Terms of reference for a Hospital Management Coach at St ... · Terms of reference for a Hospital...
Transcript of Terms of reference for a Hospital Management Coach at St ... · Terms of reference for a Hospital...
Terms of reference for a Hospital Management Coach at
St. Francis Referral Hospital (01.11.2017 to 31.12.2019)
1 Terms and Abbreviation
Abbreviation Definition
AC Award Criteria
DSM Dar Es Salaam
PPO Federal Ordinance of 11 December 1995 on Public Procurement
FDFA Federal Department of Foreign Affairs
SC Suitability Criteria
SDC Swiss Agency for Development and Cooperation
SFH St. Francis Hospital
SFRH St. Francis Referral Hospital
ToR Terms of Reference
2 Purpose of This Document
This document contains the requirements relating to the mandate for project "St. Francis
Referral Hospital: 7F-07720.01." It serves as a template for the bidder to submit an offer.
Contracts are awarded according to the invitation to tender procedure according to Art. 35 of
the PPO.
3 Goal and Content of the Mandate
3.1 Background
St Francis Referral Hospital (SFRH) is located in Ifakara in the southern part of Tanzania.
The hospital is owned by the Diocese of Ifakara (formerly Diocese of Mahenge). The
longstanding Swiss presence in Ifakara on the grounds has resulted in numerous local
institutional partnerships. SFRH with Solidarmed and Swiss Development Agency for
Cooperation (SDC); Ifakara Health Institute (IHI) with Swiss TPH; the former Medical
Assistant Training Centre (MATC), now known as the Tanzania Training Centre for
International Health (TTCIH) with Swiss TPH, Norvatis Foundation with SDC; and the Edgar
Maranta School of Nursing (EMSN) with Solidarmed and SDC. More recently, the University
College of Health and Allied Sciences (SFUCHAS) was created and joined the health related
institutions, completing what is known today as the ‘Ifakara Cluster of hospital services,
academia and research’.
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Currently SDC is carrying out a comprehensive support program with the hospital, including
constructions, Technical Assistance in the provision of quality health care services, hospital
management and administration, provision of medical equipment and strengthening of ICT
system. A credit proposal in support of SFRH was approved on the 3rd April 2012. The
overall goal of the program is to support the hospital in the development of the range of
services which are expected of a regional referral structure, and provide a conducive
environment for training of students and research. The primary beneficiaries are the hospital
staff, the local partner institutions and the inhabitants from Kilombero valley in Morogoro
region and beyond, with a population of approximately 1 million. To-date, approximately half
the planned renovations and new buildings have been completed and partially equipped. A
quality of care improvement program and a partially operational hospital management
information system has been implemented.
3.2. Project Review and Feasibility Study
A mid-term external review was undertaken from January to April 2016. The review findings
revealed strengths and weaknesses in all components. The review, recommended the
undertaking of a feasibility study prior to continuing with further hospital upgrading support.
The Feasibility Study was conducted from November 2016 to February 2017. Among other
key recommendations, the Feasibility Study recommends “the hiring of a Hospital
Management Coach by the owner (Bishop) and work in his name with a clear mandate to
improve the financial situation and, overall planning and management at SFRH”. The Bishop
of Ifakara and the St Francis hospital management both agree with this recommendation and
endorse the recruitment of an external coach as management mentor to the Medical
Director.
3.3. Objective
The Hospital Management Coach will provide advice and mentorship to the medical director
to take all administrative and managerial steps necessary to implement the
recommendations arising out of the feasibility study and the external evaluation. He/She will
strengthen the hospital management’s financial management and business planning
capabilities through mentoring. He/she will develop and support the implementation of a
realistic business plan for the hospital as well as develop a debt management strategy.The
anticipated change management will include, but is not limited to develop financial
management data systems that will allow rational management decisions resulting in
decreases in expenditure, increases in income and stabilization of the current debt situation.
The fostering of setting up of an internal audit function is also part of the change
management process. The Coach will provide data driven support towards the negotiation of
service agreements between the Diocese and the Government of Tanzania’s PORALG
(President’s Office-Regional Administration and Local Government). Finally, he/she will
assist in the review of existing human resource, their profiles and capabilities; supporting HR
alignment by the medical director are considerd part of the change management process.
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3.4. Tasks and Deliverables
Under the direct supervision of the Medical Director, and in collaboration with the SFRH
management Committee (SFRH, SDC, Project Coordinator), the Coach will develop an
action plan to implement the objective of the mandate. In particular with regards to increasing
income, the Coach shall collect cost and profit centre ‘data’ from all units and services;
establish which services are generating income and propose ways to increase their patient
load; explore possibilities to generate additional income e.g. from NHIF, CHF and private
insurances; examine potential for training or research at SFH to be turned into a business
model.
3.4.1. Specific Tasks and Responsibilities
Financial Management and Business Model Establishment
a) Negotiate and establish a realistic and transparent debt relief (payment) plan with
creditors, so that all debts are rescheduled and settled; as part of that, a negotiated level of
debt relief by all creditors, also with Government of Tanzania, should be determined.
b) Create a cost/profit centre management approach for the hospital so that it starts looking
at all existing and potential specialised hospital services with a view to sustainability, with
adequate internal controlling mechanisms. Instill a culture and practice of data driven
management decisions regarding the operational running of the hospital e.g. cost / revenue
linked to specialised services, intensity of offering specialised services (daily, monthly, pop-
up clinics).
c) Create systems, preferrably electronic using the Government of Tanzania Hospital
Management Information System (GOT-HOMIS), that ensures reliable patient data linked to
cost and income for services provided. This should also result in expansion of cashless
hospital administration. Patient relevant data will allow the quantification of the financial
implications of exemptions, insurance reimbursements, adequacy of cost recovery through
CHF, NHIF, other health insurances, adequacy of service agreements with GOT for the
delivery of designated district hospital or specialised regional services. Furthermore, data on
ability and willingness to pay by the various user populations will be assembled.
d) Develop and facilitate the implementation of a cost recovering business plan for the St
Francis Designated (Town Council) District Hospital services with the following specific
aspects:
Coordinate service provision with Kibaoni Health Centre which also offers many
District Hospital (Kilombero District) services close-by.
Identify and improve the most needed and appreciated health services (basic or
specialised) having a big impact on care and/or income.
The standardization of the care logistics of these crucial services so as to improve the
quality of services and become more efficient (lowering costs), making services
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attractive again to patients and thereby make them more willing to come and to pay
for these as needed.
Collect data on patients served (see point c. above).
Re-negotiate level of user fees and cost sharing with DMO and Councils to allow the
transparent engagement through new Service Agreements with Town, Council and
Regional levels.
e) As to specialist services, develop specific business cases for the current ‘integrated’
specialist services. The “integrated” refers to a medical doctor with recognized clinical
specialisation who is providing specialised services when required. These “integrated”
service do not warrant the establishment of fully fledged “specialised” departments; negotiate
with the RAS and RMO from Morogoro on which ‘integrated’ specialist services SFH will
provide, how much the RAS will contribute (e.g. per patients treated/service provided), and
how much can be charged to patients etc. Assist SFH Management to negotiate and sign a
Service Agreement with RAS. If need and sustainability indicate that full-time specialist
services aren’t possible, explore shared specialists on specific days when these services
could be made available.
Human Resource Management: Optimizing Management and Efficiency
f) Apart from financial management duties, the Coach will also support change with regard
to Human Resource performance management in order to optimize efficiency and foster
ethical behavior of staff.
g) The coach will mentor the Medical Director and SFRH management Committee in the
need’s assessment for specialized staff once specialized departments have been shown to
be cost effective.
h) The Coach will support the identification of an appropriate recruitment strategy
(government payroll, directly employed, subcontracted) for the different services will need to
be established.
3.5. The duty station
The duty station of the position is Ifakara town in Morogoro region (latitude: -8° 07' 59.99" S;
longitude: 36° 40' 59.99" E). The duty station is a small urban location of 50’000 inhabitants.
Ifakara is situated in the Kilombero river seasonal floodplain, surrounded by large rural
communities engaged in cash crop and subsistence agriculture. Ifakara is approximately
600km west of Dar Es Salaam. Overland travel from/to Dar Es Salaam requires
approximately 10 hours car travel. Modern communication technologies and ATM banking
are available.
3.6. The mandate
This mandate contains three distinct levels of effort:
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Full Time up from November 2017 to May 2018
Two weeks every 6 weeks June to December 2018
Two weeks every 3 months January to December 2019
For the purpose of comparability, costs budgeted for the period between1st Nov to 31st May
2018 shall be indicated in the column referring to Year 1, the ones calculated for 1st June-
31st Dec 2018 under Year 2, and assignment consolidation costs for 2019 under Year 3.
Therefore, the volume of work is estimated to be 11 person-months. Contractors may not
charge more than for 8 hours in one day (160 hours = 1 person-month) as indicated in the
table below:
Year 1 (1
st Nov 2017 - 31
st May 2018)
Year 2 (1
stJune - 31
st Dec 2018)
Year 3 (1
st Jan - 31
stDec 2019)
Working
Days 140 days 40 days 40 days
Cost
The contracting authority reserves the right to use the services listed under options in full,
partially or not at all.
3.7. The profile
The Coach is appointed by the Bishop of Ifakara for an initial period of 2 years and two
months from Nov. 2017 to Dec. 2019.
The Coach reports directly to the Bishop appointed Hospital Management Committee with
second level supervisor being the Bishop of Ifakara.
The Coach advises and supports change management by the Medical Director when
implementing the recommendations of the feasibility study and those of the external
evaluation.
Qualifications:
University Degree, Master Degree preferable (in hospital administration, business
administration, health care management) or equivalent.
Experience:
Ten or more years of experience in hospital or large project management
Five or more years of experience in a senior health care management position.
Proven track record of people management and documented leadership skills
Three or more years working in non-profit health care, ideally in Tanzania
Proven skills and track-record in efficient hospital administration and in costing of health
care
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Proven track-record indicating that he/she has considerably improved the hospital or
department in which he/she was responsible, in terms of cost-effectiveness and quality of
services.
Working experience in Tanzania an advantage
Skills:
People management
Analytical, conceptual and strategic thinking
Motivate teams to achieve targets and to achieve organizational change
Negotiation, influencing and conflict management
Multi-cultural communication
Team player
Full fluency (written, oral, comprehension) in English required
3.8. Reporting Requirement
Monthly hospital management committee minutes will serve as monthly progress reports.
Annual analytical progress report. This report will be part of the consolidated annual
report of the SFRH project produced by the Project Coordinator.
A final report (font size 11, Arial, max. 30 pages including annexes) will include an
abstract/executive summary and a main report informing the key findings: achievements,
challenges and possible solutions, lessons learned and recommendations.
3.9. Accountability and Administrative Arrangements
The mandate will be financially supported by the Embassy of Switzerland through its Agency for Development and Cooperation - SDC.
3.10. Timelines for the Application (all deadlines are 23:59 East African Time (GMT+3))
The following are the critical time lines for the application of this mandate; it is the planned schedule at the time of the publication of the invitation for bids. The issuing authority reserves the right to make amendments.
Deadline Activity
15 August 2017 Publication of the mandate on: www.eda.admin.ch and invitations sent out to minimum 3 potential bidders
31 August 2017 Deadline for submission of questions by email
30 September 2017 Deadline for submission of offers
13 October 2017 Evaluation of offers
20 October 2017 Negotiations
23 October 2017 Awarding of mandate and notice to unsuccessful bidders
31 October 2017 Signing of the contract
1 November 2017 Mandate begins
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4. Formal Aspects of the Tender
4.2. Contracting Authority
The Embassy of Switzerland through its Agency for Development and Cooperation (SDC) - Tanzania manages the award procedure and is also the direct mandating party for the bidder. Physical and Postal Address: 79, Kindondoni Road, P. O. Box 2454, Dar es Salaam, Tanzania.
4.3. Type of Procedure
Procurement in the invitation to tender is in accordance with the Federal Ordinance of 11
December 1995 on Public Procurement, PPO, SR 172.056.11.
The award of contract cannot be contested.
Composition and Content of the Offer
Please respect the following structure for your offer and requested documents, which is
compulsory.
Chapter Description No.
pages
max
SC/ AC1
00 Cover letter with signature(s) 2 --
01 Form «Bidder Information» -- SC 1
02 Self-declaration supplier «Compliance with working
conditions»
-- SC 2
03 Acceptance GCB -- SC 3
04 Acceptance Electronic Bill -- SC 4
05 Legal documents -- SC 5
06 Bidder’s availability and ability to carry out the mandate -- SC 6
07 Qualification:
Self-declaration of bidder’s completion of University Degree --
SC 7
08 Experience
Name of company and address of contact person(s) and telephone numbers
Volume of the executed mandate
Description of the provided services
3 SC 8
09 Language Skills -- SC 9
1 Reference to Suitability Criterion (SC) or Award Criterion (AC)
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Chapter Description No.
pages
max
SC/ AC1
10 Approach -- AC 1
11 Experience -- AC 2
12 Financial Offer according to the budget form in annexes iv
and v (type B and for Local Mandate respectively)
-- AC 3
4.4. Budget
The offer must be established in USD. Please refer to the annexed budget template
published by the Swiss Federal Department of Foreign Affairs (for local and international
applicants respectively). It should be used as a reference in preparing the financial proposal.
No reimbursement can be made for the bidder's work in preparing and submitting his or her
offer.
Terms of Remuneration
Payment of invoices will be made on the basis of the acceptance, by the SFRH Review
Committee and the Client, of expected deliverables. Deliverables that generate payments are
identified above in section 3.4, subheading “Tasks and Deliverables” (page 2).
Fee rates
Please refer to footnote 1 for general guidance on budgeting.
Please note that all fee rates must cover:
Consultant’s overheads, profit and backstopping facilities such as general
administration and administration related to the services (management, personnel
administration, secretarial services, other support, etc.).
Accommodation and insurance.
International travel costs
Any additional personnel emoluments
Internal quality management and assurance,
Marketing (promotion, tendering, negotiations etc.),
HRD and business development.
Contractors may not charge more than for 8 hours in one day (160 hours = 1 person-month),
as indicated in section 3.6 above.
Local travel within Tanzania
Travel costs for mission to be undertaken by staff as part of the assignment away from the
base of operation in the country of the assignment. Such travel expenses may comprise:
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Travels by air/ground by the most appropriate means of transport and the most direct,
practicable route, and shall be on what corresponds to economy class using existing
discount schemes.
4.5. Contractual Terms
The contract to be concluded is subject to the general terms and conditions for mandate type
A and B (see Contract documents of the FDFA2). The general terms and conditions are
considered to be accepted when an offer is submitted. No subcontracting is allowed.
5. Suitability Criteria
The bidder can verify his or her ability to fulfil the mandate in technical and financial terms
and shall confirm this with a self-declaration.
No. Suitability criterion Verification
SC1 Information of bidder
The bidder has to fill in the bidder information.
Written
confirmation,
signed by the
bidder according
to annex i
SC2 Self-declaration supplier «Compliance with working
conditions»
Legal signature
on the self-
declaration
(annex ii Form
Declaration
working
conditions)
SC3 Acceptance GCB
The bidder shall explicitly confirm, without limitation or
modification, the acceptance of the FDFA’s General
Conditions of Business (GCB) as per annex iii of the
present tender document.
Written
confirmation
SC4 Acceptance electronic bill
Contractors are obliged to submit an electronic bill to the
FDFA if the contract value is above CHF 5’000 (excl. VAT),
except for local Contractors of the FDFA representations
abroad. Information on the electronic billing system is
available under the following link: www.e-
rechnung.admin.ch. The bidder shall confirm that he/she is willing to submit an
electronic bill to the FDFA.
Written
confirmation
2 https://www.eda.admin.ch/deza/en/home/partnerships-mandates/mandates-
contributions/information-downloads/contract-documents-fdfa.html
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SC5 Legal Status The bidder confirms to fulfill the legal requirements
according to his status.
Evidence
according the
legal status.
Legal persons and institutions Excerpt from the
commercial
register. Bidders
from abroad are
required to
present
comparable
current foreign
official
certificates (copy
of original; not
older than 3
months)
Natural persons
For Self-employed persons (*see information below)
This criterion is only to be met by self-employed persons,
whereby they submit valid proof (not older than two years)
of professional independence in accordance with 'AHV'
law.
Proof (not older
than two years)
provided by the
responsible
social insurance
authority at which
the
company/person
is registered
For Employed persons
Bidders who do not qualify as self-employed in accordance
with 'AHV' law and non-legal persons (AG, GmbH, etc.) are
considered as employed persons for whom the FDFA, as
contracting authority, must pay the statutory social
insurance contributions.
Declaration of
agreement that
all social
insurance
contributions are
to be paid by the
contracting
authority.
Indication of
'AHV' number
and date of birth.
Foreign nationals
who do not have
a 'AHV' number
only indicate their
date of birth.
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SC6 Self-declaration of bidder on availability and ability to carry
out our mandate for full duration from 1ST Nov 2017 to 31st
Dec 2019, as well as on the availability of resident and
work permit at the time of signing the contract
Application letter
SC7 Self-declaration of bidder’s completion of University degree
(master degree is preferable) in Hospital Administration,
Business Administration, Health Care Management or
equivalent.
Application letter
and Graduate
Certificate
SC8 Experience:
Self-declared experience with similar mandates, in Africa,
with contact details of five referees related to similar
projects undertaken in past.
Ten or more years’ experience in hospital management
Five or more years of experience in a senior health
care management position.
Three or more years working in the sector of non-profit
health care in Tanzania
Written proof of
the references
giving at least the
following data:
Name of company and address of contact person(s), telephone numbers and email contacts;
Time and place of execution of the mandate;
Volume of the executed mandate;
Description of the provided services;
The contracting
authority
reserves the right
to contact the
contact persons
indicated.
SC9 Language skills
The bidder engages to deploy only personnel able to
fluently communicate in English both orally and in writing
and are able to compile and supply the project results and
documentation in English. Ideally he/she has Swahili skills
fully supportive of daily work.
Written
confirmation with
clearly
understandable
documentation
about the
language skills of
the key persons.
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6. Award Criteria
Of the valid offers submitted, the contract will be awarded to the economically most favorable
bid. Proposals shall be evaluated using the principle of Quality and Cost Based Selection
with a weight of 80% given to the technical proposal and a weight of 20% to the financial
proposal. Offers will be assessed according to the following award criteria and weighting:
i) Technical Proposal Analysis
AC Key Staff Sub weighting Total weight
Technical proposal 80%
AC1 Approach 40%
AC 1.1 Demonstrated clear approach on
how to implement the mandate
50%
AC 1.2 Analytical, conceptual and strategic
thinking
25%
AC 1.3 People management and
motivate teams to achieve
targets and to achieve
organizational change
25%
AC2 Experience 40%
AC 2.1 Proven skills and track-record in
efficient hospital administration,
people management and
documented leadership skills
50%
AC 2.2 Proven track-record indicating that
he/she has considerably improved
the hospital or department in which
he/she was responsible, in terms of
cost-effectiveness and quality of
services.
50%
AC 3 Financial offer - Overall price 20 %
AC 3.1 The overall price is to be submitted
in USD only together with the
budget form as per Annexes 4.1
and 4.2. of the tender document
(budget form type A and B)
The overall amount (excl. VAT)
across the mandate will be
estimated using the following
formula:
Score= (Pmin×max.Points
P)
100%
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P = price of bid being assessed
P min = price of cheapest bid
max. Points = 5
Total 100 %
Each award criterion will be evaluated according to the following score table:
score Fulfilment and quality of the criteria
0 Cannot be established Information has no significance.
1 Very bad fulfilment Information is incomplete
Data quality is very poor
2 Bad fulfilment Information relates inadequately to the
requirements
Data quality is poor
3 Average fulfilment Information globally responds
inadequately to the requirements
Data quality is adequate
4 Good fulfilment Information focuses well on requirements
Data quality is good
5 Very good fulfilment Information clearly relates to the achievement
of outputs
Data quality is excellent
Total Score Determination
The total score of the Proposal shall be determined be weighting and adding the technical
and financial scores.
7. Additional points to be noted by the bidder
7.1. Address for Submission of Offers
E-mail Address: [email protected] with cc to
7.2. Language of documents, language of bids
The bid must be submitted in English. The documents are available in English.
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7.3. Answering Questions
Questions concerning the awarding of the mandate in question can be sent by 31 August
2017 (23:59 East African Time (GMT+3)) to the contact person named under point 7.1.
Please send in questions in writing by e-mail. The answers will be made available within 24
hours and will be made available to all known bidders.
7.4. Deadline for Submitting a Bid and Validity
The bid must be sent by email to the contact person named under point 7.1 by
30 September 2017 (23:59 East African Time (GMT+3)) at the latest with the following
note: Offer 7F-07720.01. The bid is valid for up to 90 days after the aforementioned date for
submission. Please submit the financial proposal in US$.
7.5. Negotiations
Remain reserved.
7.6. Confidentiality
All information of any kind that comes to the attention of the bidder in connection with the
tendered mandate of the awarding authority is to be treated as confidential. The content of
the present tender may only be made available to persons taking part in the preparation of
the bid.
The tender documentation may not be used for any other purposes than preparation of the
bid, even in extracts.
Bidders treat facts as confidential that are not public knowledge or publicly available. In
cases of doubt, facts are to be treated as confidential. This obligation to secrecy remains
valid even after conclusion of the tender procedure.
The awarding authority undertakes to maintain confidentiality about this bid towards third
parties subject to the reserve of statutory publication requirements.
7.7. Integrity Clause
Bidders undertake to take all necessary measures to avoid corruption, especially not to offer
or accept payments or other advantages.
Bidders who violate the integrity clause are required to pay a contractual penalty to the
contracting authority amounting to 10% of the contract sum or at least CHF 3,000 per
violation.
The bidder notes that a violation of the integrity clause leads as a rule to the cancellation of
the award or to early termination of the contract by the contracting authority for important
reasons.
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The Parties shall inform each other in case of any well-founded suspicions of corruption.
7.8. Protected Rights
All protected rights that arise from executing the mandate shall be transferred to the
contracting authority.
7.9. Reference Documents
SDC consultant’s external review report (Dr. Jeene Harry et al.)
SDC consultant’s feasibility study report (Geert Venneste et al.)
7.10. Annex
i. The bidder has to fill in the bidder information.
ii. Form: Declaration working conditions
iii. General Terms and Conditions (for mandate type A and B)
https://www.eda.admin.ch/deza/en/home/partnerships-mandates/mandates-
contributions/information-downloads/contract-documents-fdfa.html
Financial offer: Mandate B template attached (will have been shared by e-mail upon
expression of interest).
iv. Offer Form Type B
v. Local Mandate
vi. Project Mid-Term External Review Report
vii. Project Feasibility Study Report
a. Situational Analysis Report on Construction
b. Technical Report and Recommendations
c. Map - SFRH