The Art of War, a Chinese military treatise written in the 6th century BC, holds a piece of advice for the 21st century GP bidding to win a vacant practice or to provide services: know your enemy.
But how do you go about weighing up companies as diverse as UnitedHealth, Care UK or Atos Origin?
Dr Michelle Drage, joint chief executive of Londonwide LMCs, says: 'Look around at the applications that have already been successful in other parts of your territory and then examine how they achieved that.'
Potential rivals might be identified through trawling the web, asking colleagues - or even by having a quiet word with the right person at the PCT.
Possessing a detailed knowledge of local healthcare needs can tip the scales in GPs’ favour
Visit rivals' premises
London GP Dr Clare Gerada, who has been involved in four successful bids with her Hurley Group practice, says finding out who you are up against might be possible at meetings held by the PCT for all prospective bidders or by making an educated guess.
'GPs have to take this seriously. Find out as much as possible about potential rivals and about the area where your bid is based, she says. 'My experience is that most big companies do a cut and paste job (with tenders). GPs can gain points by showing how much they know about the local area's health needs.'
Justin Cumberlege, a primary care legal expert with London solicitors Carter Lemon Camerons, suggests studying the services rivals already offer and ascertaining whether they are achieving their aims. Ideally this should be by visiting the surgeries concerned and talking to doctors working there.
'You need to pick up ideas from your rivals and make sure you match and improve on them.' He adds that it is a good idea to talk to GPs who have already won tenders.'
In-depth information can be gleaned via private sector companies' annual reports filed at Companies House and through making Freedom of Information (FOI) Act requests. Valerie Martin-Long, national medical director for accountants PKF, recommends going to the PCT and asking to see past tenders.
The tendering process appears to favour the private sector. Ten months ago Dr Kambiz Boomla and his colleagues from two nationally-acclaimed practices in East London bid to run a vacant practice but lost out to Atos Origin, a £4 billion multinational company.
Dr Boomla argues that the bids scoring process is loaded against GPs on the basis of procurement, branding and price - areas where a multinational corporation is invariably strong.
But GPs may have less to fear on quality of service. Dr Boomla says: 'What seems to have emerged is that local GP practices were perhaps over-ambitious in proposing a higher level of quality than the PCT was prepared to pay for.'
Portsmouth GP Dr Julian Neal knows all about weighing up the opposition. He is chairman of 160 GPs-strong Spinnaker Health, a company formed to bid for provider services. When looking for a private sector partner for Spinnaker, Dr Neal spent 18 months studying several including Assura, Virgin and Care UK. The group finally opted to work with Circle, a partnership of 1,000 consultants and 600 GPs.
'I think a practice can't do anything apart from a few local enhanced services on its own. Most practices have less than 15,000 patients and even in my case with a provider organisation of up to 160 GPs covering 330,000 patients we couldn't get any contracts.'
He believes that PCTs do not see GP practices as credible provider organisations, a view that GPs who have already won tenders will take issue with.
Access expert advice
Medical accountant Laurence Slavin, whose firm Ramsay Brown & Partners has hundreds of GP practices as clients, says that pricing bids is crucial.
'GPs' competitors will probably be prepared to spend more on getting the contract and to make a loss just to get into the market,' he says.
LMCs might also be able to help you find details on potential rival bidders. For example, Londonwide LMCs is building up a catalogue of information about private sector providers.
Practices may want to take a leaf out of their rivals' books by bringing in some expertise from a private consultancy. 'For GPs to put their best foot forward they need to get professional advice,' Dr Drage says.
Do your homework
- Study other successful bids in your area: ask the PCT for details of past tenders.
- Trawl the web and talk to local colleagues to identify potential rivals.
- Check out the people attending PCT sessions for potential bidders.
- Know more about local health needs than other bidders.
- Visit rivals' healthcare facilities to get an insight how they operate.
- Get information from Companies House (www.companieshouse.gov.uk) and via the Freedom of Information (FOI) Act. Details on how to make FOI requests, can be found at www.ico.gov.uk
Apply for information about competitors' previous bidding documents and contracts under the Freedom of Information Act. Even if confidential financial information is withheld, you can glean useful intelligence about the services your rivals offer.