NHS Coventry and Warwickshire Integrated Care Board: intention to award a contract for Out of Hospital Services without further publication

Description

In 2018 the three legacy Coventry and Warwickshire CCGs, the predecessor organisations to Coventry and Warwickshire Integrated Care Board (the "ICB") recognised the benefits of introducing a lead provider approach to drive a range of benefits for the health and care system, including in relation to Out of Hospital services to deliver a clinical model where services are integrated to ensure the most appropriate care for their patient population; ensuring the reduction in duplication and where possible reduce or eliminate professional boundaries issues. The purpose of this prior information notice is to notify the market of the ICB's intention to award Lead Integrator Service contracts to the Proposed Lead Providers without a call for competition in Find a Tender (the "Proposed Contracts"). If anyone in the market believes it could deliver this service (please see scope below), they should contact the ICB using by e-mailing agcsu.southprocurement@nhs.net, within 30 days of this notice being published. The ICB will then apply assessment criteria. Criteria will be able available on request. Please see II.2.4 below for full details Lot 1: In 2018 the three legacy Coventry and Warwickshire CCGs, the predecessor organisations to Coventry and Warwickshire Integrated Care Board (the "ICB") recognised the benefits of introducing a lead provider approach to drive a range of benefits for the health and care system, including in relation to Out of Hospital services to deliver a clinical model where services are integrated to ensure the most appropriate care for their patient population; ensuring the reduction in duplication and where possible reduce or eliminate professional boundaries issues. Building on progress delivered to date via these contractual arrangements, the ICB intends to continue with this strategic direction and enhance this model, whereby Lead Providers take on an increasing responsibility for the delivering and commissioning decisions for Out of Hospital services. The ICB refers to this as a "Lead Community Integrator". The ICB has considered its obligations under the Public Contracts Regulations 2015 and NHS (Procurement, Patient Choice and Competition) (No.2) Regulations 2013 ("NHS Regulations") and has identified two Lead Providers that it believes are the only capable providers of delivering the Lead 'Community Integrator' Service and meeting the objectives under the NHS Regulations. They are: South Warwickshire University NHS Foundation Trust ("SWUFT") for Warwickshire; and University Hospitals Coventry and Warwickshire NHS Trust ("UHCW") for Coventry; (together the "Proposed Lead Providers"). The purpose of this prior information notice is to notify the market of the ICB's intention to award Lead Integrator Service contracts to the Proposed Lead Providers without a call for competition in Find a Tender (the "Proposed Contracts"). If anyone in the market believes it could deliver this service (please see scope below), they should contact the ICB by e-mailing agcsu.southprocurement@nhs.net, within 30 days of this notice being published. The ICB will then apply assessment criteria. Criteria will be available on request. The ICB believes the Proposed Lead Providers are the only capable providers because: • Under the scope of this service, the intention is for the ICB to delegate commissioning budgets and functions for Discharge to Assess and Continuing Healthcare Fastrack packages to the lead providers. Under the Health and Care Act 2022, the ICB can only delegate to NHS Trusts and NHS Foundation Trust providers. This significantly limits the market of capable providers. Across Coventry and Warwickshire there are only 3 Providers who meet this requirement and only UHCW and SWUFT wish to deliver the Proposed Contracts; • A key feature of the service specification is the ability for Lead Providers to enable total system integration across a Place footprint. Working in Partnership with the Care Collaboratives to leverage significant collaboration across Primary Care, Secondary Care, Social Care, Intermediatory Care services and local VCFSE providers. The capability to build on existing relationships with local partners would provide significant benefits in enabling the level of transformation at the pace required and delivery of the totality of benefits. • In-depth understanding of local health needs and patient behaviours will be essential to ensuring services are tailored to meet local need. An established local acute provider, with extensive operational knowledge and expertise of delivering large scale health services to the local communities identified in the specification, will be in a strong position and therefore better placed to quickly identify where things do not work well for patients or local services and transform services at the pace required to expedite the benefits to patients. • The capability to build trust and coproduce services with local communities is critical to delivery of the Community Integrator Service. An established local provider will be able to draw on existing community links and relationships, and established community engagement and involvement networks. • Lead Provider is committed to and has capability to onboard their data to the Coventry and Warwickshire 'HealtheIntent' Population Health Management platform. The use of Population Health Management data and therefore access to HealtheIntent is a highly significant element of the specification and will be essential for multi-disciplinary teams to be able to deliver the personalised care requirements • Building on the requirements to ensure patients are offered personalised care; the capability to develop truly integrated pathways of care which enable patients to be treated in line with their personal preferences, whilst managing and sharing the clinical risk across services is essential. Consolidation of Acute and Community services under a single organisation, and therefore a single clinical governance framework will support a more responsive patient-centred approach as there is no requirement to seek consensus between two providers. Local Acute Providers are uniquely placed to develop blended workforce models utilising current IT and operational infrastructure that allow different parts of the system to work cohesively, and thus maximise the range of the service offer within the fixed financial envelope. • Similarly, the capability to leverage the fiscal shift from hospital-based services to a more preventative and proactive care model, whilst managing the potential financial risk this could expose individual services or organisations to in the short term will be crucial. • Consolidation of acute and community resources under a single organisation supports an integrated model of patient care which reduces waits and duplication because there is one provider overseeing all demand and capacity. The capability to flex capacity across the services, particularly during periods of system pressure, brings the added benefit of ensuring the system resilience and patient safety. Scope The following services will be in scope of the Proposed Contracts. The Lead Provider will be responsible for determining the range of services required, and how they are delivered to achieve the contract outcomes. This will include the delivery and commissioning of the services listed below, including subcontracting services to other providers where they are best placed to provide some of those services. As such the Lead Provider must be able to demonstrate an understanding, capability and compliance with commissioner statutory responsibilities, e.g. procurement regulations. Contracts: • Adult (over 18) community services • End of Life services with the aim of collaborating across the system for specialist elements such as palliative consultant care to ensure resilience; • Health led Discharge to Assess (D2A) - delegated ICB Budgets and Contracts; • Continuing Healthcare Fast track packages - delegated ICB Budgets and Contracts; • Community Equipment Contracts (Health); • Other Community Delivered Services not previously aligned e.g. Dietetics, and Podiatry. It is anticipated that the scope of services to be arranged by the Lead Providers under the Proposed Contracts may expand during the term of the Proposed Contracts to include community-based services commissioned by Local Authorities. It is also anticipated that some services may be relocated from an acute setting to a community environment (such as but not limited to endocrinology, respiratory care, or frailty services) and the Lead Providers will be expected to engage with providers in order to investigate the potential impact on patient care and how it may benefit from such a change, and agree the financial mechanisms directly with the Acute providers across Coventry and Warwickshire to facilitate a shift in investment from the Acute to Community to support the transformation required across the system to deliver the contract outcomes. Dementia services are not within scope of the Proposed Contracts but the Lead Providers will be expected to engage with the Mental Health Collaborative with respect to services in this area. The Proposed Contracts will be based on the NHS Standard Contract for the relevant contract year. The term of the Proposed Contracts will be 5 years with the option to extend the Proposed Contracts (with both or either Proposed Lead Provider) for up to a further 5 years. The estimated total value of the Proposed Contracts in section II.1.5 includes the potential 5 year extension. Should the extension not go ahead, then the total estimated value would be £410m. The ICB has a statutory duty to have regard to the need to reduce health inequalities and the appointment of the Proposed Lead Providers will be a key contractual mechanism for achieving this. The Proposed Lead Providers will be expected to work in partnership with other stakeholders who have an impact on the wider determinants of health and well-being and delivery of services in meeting its contracted outcomes. This contract will not be governed by the GPA (the World Trade Organisation Agreement on Government Procurement). The ICB is not liable for any costs of any provider that wishes to respond to this PIN. The purpose of this PIN is to test whether the ICB is right to conclude it has identified the only capable providers for the service described. The ICB is not commencing a procurement process by publishing this PIN and will publish an update and/or contract award notice in due course. Additional information: Please note that the intended contract term to be awarded under this contract is 5 years with an option to extend at the sole discretion of the commissioner for up to 5 years. Please also note that the stated contract value in II.1.5 above will be split over two contracts as follows: Coventry - £27,070,282 per annum (c.£270.7m over the potential full 10 year contract term) Warwickshire - £55,060,607 per annum (c.£550.6m over the potential full 10 year contract term)