procurement of sexual health services in bristol, north ... · (presenting on behalf of becky...

Procurement of Sexual Health Services in

Bristol, North Somerset and South Gloucestershire

Local Government Association Sexual and reproductive health:building strong relationships, meeting local needs

Thursday 13th July 2017Thara Raj, Consultant in Public Health

(presenting on behalf of Becky Pollard, Annette Billing, Matt Lenny, Lindsey Thomas, Lottie Lawson,Paul Sheehan (B&NES), Inge Shepherd)

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• Background and organisational context

• Lessons learnt

– Tender process

– Partnership

• Next steps

Overview

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Services in scope

Level 3 specialist services – complex contraception, STI testing and treatment

HIV prevention

Young people’s level 1 & 2 services

Community based Level 2 services – LARC, chlamydia screening

Community based Level 1 services – EHC, chlamydia screening and treatment

Chlamydia screening programme and Partner Notification

Termination of Pregnancy

Services out of scope

GP practices and community pharmacies

Background and Organisational Context

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Current location of BNSSG Sexual Health Services mapped against LSOA IMD

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Aspirations for the new system

• Outcome focussed service

• Pathways for patients are clear, understandable and properly thought through

• Easily recognisable services under one name• One website and one phone number for patients to access

services• Able to book patients into any service so they only make

one call• Improved data quality and common data sets across all

providers

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• Multiple commissioners (x7) with different governance arrangements and desired outcomes

• Uncertainty around market – may have been little appetite for providers

• Demand led service with increasing sexually active population profile

• Financial uncertainty around public health grant

Challenges for reprocurement

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• West of England Partnership governance

• Pooled budgets

• Single lot

• Block contract

• Partnerships and consortium bids encouraged

• Assessed draft bids

Methods we used

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Procurement method

Pseudo-competitive dialogue

Following receipt of tenders, bidders were invited to meet with commissioners to discuss their proposals in more detail.

Bidders had the opportunity to revise their proposals, should they wish, based on feedback during this unscored dialogue

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• Needs assessment and draft Jan 2015 to Oct 2015

service specification

• Public consultation Nov 2015 to Jan 2016

• Approval to go out to tender Feb 2016

• Tender advertised Apr 2016

• Bidding period (out to tender) Apr 2016 to July 2016

• Evaluation of bids July 2016

• Award contracts Sep 2016

• Mobilisation of contracts Sep 2016 to Mar 2017

• New service(s) commence Apr 2017

Programme Timeline

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Lessons learnt

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Tender process

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• Stronger bid because we used a negotiated bidding process

• Community engagement in evaluation is key

• Dynamics changed once preferred bidder announced

• Risk sharing

• CCG being a named commissioner meant we had to use an NHS standard contract

Lessons learnt

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Partnership/resources

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• We had a great partnership and everyone brought something to the group

• Clear governance and accountability – collaborative agreement -escalate to West of England Partnership

• Coordinating commissioner

• Is size important? Equality of partnership ≠ size of budget

• Decisions by committee time consuming – allow time; RASCI

• Right project and procurement support

• Strengths and expertise useful but review roles and responsibilities throughout - avoid 2 MOUs

• Know decision making pathway of all partners

• Maintain a commissioner issues log

Lessons learnt

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Unity partnership led by University Hospitals Bristol includes Brook, THT, Marie Stopes

UK, North Bristol NHS Trust, Weston Area Health Trust (and also Eddystone Trust)

Good news Fully mobilised Unity service

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Next steps

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Location of BNSSG GP practices and pharmacies

Next steps• Primary care• Hep A

vaccinations• PrEP• 2019

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Key ContactsCommissioner BCC: Annette Billing and Thara RajAnnette.Billing@bristol.gov.ukThara.Raj@bristol.gov.ukCommissioner NS: Matt LennyMatt.Lenny@n-somerset.gov.ukCommissioner SG: Lindsey Thomas and Lottie LawsonLindsey.Thomas@southglos.gov.ukLottie.Lawson@southglos.gov.ukCommissioner B&NES: Paul SheehanPaul.Sheehan@bathnes.gov.ukCommissioner CCGs: Inge ShepherdInge.Shepherd@bristolccg.nhs.uk