Health and social work services

Tender description

North East Essex Clinical Commissioning Group wishes to establish a single community provider contract for the provision of Carpal Tunnel Services. This will be a Community Service provided under a separate community contract. The Provider will receive all North East Essex referrals into this community service and there will be a community fixed price tariff i.e. non-Payment by Results (PbR). Referrals will be made by North East Essex GP Practices, the community physiotherapy service and the Clinical Assessment Service. In-line with the Department of Health Patient Choice Framework, as a community service is available, there will be no legal requirement for a patient to be offered a choice of provider. GP practices will make the initial assessment and provide the 1st stage of conservative treatment i.e. wrist brace (where deemed appropriate) in primary care. Practices that are clinically competent will also administer steroid injections as the 2nd stage of conservative treatment where appropriate. Practices recorded by the CCG as not being able to administer injections will refer patients to this community service for 1 course of treatment only (unless exceptional circumstances such as surgery is not an option). Following receipt of an injection, patients will be discharged back to their GP. If the GP believes that the conservative treatment has not been effective following the prescribed period, the GP may make a separate referral for decompression. On a restricted basis, if a patient has been referred for an injection, but the service feels the patient should go straight to surgery, then this will be permitted without referral back to the GP. Where following assessment by this service, the patient is found to have more complex needs and requires referral to an acute provider, this Service will make the referral and offer a choice of provider. Where this service is unable to achieve an accurate diagnosis, it may refer to secondary care for an Electromyograph (EMG) test, if required or perform the EMG test independently if competent to do so, subject to a threshold on numbers. The Community Provider will be expected to keep diagnosis via EMG tests to a minimum. GPs will not have direct access to EMG tests from acute providers, in order to reduce costs. This pathway will be supported by a local protocol for GPs with restriction criteria concerning referrals. Please refer to the CTS GP Protocol document. The CCG is seeking to commission a consistent, timely, high quality, flexible and accessible service to patients that will focus on patient outcomes. The CCG aims to commission a Community Provider that can deliver this NHS non-urgent clinical pathway through: — Clinical assessment and treatment in-line with NICE guidelines; — Accredited clinicians with established peer review programme; — Provision of appropriate CQC compliant premises and facilities; — Access to Electromyograph (EMGs) tests where further diagnosis is required; — Assessment and treatment offered in-line within defined response times; — Ability to run ad hoc clinics in a community setting for assessment and conservative treatment; — Flexible operating times that will accommodate working patients; — Increased self-management through provision of education and advice; — A robust programme of planned clinical audits to demonstrate planned cycles of continual measurement and improvement; — Package prices on a cost per case basis via a local tariff i.e. consultation, assessment, procedure and follow-ups as necessary.