Employment Related Medical Services Prequalification Scheme

Description

A panel of service providers for employment related medical assessments and other medical services.

Scope

This is a full prequalification process which will enable Applicants, once prequalified, to be engaged by Agencies under the Scheme with no value limit. As part of the prequalification process Applicants are required to provide business details, information about services, capability statements, fees/ service rates, and any information about their business service delivery philosophy. Applicants must use the templates provided where applicable. Information provided as part of this Application will inform the capability assessment process to determine membership to the Scheme.

• Schedule 1_Standard Form of Agreement (Agency Agreement) October 2021

  Schedule-1_Standard-Form-of-Agreement-Agency-Agreement-October-2021.docx (VND.OPENXMLFORMATS-OFFICEDOCUMENT.WORDPROCESSINGML.DOCUMENT, 87 kb)

• Schedule 2_Description of Service requirements

  TAB-A-Schedule-2_Description-of-Service-requirements.pdf (PDF, 103 kb)

• Schedule 3_Service levels and key performance reporting October 2021 PDF.pdf

  Schedule-3_Service-levels-and-key-performance-reporting-October-2021-PDF.pdf (PDF, 215 kb)

• Schedule 4_Form 01_Agency Referral for Medical Services October 2021

  Form-01_Agency-Referral-for-Medical-Services-October-2021.docx (VND.OPENXMLFORMATS-OFFICEDOCUMENT.WORDPROCESSINGML.DOCUMENT, 679 kb)

• Schedule 4_Form 02_Employee Acknowledgement October 2021

  Form-02_Employee-Acknowledgement-October-2021.docx (VND.OPENXMLFORMATS-OFFICEDOCUMENT.WORDPROCESSINGML.DOCUMENT, 34 kb)

• Schedule 4_Form 03_Privacy and Consent to Release Medical Information October 2021

  Form-03_Privacy-and-Consent-to-Release-Medical-Information-October-2021.doc (MSWORD, 46 kb)

• Schedule 4_Form 04_Request for Review of Medical Assessment October 2021

  Form-04_Request-for-Review-of-Medical-Assessment-October-2021.docx (VND.OPENXMLFORMATS-OFFICEDOCUMENT.WORDPROCESSINGML.DOCUMENT, 56 kb)

• Schedule 4_Standard forms and templates October 2021

  Schedule-4_Standard-forms-and-templates-October-2021-PDF.pdf (PDF, 596 kb)

• Schedule 5_Agency report on Service Provider performance October 2021

  Schedule-5_Agency-report-on-Service-Provider-performance-October-2021.docx (VND.OPENXMLFORMATS-OFFICEDOCUMENT.WORDPROCESSINGML.DOCUMENT, 31 kb)

• Schedule 6_Referee Report template for Applicants October 2021

  Schedule-6_Referee-Report-template-for-Applicants-October-2021.docx (VND.OPENXMLFORMATS-OFFICEDOCUMENT.WORDPROCESSINGML.DOCUMENT, 36 kb)

• Schedule 7_Service Provider six-monthly reporting template October 2021

  Schedule-7_Service-Provider-six-montly-reporting-template-October-2021.xlsx (VND.OPENXMLFORMATS-OFFICEDOCUMENT.SPREADSHEETML.SHEET, 22 kb)

• Information Sheet Medical Assessment

  TAB-A-Information-Sheet_Employee-Information_Medical-Assessments.docx (VND.OPENXMLFORMATS-OFFICEDOCUMENT.WORDPROCESSINGML.DOCUMENT, 73 kb)

• Guide for Applicants

  Guideline_Medical-Assessments-for-the-Public-Sector-2021-PDF.pdf (PDF, 272 kb)

Scheme Requirements

SCM2231 Scheme specific questions

Medical assessments

Please describe: What systems, processes (including timeframes and triage processes) and practices are in place to manage and provide employer referrals for medical assessments. Indicate if the systems and processes are different for non-work related health conditions. How your organisation will determine the most appropriate medical assessor for the referral, including medical specialists, where necessary. Describe any governance arrangements to ensure fairness and objectivity.

Response type:

Text area

Administrative support to the Review Panel

Please describe systems, processes and mechanisms your business will apply to provide this service.

Response type:

Text area

Pre-employment and periodic health assessments

Please describe systems, processes (including timeframes and triage processes) and practices your business applies to an agency referral for pre-employment medical and periodic health assessment. Describe any governance arrangements to ensure fairness and objectivity.

Response type:

Text area

Medical certificate validations

Please describe systems, processes and practices your business applies to providing this service. Describe any governance arrangements to ensure fairness and objectivity.

Response type:

Text area

Quality assurance

Please describe how your business ensures quality assurance/review processes across all services nominated for prequalification in your application. Include how your business will ensure there are no conflicts of interest and that privacy and confidentiality and professional and ethical conduct is maintained. Where applicable, please also outline any differentiation in the process between internal and sub-contracted resources.

Response type:

Text area

Privacy and confidentiality

Access to personal and sensitive information will be provided during the course of an engagement. Please describe and outline the systems and processes that will be in place to manage and ensure privacy and confidentiality of such information. Where applicable, please also outline any differentiation in the process between internal and sub-contracted resources.

Response type:

Text area

Record keeping

Records relating to employee and agencies will be generated with each service engagement. Please describe systems and processes of your business in record keeping, retrieval and reporting, in both paper and electronic formats. Where applicable, please also outline any differentiation in the process between internal and sub-contracted resources.

Response type:

Text area

Tier One: Applicant referee reports

Applicants must provide at least three (3) referee reports in the specified template (Schedule 6 of the Scheme Conditions) for each ‘Tier’ of service nominated in the application. Referee reports must refer to completed engagements provided or completed in the last 18 months and within Australia. Applicants should indicate the relevant 'Tier' they are applying for on the form before sending it onto their referees for completion. The applicant must then upload all completed referee reports in a single zip folder. Referee reports will only be considered if they: ·relate to fee-for-service engagements; ·have been completed in the specified template and signed by an authorised representative; and ·relate to services nominated by the applicant and are covered by this Scheme. DFSI/PSC may contact the referee to verify or clarify aspects of a referee report as part of the prequalification process, and agencies may contact referees as part of their procurement process. Please use the attached template to provide your three (3) Referee Reports relating to medical assessments.

Response type:

File upload

Financial solvency

Please upload a recent letter/statement from an independent accountant stating the solvency of the Applicant. The letter/statement must have been prepared within the last twelve (12) months and explicitly state financial solvency of the Applicant. The letter/statement cannot be open to interpretation, so financial statements or annual reports are not acceptable.

Response type:

File upload

Operational readiness and ongoing performance

Will your business be operationally ready to provide Services when the Scheme commences and for the duration of the Scheme period

Response type:

Radio button yes/no

Operational readiness and ongoing performance

If you answered ‘Yes’ to the previous "Operational readiness and ongoing performance" question, please outline how your business will prepare for the start of the Scheme and ongoing performance, including planning, governance, risk management, resourcing, technology, marketing, legal and financial arrangements.

Response type:

Text area

Facilities

Please describe your business’s facilities for service provision under the Scheme. This may include location/s of facilities that comply with disability access and privacy requirements; technology and equipment. Where applicable, please indicate any differentiation in facilities for sub-contracted service delivery.

Response type:

Text area

Work health and safety statutory obligations

Do you comply with all Work health and safety obligations?

Response type:

Radio button yes/no

Fees

Please use the attached fee schedule template for rates and fees that will apply for at least 12 months from the date of acceptance onto the Scheme.

Response type:

File upload Date

Terms and conditions

• Terms and conditions

  Medical-Assessment-Pre-qualification-Scheme-Conditions-2022-Update.pdf (PDF, 428 kb)

View amendments to this scheme

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