Provision of Co-occurring Mental Health, Alcohol & Drug (COMHAD) Services

Description

COMHAD supports both Bromley mental health and Bromley substance misuse services that enable the long-term recovery, rehabilitation, and social re-integration of people in Bromley affected by co-occurring substance use and mental ill health. COMHAD is a small element of a wider mental health service but an important pathway as it avoids excluding people because of their alcohol/drug use. COMHAD also provides a pathway for those who may otherwise be excluded from drug and alcohol treatment services due to their mental health issues. Residents with COMHAD challenges represent a significant proportion of the treatment population across both the mental health service (Oxleas) and the substance use service. Effective collaboration between these services is essential to achieving the best outcomes for individuals accessing support. Lot 1: COMHAD supports both Bromley mental health and Bromley substance misuse services that enable the long-term recovery, rehabilitation, and social re-integration of people in Bromley affected by co-occurring substance use and mental ill health. Bromley has a higher proportion (37%) of new clients presenting with a co-occurring mental health condition compared to England (24%). Within acute mental health settings up to 70% of clients have co-occurring needs. Substance use continues to be a significant factor in hospital admissions and serious incidents. Oxleas NHS Foundation Trust is uniquely positioned to deliver COMHAD provision due to: ➢ Exclusive access to patient records within community mental health services ➢ Ability to identify and support eligible individuals ➢ Supporting a 'no wrong door' approach, residents can access support regardless of their entry point, mental health or substance use services. Third parties could not access the necessary information to deliver COMHAD effectively. COMHAD provision is clinically embedded within community mental health services. In essence, COMHAD is not a standalone service, it functions as an integrated component of community mental health provision. Disaggregating it could compromise service quality, patient safety and statutory compliance. The Award has been made following Direct Award Process A of the Health Care Services (Provider Selection Regime) 2023 Regulations. The contract will be for a period of three years commencing on 1st April 2026 with a whole life value of £511.310.00 Additional information: The Contract to Oxleas NHS Foundation Trust was awarded via the Direct Award A process of the Health Care Services (Provider Selection Regime) 2023. Justification for the Direct Award include: • The current existing contract is ending 31 March 2026. • The proposed contract terms and conditions are not changing. • The London Borough of Bromley, in partnership with the ICB (Integrated Care Board), already commissions Oxleas to provide community mental health services. This integrated arrangement supports joined-up care pathways, which are essential for residents with co-occurring conditions. • The London Borough of Bromley is satisfied that the provision offered by the current provider (Oxleas) is of a good standard. The service is meetings clinical, operational and safeguarding expectations. • Oxleas is uniquely positioned to deliver COMHAD provision due to: ➢ Exclusive access to patient records within community mental health services ➢ Ability to identify and support eligible individuals ➢ Supporting a 'no wrong door' approach, residents can access support regardless of their entry point, mental health or substance use services. • Third parties could not access the necessary information to deliver COMHAD effectively. This could compromise the Council's ability to meet its statutory duties under health and social care legislation. • COMHAD provision is clinically embedded within community mental health services. Disaggregating it would: • Fragment care • Introduce clinical risk • Undermine service efficiency and service user outcomes. Which would all result in the provider not being able to fulfil the requirements of the contract. • A direct award to the community mental health provider in Bromley aligns with local practice across SEL (South East London) and Bromley's neighbouring boroughs. COMHAD provision is consistently delivered by the community mental health provider in each borough and reflects a regional best practice model, reinforcing the appropriateness of a direct award to Oxleas NHS Foundation Trust. • COMHAD is not a standalone service, it functions as an integrated component of community mental health provision. Disaggregating it could compromise service quality, patient safety and statutory compliance.