Agenda item

Report of Head of Quality and Efficiency

Steve Oakley, Head of Quality and Efficiency, presented the report of the Director of Public Health. A number of contracts will expire in April 2015, and preparation for procurement needs to start now. Flexibility will be built into any contract planning, such as shorter notice periods, to reduce any risk associated with the possibility of budgets being reduced.

RESOLVED to:

(1)  approve the procurement of those services outlined in tables A and B in exempt appendix 1, in line with Nottingham City Council procurement procedures;

(2)  approve the procurement of the Locally Commissioned Public Health Services outlined in table C, exempt appendix 1, in line with Nottingham City Council procurement procedures;

(3)  delegate authority to the Director of Public Health, in consultation with the Portfolio Holder for Adults, Commissioning and Health, to agree the final values and award contracts for the services listed in tables A, B and C, exempt appendix 1, up to the maximum values indicated;

(4)  delegate authority to the Head of Quality and Efficiency to sign the final contracts and contract extensions in respect of all services detailed in tables A, B and C, exempt appendix 1, following approval by the Director of Public Health to the agreed contracts;

(5)  approve the budget to support the contractual values set out in exempt appendix 1. If the contractual values exceed the indicative maximum values, a separate report will be presented to the Executive Board Commissioning Sub-Committee for approval.

Reasons for Decision

(1)  The Public Health contracts listed in exempt Appendix 1 Table A, are due to expire on 31 March 2015, but do not have an existing option to extend.  It is recommended that these contracts are re-procured on a time limited basis in order to ensure citizens can continue to access services, while longer term commissioning strategies are finalised. The exempt appendix sets out the rationale for re-procuring each service, along with details of the proposed maximum service values, contract duration and details of potential efficiencies. It is envisaged that the re-procurement of services listed in exempt Appendix 1, Table A will commence during quarter 3, so that it can be completed in time for new contracts to be in place from 1 April 2015.

(2)  It is recommended that the Public Health contract detailed in exempt Appendices 1 Table B, which is also due to expire on 31 March 2015, but does have an option to extend is also re-procured on a time limited basis.  In this instance work to release efficiencies is more advanced and extensive remodelling is not required. It is also best practice to test the market through an open tender process, unless there are clear circumstances that prevent this. Table B sets out the rationale for re-procuring the service, along with details of the proposed maximum service values, contract duration and potential efficiencies. Again it is envisaged that the re-procurement will begin in quarter 3, so that it can be completed in time for a new contract to be in place from 1 April 2015.

(3)  For 2014/15, Locally Commissioned Public Health Services contracts for a number of sexual health services were directly awarded to General Practitioners and community pharmacy providers. Previously known as Locally Enhanced Services, these contracts offer citizens easy open access to a range of sexual health and contraception services. For 2015/16 and 2016/17, it is recommended that an accreditation type procurement exercise is undertaken. It is envisaged that the re-procurement of services listed in exempt Appendix 1, Table C will commence during quarter 3 and be completed in time for new contracts to be in place from 1 April 2015.

(4)  General Practitioners and community pharmacies are important providers of demand led community based primary care services. There is good evidence that open access to sexual health services is important to address identified public health needs across Nottingham City.  In particular, the LCPHS contracts enable front line providers to help address the high rates of sexually transmitted infections in the City and reduce further transmission.  As well as ensuring easy access within local communities, the services offer the additional benefit of building on well-established and trusted relationships between citizens and their local GP and community pharmacists.

Other Options Considered

(1)  Decommissioning all services in exempt Appendix 1 Tables A, B and C, on expiry of the contract dates. This would provide no continuity of service and would not be in the best interests of citizens. A range of services, essential to addressing health inequalities and meeting the health priorities set out in the both Nottingham Plan and the Health and Wellbeing Strategy, would be lost. The local authority also has a specific mandatory responsibility to ensure that a comprehensive programme of sexual health services is provided. The contracts detailed in exempt Appendix 1, Table C offer a relatively low cost alternative to the Genitourinary Medicine service provided by Nottingham University Healthcare Trust. Any reduction in activity is likely to lead to increased take up of more expensive provision. For these reasons, this option was rejected.

(2)  Extending the contracts in exempt Appendix 1 Tables A, B and C rather than re-procuring them for a further year. It is considered important to test the market through an open tender process, unless there are clear circumstances that prevent this. Dispensation from financial regulations would be required for a one year extension and would not ensure best value. For these reasons, this option was rejected.