Health services

Tender description

City and Hackney CCG are implementing a transformational programme in the provision of lymphoedema/wound care services locally. The focus of this transformational programme is to deliver specialist care in the community with an emphasis on prevention, early intervention, joint working and care planning. A primary aim for City and Hackney CCG is to provide treatment for lymphoedema closer to the homes of patients. In order to achieve this, the provider is required to work closely with commissioners, health services, social care services and other local care services. The provision of the lymphoedema service, the dressing optimisation scheme, the garments made easy service, and complex wound care are a key part of this local transformation. City and Hackney CCG is considering awarding the contract for these services to accelerate CIC from June 2020 under regulation 32(2)(b)(ii) and 32(2) (c) of the Public Contracts Regulations 2015. Accelerate CIC have provided the lymphoedema/wound services in City and Hackney since 2014. Wound and lymphoedema services to be procured The lymphoedema service provides specialised clinical care for lymphoedema patients in the community for City of London and Hackney. The lymphoedema service will provide the following kinds of support for lymphoedema patients: • supporting self-care, • long term management, • intensive treatment/complex case management. The total caseload is expected to be approximately 700 patients per annum, including those supported with compression garments and self-care. The service model includes a lead nurse supervising 3 lymphoedema specialists. The service provides direct patient care in clinic and at patient homes- working to de-escalate patient care needs. It also works as a leader for lymphoedema care engaging and training local partner organisations in best practice lymphoedema management to support care in the community. The provider will need to work in partnership with local health and care organisations to ensure that lymphoedema care/management is optimised. The value of this part of the contract is GBP 230 000 per annum. Dressing Optimisation Scheme (DOS) City and Hackney CCG will commission a provider to manage a centralised dressing store to coordinate and streamline the provision of wound care products in the City of London and Hackney. The provider of the DOS will place orders with an agreed dressings supplier (currently NHS Supply Chain) through a web-based online ordering platform, to supply an adequate range and quantity of wound care products from within the City and Hackney and Homerton Community Health Services Wound Management Guide and Preferred List of Dressings (the ‘Formulary’). This service is required to be available to all patients accessing wound care services through GP surgeries, district nursing, venous leg ulcer clinics, tissue viability service, and nursing homes within City and Hackney, who are registered to a City and Hackney GP. The dressing optimisation scheme will also be how self-managing patients will access care and dressings. The service will need to give advice on dressings and deal with any issues that clinicians encounter in accessing dressings via the service. The value of this part of the contract is GBP 48 000 (including VAT) per annum. Garments Made Easy Service (GME) This service will manage the procurement of hosiery and other compression garments for patients managed by the lymphoedema Service. This will ensure: faster provision for the patient; the standardisation of certain supplies; a reduction in clinician time spent prescribing compression garments; and improved management of lymphoedema through more accurate provision managed by specialists. The value of this part of the contract is GBP 30000 (including VAT) per annum. Complex wound care pilot This service will provide complex wound management for patients referred by GP, community nursing, the tissue viability service and secondary care. The service provides initial wound assessments, wound reviews and gait assessments. The patient cohort will be those with sufficient complexity that intensive specialist input is required- typically they will be in a worsening state and need intensive support. These will be offered in a clinic setting or at home. They will be undertaken by a single specialist or in complex cases by a multi-disciplinary team- dependent on the complexity of the presenting patient case. The CCG projects there will be 225-275 patient contacts per annum. The value of this part of the contract is up to GBP 45 000 per annum. Rationale for plan to award services to accelerate CIC The CCG believes that Accelerate Community Interest Company, which was established specifically to deliver these types of services in East London, has strong links with local: health, social care, community and third sector organisations. This enables it to deliver services in an integrated way and provide holistic care that meets the needs of local patients. Accelerate CIC has a caseload of patients which, on average, have courses of treatment which last for 2 years. The CCG believes that a change of provider would disrupt continuity in care for these patients. The CCG believes that this would be to the detriment of patient care. The caseload of the lymphoedema Service is also projected to grow in the coming months. The CCG believes that to introduce a new provider would hamper the ability of the service to take on new patients. The CCG also believes that the health risk of Covid-19 makes it a very challenging time to change providers- given the other pressing priorities for the local health system. The commissioned package of services is a unique combination of services consisting of: lymphoedema long term management, supported self-care, dressing optimisation, compression garment provision and tissue viability services which have been locally developed in East London to meet the needs of local patients. The combination of these services allows for efficiency and expertise to be centralised and delivered for the CCG at a competitive price. The CCG believes that there are no other local providers that can deliver this combination of services as efficiently for local patients. The incumbent provider operates from premises in the local area which are co-located with local NHS providers and has established links with local hospitals and specialised services. The CCG believes that even where a provider already has these services at another site/s, mobilising them in the CCG area would be too time intensive and would be to the detriment of existing working relationships with other local services. Working relationships with other local partners are particularly important currently with the development of the local provider Alliance. All providers are also struggling with capacity due to the impact of Covid-19 and would struggle to engage in developing a relationship with a new provider in the short-medium term. Services are to be provided for patients who are registered with a City and Hackney GP.