Section one: Contracting authority/entity
one.1) Name and addresses
NHS HAMPSHIRE AND ISLE OF WIGHT ICB
NHS Hampshire and Isle of Wight Integrated Care Board Hampshire Fire and Police Headquarters
Eastleigh
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
Lot 2 - Community ENT - Mid Hampshire
Reference number
F7607
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 service provides consultant led Community ENT services to the population of Mid Hampshire (formerly covered by West Hampshire CCG). The service provides a single point of access for routine ENT referrals, and treats all conditions suitable for management and treatment in a community setting including:
• Ear
• Hearing loss unilateral and bilateral where not thought to be age related (55yrs) to the Adult hearing Aid Service, following the hearing aid pathway
• Conditions requiring surgical opinion/resolution
The overall aim of the service is to improve the quality of life, through diagnosis and treatment, for people with ear, nose or throat problems in the community and to reduce the need for unnecessary secondary care referrals by providing a service which supports primary care and the wider health system. As such, the service is expected to:
• Reduce referrals into the secondary care environment, providing care delivered in the community where appropriate; aiming for a new to follow-up out-patient activity 1:0.2 in year
• Ensure positive experiences for patients treated in the service
• Provide timely assessment, diagnosis and treatment, measured as 100% adherence to referral to treatment standards
• Deliver activity levels contained within agreed plans
• Provide rapid onward referral where necessary, measured as maximum 3 working days
• Clinically triage all referrals within 48 hours of receipt and identify the appropriate pathway. The status of referrals deemed incomplete, sub-optimal or inappropriate will be clarified with the referrer and actioned within a further 48 hours of this assessment.
• Provide GP and General Practitioner with Extended Role (GPwER) educational forums in collaboration with secondary care providers at least annually
• Ensure patients with age related hearing loss are offered a choice of hearing aid provider.
The service provides 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. The service is expected to achieve all local and national waiting time targets and other key national and local key quality and performance targets.
The majority of referrals are received from GPs or primary care team members with referral rights. However, referrals from secondary care are accepted, for patients assessed as needing specialist level management or ongoing follow-up which is beyond the normal scope of general practice but not requiring hospital based care and expertise (in line with Consultant to Consultant Policy). The service accepts referrals from Mid Hampshire Adult Hearing Aid service providers for assessment or ongoing aural toilet. The provider has agreed referral criteria to and from secondary care and adult hearing aid providers with clinical colleagues to facilitate effective clinical pathways.
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 but not limited to:
• Primary care medical, dental and optical practices
• Primary Care Networks and associated GP Federation Providers
• NHS Acute and Community Trusts
• Community-based services and clinicians where appropriate and relevant
• AQP providers across clinical pathways, including locally qualified providers of audiology and hearing aid 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 000-019558
Section five. Award of contract/concession
Contract No
F7607
five.2) Award of contract/concession
five.2.1) Date of conclusion of the contract/concession award decision:
26 March 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
Omnes Healthcare
London
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: £2,658,600
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:
The service provides consultant led Community ENT services to the population of Mid Hampshire (formerly covered by West Hampshire CCG). The service provides a single point of access for routine ENT referrals, and treats all conditions suitable for management and treatment in a community setting including:
• Ear
• Hearing loss unilateral and bilateral where not thought to be age related (55yrs) to the Adult hearing Aid Service, following the hearing aid pathway
• Conditions requiring surgical opinion/resolution
The overall aim of the service is to improve the quality of life, through diagnosis and treatment, for people with ear, nose or throat problems in the community and to reduce the need for unnecessary secondary care referrals by providing a service which supports primary care and the wider health system. As such, the service is expected to:
• Reduce referrals into the secondary care environment, providing care delivered in the community where appropriate; aiming for a new to follow-up out-patient activity 1:0.2 in year
• Ensure positive experiences for patients treated in the service
• Provide timely assessment, diagnosis and treatment, measured as 100% adherence to referral to treatment standards
• Deliver activity levels contained within agreed plans
• Provide rapid onward referral where necessary, measured as maximum 3 working days
• Clinically triage all referrals within 48 hours of receipt and identify the appropriate pathway. The status of referrals deemed incomplete, sub-optimal or inappropriate will be clarified with the referrer and actioned within a further 48 hours of this assessment.
• Provide GP and General Practitioner with Extended Role (GPwER) educational forums in collaboration with secondary care providers at least annually
• Ensure patients with age related hearing loss are offered a choice of hearing aid provider.
The service provides 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. The service is expected to achieve all local and national waiting time targets and other key national and local key quality and performance targets.
The majority of referrals are received from GPs or primary care team members with referral rights. However, referrals from secondary care are accepted, for patients assessed as needing specialist level management or ongoing follow-up which is beyond the normal scope of general practice but not requiring hospital based care and expertise (in line with Consultant to Consultant Policy). The service accepts referrals from Mid Hampshire Adult Hearing Aid service providers for assessment or ongoing aural toilet. The provider has agreed referral criteria to and from secondary care and adult hearing aid providers with clinical colleagues to facilitate effective clinical pathways.
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 but not limited to:
• Primary care medical, dental and optical practices
• Primary Care Networks and associated GP Federation Providers
• NHS Acute and Community Trusts,
• Community-based services and clinicians where appropriate and relevant
• AQP providers across clinical pathways, including locally qualified providers of audiology and hearing aid services
• Any community, primary care triage or alternative service models that are commissioned during the course of the contract
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:
£2,658,600
seven.1.7) Name and address of the contractor/concessionaire
Omnes Healthcare
London
Country
United Kingdom
NUTS code
- UKI - London
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):
Nature and extent of the modifications:
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 Tier 2 Mid Hampshire ENT Service 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 have been redirected to support frontline activities during the initial and subsequent waves, 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.
• The ability to undertake meaningful engagement and consultation as part of any review process was limited by the pandemic, for example as infection prevention control guidance has precluded 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 and IOW ICB to extend the existing contract for the Tier 2 Mid Hampshire ENT Service with Omnes Healthcare Ltd for 19 months.
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 form the commissioning model.
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 Community ENT Service contract.
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.
• The ability to undertake meaningful engagement and consultation as part of any review process has been limited by the pandemic, for example as infection prevention control guidance has precluded the convening of patient and public groups.
The pandemic and related emergency measures 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.
• 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 had been formed, bringing opportunities to consider demand and capacity modelling, speciality reviews and innovative models of care across a wider geography. From 1st July 2022 further changes have taken place with the formation of the Hampshire and Isle of Wight Integrated Care Board.
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 and IOW ICB has decided there is a requirement to extend the existing contract for Tier 2 ENT Service with Omnes Healthcare Ltd for 19 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 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: £2,658,600
Total contract value after the modifications
Value excluding VAT: £3,648,617