Primary Care Local Enhanced Services for NHS Herefordshire and Worcestershire Integrated Care Board

Concepts

• medical practice
• worcester
• primary care
• primary medical services
• worcestershire integrated care board
• worcestershire integrated care board strategic commissioning committee
• wound care
• shared care
• local services
• enhanced service

Location

The Counties of Herefordshire and Worcestershire. For further details, please see Section II.2.4 below for the of list of GP Practices which are the main sites or places of performance.

Description

This Contract Award Notice is placed by Midlands and Lancashire Commissioning Support Unit on behalf of NHS Herefordshire and Worcestershire Integrated Care Board to confirm the direct award of contracts for Local Enhanced Services for 2024/45 pursuant to Regulation 8 (Direct Award Process B) of the NHS Provider Selection Regime (PSR) regulations. Local Enhanced Services are services outside of the national GP contract providing a wider range of primary medical services to meet local population needs and priorities. Local Enhanced Services are included as an appendix to each Practice's General Medical Service's (GMS) Contract. A description of each contract is provided in Section II.2.4 below.

Total Quantity or Scope

The purpose of this Contract Award Notice is to advise that NHS Herefordshire and Worcestershire Integrated Care Board has directly awarded contracts for Local Enhanced Services pursuant to Regulation 8 (Direct Award Process B) under the the NHS Provider Selection Regime for the period of 1st April 2024 to 31st March 2025 to 78 GP Practices across the Herefordshire and Worcestershire geographical area. These are existing Local Enhanced Services provided by existing providers. Below is a description of each Local Enhanced Service to be provided: Safe Prescribing: this service provides funding for practices within Worcestershire to manage systems for initiation, where clinically appropriate, and an ongoing enhanced level of monitoring of prescribed medicines. Phlebotomy: blood tests to monitor, diagnose and treat patients in primary care, reducing the number of patient visits to hospital proving convenient, local services to patients. Treatment Room: includes a wide variety of work such as phlebotomy, dressings, suture removal, ear syringing, wound care, 12 Lead Electrocardiograms (ECGs). Diabetes: management of patients with insulin, including insulin initiation for Type 2 diabetes, some with shared care, and Glucagon-like peptide-1 (GLP-1) Analogue treatment. Leg Ulcer: support for Leg Ulcer Healing beyond that defined in the General Medical Services (GMS) contract; the pathway includes assessment by an appropriately qualified Practice Nurse/District Nurse, treatment of Venous Leg ulcers for ambulant service users, and follow up provision of hosiery and advice, including repeat doppler testing to ensure ongoing stability of compression hosiery. District Nurses will treat housebound patients on their caseload, utilising Leg Club mode wherever possible. Compression Bandaging: service includes doppler assessment, application of compression bandaging and dressings in line with treatment plan. Deep Vein Thrombosis (DVT): exact service requirements differ across the geographical area, but all include the provision of a diagnostic service for patients with suspected DVT and initial anti-coagulation. Spirometry: diagnostic spirometry in primary care for early detection and diagnosis of respiratory conditions including Chronic Obstructive Pulmonary Disease (COPD) and/or Asthma. The service enables patients to be managed more appropriately and improves longer term outcomes. Fractional Exhaled Nitric Oxide (FeNO) Testing: FeNO testing in primary care is used to help diagnose Asthma by identifying people, not currently on the Asthma register, who are likely to respond to treatment with inhald corticosteroids (ICS). Prostate-Specific Antigen (PSA) - Stable Prostate Cancer: patients with prostate cancer or a raised PSA receive monitoring and management within primary care if clinically indicated. WF specification includes stable long term patients. Ring Pessaries: Vaginal Ring Pessary treatment for utero-vaginal prolapse. 12 Lead ECG: 12-Lead ECG is used as a diagnostic tool in the management of confirmed and suspected Cardiovascular Disease within primary care close to patients' homes, to include recoding and interpretation of routine ECGs. Cardiology - 24 Hour ECG: facilitates diagnosis, management and treatment of arrhythmias within a primary care setting. The service includes: clinical evaluation of the patient, education of the patient on equipment safety, fitting and removal of ambulatory ECG testing equipment, production of a permanent record (electronic or paper based) record of the investigation results, and specialist referral if required. Safeguarding Multi Disciplinary Team (MDT) Meetings: to ensure that all relevant information is submitted by GPs in a timely fashion to child protection case conferences, including production of Parents Report, Child Safeguarding Summary and completion of an electronic audit. Safeguarding Network Model: New Safeguarding Network Operating Model to embed good practice and support safeguarding work linked to the safeguarding reporting enhanced service. Supports GP practices working as part of a network to achieve consistent, safe and effective approach to safeguarding. Microsuction: a primary care based ear canal clearance service to patients aged 18 years and over, separate to ear syringing. Requires specialist equipment. Managing Menorrhagia: increases the availability of levonorgestrel-releasing intrauterine system (LNG-IUS) in the management of menorrhagia in primary care. Discharge to Assess (D2A)/Step-Up Step-Down Beds: the service requires a primary care clinician to attend the home to review the patient within 24 hours of admission, including a review of patients' ongoing medical and medication needs, and subsequent visits as required. Complex Care Homes: there are two homes (Pirton Grange Care Home and Inspire Care) within Worcestershire caring for complex neuro disability patients. The service requires a weekly GP session at the care homes and is based on an assessment of clinical complexity and time required. Care Home Flu Antiviral: GP practices to respond to a Public Health England alert of a localised community outbreak of influenza by ensuring appropriate clinical assessment and the prescribing of antivirals. Below is the estimated annual budget value for 2024/25 for each Local Enhanced Service, broken down by county area: Safe Prescribing: Herefordshire £454,811 / Worcestershire £1,661,049 / Total £2,115,860 Phlebotomy: Herefordshire £431,606 / Total £431,606 Treatment Room: Worcestershire £1,059,160 / Total £1,059,160 Diabetes: Herefordshire £366,657 / Worcestershire £1,092,585 / Total £1,459,242 Leg Ulcers: Herefordshire £152,949 / Total £152,949 Compression Bandaging: Worcestershire £171,023 / Total £171,023 DVT: Herefordshire £50,285 / Worcestershire £90,071 / Total £140,356 Spirometry: Herefordshire £79,615 / Worcestershire: £170,426 / Total £250,041 FeNO: Worcestershire: £58,827 / Total £58,827 PSA: Worcestershire £251,250 / Total £251,250 Ring Pessaries: Worcestershire £130,000 / Total £130,000 12-Lead ECG: Herefordshire £108,948 / Total £108,948 Cardiology - 24 hr ECG: Worcestershire £90,421 / Total £90,421 Safeguarding MDT Meetings: Herefordshire £15,177 / Worcestershire £51,503 / Total £66,680 Safeguarding Network Model : Worcestershire: £183,000 / Total £183,000 Microsuction: Worcestershire: £127,034 / Total £127,034 Managing Menorrhagia: Herefordshire £18,857 / Worcestershire £53,129 / Total £71,986 D2A/Step Up Step Down: Worcestershire £33,000 / Total £33,000 Clinically Complex Care Homes: Worcestershire £20,000 / Total £20,000 Flu Antivirals in Care Homes: Herefordshire £5,000 / Worcestershire £31,440 / Total £36,440 Local Enhanced Services Grand Total: Herefordshire £1,683,906 / Worcestershire £5,273,916 / Total £6,957,822 Below is the list of 78 GP Practices within Herefordshire and Worcestershire: Abbey Medical Practice Abbottswood Medical Centre Albany House Surgery Alton Street Surgery Aylmer Lodge Cookley Partnership Barbourne Health Centre Barnt Green Surgery Belmont Medical Centre Bewdley Medical Centre Bredon Hill Surgery Cantilupe Surgery Catshill Surgery Chaddesley Corbett Surgery Church Street Surgery Churchfields Surgery Colwall Surgery Corbett Medical Practice Cornhill Surgery Crabbs Cross Medical Centre Crabbs Cross Surgery Cradley Surgery Davenal House Surgery Partnership DeMontfort Medical Centre Elbury Moor Medical Centre Elgar House Surgery Fownhope Medical Centre Glebelands Surgery Golden Valley Practice Great Witley Surgery Grey Gable Surgery Hagley Surgery Haresfield Surgery Hereford Medical Group Hillview Medical Centre Hollyoaks Medical Centre Hollywood Medical Practice Kidderminster Medical Centre Kington Medical Practice Knightwick Surgery Ledbury Health Partnership Malvern Health Centre Merstow Green Medical Practice Mortimer Medical Practice Much Birch Surgery New Barn Close Surgery New Court Surgery New Road Surgery, Bromsgrove New Road Surgery, Rubery Northumberland House Surgery Nunwell Surgery Ombersley Medical Centre Pendeen Surgery Pershore Medical Practice Riverside Surgery Ryeland Surgery Salters Medical Practice Severn Valley Medical Practice Spa Medical Practice Spring Gardens Medical Practice St Johns House Medical Centre St John's Surgery St Martins Gate Surgery St Saviours Surgery St Stephen's Medical Partnership Stanmore House Surgery Stourport Medical Centre Tenbury Surgery The Bridge Surgery The Dow Surgery The Ridgeway Surgery The Surgery Kingstone Thorneloe Lodge Surgery Upton Surgery Wargrave House Weobley & Staunton on Wye Surgeries Whiteacres Medical Centre Winyates Surgery Wolverley Surgery

Award Detail

Award Criteria

CPV Codes

• 85121000 - Medical practice services
• 85121100 - General-practitioner services

Indicators

• Award on basis of price.

Legal Justification

This is a Provider Selection Regime (PSR) confirmation of contract award notice. This contract has been awarded under the Health Care Services (Provider Selection Regime) Regulations 2023 Direct Award Process B. For the avoidance of doubt, the provisions of the Public Contracts Regulations 2015 do not apply to this award.

Other Information

This is a Provider Selection Regime (PSR) confirmation of contract award notice. This contract has been awarded under the Health Care Services (Provider Selection Regime) Regulations 2023, Regulation 8. For the avoidance of doubt, the provisions of the Public Contracts Regulations 2015 do not apply to this award. The Local Enhanced Service Contracts were approved at the meeting of the NHS Herefordshire and Worcestershire Integrated Care Board Strategic Commissioning Committee on 13th March 2024. A declaration of interest register was circulated to Strategic Commissioning Committee members, with no further declarations or conflicts raised during the meeting. The meeting was confirmed as quorate. For the purposes of this notice, a value must be inputted at Section V.2.2. however, this is superseded by the information stated in Section II.2.4.