Section one: Contracting authority/entity
one.1) Name and addresses
NHS HAMPSHIRE, SOUTHAMPTON AND ISLE OF WIGHT CCG
Castle Street
Winchester
SO23 8UJ
Contact
Celine Machola - Rogers
celine.machola@soeprocurement.nhs.uk
Telephone
+44 1489779175
Country
United Kingdom
NUTS code
UKJ3 - Hampshire and Isle of Wight
Internet address(es)
Main address
Section two: Object
two.1) Scope of the procurement
two.1.1) Title
NHS Elective Treatment and Diagnostic Services (NHS Southampton Elective Treatment Centre)
Reference number
F7560
two.1.2) Main CPV code
- 85100000 - Health services
two.1.3) Type of contract
Services
two.2) Description
two.2.2) Additional CPV code(s)
- 85100000 - Health services
two.2.3) Place of performance
NUTS codes
- UKJ3 - Hampshire and Isle of Wight
two.2.4) Description of the procurement at the time of conclusion of the contract:
The Contract was awarded for 5 Years plus optional extension of 24 month commencing on 28th October 2015 and ends on 27th October 2022. Please note the Awarding Contracting Authority at the time was NHS Southampton City CCG, the new legal entity for the CCG is Hampshire, Southampton and Isle of Wight CCG. The Contract was awarded to Care UK Clinical Services Ltd who now operate as Practice Plus Group, Hospital Southampton,following the completion of the full tender process.
The service provides routine and urgent elective inpatient and outpatient care for adults and children 16 years and over in the following specialties:
• Orthopaedics including:
o Lower limb: Hip, Knee, Ankles and Foot
o Upper limb: Shoulder, elbow, wrists and hand.
o Excludes spinal surgery
• General Surgery
• Urology including cystoscopy
• Ear Nose and Throat
• Gynaecology: Excludes pre-natal, early pregnancy.
• Ophthalmology
• Anaesthetics, including Pain Management Interventions
• Diagnostic Radiology
• Diagnostic Endoscopy
• Pathology; routine samples
• Post-operative in-patient therapies; Physiotherapy, Speech and Language, and Occupational Therapy (internal consultant referral only)
• Oral Surgery NHS England Only
This service is commissioned to ensure sufficient and high quality local elective secondary care capacity for adults and children 16 years and over, including outpatients, diagnostics, elective inpatient and post-operative services. The catchment includes the populations of Hampshire, Southampton and Isle of Wight CCG, and associates to this contract, plus the wider Wessex catchment for referral for Oral Surgery.
The service should provide high quality and cost effective services to ensure that all patients are treated appropriately in line with adopted NICE clinical guidelines and mandatory technical appraisals, including local Individual Funding Request Policy Guidelines, clinical thresholds and referral criteria. Services should achieve all local and national waiting time targets and other key national and local key quality and performance targets.
The expected outcomes of the service are to:
• Provide safe and effective care in line with national best practice and local guidelines to optimise clinical outcomes;
• Deliver timely assessment, diagnosis and treatment for our population within NHS Constitutional waiting times
• Engage our communities and patients in the delivery of their healthcare, to support self-care, informed decisions and better personal experience and outcomes.
• Develop confident working relationships with referrers and consultant colleagues in other local providers to serve the best interests of the patient by minimising delays, providing advice, avoiding unnecessary tests or treatment, referring on or back when appropriate and providing clear communication and information
• Drive cost-efficiencies over the life of the contract
• Provide patient education and information in an engaging, user-friendly way, on message with the local system to help patients understand modern healthcare provision
• Participate in and contribute to local educational forums independently or in partnership with our other providers
• Meet the quality, safety and reporting arrangements as outlined in the NHS contract, ensuring a safe, effective and positive experience for the patient.
• Stimulate efficiencies and improvements through innovation to support a sustainable local health economy.
The service provides a 24- hour, 7 day inpatient facility to safe standards. It offers day time, evening and Saturday appointments with some weekend diagnostic and operating sessions for those who find it difficult to attend during working hours. The service accepts:
• Referrals for opinion from GPs, GPwERs, community based services, Tier 2 services, Acute Hospital Consultants (subject to agreed policies), and dentists; and provides daily accessible advice in response.
• Referrals for treatment from GPs, GPwERs, community based services, Tier 2 services, Acute Hospital Consultants, and dentists (in all cases, subject to agreed policies). The patient's referral will be logged upon receipt, and clinically assessed for appropriateness for the service to which it has been referred. Patients will receive general assessment, investigation, diagnosis and treatment for all planned care using agreed guidelines and operational procedures. If the referral would be more appropriately seen by another service, the referral should be transferred to that service, and the referring clinician informed, in accordance with local Commissioner policies. If the referral is inappropriate or does not meet the clinical threshold criteria, it should be returned to the referrer with advice.
The service is offered as an option for patients under national NHS Choices, where appropriate, delivering NHS Constitutional Standards. For non-dental activity, the provider receives the majority of referrals electronically via NHS E - Referrals. Dental activity should be received via Dental E - Referrals. Ophthalmology referrals should be received either through NHS e-RS or e-ERS via OPERA direct from Primary Eye Care Services (or otherwise agreed with commissioners).
The provider is a key partner in delivery of care in the local area and as such is expected to work in a collaborative and integrated fashion. This requires clinical collaboration with providers across the health system, adhering to locally-agreed pathways, including:
• Primary care medical, dental and optical practices, including Primary Eyecare Services Ltd (PES).
• Primary Care Networks and associated GP Federation Providers
• Southern Health NHS Foundation Trust (Mental Health, Acute and Community, including Community ENT Services)
• Solent NHS Trust (Community)
• Hampshire Hospitals NHS Foundation Trust (Acute)
• University Hospitals Southampton NHS Foundation Trust (Acute, Tertiary, Cancer Centre, Trauma Centre)
• Royal Bournemouth and Christchurch NHS Foundation Trust (Acute)
• Salisbury NHS Foundation Trust (Acute)
• Portsmouth Hospitals NHS Trust (Acute, Tertiary, Cancer Centre)
• Isle of Wight Healthcare Trust (Acute)
• Community-based services and clinicians from a range of disciplines including district nursing, podiatry and therapies, GPwERs and Tier 2 Community services such as MSK, Pain & Rheumatology, ENT, Dermatology, PES and Diagnostic specialists
• Other AQP providers across clinical pathways, including locally qualified providers of audiology and hearing aid services
• Southampton City, Hampshire and Isle of Wight Social Services
• Equipment services, including local Wheelchair centres
• Patient Transport Provider (South Central Ambulance Services)
• Blood Transfusion Services
• South Central Ambulance Services (PTS and 999)
• 111 and Out of Hours services
• Any community, primary care triage or alternative service models that are commissioned during the course of the contract.
two.2.7) Duration of the contract, framework agreement, dynamic purchasing system or concession
Duration in months
84
Section four. Procedure
four.2) Administrative information
four.2.1) Contract award notice concerning this contract
Notice number: 2022/S 000-002835
Section five. Award of contract/concession
Contract No
F7560
Title
NHS Elective Treatment and Diagnostic Services (NHS Southampton Elective Treatment Centre )
five.2) Award of contract/concession
five.2.1) Date of conclusion of the contract/concession award decision:
9 February 2015
five.2.2) Information about tenders
The contract/concession has been awarded to a group of economic operators: No
five.2.3) Name and address of the contractor/concessionaire
Practice Plus Group - previously Care UK Clinical Services Ltd
Berkshire
Country
United Kingdom
NUTS code
- UKJ3 - Hampshire and Isle of Wight
The contractor/concessionaire is an SME
No
five.2.4) Information on value of the contract/lot/concession (at the time of conclusion of the contract;excluding VAT)
Total value of the procurement: £151,900,000
Section six. Complementary information
six.4) Procedures for review
six.4.1) Review body
South of England Procurement Services
Fareham
Country
United Kingdom
Section seven: Modifications to the contract/concession
seven.1) Description of the procurement after the modifications
seven.1.1) Main CPV code
- 85100000 - Health services
seven.1.2) Additional CPV code(s)
- 85100000 - Health services
seven.1.3) Place of performance
NUTS code
- UKJ3 - Hampshire and Isle of Wight
seven.1.4) Description of the procurement:
This Modification Notice is being published to notify the extension of the contract for the NHS Southampton Elective Treatment Centre for 24 months, under Reg 72(1)(c) Public Contract Regulation 2015, due to circumstances which a diligent Contracting Authority could not have foreseen. The modification does not alter the overall nature of the contract.
Following the Modification Notice, the NHS Southampton Elective Treatment Centre will continue to provide routine and urgent elective inpatient and outpatient care for adults and children 16 years and over in the following specialties:
• Orthopaedics including:
o Lower limb: Hip, Knee, Ankles and Foot
o Upper limb: Shoulder, elbow, wrists and hand.
o Excludes spinal surgery
• General Surgery
• Urology including cystoscopy
• Ear Nose and Throat
• Gynaecology: Excludes pre-natal, early pregnancy.
• Ophthalmology
• Anaesthetics, including Pain Management Interventions
• Diagnostic Radiology
• Diagnostic Endoscopy
• Pathology; routine samples
• Post-operative in-patient therapies; Physiotherapy, Speech and Language, and Occupational Therapy (internal consultant referral only)
• Oral Surgery NHS England Only.
The service will provide routine and urgent elective inpatient and outpatient care for adults and children 16 years and over in the above specialties. The service will ensure sufficient and high quality local elective secondary care capacity for adults and children 16 years and over, including outpatients, diagnostics, elective inpatient and post-operative services. The catchment includes the populations of Hampshire, Southampton and Isle of Wight CCG, and associates to this contract, plus the wider Wessex catchment for referral for Oral Surgery.
The service will provide high quality and cost effective services to ensure that all patients are treated appropriately in line with adopted NICE clinical guidelines and mandatory technical appraisals, including local Individual Funding Request Policy Guidelines, clinical thresholds and referral criteria. Services should achieve all local and national waiting time targets and other key national and local key quality and performance targets.
The expected outcomes are the same as outlined in Section II 'Description of the procurement at the time of conclusion of the contract' above.
The service will provide a 24- hour, 7 day inpatient facility to safe standards. It will offer day time, evening and Saturday appointments with some weekend diagnostic and operating sessions for those who find it difficult to attend during working hours. Referral routes are the same as outlined in Section II 'Description of the procurement at the time of conclusion of the contract' above.
The provider is a key partner in delivery of care in the local area and as such is expected to work in a collaborative and integrated fashion. This requires clinical collaboration with providers across the health system, adhering to locally-agreed pathways, as outlined in Section II 'Description of the procurement at the time of conclusion of the contract' above.
seven.1.5) Duration of the contract, framework agreement, dynamic purchasing system or concession
Duration in months
84
seven.1.6) Information on value of the contract/lot/concession (excluding VAT)
Total value of the contract/lot/concession:
£151,900,000
seven.1.7) Name and address of the contractor/concessionaire
Practice Plus Group
Berkshire
Country
United Kingdom
NUTS code
- UKJ3 - Hampshire and Isle of Wight
The contractor/concessionaire is an SME
No
seven.2) Information about modifications
seven.2.1) Description of the modifications
Nature and extent of the modifications (with indication of possible earlier changes to the contract):
The Covid pandemic has resulted in emergency measures which have delayed the process of reviewing, consulting on and agreeing the commissioning strategy and re-procurement of the NHS Southampton Elective Treatment Centre contract.
as:
• Management of the Covid-19 response has necessarily been the focus of the contracting authority, the incumbent provider and key partners and stakeholders since March 2020.
• Resources in the contracting authority were redirected to support frontline activities including direct care for patients, efforts to support supply chain activities and vaccination programmes in line with national guidance around removing routine burdens and freeing up as much capacity as possible to focus on the pandemic response.
• Resources in the wider system, including Acute and Community NHS Trusts and providers, Primary Care, Community and Tier 2 Providers and Clinicians, and other partners/ stakeholders, all of whom would have been engaged in the review and re-tendering exercise, were redirected to support frontline activities and the pandemic response.
• As part of the Covid-19 response, NHS E&I secured all available independent sector capacity including the Southampton Elective Treatment Centre (currently run by Practice Plus Group). The national contract commenced on 23 March 2020 and was extended several times under different terms and conditions, finally expiring on 31 March 2021. During this period, the CCG's contract with Practice Plus Group was suspended and, as the CCG was not the contract holder, limiting its ability to undertake key activity.
• The ability to undertake meaningful engagement and consultation as part of any review process has been limited by the pandemic, for example as national 'lockdowns' would preclude the convening of patient and public groups.
• This modification is required to ensure essential service delivery can be maintained, with no detrimental impact on patient care given the above unforeseeable circumstances.
Accordingly, under Reg 72(1)(c) Public Contract Regulation 2015 this Modification Notice is being published as notification of the decision by Hampshire, Southampton and IOW CCG to extend the existing contract for NHS Treatment Southampton Elective Treatment Centre) with Practice Plus Group for 24 months outside of the terms originally procured.
This modification is required under Reg 72(1)(c) Public Contract Regulation 2015, due to circumstances which a diligent Contracting Authority could not have foreseen. The modification does not alter the overall nature of the contract and any increase in price does not exceed 50% of the value of the original contract. This time is considered necessary and proportional to alleviate the risk stated in this notice and will give the above-named Contracting Authority sufficient time to review the service to inform any future commissioning strategies and models.
seven.2.2) Reasons for modification
Need for modification brought about by circumstances which a diligent contracting authority/entity could not foresee.
Description of the circumstances which rendered the modification necessary and explanation of the unforeseen nature of these circumstances:
The Covid pandemic has resulted in emergency measures which have delayed the process of reviewing, consulting on and agreeing the commissioning strategy and re-procurement of the NHS Southampton Elective Treatment Centre contract.
Originally, the contracting authority had plans in place to undertake a thorough service review of the scope of services and service model, with deliverables including:
• Agreement on commissioning strategy April 2020
• Set up Procurement Board May 2020
• Full review of specialities, strategy, specification etc.May-Dec 2020
• Market notice published Jan 2021.
The Covid pandemic and related unforeseen circumstances have resulted in significant delays to the scheduled service review and subsequent re-tendering activity, for example as:
• Management of the Covid-19 response, both in terms of immediate measures and the subsequent recovery of diagnostic and elective activity (in between Covid waves), has necessarily been the focus of the contracting authority, the incumbent provider and key partners and stakeholders since March 2020.
• Resources in the contracting authority were redirected to support frontline activities including direct care for patients, efforts to support supply chain activities and vaccination programmes in line with national guidance around removing routine burdens and freeing up as much capacity as possible to focus on the pandemic response.
• Resources in the wider system, including Acute and Community NHS Trusts and providers, Primary Care, Community and Tier 2 Providers and Clinicians, and other partners/ stakeholders, all of whom would have been engaged in the review and re-tendering exercise, were redirected to support frontline activities and the pandemic response.
• As part of the Covid-19 response, NHS E&I secured all available independent sector capacity including the Southampton Elective Treatment Centre (currently run by Practice Plus Group). The national contract commenced on 23 March 2020 and was extended several times under different terms and conditions, finally expiring on 31 March 2021. During this period, the CCG's contract with Practice Plus Group Southampton was suspended and, as the CCG was not the contract holder, limiting its ability to undertake key activity.
• The ability to undertake meaningful engagement and consultation as part of any review process has been limited by the pandemic, for example as national 'lockdowns' would preclude the convening of patient and public groups.
The pandemic and related emergency measures, including the national contract, has also meant that:
• Data (e.g. activity and demand), which is essential to inform future commissioning strategies and models, is now out of date. The last 'steady state' data available is from 2019/20, prior to the pandemic.
• Data gathered during the pandemic is not relevant or comparable, as the CCG's contract with Practice Plus Group was suspended during this time, and the incumbent provider's capacity redirected to activity to support the Acute NHS Trust.
• Ways of working, patient behaviours and care pathways have all changed as a result of the pandemic. As noted in national guidance, it is vital that future work takes account of lessons learned during Covid, by locking in beneficial change and addressing both opportunities and weaknesses highlighted since March 2020.
• As such, the 2019/20 baseline cannot be viewed as a reliable source for modelling future requirements. Given the pandemic is still ongoing, as is the analysis of lessons learned from Covid, and this will be essential to developing robust and future proof service models which meet the needs of our population.
At the same time, the restructure of the NHS including the merging of CCGs is going ahead despite the disruption caused by the pandemic. As such, the health and care landscape is changing significantly. The Hampshire, Southampton and Isle of Wight CCG has been formed, bringing opportunities to consider demand and capacity modelling, speciality reviews and innovative models of care across a wider geography. Further changes are anticipated with the formation of Integrated Care Systems in July 2022.
The Contracting Authority considers the above issues have resulted in a set of circumstances which a diligent Contracting Authority could not have foreseen. Accordingly, Hampshire, Southampton and IOW CCG has decided there is a requirement to extend the existing contract for NHS Southampton Elective Treatment Centre with Practice Plus Group for 24 months outside of the terms originally procured under Reg 72(1)(c) Public Contract Regulation 2015. The modification will enable a review to be undertaken in order to inform decisions about the type and scope of service required to meet future needs, based on robust data gathering, patient, clinical and stakeholder engagement, and lessons learned from the pandemic and the NHS restructure. The modification will also enable a robust, competitive procurement to be undertaken, including an adequate mobilisation period to minimise any risk of service discontinuity or negative impacts on patients or the wider system.
The modification does not alter the overall nature of the contract and any increase in price does not exceed 50% of the value of the original contract.
seven.2.3) Increase in price
Updated total contract value before the modifications (taking into account possible earlier contract modifications, price adaptions and average inflation)
Value excluding VAT: £151,900,000
Total contract value after the modifications
Value excluding VAT: £186,032,158