Health services

Description

This is a Voluntary Ex Ante notice for the purpose of Transparency and is not a call for competition. NHS Shropshire CCG wish to publish their intent with regards to the following service – Shropshire Fracture Liaison Service. The Fracture Liaison Service (FLS) is a multidisciplinary service, which aims to systematically identify, investigate, initiate treatment and integrate care for all eligible patients, over the age of 50 within the Shropshire CCG local population who have suffered a fragility fracture; with the aim of reducing their risk of subsequent (or secondary) fractures. The intent is to award this contract to Shrewsbury and Telford Hospitals NHS Trust (SATH) without a call for competition. Providers are invited to express comment or interest on this intent. This notice aims at providing voluntary prior transparency as referred to in Article 2d(4) of Directives 89/665/EEC and 92/13/EEC on Remedies, and Article 60(4) of Directive 2009/81/EC (information on the award of the contract without prior publication of a contract notice in the Official Journal of the European Union). This is a Voluntary Ex Ante notice for the purpose of Transparency and is not a call for competition. NHS Shropshire CCG wish to publish their intent with regards to the following service – Shropshire Fracture Liaison Service. The Fracture Liaison Service (FLS) is a multidisciplinary service, which aims to systematically identify, investigate, initiate treatment and integrate care for all eligible patients, over the age of 50 within the Shropshire CCG local population who have suffered a fragility fracture; with the aim of reducing their risk of subsequent (or secondary) fractures. The Fracture Liaison Service shall operate 5 days per week Monday to Friday 9:00 am — 5:00 pm. The service will promote coordination between acute, community and primary care to ensure that care is seamless and consistent. This integrated approach will include: — case-finding – identifying all fragility fractures in patients over 50 years, — assess all appropriate patients with new clinical and/or radiological fragility fracture presentation at any skeletal site. This would include the following groups of patients: — inpatients on SATH acute orthopaedic/trauma wards, — inpatients on SATH general medical or elderly care wards admitted with a fragility fracture, — those presenting acutely and not requiring hospital admission but managed as outpatients via orthopaedic fracture clinic or emergency department follow up, — new spine fractures identified on radiology reports (incidental or anticipated), — new fractures because of a fall during hospitalisation for other reasons, — patients have a CT or other scan where a fragility fracture might be detected opportunistically, — triage and provide a bone health assessment of identified patients within 3 months of incident fracture. These patients will have a bone health clinical assessment by a Fracture Liaison Nurse, who will do this assessment, — diagnosis of osteoporosis using DEXA (NICE TA16141), — Appropriate investigations to exclude secondary causes of osteoporosis or fracture, — identification of the modifiable faller and referral to a falls prevention service, — provision of appropriate diet and lifestyle advice, in line with local guidelines, — bone health management plan to be agreed with the patient. This should include information on bone health, lifestyle, nutrition and bone protection treatments. A copy to be held by the patient and the patient’s general practitioner, — initiation of pharmacological treatment for fracture risk reduction in line with agreed guidelines. Osteoporosis treatment is typically recommended in about 75 % of cases, — liaison with the patient’s general practitioner with the aim of optimising long-term treatment, — follow up of patients at 4 and every 12 months thereafter to monitor adherence with plan, — promotion of FLS to relevant hospital teams to maximise case finding, — specialist clinic support for secondary care clinicians in managing complex and rare bone conditions, — a database of patients assessed through the service to support follow up and quality reporting, — participation in Fracture Liaison Service Database, — education and support for primary care, — promotion of service to all relevant hospital teams to maximise case finding, — survey of patient experience. The CCG are looking to award this contract to Shrewsbury and Telford Hospitals NHS Trust for 5 years to form part of their core contract.