Current and Recent MSK and Related Commissioning Activities: NHS Luton Clinical Commissioning Group

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1 Current and Recent MSK and Related Commissioning Activities: NHS Luton Clinical Commissioning Group The MSK Service should manage all MSK referrals and if referral criteria are not met, support the upskilling of GP practices accordingly. Clinically appropriate referrals will be triaged to physiotherapy, other procedures (such as joint injection), extended-scope physiotherapy assessment, orthopaedic surgeon assessment, pain clinic or other relevant services as appropriate, all in the community setting. The MSK Service should also integrate with local primary care clinicians who provide services such as joint injections, in the interest of enhancing the choice, convenience and flexibility available to patients. Patients deemed to potentially require surgical management should be seen in the community setting by an orthopaedic surgeon, directed as appropriate to relevant services to optimise post-operative outcomes, and then directly listed for surgery (in accordance with local policies and guidelines), with follow-up in the community. The integrated MSK Service should allow movement of patients seamlessly from one element to another, streamlining the experience for patients and reducing unnecessary waiting and inefficiency. The MSK Service should not be limited to treating patients, but also must be committed to empowering the population to self-care for their MSK issues and share responsibility of the management of their conditions, with a focus on education and lifestyle modification, as well as making effective use of local services such as Live Well Luton. Estimated cost excluding VAT: 6,500,000 Nottingham City CCG Orthopaedic ICATS Nottingham City CCG invites offers from suitably qualified and experienced providers of Integrated Clinical Assessment and Treatment Services (ICATS) to the Patient population of Nottingham City. The service will provide a comprehensive orthopaedic patient management service for Nottingham City GPs covering; Triage to the most appropriate secondary care or community service. Assessment and treatment. Ordering of x-rays and MRI where these haven t been ordered by the referring GP. Coordination of orthopaedic pathways. Supporting and educating GPs with the management and diagnosis of orthopaedic conditions. The orthopaedic ICATS consists of the following service elements; 1. The low back pain pathway consisting of Triage service Integrated Clinical Assessment and Treatment Service (ICATS) Case conference 2. Orthopaedic triage service 3. Hip and knee ICATS 120K to 300K. The estimated length of contract is 3 years with the option to extend for up for up to an additional 2 years (1 year + 1 year). 1

2 Merton Community Health Services NHS Merton Clinical Commissioning Group (MCCG) and London Borough of Merton (LBM) wish to engage with prospective providers who are interested in tendering for the provision of Community Health Services within the borough of Merton. The service is to be delivered on behalf of all Merton registered patients. Community health services included are, Community nursing including night nursing and tissue viability, Specialist nursing heart failure, respiratory, continence, HIV, Parkinson s, Diabetes service (nursing, dietetics and podiatry), End of life nursing, Adult rehab services including Holistic Assessment Rapid Investigation( HARI), Community Prevention of Admissions Team (CPAT), neuro rehab and community physiotherapy, Specialist children s services including therapies, SALT and children s specialist nursing, Children s community nursing, Children s safeguarding, Cedar Lodge (children s residential respite and outreach service), Outpatient physiotherapy and MSK services, Community podiatry, Podiatric surgery, Dysphagia service for people with learning disabilities, Falls prevention service, School nursing, Community dietetics (NB tier 3 under discussion around transfer back to the CCG), Contraceptive and sexual health services and Health visiting. Contract Term: 5 years with the option for a further 2 years. Estimated annual: 14.1 million (current 2014/15) Estimated Contract Value: 70.5 million million Location where the contract is to be carried out: Merton Name of the buying organisation: NHS Merton Clinical Commissioning Group. Sunderland CCG Integrated Musculoskeletal Services The purpose of this specification is to set out the requirements for a community-based MSK clinical assessment and treatment service. The integrated service will include community assessment and treatment service offering joint injections and patient self-management, community physiotherapy and integration with Secondary Care services including, Trauma and Orthopaedics (T&O), Rheumatology, Pain Management and Podiatry. It is expected that patients and GP Practices will benefit from the introduction of training and education, advice and guidance and access to other relevant services, such as psychology, at an earlier stage to improve social functioning and life management skills. The service will be an interface service providing a single point of access with triage for referrals for all types of MSK assessment, treatment, management and onward referral to Secondary Care and other relevant services. Barking and Dagenham, Havering, Redbridge and Waltham Forest CCGs Elective Care Services are currently provided by Care UK at the North East London Treatment Centre (NELTC), which is located within the grounds of King George Hospital, Barley Lane, Goodmayes, Essex, IG3 8YB. They currently provide day case, in-patient surgery and diagnostic procedures for the following specialities: orthopaedics, ophthalmology, general surgery, gastroenterology and ENT. However, there is an interest in exploring the potential for some outpatient initial assessment and follow up appointments to be provided more locally in each CCG area, to enable greater patient access. The above are in relation to the following specialities to be procured: ENT; Gastroenterology; Gynaecology (new); General Surgery; Ophthalmology; Trauma and Orthopaedics; Urology (new). Estimated Contract Value per annum: between 9,300,000 and 11,700,000. 2

3 NHS Herefordshire Clinical Commissioning Group NHS Herefordshire CCG Enhanced Services. ('the CCG') is seeking to procure primary medical services which have hitherto been delivered in Primary and Community Care settings via the mechanism of Enhanced Service (ES) schemes. Following a recent review of all of its existing ES schemes, the CCG has concluded that these are of sufficient clinical benefit and value for money to continue, however also require some amendments to increase their effectiveness. Therefore, the primary medical schemes listed below shall be tendered and shall be contracted using methods which shall provide the CCG with the greatest quality outcomes and value for money: Community Anticoagulation Service; Community Dermatology Service; Community Insulin Start and Review Service; Community Leg Ulcer Healing Service; Community Deep Venous Thrombosis Service; Community Musculoskeletal Service; Community Patient Safety and Medicines Monitoring Service. CPV: 85,000,000. NHS North Lincolnshire Clinical Commissioning Group The NHS Lincolnshire Clinical Commissioning Groups are seeking to extend the current provision of Community Surgery services. Please note that under Any Qualified Provider contracts there will be no guarantees of volume in the contracts awarded. Further, prices (e.g. hourly rates) are set. The aims of the service is to provide an accessible, comprehensive and confidential assessment, treatment and triage service for certain conditions which can be treated in a safe and effective way via surgery in the community for all patients over the age of 16. The service will cover a range of specialties including orthopaedic, dermatology, ophthalmic, general surgery, podiatry, gynaecology and urology. North West Surrey Clinical Commissioning Group Patients over 18, Elective MKS conditions, Chronic pain services, Rheumatology, MSK imaging including ultrasound and MRI, MSK related plastic surgery, Podiatry, Orthotics, Short term equipment MSK related, Patients that are past the trauma, Post Urgent care centre attendees with and MSK condition, Occupational Therapy, Psychological behaviour therapy relating to the In-Scope services, MSK physiotherapy, MSK referral management centre / Single point of access for all imsk referrals, Medicines relating to In-Scope services, IFR process for In-Scope services in line with the CCG processes, Outpatient Physiotherapy and Domiciliary Physiotherapy, All Rheumatology services, including (but not limited to) the current Spinal Service, outpatients, elective inpatient admissions, procedures and interventions, All Chronic Pain services, including (but not limited to) outpatients, elective admissions, procedures and interventions including pelvic pain, neuropathic pain services, Elective Orthopaedics, including (but not limited to) outpatients, elective admissions, elective surgery, procedures and interventions, Medicines management (except PbR-e), In-patient physiotherapy and post-op rehabilitation and physiotherapy, Psychological services related to pain services. Contract is of the order of 120 million to 140 million over 5 years. NHS Sutton CCG Sutton Community Services will have the following main features: Easy access to community health services Specialist input for long term conditions in the community that is integrated with the locality teams Well-coordinated and joined up care Localised integrated care that enables 3

4 complex case management Rapid response to admission avoidance service, intermediate care and supported discharge Facilitates seamless flow between planned and unplanned care. Community health services included are: Planned Locality Services: Adult Community Nursing including Continence, End of life nursing, HIV, IV antibiotics. Specialist Nursing including Diabetes, Heart Failure and Respiratory. Dietetics, Speech & Language therapy, Neurological Rehabilitation & Early supported discharge for Stroke patients and Community Rehabilitation Service (including Physiotherapy and Falls Prevention) Planned Clinic services: Community Heart Failure Nursing, Community Podiatry, Community Podiatry Surgery, Diabetes Intermediate (tier 3), Dysphagia for adults with Learning Disabilities, Parkinson s Specialist Nursing, Musculoskeletal service, Outpatient Physiotherapy, Specialist Community Respiratory service and Older Peoples Assessment & Rehabilitation Service (OPARS). Unplanned and Supported Discharge Services: Emergency Department Rapid Response, Community Prevention of Admission Team, Intermediate Care service. Children s services: Children s therapy (Physiotherapy, Occupational Therapy, Speech & Language therapy and dietetics), Specialist Children s Nurses Service (LAC- Special schools), Cedar Lodge residential respite and outreach services. Contract value: 14,000,000 per annum. Cardiff and Vale Health Board Physiotherapy contract The provider must provide appropriately qualified, skilled and experienced GPs to see and treat chronic shoulder problems, knee problems, and sports exercise related injuries. The provider must also triage all referrals identified by the Cardiff and Vale UHB clinical referral centre The MSK Care Pathway has been reviewed and agreed and the model for funding the new regime is to be completed. It is clear that an integrated approach to include a single point of access will provide a better and holistic pathway for patients with an MSK condition (spinal and hand pathway excluded), and developing and implementing this work is being led by an integrated approach between the PCIC and CD&T Clinical Boards. The preferred model is to develop a multidisciplinary triage and treatment clinic to include a GP with a specialist interest, physiotherapist and podiatrist in the community setting with the following objectives: Surgery: Implement standard 6 hour treatment for ankle fractures Introduce primary care OT led hand service Redesign orthopaedic services and with use of virtual clinics and primary care hand OT service Redesign surgery services including SAU model; day of surgery admission as norm; direct listing for minor cases and appraise intestinal failure service. Redesign urology services including day of surgery admission; hot clinics; one stop PSA clinics and facility for flexicystoscopies. Redesign ENT services including development of decontamination unit; non-medical follow ups and day of surgery discharge. Redesign ophthalmology service including glaucoma ODTC; nurse led out-patient cataract service and improved management of lists 4

5 Ipswich and East Suffolk Clinical Commissioning Group Commission Any Qualified Provider (AQP) Community Physiotherapy Service. The service shall cover the range of MSK problems common to primary care. These include for example, but are not limited to: Upper Limb: Hand & Wrist, Elbow, Shoulder, Back & Neck (mild/moderate), needs arising from generalised Rheumatological conditions, Lower Limb: Foot and ankle, Knee, Osteoarthritis (OA), Hip, needs arising from generalised Rheumatological conditions The service will provide triage, assessment and management for all patients registered with an I&ESCCG GP practice and for all those the Clinical Commissioning Group is responsible for under the Who Pays guidance. North East Lincolnshire Clinical Commissioning Group A Provider Framework Approach, to appoint multiple organisations capable of delivering the specified service to the locality and offer a choice for referring GP's and their clients. The provider/s will need to deliver a robust, dynamic and flexible community MSK physiotherapy service which not only offers the best clinical treatment in line with all relevant guidelines and standards, but also emphasises the importance of self-management, equipping people to manage their own condition where possible. The promotion of independence & wellbeing is paramount. NHS Vale Of York Clinical Commissioning Group This procurement exercise is for the provision of an Elective Orthopaedic Service delivered from Clifton Park Hospital. The aims of the elective orthopaedic service for adults are to provide a sustainable, evidenced based, high quality, value for money service to adult NHS patients, supporting the 18 week waiting time target, providing patient choice and diversity, and promoting affordable innovative service models. As a minimum requirement the Provider will be expected to deliver, an easily accessible range of Orthopaedics Elective Care services. Estimated value excluding VAT: 50,000,000 NHS East Sussex Clinical Commissioning Group This notice relates to the procurement of a Fracture Liaison Service on behalf of NHS Eastbourne Hailsham Seaford, NHS Hastings and Rother and NHS High Weald Lewes Havens CCGs. Objectives and core activities of the FLS To develop appropriate processes and pathways to ensure routine and systematic case finding, assessment and treatment (as appropriate) of eligible patients at high risk of future fragility fracture and most likely to benefit from treatment.to develop individual treatment and management plans in partnership with every assessed patient and their GP, To initiate treatment, including suitable pharmacological and non pharmacological interventions, and/or support review and optimisation of existing medication as appropriate.to provide advice and guidance to patients and health and social care professionals working with individuals at risk of fragility fracture on interventions to modify and reduce future fracture risk, support self-management and on leading healthier lifestyles Contract value is 330, ,600 5

6 Portsmouth, Fareham and Gosport and South Eastern Hampshire Clinical Commissioning Groups To deliver to patients and referring GPs, a broad range of planned elective surgical and diagnostic services that are fully consistent with the requirements of the NHS Constitution (March 2013). The key Service elements include but are not limited to: Diagnostic Service Outpatient Services Day Case Procedures Minor Injuries Unit Minor Ailments Service To ensure the Services meet the needs of patients, carers and referring clinicians across the local health economy, the following are regarded by the Commissioners as being key objectives for the successful Bidder. It is anticipated that the Services will be delivered under the following specialties: General Surgery, Dermatology (minor skin procedures), Ophthalmology, Gastroenterology, Non Trauma, ENT, Orthopaedics, Urology, Gynaecology and a Walk in Centre. The Services will also include the provision of Advice and Guidance to referring General Medical Practitioners, Optometrists and General Dental Practitioners upon their request. The Services will be provided from St Mary s Treatment Centre, Oak Park Community Clinic, Chase Community Hospital, Gosport War Memorial Hospital and Fareham Community Hospital. Central London Clinical Commissioning The key conditions included in musculoskeletal (MSK) services are Community Physiotherapy Services Back Pain The non surgical management of Osteoarthritis Rheumatoid Arthritis Physiotherapy (The main stay of Rh Arthritis i.e. the prescribing of disease modifying anti-rheumatic drugs will stay with the acutes) Joint injections where indicated Muscular sprains, strains and overuse injuries. Hand Pain Ligament injuries Chronic pain management Fibromyalgia St Austell Integrated Community Elective service procedures including: General Surgery; Trauma & Orthopaedics; Gastroenterology; Ophthalmology; Dermatology; Rheumatology; Gynaecology; ENT; Cardiology; Urology. Any Qualified Provider (AQP) Hub on behalf of NHS Somerset CCG The key objective of the Contracting Authority procurement is to secure Any Qualified Providers for elective services provision for the community of Somerset in the following areas: General Surgery, including vascular, breast and colorectal surgery Dermatology Gastroenterology including Endoscopy Gynaecology Ophthalmology Orthopaedics Ear Nose and Throat Urology Cardiology. The process achieves the following key objectives: 6

7 NHS Brent Clinical Commissioning Group (CCG) Invites suitably qualified and experienced providers to participate in this procurement for the provision of Outpatient MSK Services, comprising: Community Physiotherapy services Rheumatology services Trauma and orthopaedic services; and MSK related Podiatry services The Health & Social Care Board (HSCB) Northern Ireland To procure additional Elective Orthopaedic services including outpatient assessment and follow up treatments. These services will be provided to patients who are either currently on a waiting list to have a first outpatient appointment or are post outpatient assessment, currently waiting for inpatient or day case surgery. NHS North Of England Commissioning Support Unit Provision of a Planned Elective Inpatient & Day Case Surgery and Associated Outpatient Services for NHS Patients. The list below represents the possible range of services to be delivered: Dermatology; Ear Nose and Throat; General Surgery; Gynaecology; Ophthalmology; Oral surgery; Urology; Plastic surgery; Pain management; Trauma and orthopaedics/ Musculoskeletal; Gastroenterology; Upper Gastrointestinal surgery; Maxillo Facial Surgery/Oral and Maxillo Facial Surgery; Surgical Dentistry; Anaesthetics NHS Greater East Midlands Commissioning Support Unit The aims of the service is to provide an accessible, comprehensive and confidential assessment, treatment and triage service for certain conditions which can be treated in a safe and effective way via surgery in the community for all patients over the age of 16. The service will cover a range of specialties including orthopaedic, dermatology, ophthalmic, general surgery, podiatry, gynaecology and urology. 7

8 NHS Coastal West Sussex Musculoskeletal integrated care service (includes Goring by Sea and Worthing) Coastal West Sussex Clinical Commissioning Group (CWS), has a GP registered population of 498,000, intends to seek through competition a prime provider of integrated musculoskeletal services. For the purposes of this competition a Prime Provider will be the contractual partner of the CCG that will be solely accountable for the single MSK budget, the MSK patients and the entire MSK integrated care service. The intended financial envelope over a five year period is expected in the range of 190m 215m. The contract will include an element of gain-share that will be linked to specific outcomes. The aim of the Musculoskeletal Integrated Care Service is the holistic provision of care along the entire MSK patient treatment pathway, equitably across all areas of Coastal West Sussex, specifically: A single point of access and triage for all MSK referrals; Adult community MSK physical therapies that must include, but is not restricted to, extended scope Physiotherapy, Osteopath and Chiropractor services. Community MSK service, to include as a minimum all services previously provided by the Musculoskeletal Assessment Triage Treatment team (MATT) which is a specialist MSK assessment and treatment service supporting primary care and reducing demand on secondary care. It is primarily staffed by Extended Scope Physiotherapists. Elective Orthopaedics (including elective surgery, but excluding emergency trauma care) Rheumatology (all services) Chronic Pain, which must include (but is not restricted to) medical interventions and treatment, specialist nursing, psychological therapies and support for patients to self-manage. The integrated services will be more effectively coordinated and the Prime Provider will be accountable for the entire MSK patient journey, rather than individual services taking responsibility only for their own service. This will drive an integrated joined up way of working. Range: between 200,000,000 and 250,000,000 Health And Social Care Northern Ireland Proposes to procure additional Elective Orthopaedic services including outpatient assessment and follow up treatments. These services will be provided to patients who are either currently on a waiting list to have a first outpatient appointment or are post outpatient assessment, currently waiting for inpatient or day case surgery. NHS Bradford Districts Clinical Commissioning Group Wish to tender for services at Eccleshill Treatment Centre. This includes a diagnostic service containing: CT & CT Colonography MRI Ultrasound Plain X-ray and contrast studies New and developing diagnostics as they become available The safe prescription, dispensing and administration of drugs prior to and during diagnostics. Out-patients appointments: General Surgery / Endoscopy Gynaecology Orthopaedics Plastics Surgery Urology Day case procedures which include and have been risk- assessed by the provider and agreed with the Commissioners as suitable procedures: General Surgical (but not laparoscopic Cholecystectomy) / Endoscopic procedures Gynaecology Orthopaedics Plastics Surgery Urology Additional Services may be negotiated to include Contract Value 85,100,000. 8

9 NHS High Weald Lewes Havens CCG Co-ordinated and integrated care across the musculoskeletal (MSK) pathway as a whole - orthopaedics, rheumatology, MSK pain management, physiotherapy, diagnosis and associated podiatry services. The objective of this procurement exercise is to appoint a provider (the Prime Provider) to deliver integrated MSK care. The Commissioner expects that the Prime Provider demonstrates a credible approach to engaging patients and representative groups in design and delivery of services, and fundamentally offers the best fit for delivery of integration. MSK Ambulatory Care will be provided within a hub and spoke' framework. The MSK service will deliver: Co-ordinated and integrated care across the MSK pathway as a whole (orthopaedics, rheumatology, MSK pain management, physiotherapy, diagnosis and associated podiatry services) 9