Having spent many years reviewing tender proposals, senior health and community services executive Eugene McGarrell has some practical advice for those preparing proposals for commissioners of health and social services.
Eugene McGarrell writes:
I have spent more than 20 years on the buyer side of health and social care commissioning. Currently, as General Manager Commissioning at Sydney North Health Network and, before that, overseeing NSW Health’s state-wide mental health portfolio and commissioning roles at NSW Government Department Family and Community Services.
In that time, I have read hundreds of tender proposals.
I have tried to understand the gap between what providers think their service proposals say to commissioners, and what commissioners take from them.
The gap is significant and worth reflecting on. The gap sits in the evidence around the narrative and data given as evidence for the work they do. The reports, the dashboards, the case studies.
The difference between the successful and unsuccessful proposal is how the narrative and data land in the room where procurement decisions are made.
In my experience I see three patterns that weaken provider positions when procurement panels sit to assess the proposals. All are visible in the reports themselves. It’s a shame that none get surfaced until it is too late.
Pattern one: activity reported as impact
The most common pattern is the substitution of activity for impact.
“We delivered 847 group sessions this quarter.” “We engaged 312 new clients.” “Intake numbers grew by 18 per cent.”
These are activity statements. They tell the procurement panel what the provider did. They do not say what changed for the community.
Back in the day, commissioners could make funding decisions based on activity. It assumed that if a service reached more people, they produced more outcome. That logic no longer holds. The commissioner needs to be able to know what changed, for whom, by how much, and how do we know.
Proposals that lead with activity means that the commissioner needs to do the work to translate impact. Most will not have the time.
The absence of an impact frame reads as an absence of impact. Ironically the data is held with the provider, most likely in clinical files, including outcome measures, and follow-up notes. But sadly, for unsuccessful proposals, the data does not make it into the report.
Here is a simple test for every tender writer to take before submitting the proposal.
Could a commissioner reading your executive summary be confident that your service will deliver demonstrable and reportable outcomes for community? The answer must be “YES”.
Pattern two: case studies contradicting the data
The second pattern is more subtle. Providers who have invested most in story telling are the most exposed.
I have read many proposals that included two or three case studies. They are vivid and well-written. They show the program at its strongest: complex clients, intensive support, transformative trajectories.
But often there is a dissonance, particularly when they sit alongside data showing that usually clients only receive one or two contacts a year.
As commissioners, we read both and feel confused. The case studies tell one story. The data tells another. A commissioner who has read several hundred reports treats the data as the truth and the case studies as exceptional. This means that the case study has weakened the report, not strengthened it.
The fix is not to remove case studies. It is to write case studies that sit inside the data. “This case is at the upper end of our service intensity. The regular journey looks like…” Or “Cases of this type are about twelve per cent of our caseload.”
That tells the commissioner the provider knows what is typical and what is exceptional and is reporting both. The case study shifts from a marketing exercise to analysis of the facts. That is the version commissioners trust.
Pattern three: the absent comparator
The third pattern is the most consistent. It is also the easiest to fix.
“We saw 1,840 clients this quarter.” Is that good?
Commissioners without a comparator build one of their own. We look at the last quarter, contracted target, population estimate, or a similar service in another region. Those comparators rarely tell the real story and fail to promote the provider’s real impact.
A report that supplies its own comparators controls the frame. Contracted target. Prior-period trend. Equity-stratified breakdown. Baseline population estimate where one exists.
A report that does not supply them gives that frame away. At procurement, commissioners may be looking at three or four providers’ reports side by side. The absence of a comparator is a lost opportunity for the provider that has a powerful story to tell.
The equity comparator matters most right now. Data that hide who is not being reached are increasingly read as a red flag and governance concern.
A provider serving a region with a known Aboriginal and Torres Strait Islander population, a known CALD population, or a known cohort of older adults living alone, and reporting only aggregate numbers, is asking the commissioner to assume the equity question has been thought about. Commissioners no longer make that assumption.
What this is, and what it is not
None of these patterns are evidence of poor work. They show a system built for an outdated set of commissioning questions.
The questions need to be redesigned to guide the answers that will tell the story behind the numbers. Providers have kept reporting on the outdated set of questions, designed when commissioners needed a set of different answers.
Providers can take the lead and run the questions on equity and impact themselves. Providers can draft their proposals from the perspective of closing the health and social outcome gap. Demonstrating intent and showing real examples of how the gap will be closed for underserved and vulnerable communities is powerful.
Read the executive summary first. Ask yourself honestly whether you have mistaken activity for impact. Ask whether the case studies sit comfortably alongside the data. Ask whether the numbers have a frame in which they read favourably.
Successful proposals to deliver health and social care will usually convince commissioners to fund those services, if they can show how they will reduce health and social inequity.
This requires providers to be honest with themselves and to be open to transforming their models of care that demonstrably close the gap.
This is the work.
Author details
Eugene McGarrell GAICD is a senior health and community services executive with over 30 years’ experience leading large-scale system reform to improve mental health, social, and population health outcomes. He has held CEO and executive leadership roles across government, Primary Health Networks, and not-for-profit organisations, with deep expertise in commissioning, health equity, and mental health and suicide prevention. A Graduate of the Australian Institute of Company Directors and an experienced non-executive director, he is recognised for strategic leadership, collaborative system design, and the ability to translate complex policy and data into practical, outcome-focused change. His work consistently centres on improving outcomes for vulnerable people, families and communities through innovation, partnership, and evidence-based decision-making. In his current role with Sydney North Health Network, Eugene leads the design and implementation of the Neighbourhood Health Hub model. The Hub is an integrated health and social care approach for communities most affected by inequity, anchored by a peer-led safe space for mental health drop-in support and a wellbeing café run as a social enterprise that employs people with lived experience. It grows in three stages, from small teams to a team of teams, to a full hub facility, so each community can move at its own pace.
AI declaration: First draft written by author. Claude AI used to polish the first draft. Third and final draft edited by author.
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