Procurement Plan
Act
Improving Access to Gender-Affirming Care –
Guidelines for Gender-Affirming Care
Information
6 March 2023
Official
the
under
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Procurement Plan for
Update to guidelines for gender-affirming care
Supporting Documents
Budget ‘22 paper for approval of funding for this project
Short Form NDE Contract
Act
We recommend you
approve this procurement plan
agree to the process proceeding to the next stages as stated in this Procurement Plan
Author
s 9(2)(a)
Peer Review
Information
Date:
2 February 2023
Document
Version
V1.5
Status
Initiation
Official
Tender Start
March 2023
Contract Start
April/May 2023
the
Contract Type
NDE Short Form
Contract Term
April 2023 – December 2023
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Approval
Name
Role
Approved
Approval date:
Email
28/02/23
s 9(2)(g)(ii)
Corina Grey
Chief Clinical Advisor
Email
25/01/2023
Act
s 9(2)(g)(ii)
Allan Moffitt
Senior Responsible Officer,
Teams
1/03/23
Interim Clinical Director
Commissioning
Email
3/3/23
s 9(2)(g)(ii)
Information
Email
6/3/23
s 9(2)(g)(ii)Official
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1. Summary
The purpose of this document is to provide an overview of the closed procurement process,
namely a closed tender process to select a provider to update national gender-affirming
health care guidelines.
2. Project Background
Background
Across multiple determinants of health, transgender and non-binary people experience poorer health
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outcomes than the general population1. Transgender and non-binary identities intersect with every other
further compounding health inequities.
On 1 July 2022, Budget 2022 al ocated $2.182 mil ion over four years to a project aimed at improving
access to primary care for transgender and non-binary people.
The funding has been al ocated to the fol owing work streams:
a. funding up to eight primary and community health providers to deliver gender-affirming services over
four years,
b. updating national guidelines for gender-affirming health care and lead referral pathways for gender-
Information
affirming health services and supports,
c.
development of training and workforce programmes to improve workforce responsiveness to
transgender and non-binary patients.
This procurement plan relates to workstream B – ‘updating national guidelines for gender-affirming health
care and lead referral pathways for gender-affirming health services and supports.’ Given that the lead
referral pathways for gender-affirming care require updated guidelines to complete, this procurement plan
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relates only to updating the guidelines for gender-affirming health care.
Project Overview
The Aotearoa Guidelines for Gender-Affirming Healthcare for Gender Diverse and Transgender Children,
the
Young People and Adults in Aotearoa New Zealand (2018) (Aotearoa Guidelines) are adapted to a New
Zealand context from the World Professional Association for Transgender Health’s (WPATH) Standard of
Care Version 7, which were published in 2012.2 In 2022, WPATH released their Standards of Care Version
8 document (SOC v.8).3 The Aotearoa Guidelines now need to be updated to reflect the newest Standards
of Care version to ensure that the standard of care for transgender and non-binary people in Aotearoa New
Zealand stays up to date with international best practice.
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1 Veale J, et al. (2019) Counting Ourselves: The health and wel being of trans and non-binary people in Aotearoa
New Zealand. Transgender Health Research Lab, University of Waikato: Hamilton NZ
2 : Oliphant J, et al. (2018) Guidelines for gender affirming healthcare for gender diverse and transgender children,
young people and adults in Aotearoa, New Zealand. Transgender Health Research Lab, University of Waikato:
Hamilton NZ
3 : E. Coleman, A. E, et al. (2022) Standards of Care for the Health of Transgender and Gender Diverse People,
Version 8, International Journal of Transgender Health, 23:sup1, S1-S259, DOI: 10.1080/26895269.2022.2100644
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The amended Guidelines wil also include guidance for commencing hormone therapy in primary care which
wil outline principles and approaches that encompass the diversity of transgender people, including a
Te Whatu Ora is looking for a provider to:
a. facilitate the development of updated national guidelines for gender-affirming primary health care for
health professionals and the transgender community,
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b. ensure that national gender-affirming care guidelines are aligned with international best practice
models of care as outlined in WPATH SOC v.8,
c.
ensure that gender-affirming care guidelines reflect the cultural and regional needs of primary health
care services in Aotearoa New Zealand,
d. carry out engagement with relevant stakeholders to ensure that updated guidelines both meet the
needs of transgender and non-binary communities in Aotearoa New Zealand and are relevant and
clinical y safe for practitioners to use.
3. Scope
In Scope
Out of Scope
Information
Updating national guidelines for gender-
Developing a lead referral pathway for referral
affirming care in line with international best
to secondary services
practice
Developing workforce training and resources
Adapting international best practices to reflect
for primary care professionals
the cultural and regional needs of healthcare
Increasing the capacity of the gender-affirming
providers in Aotearoa New Zealand
genital surgery service
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Carrying out consultation with the community
Developing consistency in pathways to gender-
and stakeholders, ensuring that both clinical
affirming non-genital surgery
safety and community needs are factored into
the updated guidelines
Creating centres of excel ence delivering peer
the support to clinical providers
Developing a rights-based protocol to prevent
medical y unnecessary medical intervention on
intersex children
Providing funding to secondary services to
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provide access to gender-affirming care
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4. Approach to Market
The approaches to market considered were RFP, a two-stage ROI then RFP, direct sourcing,
and a closed competitive process using a single-stage RFP (or simplified request for
proposal process) to a selected provider(s). The recommended approach to market is a
closed tender process to find a provider to update gender-affirming care guidelines.
The reasons for this approach include:
a. the maximum estimated value of the procurement of the services is unlikely to exceed
the value threshold for going to the market for procurements $100K and above, in
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accordance with the Procurement Rules
b. where procurements are below the threshold there is a requirement for agencies to
Pasifika businesses) that could fulfil the contract opportunity
c.
the work of updating the Guidelines requires both specialist clinical knowledge and the
ability to carry out engagement with the community and key stakeholders. Given the lack
of specialist knowledge that has prompted this budget initiative, the team has advised
that there are limited potential providers that have the required skil s to work with both
the community and ensure clinical safety standards are met. Information
d. after engaging with key stakeholders across the sector, the project team has concluded
that the following two potential providers are the only providers with the requisite clinical
knowledge and transgender expertise that would be able to do this work:
i. Professional Association for Transgender Health Aotearoa (PATHA),
i . Gender Minorities Aotearoa (GMA).
These two providers were selected to provide proposals because of their specific expertise in
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gender-affirming healthcare and the needs of transgender and non-binary communities. A
simplified request for a proposal document wil be sent directly to the two providers (not on
the Government Electronic Tender Service). Note that individuals who are part of Gender
the
Minorities Aotearoa are also members of PATHA (a professional association with many
members) however they are not part of the Executive Committee of PATHA which wil be
pul ing together any proposal. Neither organisation is aware of any conversations Te Whatu
Ora has had to date regarding this work with the other organisation. We wil strengthen the
declarations in the proposal document to ensure no collusion or conflicts of interest around
this and that both parties agree not to talk to each other about any aspect of this procurement
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process.
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5. Deliverables and Schedule
The following timelines are subject to change and wil be refined as we move through the
process at each stage.
Milestones (Key steps along the
Deliverable
Date
Owner
way)
Engagement with
3 Feb
Project team
Hauora, Te Aka Whai Ora,
Pacific Health, Finance and
Act
Health Legal
Develop Procurement Plan
Completed Procurement Plan in
End Feb
Project team &
conjunction with Te Aka Whai Ora and 2023
Procurement
team
Sign off Procurement Plan
Procurement Plan signed off by Te
6 March
Project team &
Whatu Ora signatories
Procurement
team
Appointment of Evaluation
6 March
Project team
Panel and review of criteria
Information
Development of Proposal
Completed proposal document ready for 6-9 March
Project team &
document
sending to suppliers
Procurement
team
Proposal document sent to
Proposal document sent
9 March
Project team &
selected providers
Procurement
team
Questions from providers
Questions answered as they come
13 March
Project team &
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answered
through and posted to providers
Procurement
within 48 hours
team
the
COI sent to panel and
Initial COI form sent to each Evaluation 13 March
Project team &
returned
Panel member and mitigation plan COI
Procurement
put in place (If required)
team
Deadline for submission of
Proposals due by both providers by
23 March
proposals closed (we are
midday
under
al owing 2 weeks)
Proposals assembled and
27 March
Project team &
sent to panel for assessment
Procurement
team
Panel pre-meet briefing 1
21 March
Project team &
hour
Procurement
team
COI update for Panel
Address potential or perceived interest 2 March
Project team &
members to complete
in partnership organisations
Procurement
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Milestones (Key steps along the
Deliverable
Date
Owner
way)
team
Evaluation of Proposals
Panel members individually assess the 27-29
Evaluation
completed
two proposals and complete forms and March
Panel
send to Panel Chair
Panel evaluation
Panel meeting in person or online to
30 March
Project team &
Act
meeting
agree scores
Procurement
team
Recommendation Report
Procurement Lead to complete Report
3 April
Project team &
completed and sent for
and send to those that require to sign it
Procurement
signing
team
Preferred providers
5 April
Project team &
notified and initial contract
Procurement
meeting set up
team
Contract negotiation
6-10 April
Health Legal,
meetings/Contract prepared
Project team &
Information
Procurement
team
Contract signed
mid April
Provider,
Project team &
Procurement
team
Debrief with unsuccessful
By end of
Project team
Official
provider
April
6. Evaluation Methodology and Crit
the eria
The evaluation model that wil be used is a weighted attribute score using the evaluation criteria
outlined in the table below. Price wil not be a weighted criterion. Instead, the price wil be taken
into account in determining overal public value over the whole-of-life of the contract. A two-
envelope process wil be used, and suppliers’ pricing wil only be opened once the criterion scoring
is completed.
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Two envelope system
We wil use the ‘two-envelope’ system to conduct evaluations. Respondents must provide all
financial information relating to price, expenses and costs in a separate sealed envelope or soft
copy file. The evaluation panel wil score each Proposal according to the weighted criteria in the
Evaluation Criteria table below, and then examine the financial information of each Proposal.
The best ‘public value’ offer wil be calculated based on a combination of the non-price ranking
and the corresponding whole-of-life pricing. The Evaluation Panel’s decision will be based on
the offer representing the best solution at the best reasonable price. For example, if the highest
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ranked non-price offer is the most expensive, the Evaluation Panel would determine whether the
additional cost represents good public value for the extra solution being delivered. If that is the
case, then that offer would be recommended for acceptance. However, if the additional cost
cannot be justified, the second ranked offer would then be considered in the same way.
Evaluation criteria
Weighting
1. Organisational capacity
15%
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2. Solution fit for purpose: Clinical safety and alignment with international
30%
best practices approach
3.
35%
4. Capability of the organisation to consult and col aborate with relevant
20%
stakeholders on gender-affirming health care.
TOTAL
100%
Refer to Appendix One for details of the questions used in the request for proposals document.
Information
Evaluation Process
Each evaluator on the Panel wil carry out an independent evaluation by scoring the individual
proposals. Individual scores from 0 to 5 (as noted in the Rating Scale further below) for each
of the above criteria wil be reviewed and discussed as a panel for an overal scoring for each
criterion and an overall score for the proposal. The overal score will be weighted as per the
table above.
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Following the Conflict of Interest disclosures and any other probity and administrative matters,
the evaluation panel wil meet to discuss the proposals and the individual scores in detail at
the meeting. Evaluators wil be given the opportunity to note an agreed re-score to reflect any
the
new considerations that have come up in panel discussion before finalising their scores for
each proposal. Individual scores wil be moderated, and a consensus score must then be
sought. Where an agreement on a provider evaluation cannot be reached by consensus in the
Panel, the Chair may direct that a decision be arrived at by calculating the median score from
al of the individual Panel Member scores.
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Only information contained in the submissions will be evaluated by Panel members. Panel
members wil evaluate each submission on its merit and not in comparison to another
submission.
Clear, succinct but comprehensive notes wil be required in support of panel evaluation
scores. All collective Panel evaluation notes and the material will be retained for audit
purposes and for debriefs for unsuccessful proposals. Al individual scores and notes will be
col ected after the process has been completed.
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Evaluation Panel
The Evaluation Panel wil comprise the fol owing people.
Name
Evaluation area
Role
Voting/Non-voting
Panel member
Voting
s 9(2)(g)(ii), s 9(2)(a)
Panel member
Voting
Act
Panel member
Voting
Panel member
Voting
Observer
Non-voting
Independent chair Non-voting
Observers may be present but must NOT contribute to the Evaluation Panel’s discussion.
This needs to be stressed at the pre-evaluation meeting.
Information
The Evaluation Panel wil consist of voting members and a Chair. Only those members noted
as having voting rights will score Responses. Additional technical, project or other expertise
may be cal ed upon during the evaluation process however these people wil provide
information and advice only and wil not be voting members.
Each Panel member wil complete a Conflict of Interest and Confidentiality Declaration. Any
plans for managing conflicts of interest wil be updated at each stage of the procurement
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process, including when Providers are known to the Panel (refer to the timetable above).
Management Plans for Conflicts of Interest must be approved by the Project Sponsor.
For Panel meetings attendance of three voting members wil be considered a quorum.
the
The rating scale that wil be used by Panel Members to score the responses against the
evaluation criteria is based on a 0 to 5 rating scale as shown below.
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Rating Scale
Assessment
Definition
Score
Excellent
Exceeds the requirement. Exceptional demonstration by the
5
supplier of the relevant ability, understanding, experience, skil s,
resources and quality measures required to provide the
goods/services. Response identifies factors that will offer potential
added value, with supporting evidence.
Good
Satisfies the requirement with minor additional benefits. Above
4
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average demonstration by the supplier of the relevant ability,
understanding, experience, skills, resources and quality measures
required to provide the goods/services. Response identifies factors
that wil offer potential added value, with supporting evidence.
Acceptable
Satisfies the requirement. Demonstration by the supplier of the
3
relevant ability, understanding, experience, skil s, resources and
quality measures required to provide the goods/services, with
supporting evidence.
Minor
Satisfies the requirement with minor reservations. Some minor
2
Reservations reservations of the supplier’s relevant ability, understanding,
experience, skil s, resources and quality measures required to
Information
provide the goods/services, with little or no supporting evidence.
Serious
Satisfies the requirement with major reservations. Considerable
1
Reservations
reservations of the supplier’s relevant ability, understanding,
experience, skil s, resources and quality measures required to
provide the goods/services, with little or no supporting evidence.
Unacceptable Does not meet the requirement. Does not comply and/or insufficient 0
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information provided to demonstrate that the supplier has the
ability, understanding, experience, skil s, resources and quality
measures required to provide the goods/services, with little or no
supporting evidence.
the
The proposal with the highest score wil be considered the preferred provider. Contract
negotiations may also include negotiating with the preferred provider to expand their
programme with additional skills not included in their programme if they have capability and
capacity to do so.
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7. Project Team
Role
Tasks/purpose
Person
Oversight of programme and contracting, peer
s 9(2)(g)(ii) review, contract management
s 9(2)(g)(ii)
Project advisor and support and management of
the project
Programme
Senior Responsible Officer
Al an Moffitt
Act
Director
Oversight of programme and inclusion in the
s 9(2)(g)(ii)
s 9(2)(g)(ii)
development of the RFP and overall project
Oversight of programme and inclusion in the
Corina Grey
development of the RFP and overall project
Providing procurement support and advice in
s 9(2)(g)(ii)
s 9(2)(g)(ii)
development of procurement documents and
running the procurement projects.
8. Financial Management
Information
Overal cost breakdown of budget by financial year for the work to produce the guidelines:
22/23
23/24
Total
Updating guidelines for
$80,000 - 95,000 -
$80,000 - 95,000
gender-affirming care
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9. Communication and Stakeholder Engagement
the
Key Stakeholders
Internal
External
Professional Association for Transgender
Health Aotearoa (PATHA)
s 9(2)(g)(ii)
Dr. Corina Grey - Chief Clinical Advisor –
under
Gender Minorities Aotearoa (GMA)
Royal New Zealand Col ege of General
s 9(2)(g)(ii)
Practitioners (RNZGP)
Hauora
Rainbow Youth (RY)
Counting Ourselves
s 9(2)(g)(ii) Inside Out Koaro
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OutLine Aotearoa
Te Ng
F’INE
External Communication Plan
Stakeholder
Concerns
Contact Type Frequency
Professional
PATHA is one of the two providers we are
Direct email
Contact provider Act
Association for seeking proposals from. PATHA’s
with the proposal
Transgender
membership includes the authors of all
document
Health Aotearoa previous editions of clinical gender-affirming
06/02/23, ongoing
(PATHA)
guidelines in Aotearoa New Zealand and one
engagement
author of the World Professional Association
depending on the
for Transgender Health standards of care v.8
outcome of the
tender process
Gender
GMA is one of the two providers we are
Direct email
Contact provider
Minorities
seeking proposals from. GMA is a
with the proposal
Aotearoa
community advocacy and support
document
(GMA)
organisation that will likely have an interest
06/02/23, ongoing
in ensuring that the guidelines reflect the
engagement
Information
needs of the communities they support
depending on the
outcome of the
tender process
Royal New
RNZCGP may be involved in other workstreams Email
Project updates as
Zealand
of this project and wil be involved in the
development is
College of
delivery of these guidelines
underway
General
Practitioners
Official
(RNZCGP)
Rainbow Youth RY holds a contract with Te Toka Tumai to
Email
Project updates as
(RY)
deliver peer support services to transgender
development is
the
and nonbinary young people. RY wil need to
underway
update staff on changes made to guidelines
Counting
A significant source of data on the health,
Email
Project updates as
Ourselves
wellbeing and needs of transgender and non-
development is
binary communities. Data from the Counting
underway
Ourselves report may inform an update to the
guidelines.
under
OutLine
OutLine holds a contract with Te Toka Tumai to Email
Project updates as
Aotearoa
deliver peer support services to transgender
development is
and nonbinary young people. OutLine will need
underway
to update staff on changes made to guidelines
Email
Project updates as
Kahukura
services and community organisations to
development is
disseminate information on transgender health
underway
and primary care to the community. Could be a
conduit for informing the community about
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changes made to guidelines
F’INE
New Zealand-based Pacific MVPFAFF /
Email
Project updates as
LGBTQI+ focused not for profit organisation
development is
underway
to Fa’afafine or Fa’atama (Samoa, American
Samoa), Fakaleiti or Leiti (Tonga), Fakafifine
(Niue), Akava’ine (Cook Islands),
Vakasalewalewa (Fiji), Palopa (Papua New
Guinea), Mahu (Hawai ) Haka huahine
(Tokelau) and Rae rae (Tahiti) - Could be a
Act
conduit for informing the community about
changes made to guidelines
Stakeholder Engagement Plan
Internal
Engagement/
Person
Date
responsible
communication
In correspondence over email
s 9(2)(g)(ii) 16/11/22
s 9(2)(g)(ii)
In regular correspondence over
21/11/22
email and face to face
Information
In correspondence over email
21/11/22
Dr. Corina Grey - Chief Clinical
In correspondence over email
28/11/22
and face to face
Hauora
Official
In correspondence over email
30/01/22
and face to face
s 9(2)(g)(ii) In correspondence over email
01/12/22
the
Charmaine Satchy, Health Legal,
In correspondence over email
13/01/22
Restrictions on contact with suppliers
under
During the period the procurement activity is open, (including the evaluation and negotiation phases and
up until the formal announcement of the successful supplier/s) New Zealand Health Partnerships shal be
the single point of contact with potential suppliers and responders to the request for proposals.
Other team members should note during the period that the procurement activity is open not to:
a. pass information or make comments to any potential supplier about the procurement activity,
b. receive any gift, gratuity, hospitality, benefit, or inducement from a potential supplier,
c. meet with a potential supplier to discuss the procurement activity or any other New Zealand Health
Partnerships contract activities (except for business as usual contact with existing suppliers).
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Roles & Responsibilities for Tender Process
er
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r
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e
so
ana
t
an
on
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P
p
en
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ram
rem
ation
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ject S
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alu
Act
ro
ro
ro
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ega
Activities
P
P
P
E
(refe
L
Business Requirements
A
R
C
Risk Assessment
A
R
C
RASCI
A
R
R
Procurement Plan
A
R
R
Sign off Procurement Plan
A
R
I
Information
Probity
A
S
R
S
I
Conflict of Interest
A
C
C
R
Evaluation Plan/Criteria
C
A
R
C
RFP Sign Off
A
S
R
C
Official
RFP Issued and ‘live’
I
A/R
A/R
I
I
RFP Evaluation process
I
S
A/R
R
the
Eval Recommendations Signoff
A
S
R
S
Unsuccessful Provider Notification
and debrief
A
R
S
under
R
Responsible – the doer
A
Accountable – the “buck stops here”
S
Support – Helps complete the task
C
Consulted – provides input
I
Informed – keep in the loop
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10. Risk Management
Project Risk Register
Risk
Risk
Potential
Likelih
Risk
Mitigation
ID
Consequence
ood
Level
s 9(2)(g)(i)Act
Information
Official
the
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Risk
Risk
Potential
Likelih
Risk
Mitigation
ID
Consequence
ood
Level
s 9(2)(g)(i)Act
Information
Official
the
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10. Appendix One - Questions relating to Evaluation Criteria
Evaluation criteria
Weighting
1. Organisational capacity
15%
2. Solution fit for purpose: Clinical safety and international best practice
30%
approach
Act
3.
35%
4. Capability of the organisation to consult and col aborate with relevant
20%
stakeholders on gender-affirming health care.
TOTAL
100%
Questions relating to Evaluation Criteria
1.
Capacity of your organisation
Section
Weighting
Information
15%
1a. Provide a brief overview of your organisation. Include a brief description of the number of
years your organisation has been operating, its organisational structure, a description of services
the organisation currently delivers and a summary of any current contracts it holds with
Government Agencies (5% overal ).
[Insert Respondent answer]
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1b. Describe details of what resource wil be provided to the update of gender-affirming care
guidelines including the team of people/person delivering an update of the guidelines, cultural
support and stakeholder consultation. Outline any significant risks associated with resourcing
the
capability and mitigation of these risks (10% overal ).
[Insert Respondent answer]
2.
Solution fit for purpose: Clinical safety and international best practice
Section
approach
Weighting
under
30%
2a. Provide an overview of your proposed solution to update gender-affirming care guidelines,
and a brief outline of the changes to be made, including updating the guidelines to bring them in
line with the World Professional Association for Transgender Health Standards of Care (15%
overal ).
[Insert Respondent answer]
2b. Provide a description of how you will ensure that the updated guidelines wil be applicable to
primary and community care providers, with clear guidance on commencing hormone therapy in
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primary care (10% overal ).
[Insert Respondent answer]
2c. Provide a brief description of your organisation’s experience in developing clinical or other
guidelines for professionals (5% overal ).
[Insert Respondent answer]
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3.
Section
We are seeking respondents that have demonstrated a commitment to
Weighting
35%
gender-affirming healthcare in Aotearoa New Zealand.
3a. Describe the following (15% overal ):
i.
updated Guidelines,
Act
i .
the Guidelines development,
i i.
how your organisation wil ensure that your Guidelines are appropriate for and address
iv.
how your organisation will ensure your stakeholder engagement processes are
[Insert Respondent answer]
3b. Describe how your organisation wil ensure that the updated Guidelines are appropriate for
Information
[Insert Respondent answer]
3c. Describe how your organisation and the proposed solution will embed Te Tiriti o Waitangi
principles into the design and delivery of Guidelines (5% overal )
[Insert Respondent answer]
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4.
Capability of the Organisation to carry out consultation with the
Section
relevant stakeholders on gender-affirming health care
Weighting
20%
the
4a. Provide a brief overview of your proposed plan for developing guidelines in partnership with
and for transgender and non-binary patients, including the multiplicity of trans, non-binary,
and regional needs.
Please include a summary of your experience working this way (10% overal ).
under
[Insert Respondent answer]
4b. Describe your organisation’s plan for how guidelines wil be developed in partnership with
clinical and medical perspectives, ensuring that guidelines wil be applicable for health
professionals across the health system and meet requirements to deliver clinical and medical
services safely (5% overal ).
[Insert Respondent answer]
4c. Please provide a brief description of your organisation’s previous work with health and/or
education organisation(s). Provide a brief description il ustrating how your organisation has
worked together with health and/or education organisations to successfully deliver a project or
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service within the last three years (5% overall).
[Insert Respondent answer]
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