Health services

Description

Luton CCG and Luton Council are in the process of reviewing Community Health Service provision for the Luton population working towards developing a “Placed Based” Community Health Service in line with the Integrated Care System ((ICS) vision with Bedfordshire and Milton Keynes (The BLMK STP). To achieve the vision commissioners believe that true integration of services vertically and horizontally would best secure the identified needs of the population, improve quality and efficiency of services, realise seamless service provision across pathways and increase system sustainability. The service outcomes will reduce reliance on hospital based care and ensure that people have access to good quality, safe, locally delivered health care services including primary care, health and social care across Luton. The community services which are subject of this notice includes both children's and adult's services, and has a current estimated value of 24 900 000 GBP per annum. The traditional commissioner and provider split is acknowledged as no longer being a helpful paradigm to address the challenges faced by the NHS whilst importantly improving the Health and Wellbeing of the Luton’s population. This was also endorsed following initial engagement/feedback from Providers at an early Market engagement event held on 10.11.2017 (advertised on the Contracts Finder Website on 23.10.2017). Consequently, commissioners agreed that a new approach is needed to change behaviour and incentivise providers which will support the design/development of new ways of working and models of delivery for integrated care to the population. As such tendering processes for community services contracts in Luton will be deferred for 18 months which will give local commissioners and local providers opportunity to work together to progress and deliver their visions for place-based community health and care services and work with the STP in readiness for an “integrated care” procurement exercise in 2019/20. The rationale for the delay fits within the Priority 5 work programme of the STP. Primarily: — The BLMK ICS Priority 5 work programme has not yet delivered the components to enable a successful outcomes based strategic commissioning of the services to take place, — The national integrated care contract is not yet available and will be subject to public consultation in 2018, — Due to the current stage of the BLMK STP programme, Luton place-based systems are not yet able to specify to the required level of detail the model of care and outcomes they are trying to achieve, — The supply side is not considered to be mature enough to respond appropriately to an outcomes based procurement exercise, — BLMK ICS lacks the activity data and clarity about the future model of care to be able to define its requirements with sufficient accuracy to reduce to an acceptable level the risk of challenge due to requesting significant contract variations early in the contract period, — The risk of distracting commissioning and provider resources by initiating a procurement process is too great at the current stage in the BLMK ICS development. There is a risk that system transformation will be significantly delayed until the procurement process is concluded. Therefore community service contracts are to be awarded to existing providers until 31.9.2020 to enable the BLMK ICS model to develop to sufficient maturity to be able to run an outcomes based commissioning process. Dedicated work to commence this outcomes based commissioning process would need to commence no later than August 2019. It is likely than an outcomes based commissioning approach would need to comply with NHSE/NHSI’s Integrated Support and Assurance Process (ISAP) which may impact timelines.