Medical practice and related services

Tender description

NHS Gloucestershire Clinical Commissioning Group (GCCG) is responsible for commissioning Improved Access (IA) to primary medical services. By this PIN GCCG signals its intent to award contracts for these services for 2019-2022 (with an option to extend for a further period of 2-years) to its 76 General Practices (working collaboratively within 14 established GP clusters) and GP membership organisation which comprises all 76 GP providers without further publication, unless expressions of interest are received from alternative economic operators in response to this PIN. Gloucestershire is a mainly rural county with a population of circa 645 000. At present individually designed pilot schemes are being delivered within GP clusters working at scale to provide their population with IA to primary care services. These models are tailored to the needs of their patients and geography. GCCG considers that the GP practices will be most capable of delivering IA to meet the needs of their patients. Gloucestershire CCG has a Primary Care Strategy that supports the General Practice Forward View (GPFV) in developing general practice to work at scale. Improving Access is seen as a key enabler to deliver the sustainability and transformation of primary medical services through services being delivered in an integrated way at scale and based around established GP clusters. The Gloucestershire GP clusters are well established with full engagement of their GP practice members, meeting regularly and led by GPs working in close collaboration with the GP membership provider organisation. Many GP clusters have engaged new skill mix within their delivery models. GCCG wishes to commission Improved Access primary medical services which form part of a fully integrated primary care service which builds on existing strong primary care performance an established / integrated links to other NHS and private sector healthcare services in the county. It is envisaged that the delivery model will be based around the existing GP clusters. The national and local core requirements of the Improved Access service are: — delivering additional GP appointments to meet the national core requirements within the established GP clusters with wide geographical coverage for the purpose of maintaining good equity of access. The additional patient appointments will be from 18:30 to 20:00 Monday to Friday and 8:00 to 20:00 on Saturdays and Sundays with additional cover on Bank Holidays. In addition to the core requirements of 30 minutes per 1 000 rising to 45 minutes and 1,5 hours GP appointments each weekday evening the existing models have been challenged to deliver more appointments across the day using new ways of working and to support the development and resilience of primary care working at scale, — ensuring equity of access to services is critical. Most of the current pilot delivery models have rotational hubs for GP clusters using existing GP practice premises and existing reception staff, — all appointments held during the evenings, weekends and Bank Holidays must have GP appointments available. Appointments are for a maximum of 15 minutes and a mix of pre-bookable routine appointments with access to the patient record and urgent appointments. The current staffing model mainly uses existing partners and salaried GPs giving continuity of care for patients, supported by other skill mix during the day, — patients are offered appointments on an equal footing through their GP registered practice accessing a shared booking system, — engaging with individual GP practices Patient Participation Groups and using patient surveys to develop the IA model and meeting with other primary medical service providers within the locality to share best practice and new ways of working in line with the GPFV strategy. The GCCG considers that GP providers and the GP membership organisation in Gloucestershire are likely to be most capable of meeting the above requirements. Therefore, unless expressions of interest are received from alternative economic operators in response to this PIN, GCCG intends to negotiate with and award contracts to the GP practices and GP provider organisation as described above. If expressions of interest are received, GCCG will likely run a competitive process and would issue a Standard Selection Questionnaire to those providers who express an interest in response to this PIN. Should a competitive process be run, the award criteria for determining the successful provider(s) are likely to be based on the topics detailed in section II.2.5) below. In terms of procedure, the competition may have some features which are similar to the restricted procedure (as indicated in IV.1.1) below), however, as the services in question are light regime services GCCG is not bound to follow any specific procedure. Further details of the competitive process, including the award criteria, will be confirmed in the event that a competitive process is required.