelihood of any non-compliance meaning the Department is unable to agree a contractual arrangement with that Tenderer.
4. The appropriateness of any information which the Tenderer proposes be kept confidential and the extent of any associated risks to the Department.
5. The extent to which any risks associated with the number and type of any conflicts of interest which have been identified by the Tenderer, or which may later arise can be, have been, and/or will be, appropriately managed.
6. The extent to which the Tenderer does or will meet Commonwealth policy requirements.
7. The Tenderer’s proposed strategies to contribute to the economic benefit of the Australian economy
8. The environmental sustainability of the proposed goods and services (such as energy efficiency, environmental impact and the use of recycled products).
9. The extent to which the Tenderer does or will meet all security requirements.
10. Any other risks to the Department which are inherent in, or associated with, the Tenderer's offer.

The Department may:

1. consider any part of a Tender in the evaluation of any or all the Evaluation Criteria; and
2. use material provided in response to one Evaluation Criterion in its evaluation of other Evaluation Criteria.

The timeframes for the RFT. Responses close on 7 July 2025. Responses will be evaluated on 21 July with the contract proposed to start by 1 August 2025. Once the contract is finalised, the expected delivery timeframe for this service will be between 1 August 2025 to 30 June 2028.

• Please provide all questions related to this RFT in writing to the email address to uccassurance@health.gov.au.
• The Department will issue any Addenda via AusTender. It is your responsibility to ensure that you check AusTender regularly for communication from the Department.
• A reminder that communication, other than the methods outlined above, should not occur in relation to this RFT.

This concludes the industry briefing. Thank you for listening.