Community Health Services

Description

This notice relates to the process set out in Regulation 10 of The Health Care Services (Provider Selection Regime) Regulations 2023. London Borough of Hounslow is looking for a provider to temporarily lead the provision of community health services in Hounslow for 21 months. We are seeking an experienced provider, currently delivering a wide range of Local Authority commissioned community health services to support delivery of these priorities: • Improve outcomes in population health and healthcare • Prevent ill-health and tackle inequalities in outcomes, experience, access to care • Enhance productivity and value for money • Support broader economic and social development We need a provider who can ‘hit the ground running’ and understand the specific challenges for the diverse population of Hounslow. In addition, the provider must have experience of addressing knotty challenges in community provision – be they workforce pressures or working in partnership with primary care. To reduce the period of uncertainty for current staff we need the leadership skills and capacity to support a quick mobilisation, with services required to begin on 1st July 2024. Any provider will need to be able to demonstrate capability against a number of key criteria during the selection process; o Quality and innovation; o Value; o Integration, collaboration and service sustainability so as to improve health outcomes; o Improving access, reducing health inequalities and facilitating choice; o Social value To deliver on the above criteria LBH is looking for a provider who: 1 Can provide the workforce to deliver community services 2 The provider can mobilise the contract from 1st July 2024. Has recent experience of TUPE and mobilisation across a number of services at one time, within a short lead time from contract award 3 Has a Leadership team with capacity and experience of comparable transfer of services and are able to provide assurance that leadership capacity will be available to support service transfer 4 Can provide insurance to the value of £50m 5 Is a current lead provider of comparable Community Services contracts including a comparable range of adults, children’s and specialist services working with local authority, Borough Based Partnership, practices/ GP federations to deliver integrated pathways and benefits for residents. 6 Can accurately describe the specific needs of the Hounslow population and demonstrate a plan to positively impact within the contract period 7 Can provide evidence of how you ensure workforce are trained and competent to deliver services and ensure safe, effective patient experiences where there are gaps in workforce 8 Can provide evidence of a positive track record on recruitment/retention and has a committed organisational approach to positively improving staff wellbeing 9 Has a robust financial position including no deficit 10 Has a CQC rating that is predominantly good/outstanding 11 Holds contracts for both NHS and Local Authority commissioned services. 12 Is willing to take on NHS estates 13 Has a track record of taking a lead role in a provider collaboration 14 Can evidence their track record of working to include residents and service users in development and delivery of service change 15 Pays the London living wage Requests to participate should be sent to ann.phillips@hounslow.gov.uk by 17:00 on the 22nd April 2024 Lot 1: Services which will need to be delivered as part of the contract 1. Hounslow Falls Prevention Service The aim of the service is delivery of a whole system and community coordinated approach to preventing falls through partnership working using existing skills knowledge and expertise to solve problems and realise opportunities. At the core of this Service is a clinically led, referral based intervention service, supported by a wider information and advice offer. This will be achieved by: effective joint working and coordination of partners who contribute to supporting older people in the community and promoting independence Early and effective assessment Training and supporting care providers Provide proactive follow up of those who are assessed as requiring Falls Prevention intervention at 12 weeks and 6 months to ensure that individuals’ gains made are maintained To support Hounslow residents the new service will have integrated community and clinical pathways. Clinical Provide access to timely screening and follow-up assessments in the community (including in primary health care settings/teams and other community access points) using a common validated brief assessment tool. Consist of a community-based team that will work with the hospital based clinical falls service. Provide access to specific falls prevention exercise programmes PCN (Primary Care Network) will be aligned with service provision delivered through a community-based team providing occupational therapy, physiotherapy, and nurse services to clients aged 65 years + who are at risk of falling Community Provide a range of information about how to access support in Hounslow including steps residents can take for self-management to reduce their risk of a fall. Establish systems and processes for voluntary and community sector to identify people at risk of falling and refer them into the falls assessment pathway. Provide residents with access to home safety/hazard self-assessments that allows for self referral The service will accept self-referrals and referrals from relatives, GPs, care home staff, community nurses, hospital staff and social workers for adults over the age of 65, living in Hounslow – referrals will only be accepted for those within the defined ‘at risk / over 65s’ cohort. Interventions and support will be time limited KPIs Number of falls related emergency hospital admissions in cases over 65 and under 80 Where falls occur, and a profile of residents who fall, age, gender, ethnicity, activity levels, where they live, pre-exiting co-morbidities Numbers of repeat falls (with/ without acute admission) within 1 year (April to March) Number of falls identified within care setting (assessed frailty resulting in prevention intervention) Number of hip/ other fractures sustained due to a fall Number of frailty assessments undertaken that lead to referral to a Falls Prevention service Audit quality of assessments, quality of referrals, follow up assessments at 12 weeks and 6 months to determine sustained improvements 2. CVD Prevention (Healthy Hounslow) Healthy Hounslow is an Alliance of four providers who deliver the borough’s integrated health and wellbeing service via four ‘Lots’. The aim of the Lot 4 CVD Prevention service is an early intervention, detection, and prevention service in the community. CVD Outreach The service will deliver CVD outreach in the community including education, awareness, and 1,000 blood pressure readings annually. A clinical pathway will be developed for high/low blood pressure readings. Community NHS Health Checks (CNHSHC) The service will be required to provide 500 targeted outreach CNHSHC per year, at a minimum of 3 outreach clinics per week. The service will target areas of higher deprivation, the routine and manual workforce, and residents with a higher risk of developing CVD, diabetes, and other long-term conditions. CNHSHC will be offered to those who live, work, study and/or are registered with a Hounslow GP aged 25 to 74 years old, providing they do not meet any of the exclusion criteria set out in the NHS Health Check Best Practice Guidance. The service will offer CNHSHC at varying times, including outside working hours and weekends, to maximise access. The provider is expected to adhere to all associated quality measures, clinical governance and information governance requirements, including NHS Health Check Best Practice Guidance. The provider will source and maintain stock levels of equipment for CNHSHC. The cost of consumables must be met within the contract value. CVD Health Coaching The service will offer CVD Health Coaching to residents who are identified to have any of the following risk factors: smoking, lack of physical activity, obesity, or Q-risk ≥ 10%. CVD Health Coaches will offer up to 6x 1-1 sessions over no more than three months (including how to manage risk, and lifestyle behaviour change information and support). Sessions will be tailored to the service user’s requirements and will involve motivational interviewing and goal setting. Sessions will be arranged at a time and location suitable for the client. Virtual and/or face-to-face options will be available. Outreach activities and events will be held in locations suitable for recruiting target populations, including but not limited to faith settings, supermarkets, workplaces, leisure centres, and community events. The oversight for the clinical governance of the CNHSHC will come under the BBP CVD group. Key performance indicators 500 CNHSHC annually. Report the proportion of relevant risk factors e.g. high BMI, high BP Additional 1000 blood pressure readings annually in the community. Breakdown of results (categorised low/normal/elevated/high) 80% of all eligible patients referred to lifestyle interventions programmes, signposted to other support or declined either Record breakdown by community venue/workplace Record breakdown by gender, age, ethnicity, GP Practice, postcode, priority groups Record number of residents supported by CVD Health Coaching 3. 0-19 Service Healthy Child Programme (HCP) Our Public Health Nursing (PHN) offer incorporates Health Visiting (HV) and School Nursing (SN) services to deliver Hounslow's Healthy Child programme (HCP). The Service has a significant opportunity to improve health and wellbeing outcomes and reduce inequalities by focusing on prevention and Early Help and deliver Targeted support to intervene to reduce risks among children, young people and their families. The Public Health Nursing service that delivers the HCP, plays a key role to ensure that every child gets the good start they need to lay the foundations of a healthy life and where necessary receive targeted support to develop greater equality and reduce health inequality. The Public Health Nursing Service should identify health and social care need (early identification), respond to this need (prevention, signposting, referral and intervention), and ensure the equality of population health outcomes (reduction in health inequalities). The PHN service is expected to articulate national standards into a local service and work in an agile manner to review and adapt its model, develop and incorporate new research investment and priorities as these are published. The service model has a clear focus on improving access to help and support for a whole range of health issues at a much earlier stage in the life course of children, young people and their family. The model required in the Service’s redesign presents new opportunities for strengthening primary prevention, health promotion and early help by developing a robust approach to improving health outcomes for children, young people and families across Hounslow. This service model delivers innovative solutions to existing problems that impede the delivery of integrated services and demonstrates best practice partnership/multi-agency working. It actively seeks to support families as well as individuals from birth, through school, and into adulthood. Health Visiting and School Nursing combined services will take a ‘think family’ approach to supporting children and families, with a focus on universal services, early help and prevention of risk-taking behaviours. There is an expectation that the Provider will develop a Strengthening Families model which may incorporate the Target Maternal Early Childhood Sustained Health Visiting (MESCH) and the Family Nurse Partnership (FNP) a key element of the HCP to support vulnerable families. There is a high level of expectation that the Provider can continue the service development and improved KPIs achieved of the the last year. This will require rapid understanding of the local offers and consistency of staff empowerment and innovation. Performance measures. The Provider will ensure the Programme’s indicators (KPIs) nationally and locally reported are made available quarterly, alongside staffing and financial position, alongside a narrative on the previous quarter’s performance and a forward plan including any mitigating actions will be presented. Performance measures consist of the national data set and localised service improvement measures.