Section one: Contracting authority/entity
one.1) Name and addresses
NHS Hampshire and Isle of Wight Integrated Care Board (ICB)
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
Justification for not providing organisation identifier
Not on any register
Internet address(es)
Main address
Section two: Object
two.1) Scope of the procurement
two.1.1) Title
St Mary's Treatment Centre, Portsmouth
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 urgent, elective, and diagnostic care for residents of Portsmouth and Southeast Hampshire.
Urgent
Urgent Treatment Centre
• Minor Injuries Unit (Children and Adults over 18yrs) - Patients are assessed and treated for minor injuries and simple fractures in line with National standards and best practice.
• Minor Ailments Service (Children and Adults over 18yrs) - Patients are assessed and treated for minor illnesses in line with National standards.
Diagnostics
• The delivery of a consistent, comprehensive, effective, safe, and appropriate diagnostic imaging service (Children and Adults over 18yrs) providing X-rays, Ultrasound, Echocardiograms Endoscopies and Cardiac event monitors.
Elective
• Day Surgery (Adults over 18yrs) - The service provides surgical services including outpatient clinics, pre-op assessment and follow up in a safe and effective manner in the following specialties:
o Orthopaedics
o Gastroenterology
o General Surgery and minor skin procedures
o Ophthalmology
o Urology
• Age Related Audiology Service (Adults over 55yrs) - Provision of direct access adult hearing service for age related hearing loss in line with national guidance and local requirements.
• Community ENT Service (Adults over 18yrs) - Triage, diagnosis, and where appropriate treatment for the following conditions:
o Otalgia
o Otorrhoea
o Aural Toilet
o Otitis Externa
o Otitis Media
o Impacted Ear Wax removal
o Perforation of eardrum
o Mastoid cavities requiring evaluation and toileting
o Dizziness/vertigo
o Nasal Polyps
o Chronic Rhinitis
o Nose Bleeds (Epistaxis)
o Glue Ear
o Globus (excluding suspicion of cancer intermittent)
• Community Ophthalmology Service - Provides clinical triage of ophthalmology including treatment where appropriate for the following conditions:
o Glaucoma
o Cataract
The Treatment Centre 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 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
• Solent NHS Trust (Mental Health, Acute and Community)
• Portsmouth Hospitals NHS Trust (Acute, Tertiary, Cancer Centre)
• Hampshire Hospitals NHS Foundation Trust (Acute)
• University Hospitals Southampton NHS Foundation Trust (Acute, Tertiary, Cancer Centre, Trauma Centre)
• Isle of Wight Healthcare Trust (Acute)
• Social Services (Portsmouth, Southampton City, Hampshire and Isle of Wight)
• Equipment services, including local Wheelchair centres
• Patient Transport Provider (South Central Ambulance Services)
• Blood Transfusion Services
• South Central Ambulance Services
• 111 and Out of Hours services
• Any community, primary care triage or alternative service models that are commissioned during the course of the contract.
• The service will be expected to work with other service providers when required, to support the development of interoperability of their respective electronic clinical systems, allowing a seamless flow of patient information as per e-GIF (e-Government Interoperability Framework).
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 000-023537
Section five. Award of contract/concession
Contract No
F6806
Title
St Mary's Treatment Centre, Portsmouth
five.2) Award of contract/concession
five.2.1) Date of conclusion of the contract/concession award decision:
1 June 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
Berkshire
Country
United Kingdom
NUTS code
- UKJ3 - Hampshire and Isle of Wight
Justification for not providing organisation identifier
Not on any register
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: £92,608,000
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)
- 85000000 - Health and social work 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 St Mary's Treatment Centre, Portsmouth for 12 months to 31st March 2024 with an additional option to extend for up to 6-months should it be required (18-months in total), 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, St Mary's Treatment Centre, Portsmouth will continue to provide urgent, elective, and diagnostic care for residents of Portsmouth and South-east Hampshire as listed above under Section II.
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:
£92,608,000
seven.1.7) Name and address of the contractor/concessionaire
Practice Plus Group
Berkshire
Country
United Kingdom
NUTS code
- UK - United Kingdom
Justification for not providing organisation identifier
Not on any register
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 (with indication of possible earlier changes to the contract):
Due to the disruption caused by the COVID-19 pandemic, and complexities surrounding the changing landscape, both nationally and locally, the process of reviewing, consulting on and agreeing the commissioning strategy and re-procurement of the St Mary's Treatment Centre, Portsmouth has been delayed:
• 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 Elective element of the Portsmouth 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 ICB (formally CCG) elective element of the contract with Practice Plus Group was suspended and, as the ICB (formally 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 and IOW ICB to extend the existing contract for St Mary's Treatment Centre with Practice Plus Group for 12 months to 31st March 2024 with an additional option to extend for up to 6-months should it be required (18-months in total) 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 resulted in emergency measures which have delayed the process of reviewing, consulting on and agreeing the commissioning strategy and re-procurement of the St Mary's Treatment Centre, Portsmouth contract.
Originally, the contracting authority started their plans to undertake a thorough service review of the scope of services and service model in 2019/20, this process was halted in February 2020 due to the Covid Pandemic.
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 elective capacity including St Mary's Treatment Centre, Portsmouth (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 ICB's (formally CCG) contract with Practice Plus Group Portsmouth was suspended and, as the ICB (formally 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' precluded 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 ICB's (formally CCG) 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 because 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 has gone ahead despite the disruption caused by the pandemic. As such, the health and care landscape is changing significantly. The Hampshire and IOW ICB has been formed, bringing opportunities to consider demand and capacity modelling, speciality reviews and innovative models of care across a wider geography across the Integrated Care System.
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 St Mary's Treatment Centre, Portsmouth with Practice Plus Group for 12 months to 31st March 2024 with an additional option to extend for up to 6-months should it be required (18-months in total) 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, review to be undertaken, and 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: £92,608,000
Total contract value after the modifications
Value excluding VAT: £117,646,000