£1bn adult health contract to go out to tender despite concerns

A £1billion contract to provide adult community services across Bristol, North Somerset and South Gloucestershire will go out to tender despite calls for the Health Secretary to puts the plans on hold.

Bristol South MP Karin Smyth said the complex and secretive negotiations were not how the NHS should be managed, and raised concerns that the outcome could conflict with its new long-term plan.

But Bristol, North Somerset and South Gloucestershire clinical commissioning group leaders said the reprocurement was an opportunity to shape the service for years to come – in a way which fits well with the Government’s strategy.

The CCG’s governing body on Tuesday voted to press ahead with the procurement in principle, but will review the decision if legislation changes during the process.

The contract is worth £100m a year for ten years, in line with current spending, and will begin on April 1, 2020.

Calling on Health Secretary Matthew Hancock to intervene, Smyth wrote online: “I am concerned to see the CCG pursuing a complex legal procurement process for just some of our community services, without a clear understanding of what is required and without any attempt at cooperation with other partners who also provide vital services.

“This approach creates potential conflict where there should be collaboration between service providers, which is not in keeping with the national direction.

“What is proposed is a complex set of negotiations with providers outside of the NHS, held entirely in secret. This is not how the NHS should be managed.

“Only by working together to create a joined-up approach to services can we — NHS England, the CCG, NHS staff, local authorities and the public — succeed in delivering quality health and social care for people.

“We have a brilliant asset in South Bristol Community Hospital which we should be making the most of. I’m concerned that re-tendering services here may have a negative impact on the hospital and supporting services.

“We need a considered and strategic approach with increased accountability in order to ensure patients in Bristol South and beyond have the services they need and deserve.”

South Bristol Community Hospital

Smyth also spoke in the House of Commons, where Hancock said he would raise her concerns with the head of NHS Improvement.

The CCG is re-procuring its adult community services and wants a single provider to cover the whole of Bristol, North Somerset and South Gloucestershire.

The contract will cover all adult community health services: integrated locality teams, urgent and reactive care teams, specialist advice and support and locality hubs.

CCG chief executive Julia Ross (main photo) said the specification allies closely with the NHS long-term plan, which was announced by the Government on Monday.

She said: “The reason we are going for a ten-year contract is because we want a partner who will operate as a core member for the long-term so they are embedded in the changes and aren’t looking over their shoulder for when the next procurement is going to come up.”

Clinical chair Dr Jon Hayes said the ten-year contract will give the provider more stability and make it easier to invest in services.

Dr Brian Hanratty, who represents Bristol South on the CCG, said: “I’ve been doing this for 15 years. For 15 years I’ve been trying to develop a community-based service that will help our patients that don’t need to go into hospital and need provision for the increasingly complex conditions and increased frailty.

“For me, this [the procurement] sets us up for the future to be able to provide a service, pulling the whole system together for the benefit of our patients.”

Responding to Smyth’s comments, he said there had been extensive engagement with a wide range of stakeholders and it was “disingenuous” to suggest otherwise.

Deborah Al-Sayed, the CCG’s head of transformation, said it was an opportunity to invest in technology.

Governing board members voted to follow Ross’ recommendations.

Bristol councillor Gill Kirk said she was disappointed not to be allowed to speak before the vote took place, because it needed democratic oversight from elected representatives.

She said the process had been “rapid” and concerns from councillors and Smyth about the “major” changes proposed had not been addressed.

In response, Ross said there had been extensive engagement on the procurement process, including with the three local authorities in the area, and it had been ongoing since March 2018.

She said the legislation may change under the long-term plan for the NHS – but currently the NHS is legally required to ensure services are delivered, and two contracts will come to an end next year.

Ross said she would be reluctant not to give the future provider as long as possible to prepare.

Councils were involved in drawing up the specification and will help evaluate the applicants.

Ross said it was a minor change and is “business as usual” for a CCG, adding: “I think this is the right decision. We need to go ahead and get the job done.”

Ross said in a statement: “Thriving community health services are vital to our vision of better health for everyone in Bristol, North Somerset and South Gloucestershire.

“Two of our three CCG community service contracts come to an end in 2020. We are now seeking a single provider for the area, to ensure that wherever you live, you will have access to consistently high quality care, closer to home – a key ambition of the NHS Long Term Plan.

“When a contract for an NHS service comes to an end, commissioners have a legal duty to review those services, to ensure they can best meet current and future needs. Our approach to this competitive procurement, through a process of open competition, is supported by our regulators and consistent with current legislation. Of course, should the law in this area change we will adapt our plans accordingly.

“We look forward to developing community services in our area and will continue to engage appropriately with all interested parties throughout the procurement phase.”

Stephen Sumner is a local democracy reporter for Bristol

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