Commissioning and Procurement Case Study

NHS Sheffield
Commissioning the Watch It Programme in Sheffield
This case study sets out the process by which a pilot project was commissioned by NHS Sheffield. The
Watch It programme is a weight management programme for children who have been identified as being
overweight or obese (at the 91st centile or above).The work was commissioned by the Public Health lead
for Childhood obesity, working with the public health Directorate in NHS Sheffield [the PCT].

The drivers for the commissioning process

There were three main drivers for the commissioning of this piece of work.
1. NICE Guidance
The first was the NICE guidance on managing and preventing childhood obesity.The specific bit of guidance states that
each local PCT should be commissioning children’s weight management programmes within their areas.
Although this is only guidance, it strongly influences how PCT’s go about commissioning work.This is further reinforced
by visits from the Department of Health’s National Support teams. They will visit a PCT, interview officers and
stakeholders for two days and then on the third day report back their findings to the PCT on how it is performing
against NICE guidance and other national policies and strategies. Where they identify non compliance with the
guidance, there is then an expectation that this will be rectified. So officers were aware of a gap in provision.
2. Evidence of need
The second driver was evidence, captured from an existing programme which has been running for 4 years [the
National Child Measurement Programme], which weighs and measures all school children in their reception year at
Primary school and then again in their final year (year 6). This indicated that overweight and obesity in children in
Sheffield was significantly high in certain areas of the city, year on year data has also highlighted that these numbers are
increasing in some areas. Data from the NCMP has shown a strong correlation between areas of deprivation and
increased obesity in children.
The PCT through this programme have been providing universal Tier 1 services such as the Healthy Schools
Programme, the 5 A DAY Programme [the NCMP] but there was clearly a gap in Tier 2 – providing services for children
and their families who have been identified as having a weight problem and needing to prevent them moving onto
needing Tier 3 (treatment) services.
Therefore from an intervention and prevention point of view, the PCT had an obligation to intervene.
Lesson learned. Evidence of need is paramount in securing new resources.
3. World Class Commissioning (WCC)
The competencies set out within WCC provide PCT’s with a commissioning framework and requirements that
should be followed when any new activity is commissioned. There was a clear expectation that this process would
be followed to commission the Watch It Programme.

Lesson Learned: Commissioning officers work to, and are assessed and audited on, national strategies and
national standards.

A joint initiative to strengthen support services for the third sector

The ACEVO Commissioning Support Service

Commissioning intentions – making the case
Having looked at the evidence and established the need, the lead for Childhood obesity put forward a business case
through a process; called a Commissioning Intention. This set out the evidence of need and what services and
resources were required to meet this need. The Commissioning Intention went through the NHS processes which
included a competitive scoring assessment against existing services and against other commissioning intentions. Due to
being a new service it needed to be evaluated against its outcomes, and therefore secured funding for 2 years to run
as a pilot.

Lesson Learned: That Commissioning officers have to compete internally for projects and resources and it is useful
to understand what these processes are.

Designing the new service

There followed a period of research, where the lead and other Public Health colleagues working with children, went to
look at existing models across the UK.They were also looking for services that would meet the cultural needs of the local
population.They identified the Watch It model in Leeds, which provided evidence that that particular model worked.
This was discussed with other officers in the PCT and was taken to the Children’s Joint Commissioning Group for
comment. It was also taken to the Local Medical Committee to be shared with GP’s. The lead officer was aware of
independent sector organisations delivering related activities in Sheffield and had met with some of them.
In creating the specification the lead officers had identified some key requirements:
• That the service had to based out in the community and delivered city-wide, particularly in neighbourhoods where
obesity prevalence was high
• That the service had to follow the Watch It model
• They were specific about how many children and families needed to be worked with, the number of sessions, and the
outcomes they required

Procurement process
Having identified the need, based on clinical evidence, then secured the resources for a pilot programme, then identified the
requirements of the service to be delivered, the commissioners handed this over to the Procurement Team at NHS Sheffield.
The Procurement team put this out to competitive tender [because it was over their £40,000 threshold]. This was a three
stage process. The specification went out to advert and interested organisations filled in a Pre Qualification Questionnaire
[PQQ]. Those that met the requirements of the PQQ were invited to tender, the tenders then went through a scoring
process which led to a number of organisations being invited to deliver a presentation.
Lesson Learned: If an organisation is not able to score highly at PQQ stage it has no chance of getting through the
process.

Mobilisation, activity and performance management

A community development organisation – ZEST – won the tender. There followed a period of mobilisation where ZEST
worked with PCT officers through monthly contract meetings to establish the programme, the venues, undertake risk
assessments and partner with other organisations [in this case Activity Sheffield who deliver physical exercise element of
the Watch It Programme].
The performance of the programme will be monitored against measurements and outcomes set out in the specification.
If successful, this will provide evidence for a continuation of the programme and will form the basis for the nest
commissioning intention.

ACEVO Commissioning Support Helpline

Contact us for advice and support on procurement and commissioning issues:
E: commissioning.support@acevo.org.uk
T: 0207 280 4937
www.acevo.org.uk/commissioning