NHS Elective Treatment and Diagnostic Services (NHS Southampton Elective Treatment Centre)

Concepts

• health services
• nhs southampton elective treatment centre
• winchester
• urgent elective inpatient
• nhs elective treatment
• local elective secondary care capacity
• diagnostic radiology
• post-operative services
• effective services
• diagnostic endoscopy

Location

Winchester

Description

The Contract was awarded for 5 Years plus optional extension of 24 month commencing on 28th October 2015 and ends on 27th October 2022. Please note the Awarding Contracting Authority at the time was NHS Southampton City CCG, the new legal entity for the CCG is Hampshire, Southampton and Isle of Wight CCG. The Contract was awarded to Care UK Clinical Services Ltd who now operate as Practice Plus Group, Hospital Southampton,following the completion of the full tender process. The service provides routine and urgent elective inpatient and outpatient care for adults and children 16 years and over in the following specialties: • Orthopaedics including: o Lower limb: Hip, Knee, Ankles and Foot o Upper limb: Shoulder, elbow, wrists and hand. o Excludes spinal surgery • General Surgery • Urology including cystoscopy • Ear Nose and Throat • Gynaecology: Excludes pre-natal, early pregnancy. • Ophthalmology • Anaesthetics, including Pain Management Interventions • Diagnostic Radiology • Diagnostic Endoscopy • Pathology; routine samples • Post-operative in-patient therapies; Physiotherapy, Speech and Language, and Occupational Therapy (internal consultant referral only) • Oral Surgery NHS England Only This service is commissioned to ensure sufficient and high quality local elective secondary care capacity for adults and children 16 years and over, including outpatients, diagnostics, elective inpatient and post-operative services. The catchment includes the populations of Hampshire, Southampton and Isle of Wight CCG, and associates to this contract, plus the wider Wessex catchment for referral for Oral Surgery. The service should provide high quality and cost effective services to ensure that all patients are treated appropriately in line with adopted NICE clinical guidelines and mandatory technical appraisals, including local Individual Funding Request Policy Guidelines, clinical thresholds and referral criteria. Services should achieve all local and national waiting time targets and other key national and local key quality and performance targets. The expected outcomes of the service are to: • Provide safe and effective care in line with national best practice and local guidelines to optimise clinical outcomes; • Deliver timely assessment, diagnosis and treatment for our population within NHS Constitutional waiting times • Engage our communities and patients in the delivery of their healthcare, to support self-care, informed decisions and better personal experience and outcomes. • Develop confident working relationships with referrers and consultant colleagues in other local providers to serve the best interests of the patient by minimising delays, providing advice, avoiding unnecessary tests or treatment, referring on or back when appropriate and providing clear communication and information • Drive cost-efficiencies over the life of the contract • Provide patient education and information in an engaging, user-friendly way, on message with the local system to help patients understand modern healthcare provision • Participate in and contribute to local educational forums independently or in partnership with our other providers • Meet the quality, safety and reporting arrangements as outlined in the NHS contract, ensuring a safe, effective and positive experience for the patient. • Stimulate efficiencies and improvements through innovation to support a sustainable local health economy. The service provides a 24- hour, 7 day inpatient facility to safe standards. It offers day time, evening and Saturday appointments with some weekend diagnostic and operating sessions for those who find it difficult to attend during working hours. The service accepts: • Referrals for opinion from GPs, GPwERs, community based services, Tier 2 services, Acute Hospital Consultants (subject to agreed policies), and dentists; and provides daily accessible advice in response. • Referrals for treatment from GPs, GPwERs, community based services, Tier 2 services, Acute Hospital Consultants, and dentists (in all cases, subject to agreed policies). The patient's referral will be logged upon receipt, and clinically assessed for appropriateness for the service to which it has been referred. Patients will receive general assessment, investigation, diagnosis and treatment for all planned care using agreed guidelines and operational procedures. If the referral would be more appropriately seen by another service, the referral should be transferred to that service, and the referring clinician informed, in accordance with local Commissioner policies. If the referral is inappropriate or does not meet the clinical threshold criteria, it should be returned to the referrer with advice. The service is offered as an option for patients under national NHS Choices, where appropriate, delivering NHS Constitutional Standards. For non-dental activity, the provider receives the majority of referrals electronically via NHS E - Referrals. Dental activity should be received via Dental E - Referrals. Ophthalmology referrals should be received either through NHS e-RS or e-ERS via OPERA direct from Primary Eye Care Services (or otherwise agreed with commissioners). The provider is a key partner in delivery of care in the local area and as such is expected to work in a collaborative and integrated fashion. This requires clinical collaboration with providers across the health system, adhering to locally-agreed pathways, including: • Primary care medical, dental and optical practices, including Primary Eyecare Services Ltd (PES). • Primary Care Networks and associated GP Federation Providers • Southern Health NHS Foundation Trust (Mental Health, Acute and Community, including Community ENT Services) • Solent NHS Trust (Community) • Hampshire Hospitals NHS Foundation Trust (Acute) • University Hospitals Southampton NHS Foundation Trust (Acute, Tertiary, Cancer Centre, Trauma Centre) • Royal Bournemouth and Christchurch NHS Foundation Trust (Acute) • Salisbury NHS Foundation Trust (Acute) • Portsmouth Hospitals NHS Trust (Acute, Tertiary, Cancer Centre) • Isle of Wight Healthcare Trust (Acute) • Community-based services and clinicians from a range of disciplines including district nursing, podiatry and therapies, GPwERs and Tier 2 Community services such as MSK, Pain & Rheumatology, ENT, Dermatology, PES and Diagnostic specialists • Other AQP providers across clinical pathways, including locally qualified providers of audiology and hearing aid services • Southampton City, Hampshire and Isle of Wight Social Services • Equipment services, including local Wheelchair centres • Patient Transport Provider (South Central Ambulance Services) • Blood Transfusion Services • South Central Ambulance Services (PTS and 999) • 111 and Out of Hours services • Any community, primary care triage or alternative service models that are commissioned during the course of the contract.

Ammendments to Previous Notice

Award Detail

CPV Codes

• 85100000 - Health services

Indicators

• Contract modified due to unforeseen circumstances.

Legal Justification

The Covid pandemic has resulted in emergency measures which have delayed the process of reviewing, consulting on and agreeing the commissioning strategy and re-procurement of the NHS Southampton Elective Treatment Centre contract. Originally, the contracting authority had plans in place to undertake a thorough service review of the scope of services and service model, with deliverables including: • Agreement on commissioning strategy April 2020 • Set up Procurement Board May 2020 • Full review of specialities, strategy, specification etc.May-Dec 2020 • Market notice published Jan 2021. The Covid pandemic and related unforeseen circumstances have resulted in significant delays to the scheduled service review and subsequent re-tendering activity, for example as: • Management of the Covid-19 response, both in terms of immediate measures and the subsequent recovery of diagnostic and elective activity (in between Covid waves), has necessarily been the focus of the contracting authority, the incumbent provider and key partners and stakeholders since March 2020. • Resources in the contracting authority were redirected to support frontline activities including direct care for patients, efforts to support supply chain activities and vaccination programmes in line with national guidance around removing routine burdens and freeing up as much capacity as possible to focus on the pandemic response. • Resources in the wider system, including Acute and Community NHS Trusts and providers, Primary Care, Community and Tier 2 Providers and Clinicians, and other partners/ stakeholders, all of whom would have been engaged in the review and re-tendering exercise, were redirected to support frontline activities and the pandemic response. • As part of the Covid-19 response, NHS E&I secured all available independent sector capacity including the Southampton Elective Treatment Centre (currently run by Practice Plus Group). The national contract commenced on 23 March 2020 and was extended several times under different terms and conditions, finally expiring on 31 March 2021. During this period, the CCG's contract with Practice Plus Group Southampton was suspended and, as the CCG was not the contract holder, limiting its ability to undertake key activity. • The ability to undertake meaningful engagement and consultation as part of any review process has been limited by the pandemic, for example as national 'lockdowns' would preclude the convening of patient and public groups. The pandemic and related emergency measures, including the national contract, has also meant that: • Data (e.g. activity and demand), which is essential to inform future commissioning strategies and models, is now out of date. The last 'steady state' data available is from 2019/20, prior to the pandemic. • Data gathered during the pandemic is not relevant or comparable, as the CCG's contract with Practice Plus Group was suspended during this time, and the incumbent provider's capacity redirected to activity to support the Acute NHS Trust. • Ways of working, patient behaviours and care pathways have all changed as a result of the pandemic. As noted in national guidance, it is vital that future work takes account of lessons learned during Covid, by locking in beneficial change and addressing both opportunities and weaknesses highlighted since March 2020. • As such, the 2019/20 baseline cannot be viewed as a reliable source for modelling future requirements. Given the pandemic is still ongoing, as is the analysis of lessons learned from Covid, and this will be essential to developing robust and future proof service models which meet the needs of our population. At the same time, the restructure of the NHS including the merging of CCGs is going ahead despite the disruption caused by the pandemic. As such, the health and care landscape is changing significantly. The Hampshire, Southampton and Isle of Wight CCG has been formed, bringing opportunities to consider demand and capacity modelling, speciality reviews and innovative models of care across a wider geography. Further changes are anticipated with the formation of Integrated Care Systems in July 2022. The Contracting Authority considers the above issues have resulted in a set of circumstances which a diligent Contracting Authority could not have foreseen. Accordingly, Hampshire, Southampton and IOW CCG has decided there is a requirement to extend the existing contract for NHS Southampton Elective Treatment Centre with Practice Plus Group for 24 months outside of the terms originally procured under Reg 72(1)(c) Public Contract Regulation 2015. The modification will enable a review to be undertaken in order to inform decisions about the type and scope of service required to meet future needs, based on robust data gathering, patient, clinical and stakeholder engagement, and lessons learned from the pandemic and the NHS restructure. The modification will also enable a robust, competitive procurement to be undertaken, including an adequate mobilisation period to minimise any risk of service discontinuity or negative impacts on patients or the wider system. The modification does not alter the overall nature of the contract and any increase in price does not exceed 50% of the value of the original contract.