Thrombotic Thrombocytopenic Purpura (TTP)

Tender description

Thrombotic Thrombocytopenic Purpura (TTP) is a serious blood disorder that results in blood clots forming in small blood vessels throughout the body. It affects the kidneys, heart and brain. If a patient is treated outside a specialist centre, mortality is 50%; in a specialist centre, it is 20%. There is also an appreciable acute morbidity, particularly in neurological disorders. The condition can be difficult to diagnose because initial presentation can be non-specific. Rapid treatment is essential for optimal outcomes and includes plasma exchange and a range of drugs. This disease primarily affects adults. Children are treated in paediatric haematology centres and are outside the scope of this process. Lot 1: Thrombotic Thrombocytopenic Purpura (TTP) – London and parts of the South East (Kent, Surrey & Sussex) TTP is a very rare, complex condition which can present as an acute life-threatening disorder that requires prompt diagnosis, early referral and effective immediate management in a centre with comprehensive provision and a multi-discipline approach. Specialist aftercare is also required. There is also a cohort of patients who have a congenital form of the disease who require ongoing apheresis (where a patient’s blood is filtered and then put back into their body). The prevalence is 330 patients in England, with an acute incidence of 150 patients. There is a very high mortality rate for patients with this disease: if a patient is treated outside of a specialist centre, the death rate is 50%. There are two centres in England where there are recognised services. The Commissioners are planning to initially enter into contract with two providers for a term of four years to provide cover for patients in (a) the North West and (b) London and parts of the South East. The reasons for this decision are: - The providers are the only two fully capable providers with recognised established services to meet the specification and will offer access to services, whilst new providers are identified through a competitive process to ensure access to services across England; - The two providers have full capacity and the necessary skills to deliver the service and have been assessed as meeting the service requirements and thus are eligible to be commissioned by NHS England and Improvement. Commissioners have undertaken a negotiated procedure without prior publication and have undertaken a due diligence assessment of the two Providers. They were required to complete a self-assessment questionnaire to ensure quality of service provision; which was approved as part of the strategic approach to commissioning these services and is in line with Commissioners internal governance mechanisms/processes to award these services. While the Commissioners are intending to award a contract for services across London and parts of the South East (Kent, Surrey & Sussex) based on the negotiated procedure without publication, they wish to seek further expression of interest, which is due to be published in February 2021, to secure provision for up to a further 7 Lots across England which includes South West, West Midlands, East Midlands, East of England, North East, Yorkshire and Humber and parts of the South East (Thames Valley, Hampshire and the Isle of Wight)*. Providers who are interested in these future opportunities will be required to register and respond separately to any future Notice as applicable, published in line with the regulations following conclusion of this notice. *Note, in securing the provision for parts of the South East, the Commissioners require the successful provider to work with the already established London provider. This will support shared care and improve local patient access to the service whilst ensuring availability of clinical expertise as appropriate. Lot 2: Thrombotic Thrombocytopenic Purpura (TTP) – North West TTP is a very rare, complex condition which can present as an acute life-threatening disorder that requires prompt diagnosis, early referral and effective immediate management in a centre with comprehensive provision and a multi-discipline approach. Specialist aftercare is also required. There is also a cohort of patients who have a congenital form of the disease who require ongoing apheresis (where a patient’s blood is filtered and then put back into their body). The prevalence is 330 patients in England, with an acute incidence of 150 patients. There is a very high mortality rate for patients with this disease: if a patient is treated outside of a specialist centre, the death rate is 50%. There are two centres in England where there are recognised services. The Commissioners are planning to initially enter into contract with two providers for a term of four years to provide cover for patients in (a) the North West and (b) London and parts of the South East across England. The reasons for this decision are: - The providers are the only two fully capable providers with recognised established services to meet the specification and will offer access to services, whilst new providers are identified through a competitive process to ensure access to services across England; - The two providers have full capacity and the necessary skills to deliver the service and have been assessed as meeting the service requirements and thus are eligible to be commissioned by NHS England and Improvement. Commissioners have undertaken a negotiated procedure without prior publication and have undertaken a due diligence assessment of the two Providers, who were required to complete a self-assessment questionnaire to ensure quality of service provision; which was then approved as part of the strategic approach to commissioning these services and is in line with Commissioners internal governance mechanisms/processes to award these services. While the Commissioners are intending to award a contract for services across London and parts of the South East (Kent, Surrey & Sussex) based on the negotiated procedure without publication, they wish to seek further expression of interest, which is due to be published in February 2021, to secure provision for up to a further 7 Lots across England, which includes South West, West Midlands, East Midlands, East of England, North East, Yorkshire and Humber and parts of the South East (Thames Valley, Hampshire and the Isle of Wight)*. Providers who are interested in these future opportunities will be required to register and respond separately to any future Notice as applicable, published in line with the regulations following conclusion of this notice *Note, in securing the provision for parts of the South East, the Commissioners require the successful provider to work with the already established London provider. This will support shared care and improve local patient access to the service whilst ensuring availability of clinical expertise as appropriate.