SEL ICB (Bromley) Community Phlebotomy

Description

NHS South East London Integrated Care Board (SEL ICB) is seeking to commission a Community Phlebotomy Service for the London Borough of Bromley. The Community Phlebotomy Service was first commissioned in Bromley in 2017 to provide accessible, out-of-hospital provision for blood collection for patients across the borough. The service provides blood tests in accessible community settings that enables earlier interventions to help manage more people in the community, reduces the reliance on hospital-based testing, and contributes to better referral quality to secondary care. The service aims to: • Provide an accessible phlebotomy service that facilitates GP direct access to blood tests and urgent access if required. • Enable GPs to effectively manage their patients in primary care or to improve referrals to secondary care with the appropriate diagnostic investigations already completed. • Ensure that the provision of tests is conducted consistently and effectively across Bromley through achieving a set of agreed core standards, key performance indicators, and reporting arrangements. • Support the commissioning of the highest value and quality services that meet national guidance. The key service objectives for this contract term are (and these will be used to evaluate potential expressions of interest) to: • Empowering Bromley GPs with phlebotomy services in a primary and community care setting. • Provide a more accessible service in community settings and convenient locations, as outlined in sections 2.4 and 2.14. For certain sites, the provider will be required to operate from locations specified by the commissioner, while others will be subject to assessment and confirmation. • Provide a flexible and appropriate service that is responsive to changes in demand, patient care and organisational requirements. • Provide a quality and clinically safe reporting service supported by the necessary trained, experienced and well-established workforce. • Deliver an integrated service that works seamlessly with GPs, the pathology provider, and wider health services, while developing and maintaining strong local relationships through collaboration with primary care clinicians, services, and pathways. • Works in integrated approach with other interdependent services in the local system to develop and contribute to a sustainable neighbourhood diagnostics provision in Bromley. • Work with the pathology provider on planned transformation of GP blood test requesting technology and adapting to changing requirements of the service. • Provide safe, efficient, responsive, comprehensive and effective services which meet National guidelines, quality standards, accreditation requirements and statutory regulations. • Provide services that comply with information governance, data privacy and sharing agreements, facilities requirements and governance standards. The provider is expected to demonstrate a proven track record in delivering community phlebotomy services for a minimum of three years in South East London, with prior experience in meeting the key objectives and service requirements as outlined. Lot 1: Currently, the Community Phlebotomy Service delivers phlebotomy at 10 locations across Bromley. Two of these are big-size venues, including the Orpington Health and Wellbeing Centre. The remaining eight sites are based within individual GP practices throughout the borough. In 2024/25, the service facilitated over 100,000 blood tests, demonstrating its critical role in supporting diagnostics and improving access to care within the community. Under this contract, the provider will be expected to deliver a between 120,000 -132,000 blood tests annually. The contract will be on a cost and volume basis with a per-unit price (per bleed) of £7.39. The contract period for the service will be two years with the option to extend for a further one year. The process being followed is a Most Suitable Provider Process under the Provider Selection Regime 2023. We are not required to actively invite anyone to express interest but rather seek to notify the market of the intention. For enquiries or to register interest, please contact hub.queries@nhs.net AND k.uppal3@nhs.net using reference number PRJ-2138. The commissioner is seeking to achieve, via this procurement, a service and provider that is committed to supporting the development of neighbourhood models of healthcare. The 10-Year Health Plan mandates neighbourhood models of healthcare and these are currently being developed across England. In Bromley, by 2026, the borough will have in place four neighbourhoods each with a new integrated neighbourhood team. The new model for this service is to operate under a hub and spokes model in each neighbourhood to ensure equitable access and efficient resource utilisation while maximising accessibility for patients. Hubs are high-capacity sites designed to offer designed to offer consistent, easily accessible appointments for a large volume of patients. Spokes are smaller, community-based clinics that provide convenient, localised access to phlebotomy services, helping to reach patients closer to where they live. The hubs and spokes will operate in an integrated and collaborative approach ensuring that patients receive a seamless experience regardless of the site they attend, and that resources are used efficiently across the system. Each neighbourhood will have at least one hub at a designated central location as the main service delivery point with satellite clinics as spokes providing localised access to blood testing. The provider is expected to undertake an assessment based on factors to determine an appropriate number of spokes clinics in each neighbourhood with an agreement with the NHS Southeast London ICB. During the course of the contract, the provider will be expected to potentially change locations or delivery model as needed to align with the neighbourhood development programme. The functions of the hubs and spokes are as follows - Hub sites: • Highly accessible and central locations one in each neighbourhood. Provider will utilise existing the Health and Wellbeing Centres venue in two neighbourhoods. • Equipped to support higher patient volumes. • Have provision for service bookable appointments on all weekdays, walk-in sessions and same day urgent phlebotomy with ability to provide service out-of-hours and on weekends. • Have ability to expand capacity in time of high demand (Winter). Spoke sites: • Satellite locations (e.g. GP practices or community venues) providing good coverage of neighbourhood geography across the borough to ensure equitable access. • Particularly aimed to providing access closer to patients, patients with mobility issues, targeting underserved areas. • The number of locations will be determined through an assessment based on factors such as access, coverage, equitable provision across neighbourhoods, health inequalities, stable activity and operational feasibility and clinical suitability of the locations. The Community Phlebotomy service is available to all people aged 13 years and above who are registered with a Bromley GP practice. It will offer patients bookable appointments, walk-in sessions, and on the same day urgent appointments*. * Urgent blood tests - Referrer or clinician who in their clinical judgement require same day appointment for the patient. Not suitable for patients who are acutely unwell or clinically unstable requiring secondary care referral. The phlebotomy service would have ring fenced capacity in each day's planning for urgent blood testing. Care Pathway: • The requesting practice provides the patients with information to book the blood tests. • The patient can access the appointment online. There should be a provision for the patient to cancel and rebook the appointment. • The patient attends the appointment. The phlebotomist accepts the patients with relevant request form. • The phlebotomist stores sample appropriately. • The pathology provider is responsible for collecting the specimens, analysing the sample and communicating the results to the referrer practice or to agreed generic email inbox. • The requesting practice has a system in place for receiving the results. It is the responsibility of the referrer or practices to act upon the results and contact the patients accordingly. Additional information: Referral Pathway: All patients requiring diagnostics will be referred by GPs, nurses, and other healthcare professionals using electronic order communications system. Currently this is facilitated by tQuest. Provider will be expected to work with Pathology services and system partners in the transition from tQuest to a new order communication system scheduled for October 2026. • The electronic referral is sent to the pathology provider. • Patients receive a blood test form from their practice. • The form has a unique barcode with the details of the patient and the test requested. • The patients contact the phlebotomy service to arrange the appointment. • Patients bring the form to the phlebotomy appointment. • The phlebotomist takes the label with barcode from the form and places on the sample tubes. • The pathology provider is responsible for collection of the samples from the clinic locations. The provider will have a system that allows clinicians to refer directly for urgent blood testing. In line with the 10-year Health Plan, the long-term ambition for all community services is for patients to be able to book, cancel, and rearrange appointments online and integrated with the NHS App. Role and Responsibilities of the provider: The service provider's role is to lead and coordinate the service, and they will be responsible for: A. Overall: • Deliver a user-friendly blood testing service that prioritises patient needs, is respectful and easy to navigate for all patients. • Manage booking of the patients' appointments via online booking and have an alternative way for booking service using a dedicated telephone number. • Arrangements for booking urgent appointments by GPs and their practices. • Provide qualified phlebotomists who meet competency standards and have up-to-date training. • Provide any equipment's and consumables to facilitate venepuncture. • Monitor efficiency and waiting times of hub and spoke clinics and make changes to maximise slot utilisation. • Ensure appropriate infection prevention and control at all locations. • The provider is responsible for providing consumables, which must meet the requirements of the PRUH Pathology Laboratory. • Provide service reporting to the ICB as agreed with commissioners. B. With clinics and appointments: • Clinics will be in accessible locations with good public transport links. • Clinics and clinic times can be modified, in agreement with the NHS South East London ICB, to best utilise the service. • The number of appointments available at each phlebotomy hub will be determined by o evidence for demand in the area (i.e. audits, tQuest data), o ongoing monitoring of utilisation of the service (monthly reporting to commissioners), and o equitable appointments per weighted population in each neighbourhood. • Appointment slots are no more than 5 minutes, and the service should not exceed 15 minutes in delay of appointments. • The provider is responsible for keeping DNAs to no more than 5% and will utilise text reminders to patients. • The service should time slots for dedicated same day urgent blood testing. • The service should have routine walk-in clinic sessions. • The service will implement any reasonable adjustments required to facilitate blood tests for people with physical disabilities, learning disability and/or mental health conditions. • The provider is responsible for service administration and minimising impact on host GP practices or venues, e.g. bookings and management of slots. C. With specimen collections: • Liaise with the pathology sample collection provider to agree sample collection schedules, including collection locations and pick-up times to ensure feasible transport routes. • Changes in collection times must be coordinated with the pathology service provider. • Ensure all samples are correctly labelled and matched to patient records and stored in appropriate conditions for collection. • In event of missed or delayed collections, the provide will use agreed escalation process with pathology and specimen collection couriers. D. With patient experience: • Patients will have their blood samples taken in a clean, safe, and clinically appropriate environment by trained phlebotomists who are skilled in minimising discomfort and anxiety during the procedure. • The service will be responsive to the needs of patients who experience difficulty with blood tests, such as those with needle phobia or heightened anxiety. Reasonable adjustments will be made for such patients including extended appointment slots to allow for a calmer experience, private and quiet clinic settings to reduce stress, and for the phlebotomists trained in trauma-informed care and anxiety management. • Patients will be seen within 15 minutes of their scheduled appointment time, ensuring a timely and efficient service. • Facilities should be available for patients to recover in cases of patients who suffer from vasovagal fainting episodes. • Provider should have a system in place to gather and record patient feedback and report this to the commissioners through contract management. E. With promotion and publicity of the service: • The provider will be responsible for communications with general practice staff and general public awareness on how to access the service through their own channels. • The provider will support the NHS South East London ICB for communications through the Bromley Practice Bulletin and intranet platforms. • The provider will use their own digital platforms such as websites for detailed outline of the service or social media channels to raise awareness and encourage uptake across the community.