Integrated Community Musculoskeletal and Pain Service

Description

This Intended Approach Notice to follow the Most Suitable Provider Process relates to the decision made by NHS Mid and South Essex Integrated Care Board (the Authority) to award a contract for an Integrated Community Musculoskeletal and Pain Service (the Service) via undertaking (and holding themselves bound solely by those Regulations applicable to) the Most Suitable Provider (MSP) process (the Process) as defined by Regulations 6(6) and 10 under the Health Care Services (Provider Selection Regime) Regulations 2023. Historic commissioning arrangements of the Service have led to health inequalities in access and delivery of pathways across the Mid and South Essex (MSE) Integrated Care System (ICS). Due to new ways of working, increasing collaboration, and communication across primary, community and secondary care, implementing the Service will ensure there is equitable provision and pathways for all MSE residents. Working with stakeholders the Authority developed a new community pathway for people aged 16 years+, based on the East of England Musculoskeletal (MSK) Pathway Improvement Framework, the Best MSK high impact recommendations and adhering to the Getting It Right First Time (GIRFT) pathway. This new model of care will provide integration across the Best MSK pathway including Single Point of Access (SPoA), clinical triage, physiotherapy, orthopaedics, spinal, rheumatology, pain management, surgical interventions and therapies across MSE. It will assess and treat more patients outside of acute services and deliver improved outcomes, quality and patient experience of care. In applying the Process, the Authority has considered the five Key Criteria and has identified the Service and proposed contracting model will support the MSK core purposes of reducing unwarranted variation, sharing best practice, improving access, outcomes and experience of patients, enabling best lifelong MSK health within all communities, and improving quality and patient safety. Additionally, it aligns with the ICS four purposes to improve outcomes in populations health and healthcare, tackle inequalities in outcomes, experience and access, enhance productivity and value for money and help the NHS support broader social and economic development. In applying this Process, the Authority has undertaken appropriate pre-market engagement to update its knowledge of relevant providers including understanding their ability to deliver the Service to the relevant local population and connections with other parts of the MSE ICS. Through clinical congress with stewards across the system, it is of the view, taking into account likely providers and all relevant information available to it at this time, that it is likely to be able to identify the MSP without running a competitive process. Further details can be found at sections II.2.4) , II.2.14) and VI.3). Lot 1: For the purposes of this Process, the Authority defines the Most Suitable Provider as the lead economic operator participating in the Process and acting on behalf of a group/consortium of organisations that will come together specifically for the purpose of being assessed by the Authority as most suitably qualified and experienced and technically and professionally capable of collaboratively delivering the Proposed Contract via the groups/consortiums chosen bidding model and legal structure, which will be determined and agreed to best meet the Authority's Specification and requirements. For example, a Special Purpose Vehicle (SPV) or Lead Provider and Sub-Contractor arrangements. To satisfy the Regulations, the Authority intends to undertake appropriate due diligence to assess the MSP in accordance with Regulation 19 (Basic Selection Criteria) and Regulation 20 (Exclusions) and with reference to the Key Criteria (Regulation 5), ensuring the most suitable provider has the legal and financial capacities and the technical and professional abilities to deliver the Proposed Contract over the term. Additionally, the Authority will hold a series of structured dialogue sessions with the MSP to further assess the MSP against the Key Criteria. As a result of a successful conclusion to such assessment and Process, the Authority intends to make a decision to award the Proposed Contract to the MSP. The Authority will observe a minimum of 14 days after the day on which this Notice of Intention is submitted for publication prior to assessing the MSP in accordance with Schedule 5 of PSR. The Proposed Contract duration is five years from 1st November 2025 until 31st October 2030 with an option to extend for a further three years until 31st October 2033. The MSP must evidence that it satisfies the basic selection criteria, and: • is most suitably qualified and experienced and technically and professionally capable of delivering the Proposed Contract through an appropriately structured bidding model and legal status • has a demonstrable track record of successful integrated delivery of the Service and has the necessary experience in multi-disciplinary integrated care. • is pro-actively committed to working collaboratively with other providers within the group/consortium to deliver the Service outcomes across MSE in a whole system approach, via shared objectives and governance framework. • is uniquely placed to deliver the specification, vision, and strategic objectives of the MSE ICS. • is capable of financially holding and managing the scale of risk through a degree of income risk share. • is willing and capable of developing mature system relationships (and associated contractual mechanisms) enabling the governing bodies of all participating organisations within any group/consortium to accept any financial risks and potential gains associated with joint working. • is willing to sign an NHS Standard Contract with the Authority, and / or sign sub-contracts that are back-to-back with such NHS Standard Contract, where relevant to the successful bidding model. The Authority proposes a cost and volume financial model (local prices) in line with national guidance. The potential aggregate contract value (incl. extension term, growth/inflation assumptions, and potential variations) is £164,452,499 (excluding VAT). The financial envelope which acts as an affordability cap for the purposes of the Process is £86,540,287 based on the initial 5-year contract term. Additional information: This is a Provider Selection Regime (PSR) intended approach notice. The awarding of this contract is subject to the Health Care Services (Provider Selection Regime) Regulations 2023. For the avoidance of doubt, the provisions of the Public Contracts Regulations 2015 do not apply. The award decision-maker for this process is NHS Mid and South Essex Integrated Care Board (ICB).