MEETING: GOVERNING BODY MEETING IN PUBLIC AGENDA ITEM: 2.2 DATE: 3 FEBRUARY 2015 TITLE: NHS 111 AND OUT OF HOURS PROCUREMENT FROM: JESSICA BAWDEN, DIRECTOR OF CORPORATE AFFAIRS FOR: APPROVAL SECTION: STRATEGY 1 PURPOSE 1.1 The purpose of this paper is to update the Governing Body on the NHS 111 and Out of Hours procurement process. 1.2 The paper also updates the Governing Body on the consultation process which has started, as delegated by the Governing Body in November. 2. STRATEGIC AIM / CCG ASSURANCE FRAMEWORK / EDSLINKS 2.1 This paper is aligned to Strategic Aim 4 – Change Management and Transformation, Strategic Aim 5 – Contracts Management and Performance and Strategic Aim 7 – Governance. 3. CONTEXT 3.1 UPDATE TO THE PREVIOUS PAPER 3.1.1 The Governing Body approved the procurement to start with a Pre-Qualification Tender which was released on 20th January 2015, following a bidder market event on January 14th, attended by ten organisations. 3.1.2 At the market event, a number of suppliers, but not all reported that they felt that the mobilisation period of 4 months was not sufficient and would place the current providers in a more competitive position. The procurement paperwork has therefore been updated to reflect that the CCG would allow a mobilisation to take up to a maximum of six (6) months. This is a precautionary measure to reduce the risk of an unsuccessful bidder challenging the procurement process. 3.1.3 The effect of the preferred bidder not being in a position to fully mobilise by 2nd week on November 2015, would delay service launch until start of February 2016. No service would be allowed to launch in the winter period. 3.1.4 The managerial effect of this is that the CCG will have to create a provision of extending the current contracts for three months to end of January 2016 which may CCG Governing Body Meeting in Public 03.02.2015 Agenda Item 2.2 Page 1 of 4 result in some additional costs. These cannot be fully assessed at this stage, but we are in discussions with current providers around this, and ensuring continuity of service for patients is what we are all working towards. 3.1.5 The scope of the procurement will exclude the three Royston practices as they will join the East and North Herts CCG Herts procurement, who commission their current services. 3.1.6 The procurement will also exclude the four Wisbech practices as agreed by the Governing Body. They are working with the consortia of Norfolk CCGs. We are also establishing engagement meetings with the PPGs in Wisbech so that they can feed into the procurement. Due to the timescales of the Norfolk process, the paper with recommended provider following the procurement evaluation process will be ready no earlier than 3 March 2015, which is the date the Governing Body meets again in public. Due to timing, therefore, we would recommend that the Wisbech LCG Board reviews the outcome of the process and the recommended bidder. The Governing Body would then delegate approval to the Lay Chair, Chief Clinical Officer, Chief Operating Officer and Chief Finance Officer to approve the recommendation. 3.1.7 The procurement will include the Oundle and Wansford Northamptonshire practices, which currently use Peterborough based OOH services. 3.2 PROGRAMME OVERSIGHT 3.2.1 The structure to manage the process is already in place. It was agreed that the Programme Board was established to oversee the NHS 111 and Out of Hours Procurement. The Board has now met three times and draft service specifications have been released to all members who have signed confidentiality and have no conflict of interest. 3.2.2 The Programme Board will ensure overall linkages between the CCG, the LCGs, Councils, Health Watch organisations in Cambridgeshire, Peterborough and Northamptonshire, the Local System Resilience Groups (Urgent Care Boards), the System Transformation Team, the OPACS mobilisation teams and bordering Commissioners. The LCGs have nominated Clinical leads for specification development on behalf of their boards. 3.2.3 In line with requests from the SRG and LCGs boards and due to the known and potential conflicts of interest that exist, the Programme team would like to share the specifications publically with the SRGs and LCG boards, once the PQQ has been completed in mid-March. This will allow a short window for the SRGs and LCGs to feed back to the procurement board. In advance of this review, we have requested that the SRG’s and LCGs discuss what they would like to include in the specification. 3.2.4 In line with the CCG Constitution’s Policy for Involvement of External Clinical Advisors in Commissioning Decisions for Service Reconfiguration, the Programme Board is will be appointing an Independent External Clinical Advisor to the Programme Board to support the procurement from the ITT stage. 3.2.5 The oversight for the project will include the non-mandatory but best practice assurance framework produced by NHS England for NHS 111 procurements. CCG Governing Body Meeting in Public 03.02.2015 Agenda Item 2.2 Page 2 of 4 3.3 PUBLIC ENGAGEMENT 3.3.1 Following agreement by Cambridgeshire and Peterborough Scrutiny Committees, a 9 week public consultation started. The Consultation Document and Process was signed off by the Lay Chair, Chief Clinical Officer and Lay Member for Patient and Public Engagement in line with the delegated approval agreed by the Governing Body at its last meeting. 3.3.2 Due to difficulties with distribution of information over the Christmas period, the decision was taken to extend the consultation for an additional two weeks. This has been widely publicised and additional meetings put in place after requests from the public. We have also publicised the fact that there was a problem with the online response form and this was rectified immediately. 3.3.3 The consultation now ends on Friday 6 March at 5pm. We are proposing to bring an interim report for the first 9 weeks of the consultation period to the March Governing Body meeting and will ask that the final updated version, including any new themes and comments is considered by the Programme Board and the Patient Reference Group, so that we can ensure that points are taken into account before we enter the Invitation to Tender stage. 3.3.4 All responses will be reviewed for inclusion within the service specification the dates of the public meetings are included and have been advertised and circulated to the media, our stakeholder database, advertised in the press and via social media. 4. SHORT-TERM CONTRACT MANAGEMENT APPROACHES 4.1 The 111 contract is operationally managed through the 111 Clinical Governance Group. The Programme Board asked to be sighted on this. Short term measures around the current service are made through that group for NHS 111 and through the Contracting and Performance teams and Clinical Leads. 4.2 The Clinical Governance Group for 111 has highlighted the short term issues that are being experienced as detailed below: 1. Driving up Emergency Department (ED) attendances by actual referrals from 111 to ED. A pilot scheme with a GP reviewing these is now in place and is reducing dispositions to ED significantly. 2. Driving up Ambulance dispatches in Red 2 and Green 1-4 categories. A pilot scheme has started with NHS 111 Clinical Advisors and East of England Ambulance Trust paramedics in the call centre to start addressing Green Ambulance dispatches from 111. Additionally a GP in the pilot scheme has been trained in NHS Pathways to have the ability to review ED dispositions and Green ambulances within the pathways system. 3. A mechanism for access to a GP for Care Homes and residential homes is now in place and has been funded by NHS England. 4. Expanding the Directory of Services (DOS) to include more referral options has been funded by NHS England and this work is on-going. 5. The Programme Team bid for monies to be involved with the second phase of the National Pilots, but were unsuccessful and have a review with the National Team at the start of February 2015. CCG Governing Body Meeting in Public 03.02.2015 Agenda Item 2.2 Page 3 of 4 6. All this work is in line with a letter received from Dame Barbara Hakin, National Director of Commissioning Operations at NHSE on 23 January about early Clinical Input into the 111 Service. 5. RECOMMENDATION 5.1 The Governing Body is asked to note the potential mobilisation extension for the service. 5.2 The Governing Body is asked to support the work of the Programme Board and support Clinical involvement with development of an outcome based specification with common outcome measures. The specification to address the needs of each LCG and their population demographics. 5.3 The Governing Body is asked to note the consultation currently underway and the extension and agree the process for reviewing both the interim consultation response on 3 March 2015 and the final response after 6 March 2015. 5.4 The Governing Body is asked to delegate approval for the Wisbech procurement (as part of the Norfolk CCG) to the Lay Chair, Chief Clinical Officer, Chief Operating Officer and Chief Finance Officer following review by the Wisbech LCG Board. Author: Jessica Bawden Director of Corporate Affairs 29 January 2015 CCG Governing Body Meeting in Public 03.02.2015 Agenda Item 2.2 Page 4 of 4
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