NHS Leeds West CCG Governing Body Meeting

Transcription

1 Agenda Item: IFI2 FOI Exempt: N NHS Leeds West CCG Governing Body Meeting Date of meeting: 27 January 2016 Title: Summary of Procurement Activities Plan for 2015/16 Lead Governing Body Member: Susan Robins, Director of Commissioning, Performance & Strategy Category of Paper Tick as () Report Author: Helen Lewis, Head of Acute Provider Commissioning Reviewed by SMT: N/A Reviewed by Committee: N/A Checked by Finance: N/A Decision and Approval Information Discussion Approved by Lead Governing Body member (Y/N): Y Strategic Objectives that this report relates to Tick as () 1. To tackle the biggest health challenges in West Leeds, reducing health inequalities 2. To transform care and drive continuous improvement in quality and safety 3. To use commissioning resources effectively 4. To work with members to meet their obligations as clinical commissioners at practice level and to have the best developed workforce we possibly can Joint Health & Wellbeing Strategy Outcomes that this report relates to Tick as () 1. People will live longer and have healthier lives 2. People will live full, active and independent lives 3. People will enjoy the best possible quality of life 4. People are involved in decisions made about them 5. People will live in healthy and sustainable communities Assurance Framework - to which risks on the GBAF does this report relate? N/A 1

2 EXECUTIVE SUMMARY: BACKGROUND 1. In January 2015 the Governing Body reviewed the NHS Leeds West Clinical Commissioning Group (CCG) procurements undertaken in 2014/15 and approved a forward plan for procurements for 2015/16. The purpose of this paper is to update the Governing Body on the progress on these pre-agreed procurements and to indicate the draft programme for 2016/17 2. UPDATE ON 2014/15 PROCUREMENTS and 2015/16 MOBILISATION Diagnostic Imaging, endoscopy and gastroenterology: 3. We procured these services in 2014/15 to replace capacity lost to the system at Eccleshill Treatment Centre. Mobilisation began in the Autumn of 2014 and this has continued with services being mobilised across Leeds through the year. The procurement has enabled a wider number of locations for Leeds residents for MRI, Ultrasound and Endoscopy. Vasectomy 4. This AQP procurement formalised previous historic arrangements with a number of GP providers and introduced two new providers to the Leeds area. All providers are now mobilised and operational. Excision of low risk Basal Cell Carcinomas (BCC) 5. This procurement was to create additional community capacity for the identification and excision of low risk basal cell carcinomas, to help reduce waiting times for these patients and free up hospital capacity for higher risk cancers. Three providers were qualified to provide the service subject to completion of training. One of these providers is commencing service January 2016 and the other two are now trained and preparing to provide the service. Consultant led Community Ophthalmology 6. This AQP procurement replaced the AQP contract which expired on 31 st March A revised service specification was drawn up with input from all existing providers which included a tighter requirement for consultant input and participation in a Consultant Led Ophthalmology Delivery Network (CLODN). The service commenced 1 st April 2015 for existing providers and introduced three new providers to the Leeds area, one of which has yet to mobilise. Consultant-led Community ENT and Adult Hearing Loss Services 7. This AQP procurement replaced the AQP contract for ENT services which expired on 31 st March 2015 and introduced an integrated consultant led ENT and Adult Hearing Loss Service (hearing aid assessment, fitting and aftercare) in community 2

3 settings. The service commenced in 1 st April 2015 for existing providers and introduced two new providers to the Leeds area, one of which has yet to mobilise. The procurement attracted two providers who are now providing a full Adult Hearing Loss service from a number of locations in Leeds thus expanding choice of location for hearing aid services. Community Chronic Pain Management services 8. This AQP procurement replaced the AQP contract for Chronic pain Management services which expired on 31 st March 2015 and allowed for material changes to be made to the service following extensive clinical consultation. The revised services commenced on 1 st April 2015 with two providers. Stroke follow up service 9. This single tender procurement secured a city-wide provider to carry out six month reviews for stroke patients in line with national best practice guidance for CCGs and to deliver a CCG outcomes framework measure. The service commenced in early 2015 and early evaluation has determined that there was not a previously unmet need in stroke follow up services. As a result this service is unlikely to be reprocured on termination of the current contract, but we await the final evaluation in the summer of UPDATE ON THE 2015/16 FORWARD PLAN Minor Surgery Services 11. A review of minor surgery services was undertaken during Quarter 1 and the service specification was revised. The advertisement was published 17 th July 2015 with providers being qualified at the end of September Services under this contract commenced on 1 st October 2015 for existing providers with new providers commencing mobilisation in January No formal patient engagement was required as this was to formalise existing contract arrangements. Community Benign Gynaecology Services 12. Following the review undertaken by NHS Leeds South and East Clinical Commissioning Group (CCG) a workshop was held to address a number of themes which had emerged from the review. Work is now focusing on full implementation of current pathways aiming for standardisation of referral pathways. This will produce efficiencies and smoother flow for patients. The acute and community teams have agreed to work across organisational boundaries. Further patient engagement work is progressing. No decision re future re-procurement has been made. Consultant led Community Services 3

4 13. Some Urology, Cardiology and Paediatric services are provided in the community by single providers. These services are subject to city-wide discussion and agreement on a way forward Podiatric Surgery 14. Currently there is one provider for podiatric surgery outside of the hospital providers both NHS and Independent. The current activity levels are low, but the capacity that is available offers further patient choice and additional resources when waiting lists at other providers start to lengthen. The next step in determining whether to reprocure will be subject to city-wide discussion and agreement. Other Community Provided Services 15. The other remaining services that have not yet been formally procured or had a governing procurement waiver are: Termination of Pregnancy services There are currently two providers within the Leeds area who provide this service out of hospital. The hospital providers do not routinely provide this service for non-complex cases and there are no other providers currently in the market. 16. Outpatient Physiotherapy - Decisions on the physiotherapy service needs further discussion with NHS Leeds South & East CCG who are currently completing a review of the physiotherapy services provided by Leeds Community Healthcare who provide the vast majority of these services in the City /17 FORWARD PLAN Consultant-led Community Dermatology 18. The service will undergo a review in Quarter 1 prior to going out to procurement in the latter half of The current AQP expires 31 st March Tier 3 Weight Management Services 19. Work has been ongoing to design a NICE compliant Tier 3 weight management service which integrates with services commissioned by Public Health for Tier 2 weight management and provides a genuine weight management experience prior to any patient being considered for Tier 4 Bariatric Surgery. It is anticipated that service specifications (for both Tier 3 and Tier 4 services) and pathways will be completed by the end of Quarter 1 and procurement will be undertaken in Quarter 2. 4

5 Gastroenterology/Endoscopy/Radiology 20. With increased demand and emphasis on cancer pathways it is envisaged that there will be an impact on diagnostic services. The contracts and the qualification for the providers of Endoscopy and Radiology expires in July A review of cancer diagnostic services is underway and the intention is to utilise the review to underpin the procurement of diagnostic services. It is anticipated that new service specifications will be prepared and a decision made on the preferred procurement option by the end of Quarter 2 with procurement being undertaken in Quarter EQUALITY IMPACT ASSESSMENT 22. The service reviews already undertaken and the contracts let in 2014/15 and 2015/16 require all providers to take into account the need to reduce inequalities of access and outcome. All providers are bound by the national requirements on equality and diversity through the NHS Standard Contract for Healthcare Services. The patient engagement exercises undertaken were structured to try to particularly capture the views of under represented groups. Future service reviews will similarly be structured to identify the needs of those groups who are known to have poorer access to services or worse health outcomes. 23. FINANCIAL IMPLICATIONS AND RISK 24. The budgets for the re-procured services and those to be re-procured are already within the financial plans for 15/16 and 16/ The budget for the Tier 3 weight management service will be subject to re-allocation across the system following the design of the pathway. Tier 4 provision will be dependent on allocations being returned from NHSE which once known will determine the specifications and eligibility criteria. 26. RECOMMENDATION: 27. The Governing Body is asked to note the progress on the procurements and mobilisation in 2014/15 and 2015/16 and the outline procurement plan for 2016/17. The Governing Body is asked to: NOTE the progress on the procurements and mobilisation in 2014/15 and 2015/16 and the outline procurement plan for 2016/17. 5